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Cholesterol


Expert reviewer, Mr Paul McArdle, Registered Dietitian
Next review due July 2021

Cholesterol is a type of fat that’s made in your liver and found in some foods. You have cholesterol in every cell in your body – it’s vital for good health.

Cholesterol forms part of the outer membranes of cells, and your body needs it to make hormones and vitamin D. It’s also needed to make bile acids, which help your gut to digest the food you eat.

Although your body needs cholesterol to work properly, too much of some types of cholesterol can be harmful. Having a high cholesterol can cause narrowing of your blood vessels, leading to heart disease and stroke. But there’s a lot you can do to keep your cholesterol at healthy levels. For more details, see our information on high cholesterol.

Types of cholesterol

To travel in your bloodstream around your body, cholesterol needs to be attached to proteins. When cholesterol and protein are combined like this, they form a lipoprotein. There are two main types of lipoprotein.

  • Low-density lipoprotein (LDL). This is sometimes called ‘bad’ cholesterol. This is because large amounts of LDL cholesterol in your blood can cause fatty deposits to build up in your blood vessels (atherosclerosis). This can lead to heart disease and stroke.
  • High-density lipoprotein (HDL). This is sometimes called ‘good’ cholesterol because it helps to remove excess cholesterol from your body. HDL takes it to your liver, where it can be broken down for your body to get rid of it. Having lots of HDL in your blood is a good thing – it helps to prevent heart disease.

Sources of cholesterol

Bupa's understanding different fats infographic

Most of the cholesterol in your body is made by your liver from fats that you eat. Only a small amount comes directly from the cholesterol in your food.

Cholesterol you make from fats in your diet

Your body makes cholesterol mainly from saturated fats. Examples of foods high in saturated fat include cream, butter, cheese, ghee, palm oil, coconut oil and fatty meat. Eating a lot of saturated fat is likely to increase the amount of LDL (bad) cholesterol in your blood. This may increase your chances of developing heart disease or having a stroke.

Trans fats (hydrogenated vegetable oils) are another type of fat that can also increase the amount of LDL cholesterol in your blood. Trans fats are found in lots of processed foods, such as biscuits, cakes and pastry.

Cholesterol in food

Some foods naturally contain small amounts of cholesterol, such as eggs, shellfish and offal (liver, kidney, etc). But eating these foods has much less effect on your cholesterol levels than eating foods that contain saturated and trans fats.

If you want to reduce your cholesterol levels, it’s better to eat less saturated and trans fat than to eat fewer foods that contain cholesterol. It’s fine to keep eating foods that contain cholesterol, unless your doctor or dietitian has told you otherwise.

You can click on the image to open a larger version of the 'Understand the different fats' infographic.

Measuring cholesterol

Your GP can measure your cholesterol levels with a blood test.

The test measures the different types of cholesterol as well as the total amount of cholesterol in your blood. You might be asked not to eat anything for about 12 hours before having the blood test, although this isn’t usually necessary these days. But follow any instructions your doctor or GP surgery gives you.

Your GP will discuss the results of the test with you. If your cholesterol levels are high, they’ll give you advice about how to reduce this. This will include lifestyle changes and might mean taking medicines to lower your cholesterol, such as statins. You may find it helpful to read our information on high cholesterol.

If your levels aren’t high, it still makes sense to think about making healthy changes to your diet and lifestyle. This will help you to prevent health problems in the future such as heart disease. See the next section, Keeping healthy cholesterol levels, to find out what you can do.

Keeping healthy cholesterol levels

It’s important for everyone to aim for healthy blood cholesterol levels. This means a low-total cholesterol, low level of LDL cholesterol and a high level of HDL cholesterol. Your GP or practice nurse can tell you the levels and balance between the various results you should be aiming for.

There are a number of ways to keep your cholesterol levels healthy.

Making changes to what you eat

You need to eat a certain amount of fat to be healthy, but eating less saturated fat and trans fat can help to keep your cholesterol levels healthy. Try to replace saturated fats with unsaturated fats where you can.

The following tips may help.

  • Go for lower-fat options. For example, choose lean meat or alternatives to meat, such as beans, tofu or lentils. Use low-fat dairy products such as skimmed milk and reduced-fat cheese.
  • Eat only small amounts of foods that are high in saturated fats or trans fats.
  • Choose low-fat ways of cooking, such as grilling, steaming or baking foods.
  • When you do cook with fat, use an unsaturated fat, such as olive oil, sunflower oil or rapeseed oil.

See our information on fat to find out more about what fats you need, and how to eat the right amounts.

Eating more fibre and more whole grain carbohydrate foods can also help to lower LDL cholesterol. This means eating more foods like fruit and vegetables, oats, beans and pulses (for example, lentils and soya).

Adding plant stanols and sterols to your diet may help keep your cholesterol levels healthy. These are substances found naturally in foods like fruits, vegetables, nuts and wholegrains. They are also added artificially to some food and drink, such as mini-drinks, yogurts and spreads.

You may find it helpful to read our information on healthy eating. And for more tips on changing your diet to keep healthy cholesterol levels, see the organisations listed in ‘other helpful websites’ below.

Being a healthy weight

If you're overweight, losing excess weight can help to reduce your LDL cholesterol level. If you’re not sure, have a look at our information on what is a healthy weight.

Keeping active

Being physically active can also help to keep your cholesterol levels healthy. Aim to do 150 minutes (two and a half hours) of moderate activity spread across each week. Moderate activity is anything which causes you to breathe faster and feel warmer, and which increases your heart rate. If you’re not very active at the moment but would like to become more active, see our information on Getting started with exercise.

Stopping smoking

Smokers have less HDL (‘good’) cholesterol in their bloodstream. By giving up smoking you can help to keep your cholesterol levels healthy as well as improving your health generally.


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Related information

    • Hypercholesterolaemia. BMJ Best practice. bestpractice.bmj.com, last reviewed June 2018
    • Overview of lipid metabolism. The MSD Manuals. www.msdmanuals.com, last full review/revision March 2018
    • Lipid modification - CVD prevention. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2015
    • Lipids and hyperlipidaemia. Oxford Handbook of Endocrinology and Diabetes (online). Oxford Medicine Online. www.oxfordmedicine.com, published March 2014
    • Macronutrients and energy balance. Oxford Handbook of Nutrition and Dietetics (online). Oxford Medicine Online. www.oxfordmedicine.com, published January 2012
    • Cardiology and vascular disease. Oxford Handbook of General Practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014
    • Cholesterol. Food fact sheet. BDA: The Association of UK Dietitians, 2017. www.bda.uk.com
    • Fat. Food fact sheet. BDA: The Association of UK Dietitians, 2015. www.bda.uk.com
    • Lipid profile. Lab Tests Online. labtestsonline.org.uk, last reviewed 29 May 2015
    • Physical activity guidelines for adults (1964). Chief Medical Office (CMO) 2011. www.gov.uk
    • High cholesterol. British Heart Foundation. www.bhf.org.uk, accessed 4 July 2018
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, July 2018
    Expert reviewer, Mr Paul McArdle, Registered Dietitian
    Next review due July 2021



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