High cholesterol

Cholesterol is a fatty substance found in the blood. It's mainly made in the body, and plays
an essential role in how every cell in the body works. However, too much cholesterol in
the blood can increase your risk of cardiovascular disease.

LDL cholesterol and HDL cholesterol

Cholesterol is carried around the body by proteins. These combinations of cholesterol and
proteins are called lipoproteins. There are two main types of lipoproteins:

 LDL (low-density lipoprotein) is the harmful type of cholesterol

 HDL (high-density lipoprotein) is a protective type of cholesterol

Having too much harmful cholesterol in your blood can increase your risk of getting
cardiovascular disease. The risk is particularly high if you have a high level of LDL
cholesterol and a low level of HDL cholesterol.

Triglycerides
Triglycerides are another type of fatty substance in the blood. They're found in foods such
as dairy products, meat and cooking oils. They can also be produced in the body, either by
the body’s fat stores or in the liver.

People who are very overweight, eat a lot of fatty and sugary foods, or drink too much
alcohol are more likely to have a high triglyceride level. People with high triglyceride
levels have a greater risk of developing cardiovascular disease than people with lower
levels.

What causes high cholesterol?

A common cause of high blood cholesterol levels is eating too much saturated fat.

However, some people have high blood cholesterol even though they eat a healthy diet.
For example, they may have inherited a condition called familial hyperlipidaemia (FH).

The cholesterol which is found in some foods such as eggs, liver, kidneys and some types
of seafood eg. prawns, does not usually make a great contribution to the level of
cholesterol in your blood. It's much more important that you eat foods that are low in
saturated fat.

How can I reduce my cholesterol level?

Cut down on saturated fats

To help reduce your cholesterol level, you need to cut down on saturated fats and instead
use unsaturated fats such as olive, rapeseed or sunflower oils and spreads. You should also
reduce the total amount of fat you eat.

Eat oily fish regularly

Oily fish provides the richest source of a particular type of polyunsaturated fat known as
omega-3. Omega-3 from oily fish can help to lower blood triglyceride levels, helps
prevent the blood from clotting, and can also help to regulate the heart rhythm.

Eat a high-fibre diet

Foods that are high in soluble fibre such as oats, beans, pulses, lentils, nuts, fruits and
vegetables, can help lower cholesterol.

Do regular physical activity

This can help increase your HDL cholesterol (the 'protective' type of cholesterol).

Will eating sterol-enriched foods help reduce my cholesterol level?

Although the effect varies between individuals, there is evidence to show that substances
called plant sterols and stanols can help to reduce LDL cholesterol levels by up to 10-15%
when 2g per day is regularly consumed as part of a healthy balanced diet. Stanols and
sterols are added to certain foods including margarines, spreads, soft cheeses and yoghurts.

But remember, these products are not a substitute for a healthy, balanced diet or a
replacement for cholesterol lowering drugs. If you decide to use these products make sure
you follow the manufacturer's instructions on the amounts you need to consume each day
to provide you with 2g of the plant stanol or sterol.

I've heard that eating too many eggs can raise your cholesterol - how
many can I eat?

For most people there is currently no limit on the number of eggs that you can eat in a
week. However, because the recommendation has changed over the years, it's often a
common source of confusion.

In the past a restriction on eggs was recommended because we thought that foods high in
cholesterol (including liver, kidneys and shellfish, as well as eggs) could have an impact
on cholesterol levels in the body.

However, as research in this area has developed, so has our understanding of how foods
that contain cholesterol affect people’s heart health.
For most people, the amount of saturated fat they eat has much more of an impact on their
cholesterol than eating foods that contain cholesterol, like eggs and shellfish. So unless
you have been advised otherwise by your doctor or dietician, if you like eggs, they can be
included as part of a balanced and varied diet.

Will I need to take medication?

Whether you need to take cholesterol-lowering drugs or not depends not just on your total
cholesterol, HDL and LDL levels, but also on your overall risk of cardiovascular disease.

Cholesterol-lowering medicines such as statins are prescribed for people who are at
greatest overall risk of suffering from cardiovascular disease.