Cholesterol - the facts


High cholesterol significantly increases your risk of developing cardiovascular disease in the future. It does this by infiltrating the walls of arteries creating stiff, disruptive plaques that can then rupture causing potentially life-threatening blood clots.

The good news however is that unless you're one of the one in 500 that have a genetic predisposition, high cholesterol is almost entirely a direct result of lifestyle - which means that you are largely in control.

Cholesterol levels

When assessing your cholesterol levels we've looked at two key values - the total cholesterol (TC) level which should be below 5.0 and then the level of protective HDL cholesterol which should be at least 1.0. HDL cholesterol plays a crucial role in transporting excess cholesterol away from the circulation and into the liver where it's broken down - so keeping your HDL levels high is important.

We also combine both of these levels to give the TC:HDL ratio which should be below 5.0 - or to put it another way, TC should not 'outweigh' HDL by more than 5:1. This a measure of the 'quality' of your cholesterol.

A third type of cholesterol - LDL cholesterol - is also important. This is HDL's 'adversary' and along with TC should be controlled - a level of 3.0 is the healthy target here.

These levels are the recommended targets for healthy people who don't have medical conditions such as type 2 diabetes, heart attack or stroke - the targets if you have one of these conditions may be lower.

Cholesterol and lifestyle

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

1. Physical activity

Regular exercise can have a dual effect on your cholesterol levels by reducing your TC level and increasing your HDL level. You don't have to exercise hard either - moderate-intensity activities such as brisk walking, active gardening and cycling can significantly improve your cholesterol profile.

A minimum of half an hour of brisk activity - either continuously or in smaller intervals - on at least five days each week will be enough to ensure improvements.

2. Diet

The two main areas of your diet to focus on here are fats and fibre:

Fats

Saturated fats increase both your TC and LDL levels so minimising these in your diet is the first step. Saturated fats are most commonly found in food of animal origin, especially red meats and dairy products . They are often solid and visible at room temperature but also hidden in many foods.

Unsaturated fats on the other hand will help to improve your cholesterol levels by reducing TC and LDL levels. There are two main types to go for - mono-unsaturated fats, such as olive oil but also found in nuts and seeds and Omega 3 and omega 6 fats, found in oily fish, nuts and seeds.

Trans fats are possibly the most damaging fats of all. They are artificially created by adding hydrogen to vegetable oils to give the resulting food products a longer shelf life. Trans fats can really affect your cholesterol profile by increasing your HDL level and reducing your HDL level. They are to be avoided as much as possible and are commonly found in the following foods:

  • Processed foods
  • Confectionery
  • Fast foods
  • Fried foods
  • Commercially baked foods - especially biscuits and doughnuts
  • Margarines and shortening.

Fibre

Foods high in dietary fibre - especially soluble fibre - are particularly good at reducing TC and LDL levels. Great sources of soluble fibre include:

  • Foods high in oats, rye and barley - porridge is a great choice
  • Legumes - especially peas and beans
  • Certain fruits - especially apples, pears, bananas, prunes and plums
  • Certain vegetables - especially broccoli, cauliflower and root vegetables such as potatoes, carrots and onions.

3. Alcohol

Drinking at higher levels can significantly worsen your cholesterol profile as well as increase your risk of other conditions. Moderate alcohol consumption is associated with slightly increased HDL levels - but the benefits are not strong enough to recommend alcohol consumption as a way of managing your cholesterol levels if you don't already drink.

If you do drink however, make sure you stay well within the recommended limits:

Males : 21 units per week with no more than four units on one day

Females : 14 units per week with no more than three units on one day.

4. Smoking

The message here is simple - 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.