#029 - Understanding Cholesterol

Cholesterol often gets a bad name but it plays a vital role in our body for digestion, hormone production and cell membrane formation. Too little of it and our body is unable to function and too much of it and we can develop ‘atherosclerosis’- furring up of your arteries leading to heart disease and strokes. Balance is key and a poor understanding of cholesterol can lead to poor choices.

Cholesterol is carried around the body by small molecules called lipoproteins. The important ones to remember are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). When there is excess cholesterol-carrying LDL’s, the cholesterol gets carried and absorbed into the walls of the blood vessels and contribute to atherosclerosis. Over time this increases your risk of heart disease and strokes. HDL’s do the opposite: they carry cholesterol back away from the vessels to the liver for metabolism and reduce your risk of heart disease and strokes. Hence why HDL’s are considered the ‘good cholesterol’ and LDL’s the ‘bad cholesterol’. This is a slight misnomer as cholesterol is cholesterol and the good and bad is related to the carrier proteins. In essence we want normal cholesterol levels and an adequate balance between the HDL and LDL components.

How do we get this?

Controlling our HDL, LDL and cholesterol levels involves a combination of lifestyle changes and medication. Lifestyle changes are the most important factor and in most cases are enough, however some people may have difficult to control cholesterol or inherited conditions that predispose them to very high levels of cholesterol and may require medications from their doctors.

Diet:

-Avoid trans fats (processed/fried foods).

-Limit saturated fats (red meat, full fat dairy).

-Include healthy fats (avocados, nuts, oily fish).

Exercise:

-Regular physical activity increases HDL and reduces LDL.

-150 mins aerobic exercise or 75 mins vigorous exercise per week.

Maintain a healthy body composition:

-Aim to reduce excess bodyfat whilst adding or maintaining muscle mass.

Stop smoking:

-Smoking lowers HDL levels and contributes to atherosclerosis via other mechanisms.

Limit alcohol intake:

-Moderation is key but too much alcohol impacts your HDL/LDL balance.

Attend an NHS health check:

-If you are aged between 40-74 you are eligible for a free NHS Health Check every 5 years. This includes a blood test to check your cholesterol levels.

-Enquire with your GP.

Medications:

-These will be recommended and prescribed by your GP if your cholesterol levels remain high despite lifestyle changes.

Cholesterol itself isn’t the enemy, it’s about balance. Understanding the roles of LDL and HDL cholesterol can empower you to make informed choices about your health. Through proper diet, exercise, and medical support if necessary, you can keep your cholesterol levels balanced and reduce your risk of heart disease and strokes.

Thanks

Dr Jack Maynard