How to lower cholesterol levels and avoid some of Britain’s biggest killers

High levels of it can increase the risk of heart disease and strokes – two of Britain’s biggest killers. Dr Lizzie Kershaw-Yates, GP and medical team member at TheOnlineClinic, puts us straight about exactly what cholesterol is

It’s actually essential

We all need it – it’s a biological substance our bodies create (although some naturally create more than others). However, our Western diet is high in fat and sugar, which often leads to raised cholesterol levels.

A high level of cholesterol doesn’t necessarily mean you need treatment. It will depend on other things, including your family’s medical history and risk factors for cardiovascular disease.

What is the correct level of cholesterol?

The total cholesterol level (TCL) should be less than five mmol/l. Your doctor will also be interested in the ratio of HLD to TCL, which should also be five or less.

What affects our cholesterol levels?

The main factor is diet, especially eating lots of fatty foods.

An underactive thyroid gland and some rare liver and kidney disorders can also cause it, as can heavy drinking and obesity .

Why do we worry about high levels of cholesterol?

The higher the levels, the more likely you will lay down cholesterol in your arteries.

Once there, these ‘plaques’ of cholesterol cause further attraction of blood cells and inflammatory markers which can cause a blockage in an artery.

If the artery is to your kidney, this can cause kidney failure. If it is your carotid artery, you might have a stroke , and if is the main artery, which supplies your heart, you might have a heart attack.

Other things that can affect the ability of your arteries to remain healthy and repair themselves are smoking , high blood pressure and diabetes.

What is ‘good’ cholesterol?

‘Good’ cholesterol is what we call a high-density lipoprotein, which is protective of your arteries. These fats are usually found in plant-based cholesterols, including nuts, seeds and olive oil.

The fat found in oily fish is also ‘good cholesterol’ and contains omega-3, which is known to help maintain a healthy vascular system.

When should you get your cholesterol checked out?

There are a few factors that could mean you are at a greater risk than some other people of developing high cholesterol. You would normally be advised to get it checked:

– If you are diagnosed with high blood pressure, diabetes or any disease that indicates vascular damage, such as a stroke or angina. Your doctor will take blood to check the level of your cholesterol and lipid profile and is likely to suggest you take medication if the numbers are raised.

– If you are overweight and have other risk factors for vascular disease – smoking, BP family history, excess alcohol consumption – it might be worthwhile checking your cholesterol. But don’t forget, people can have a normal body weight and a raised cholesterol level, so it is a good idea to discuss it even if you aren’t overweight.

– If you are from a family in which anyone under the age of 55 has already suffered a heart attack or a stroke. See your doctor for risk stratification and possible investigation of your cholesterol levels.

Will you need tablets?

A lot of people ask whether they can lower their level of cholesterol without taking tablets and the simple answer to this is yes.

Diet and exercise can lower your cholesterol, usually by 10 to 20 per cent. However, if you are a member of one of the families that genetically produce more cholesterol, you may not be able to reduce it enough.

What you can do

Reduce the ‘risk factors’ by examining your diet and lifestyle and cutting down on the amount of unhealthy food you eat.

Reduce the quantity of alcohol you drink, stop smoking and start taking regular exercise.

Some foods containing plant sterols and stanols would appear to have the ability to reduce cholesterol. These can be found in products such as plant-based margarine spreads, yoghurts and milk drinks.

However, it is not advisable to start taking these as a way of reducing cardiovascular risk until proper clinical trials have demonstrated their efficacy.

Changing your lifestyle can make a huge difference, but your doctor may decide you also need medication to help lower cholesterol levels.

Such medication might be recommended if you are considered to be in a high-risk group.

In such a case, changing your lifestyle alone will probably not be enough to lower cholesterol to a safe level, so your doctor is likely to prescribe statins, which block the enzyme responsible for making cholesterol in the liver.

Statins can have some side-effects such as muscle ache or fatigue. However, never stop taking the statins without first speaking to your GP, who may be able to prescribe a different formulation.

Stay vigilant

If you have a normal cholesterol level today, do not take that as a ticket to future health.

As we get older, the body cannot process things as efficiently and your high-fat diet might begin to catch up on you. Make sure you get your cholesterol tested regularly.


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