October has been designated National Cholesterol Month in a bid to raise awareness of the grave health risks of having too much ‘bad cholesterol’. Fortunately, making a few basic lifestyle changes can reduce its level in your blood and mitigate the threat to your cardiovascular wellbeing, as our experts explain
Coronary heart disease is the UK’s biggest killer, accounting for about 155,000 deaths every year, and excessive cholesterol is one of several contributing factors. This essential compound is produced by the liver
and used by every cell in the body. A component of bile, which is vital for digestion, it helps to make vitamin D, which we need for healthy bones.
“When you have a blood test, your cholesterol levels are divided into high-density lipoprotein (HDL) and low-density lipoprotein (LDL). The first is ‘good’ and the second is ‘bad’,” says Mike Knapton, associate medical director at the British Heart Foundation (BHF).
HDL particles carry cholesterol molecules away from the cells and back to the liver where these are broken down, which is why they are considered good. LDL particles carry cholesterol molecules in the opposite direction, depositing these into the artery walls. Excessive amounts of cholesterol can build up in a layer of plaque that narrows the vessel and impedes the flow of blood – a condition known as atherosclerosis.
This could ultimately increase the risk of angina pectoris, heart attacks and strokes. Hence LDL is considered bad.
“The main reason for finding out your cholesterol level is, if it’s elevated, to do something about it and reduce your cardiovascular risk,” Knapton says.
For many people this can mean making just a few simple lifestyle changes. Our experts recommend the following six measures.
1 Cut your intake of saturated fat
Leading charities Heart UK and the BHF strongly recommend eating less saturated fat, which is thought to be a cause of inflated cholesterol levels. Saturated fat is found mostly in animal products such as cream, cheese, butter and other whole-milk dairy foods, as well as fatty meats, but also in some plant products, such as coconut and palm oils.
“Eating too much saturated fat can lead to an increase in your LDL cholesterol levels,” says Victoria Taylor, senior dietician at the BHF. “Replacing the saturated fats in your diet with unsaturated fats has been shown to help reduce your LDL levels and slightly increase your HDL cholesterol count. Choosing avocado on toast instead of a cheese sandwich would be a good way of switching from saturated fat to unsaturated fat, for instance.”
2 Avoid trans fats
Trans fats can be found in fried foods, packaged breads and cake products, biscuits and crackers, and some margarines.
“They form a very small part of the UK diet – less than two per cent – but these extremely potent fatty acids lead to the development of atherosclerosis,” Knapton says. “They are used by food manufacturers to help extend the shelf life of certain foods. The BHF’s view is that, because they are so toxic from a cardiovascular point of view, trans fats shouldn’t be in your diet at all.”
He adds that you shouldn’t get caught up analysing the nutritional data on each item in your basket to see if it contains any trans fat. “In practice, people don’t eat trans, saturated and unsaturated fats; they eat foods. The simple message is: reduce the amount of all fat in your diet, as you may be eating too much.”
3 Follow a ‘Mediterranean diet’
Excess body fat is an indicator of high cholesterol. Losing weight, particularly around the stomach, is clinically proven to improve your LDL-to-HDL ratio. But, even if your weight is considered healthy, your overall cholesterol level may still be too high. Changing to a healthier diet can reduce it by between 10 and 15 per cent, so it’s a beneficial choice even if you don’t lose weight as a result.
Research indicates that cardiovascular disease is less prevalent in Mediterranean countries than it is elsewhere in the world, which is why the BHF recommends “a balanced, so-called Mediterranean diet. You increase the amount of plant products, fruits and vegetables you consume and eat less of the three things that are bad for you: salt, fat and sugar,” Knapton says.
4 Exercise daily
Recent research by Public Health England (PHE) has found that 40 per cent of people aged between 40 and 60 fail to do 10 minutes of brisk walking a month, thereby increasing their risk of heart disease and other illnesses.
“Keeping active for at least 150 minutes every week is recommended,” says Jules Payne, chief executive of Heart UK. “Aerobic activity is particularly beneficial. Walking more of your route to work – at a brisk rate – is a good start to finding ways of incorporating more aerobic exercise into your daily routine.”
Sir Muir Gray, clinical adviser to PHE’s One You physical activity campaign, adds: “By walking at a brisk pace for only 10 continuous minutes every day, an individual can reduce their risk of early death by 15 per cent.”
5 Be prepared
“It’s important to plan your meals as much as you can. We’re all getting busier – it’s hard to stick to a diet when you haven’t got the right food at home because you haven’t had time to shop,” says Taylor, who advocates grazing on healthy snacks such as fruit and nuts between meals, as “you tend to make bad choices when you’re overly hungry”.
She continues: “Check your diary to see where you’ll be eating out next week, so you can preview the menu. Think about making some rules if you’re on a business lunch. For example, always have salad as a starter and fish as a main – as long as it’s not deep fried. If you know you’re going to be travelling, you can take some healthy food with you instead of relying on what’s available en route.”
6 Consult the professionals
High blood cholesterol has no discernible symptoms and, as Knapton observes, unlike weight and even blood pressure, you can’t measure it yourself. Unfortunately, the first indication is all too often a heart attack or a stroke. Blood tests are available through the NHS, private health clinics and some pharmacists.
“Eating healthily, being active and not smoking are an essential part of lowering cholesterol,” Payne says. “This may be enough for some people, but others may need extra help from a statin [a cholesterol-lowering prescription drug].”
Heart UK recommends that people aged between 40 and 75 undergo a test every five years. For anyone who is taking statins or has a first-degree relative with inherited high cholesterol (familial hypercholesterolaemia), a test should be an annual event.
Easy swaps to reduce your cholesterol
Visit heartuk.org.uk/get-involved for information on National Cholesterol Month and on how to take part in the charity’s Great Cholesterol Challenge