In the last blog surrounding cardiovascular disease (CVD), we discussed what high blood pressure is, the consequences it can have, and ways to reduce the risk of developing high blood pressure with diet and lifestyle changes. You can check this out by clicking here, titled ‘CVD: Managing Blood Pressure with Diet’. In the final blog post of the series, this week we will be exploring how to manage raised cholesterol, another modifiable risk factor for CVD, using nutrition.
What is High Cholesterol?
Cholesterol is a fatty substance in the blood, which is produced in the liver. High cholesterol is when there is too much cholesterol in your blood, increasing your risk of CVD. However, as mentioned in our blog post on fat, there are good and bad cholesterols. High-density lipoproteins (HDL) are known as ‘good’ cholesterol as they remove ‘bad’ cholesterol from the blood by taking it to the liver, where it can be broken down and removed from the body. Foods containing unsaturated fats are good sources of HDL, these include olive oil, avocados, nuts and oily fish. Low-density lipoproteins (LDL) are known as ‘bad’ cholesterol as they can clog up blood vessels when consumed in large amounts. They build up on the walls on blood vessels causing narrowing, which increases the risk of heart attacks and strokes [1]. Saturated and trans fats are sources of LDLs, such as butter, bacon, cheese, and fried foods.
High cholesterol is often a hidden risk factor as there aren’t usually any signs that you have it. You can get your cholesterol levels measured by a GP or nurse. This is done either by taking blood from your arm or through a finger-prick test. A needle is used when taking blood from your arm and your sample will be sent to a lab to check your cholesterol level. A finger-prick test is done by pricking your finger and putting a drop of blood on a strip of paper. The paper is put into a machine which checks your cholesterol in a few minutes, you may have to wait a few days if having blood taken from your arm. A healthy cholesterol level is 5 or below for total cholesterol; 1 or above for HDL; and 3 or below for LDL [2].
Risk Factors for High Cholesterol
Risk factors that can increase your chance of developing raised cholesterol include:
- Obesity
- Type 2 diabetes
- A diet high in saturated and trans fat
- Inactivity
- Smoking
- Family history
- Age
- Gender – men are more likely to have high cholesterol
Managing High Cholesterol with Diet
The NHS suggests lifestyle changes such as increasing activity, quitting smoking and cutting down on alcohol to manage or prevent high cholesterol. You should aim to eat a healthy, balanced diet and cut down on foods containing ‘bad’ cholesterol. You can do this by trying to eat more oily fish, whole grain carbohydrates, nuts and seeds, and fruit and vegetables. You should try to eat less fatty meats, butter, hard cheeses, cakes and biscuits, and foods containing coconut or palm oil [3]. You can check the nutrition labels on everyday food products to find out how much saturated fat is in them.
The Mediterranean diet is often cited as a diet that is effective in reducing high cholesterol and the risk of cardiovascular disease as a whole. A study of around 26000 women discovered that women who followed a Mediterranean diet had 25% less risk of developing CVD, over a period of 12 years. The diet is mainly plant based and includes whole grains, fruit, olive oil, vegetables, beans, nuts and legumes. Fish and seafood are the main types of animal protein that are eaten in the diet. There is an emphasis on the consumption of healthy fats, like olive oil, avocado and salmon, over saturated and trans fats, like margarine and cheese. This supports reduction and prevention of high cholesterol [4].
Additionally, the fact that the Mediterranean diet is mainly plant based means that an individual’s intake of plant stanols and sterols will be increased. Plant stanols and sterols are nutrients that have a similar structure to cholesterol. They work to decrease the absorption of cholesterol in your gut so that more cholesterol is lost in faeces, reducing total cholesterol levels. Stanols and sterols can also be taken as supplements or found in fortified food products, but it is important to consult your doctor before taking any supplements [5].
Top Tips for Managing Raised Cholesterol with Diet
- Go for lower fat options of your everyday food items
- Grill, bake or steam foods instead of roasting or frying
- Choose leaner cuts of meat
- Bulk out curries and stews with vegetables and beans rather than meat
- Swap snacks high in saturated fat for fruit, wholegrain toast, or nuts
We hope you have enjoyed our series on CVD and ways that you can make changes to reduce your risk of developing it. Remember that small changes are often easier and more sustainable than simply changing your eating habits overnight!
[1] https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol
[2] https://www.nhs.uk/conditions/high-cholesterol/
[3] https://www.nhs.uk/conditions/high-cholesterol/how-to-lower-your-cholesterol/
[4] https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/
[5] https://www.bda.uk.com/resource/food-facts-plant-stanols-and-sterols.html
Caroline Hill is a specialist menopause dietitian supporting women making dietary change. Caroline uses her extensive knowledge, skills and expertise of food and nutrition to help women manage their symptoms and weight during menopause. Caroline believes in providing sustainable, individualised, evidence-based advice to women making dietary change.