How Is High Cholesterol Diagnosed
Your doctor / physician will diagnose high cholesterol by means of a blood test.
Because it is easy and cheap to do, the initial test only measures your total cholesterol and HDL cholesterol. These two measures give a general overview of your risk. If your results show that the two measurements are within recommended target levels, then no other tests are usually required.
However, if one of those measurements is outside the norm , you may be asked to take a more detailed blood test. This second test measures your total, HDL and LDL cholesterol levels, plus triglycerides, and provides a more accurate risk assessment.
Note: Triglycerides are other types of fats made in the body and which also have been associated with an increased risk of heart disease. So these are measured as well.
Some factors affecting triglyceride levels are:
- being obese / overweight
- diet high in carbohydrates
Increase Your Physical Activity
Physical activity increases levels of HDL cholesterol the good cholesterol that removes LDL cholesterol from the blood. Vigorous aerobic exercise is best.
If you havent been exercising much lately, gradually build up to the recommended amount of physical activity:
- People aged 18-64 years should do 30 to 60 minutes of moderate-intensity physical activity on most days of the week.
- People aged 65 years and over should aim for a total of 30 minutes of moderate physical activity on most days .
Moderate-intensity exercise is a level that increases your heart rate and breathing but allows you to keep talking. Vigorous intensity exercise makes your heart rate higher and makes you breathe more heavily.
Resistance training and muscle-toning exercises can increase HDL cholesterol. Aim to do this twice a week.
Why Exercise Is Effective At Lowering Cholesterol
Cholesterol is one of the fatty substances we have circulating in our blood. If we have too much, it can stick to the inside walls of our arteries, narrowing them and increasing risk of cardiovascular disease.
Its not only the amount of cholesterol in the blood that affects our risk, though. Other factors play a part. One of these is the type of protein that carries the cholesterol through the body. Low-density lipoprotein cholesterol is more likely to cause problems. High-density lipoprotein cholesterol protects the body from cholesterol buildup.
Exercise helps increase levels of HDL good cholesterol. Researchers reported on this in Arteriosclerosis, Thrombosis, and Vascular Biology found similar results. In men with belly fat, regular endurance exercise increased HDL good cholesterol levels.
Exercise may even change the nature of our cholesterol. In 2002, researchers from Duke University Medical Center found that exercise improved the number and size of the particles carrying cholesterol through the body. Those who exercised more had larger, fluffier particles that were less likely to clog arteries.
Exercise can help you lower cholesterol numbers even if youre overweight. In the Journal of Obesity, researchers reported that overweight and obese adults who walked, jogged, and cycled while eating a cholesterol-lowering diet improved total cholesterol, LDL cholesterol, and triglyceride levels.
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Foods That Help Lower Your Cholesterol
From chocolate and red wine to beans and legumes, food and drink can help you get your cholesterol levels down.
My patients often ask me if there are any foods that can help with reducing high levels of low-density lipoprotein cholesterol. This is the so-called “bad” cholesterol that can cause plaque to form in your coronary artery walls, increasing your risk of heart attack and stroke. My answer is a qualified “yes,” since high LDL can be the result of many factors, including poor genes, obesity, and lack of exercise. For this reason, not everyone will react to dietary changes the same way, and optimal LDL levels are different for every individual.
Cholesterol is a waxy, fat-like substance that your body uses to make hormones, vitamin D, and substances that help you digest food. At normal levels, its essential for health, but if the concentration in the blood becomes too high, LDL, the so-called “bad” cholesterol can build up in your arteries forming plaques that put you at risk for cardiovascular disease, including chest pain , heart attack, and stroke.
Frequently, too much LDL is the result of a diet rich in saturated fats and trans fats . Eliminating these foods from your diet is a good first step in improving your LDL. Then try adding some or all of the following LDL-lowering foods every day. If you’re already on a statin, dietary changes may help you reduce your dosage, but never reduce or stop taking a statin drug without first consulting your doctor.
Where Cholesterol Comes From
The two sources of cholesterol are your own body and the food you consume.
This may come as a surprise to many people under the mistaken impression that cholesterol comes only from the food they eat.
In fact, even if you never ate any food with cholesterol, your body would still produce the 1,000 mg or so of cholesterol it needs for proper functioning.
Your Body
Cholesterol is found in every cell in your body. It is mainly produced in your liver with some also made in the small intestine and, of course, your body’s cells.
The liver is so good at producing cholesterol it can even supplement the amount produced by the cells themselves when required. This is especially important for those cells that require a lot of cholesterol, e.g. in the production of sex hormones.
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Bike To Work Or Just For Fun
Cycling expends about the same energy as jogging, but its easier on your joints. Thats an important thing for many people as they age. Hips and knees are vulnerable to arthritis, and we all do need to watch out for them. If youre starting to feel some pain in these joints, it may be best to choose cycling over running.
If its possible to bike to work, try it. Studies have shown some positive benefits. Scientists reported in the that people who biked to work were less likely to develop high cholesterol than those who didnt.
A second study published in found that cycling reduces risk of heart disease. A group of adults between the ages of 5065 who regularly spent time biking had 1118 fewer heart attacks over the period of 20 years than those who didnt.
How Can I Lower My Cholesterol With Medicines
As well as making lifestyle changes, some people will need to take cholesterol-lowering medicines to reduce their risk of heart and blood vessel disease, known as cardiovascular disease. The medicines most commonly used are called statins.
Your doctor will consider all your risk factors for cardiovascular disease before suggesting medication not just your cholesterol and lipid results. If youve already had a heart attack or stroke, taking statins can substantially lower your risk of having another one.
Statins work by slowing the amount of cholesterol made in your liver. In response, your liver uses the cholesterol already in your blood to make up for the deficit. This lowers the level of LDL cholesterol in your blood.
If statins alone do not lower your cholesterol enough, you may need additional medicines.
Contact your doctor if your medicines are causing any side effects.
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What Is The Pritikin Diet
The Pritikin diet significantly reduces saturated fatty acids trans fatty acids , and dietary cholesterol. It also increases dietary fiber in the form of natural, nutrient-rich foods like fruits, vegetables, whole grains, and beans. This is the healthiest way to lower cholesterol, points out cardiologist Ronald Scheib, MD, physician and educator at the Pritikin Longevity Center in Miami, where the Pritikin Program has been taught since 1975.
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What Foods Will Make My High Cholesterol Worse
If you have high cholesterol, its most important to eat less saturated fat. Foods that are high in saturated fats are things like fatty and processed meat, pies and pastry, butter, cream, and coconut oil.
Some foods contain dietary cholesterol but surprisingly they dont make a big difference to the cholesterol in your blood. These are foods like eggs, some shellfish like prawns and crab and offal such as liver, liver pate and kidney. They are low in saturated fat and so are fine to eat as part of a healthy diet.
Find out more about cholesterol and eggs
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Increase Your Consumption Of Dietary Fiber
Ideally, you should be getting 25 to 35 grams of fiber a day, says Dr. Cho. Fiber binds to cholesterol and eliminates it from your body.
To increase your fiber intake, eat more whole grains, legumes like beans and lentils, vegetables and fruits. You should be getting a good mix of both soluble fibers, which are more beneficial for cholesterol, and insoluble fibers, which are better for your gut health.
Lower cholesterol isnt the only benefit of getting enough fiber. Other benefits include reducing your risk of diseases, preventing constipation and keeping you full longer.
Eat Fewer Refined Grains Such As White Flour
Were a nation of white food eaters white bread, white rice, white pasta, and white-flour foods like muffins, croissants, bagels, crackers, dried cereals, tortillas, pretzels, and chips. Yes, more than half of many Americans typical diets are made up of hyperprocessed refined white flour, often injected with sugar, salt, and/or fat.
Thats a real problem in part because the more white, or refined, grains we eat, the fewer whole grains we tend to take in. Research has found that eating whole grains can help lower both total and LDL cholesterol, and improve heart health.
In Harvard Universitys Nurses Health Study, for example, women who ate two to three servings of whole-grain products each day were 30% less likely to have a heart attack or die from heart disease over a 10-year period than women who ate less than one serving of whole grains per week.2
When first starting to make the switch from refined to whole grains, many people often feel a bit confused. Where to begin? Whats whole? What isnt?
The registered dietitians at the Pritikin Longevity Center start with one very simple rule. When looking at products like breads and cereals, they recommend turning the package around and making sure the first word in the Ingredient List is whole. If you see the word whole at the top of the list, its a good bet that what youre buying is in fact 100% whole grain, or close to it.
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Foods With Added Sterols And Stanols
Sterols and stanols are plant chemicals which are a similar size and shape to cholesterol. They are absorbed from the intestines into the blood stream and block some cholesterol from being absorbed, lowering the cholesterol in your blood.
We get a small amount of sterols from plant-based foods such as vegetable oils, nuts, seeds, whole grains, fruits and vegetables, but its not enough to lower cholesterol. So, food companies have developed foods with plant sterols or stanols added to them, such as mini yogurt drinks, fat spreads, milk and yogurts.
These fortified foods lower your cholesterol gradually, over a few weeks, and how much depends on the amount you eat. Some experts believe they are the most effective single food for lowering cholesterol.
Who should eat foods with sterols and stanols added?
Sterols and stanols have been thoroughly researched, so they can be added to foods and are safe to eat.
They are suitable for:
- People with high cholesterol theres no real benefit if you dont have high cholesterol.
- Children with inherited high cholesterol such as familial hypercholesterolaemia with support from a doctor or dietitian.
- People taking statins sterols and stanols will help to lower your cholesterol further because they work in a different way to the statin.
They are not suitable for:
Aim for: one to three servings of fortified foods a day. This will give you 1.5 to 3g of stanols and sterols.
Three servings of: OR
- 1 glass of milk
One product a day:
Will Stopping Smoking Lower My Cholesterol
If you’re a smoker you might already know you should stop if you have high cholesterol. Smoking increases bad cholesterol and lowers good cholesterol, increasing your risk of heart attacks and stroke.
- If youre struggling to stop smoking, talking to your GP is a great first step, or if youre in England you can call the NHS Stop Smoking Service on 0300 123 1044.
- There are also free services in Scotland, Wales and Northern Ireland.
These services will be able to give you useful advice on how to deal with cravings and gradually stop smoking.
Find out more about what smoking does to your body.
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Putting Together A Low Cholesterol Diet
When it comes to investing money, experts recommend creating a portfolio of diverse investments instead of putting all your eggs in one basket. The same holds true for eating your way to lower cholesterol. Adding several foods to lower cholesterol in different ways should work better than focusing on one or two.
A largely vegetarian “dietary portfolio of cholesterol-lowering foods” substantially lowers LDL, triglycerides, and blood pressure. The key dietary components are plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants. Add margarine enriched with plant sterols oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber soy protein and whole almonds.
Of course, shifting to a cholesterol-lowering diet takes more attention than popping a daily statin. It means expanding the variety of foods you usually put in your shopping cart and getting used to new textures and flavors. But it’s a “natural” way to lower cholesterol, and it avoids the risk of muscle problems and other side effects that plague some people who take statins.
Just as important, a diet that is heavy on fruits, vegetables, beans, and nuts is good for the body in ways beyond lowering cholesterol. It keeps blood pressure in check. It helps arteries stay flexible and responsive. It’s good for bones and digestive health, for vision and mental health.
Eat More Plant Sources Of Protein
Excellent plant proteins include beans all beans, like lentils, red beans, pinto beans, and soybeans. Rather than raising blood cholesterol levels, as animal sources of protein do, beans actually help lower cholesterol.
Beans also help reduce blood sugar and insulin levels, and may even lower cancer risk.
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Can I Eat Fish
Oily fish like salmon, tuna, sardines, mackerel and herring are best. Dr. Cho recommends aiming for 2 servings per week.
You can supplement with fish oil, but be careful because very high doses of pure fish oil can lower your triglyceride levels and increase your good cholesterol, she says. It doesnt lower your LDL, though. Be sure to read your fish oil supplement label.
When reading the label of your fish oil bottle, look out for the EPA plus DHA in each serving since those are the effective ingredients. For example, if your fish oil says 1000 mg of fish oil but only contains 300 mg of EPA and DHA, know that youre taking 700 mg of unnecessary fish blubber. Make sure youre choosing fish oil with the highest amount of EPA plus DHA in each pill.
Is Diet The Only Way To Improve My Cholesterol Levels
While diet is one of the best ways to improve cholesterol levels, there are other lifestyle modifications that can also help!
- Weight loss: If you are above a healthy weight, losing 5-10% of your body weight can reduce total and LDL cholesterol and increase HDL cholesterol.
- Exercise: Aiming for at least 30 minutes of moderate-intensity aerobic activity on most days can improve your cholesterol levels. Try starting off with improving your daily step count!
- Quitting smoking: Smoking lowers HDL cholesterol. Quitting smoking is important to reduce your risk of heart disease and stroke, especially if you have high cholesterol.
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Increase The Amount Of Fiber In Your Diet
Most of us do not get enough fiber in our diet. The recommended amount is 25-35 grams of dietary fiber per day. Dietary fiber is a type of carbohydrate that the body cannot digest. As fiber passes through the body, it affects the way the body digests foods and absorbs nutrients. Fiber can help reduce your LDL cholesterol level. A fiber-rich diet can also help control blood sugar, promote regularity, prevent gastrointestinal disease and help you manage your weight.
There are two types of dietary fiber: soluble and insoluble. To receive the greatest health benefit, eat a wide variety of all high-fiber foods. Refined foods, like white bread, white pasta and enriched cereals are low in fiber. The refining process strips the outer coat from the grain, which reduces the amount of fiber thats left.
The best sources of fiber are whole grains, fruits, vegetables and legumes .
Treatment For High Cholesterol
Making lifestyle changes, especially changing some of the foods you eat, and regular physical activity, are very important to help reduce high LDL cholesterol.
You may also need to take cholesterol-lowering medicines to help manage your cholesterol and reduce your risk of having a heart attack or stroke. Talk to your doctor about finding the most appropriate treatment for you.
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Beans: Healthy Pintos And Garbanzos Stand Out
All types of beans and other legumes pinto, red, white, navy, black, garbanzo, lima, and lentil, for example are excellent sources of soluble fiber. Fiber binds to cholesterol-laden bile salts in the small intestine and promotes their excretion along with waste. When this happens, the liver must use more cholesterol to produce more bile salts, therefore lowering the amount of cholesterol available to make LDL.
Still, results of nutrition surveys published in January 2016 in PLoS One show that awareness of the cholesterol-lowering benefits of beans is low. Eating as little as one half cup of cooked pinto beans per day may lower total cholesterol and LDL cholesterol significantly, noted a study published in the Journal of the American College of Nutrition in June 2007.