High cholesterol means that you have too much of a fatty substance known as cholesterol in your body. High cholesterol or hyperlipidaemia affects people of all ages, including those who feel healthy and are active. High cholesterol usually has no symptoms, but left untreated leads to complications.

Cholesterol is deposited in the inner walls of your arteries over time, leading to the formation of plaques. These plaques increase in size, causing narrowing and hardening of your arteries. These plaques reduce blood flow through your arteries and increase your risk of developing harmful blood clots. This plaque formation is known as atherosclerosis. Atherosclerosis leads to life-threatening complications such as:

• Angina or chest pain
• Stroke
• Heart attack
• High blood pressure
• Transient ischaemic attack (TIA)
• Peripheral vascular disease
• Chronic kidney disease

Not everyone with high cholesterol needs to take medication. Some people only need lifestyle changes. Others need lifestyle changes with medication. People with underlying medical conditions that affect their cholesterol levels need a more complex approach. Your healthcare professional would consider your family history, medical history and lifestyle factors in helping you to reduce your cholesterol levels.

The following lifestyle changes can help lower your cholesterol levels.

Avoid foods high in saturated fats.

Reduce your intake of saturated fats and trans fats. Excessive intake of these fats increases LDL or “bad” cholesterol over time and increases your risk of severe health problems. The American Heart Association recommends limiting saturated fat to less than 6% of daily calories and avoiding trans fats.

Foods rich in saturated and trans fats include fatty cuts of meat, red, processed meats such as sausages, egg yolk, fried foods, fast foods, cakes and pastries. Full-fat dairy products such as whole milk, butter, cheese, sour cream and cream, ice cream, chocolates, and coconut cream contain saturated and trans fats. Opt for fat-free or low-fat dairy products and skimmed milk. Limit your intake of palm oil and coconut oil that contain saturated fats.

Eat more unsaturated fats.

Foods rich in unsaturated fats boost HDL or good cholesterol and consequently reduce bad cholesterol. HDL cholesterol carries LDL or bad cholesterol from the blood to the liver to be removed from the body.

Oily fish such as mackerel, salmon and trout are high in omega-3 fatty acids that boost good cholesterol levels and reduce bad cholesterol levels. Foods that contain monounsaturated fats and polyunsaturated fats, such as olive oil, avocado, nuts and seeds, actively work to decrease bad cholesterol.

Increase your fibre intake.

Foods high in fibre, such as whole grains, fruits and vegetables, contain a type of fibre called beta-glucans that bind to bad cholesterol and help excrete it from your body. Fibre also reduces high blood sugar. When blood sugar is high, more triglycerides are present, thus increasing cholesterol production. Good sources of fibre are oats, wheat, beans, chickpeas, broccoli, avocados, spinach, apples and dried fruits.

Reduce your sugar intake.

Limiting sugar from your diet can lower your cholesterol levels. Excessive sugar intake causes your liver to produce more LDL cholesterol while reducing HDL cholesterol. High sugar levels in the blood also increase triglycerides, which increase cholesterol production. Also, limit your intake of salt.

Exercise

Exercise boosts HDL or good cholesterol levels, lowers blood pressure, reduces the risk of atherosclerosis, and helps you lose weight. At least 150 minutes of moderate-intensity aerobic exercise during the week can lower cholesterol levels. Physical activity such as brisk walking, jogging, swimming, cycling or vigorous outdoor work for 30 minutes on most days of the week will help reduce your cholesterol levels. Losing weight and maintaining a healthy weight will also lower cholesterol.

Reduce your alcohol intake.

Excessive alcohol consumption can raise your triglyceride levels – a type of blood fat that increases cholesterol production.

Stop Smoking

Smoking lowers your HDL cholesterol and raises LDL cholesterol.

Stress

Managing stress will help lower high cholesterol levels. Stress triggers hormonal changes that cause your body to produce cholesterol. Stress also promotes inflammatory markers associated with cardiovascular disease.

References

American Heart Association. Prevention and treatment of high cholesterol. (https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia)

Mayo Clinic. High Cholesterol. (https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800)

Healthline. Everything you need to know about high cholesterol. (https://www.healthline.com/health/high-cholesterol)

Cholesterol is a type of fat (lipid) found in the body. The liver produces all the cholesterol your body needs. Other sources of cholesterol are from foods from animal sources such as meat, poultry and dairy products. As dietary fat intake increases, the liver adjusts by decreasing its production of cholesterol.

Cholesterol is needed in the body to build cells and make vitamins and other hormones. However, too much cholesterol cannot be used by the body. The excess cholesterol or lipids is deposited in your blood vessels. These deposits increase in size over time, forming plaques and making your arteries hard and narrow, leading to a medical condition known as atherosclerosis. These plaques block your arteries, thus reducing the blood flowing through your arteries. This can result in high blood pressure. The cholesterol deposits can suddenly break off and form clots that cause a heart attack or stroke.

Good Cholesterol and Bad Cholesterol

Cholesterol circulates through the blood attached to proteins. This combination is known as a lipoprotein. There are different types of cholesterol based on what the lipoprotein carries. The main ones are:

• High-density lipoprotein or good cholesterol (HDL) – Good cholesterol or HDL transports excess cholesterol to your liver to be removed from your body. Your liver produces enough cholesterol for your body’s needs and disposes of the rest. If your HDL is too low, there will be too much cholesterol circulating in your blood.
• Low-density lipoprotein or bad cholesterol (LDL) – LDL or “bad” cholesterol transports cholesterol throughout your body. LDL cholesterol builds up in the inner walls of your arteries, making plaques form in your arteries. Too much LDL cholesterol increases your risk of cardiovascular disease.

The most common type of fat in the body is triglycerides. They store excess energy from your diet. High triglyceride levels with high LDL cholesterol or low HDL cholesterol also increase your risk of heart disease.

Causes of High Cholesterol

High cholesterol, also known as hypercholesterolemia or hyperlipidaemia can be inherited, but the most common cause of high cholesterol is poor lifestyle choices such as physical inactivity, eating a diet high in saturated fats and drinking too much alcohol.

Unhealthy diet

Eating too many foods that are high in cholesterol, saturated fats, and trans fats may increase your risk of developing high cholesterol. Fatty meat, poultry, and full-fat dairy products like butter, cheese and cream contain dietary cholesterol and saturated fats and can increase cholesterol levels. Palm oil, palm kernel oil and coconut oil contain saturated fat that can increase bad cholesterol. Snacks and desserts such as cakes, meat pies, sausages and biscuits are high in saturated and trans fats.

Physical Inactivity

Exercise helps to reduce LDL cholesterol or bad cholesterol and helps improve HDL cholesterol levels.

Obesity

Being overweight or obese predisposes you to having high cholesterol levels.

Stress

Being under a lot of stress causes your body to produce cholesterol by triggering hormonal changes.

Alcohol

Drinking too much alcohol can raise your total cholesterol level.

Smoking

Smoking increases bad cholesterol (LDL) and decreases good cholesterol (HDL).

Age

The liver removes LDL cholesterol from your bloodstream. As you age, this process decreases. Even though young people can have high cholesterol, it is more common in people over 40 years.

 Medications

Some medications used to treat other health conditions can increase your cholesterol levels. These include medications for the following conditions:

• High Blood Pressure
• Irregular heart rhythms
• Acne
• Cancer
• HIV/AIDS
• Organ Transplants

Medical Conditions

Some medical conditions can increase your risk of developing high cholesterol. These include:

• Chronic Kidney disease
• Diabetes mellitus
• Thyroid disease
• HIV/Aids
• Polycystic Ovarian Syndrome
• Lupus

Symptoms of High Cholesterol

High cholesterol usually has no symptoms. A blood test is the only way to detect it.

Prevention

Healthy lifestyle changes can help lower your cholesterol levels. Eat a healthy diet rich in fruits, vegetables, whole grains, poultry and fish. Limit your intake of fatty, red meat and full-fat dairy products. Limit fried foods, salty and sugary foods and unhealthy oils.

Engage in at least 150 minutes of moderate-intensity aerobic exercise a week. Lose excess weight and maintain a healthy weight. Manage your stress levels. Stop smoking and reduce your alcohol intake.

References

American Heart Association. What is Cholesterol? (https://www.heart.org/en/health-topics/cholesterol/about-cholesterol)

American Heart Association. Causes of High Cholesterol. (https://www.heart.org/en/health-topics/cholesterol/causes-of-high-cholesterol)

Cleveland Clinic. High Cholesterol diseases.  (https://my.clevelandclinic.org/health/articles/11918-cholesterol-high-cholesterol-diseases)

Mayo Clinic. High Cholesterol. (https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800)