Heart health is important for everyone, but it’s often not considered much unless or until a problem develops. Cholesterol is one part of the puzzle, affecting our veins, arteries and heart. So what is it exactly, what’s the difference between good and bad cholesterol, and how do you lower cholesterol?
What Is Cholesterol?
Cholesterol is a waxy, fatty substance in the blood. We need this vital chemical to stay healthy as it’s involved in cell function, creation of hormones, digestion and more. A problem arises when there’s too much of it in the blood, so having “high cholesterol” means there’s too much of this substance. Over time, it could block your blood vessels, which in turn puts you at greater risk of having a stroke or heart attack.
What’s The Difference Between LDL and HDL Cholesterol?
Cholesterol makes its way through the blood via lipoproteins. There are two types of these proteins to carry cholesterol, which we refer to as “good” and “bad” cholesterol:
LDL Cholesterol — low-density lipoprotein (also known as non-HDL) — the “bad” cholesterol
HDL Cholesterol — high density lipoprotein — the “good” cholesterol
When discussing cholesterol, there’s the overall level of it that’s taken into consideration, but so too is the ratio between LDL and HDL levels.
We need cholesterol, but it’s better to keep overall amounts at a safe level and especially reduce the amount of LDL.
Too much cholesterol, especially too much LDL, can build up on the walls of blood vessels. This “plaque” can cause health problems, especially if it leads to a blockage or obstruction of a vessel. A blockage in an artery in the heart, for instance, can cause a serious type of heart attack.
Triglycerides complicate the picture. Tricyclerides are a fat source that the body utilises for energy but combining high levels of them with cholesterol can up the risk of serious health problems like stroke and heart attack.
High cholesterol or too much LDL is usually the result of lifestyle and diet. In some cases, high cholesterol can sometimes run in families in what’s called familial hypercholesterolaemia.
Things that affect cholesterol can include lack of exercise, a poor diet (often high in fat), alcohol, smoking, and being overweight.
What Is The Normal Range For Cholesterol?
While figures can vary, the NHS gives rough guidelines for cholesterol (in millimoles per litre) as follows:
- Total Cholesterol – 5mmol/L or below
- LDL (bad) – 4mmol/L or below
- HDL (good – 1mmol/L or above
- Total cholesterol to HDL ratio – 6 or below
- Fasting triglycerides (no food prior to test) – 1.7 or below
- Non-fasting triglycerides (eat as normal prior to test) – 2.3 or below
What Are The Symptoms Of High Cholesterol?
High cholesterol in itself doesn’t usually cause symptoms. Symptoms may arise from the knock-on effect to block vessels, such as breathlessness and oedema from heart failure. The only way to know what your levels are like is to get a blood test. It’s a simple test that you should be able to ask your doctor for if you have any concerns or are curious what your level is.
How Do I Know If I Need To Reduce This Compound?
Doing a review of your diet and lifestyle can be beneficial for any of us, because small changes add up. You don’t need to have been diagnosed with high cholesterol or too much LDL to make changes to help your heart health. As mentioned above, ask your GP for a blood test or, if you’re in the UK, you could order a simple finger-prick blood test to do at home via Medichecks.
Browse Medichecks – Save 10% on your blood test order by using this link & the code INVISME10 at checkout.
Anyone can have high cholesterol, even if you exercise, are young, eat well and are a healthy weight. The only way to know is to get checked out with a blood test. But making small changes to our diet and lifestyle is beneficial in many ways, so it doesn’t hurt to look after yourself regardless of your levels.
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How Can You Lower Cholesterol?
Cholesterol can often be lowered naturally through diet and lifestyle changes. For some people, prescription treatments are required, in a similar way as how some people will need medication to lower high blood pressure.
Eating a varied and healthy diet is important for overall wellbeing, cholesterol levels and heart health. There are a few key elements to ensure you get in your diet to help reduce cholesterol, such as Omega 3 and Vitamin D.
Blackcurrants and other berries are also thought to be good at reducing cholesterol. A diet rich in fruits and vegetables generally will help balance cholesterol and provide essential nutrients. Soybean (ie. as soy milk or tofu) is also thought to be effective at reducing LDL.
We all need fats to keep us functioning healthily, but to help balance your levels of this compound you might want to read the labels of what you’re buying and go for unsaturated fat options rather than saturated fat. Saturated fat can raise cholesterol levels, so it’s a good idea to reduce foods and oils with high saturated fat. For individuals with cardiovascular disease or who are at higher risk of developing it, it’s recommended to limit the daily intake of saturated fat to no more than 300mg.
You could cut down on foods with high saturated fat and cholesterol like animal fats (included in the likes of spreads, butter, lard), processed and fatty meat, and full fat dairy produce. Or you could do some swaps, checking different products and varieties to opt for healthier versions. For instance, spreads with plant phenols, leaner cuts of meat and white meat, meat-free options instead of processed meat ready meals, or add specialist cholesterol-lowering yoghurts and drinks to your diet.
Wholegrains are an important part of keeping our heart healthy. They’re essentially the seeds of cereal plants, like rye, barley and wheat, and they contain various nutrients. For instance, B vitamins, folic acid, iron, zinc, fibre, magnesium, carbohydrate, protein, Vitamin E, unsaturated fats, phytonutrients, and selenium.
It’s interesting to note that there’s no cholesterol in plants, fruits, seeds, nuts, lentils, grains or vegetables. They may still have fat, such as in the case of nuts, so balance what you eat if you need to manage your weight.
More information on what constitutes a heart healthy diet can be found here.
Alcohol & Cigarettes
A little imbibing here and there is going to be fine for most people, but if you indulge in alcohol more regularly it may be worth cutting back if possible as this can help reduce your cholesterol. If you have problems with your drinking, it’s not going to be easy. Please speak to your doctor or a charity who can talk you through the issue and get you the help you need.
Stopping smoking is always touted as a positive no matter what is being discussed. If you can’t quit, cutting down is a good first step. There are tips online, self-help books, meditation CDs, YouTube videos and a range of nicotine replacement therapy that could all help. If you need more support, speak to your GP or see if there’s a stop smoking service near you.
Lose Weight or Maintain A Healthy Weight
Being overweight can put more strain on the body and raise LDL cholesterol levels. If you’re overweight or obese, losing weight could be one significant step to better health and managing your cholesterol. If you’re at a good weight you feel happy with, work at maintaining it. At the same time as being overweight can cause health problems, being underweight is not beneficial for the body either. The goal should just be small changes and manageable goals to get to, or maintain, a ‘healthier’ weight that suits you. Speak to your doctor and perhaps ask for a referral to a nutritionist if you need further support.
Exercise will look different for all of us. If you’re physically capable of it, more cardiovascular exercise on a regular basis is usually recommended. You might find online exercise videos or local fitness classes helpful to get you motivated and give you ideas. But you can only do what you can, and if chronic illness, pain and disability prevent the typical exercise recommendations from being possible, then find a workaround. Gentle activity and a little more movement when possible is better than nothing. Regularly take breaks to stand and move rather than being sat for a prolonged period. Stretching, yoga, walking, chair-based exercises all count too.
Prolonged stress is a well-known danger to our mental and physical health. Some studies are suggesting that stress can increase cholesterol levels, especially the LDL “bad” cholesterol. A more substantial piece of research involving 91,500 adults discovered those with high work-related stress were more likely to have high cholesterol, with high LDL and low HDL, and were more likely to be on cholesterol-busting treatment.
A little stress can be beneficial for humans to motivate us, but all too often in this modern day and age stress becomes a routine experience. If you think stress if a problem for you, take a look at what in particular is causing you stress. Are there ways to reduce it, to reduce your focus on productivity and get more balance in your life? Can you add more breaks to your days and pace better? Can you speak to someone, like a friend or a charity, about how you’re feeling? Can you cut back in certain areas of your life that are causing harm, and add more good stuff to your days?
There are ways to reduce stress temporarily, and these small stress-relief tools can be built in to your daily routine or as required. For instance, journalling, meditation, walking and getting out into nature, acupressure mats, CBD, music and dancing, exercise, colouring and art, yoga, deep breathing, breathing, enjoyable hobbies, etc.
If you’re struggling with stress and/or other elements of your mental health like anxiety, please do seek professional support from your doctor.
Medications To Reduce Cholesterol
For those who cannot cut cholesterol enough through diet and lifestyle, are at greater risk of a heart attack or stroke, or who need quick remediation following a coronary event, medication may be prescribed.
Statins are the most well-known and often prescribed treatment for high cholesterol. They’re usually very effective at reducing cholesterol levels. Once started, many people stay on statins for life but they can come with side-effects.
If statins aren’t effective for an individual or have intolerable effects, there are other tablets that could be prescribed, such as fibrates, bempedoic acid, bile acid sequestrants or resins, and ezetimibe (which prevents the body from taking in cholesterol from food).
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