“The trouble with cholesterol is that it's not a 'sexy' subject,” says Linda Main, Dietetic Adviser with cholesterol charity HEART UK. “It's a complex area of science. Also, because raised cholesterol has no symptoms, people don't take as much notice of it as they should.”

That attitude needs to change, says Main. In fact, if we're aged between 40 and 75, we should undergo tests every five years to check our levels because raised cholesterol is linked to an increased risk of cardiovascular disease. The first sign we have a problem could be a heart-attack.

Cholesterol is a lipid (or fat) that's made in the body by the liver; and six out of 10 us have raised or abnormal levels of it. Why this gets complex — and where people get confused — is because the body makes 'good' cholesterol (HDL) and 'bad' cholesterol (LDL).


Why we need 'bad' cholesterol


To make it even more bewildering, our bodies need a certain amount of 'bad' cholesterol to function. “LDL is essential for growth, sex hormones, the production of vitamin D, the production of bile — which is needed for fat digestion — and for tissue repair, etc,” says Main. “The problem is, if we have too much of it, it can be deposited into the linings of blood vessels and, over time, fur up arteries. That can lead to circulatory problems, heart attacks and strokes.”

Our 'good' HDL cholesterol has an important part to play here. Main likens it to a team of cleaners travelling around the arteries, picking up excess LDL cholesterol and taking it back to the liver where it can be broken down and disposed of.


Understand your cholesterol results


So what's a healthy level of cholesterol? Unfortunately, that's not simple either. When you have a cholesterol test, the results will include an overall level and a breakdown of numbers to give your GP an indication of the balance between the good and bad cholesterol your body is producing. “For example, if your overall cholesterol level is 7.0, we would consider that to be raised,” says Main. “But if your HDL was at a healthy level — say 2.0 or 2.5 — we would be less concerned than if it was lower: say 0.9.”

If you are otherwise healthy — that is, you don't have heart disease or some other pre-existing condition — a good result would be a total cholesterol level below 5.0, with an HDL level above 1.0 in men and above 1.2 in women. Make an appointment with your GP who can explain the numbers to you.


Those with raised cholesterol risk


Raised cholesterol can be genetic, which may affect around 1 in 250 people. Age is also a major factor, so the older you are, the higher it will be. Eating saturated fat is another cholesterol-raising culprit. “We eat meat that contains cholesterol,” says Main. “So cutting out fatty meat and eating lean meat, such as chicken, is important. Don't forget that dairy is a saturated fat, too.” On the other hand, there is a list of food which naturally helps lower cholesterol, such as red and green lentils, porridge, baked beans, oatcakes, pearl barley, soya and tofu.

Exercise is recommended because it increases 'good' cholesterol (this doesn't necessarily entail going to the gym: a brisk walk will be beneficial); and, of course, you should cut out smoking and only drink alcohol in moderation.


How medication can help


But if your overall level still stays stubbornly high — and once other risk factors have been factored in such as family history, body mass index (BMI) and blood pressure — your GP will assess your chance of having a cardiac event or stroke over the next 10 years. If it's more than 10 per cent, you may be prescribed cholesterol-lowering medication such as statins which are well tolerated by the vast majority of people.

Raised cholesterol isn't just associated with cardiovascular disease. “It's also linked to kidney disease, dementia and circulatory problems, such as peripheral arterial disease,” says Main. “That's why the majority of UK adults should know their cholesterol levels, understand what it means for their health and take action to improve them if necessary.”

Find out more at https://heartuk.org.uk.

Learn more

At HEART UK we offer free and impartial advice on ways to manage cholesterol. We have plenty of information about statins and other medication, what food to eat to effectively lower cholesterol and tips on what to avoid. Some foods punch well above their weight in helping to reduce cholesterol levels like nuts, oats and barley and foods fortified with plant sterols and stanols  and we’ve plenty of healthy recipes to try out too.

Website: www.heartuk.org.uk/