Receiving a diagnosis of high cholesterol can be concerning, but it’s important to know that you’re not alone; approximately 53% of adults in the UK have total cholesterol levels exceeding the recommended limits. This article will explore what cholesterol is, the health risks associated with elevated levels, and potential steps you can take if your cholesterol numbers are high.
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What is Cholesterol?
Cholesterol is a fatty, waxy substance essential for nearly every cell in our body. It plays a critical role in forming cell membranes and synthesizing hormones such as estrogen and testosterone. Additionally, cholesterol aids in nerve repair, contributes to the bile needed for fat digestion, and is vital for producing vitamin D. It also enhances memory and elevates mood by facilitating the production of serotonin, the mood-regulating hormone.
However, while cholesterol is necessary for our health, excessive amounts of certain types can increase the risk of heart attacks and strokes. For years, high total cholesterol was considered a major threat to heart health, but recent research indicates that it’s a more nuanced issue.
Learn everything you need to know about high cholesterol. Additionally, browse our cholesterol-friendly recipes, heart-healthy recipes, and low-fat meals.
What is High Cholesterol?
Your doctor will assess your cholesterol levels through a straightforward blood test, which may involve drawing blood from your arm or using a finger prick test. If you are over 40 and have never been tested, are overweight, have a genetic tendency toward high cholesterol, or have a heart condition, you may qualify for an NHS cholesterol test. People over 40 can also access a midlife health check, which includes cholesterol reviews, available every five years through the NHS.
In the UK, cholesterol levels are measured in millimoles per litre (mmol/L), with the current recommendations being:
- Total cholesterol: below 5mmol/L
- HDL (high-density lipoprotein): above 1.00mmol/L for men and above 1.2mmol/L for women
- Non-HDL: below 4.00mmol/L (this figure represents your total cholesterol minus HDL and mainly consists of LDL and other less favorable types)
- LDL (low-density lipoprotein): below 3.00mmol/L (this is an estimate).
You may be diagnosed with high cholesterol (hyperlipidemia) if your total cholesterol level is excessive. It’s crucial to ask your healthcare provider for an explanation of the different numbers reported, as this understanding is key to grasping the implications of your cholesterol level.
Explore what your cholesterol numbers mean.
Who is Affected by High Cholesterol?
Various factors can influence cholesterol levels, resulting in many of us potentially being affected, including:
- Your diet, particularly foods high in saturated fats such as processed meats and fast foods that may also contain trans fats, along with highly refined carbohydrates
- Your weight—being overweight or obese, particularly with high levels of visceral or abdominal fat
- Smoking, which can adversely affect the balance of different cholesterol types
- Excessive alcohol consumption, which raises cholesterol and other blood fats
- Medical conditions, including diabetes, chronic kidney disease, and HIV
- Certain medications, including some blood pressure medicines and treatments for HIV
- Your age—cholesterol levels typically rise as we get older
- Your gender—women often see an increase in cholesterol levels after menopause
- Having recently given birth, which may elevate your cholesterol levels
- Your genetics—family history of high cholesterol can increase your risk
- The time of year—cholesterol levels tend to be higher during colder months
What Are the Symptoms of High Cholesterol?
High cholesterol is generally asymptomatic, although certain risk factors may suggest potential issues. Indicators include obesity, smoking, heavy drinking, inadequate sleep, and high stress levels. Diets rich in saturated fat, ultra-processed foods, refined carbs, and processed meats are further warning signs.
A family history, particularly if it includes familial hypercholesterolemia, could also be relevant. Over time, possible symptoms may emerge, such as fatty deposits on the skin, yellowish areas around the eyes, or a pale ring around the iris. Other signs may include swollen tendons or bumps near joints, like the knuckles.
What Are the Health Implications of High Cholesterol?
Cholesterol levels are significant because they provide insight into your risk of heart disease. Cholesterol is one of many factors that can indicate an increased likelihood of heart attack or stroke, alongside high blood pressure, diabetes, smoking, and inactivity. High cholesterol can accumulate in the arteries, leading to atherosclerosis or hardening of the arteries. While cholesterol might not seem like the sole significant factor for those concerned about heart health, ignoring it could overlook an important piece of the overall heart disease puzzle.
Elevated cholesterol levels are particularly concerning if they remain elevated over time. Fluctuating total cholesterol and triglyceride levels during mid-life (after age 60) may be linked to a higher risk of dementia and Alzheimer’s in later years, although more research is necessary to confirm this.
High levels of blood fats and cholesterol can also serve as risk factors for non-alcoholic fatty liver disease, obesity, diabetes, and the eye condition known as glaucoma.
In some cases, high cholesterol might indicate an underlying health issue. For example, thyroid dysfunction can lead to elevated blood fats. After treatment, cholesterol levels typically normalize. Other conditions linked to increased cholesterol include growth hormone deficiency, kidney disease, and gout.
Is High Cholesterol Linked to Diet?
It was previously thought that eggs were a major culprit in increasing cholesterol levels; however, we now understand that this is not the case, as only a small fraction of dietary fat contributes to blood cholesterol. You’d need to consume a significant quantity of such foods to adversely affect your cholesterol levels. A high intake of saturated and/or trans fats, however, is likely to elevates cholesterol levels.
Moreover, high consumption of refined carbohydrates, particularly pastries, cakes, and biscuits made from white flour that have a high glycemic impact (causing spikes in blood sugar and insulin) can contribute to undesirable shifts in blood fats, including cholesterol production.
Ways to Lower High Cholesterol
Making dietary adjustments can significantly aid in managing high cholesterol levels. Consider the following changes:
- Reduce intake of saturated and trans fats (found in red meat, butter, and coconut oil, as well as fast foods and takeaways)
- Limit refined and processed foods (such as pastries, bread, and biscuits)
- Focus on mono- and polyunsaturated fats found in oily fish, nuts, seeds, and olive oil
- Increase your intake of plant-based foods like beans and pulses
- Incorporate more sources of fiber, particularly soluble fiber from oats and flaxseeds to help eliminate excess cholesterol
- Foods such as avocado contain plant stanols and sterols that hinder cholesterol absorption
- Consume a wide variety of fruits and vegetables to protect blood vessels and reduce inflammation that may contribute to artery plaque
- Increase physical activity
- If you smoke or vape, quit
- If you drink alcohol, adhere to guidelines
- Achieve and maintain a healthy weight based on your height, age, and gender
For additional tips, refer to our guide on ten ways to lower cholesterol.
Do I Need to Know My Cholesterol Numbers?
While cholesterol is essential for life, understanding your cholesterol levels is crucial as they contribute to your overall heart disease risk. Elevated levels can also indicate underlying health issues, underscoring the importance of not ignoring this important health metric.
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Kerry Torrens BSc. (Hons) PgCert MBANT is a Registered Nutritionist with a postgraduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and the Guild of Food Writers. Over the past 15 years, she has contributed to numerous nutritional and cooking publications, including Good Food. Follow her on Instagram at @kerry_torrens_nutrition_
All health content on goodfood.com is for general informational purposes only and should not replace advice from your doctor or other healthcare professionals. If you have concerns about your health, consult your local healthcare provider. For more information, see our website’s terms and conditions.
