Making lifestyle changes to lower your cholesterol


High cholesterol is a major worry for medical professionals as it significantly increases the risk of cardiovascular disease, and it does so without showing any obvious symptoms. Many people with high cholesterol are completely unaware they have it so it's important that we get our cholesterol measured regularly.

There is, however, some good news. Unless you're one of the one in 500 people that have a genetic pre-disposition, artery-clogging high cholesterol is almost entirely a direct result of lifestyle. This means that you are largely in control, and you can take steps to reduce it.

Generally, raised cholesterol tends to be an issue as we get older, so checking our blood cholesterol every five years from our 40s onwards is a good way to monitor our health. Depending on your risk factors for heart disease, it may even be worth having more frequent tests, too - your doctor will be able to advise you on this.

What can high cholesterol do to our bodies?

Too much cholesterol, which is a fatty substance we carry in our bloodstream, can cause our arteries to narrow, stiffen and become blocked. This condition is known as atherosclerosis. If this narrowing is significant, or if the plaque ruptures and causes a clot to develop, it can prevent blood from reaching our major organs, which in turn can stop them from functioning as they should. If a blockage affects an artery feeding the heart's own tissue it can lead to a heart attack, while a clot or rupture in the brain can lead to a stroke.

Explaining your cholesterol levels

When assessing your cholesterol levels we need to look at two key values. These are the total cholesterol level (TC), which should be below 5.0 and also the level of protective HDL cholesterol. This should be at least 1.0, and it plays a crucial role in transporting excess cholesterol away from the circulation and into the liver where it's broken down.

Both of these levels combined give us the TC: HDL ratio which should be below 5.0. Another way to put it is that total cholesterol should not 'outweigh' HDL by more than 5:1. This is a measure of the 'quality' of your cholesterol.

We should also consider our LDL cholesterol. This is HDL's 'enemy' and along with total cholesterol should be controlled. A level of 3.0 or lower is the healthy target here.

If you have type 2 diabetes or other medical conditions such as a history of heart attack, stroke or heart disease, your doctor may recommend lower targets than these.

Maintaining healthy cholesterol levels

There are four main areas of lifestyle that influence your cholesterol levels. These are:

  • Exercise : Half an hour's daily exercise can reduce your TC level and increase your HDL level. Moderate intensity activities can significantly improve your cholesterol profile. These include brisk walking, active gardening and cycling.
  • Make changes in your diet : avoiding foods high in saturated fat, such as fatty red meat and processed foods and replacing them with oily fish, lean white meats and plenty of fruit and vegetables will also help your overall cholesterol profile. Salmon and mackerel are great sources of omega-3 oils, which can really help to improve your cholesterol levels, while you should also eat foods high in soluble fibre on a daily basis.
  • Watch what you drink: while there is some evidence that suggests moderate amounts of alcohol can increase HDL levels, you certainly shouldn't take up drinking if you previously refrained. If you do already like a tipple though you should stick to the healthy limits of three to four units per day and 21 units a week for men and two to three units per day and 14 units a week for women. Drinking above these levels can significantly worsen your cholesterol profile as well as increase your risk of other health conditions.
  • Smoking : Quite simply, if you smoke, stop. As well as being strongly associated with cancer and lung disease, smoking has been shown to reduce HDL levels as well as damage the interior surfaces of the arteries making it easier for cholesterol plaques to form and rupture.