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Managing your cholesterol

Dietician at Benenden Hospital

Did you know that more than one in five people in England are living with high cholesterol? This makes you more susceptible to developing heart disease, therefore increasing your risk of stroke and heart attacks. High cholesterol causes 4.4 million deaths every year (World Heart Federation). Read our guide to learn about what cholesterol is, why you might have high cholesterol and how you can lower your levels. 

What is cholesterol?

Cholesterol is a type of blood fat (or lipid) that’s made in the liver. It can be found in the membrane (the outer layer) of your cells, is used to make bile which helps you to digest the fats in your diet and also makes Vitamin D and other hormones which keep your bones, teeth and muscle healthy.

Cholesterol can’t travel freely in our bloodstream, along with triglycerides. As a result of this, the liver makes them into lipoproteins which are released into the blood and carried to whichever part of the body needs them.

Some cholesterol is used to make bile acid, which helps break down fats from food in your intestine. Most of this acid is removed when you poo, but some is reabsorbed back into the bloodstream and returned to the liver to begin the process again.

What is high cholesterol?

If too much bile acid is reabsorbed into the blood, this can cause high cholesterol which can lead to clogging of your arteries and other health problems such as heart attacks and strokes.

Why might I have high cholesterol?

There are several reasons why you might develop high cholesterol; you may not be active enough, so you don’t use the fats in your diet for energy or your diet might be too high in saturated fats.

But having high cholesterol doesn’t necessarily mean you’re unhealthy. You may be predisposed to it, especially if it runs in the family. Nona Ozerianskaya, Dietician at our hospital, says:

“You need to discuss management of your cholesterol with your doctor if you are diabetic, have coronary heart disease (CHD) or have a family history of CHD.”

Below are some factors that can cause high cholesterol which you can’t control:

  • Gender
  • Ethnic background
  • Growing older
  • Kidney or liver disease
  • Endocrine disorders such as hypothyroidism (underactive thyroid) and growth hormone deficiency
  • Familial Hypercholesterolaemia (FH); a form of high cholesterol you’re born with

How do I know whether I have high cholesterol?

High cholesterol doesn’t always cause symptoms, so you won’t know that you’re affected unless you have a blood test.

How can I lower my cholesterol levels?

1. Stay physically active

Moderate physical activity can help increase your high-density lipoproteins (‘good’ cholesterol). Government guidelines recommend 30 minutes activity, five times a week. This could include walking during your lunch hour, going on a bike ride with your family or playing sport.

Remember to speak to your doctor before you start any new physical exercise regime.

2. Lower the amount of saturated and trans (hydrogenated) fats in your diet

According to the British Heart Foundation, too much saturated fat can increase the amount of ‘bad’ (low-density lipoprotein, or LDL) cholesterol in the blood, which can increase the risk of developing CHD.

Saturated fat is usually found in foods made from animal products, such as red meat and pork, processed meats such as sausages, butter, cheese, cream and other dairy products and some oils such as coconut or palm oil. You should also limit processed foods such as biscuits, crackers, pastries and cakes which contain artificial trans fats.

Check the traffic light labelling on your foods when you buy them. This will tell you immediately whether it’s high in saturated fat (red), medium (amber) or low (green). You can find out more about the traffic light system from the British Nutrition Foundation website.

Unsaturated fats are better for you and can be found in olive, sunflower and rapeseed oils, avocados, some nuts and oily fish.

3. Eat more fibre-rich foods

You may be able to lower your cholesterol by changing your diet to include plenty of fruit and vegetables, wholegrain foods (brown rice and bread, rather than white), lean meats or poultry and fish and beans, nuts, and soya. These can lower your cholesterol and are generally good for your health.

4. Stop smoking

Stopping smoking improves your HDL cholesterol level as well as reducing your blood pressure and improving your circulation and lung function. Your risk of heart disease reduces to half that of a smoker within a year of giving up.

5. Cut down on alcohol

When you drink alcohol, it’s broken down and rebuilt into triglycerides and cholesterol in your liver. If these levels become too high, they can build up and cause fatty liver disease. Once the liver is diseased it can’t work as well to remove cholesterol from your blood.

6. Take medication

If lifestyle changes don’t work, your GP may prescribe medication to lower your cholesterol. The most widely used medicine is a statin, but there are other medicines too.

How can I get my cholesterol tested?

High cholesterol doesn’t always cause symptoms, so you’ll need a blood test to receive a diagnosis. Book an appointment with our Private GPs who can refer you.

Published on 05 October 2023