Do you have high cholesterol?
Our bodies need cholesterol to function properly, but not too much. The waxy, pale yellow fat is found in our blood, and is crucial to the production of cell membranes, vitamin D, hormones (including testosterone and oestrogen), and fat-dissolving bile acids.
Unfortunately, around half the adult population in most developed countries do have too much cholesterol, usually as a consequence of consuming excessive amounts of saturated fat in the form of meat, dairy, and processed foods such as pies, burgers, cakes, and ready meals.
Is high cholesterol a serious problem?
Yes. According to the World Health Organisation, coronary heart disease and stroke are the world's biggest killers, accounting for a combined 15.2 million deaths in 2016, a third of which were attributed to high cholesterol.
What are LDL, HDL and Triglycerides?
· Low Density Lipoprotein cholesterol (LDL)
After processing by the liver, LDL is packaged up with protein and released into the blood, which then delivers it to the body’s cells. Also known as bad cholesterol, LDL cholesterol is comprised mostly of fat, which, if there is too much of it, can collect as plaque in the arteries, creating blockages that may lead to a heart attack or stroke.
· High Density Lipoprotein cholesterol (HDL)
HDL is considered the good cholesterol because it’s comprised mainly of protein, and its primary role is to transport the bad LDL cholesterol back to the liver where it can be passed out of the body as waste, thereby preventing the formation of plaque and blockages. So it’s important for us to have sufficient good HDL cholesterol to keep the bad LDL cholesterol within acceptable limits.
Another type of fat found in our blood that forms part of a cholesterol test, is our triglycerides. When we eat, our body converts any calories it doesn't need to use straight away into triglycerides, and then stores them away in our fat cells to be released later for energy between meals. However, if we regularly eat more calories than we burn, particularly from high-carbohydrate foods, our triglycerides level will become too high, which may contribute to hardening of the arteries and/or thickening of the artery walls.
Signs and symptoms of high cholesterol
There aren't usually any obvious signs that someone has high cholesterol, which is why it's so important to get it checked out. It's a hidden risk factor, which means it happens without us realising - until we experience one of the following:
· Chest pain: If the blood flow through the arteries that supply the heart (coronary arteries) is restricted, it causes chest pain (angina).
· Heart attack: If plaques tear or rupture, a blood clot can form, which blocks the flow of blood to the heart and causes a heart attack.
· Stroke: Similar to a heart attack, a stroke occurs when a blood clot blocks blood flow to part of the brain.
· Vascular dementia: Long-term narrowing of blood vessels in the brain can impair blood flow and starve the brain of oxygen and nutrition.
· Gallstones: Commonly composed mainly of undissolved cholesterol, gallstones can cause severe abdominal pain, yellowing of the skin, and fever.
Should I have a cholesterol test?
Adults at average risk of developing coronary artery disease should have their cholesterol checked every five years. More frequent testing might be necessary if previous test results were abnormal, or if the person is overweight, physically inactive, has diabetes, smokes, or has a family history of high cholesterol or heart attacks.
What do ‘normal’ test results look like?
As a rough guide, ideally, LDL should be less than 3mmol/L (millimoles per litre); HDL should be more than 1mmol/L; and triglycerides should be less than 1.7mmol/L.
Total cholesterol (HDL level + LDL level + 20% of triglyceride level) should be less than 5mmol/L.
Is high cholesterol preventable and treatable?
Yes. The following lifestyle changes can improve everyone’s cholesterol levels naturally;
· Reduce saturated fats: Saturated fats, found primarily in red meat and full-fat dairy products, raise cholesterol, so, decreasing consumption of these foods can reduce LDL (the bad) cholesterol.
· Eliminate trans-fats: Listed on food labels as ‘partially hydrogenated vegetable oil’. Despite pressure from governments to ban them, trans-fats are still found in some margarines, cookies, and cakes, and should be avoided.
· Eat foods rich in omega-3 fatty acids: Omega3 fatty acids reduce triglycerides in the blood and the most important, Alpha-Linolenic Acid (ALA) is found in leafy green vegetables, soya and tofu products, walnuts, seeds such as chia and hemp, and oils such as rapeseed and flax.
· Increase soluble fibre: Forming a gel when dissolved in water, soluble fibre soaks up LDL cholesterol like a sponge, and carries it out of the body. Found in whole grains, legumes, fruit and vegetables. One serving of beans a day can reduce LDL cholesterol levels by around 5%.
· Try whole grains: Oats, barley, wheat and rice are rich in a type of soluble fibre called beta glucan. Try swapping white bread, cereals and regular pasta for the whole-grain varieties. One serving contains about 1g of beta glucan, and adding two portions a day to our diet can reduce LDL cholesterol by 10%.
· Swap to soya: Low in saturated fat, and high in protein, studies show that we can lower our LDL cholesterol by 10% by consuming as little as 15g of soya protein each day. That’s two large glasses of a soya milk alternative, 100g of soya mince, or two soya sausages.
· Cultivate plant stanols and sterols: The active ingredient in fortified, cholesterol lowering yoghurts and spreads available in most supermarkets. Plant stanols and sterols are found in tiny amounts in a wide range of fruits, vegetables, nuts, seeds, vegetable oils, and whole grains. Considered to be the most effective way to lower cholesterol, evidence suggests that eating 2g of plant stanols or sterols each day can reduce LDL cholesterol by up to 15% within three weeks.
· Have a tipple: Red wine contains an antioxidant called resveratrol, a substance found in the grape skin that lowers LDL cholesterol. However, drinking too much alcohol can cause a whole host of other health issues, so while a glass of red wine at dinner can be beneficial, it shouldn’t turn into three or four!
· Exercise: Moderate to vigorous physical activity such as walking, jogging, swimming or riding a bike for at least 30 minutes a day, five days a week, can help raise (the good) HDL cholesterol, and lower triglycerides.
· Quit smoking: Within three months of quitting, blood circulation and lung function begin to improve, and within a year, the risk of heart disease is half that of a smoker.
· Lose weight: Carrying even a few extra pounds contributes to high cholesterol.
If lifestyle changes aren't enough …
Sometimes healthy lifestyle changes aren't enough to lower cholesterol levels, and medication may be prescribed by your doctor, but following these lifestyle changes (or at least some of them) will boost the effects of the medication, and help to keep the dose low.
· Statins: These work by blocking the enzymes created in our liver that help make cholesterol. However, statins are only prescribed to people who are at a high risk of heart disease because they need to be taken consistently to be effective.
· Aspirin: A low dosage of aspirin may be prescribed in those who’ve had a heart attack, have a vascular disease or have a high risk of developing cardiovascular disease, as it helps prevent blood clots.
· Ezetimibe: This works by blocking the absorption of cholesterol from food so that it doesn’t reach the bloodstream.
· Bile acid sequestrants: If statins or ezetimibe don’t work, these may be prescribed. They work by binding to bile acids inside the intestines, and prevent them from being absorbed. This then prompts the body to produce more bile acid, which then lowers cholesterol levels.
Thank you for reading this blog post. If you have any thoughts to share, or ideas for future posts, please do let me know. I would love to hear from you.