Cholesterol & health – frequently asked questions
Can I get my cholesterol level any lower by changing my diet?
A good start would be to compile a food diary. Be honest and write down everything you eat over a couple of weeks. Getting a good picture of your normal intake should help you to identify some positive changes you could make.
Cut down on saturated fat wherever possible. Ideally an average woman should not exceed 20g per day (4 teaspoons of butter is around 10g of saturated fat). There are some key cholesterol busting foods that you could try such as foods fortified with plant sterol and stanols, nuts, oats and soya foods. Eating at least 5 portions of fruit and vegetables each day will also help, try to make at least one a portion of beans, peas or lentils.
How do cholesterol levels change over a lifetime?
It is true that cholesterol levels increase with age, and doctors know it is important to lower our lifetime exposure to cholesterol. So keeping your cholesterol low is important at all ages. As you get older your overall risk of circulatory disease increases. This is partly because of age and also due to other risk factors (high blood pressure, diabetes, weight gain) which may develop over time. Your GP can explain your risk of having a heart attack and what you might do to reduce the risk.
I’ve had a few tests and my HDL (good cholesterol) is relatively low. How can I increase it?
Having a low HDL-cholesterol and a high triglyceride level is quite common and often happens when the body has difficulty in dealing with dietary fats after a meal. Smoking also depresses HDL-cholesterol. We recommend the following lifestyle approach to raise HDL levels. If you are a smoker it is best to stop. Check out where to get advice and support (link to smoking page). If you carry a lot of excess weight around your waist then losing some of this could help increase your HDL and reduce your triglyceride levels. Aim to lose about 1 lb a week by being more physically active and cutting back on high calorie foods and portion sizes.
Eat a balanced diet based on starchy wholegrain foods with plenty of fruit and vegetables, and low in saturated fat. Opt for cooking oils higher in the monounsaturated fats such as rapeseed oil and olive oil (but use sparingly if overweight) and include nuts and soya regularly.
Help. how do I cope with a diagnosis of familial hypercholesterolaemia (FH)?
Don’t worry, your reaction is perfectly normal, many people feel overwhelmed by a diagnosis of FH. But it is just that, a diagnosis, not a life sentence. And those that are diagnosed and treated early can go on to live a perfectly normal life. Even if you have developed heart disease, treatment can help prevent the disease from progressing.
Please take a look at our health advice about FH, diet and lifestyle which may help. If you would like to chat to a nurse or dietitian about how this might affect you or other members of your family, then call our helpline number 0845 450 5899 between 10am and 3pm, Monday to Friday or leave a message outside these times.
I’m scared I have inherited high cholesterol from my family!
If you think you have inherited high cholesterol then you should discuss this with your GP. If your doctor suspects you have an inherited condition he should refer you to a lipid clinic where a more formal diagnosis can be made. This involves a fasting blood test, a physical examination and taking more details about your family’s history of heart disease. The specialist will complete a pedigree (a kind of family tree) which will help to identify a pattern of family members affected by inherited high cholesterol or heart disease, One form of inherited high cholesterol is called familial hypercholesterolaemia or FH for short. It affects around 1 in every 500 people and is caused by a gene alteration that is passed from parent to child. Each child has a one in two chance of inheriting the condition from an affected parent.
It is important to get a diagnosis early because, with effective treatment, people with FH can live a full and healthy life, providing they follow the advice of their doctor.
If you do have FH it is likely you will be prescribed a statin to help lower your cholesterol levels. You should also be offered support to make changes to your diet and lifestyle if these are necessary. The specialist will also talk to you about contacting other family members that might be affected.
I have high cholesterol, should I be eating shellfish and eggs?
The question of whether high cholesterol foods such as shellfish and eggs affect blood cholesterol levels is one we are often asked.
Most people with raised cholesterol do not have to restrict eggs and shellfish. Keeping saturated fat low has been shown to be better at reducing blood cholesterol than restricting eggs and shellfish.
People with an inherited form of high cholesterol such as familial hypercholesterolaemia (FH) should be more cautious about eating too much of these foods as they can still influence blood cholesterol levels. If you have FH it is worthwhile discussing this with your doctor or dietitian.
Remember not all shellfish are high in cholesterol, cockles, muscles, oysters, scallops and clams contain very little. And cholesterol is only concentrated in the yolk of the egg.
I have very recently been invited to have an NHS health check and am worried that my total cholesterol will be raised. Can you tell me what the appointment involves?
Anyone aged 40-74, who is not already known to be at high cardiovascular risk, should be invited to an NHS Health Check over the next 5 years.
It involves being weighed and measured, taking a sample of your blood, testing your blood pressure and answering some questions about your family history and your lifestyle. You may be asked to fast overnight before the test.
Your cholesterol results may be given to you on the same day or you may be asked to come back when the results are available. All the information you give will be used to calculate your risk of having a heart attack or stroke in the next 10 years. The nurse, doctor or pharmacist will also be looking to see if you are at risk of diabetes or kidney disease.
The doctor or nurse will discuss your results with you and whether it is necesary for you to take any action such as changing your diet, stopping smoking or becoming more active. If your risk of heart disease is thought to be high you may be asked to take a medicine called a statin which will help to lower your cholesterol. Statins are very safe and are generally well tolerated by most people. They are also very effective at preventing heart attacks.