Do you know if you are at risk of high cholesterol?
Are you clued up about the causes of high cholesterol?
What are the best forms or exercise or foods to eat in your diet to bring your cholesterol down to healthy levels again?
If you don’t know the answer to these questions, you’re not alone. The vast majority of people know very little about high cholesterol, the causes, or the potentially grave impacts it has on long-term health.
So we have answered the 11 most common questions people have about cholesterol so you can take back control of your health.
1. What is cholesterol?
Cholesterol is a waxy form of fat or lipid produced in the liver that helps support digestion and hormonal balance. Lipids are substances that do not dissolve in water, meaning that they do not come apart in blood. Because cholesterol has very similar physical and chemical properties, it is referred to as a lipid.
While people often refer to ‘types’ of cholesterol, specifically LDL and HDL, there is only one form of cholesterol. LDL (low-density lipoproteins) and HDL (high-density lipoproteins) are carriers that transport cholesterol throughout the body. However, it is important to distinguish that they are not cholesterol, but their relative balance does have significant health implications.
2. What does ‘high cholesterol’ mean?
When you hear the term high cholesterol, medical professionals are likely referring to your blood lipid profile. Your lipid profile measures the amounts of various lipids and lipoproteins in your blood, such as LDL, HDL, cholesterol, and triglycerides, a type of fat found in your blood. Consequently, high cholesterol often refers to elevated levels of a combination of lipids or lipoproteins in your blood.
UK guidelines give healthy blood lipid levels as:
- HDL levels above 1 mmol/l,
- LDL levels below 3 mmol/ l,
- Non-HDL below 4 mmol/l (including all lipoproteins other than HDL),
- Total cholesterol levels below 5 mmol/l,
- Triglycerides levels below 2.3 mmol/l.
3. Which cholesterol is bad or good?
There is only one form of cholesterol, but it is transported around the body by lipoproteins, which vary in their relative density of proteins to lipids. All forms of lipoproteins are essential for healthy physiological functioning and performance, and none are inherently bad. However, when there is an imbalance in lipoproteins, such as high levels of LDL and low HDL, it is much more likely that you will develop the health problems associated with elevated cholesterol levels, including atherosclerosis.
4. What is a healthy cholesterol level for adults?
There is currently no specific healthy cholesterol range for adults based on age, although there are minor differences between men and women. In general, women’s baseline for HDL is slightly higher, as female sex hormones play a role in lipoprotein regulation.
However, it is recommended that you undergo more frequent screening for high cholesterol levels as you become older. This is because cholesterol levels tend to rise with age due to a combination of factors, such as becoming more sedentary and dietary changes. For men over 45 and women over 55, it is advisable to undergo screening every one to two years and annually if you are over 65.
5. How can you tell if you have high cholesterol?
Unfortunately, there are no specific signs or symptoms of high cholesterol. The only way to conclusively measure your cholesterol is via a blood test. However, some risk factors signify a higher likelihood of elevated cholesterol, including genetics, older age, diseases like HIV/AIDS, medications, and lifestyle factors like exercise and diet. Statistics show that as many as 55% of people with high cholesterol aren’t aware, so it is even more important to visit your health care provider for screening if you fall into one of these ‘at risk’ categories[1].
6. What causes high cholesterol?
Various factors contribute to an increased risk of high cholesterol. These include medical conditions like chronic kidney disease, diabetes, hypothyroidism, and medications taken to treat cancer, high blood pressure, and HIV/AIDS.
High cholesterol is also associated with family history and genetics, known as familial hypercholesterolemia (FH). FH stems may be passed down by one or both parents and impacts how the body produces and utilises cholesterol and lipoproteins. In general, FH causes all lipoproteins to be relatively higher than usual.
Lifestyle factors like diet, exercise, and body composition are significant contributors to the risk for high cholesterol. For example, saturated fats, found in high-fat meats and dairy, have an isolated effect on increasing total cholesterol and LDL in the blood. It’s important to note that eating cholesterol-containing foods does not play a major role in poor blood lipid profiles.
Sybil (68) put her worrisome cholesterol behind her with proper weight training and diet program.
7. Does high cholesterol cause high blood pressure?
According to research, cholesterol and blood pressure levels tend to mirror one another[2]. This is because one of the leading health concerns regarding cholesterol levels is atherosclerosis, a build-up of plaque in the arteries, causing your blood vessels to narrow. Narrower blood vessels inevitably mean higher blood pressure, as your body tries to squeeze the same amount of fluid/blood through a smaller space, applying more pressure to arterial walls.
8. How can I lower cholesterol?
While many factors influence your cholesterol levels, research consistently demonstrates that lifestyle modification is an important tool for improving blood lipids. Five ways to improve your cholesterol and blood lipid levels include:
Exercise regularly. Research shows that regular exercise helps increase HDL levels and enhances your body’s ability to clear excess cholesterol[3].
Improve your body composition. Obese individuals are more likely to have poor blood lipid levels, with common trends being low HDL, high LDL, triglycerides, and total cholesterol. On the flip side, fat loss can reverse these effects and improve blood lipids.
Consume a healthy balance of fats in your diet. Saturated fats (SFAs) found in high-fat meats and dairy have an isolated effect on increasing total cholesterol and LDL[4]. Replacing SFAs with mono (MUFAs) and polyunsaturated fats (PUFAs), as found in nuts, avocados, and dark chocolate, reduces total cholesterol, increases HDL, and decreases LDL and triglycerides.
Eat a high-fibre diet. Evidence shows that consuming a healthy amount of fibre helps to reduce total cholesterol levels[5],[6]. Recommended daily fibre intake is approximately 25 g for women and 35 g for men.
Quit smoking. Smokers are up to 80% more likely to have low HDL levels than non-smokers. On the other hand, individuals who kick the habit often see their HDL levels improve, even if they gain a small amount of weight in the process[7].
9. Does exercise lower cholesterol?
Exercise improves blood lipids via multiple mechanisms. Firstly, exercise can help support fat loss, which is known to help improve blood lipids by reducing LDL and triglycerides. Likewise, exercise can independently increase HDL levels and help the body better manage cholesterol levels[8]. Specifically, it seems that higher intensity exercise, such as hard resistance training, is more effective for these goals than lower-intensity forms of activity[9].
10. What foods lower cholesterol?
In general, foods high in dietary fibre can help improve blood lipid levels by allowing your body to dispose of excess cholesterol and lipoproteins more efficiently. High fibre foods include fruits, vegetables, whole grains, lentils, and beans.
Dietary fats play an essential role in blood lipids and related disease risk. Research consistently shows that replacing trans fats (TFAs) and saturated fats (SFAs) with monounsaturated and polyunsaturated sources improves cholesterol levels[10]. While it isn’t clear whether there is a direct positive impact of increasing MUFA and PUFA intake, the evidence supports a beneficial ‘replacement effect’. High MUFA and PUFA foods include nuts, avocados, seeds, dark chocolate and oily fish. Notably, experts recommend limiting saturated fat intake to 10% of total calories.
11. Are eggs bad for cholesterol?
One of the main reasons people consider eggs detrimental to blood lipids is their relatively high cholesterol content. While it makes intuitive sense to think that your cholesterol levels may rise when you eat more dietary cholesterol, it isn’t that simple. Your body has mechanisms to balance cholesterol levels by increasing or decreasing production depending on how much you eat, similarly to how a thermostat regulates temperature[11]. If you eat more cholesterol, your body produces less, and vice versa. For this reason, the amount of dietary cholesterol you consume only plays a minor role in cardiovascular disease risk.