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Cholesterol Q&A

Dr Farhan Ahmed is a Consultant in Metabolic Medicine and Clinical Biochemistry at BMI The Saxon Clinic. He shares his advice on cholesterol and what it means to your health.

What is cholesterol and do I need to worry about it?

Cholesterol is an essential part of our body’s make-up and is found in every single cell of the body. We need it to aid the production of hormones and to coat and protect our cells.

However, it is possible to have too much cholesterol in our blood. Getting the balance right is very important.

Too much cholesterol can cause blood clots and block your blood vessels, which can increase your risk of heart disease, stroke and vascular dementia.

What about good cholesterol?

You may have heard people talking about 'good' and 'bad' cholesterol. High-density lipoprotein (HDL) is known as good cholesterol because it helps to remove Low-density lipoprotein (LDL), which is what is meant by bad cholesterol.

What is the normal cholesterol level?

A healthy level is normally defined as 5 or below overall, with LDL at 3 or below and HDL at 1 or above.

A cholesterol test can assess your total levels as well as your levels of HDL and LDL.3

Who is most at risk from high cholesterol?

Most cases are due to lifestyle factors, but there are some groups who are more at risk than others.

If you have a family history of high cholesterol, early heart attacks or stroke, then it’s worth getting your levels checked as it can be hereditary. This is sometimes due to a condition called familial hypercholesterolemia.

People from South Asian backgrounds have also been found to be at higher risks compared to other groups.

Other risk factors include gender, as men tend to develop heart disease earlier than females, and age. The older you get, the higher the risk of heart disease becomes. It's very important to keep an eye on both your HDL and LDL levels as you get older.4

What are the symptoms of high cholesterol?

In general, there are no obvious symptoms.

In rare cases, people experience severe abdominal pain and a skin rash, but this is highly unusual. A blood test is the best way to measure levels.

If you are worried you may have high cholesterol and have not yet been tested, speak to your doctor about testing the levels of cholesterol in your blood.

Will changing my lifestyle help regulate my cholesterol levels?

Certain lifestyle changes may help to reduce your cholesterol.

Improving your diet is one change that can have a significant effect. Cutting down on fatty foods and incorporating more healthy foods into your diet may well help to reduce your levels.

Foods that can help to reduce LDL levels:

  • Avocados contain monosaturated fatty acids which can boost HDL and lower LDL.
  • Nuts are also high in monosaturated fats. Pick unsweetened, unsalted versions and pay attention to the portion sizes on the pack: they're much smaller than many people think.
  • Fruit and veg with deep colours - including blueberries, red cabbage, kale and spinach - are rich in antioxidants, which boost HDL levels.
  • Omega 3 and other nutrients found in oily fish have been shown to boost HDL levels. Salmon, trout and herring all count as oily fish.

Being overweight and out of shape are two other common causes. Getting fit and maintaining a healthy body weight will boost your overall health and could help regulate your levels.

These lifestyle changes are not guaranteed to work for everyone, especially as there may be secondary medical factors that also need to be addressed.

For this reason, you should always speak to your doctor about making any changes to your lifestyle to try to reduce your cholesterol. Your physician will be able to advise on the best course of action for you.

How is high cholesterol treated?

In most cases, diet and lifestyle measures should work.

Where improved diet and lifestyle fails to improve cholesterol, secondary causes such as genetics, diabetes or thyroid problems should be considered and treated where necessary.

In some cases, medication might be needed. Your doctor will discuss the available options and help you decide which is best for you.

10 tips to reduce your cholesterol

These are some of our top tops to reduce your LDL and boost your HDL levels. Read more about these cholesterol-lowering tips here.

  1. Reduce your saturated fat intake (and instead eat unsaturated fats)
  2. Don't fry your food
  3. Eat more fruit and vegetables
  4. Eat more oily fish
  5. Switch to an HDL-fortified spread
  6. Add flavanoids to your diet
  7. Exercise more
  8. Manage your stress
  9. Quit smoking
  10. Maintain a healthy weight