What is cholesterol?
Cholesterol is a fatty substance produced in the liver and is also found in foods such as eggs, liver, and prawns. It plays a vital role in our bodily functions, it assists in making vitamin D, some hormones and helps our digestive system absorb dietary fats (1).
Cholesterol is transported around our body in the blood and there are two types of cholesterol that can impact our health. Low density lipoprotein (LDL) also known as bad cholesterol this type carries cholesterol to your artery walls and high-density lipoprotein (HDL) also known as good cholesterol this type takes any excess cholesterol away from the arteries to the liver. Overall, we should have low levels of LDL and a higher level of HDL as too much cholesterol can block our arteries which can result in heart disease and stroke (2).
Statistics
Cardiovascular disease (CVD) is the leading cause of death worldwide and in England 1 in 4 deaths are caused by CVD also causing the NHS billions. As many people are living with undetected high blood pressure and increased cholesterol the Office for Health Improvement and Disparities’ focus is to address prevention and reduce health inequalities linked to CVD.
One third of heart disease is caused by high cholesterol which is estimated to account for 7.1% of deaths in England. As we age our cholesterol levels tend to increase and modifying our overall lifestyle can aid in lowering cholesterol levels and reducing our risk of CVD (3).
Causes of high cholesterol
Increased cholesterol is mainly related to consumption of foods high in fat, lack of exercise, consuming alcohol and by smoking and it can also run in the family. It does not cause symptoms and so the best way to measure your cholesterol is to have a blood test (4).
Familial hypercholesterolaemia (FH) (also known as genetic high cholesterol) is a result of genes causing very high levels of cholesterol. Having FH means even if you have a healthy lifestyle your cholesterol levels can become higher as it impacts the way cholesterol is broken down in the body (5).
Research from large clinical trials shows that lowering LDL cholesterol levels can reduce our overall risk of death and also the risk of strokes and heart attacks irrespective of age (6).
Diet and cholesterol
Making simple changes to our overall lifestyle can aid in lowering our cholesterol levels. Reducing the amount of saturated fat in our diet such as full fat dairy products, fatty meats, biscuits, cakes, pastries, butter, ghee, lard, cream and coconut and palm oils can make a big difference to our cholesterol levels. Including more healthy fats (unsaturated fats), for example, vegetable oils such as rapeseed, sunflower and olive oil, nuts, seeds, avocados, and oily fish such as salmon can be beneficial to our heart health in moderation. Think about smart swaps to reduce saturated fat such as grilling/roasting/steaming foods instead of frying and opt for leaner cuts of meat and more plant-based foods. Choose lower fat dairy products, and include more fresh fruit and vegetables in your diet to increase your fibre content as well (7).
Also, read food labels opting for more green or amber food labels for saturated fat. Food high in saturated fat is anything more than 5g per 100g of saturated fat and food with 1.5g or less per 100g are considered to be low in saturated fats.
Incorporating oats, a soluble fibre that contains beta gluten, may help reduce our cholesterol levels as well as almonds which contain monounsaturated fats that help us to reduce our bad cholesterol levels. Plant stanols and sterols work by lowering your blood cholesterol found in foods such as nuts and seeds, green leafy vegetables, and vegetable oils. Fortified foods such as plant sterol enriched margarine or yoghurt can also be included in your diet as it is not possible to consume enough plant stanols and sterols alone (8).
Research has shown that healthy dietary patterns such as the Mediterranean diet (more vegetables, fruits, legumes, beans, cereals, fish, unsaturated fats and grains and small amounts of dairy and meat) may prevent CVD and eating a variety of foods including soluble fibre, nuts, plant proteins and plant sterols can improve LDL cholesterol levels (9).
NHS cholesterol diet advice
A third of our energy should come from fats, 70g for women and 90g for men per day and the government recommends that women should have no more than 20g of saturated fat per day and no more than 30g per day for men. To reduce our risk of heart disease we should focus on looking at our overall fat intake and swap saturated fats for unsaturated fats (10).
Also, other lifestyle factors such as aiming for at least 150 minutes of exercise a week, limiting drinking to no more than 14 units of alcohol a week and stopping smoking can all aid in lowering our cholesterol levels (11).
Support and help
Heart UK is the UK’s cholesterol charity providing support, information and influencing services for families and health professionals HEART UK – The Cholesterol Charity
The NHS health check offers a health check-up for those aged 40-74 including lifestyle interventions – see your GP to book an appointment.
See you GP to have a blood test to check your cholesterol levels – NHS Cholesterol advice: High cholesterol – Getting tested – NHS (www.nhs.uk)
Medication may be required to lower your cholesterol if lifestyle modifications do not work, and you are at risk of having a stroke or heart disease. These medicines are known as statins which your GP will prescribe accordingly.
You can also see a registered nutritionist or dietitian for more dietary support.
Contact One You Hounslow to get support to eat well, be more active, drink less alcohol and stop smoking.
Winter porridge bowl recipe
Why not try this winter porridge bowl recipe packed with fibre, healthy fats and fresh fruit, breakfast can be a great way to get some extra energy and incorporate some good nutrition into your day.
Ingredients
-3/4 cup of oats
-¾ cup of almond milk
-1 apple chopped
-A handful of blueberries
-A handful of plain almonds
-1 tsp flaxseed
-A handful of mixed seeds
-1 tsp of peanut butter
-¼ tsp cinnamon powder
-2 tbs of plain soya yoghurt
Method
Add the oats, cinnamon and milk to a pan and simmer on low heat. Stir to desired consistency. Oats should become thick and creamy. If you prefer a thinner consistency add more milk/water.
Add your porridge to a bowl, add some yoghurt along with all the toppings.
References:
1 Healthy Tip: Keeping a check on Cholesterol – Heart Research UK
3 Health matters: preventing cardiovascular disease – GOV.UK (www.gov.uk)
4 High cholesterol – NHS (www.nhs.uk)
5 What is FH? | Genetic Conditions | HEART UK
6 Flawed cholesterol study makes headlines – Heart Matters magazine (bhf.org.uk)
7 Cholesterol | British Dietetic Association (BDA)
8 What should I eat to cut my cholesterol? – BBC Food
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