Ref: CHB/News Bulletin/005/2014                                               

Cholesterol is a word that conjures an image of clogged arteries and heart attacks. The fact is, the body needs a certain amount of it for vital roles such as the manufacture of hormones, vitamin D synthesis and the insulation of nerve endings. While a small amount is vital to good health, the evidence overwhelmingly demonstrates that an elevated blood cholesterol level is one of the major risk factors for cardiovascular (heart and circulatory) disease.

What is cholesterol?

Cholesterol is a fatty substance found in the blood. A very small amount of cholesterol comes from food such as eggs - however, most cholesterol is actually produced by your liver when you eat foods high in saturated fat. Once inside the body, the liver turns saturated fat into cholesterol. Therefore, an excessive amount of saturated fat in the diet leads to increased cholesterol levels. Saturated fat is found in a range of foods including: butter, hard cheese, fatty meat and meat products, biscuits, cakes, cream, ghee, coconut oil and palm oil.

The different types of cholesterol and its effects

Cholesterol moves around the body in the blood by attaching itself to proteins, creating molecules known as lipoproteins. There are two main types: low-density lipoproteins (LDL) and high density lipoproteins (HDL).

  • LDL is the harmful type of cholesterol (think L=lousy!) Too much LDL will cause cholesterol to build up as deposits in the artery walls so it's important to keep levels of LDL within saferange.
  • HDL is a protective type of cholesterol, transporting excess cholesterol away from the arteries to the liver to be broken down and removed from the bloodstream.
  • Triglycerides are the most common type of fat. They circulate in blood but are stored in the body for extra energy. Triglyceride levels increase significantly after eating. A high triglyceride level combined with a low HDL or high LDL can speed up the process of plaque formation in the arteries

The higher the level of LDL cholesterol in your blood, the GREATER your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the LOWER your chance is of getting coronary heart disease.

Coronary heart disease is a condition in which plaque (plak) builds up inside the coronary (heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis).

Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart.

Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow to a section of your hear through a coronary artery and thus anginaor a heart attack may occur.

If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems or death.


Plaque also can build up in other arteries in your body, such as the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as blockage in the arteries of the brain, and stroke.


What causes high cholesterol?

The following may increase your levels of bad cholesterol:

  • Too much saturated fat in the diet
  • Being overweight/obese, especially around the waist
  • Sedentary lifestyles
  • Smoking
  • Genetic condition - familial hypercholesterolemia (FH)
  • Age - cholesterol levels increase with age
  • Diseases such as diabetes that specifically raises triglycerides

How can you tell if you have high cholesterol?

There are not many symptoms of high cholesterol; consequently it may be hard to tell that you have high cholesterol. One symptom that you may find is yellow patches, called xanthomas, on your skin. These particularly affect the skin around the eye area. Xanthomas can, however, be caused by other problems, such as diabetes, primary biliary cirrhosis and some cancers.

The main way to tell whether you have high cholesterol is to have a blood test. This may involve fasting for 10-12 hours before the test

What you can do
Lowering cholesterol through diet

Lifestyle is important for helping maintain healthy cholesterol levels. A diet containing a lot of saturated fat will increase your risk.

Foods to eat

  • Eat a diet high in fibre and rich in fruit and vegetables.
  • Soluble fibre - 20g daily. Soluble fibre is found in oats, oatmeal, barley, beans, pulses, fruit and vegetables. Soluble fibre can trap some of the cholesterol in our digestive system and excrete it before it is absorbed.
  • Choose 2-3g of plant stanols and sterols a day. These 'functional foods' occur naturally in small amounts in a range of plant foods such as fruits, vegetables, nuts, seeds, legumes, cereals and vegetable oils. They have a similar structure to cholesterol and therefore actively block cholesterol absorption from the gut. This can help achieve reductions in LDL cholesterol levels in the blood.
  • Choose healthier fats such as monounsaturated and polyunsaturated fats in olive oil, rapeseed oil, avocado, nuts and seeds.
  • Garlic, cooked or raw
  • Eat oily fish regularly. Omega-3 fats found in oily fish can help to lower blood triglyceride levels. Include herring, mackerel, sardines, salmon, trout and fresh tuna. Aim for 2-3 portions a week.

Foods to avoid

  • Cut back on saturated fat: cut off visible fat from meat and avoid fatty meat products such as sausages and burgers.
  • Avoid butter, ghee and lard and opt for healthy spreads and oils that are low in fat and cholesterol (mentioned in the label)
  • Avoid full-fat dairy products. Choose low-fat alternatives such as skimmed/semi skimmed milk and low-fat yogurt.
  • Avoid cakes, biscuits, pies and pastries.
  • Avoid pre-packaged meals and snacks.
  • Avoid foods that are trans-fat. Trans-fats are formed when vegetable oils are hydrogenated (reused and altered) to make margarines and processed foods. Avoid food that have hydrogenated oils or hydrogenated fat in the list of ingredients and try to consume more whole foods.

Lowering cholesterol through Exercise 

The NHS recommends that you do 150 minutes of moderate-intensity aerobic activity every week.( 30 mins 3 to 5 days a week). They define this activity as exercise that makes your heart beat faster and causes you to break into a sweat; yet still allows you to be able to talk whilst working.

Other recommendations

Other lifestyle recommendations for helping to lower cholesterol levels are as follows:

  • Keep your weight at a healthy level.
  • Avoid smoking.
  • Healthier alternatives such as Instead of frying foods, try other cooking methods like grilling, baking, steaming and poaching.

Once again it's about balance - the occasional cheese burger once in a few months isn't going to harm you - however, a diet high in saturated fat is not recommended long term. Consume fat judicially, cutting down gradually so you learn to live with less.
Compiled by Dr.Neelam Ismail



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