Most people associate the word ‘cholesterol’ with obesity, ill-health, and increased risk of heart attack. Whilst it’s certainly true that some forms of cholesterol can spell bad news for your health, it’s important to know that not all cholesterols are the same. In fact, some actually offer significant health benefits.
If you’re confused, here’s a helpful guide to break it down.
‘Good’ and ‘Bad’ Cholesterol: What Are They?
Cholesterol can be found naturally within the body, and we also obtain it from certain foods. It can’t be dissolved in the blood, and instead has to be moved through the bloodstream by lipoproteins, a type of fatty substance.
- Bad Cholesterol. ‘Bad’ cholesterol has an official name, and this is Low Density Lipoprotein cholesterol, or LDL. This substance is what is responsible for approximately 50% of all heart attacks in the UK. It contributes to the build-up of plaque, which is a hard deposit that clogs up arteries, restricting the flow of blood around the body.
- Good Cholesterol. This type of cholesterol, also known as HDL or High Density Lipoprotein cholesterol, actually helps to remove ‘bad’ cholesterol from the arteries. According to the American Heart Association, it acts as a type of scavenger, transporting ‘bad’ cholesterol to the liver, where it can be broken down safely.
Listen to Dr Chris talking about Cholesterol on the video below:
Cholesterol and Saturated Fats
LDL, or ‘bad’ cholesterol doesn’t necessarily need to be avoided entirely, but it should be limited within your diet, in order to maintain healthy arteries and reduce the risk of heart disease.
The most common types of food to contain ‘bad’ cholesterol are those high in saturated fats. Nutritionist Carina Norris states: “Saturated fats have a more dramatic effect on our cholesterol levels, because they raise levels of LDL.”
The official daily allowance of cholesterol is 300mg or less. However, this figure is largely unhelpful, as most people don’t know what this equates to, in terms of food. To give some idea, 30g of cheddar cheese contains around 19mg, and an egg contains approximately 213mg.
Men should aim to eat 27g or less of saturated fats per day, and women should aim for 22g or less. Foods high in saturated fats include: red meats, high fat dairy foods such as cream and butter, hard cheeses, not to mention many ‘sweet’ treats, such as ice cream, biscuits and cakes.
Boosting Good Cholesterol
There are number of foods that are believed to offer considerable health benefits when it comes to boosting levels of HDL cholesterol. Here are just a few:
- Oily fish. Oily fish, such as tuna and salmon, contain Omega-3, which many scientific studies have proved to be useful in lowering cholesterol in the body.
- Beans. According to a study undertaken at the University of Kentucky College of Medicine, eating just one cup of cooked beans per day reduced LDL cholesterol by 20%.
- Onions and garlic. According to a study from Harvard Medical School, eating half a raw onion a day boosted levels of ‘good’ cholesterol by as much as 30%. Another study revealed that eating three fresh cloves of garlic a day lowered ‘bad’ cholesterol by 7% and increased ‘good’ cholesterol by 23% over the course of a month.
- Oatmeal. The soluble fibre in oats or oatmeal can help bad cholesterol from being absorbed into your bloodstream.
- Olive Oil. Research has shown that a heart healthy Mediterranean diet rich in olive oil can be beneficial.
Concerned About Cholesterol?
If you’re concerned about your cholesterol levels, it’s a good idea to speak to your doctor. If you’re aged from 40 to 75, you’re entitled to a free cholesterol test within the NHS.
With just weeks to go to National Heart Month, The Best of Health speaks to Linda Main, dietetic adviser of HEART UK – The Cholesterol Charity, about how to keep your cholesterol levels in check
TBOH: How important is lowering bad cholesterol to maintaining good heart health?
Linda Main (LM): There is a straight-line relationship between the amount of LDL (bad) cholesterol in our blood and the risk of cardiovascular disease (stroke and heart attack), so most doctors agree the lower your LDL cholesterol the better.
LDL (bad) cholesterol is key to the furring up and narrowing of the arteries which leads to angina, heart disease and some forms of stroke. People with raised cholesterol and other risk factors such as smoking, high blood pressure or diabetes are at even higher risk.
TBOH: What are the main issues with people in their 50s and over fighting high cholesterol levels today?
LM: Cholesterol levels increase as we get older so it’s a common problem for people over 50. Genetics and lifestyle play a big part in whether you are affected. A healthy diet, being physically active, not smoking and taking cholesterol lowering medication are the four cornerstones of having healthy cholesterol levels.
Changing your diet, giving up smoking and being more active can all be challenging for people. Statins, are commonly prescribed for people at significant risk of cardiovascular disease. Sadly, due to the negative press they have received, there is resistance to taking them. But statins are generally well tolerated very safe and save lives so more people could benefit.
TBOH: What advice would you give to people who are concerned with their bad cholesterol levels?
LM: It is never too late or too early to do something about your cholesterol levels. Talk to your doctor about the risk that your cholesterol levels pose for you. Your doctor should be able to do a “cardiovascular risk assessment” or “health check” which involves taking some information about your health, your age, size, gender and family history and putting this into a computer programme.
The computer will generate a risk score for you – which tells the doctor how big your risk of having a heart attack is over the next 10 years. If your score is moderate or high your doctor should advise you to take some action to reduce your risk. Any changes you can make to your lifestyle will help delay the age at which you are likely to have a heart attack. You can check your own risk and find out your heart age at www.heartage.me.
There is much that individuals can do to lower their cholesterol, such as being more active, stopping smoking and eating a healthier diet. A heart healthy diet is one that is rich in fruit, vegetables, pulses, whole grains, lean meat, fish, low fat dairy foods and vegetable proteins.
We advise a diet that is low in saturated fat, which avoids fatty meats and meat products, dairy fats such as butter, cheese, full cream milk, lard, pastry, pies, pudding, cakes, biscuits, palm and coconut oils. There are also cholesterol busting foods that can actively lower your cholesterol, such as oats and barley, nuts, soya foods and products that have been fortified with plant sterols and stanols. For more food advice, take a look at HEART UK’s own cholesterol lowering diet, the Ultimate Cholesterol Lowering Plan.
TBOH: How have supplements developed over the years to help people lower their bad cholesterol levels?
LM: The dietary focus of cholesterol lowering is based on eating a healthy balanced diet. There are few supplements that can impact your cholesterol levels directly. Red yeast rice contains a natural form of statins, the preferred cholesterol lowering drug but unlike medicines the amount of the active ingredient can vary from product to product.
There are also supplementary forms of plant sterols and stanols and these can also lower cholesterol although most research has been conducted in fortified foods such as spreads, yoghurts and drinks. If you decide to take a supplement to lower your cholesterol you should keep your GP informed.
TBOH: Are there any supplements that you suggest people should take to lower their bad cholesterol levels?
LM: HEART UK’s advice would be to have a healthy balanced diet first and foremost. However, adults over the age of 65 should really be taking a vitamin D supplement, because they are at risk of deficiency and there are few vitamin D rich foods. Bone pain is a common symptom of vitamin D deficiency and can be mistaken for statin related muscle pain.
The body’s vitamin D stores are really low at this time of year (January), so this is a good time to start – a supplement providing 5mcg to 20mcg a day is a good level to aim for.
TBOH: How has the number of people with high bad cholesterol in the UK changed over the years?
LM: Roughly six in ten adults have cholesterol levels over 5mmol/l [the world standard unit for measuring glucose in blood] which is considered higher than desirable. About 1 in 500 people have a condition called familial hypercholesterolaemaia where they have double the normal level of cholesterol from birth.
These figures have not really changed over time, despite the availability of medicines and supplements that can lower cholesterol. This suggests more and more of us have high cholesterol, but that many are having their cholesterol lowered through medication.
TBOH: Why do you think cholesterol has become such a big issue in the UK?
LM: There is definitely more awareness of high cholesterol among the general public and I hope some of that is down to HEART UKs work in raising the awareness of the dangers of high cholesterol through the media, our website and our outreach work. Also, the UK has an ageing population so it is understandable that they are more aware of their cholesterol levels. Sadly, there are people who are at risk and are completely unaware of this.
HEART UK’s mission is to ensure that the majority of adults know their cholesterol levels, understand what it means for their health and are empowered and enabled to take action to lower their risk.