Registered Dietitian & Nutritionist and Disease specific Coach
HCPC registered and member of the British dietetic association (BDA)
High Cholesterol
Cholesterol is an important fatty substance, or lipid, that is essential for our body to function. The liver typically creates it, but it can also be found in a number of foods. To reduce cholesterol levels, a diet low in saturated fat is typically advised.
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Consuming cholesterol itself has little impact on the level of cholesterol in the blood. But before drastically changing your diet, you should always contact your GP first.
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Cholesterol is insoluble in water; therefore it is carried throughout the body by attaching itself to proteins. When the proteins and cholesterol combine, they are called lipoproteins. There are two relevant types of lipoproteins: LDL-cholesterol (the bad type) and HDL-cholesterol (the good type).
If you have extremely high total and LDL cholesterol levels, it can negatively impact your health - especially when combined with smoking and a high blood pressure. You may not even know you have high cholesterol as it doesn’t cause any symptoms on its own. It can however, increase the risk of developing heart disease.
What is high cholesterol?
Although cholesterol is essential for good health, having high cholesterol levels may increase your risk of cardiovascular diseases such as stroke and heart disease. As mentioned above, the odds of you noticing that you have high cholesterol are slim. This is mainly because high cholesterol itself does not cause any symptoms.
Having increased cholesterol levels, however, can cause fatty deposits - that are also known as plaques - to build up inside your arteries. Over a period of time this can this can narrow your arteries, restricting the blood flow to your heart and other important organs. This can potentially cause a pain in your chest (angina).
If one of the plaques inside your arteries bursts, it can cause a blood clot which can cut off the blood supply to your heart. This can then cause a heart attack. Or if it cuts off the blood supply to your brain, it could cause a stroke.
Types of cholesterol
The different types of lipoprotein include:
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High-density lipoprotein (HDL)
High-density lipoprotein is typically referred to as the ‘good’ type of cholesterol. This is because it helps remove excess cholesterol from your blood vessels. It manages to do this by transporting cholesterol to your liver from your tissues. Your liver then takes the cholesterol and breaks it down, which enables it to be removed from your body. HDL aids with the prevention of cholesterol build-up in your blood vessels, helping reduce the risk of stroke and heart disease.
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Low-density lipoprotein (LDL)
Low-density lipoprotein transports cholesterol around your body from your liver to whatever needs it. But if your LDL levels are too high, it can produce fatty deposits in your arteries. This can increase the risk of stroke and heart disease. This is why LDL is often referred to as ‘bad’ cholesterol.
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Cholesterol is not the only lipid (fat) to pose a risk to the vital organs. Doctors also test for:
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Triglycerides
Whereas cholesterol builds and maintains cell membranes and creates hormones, triglycerides maintain the transportation and storage of energy. Like cholesterol levels, avoiding certain fatty foods can lower triglyceride levels
What are the risks?
An individual with high cholesterol is more likely to develop serious conditions such as coronary heart disease, stroke and TIA (a mini-stroke).
Coronary heart disease
If the blood supply contains a high amount of cholesterol, there is a greater risk of fatty deposits breaking off and sticking to arterial walls. This accumulation causes a narrowing of the passage known as ‘atherosclerosis’, which restricts the blood flow to the heart. The arterial walls, now sticky and rough with the build-up of fatty deposits (referred to as plaque), can cause clotting of the blood. This can in turn cause a heart attack.
Stroke
Like a heart attack, a stroke can be caused by a blood clot or an accumulation of fatty deposits caused by high cholesterol. This blockage can restrict or entirely block the blood flow to the brain, leading to a stroke. Symptoms of a stroke include facial droopiness, limb paralysis, slurred speech and confusion.
TIA
A transient ischaemic attack, otherwise known as a mini-stroke, is similarly caused by a slight restriction of blood to the brain. With a TIA, symptoms drastically reduce within the first 24 hours.
Who is at risk?
There are a number of reasons why certain people are more likely to suffer from high cholesterol levels than others.
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Overweight or obese people
Daily dietary habit has been found to play a large role in determining cholesterol levels. A number of scientific studies have suggested a strong link between high-fat diets, high cholesterol levels and heart disease. Obesity, and particularly central obesity (carrying excess weight around the waist), which may be indicative of physical inactivity, is particularly significant. An excess of fat puts increased strain on the internal organs and heightens risks of high blood pressure, high cholesterol, heart disease and a wealth of other related problems. The good news is that following a number of simple lifestyle changes can reduce these risks. A modest sustained weight loss of 5-10% of body weight can improve lipid profiles.
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Older people
Many factors cannot be changed. For example, individuals over the age of 40 are thought to more likely to suffer from high cholesterol.
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Ethnic groups
Individuals of Indian, Pakistani, Sri Lankan or Bangladeshi descent have been found to be at a higher risk of high cholesterol than other ethnic groups.
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Family history
A small percentage of individuals will have inherited metabolic defects such as ‘familial hypercholesterolemia’, which can increase the risk of high cholesterol. People who suffer from hypercholesterolemia often lack LDL-absorbing receptors found on the surface of liver cells. This can result in a build-up of LDL cholesterol leading to an increased danger of heart disease.
In very rare cases a child may have inherited the disorder from both parents. In this case, individuals often develop heart disease at a young age and may require repeat organ transplants throughout their life, regardless of lifestyle habits.
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Individuals diagnosed with extremely high cholesterol levels (over 300mg/dl) are advised to encourage other family members to undergo testing as a precaution.