Diet And Lifestyle Changes
A doctor will look at your overall risk of cardiovascular disease and make recommendations to reduce high blood cholesterol as well as managing other risk factors such as high blood pressure, smoking and being overweight.
Reducing high blood cholesterol levels typically involves decreasing the total cholesterol level by decreasing LDL-cholesterol and triglycerides, while maintaining or increasing HDL-cholesterol levels.
- LDL-cholesterol levels are best decreased by eating less saturated fat
- Triglyceride levels are best reduced by eating less sugar-containing foods, limiting alcohol intake, and reducing the intake of total fat
- HDL-cholesterol levels are best increased by exercise, substituting saturated fats with polyunsaturated or monounsaturated fat , and maintaining a healthy weight.;
Heart-healthy dietary changes are summarised in our Heart disease diet page.
Other lifestyle changes should include:
- Exercising regularly
- Maintaining a healthy body weight
- Limiting alcohol intake
Heart-healthy exercise suggestions are summarised in our Heart disease exercise page.
How Is An Hdl Cholesterol Test Different From A Total Cholesterol Test
A total cholesterol test measures the sum of all cholesterol found in different kinds of lipoproteins. The total cholesterol number includes HDL cholesterol, LDL cholesterol, and VLDL cholesterol.
Because these kinds of cholesterol have distinct implications for cardiovascular health, tests of total cholesterol often measure HDL cholesterol as well so that more information is provided about the ratio of HDL to non-HDL cholesterol in the blood.
Are Home Cholesterol Testing Kits Accurate
The answer is yes if the tests are labeled CDC-certified. This means that the contents have been approved by the Cholesterol Reference Method Laboratory Network, a group that works with test makers, laboratories and the Centers for Disease Control and Prevention to make sure tests are accurate.
For home tests, you will still need to fast for 12 hours and to obtain blood for testing. Some kits come with packages for mailing to a lab for results. Other kits have a monitor so you can get the results at home. The cost of such home kits vary.
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Are Test Results Accurate
HDL cholesterol testing is extremely common and frequently used to evaluate cardiovascular risk. Like any test, though, HDL cholesterol tests are not perfectly accurate. Certain factors that can influence accuracy of any single test include:
- Individual variability: There can be some differences in HDL cholesterol levels based on individual factors like stress or posture during the test. Minor variation can also occur between laboratories.
- Acute illness: Levels of cholesterol in the blood are affected by inflammation, so infections or other illnesses that produce inflammation may interfere with the accuracy of HDL cholesterol tests.
- Certain blood disorders: Some conditions that affect blood cells cause an increase in a type of protein, known as an M protein, in the blood. In people with these conditions, HDL cholesterol tests may show a lower level of HDL cholesterol than is actually present in their blood.
Point-of-care and at-home tests that use a fingerstick blood sample are nearly as accurate as laboratory testing, but there may be more variability in accuracy based on the brand and the quality of its test.
How Is The Total Cholesterol Or Blood Cholesterol Test Done
A blood test is a routine test. A phlebotomist is the person whose job it is to draw blood. Blood is usually drawn from the vein in your arm. You will sit down and the phlebotomist will wrap a rubber band around your upper arm so that the vein in your elbow sticks out. Then they will use a needle to puncture the vein and remove blood. The blood is sent to the lab to be examined.
Youve probably been at health fairs where testing is offered. In that case, the person performing the test takes a drop of blood from your finger. The finger stick test uses a small blade to poke a hole in the tip of your finger to get the blood.
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You Dont Need To Avoid Eggs And Seafood
Some foods are high in cholesterol but are fine to eat in moderation, as long as your overall diet is low in saturated fats. For example:
- Egg yolks a single egg yolk contains 200250 mg of cholesterol, which is almost the uppermost recommended daily intake . However, reducing egg intake is probably not important for healthy people with normal blood cholesterol levels.
- Seafood prawns and seafood contain some cholesterol, but they are low in saturated fat and also contain healthy omega-3 fatty acids. Seafood is a healthy food and should not be avoided just because it contains cholesterol. However, avoid fried and battered seafood.
Your Total Cholesterol Figure Divided By The Hdl
Whats healthy? The lower this figure, the better. Ideally 4.5, while above 6 is considered high risk.
What should I do? This reading will help your GP work out whether your overall cholesterol levels are healthy, which in turn helps them calculate your risk of CVD – another reason why its important to have full cholesterol results, not just TC. It could be high if your TC, LDL-C and non-HDL cholesterol levels are too high, or if your HDL-C is too low, or a combination of both. Maintaining a healthy TC:HDL ratio long-term can help reduce your risk of CVD in future. You can do this by following the advice above.
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What Do The Results Mean
Cholesterol is usually measured in milligrams of cholesterol per deciliter of blood. The information below shows how the different types of cholesterol measurements are categorized.
|Total Cholesterol Level|
|Less than 40 mg/dL||A major risk factor for heart disease|
A healthy cholesterol range for you may depend on your age, family history, lifestyle, and other risk factors. In general, low LDL levels and high HDL cholesterol levels are good for heart health. High levels of triglycerides may also put you at risk for heart disease.
The LDL on your results may say “calculated” which means it includes a calculation of total cholesterol, HDL, and triglycerides. Your LDL level may also be measured “directly,” without using other measurements. Regardless, you want your LDL number to be low.
Learn more about laboratory tests, reference ranges, and understanding results.
Why Do I Have High Cholesterol
For many people, lifestyle plays a big role in the development of the condition. Its often due to a combination of diet and how active you are, as well as your genetic capacity to produce cholesterol, says Raj Khandwalla, MD, cardiologist and director of digital therapeutics at Smidt Heart Institute at Cedars-Sinai in Los Angeles. Being overweight and smoking can also increase your chances of developing high cholesterol.
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How Is High Cholesterol Diagnosed
You cant tell if you have high cholesterol without having it checked. A simple blood test will reveal your cholesterol level.
Men 35 years of age and older and women 45 years of age and older should have their cholesterol checked. Men and women 20 years of age and older who have;risk factors for heart disease;should have their cholesterol checked. Teens may need to be checked if they are taking certain medicines or have a strong family history of high cholesterol. Ask your doctor how often you should have your cholesterol checked.
Risk factors for heart disease include:
- Cigarette smoking.
- Having an immediate family member who has had heart disease.
- Being overweight or obese.
How To Lower Cholesterol: Know Your Fats
The American Heart Association recommends that just 25% to 35% of your daily calories come from fats such as those found in fish, nuts, and vegetable oils. For healthy people, saturated fat should comprise no more than 7% of your total calories. On a 2,000 calorie-a-day diet, that’s about 140 calories worth of saturated fat. If you need to lower your LDL cholesterol, limit saturated fat to 5% to 6% of calories, or about 11 to 13 grams of saturated fat on a 2,000-calorie diet. Reduce trans fats to less than 1% of your total daily calories. This means avoiding fried foods and many junk foods.
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The Total Amount Of Cholesterol In Your Blood
Whats healthy? Government advice has moved away from giving absolute figures, but ideally your cholesterol should be be 5 mmol/L or less, or 4 mmol/L if youre at high risk of CVD, or you have high blood pressure, diabetes or have had a cardiovascular event.
What should I do? If your TC level is too high, you can help bring it down by making some simple diet and lifestyle changes, such as:
- Being more active.
- Cutting down on foods rich in saturated fats, such as butter, lard and full-fat dairy.
- Swapping fatty meats for lean meats, such as chicken.
- Eating more foods with healthy fats, such as olive oil, nuts, seeds and oily fish.
- Having meat-free days -;try Quorn® or soya products instead.
- Eating more fruits, vegetables and wholegrains, especially oats and barley.
Including more foods fortified with plant sterols or stanols in your diet.
Your doctor or nurse will tell you when you need to be tested again.
What Is Dangerously High Cholesterol
You may be diagnosed with borderline-high or high cholesterol if your blood test results show:
- Total cholesterol higher than 200 milligrams per deciliter
- LDL cholesterol higher than 100 mg/dL
- Triglycerides over 150 mg/dL
- HDL cholesterol lower than 40 mg/dL
But what do these numbers really mean for your health?
While having high cholesterol isnt something youll notice day to day, it does mean youre at risk for or may already have heart disease, the leading cause of death for both women and men in the United States.
Want to know more? Here are answers to 11 frequently asked questions about high cholesterol.
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What Do Cholesterol Test Numbers Mean
If you have a lipoprotein profile, it’s important to look at all the numbers from the cholesterol test, not just the total cholesterol number. That’s because LDL and HDL levels are two primary indicators of potential heart disease. Use the information below to interpret your results . This will help you get a better idea about your risk for heart disease.
Total blood cholesterol level:
- High risk: 240 mg/dL and above
- Borderline high risk: 200-239 mg/dL
- Desirable: Less than 200 mg/dL
- Borderline high risk: 150-199 mg/dL
- Normal: Less than 150 mg/dL
Why Do I Need A Cholesterol Test
You will get a free NHS cholesterol test if you have a number of risk factors for high cholesterol including if youre over 40, have coronary heart disease or diabetes, have had a stroke or mini stroke, or have a family history of cardiovascular disease or a cholesterol-related condition.
Understanding your cholesterol levels
We hear a lot about the dangers of high cholesterol, but unless you have a blood test, you have …
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Hdl Cholesterol: ‘good’ Cholesterol
Not all cholesterol is bad. High-density lipoprotein cholesterol is considered “good” cholesterol because it actually works to keep the LDL, or “bad” cholesterol from building up in your arteries. The higher the HDL, the better. HDL levels of 60 mg/dL and higher can help reduce your risk for heart disease. Conversely, HDL levels of 40 mg/dL and lower are considered a high risk-factor for developing heart disease.
What Is The Difference Between Good Cholesterol And Bad Cholesterol
Good cholesterol is known as high-density lipoprotein . It removes cholesterol from the bloodstream. Low-density lipoprotein is the bad cholesterol.
If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, youre probably not at higher risk.
Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides.
Changing your lifestyle can improve your cholesterol levels, lower LDL and triglycerides, and raise HDL.
Your ideal cholesterol level will depend on your risk for heart disease.
- Total cholesterol level; less than 200 is best, but it depends on your HDL and LDL levels.
- LDL cholesterol levels; less than 130 is best, but this depends on your risk for heart disease.
- HDL cholesterol levels; 60 or higher reduces your risk for heart disease.
- Triglycerides; less than 150 milligrams per deciliter is best.
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What Factors Affect Cholesterol Levels
A variety of factors can affect your cholesterol levels. They include:
- Diet: Saturated fat, trans fat and cholesterol in the food you eat increase cholesterol levels. Try to reduce the amount of saturated fat, trans fat and cholesterol in your diet. This will help lower your blood cholesterol level. Saturated and trans fat have the most impact on blood cholesterol.
- Weight: In addition to being a risk factor for heart disease, being overweight can also increase your triglycerides. Losing weight may help lower your triglyceride levels and raise your HDL.
- Exercise: Regular exercise can lower total cholesterol levels. Exercise has the most effect on lowering triglycerides and raising HDL. You should try to be physically active for 30 minutes on most days of the week.
- Age and sex: As we get older,cholesterol levels rise. Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, womens LDL levels tend to rise and HDL can drop.
- Heredity: Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
Can High Cholesterol Be Prevented Or Avoided
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats . Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat . Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
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How To Lower Cholesterol: Smart Protein
To reduce cholesterol, limit red meat and eat more fish and lean poultry.
How to Prepare Healthy Proteins
- Trim all fat from meats, and remove all skin from poultry before cooking.
- Broil or bake, don’t fry foods.
- Drain fat from any meats before serving.
- Avoid processed meats such as hot dogs or cold cuts, even those labeled “reduced fat,” as many are still high in saturated fats and calories.
- Oily fish such as salmon or trout are high in omega-3 fatty acids, which can reduce triglyceride levels and improve HDL cholesterol levels.
- Soy proteins can also have a beneficial effect and help to reduce LDL cholesterol and triglycerides, while raising HDL cholesterol levels.
Why Should I Lower My Cholesterol
Evidence strongly indicates that high cholesterol can increase the risk of:
- narrowing of the arteries ;
- transient ischaemic attack ; often known as a;”mini stroke”
- peripheral arterial disease
This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a;blood clot developing somewhere in your body.
Your risk of;developing coronary heart disease;also rises as your blood’s cholesterol level increases. This can cause;pain in your chest or arm during stress or physical activity;.
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Does Stress Cause High Cholesterol
While stress is not a primary cause of high cholesterol, it may still have an effect on cholesterol levels. A study published in May 2017 in the journal Medicine found that in people who experienced stress due to work or personal conflict, higher stress was a risk factor for high cholesterol. And when you are feeling stressed and pressed for time, you may be less likely to follow heart-healthy lifestyle measures, such as eating a nutritious diet and getting exercise. The 2017 study found that regular physical exercise had a strong protective effect against cholesterol.
Is There Anything Else I Need To Know About My Cholesterol Levels
High cholesterol can lead to heart disease, the number one cause of death in the United States. While some risk factors for cholesterol, such as age and heredity, are beyond your control, there are actions you can take to lower your LDL levels and reduce your risk, including:
- Eating a healthy diet. Reducing or avoiding foods high in saturated fat and cholesterol can help reduce the cholesterol levels in your blood.
- Losing weight. Being overweight can increase your cholesterol and risk for heart disease.
- Staying active.;Regular exercise may help lower your LDL cholesterol levels and raise your HDL cholesterol levels. It may also help you lose weight.
Talk to your health care provider before making any major change in your diet or exercise routine.
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Further Information And Support
For assessment and treatment of high cholesterol levels see a doctor. For ideas about how to lower high cholesterol levels a doctor or dietitian can assist.
Testing For High Cholesterol
A simple blood test to assess cholesterol levels can be done by your family doctor or at a medical clinic. Your doctor will likely assess other risk factors for cardiovascular disease at the same time. A sample of blood is taken from a vein and is sent to a laboratory for testing. Cholesterol tests may be done using a finger prick of blood, however this is not as accurate as testing blood from a vein.
Blood cholesterol tests can be “fasting” or “non-fasting”. Fasting tests require the person not to have eaten for a period of time prior to the test being taken and give more accurate results than non-fasting tests.
New Zealand health guidelines for acceptable blood cholesterol levels are:
- LDL-cholesterol less than 2.0 mmol/L
- HDL-cholesterol greater than 1.0 mmol/L
- Triglycerides less than 1.7 mmol/L
- Total cholesterol less than 4.0 mmol/L
- Total cholesterol/HDL ratio less than 4.0.
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