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High cholesterol

This section contains answers to frequently asked questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

How do the fats in my food affect my cholesterol levels?

Answer

Fat is a good source of energy but eating too much of the wrong types of fat increases your cholesterol levels and therefore your risk of heart disease.

Explanation

Some fat is an essential part of a healthy diet, but it's important you don't eat too much of it and that you're careful about the type of fat that you eat.

Your liver turns the fat in your blood into cholesterol. Your blood then transports the cholesterol around your body. Not all cholesterol is bad for you; there is a harmful form and a protective form. The harmful form of cholesterol is called LDL or low-density lipoprotein. The protective form is called HDL or high-density lipoprotein.

You can help lower your cholesterol level by reducing the amount and type of fat that you eat. There are different types of fat in food.

  • Saturated fats – these increase your cholesterol levels. Examples of foods high in saturated fat include cakes and biscuits, pastry, meat products and hard cheese.
  • Trans fats – these have a similar effect on your cholesterol levels as saturated fats. Foods containing hydrogenated vegetable oil (which must be listed in the ingredients list on the label) might contain trans fats. Trans fats currently don't need to be labelled separately on food labels. They can be found in biscuits and cakes, fast food and some margarines.
  • Monounsaturated fats – these help lower harmful cholesterol levels. Examples of foods high in monounsaturated fats include olive oil and rapeseed oil.
  • Polyunsaturated fats – these lower both harmful and protective cholesterol levels. Examples of foods high in polyunsaturated fats include sunflower oil and soya oil.

When you're shopping for food, compare the labels so you can pick those with less total fat or less saturated fat. Buy lower fat versions of dairy foods, such as semi-skimmed or skimmed milk, and reduced-fat yoghurt, whenever you can.

There is a particular type of polyunsaturated fat called omega-3 which can help to reduce your cholesterol levels. The best source of omega-3 fats is oily fish, such as kippers, mackerel, sardines and salmon. You should aim to eat two portions of fish per week, of which one should be oily, but not more than two portions per week if you're pregnant or breastfeeding.

If you're worried about high cholesterol, ask your doctor for advice.

Are all statins the same?

Answer

Statins available in the UK vary slightly in their cholesterol-lowering effects. Your doctor will prescribe you a statin at a dose that he or she thinks is suitable for reducing your cholesterol levels, with as few side-effects as possible.

Explanation

There are different types of statin available in the UK. Examples include simvastatin, atorvastatin, and fluvastatin. All statins work in the same way, but may have different chemical structures. Statins lower the level of cholesterol in your blood, especially LDL or 'bad' cholesterol. Having a low cholesterol level reduces your risk of heart disease, including heart attacks.

The dose you take affects how much cholesterol the statin removes from your blood. Different statins may be prescribed at different doses to remove the same amount of cholesterol. These doses may also have different effects on your cholesterol levels over different periods of time. Your cholesterol levels will be checked regularly and the dose of your statin may be modified by your doctor.

As with any medicine, you may have some side-effects when taking statins, but these are generally mild and similar for all types of statin. Your doctor will monitor possible side-effects by doing a liver function blood test before you start taking the statin and again a few months later. If your liver function is affected, you may need to take a different statin.

What is the normal level of cholesterol that I should have in my blood?

Answer

Too much cholesterol in your blood can increase your risk of heart problems. There is no recommended target cholesterol level unless you have cardiovascular disease or are at high risk of getting it. For example, if you already have heart disease, your doctor may advise you to aim for a total cholesterol level under 4mmol/L. Generally, the lower your cholesterol the better.

Explanation

Cholesterol is a fatty substance that plays an essential role in how every cell in your body works. Your body makes most of your cholesterol and your blood transports it attached to a protein. This combination of fat and protein is called a lipoprotein and there are several types. LDL is often called 'bad' cholesterol because it causes cholesterol to build up in your blood vessels and HDL 'good' cholesterol because it helps prevent cholesterol building up.

There is no recommendation for the ideal level of total cholesterol or LDL. Your doctor will consider your cholesterol levels as part of your overall cardiovascular risk, taking into account other risk factors such as your age, sex, body mass index (BMI), blood pressure, family history and whether you smoke, drink alcohol or have any other illness such as diabetes.

When looking at your cholesterol levels, your doctor will consider how much HDL you have compared to your total cholesterol level. This is called your total cholesterol to HDL cholesterol ratio. You can work this out by dividing your total cholesterol level by your HDL level. It's healthiest to have high HDL, low LDL and low total cholesterol, with a total to HDL ratio of less than four.

If you have cardiovascular disease, have had a heart attack, get angina or have had an ischaemic stroke, your doctor will be aiming to help you reduce your total cholesterol level to less than 4mmol/L, and your LDL to less than 2mmol/L. He or she will be able to prescribe statins and give you advice about diet and exercise to help meet this target.

 

Produced by Krysta Munford, Bupa Health Information Team, January 2013.

For our main content on this topic, see Information.

For sources and links to further information, see Resources.
 

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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