By Rachel Hagan
Want the bad news?
Women generally have lower cholesterol levels than men, but once you hit 50, they start creeping up. However, with lifestyle and diet change it is possible to keep them down. Cholesterol isn’t bad, in fact, the body needs it. But it is once the levels of it get bad that you should worry, as it increases your risk of heart disease, which is a major cause of death in the UK.
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
Unfortunately, it's time to quit the processed meats. Think bacon, sausages and hot dogs, all of which are linked to cardiovascular disease. A study by The International Journal of Preventative Medicine shows that each additional 50-gram serving of processed meat was associated with a 42 per cent higher risk of developing heart disease.
So instead, look to making sure your diet is as balanced as possible. A low cholesterol diet mirrors a typical healthy diet. So, look to wholegrain varieties of starch and get plenty of 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. You don’t need to think too much into it, simple foods are often some of the healthiest. Meals could be a baked potato with baked beans, while dinner can be a serving of oily fish with whole grain rice and avocado.
“Reduce your cholesterol by adopting a more balanced diet,” says Dr Vishal Shah, medical director at Thriva (thriva.co). “Eat healthy fats found in nuts and olive oil, and eat less processed and fried foods, which contain harmful trans fats."
Research has shown that green tea can also help with high cholesterol. In a study with The American Journal of Clinical Nutrition, green tea intake and its cholesterol-lowering abilities were analysed and showed to help. Catechins, a type of antioxidant found in tea are the reason for this
Magnesium is one of the best ways to lower your ‘bad’ cholesterol. In order for the body to make cholesterol, it requires a specific enzyme known as HMG-CoA reductase. Magnesium regulates this enzyme and helps to maintain a proper amount of cholesterol in the body. So try supplementing this if you are suffering from high levels. The BMJ has endorsed this and said that “magnesium is critical to the cardiovascular system.”
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 exercising for at least 30 minutes each day.
Keep your weight within the ideal range
The more weight you carry, the more likely you are to have high cholesterol. Unfortunately, this links back to diet once again. Try cutting out or reducing sausages, butter, ice cream, cheese, cake and chocolate. You should only have 20g or less of saturated fats in your diet. Instead of frying, you should also consider grilling, steaming, poaching or boiling which will all reduce fat.
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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