Cholesterol is essential for many of the body’s metabolic processes, including the production of hormones, bile and vitamin D. However, there’s no need to eat foods high in cholesterol. The body is very good at making its own cholesterol – you don’t need to help it along. 

Effects of high cholesterol levels

The liver is the main processing centre for cholesterol and dietary fat. When we eat animal fats, the liver transports the fat, together with cholesterol in the form of lipoproteins, into our bloodstream.

Too much cholesterol circulating within LDL in our bloodstream leads to fatty deposits developing in the arteries. This causes the vessels to narrow and they can eventually become blocked. This can lead to heart disease and stroke.

Dietary tips to avoid cholesterol

The most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:

• Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
• Choose low or reduced-fat milk, yoghurt and other dairy products or have ‘added calcium’ soy drinks.
• Choose lean meat (meat trimmed of fat or labelled as ‘heart smart’).
• Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
• Have fish (fresh or canned) at least twice a week.
• Replace butter and dairy blends with polyunsaturated margarines.
• Include foods in your diet that are rich in soluble fibre and healthy fats, such as nuts, legumes and seeds.
• Limit cheese and ice cream to twice a week.

Other ‘storage’ fats that are transported in blood lipoproteins include triglycerides. When present in high concentrations in the blood, this fat is also a risk for heart attack. Some foods will affect the cholesterol level or the triglyceride level and some will affect both.

Lifestyle tips to cut cholesterol

Changing some of your lifestyle habits may also help to reduce your cholesterol and triglyceride levels. Suggestions include:

• Cease alcohol consumption or reduce your alcohol intake to no more than one or two drinks a day. Avoid binge drinking. This may help lower your triglyceride levels.
• Don’t smoke. Smoking increases the ability of LDL cholesterol to get into artery cells and cause damage.
• Exercise regularly (for example, at least 30 minutes of brisk walking daily). Exercise increases HDL levels while reducing LDL and triglyceride levels in the body.
• Lose any excess body fat. Being overweight may contribute to raised blood triglyceride and LDL levels.
• Control your blood sugar levels if you have diabetes. High blood sugars are linked to an increased risk of atherosclerosis (‘hardening of the arteries’), heart attacks and strokes.

Medication may be needed

For some people, diet and lifestyle changes are not enough. High blood cholesterol levels often have a genetic component. Some people inherit altered genes that cause high cholesterol and this cannot usually be changed sufficiently by lifestyle or diet.

If you are at risk of coronary heart disease and your LDL cholesterol level doesn’t drop after scrupulous attention to diet, your doctor may recommend medications to force your blood LDL levels down. Cell cholesterol levels, however, remain normal, so lowering blood cholesterol has no effect on most cell metabolic processes.

Some people get muscle aches from statins, which are the most commonly used medication to lower blood cholesterol. However, diet and exercise will still be important, even if you are taking medication. Your doctor may also refer you to a specialist who treats cardiovascular disease.