What you need to know about cholesterol

Cholesterol is complicated – our bodies need some cholesterol to make hormones, vitamin D, and the bile acids that help you digest fat. But when we have too much, we increase our risk of health problems such as heart disease, heart attacks and stroke.

High cholesterol can affect both men and women and it’s common for cholesterol levels to rise with age. But it’s often a problem for men earlier in life. That’s because the estrogen women produce prior to menopause has a protective effect on the heart, partly due to its ability to help regulate cholesterol levels.

Ministry of Health figures show that last year there were 428,000 New Zealand adults diagnosed with high cholesterol.

So here are a few of the things you need to know about cholesterol to manage the impact it can have on your health.

What is cholesterol?
Cholesterol is a waxy, fat-like substance made in the liver and other cells. It’s also found in certain foods, such as dairy products, eggs, and meat.

There are two types of cholesterol:

Low-density lipoprotein (LDL cholesterol) - sometimes called 'bad cholesterol'. When you have too much LDL cholesterol it builds up in the arteries (the blood vessels that carry blood and oxygen around the body).

The build-up of cholesterol causes lumps of hard fat called plaque to form on the artery walls. These can break off, block the artery, and cause heart attacks and strokes.

High-density lipoprotein cholesterol (HDL cholesterol) -the 'good' cholesterol. It works like a cleaner, carrying LDL cholesterol out of the arteries to your liver, where it is broken down and used by the body.

There is also another type of fat in our bodies - when we eat or drink our body turns any energy (calories) that it doesn't need into triglycerides, which are then stored in fat cells.

How is cholesterol measured?
You can’t tell or feel if you have high cholesterol. The only way to check your cholesterol levels is to get a blood test. Your doctor can arrange for you to have a test at your closest laboratory and some pharmacies offer a finger-prick test to check cholesterol levels.

There isn’t a normal level that applies to everyone. Your ideal cholesterol level depends on your overall risk of heart attack and stroke but general guidelines in New Zealand 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.

What causes high cholesterol?
There are some risk factors for high cholesterol we can’t change – these include family history, age and certain medical conditions such as kidney or liver disease, or hypothyroidism.

But there are lifestyle factors that we can change, such as:

• Eating too much food high in saturated fats, like red meat, butter, cream, and other dairy products
• Eating too many foods with refined sugars, such as sweets, baked goods, white bread and fizzy drinks
• Drinking too much alcohol
• Not being active enough each day
• Smoking
• Having too much body fat, especially around the middle

Lowering your cholesterol

Here are some tips from the Heart Foundation:

Eat heart-healthy food

What you eat can make a big difference to your cholesterol levels.

Cut back on foods high in saturated fats like: 

• pies
• cakes
• chips

 And eat a wide variety of heart-healthy foods like:

• whole grains
• nuts and seeds
• fruits and vegetables
• oily fish.

Drink less alcohol

Drinking too much alcohol can increase your LDL cholesterol and triglycerides. So drinking less is a good way to lower your cholesterol. 

The Ministry of Health recommends no more than 10 standard drinks per week for women and no more than 15 for men. One standard drink is equal to:  

• a standard can of 4% beer (300ml)
• a small glass of wine (100ml)
• a small single shot of spirits (25mls)

If you have high cholesterol or you've been diagnosed with a heart condition, you may need to drink less than this.

Quit smoking

Smoking makes your LDL cholesterol (bad cholesterol) stickier and reduces the amount of HDL cholesterol (good cholesterol) in your blood. It also damages the artery walls. This increases the build-up of plaque in your arteries and can cause risk of heart attack and stroke.

Quitting smoking is a great way to lower your cholesterol levels and reduce your risk of heart disease.

Find out how to quit smoking.

Move more

Sitting less and being more active are great ways to reduce high cholesterol. This doesn’t mean you have to join a gym or take up running – it just means you need to move your body more throughout the day. Ideally you should do 30 minutes of activity a day. 

You could try: 

• using the stairs not the lift
• parking 10 minutes away from your work or getting off the bus a stop early
• walking the dog twice around the park instead of once
• taking a walk outside during a break at work
• having a swim or walk at the beach with family
• doing half an hour of gardening or cleaning.

Read more about the benefits of exercise.

Take cholesterol medication if required

Your doctor may recommend that you take medication to lower your cholesterol. If you take this medication as directed it helps lower your chance of having a heart attack or stroke.

Usually this will be from a group of medications called statins.

The benefits of taking a statin usually outweigh any side-effects. If you experience unpleasant side-effects, talk to your doctor about them. Sometimes they can change the type of statin that you're on or adjust your dose. Never stop taking your cholesterol medication without talking to your doctor first.

We recommend trying our Healthy Blend muesli for breakfast - this is suitable for managing cholesterol and contains whole grains (whole grain oats and whole buckwheat) as well as a variety of seeds and nuts. It is low in both sugar and sodium and contains cinnamon which may be useful for managing cholesterol. All you need is 1/3 of a cup (50g) - top with a plain low-fat yoghurt and some fruit for a satisfying breakfast.

This blog is part of our Men’s Health Month Series.