Recently I have had 4 friends, all of whom I would say have reasonably healthy diets and exercise regularly, who have been told they have high cholesterol levels. Genetic factors can play a part, but I wanted to delve deeper into what their stats truly mean and what they could do to improve their situation. Here is what I learned…
What is cholesterol?
Cholesterol is a waxy, fat-like substance that is found in the cells of your body. It is produced by the liver and is also found in certain foods. Cholesterol plays a crucial role in the body as it is involved in several important function, including:
- Maintaining cell membrane structure through the body, keeping them flexible and permeable.
- Cholesterol is a precursor molecule for the production of several hormones including cortisol, aldosterone, progesterone, oestrogen and testosterone.
- Production of bile acids which are necessary for the digestion and absorption of dietary fats.
- Aiding in vitamin D production.
- Contributes to myelin sheath formation around nerves in the brain and spinal column and cellular signalling. It therefore plays a part in keeping our ability to think an react quickly.
- Acts as an antioxidant, so helps to neutralise free radicals that can cause cell damage in the body.
So it seems it is important for us to have cholesterol in our body. But we need the right sort and not too much.
What do you mean by the right sort of cholesterol?
Cholesterol is transported in the bloodstream in the form of lipoproteins. There are two main types of lipoproteins low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL cholesterol is often referred to as "bad" cholesterol because high levels of it can contribute to the build-up of plaque in the arteries, increasing the risk of heart disease and stroke.
HDL cholesterol is often called "good" cholesterol because it helps remove excess cholesterol from the bloodstream and carry it back to the liver for processing and excretion.
I like to remember this with L standing for low, feeling low, and H standing for happy 🙂
Why does it matter if it's high?
Excessive levels of LDL or imbalances of the two cholesterol types can have negative effects. High levels of LDL cholesterol and the formation of plaque in the arteries can impair blood flow to the brain, increasing the risk of cognitive decline, heart disease and neurodegenerative diseases.
For people who nurture an unhealthy lifestyle (they smoke, don't exercise, eat unhealthy food, don’t sleep enough), their blood vessel walls get damaged and their bloodstream gets filled with fats in the blood. It’s too much fat for the blood stream to cope with, so it starts to deposit the fat on the sides of the blood vessel walls. The walls then become lumpy and constricted, which results in blood flow becoming more challenging. This can lead to higher blood pressure and heart disease.
How do I know if I have high cholesterol?
Your doctor will do a test that looks at how much lipids (fats) are in your blood stream. This is called a lipid profile. They can tell you the amount of LDL and HDL in your blood stream and a ratio for this. The values you want vary depending on your age and whether you have any health conditions such as diabetes or cardiovascular disease. But roughly speaking you want:
| Healthy levels for different types of cholesterol. | |
| Result | Healthy level |
| Total cholesterol | 5mmol/L or below |
| Total cholesterol to HDL cholesterol ratio | Below 6 |
| HDL (good cholesterol) | 1mmol/L or above for men or 1.2mmol/L or above for women |
| Non-HDL (bad cholesterol) | 4mmol/L or below |
[Taken from NHS website]
Which foods increase your cholesterol levels?
If you are constantly eating any of the foods below you will slowly be increasing the amount of fats in your blood stream. You don’t need to avoid them 100% of the time, but rather look at them as occasional treats.
- Red meats like beef, lamb and pork (particularly if you don’t remove the fat)
- Processed meats like bacon, ham and sausages
- Greasy fatty fried foods – burgers, fried chicken, chips etc
- Fast food
- Butter, lard, margarine and palm oil
- Baked goods – pastries, cakes, biscuits etc.
- Alcohol
Interestingly, contrary to NHS advice, newer evidence suggests you do not need to give up:
- Cheese and plain natural yoghurt. Despite being high in saturated fat, it looks like fermented dairy products like cheese and yoghurt contain crucial naturally occurring gut microbes that actually result in an improved lipid profile: reducing LDL and increasing HDL (1). Although they are still high in calories so you may want to consider just sticking to small portions if you want to keep a check on your weight. Also mix up the cheeses that you choose to get more variety in the microbes you are getting.
- Coconut oil. Although coconut oil is high in saturated fats, some studies that have looked at the effect of extra virgin coconut oil on lipid profiles and have found them to have beneficial effects. (2)(3) But further study is definitely needed for a definitive answer on this one.
The 40 trillion bacteria in our guts (our microbiome) also play a crucial role in getting the extra fat out of our bloodstream and thus improving cholesterol levels. So, avoiding things that kill your good bacteria are also critical: alcohol, sugar, preservatives, pesticides, additives, ultra-processed foods etc. The usual suspects basically.
What can I eat to help reduce my levels?
Our blood vessels are designed to cope with lots of foods and they manage them well. If we eat plant-based foods the nutrients that we absorb from them actually are beneficial and they protect and, in some cases, rebuild that smooth lining of the blood vessels.
So, eat lots of high-fibre foods, legumes, nuts, seeds, fruits, whole grains and vegetables. These will feed the microbiome (good bacteria) and also help to regenerate the damaged blood vessel linings. They contain bioactive chemicals that stimulate regeneration. In particular blueberries and dark chocolate contains anthocyanin which helps renew and replace those old damaged liner cells in your blood vessels.
Another thing that helps is replacing unhealthy saturated fats with healthier fats such as omega-3’s found in foods such as oily fish, nuts, seeds and seafood.
What medication is given for high cholesterol?
Statins are the most commonly prescribed drug for high cholesterol. They work by metabolically lowering the amount of cholesterol and other lipids/fats that float around in the blood. They cut through the grease, much like washing up liquid in a greasy pan.
However, usually once someone starts taking statins, they will never stop taking them. Statins have side effects that can cause damage to muscles, the kidneys and the liver. They can also cause gastrointestinal issues, headaches and can slightly increase blood sugars. So, for all these reasons, they are not the ideal solution. Many people wish to try alternative natural routes instead before starting on statins.
HRT Interestingly the Zoe predict study found that peri-menopause and menopause created a sudden increase in cholesterol in women even thought their diet and lifestyle had not changed. So the lack of oestrogen protecting these women was allowing bad cholesterol to increase. So taking oestrogen in the form of HRT may help with keeping cholesterol down.
What other lifestyle factors make a difference?
- Getting regular exercise really helps. Regular physical activity gets the blood flowing round the body more easily and so fats can be transported away more efficiently.
- Stopping smoking. Smoking increases cholesterol levels and damages blood vessel linings so it is critical for people with high cholesterol to attempt to stop.
- Constant high stress levels have been found to increase LDL levels and decrease HDL levels. So, finding ways to destress daily is critical for cholesterol levels and for many many more health reasons.
- Getting more sleep. Higher sleep has been shown to increase HDL ‘good’ cholesterol and lower levels of LDL.
I hope this helps some of you out there. Good luck with making those improvements 🙂
If you need some help eating more healthily along these lines, join me for my next 21 Day Reset plan where you'll learn how to cook amazing food that will nourish your blood vessels and make your gut stronger.
