What is cholesterol?
Cholesterol is a waxy, fat-like substance that’s found in the cells of your body and in the food you eat. It is an essential component of cell membranes, and it plays a crucial role in various biological processes. Cholesterol is important for the production of hormones, vitamin D, and substances that help you digest fats.
You may associate cholesterol with being ‘bad’, but in fact, there is such thing as ‘good’ cholesterol as well as ‘bad’ cholesterol. Bad cholesterol (low-density lipoprotein) can build up on the walls of your arteries, forming plaques. This can lead to a condition called atherosclerosis, which increases the risk of heart disease and stroke.
Good cholesterol (high-density lipoprotein) helps remove the bad cholesterol from the bloodstream, and transports it to the liver for excretion. Higher levels of good cholesterol are associated with a lower risk of heart disease.
It’s important to maintain a healthy balance of cholesterol levels in your blood as high levels of bad cholesterol and low levels of good cholesterol are risk factors for cardiovascular diseases.
What can cause high levels of ‘bad’ cholesterol?
Things that can increase your risk of having high levels of bad cholesterol include:
- Lack of physical inactivity – Lack of regular physical activity can contribute to obesity and lower levels of good cholesterol, while raising levels of bad cholesterol.
- Obesity – Excess body weight, especially when it’s concentrated around the abdominal area, is often associated with higher levels of bad cholesterol.
- Smoking – Smoking not only lowers good cholesterol, but it also damages the walls of your blood vessels, making it easier for bad cholesterol to build up as plaque.
- Family history – A family history of high cholesterol or early heart disease can increase your risk, as some individuals may inherit genes that cause high cholesterol levels.
- Age and gender – Cholesterol levels tend to rise as people get older, and men are more likely to have lower levels of good cholesterol and higher levels of bad cholesterol compared to women.
- Ethnic background – If you are from a south Asian background, you are more likely to have high cholesterol.
- Certain medical conditions – Conditions such as type 2 diabetes and polycystic ovary syndrome (PCOS) can be associated with higher levels of bad cholesterol.
- High blood pressure – High blood pressure can damage the walls of arteries, making them more susceptible to the accumulation of cholesterol plaque.
- Stress – Chronic stress may lead to behaviours that can increase levels of bad cholesterol, such as overeating, poor dietary choices, and a lack of physical activity.
- Medications and medical conditions – Some medications and medical conditions can raise levels of bad cholesterol or lower levels of good cholesterol.
- Diet – Consuming a diet high in saturated and trans fats can increase levels of bad cholesterol. Foods like red meat, full-fat dairy products, and many commercially baked and fried foods are sources of these types of unhealthy fats.
High cholesterol does not cause symptoms, and you can only find out if you have it through having a blood test. If you think you are at risk of having high cholesterol, speak with your GP who may suggest having a test.
What can high levels of bad cholesterol increase your risk of?
According to Heart UK, high levels of bad cholesterol in your blood can increase your risk of:
Atherosclerosis – This is when high levels of bad cholesterol lead to the accumulation of cholesterol and fatty deposits on the inner walls of arteries. Over time, this can result in the narrowing and hardening of the arteries, reducing blood flow to vital organs.
Cardiovascular disease – This refers to the heart and blood vessels, and covers conditions such as coronary heart disease, chest pain, heart attached, stroke, mini stroke (TIAs) heart failure, peripheral arterial disease (PAD) and vascular dementia.
Other risks include:
High blood pressure – High levels of bad cholesterol can contribute to high blood pressure, which is a significant risk factor for heart disease and other health problems, such as kidney disease.
Emotional strain and mental health – The awareness of having high cholesterol and its potential consequences can lead to increased stress and anxiety, affecting an individual’s emotional and mental wellbeing.
Possible cognitive decline – Some studies suggest a link between high cholesterol levels and an increased risk of cognitive decline and conditions like dementia and Alzheimer’s disease.
Things you can do to lower levels of bad cholesterol
Here are some lifestyle changes and habits that can help:
Healthy Diet: Limit your intake of foods high in saturated fats, such as red meat, full-fat dairy products, and spreads like margarine, and avoid trans fats found in many processed and fried foods.
Eat plenty of fibre, like oats, beans, fruits, and vegetables, which can all help to lower bad cholesterol. Replace white bread, pasta, rice, flour, breakfast cereals with their wholemeal or wholegrain equivalents. Try to choose sources of healthy fats, such as olive oil, avocados, and fatty fish rich in omega-3 fatty acids. Limit processed foods and food with added sugars as these can contribute to weight gain and negatively impact cholesterol levels.
Stay hydrated: Drink plenty of water to support your overall health, including your heart health.
Regular physical activity: Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week. Try to include strength training activities a few days per week too – whether it’s resistance training or an activity such as gardening.
Maintain a healthy weight: Losing any excess weight through regular physical activity and a healthy balanced diet can help to lower bad cholesterol.
Quit smoking: Smoking damages blood vessels and lowers good cholesterol. Stopping smoking is one of the best things you can do for your health.
Limit alcohol intake: If you drink alcohol, do so in moderation, and don’t exceed the recommended limit of 14 units per week (spread across several days).
Keep an eye on your blood pressure: High blood pressure doesn’t cause symptoms and can put you at increased risk of high cholesterol. Get your blood pressure checked a few times a year, either by testing it yourself at home using a machine, visiting a pharmacy or visiting your GP.
Take steps to look after your mental wellbeing: Things such as stress can lead to unhealthy lifestyle choices and increase your risk of high cholesterol. Use healthy ways to cope with pressure and demands, such as physical activity, spending time with others, and engaging in your hobbies and interests. If work is causing stress, speak with your line manager or HR for support and look at ways to achieve a health work-life balance.
Check any initiatives your employer provides: Employee assistance programmes (EAPS) can offer confidential support for a range of challenges that could potentially contribute to unhealthy lifestyle choices. Seeking help for struggles such as financial worries or stress can therefore help to reduce risk of high cholesterol levels.Check whether your employer offers any other initiatives, such as access to health screening, health assessments and access to health and wellbeing resources.
Attend any NHS screenings you are eligible for: If you’re over 40 and live in England you may have a cholesterol test during your NHS Health Check.
Medications and treatments for high cholesterol: If your cholesterol level is found to be very high and lifestyle changes are not enough to bring it into a healthy range, your GP might suggest controlling it with medication.
Further support
Heart UK – Cholesterol charity containing support and information.
British Heart Foundation – Reducing high cholesterol.
NHS – Information about high cholesterol.
Sources:
www.heartuk.org.uk/downloads/ health-professionals/publications/ understanding-cholesterol.pdf www.bhf.org.uk/informationsupport/ risk-factors/high-cholesterol
www.nhs.uk/conditions/high-cholesterol/
This information was published November 2023.
