Are your cholesterol levels too high? How to check and what to do about it

With over half of adults in England living with raised levels, it’s time to know the facts…
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  • Want the bad news? 

    If you haven’t been affected by high cholesterol levels yet, it could be about to creep up on you. Women generally have lower levels than men, but between the ages of 50-65 years, 
our levels rise.

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    The good news is that with lifestyle changes you can keep the condition under control. But, as most people with high cholesterol won’t show any symptoms, it’s essential to get tested to find out whether you’re at risk.

    Good vs bad cholesterol

    There are different types of 
cholesterol – LDL (low-density lipoprotein) and HDL (high-density lipoprotein). “LDL is sometimes called ‘bad’ cholesterol, as it sticks to the walls of the blood vessels, making them narrow and stiff, in the same way water pipes can become clogged with limescale,” says senior consultant cardiologist Dr Michael MacDonald. HDL on the other hand is “good” because a raised HDL is associated with a lower risk of heart disease and stroke.

    What cholesterol levels are safe?

    “As a rough guide, ideally, total cholesterol should be less than 5mmol/L (millimoles per litre); LDL should be less than 3mmol/L; HDL should be more than 1mmol/L,” says Dr MacDonald.

    “However, your doctor may set different targets based on your own medical history.”

    How to test your cholesterol levels

    Testing is essential if you’re over 40, if you’re overweight, have a family history of high cholesterol or if you have a condition related to high cholesterol.

    Testing typically involves your doctor or nurse taking a blood sample, which can usually give results within 24 hours. It’s best to book tests in the morning as you may be asked to fast for 10 to 12 hours prior, to ensure that any food ingested won’t impact the result.

    “Don’t be scared of getting tested,” says Dr Holmes. “You’re giving yourself the opportunity to make changes and you might be reassured by your result.”

    How to lower cholesterol levels

    • Adopt a low cholesterol diet

    “Reduce your cholesterol by adopting a more balanced diet,” says Dr Vishal Shah, medical director at Thriva ( “Eat healthy fats found in nuts and olive oil, and eat less processed and fried foods, which contain harmful trans fats.

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    The foods you need to eat for a low cholesterol diet are ones that should make up any healthy diet. Choose wholegrain varieties of starch and eat oily fish, such as salmon, tuna or mackerel – all a great source of omega-3, which can protect your heart.” Try a bowl of oats for breakfast, which, thanks to their high fibre content, help 
to lower your cholesterol.

    Credit: Getty Images

    A cholesterol-
balancing lunch could be a baked potato with baked beans, while dinner can be 
a serving of oily fish with wholegrain rice and avocado. In-between meals, snack on fruits, vegetables and nuts, all of which help to keep your cholesterol healthy.

    • Take regular exercise

    Exercise is vital. Brisk walking, swimming or cycling will help to increase levels of HDL cholesterol, while helping your body move the LDL cholesterol to the liver, where it’s disposed of. The British Heart Foundation recommends to exercise for at least 30 minutes each day.

    • Keep your weight within the ideal range

    People who are overweight are more likely to have high cholesterol levels. It can also help to avoid too many saturated fats (these should make up 20g or less of your diet, according to the NHS). Reduce your consumption of fatty meat products, such as sausages 
or pies, butter, cream or ice cream, 
hard cheeses, cakes and chocolate.

    • Quit smoking

    Smoking reduces levels of HDL cholesterol, as a compound found in cigarettes called acrolein inhibits HDL from taking fatty deposits to the liver, leading to higher cholesterol levels. It also increases blood pressure and makes the blood more likely to clot.

    What about medication, such as statins?

    “Your GP will decide whether or not to give you statins to reduce your cholesterol after calculating your overall risk of cardiovascular disease,” says Dr MacDonald. “This is based on factors such as blood pressure, diabetes and smoking – in addition to your cholesterol level.”


    These work by blocking the enzymes created in your liver that help make cholesterol. However, statins are only prescribed to people who are at a high risk of heart disease because they need to be taken consistently to work.


    A low dosage of aspirin may be prescribed in those who’ve had a heart attack, have a vascular disease or have a high risk of developing cardiovascular disease, as it helps to prevent blood clots.


    This works by blocking the absorption of cholesterol from food so that it doesn’t reach your bloodstream.

    Bile acid sequestrants

    If statins or ezetimibe fail to work, you may be prescribed this. They work by binding to bile acids inside the intestines and prevent them from being absorbed. 
This then prompts the body to create more bile acid, which then lowers cholesterol levels.

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