Concerned you have high cholesterol? Whilst it’s not the only cause, it could be the foods that you’re eating that are causing your cholesterol levels to rise. Here, we break down the common food culprits, what you can do to prevent it, and the symptoms of high cholesterol, so you know how to spot the early warning signs.
Cholesterol plays a vital role in your body, but too much of it can significantly increase your risk of heart disease and circulatory diseases. So what can you do to reduce it? Here’s everything you need to know about high cholesterol, and how to keep it under control.
What is cholesterol?
If you’ve been told you have high cholesterol, first things first — you need to understand what cholesterol is, and exactly what it does to your body.
Cholesterol is a waxy, fatty-like substance that your liver produces naturally, but it’s also found in certain foods, like eggs, cheese, shellfish and fatty meats. Your body needs cholesterol to build and repair cells, help you digest food, and to make hormones and vitamin D, but it can cause problems if there’s too much of it found in your blood.
Cholesterol can’t dissolve in water, so it’s unable to travel through your blood on its own. Your liver, therefore, produces proteins called lipoproteins (these are particles made from fat and protein) to help it travel through your bloodstream.
Eating foods that are high in ‘dietary cholesterol’ — namely the animal products listed above — don’t usually make a huge difference to blood cholesterol, it’s the foods high in saturated fats and trans-fats, as well as a low intake of dietary fibre with unsaturated fats, that cause high cholesterol.
There are two main types of cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL cholesterol is also known as ‘bad cholesterol’. Too much LDL can stick to the walls of arteries and cause a fatty build-up called plaque. Too much plaque can cause blockages that prevent blood from flowing properly to the heart, which in turn increases your risk of coronary heart disease and stroke.
If you have too much LDL in your bloodstream, you will be diagnosed with high cholesterol.
HDL cholesterol is known as ‘good’ cholesterol. This type cholesterol can help to protect you against coronary heart disease because it carries LDL away from the arteries and back to the liver, so it can then be broken down and passed as waste.
In addition to cholesterol, your blood also contains a type of fat called triglycerides, which are are stored in your body’s fat deposits. They store unused calories and provide your body with energy. They’re the most common type of fat in the body. Your hormones realise triglycerides to make energy between meals — your body converts any extra energy (kilojoules) it doesn’t need right away into triglycerides.
Much like cholesterol, your body needs this type of fat for energy, but if your levels are too high, alongside either increased LDL cholesterol or decreased HDL cholesterol, this can increase your chances of developing fatty build-ups in the arteries – and put your more at risk of heart attack and stroke.
If you eat more kilojoules than you use, if you’re overweight, eat excessive amounts of high fat and sugary foods, or drink too much alcohol, you may have high triglycerides.
What are the symptoms of high cholesterol?
In many cases, high cholesterol rarely displays any symptoms, particularly in the early stages. But when it’s left untreated it can increase your risk of a number of serious health conditions. Typically people don’t know they have it until they develop serious complications, such as heart attack or stroke. This is usually due to a build up of plaque in the arteries, as a result of high cholesterol.
That’s why it’s important to get your cholesterol levels checked regularly. Your GP will run a blood test to measure your HDL and LDL, to determine your risk of atherosclerosis — a build-up of plaque that narrows or blocks arteries.
Although rare, other symptoms people may experience also include:
- chest pain
- angina
- heart attack
- stroke
- pain whilst walking — caused by blocked arteries that are unable to send blood to the legs
What causes high cholesterol?
Whilst for many people, high cholesterol is often a result of poor diet and lifestyle choices (such as smoking and not exercising), for others blood cholesterol can be genetic, meaning you inherit the condition from your family.
Your age, ethnicity, medical history and even gender can also influence how likely you are to have high cholesterol. Whist many of these factors cannot be controlled, there are other lifestyle factors that you can control, and by making changes you can significantly increase your risk. These include:
- Smoking
- Poor diet
- Lack of exercise
- Being overweight or obese
Making healthy changes to your lifestyle and diet is the best way to reduce your risk of high cholesterol and heart disease.
How do I know if I have high cholesterol?
Because a lot of the time there aren’t any noticeable symptoms, the only way to know you have high cholesterol is by taking a blood test.
High cholesterol is extremely common among Australians — in fact, 1 in 3 adults is diagnosed with high cholesterol. Over time, too much bad cholesterol causes a build up of fatty deposits (plaques), which can form in the walls of the arteries. This can lead to narrowing and hardening of the arteries, and puts you more at risk of heart attacks and stroke.
If you’re 45 or older (35 or older, if you are Aboriginal or Torres Strait Islander), you can book in with your doctor for a cholesterol test (also known as a lipid profile test) as part of a Heart Health Check — this will calculate your heart disease and stroke risk. If you have a family history of high cholesterol or early cardiovascular disease, high blood pressure or are overweight, you should speak to your GP about your heart disease risk.
These tests are usually recommended every five years, although if you have high blood pressure or diabetes, you will need the lipid test more regularly.
A cholesterol test will measure the following:
- total amount of cholesterol in the blood
- the level of HDL-cholesterol (‘good cholesterol’)
- the level of LDL-cholesterol (‘bad cholesterol’)
- triglycerides (another type of fat in the body)
If the test shows you have high levels of LDL cholesterol and triglycerides, then you have an increased risk of heart disease and stroke. If your levels of cholesterol and lipids go down, then your risk also goes down, too.
Cholesterol and lipid levels are just one thing that’s taken into account when working out your risk of heart disease and stroke. There are specific guidelines for target cholesterol levels in different people — your doctor will also take things like your age, gender, family history, or blood pressure into consideration to calculate your overall risk. Your doctor will be able to explain this to you in more detail.
How do I lower my cholesterol?
1. Change your diet
The best way to manage your cholesterol is through your diet. Some foods are higher in cholesterol than others, or they may contain ingredients that can increase your cholesterol levels. If you stick to a healthy, nutritious diet that’s low in saturated fats and trans-fats, avoiding foods that contain high levels of fat, salt and sugar, over time your cholesterol levels will drop.
These are the foods to stick to, to keep your cholesterol low, as recommended by the Heart Foundation:
- Plenty of vegetables, fruits and wholegrains – aim for 5 servings of vegetables every day.
- A variety of healthy protein sources (especially fish and seafood), legumes (such as beans and lentils), nuts and seeds. Smaller amounts of eggs and lean poultry can also be included in a heart healthy diet. If choosing red meat, make sure it’s lean and limit to 1-3 times a week.
- Unflavoured milk, yoghurt and cheese. Those with high blood cholesterol should choose reduced fat varieties.
- Healthy fat choices – nuts, seeds, avocados, olives and their oils for cooking
- Herbs and spices to flavour foods, instead of adding salt.
Eating foods that contain plant sterols can also help lower high cholesterol. Plant sterols are cholesterol-like substances that occur naturally in fruits, vegetables, nuts and cereals in small amounts.
Aim to eat foods rich in dietary fibre, particularly soluble fibre foods, as these can reduce the amount of LDL (bad) cholesterol in your blood and slow down your digestion, so you feel fuller for longer. These include fruit, legumes (such as chickpeas, lentils, soybeans, three-bean mix and baked beans) and wholegrain cereals and foods, like oats and barley.
You should also be wary of your portion sizes, too. Try not to fill up on unhealthy foods, and instead, stick to the foods listed above. Obesity can also increase your risk of cardiovascular disease, so portion size is key to maintaining a healthy weight.
A ‘healthy plate’ of food is generally considered to be servings of ¼ protein, ¼ carbohydrates and ½ vegetables. Although this can vary depending on your age, gender and specific nutrition needs.
What unhealthy foods should I avoid?
To keep your cholesterol low, you need to stick to a diet that’s low in saturated fats and trans-fats to lower your cholesterol. Try to avoid foods that contain unhealthy, saturated and trans-fats such as:
- fatty cuts of meat
- full fat dairy products (such as milk, cream, cheese and yoghurt)
- deep fried fast foods
- processed foods (like biscuits and pastries)
- takeaway foods (like burgers and pizza)
- coconut oil
- butter
Foods high in (unhealthy) trans fats include:
- deep fried foods
- baked goods (such as pies, pastries, cakes and biscuits)
- butter
Instead, replace saturated fats with foods that contain healthy polyunsaturated fats, such as:
- margarine spreads and oils such as sunflower, soybean and safflower
- oily fish
- some nuts and seeds
Foods high in (healthy) monounsaturated fats include:
- margarine spreads and oils (such as olive, canola and peanut)
- avocados
- some nuts
2. Exercise
Regular exercise can help increase your HDL (good cholesterol) and lower triglycerides, as well as helping you lose weight, if you need to. Choose a mix of aerobic or cardio exercise and resistance training, for 30-60 minutes per day, for four-five days per week. But you can work up to that with brisk daily walks if you’re just starting out! Start off by walking every day, then gradually adding your cardio and strength exercises, to build up your stamina.
Mix up your cardio with muscle-toning activities twice a week. These can include anything from bodyweight exercises like push-ups and squats to lifting and carrying your shopping.
3. Lose weight, if you need to
If you’re overweight, start taking steps to lose weight now, to reduce your risk of developing heart disease. Losing excess weight helps to improve all kinds of health conditions including high cholesterol, preventing type 2 diabetes, high blood pressure, heart attacks, strokes and cancer.
4. Limit your alcohol intake
Alcohol can increase your levels of triglycerides. Along with LDL cholesterol, high levels of triglycerides raise your risk of heart disease.
Drinking too much alcohol also increases blood pressure and can lead to obesity (due to the kilojoules in alcohol) —which are both additional risk factors for heart disease.
Try to limit your intake to no more than 10 standard drinks per week and no more than 4 drinks per day.
5. Quit smoking
Smoking reduces HDL cholesterol and speeds up the rate at which fatty plaques form in the walls of your arteries. It also makes your blood more likely to clot, putting you more and risk of heart attack and stroke. Stopping smoking is one of the best ways to improve your heart and blood vessel health.
What other treatments are there for high cholesterol?
Some people will have high cholesterol even if they follow a healthy, balanced diet low in saturated fats and trans-fats. These people may need to take cholesterol-lowering medicine as prescribed by their doctor. These medicines are commonly called statins — they work by slowing the amount of cholesterol made in your liver.
Your doctor will consider all your risk factors for cardiovascular disease before suggesting medication. If statins alone do not lower your cholesterol, additional medications may be prescribed.
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