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Cholesterol: Everything you need to know

Phil Day: Superintendent Pharmacist | minute read
Plate of breakfast food: fried eggs, bacon, and fork on table.

Cholesterol is a fatty substance in our bodies that’s needed to support a range of internal functions, from digesting fats from our food to helping make vitamin D. We need a certain amount of cholesterol to carry out these functions and support our cells, however too much cholesterol can lead to health risks and complications. This article outlines the difference between ‘good’ and ‘bad’ cholesterol, what you can do to help maintain healthy cholesterol levels, and what to do if you have high cholesterol.

What is ‘good’ and ‘bad’ cholesterol?

‘Good’ cholesterol helps to take ‘bad’ cholesterol out of our blood and back to the liver. It’s known as HDL cholesterol, and this is a term you’ll come across if you have your cholesterol levels checked by a healthcare professional. The medical term for ‘bad’ cholesterol is LDL cholesterol. If there’s too much LDL cholesterol in your blood, it can lead to clogged arteries that then lead to serious health conditions. This is the type we most often hear about when talking about conditions like heart disease and stroke. When you have your cholesterol levels checked, a healthcare professional will look at both readings to give an overall score. They may also look at another blood fat called triglyceride which can be another indicator of your health.

What causes high cholesterol?

  • The NHS identifies the main causes of high cholesterol as:

  • Eating too much fatty food

  • Not getting enough exercise

  • Smoking

  • Being overweight

  • Drinking more than the recommended weekly units of alcohol

As well as these lifestyle factors, there are also other ‘fixed’ factors that can lead to high cholesterol. These can’t be influenced by lifestyle changes and include:

  • Family history of heart disease or stroke

  • A genetic condition called ‘familial hypercholesterolemia’ (inherited likelihood of high cholesterol regardless of diet and lifestyle)

  • Age. The older we get, the more likely our arteries are to become narrower

  • Ethnicity. Certain ethnic groups, particularly southwest Asian populations have a higher risk of experiencing heart attacks

How can I lower my cholesterol?

While certain changes won’t necessarily have a direct effect on high cholesterol caused by ‘fixed’ factors, there are things you can do to reduce the risk of high cholesterol resulting from lifestyle habits. One of the best ways to support healthy cholesterol levels is to eat a balanced diet that’s low in saturated fats. Foods that are high in saturated fats include:

  • Fatty, processed meats like sausages

  • Dairy products such as butter, cream, and cheese

  • Chocolate, biscuits, and cakes

These should be eaten in moderation. The nutritional information and ratings included on food packaging makes it easier to be aware of what foods are high in saturated fat and should be limited in our diets.  

Fatty foods high in omega-3 are thought to offer certain health benefits, including helping to reduce triglyceride levels. These foods include oily fish like salmon and mackerel, walnuts, kidney beans, and avocado. Heart UK offers different resources for planning a cholesterol-conscious diet.

Exercise is another positive way to support healthy cholesterol levels. The NHS recommends that we should aim for 2.5 hours of activity per week. You might consider adding a 30-minute walk into your routine each day or exploring a new hobby like swimming or cycling. Being active offers lots of different health benefits, including improved physical and mental well-being, maintaining a healthy weight, better heart health, and more.

If you’re a smoker, the NHS offers free advice and resources to help you quit and stay stopped. Quitting smoking is another positive step towards better heart health.

Keeping your alcohol intake below the weekly recommended limit is another way to support healthy cholesterol levels. Try to have a few alcohol-free days each week and don’t exceed the advised 14-unit weekly limit. If you find it difficult to cut down, have a chat with your GP who’ll be able to signpost you to local support services.

Who should I speak to if I’m concerned about my cholesterol?

Your GP may advise a cholesterol test depending on several factors, including if you:

  • Are over 40

  • Have a family history of early onset cardiovascular disease

  • Are overweight

  • Live with certain medical conditions such as diabetes

  • Have another indicator that could suggest high cholesterol

They will use the results of your cholesterol test to decide the next steps.