Keeping an eye on your blood cholesterol

What is blood cholesterol?

Cholesterol is a fatty substance and a small amount is vital for the normal functioning of the body. It's mainly made by the liver, but can also be found in some foods. Having a high level of cholesterol in your blood can influence your health. High cholesterol itself doesn't usually cause any symptoms, but it increases your risk of having a heart attack or stroke.

How common is high blood cholesterol?

Two in three adults in England have high blood cholesterol.

About cholesterol

Cholesterol is carried in your blood by proteins. When the two combine, they're called lipoproteins. 

The two main types of lipoprotein are: 

• high-density lipoprotein (HDL) – carries cholesterol away from the cells and back to the liver, where it's either broken down or passed out of the body as a waste product; for this reason, HDL is referred to as "GOOD cholesterol", and higher levels are better 
• low-density lipoprotein (LDL) – carries cholesterol to the cells that need it, but if there's too much it can build up in the artery walls, leading to disease of the arteries; for this reason, LDL is known as "BAD cholesterol" 

The amount of cholesterol in the blood – both HDL and LDL – can be measured with a blood test. 

Why should I lower my cholesterol?

Cholesterol can build up in the artery wall throughout your life, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body. Your risk of developing coronary heart disease also rises as your blood cholesterol level increases.

How can I lower my cholesterol level?

The first step in reducing blood cholesterol is to maintain a healthy balanced diet throughout life including lots of fruit, vegetables, nuts, pulses and wholegrain foods.

Some foods, such as oats, contain soluble fibre which may help to lower blood cholesterol levels. Eating nuts can also influence blood cholesterol levels because they are high in mono and polyunsaturated fats. These fats lower blood cholesterol and improve the ratio of ‘good’ to’ bad’ cholesterol.

Reducing your intake of foods containing saturated fats will help to lower your blood cholesterol. These include: fatty meats and meat products; butter, ghee and lard; cream, sour cream and ice cream; cheese; biscuits, cakes and pastries; coconut oil, coconut cream and palm oil; many fried foods and confectionery.

Replacing saturated fats in the diet with the same amount of poly- and monosaturated fats, such as olive, rapeseed and sunflower oil will lower total and ‘bad’ cholesterol levels.

Other lifestyle changes, such as exercising regularly and not smoking can make a big difference in helping to lower blood cholesterol.

What causes high cholesterol?

Many factors can increase your chances of having heart problems or a stroke if you have high cholesterol. 

These include:

• an unhealthy diet – in particular, eating foods high in saturated fat
• smoking – a chemical found in cigarettes called acrolein stops HDL transporting cholesterol from fatty deposits in tissues to the liver, leading to narrowing of the arteries (atherosclerosis) 
• having diabetes or high blood pressure (hypertension)
• having a family history of stroke or heart disease

There is also an inherited condition called familial hypercholesterolaemia, which can cause high cholesterol even in someone who eats a healthy diet.

When should my cholesterol levels be tested?

Your GP may recommend that you have your blood cholesterol levels tested for several reasons including:

• have a family history of early cardiovascular disease
• are overweight 
• have high blood pressure, diabetes, or a health condition that can increase cholesterol levels 

If high blood cholesterol cannot be corrected by diet and lifestyle changes then cholesterol lowering medication may be prescribed.