Understanding cholesterol is essential for maintaining heart health. We consulted our nutritionist to clarify what cholesterol is, its role in the body, and expert recommendations for managing cholesterol levels effectively.
Explore our extensive collection of health benefit guides, and learn more about saturated fat and recommended daily fat intake.
What is Cholesterol?
Cholesterol is a waxy fat-like substance, with about 75% produced by the liver and the remaining 25% derived from the foods we consume. For many years, total cholesterol has been regarded as detrimental to heart health, though recent studies indicate that the situation is more nuanced.
Cholesterol in the bloodstream requires transport proteins known as lipoproteins. These are commonly labeled as ‘bad’ cholesterol (low-density lipoproteins or LDL) and ‘good’ cholesterol (high-density lipoproteins or HDL). However, the truth is more complex; both LDL and HDL exist in various forms, with smaller, denser types posing higher risks. Your individual profile of LDL and HDL depends not just on genetics but also on dietary choices and lifestyle.
Why is Cholesterol Necessary?
Despite longstanding fears surrounding cholesterol, it is crucial for optimal bodily function. Cholesterol is essential for building cell membranes, generating hormones like estrogen and testosterone, repairing nerves, producing bile for fat digestion, and synthesizing vitamin D. Additionally, cholesterol enhances memory and mood by aiding in the production of serotonin, the hormone associated with happiness.
What Are Triglycerides?
Cholesterol is not the sole type of fat in your bloodstream. If you’ve undergone a blood test to check cholesterol levels, you might have also been informed about your triglyceride levels. Triglycerides serve as the primary storage form of fat in the body, and elevated levels can significantly increase the risk of heart disease.
What Symptoms Indicate High Cholesterol?
For many, high cholesterol does not present noticeable symptoms—often detected only through blood tests or following a heart attack or stroke. An exception occurs for individuals with familial hypercholesterolemia, particularly in advanced stages where visible indications may arise, including:
- Small yellow lumps on the skin near the eyes, knuckles, feet, elbows, or knees
- A pale white ring around the iris of the eye
How Can I Test My Cholesterol Levels?
Cholesterol and other blood lipids can be easily measured via a simple blood test conducted by your doctor. Further details on cholesterol testing are available on the NHS website. It is advisable to request a cholesterol test if you have not had one before, or if you are over 40, overweight, have a family history of high cholesterol or heart issues, or suffer from familial hypercholesterolemia.
Do Dietary Fats Contribute to High Cholesterol?
Fat has historically faced scrutiny, especially saturated fat, which has been linked to cardiovascular disease and elevated cholesterol. Foods like red meat, butter, cheese, and processed meats are high in saturated fat, often accompanying ghee, coconut, and palm oils. Diets abundant in saturated fats can elevate blood lipids and heighten risks for obesity, heart disease, type 2 diabetes, and stroke. Nevertheless, recent research indicates that saturated fats in products such as cheese may not be as detrimental as previously thought, likely due to beneficial nutrients found in these foods like calcium or fermentation processes that may mitigate their impact on triglyceride levels.
Which Dietary Factors Should I Prioritize for Heart Health?
Increasing evidence suggests that excessive consumption of sugary, refined carbohydrates fosters inflammation, elevated insulin levels, high blood pressure, and increased cholesterol and triglyceride levels. You might also have heard of trans fats—artificial fats that behave similarly to saturated fats, but with potentially worse effects because the body struggles to recognize them. These are commonly found in processed foods. Minimize their intake by preparing meals from scratch and reading food labels carefully for terms like hydrogenated or partially hydrogenated vegetable fats.
How Can I Determine if a Product Is High or Low in Fat?
A practical approach to monitoring fat intake involves adopting the habit of reading food labels. Check the nutritional panel on the package, focusing on the ‘per 100g’ column to assess both ‘total fat’ and ‘saturated fat’ content. Here’s a guideline:
Total Fat:
- High: over 17.5g of fat per 100g (packaging may be marked red)
- Low: 3g of fat or less per 100g (packaging may be marked green)
Saturated Fat:
Look for the terms ‘saturates’ or ‘sat fat’ on labels, indicating saturated fat content.
- High: over 5g saturates per 100g (packaging may be marked red)
- Low: 1.5g saturates or less per 100g (packaging may be marked green)
If the fat or saturated fat value lies between these figures, it’s considered medium and may be marked amber on the packaging.
How to Lower Cholesterol
A balanced and nutritious diet is vital for overall health, particularly when it comes to heart health. Consider incorporating the following food categories that are particularly beneficial for maintaining normal cholesterol levels.
1. Prioritize Unsaturated Fats and Limit Saturated Fats
Replacing some saturated fats in your diet with unsaturated fats has been shown to be advantageous for heart health. Aim for a significant amount of monounsaturated fats, such as those found in avocados and olives, and polyunsaturated fats, particularly the omega-3 fatty acids prevalent in oily fish such as sardines, mackerel, salmon, and trout.
It’s essential to adhere to reference intakes—the daily recommendations for key nutrients. Aim for no more than one-third of your daily fat intake to be saturated, with the rest coming from monounsaturated and polyunsaturated sources like olive oil, rapeseed oil, unsalted nuts, and seeds.
Explore these enticing recipes…
Almond Butter
Fish Tagine with Saffron & Almonds
Sesame Salmon with Broccoli & Sweet Potato Mash
Mediterranean Sardine Salad
Avocado Salad
Chunky Tomato & Avocado Salsa
2. Consume Dairy Foods in Moderation
The fats in fermented dairy products such as yogurt, kefir, and cheese are not as harmful to cholesterol as once believed. Nonetheless, moderation is key. For plant-based alternatives, consider fortified soya products, as soy has natural cholesterol-lowering properties.
Try these delightful dairy recipes:
Raspberry Kefir Overnight Oats
Peach & Orange Yogurt Pots with Ginger Oats
Orange & Dark Chocolate Yogurt Bowls
Healthy Salmon Bowl
Cajun Chicken Traybake with Sweet Potato Wedges & Chive Dip
3. Incorporate 2-4 Servings of Oats or Barley Daily
Research indicates that oats and barley can effectively manage cholesterol levels. Both grains are abundant in a soluble fiber known as beta-glucan, which forms a gel that binds to cholesterol and limits its absorption. Consuming around 3g of beta-glucan daily—achievable through three servings of oats or barley—has been shown to make a positive impact. If a product claims to “lower cholesterol,” it should include at least 1g of beta-glucan per serving.
Consider these recipes:
Apple & Linseed Porridge
Vanilla-Almond Chia Breakfast Bowl
Pink Barley Porridge with Vanilla Yogurt
Squash & Barley Salad with Balsamic Vinaigrette
Bean & Barley Soup
4. Add Foods with Plant Sterols or Stanols
Plant sterols and stanols resemble cholesterol in size and shape. When consumed, they help block some cholesterol absorption in the intestines and inhibit its production in the liver, thereby contributing to lower LDL-cholesterol levels.
Avocados are a rich source of these compounds. Nonetheless, reaching the recommended levels through diet alone would require substantial consumption. Consequently, many food manufacturers have integrated sterols or stanols into products like yogurt, dairy drinks, spreads, and milk. It is advisable to consume 1-3 servings daily to achieve a total of 1.5g to 3g of sterols or stanols.
Please Note: These foods are unsuitable for pregnant or breastfeeding women and children.
5. Incorporate Oily Fish into Your Diet Twice a Week
Consume two portions (140g each) of oily fish each week, or more often if you have a history of heart problems. The omega-3 fatty acids found in these fish types can help reduce harmful blood triglycerides. Options include herring, mackerel, pilchards, sardines, trout, and fresh tuna.
Explore these oily fish recipes:
Tuna Steaks with Cucumber Relish
Basil & Lemon Chickpeas with Mackerel
Grilled Mackerel with Harissa & Coriander Couscous
Tandoori Trout
6. Emphasize Dietary Fiber
Opt for whole grain carbohydrates like wholemeal bread, brown rice, and wholemeal pasta instead of their white refined counterparts. These whole grains are nutrient-dense and fiber-rich.
Fiber, particularly soluble fiber, slows digestion and aids in cholesterol elimination. Other foods high in soluble fiber include sweet potatoes, beans, peas, and lentils.
Try these satisfying recipes:
Lentil Salad with Tahini Dressing
Spinach, Sweet Potato & Lentil Dhal
Mexican Bean Soup with Guacamole
Tomato Penne with Avocado
7. Reduce Sugary Foods and Refined Carbohydrates
Cookies, cakes, and sugary drinks are loaded with sugar and calories while offering minimal nutritional benefit. Consistent consumption can lead to weight gain and increase triglycerides.
Consider these healthier treats:
Matcha with Vanilla
Raw Raspberry Shrub
Healthy Flapjacks
Healthy Cookies
8. Frequently Include Nuts
While often seen as high in fat, nuts are an excellent snacking choice. They are primarily composed of unsaturated fats, offer a good source of dietary fiber, and contain micronutrients like vitamin E, magnesium, and potassium, all of which contribute to heart health.
Aim for a daily portion of unsalted nuts (about 30g). Choose those with their skin intact for added beneficial plant compounds known as polyphenols.
Learn more about the health advantages of nuts.
9. Maintain Balanced Intake of Fats, Proteins, and Carbs
Regular eating intervals help maintain balanced blood sugar levels and prevent extreme hunger, which can lead to unhealthy food choices. Distributing your fat intake evenly throughout the day allows the body to metabolize it better, reducing the risk of inflammation—an issue that can harm your arteries and increase the likelihood of heart disease and stroke.
10. Educate Yourself on Healthy Choices
Knowledge is vital when it comes to making health-conscious decisions. When dining out, request to see menus with nutritional data or check online beforehand. If this information isn’t available, select steamed, poached, or grilled dishes while avoiding those that are fried, sautéed, heavy in butter or cream.
Which Lifestyle Factors Influence Cholesterol Levels?
Your lifestyle significantly impacts heart health in addition to dietary choices. Key factors include smoking, obesity—particularly around the abdomen—stress, physical inactivity, and excessive alcohol consumption. Moreover, conditions such as high blood pressure, diabetes, or a family history of early heart disease can elevate your risk of heart issues.
For a healthier lifestyle, consider these tips:
Managing Stress: How Diet and Lifestyle Can Help
Checking Your Weight
Guidelines for Responsible Drinking
Affordable Ways to Achieve Your 5-a-Day
Interested in More? Discover…
Heart-Healthy Portions
Top 10 Heart Health Tips
Is Saturated Fat Detrimental?
Recommended Daily Fat Intake
Daily Fiber Recommendations
This article was reviewed on 15 November 2023 by Kerry Torrens.
Kerry Torrens BSc. (Hons) PgCert MBANT is a BANT 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 a member of the Guild of Food Writers. Over the last 15 years, she has contributed to various nutritional and cookery publications, including BBC Good Food.
All health content on bbcgoodfood.com serves as general information only and is not a substitute for professional medical advice. If you have concerns about your health, please consult your local healthcare provider. For more information, see our terms and conditions.
