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SHARP - Scottish Heart & Arterial Risk Prevention
site updated: March 2006
Cholesterol

What is cholesterol?

Cholesterol, one of the groups of fats in the blood called lipids, is a word we have all heard many times, especially, since it was established that cholesterol was one ofthe most important factors in the development of coronary heart disease (CHD).

Cholesterol is a small molecule but despite this has been so intensively studied that by 1985 it had been the subject of 13 Nobel prizes.

In the 1980s there was considerable reluctance to treat cholesterol abnormalities, however in 1994 evidence became available that lowering cholesterol reduced the incidence of heart attacks, strokes and the devlopment of angina and lowered overall mortality. Since that time there has been unprecedented growth in the prescription of medicines to lower cholesterol.


Is cholesterol bad for you?

Cholesterol is bad for you is a statement most people would accept. In fact, cholesterol is essential for life and we could not live without it, but problems arise when cholesterol levels in the blood are too high.

How can there be 'good' cholesterol and 'bad' cholesterol? They sound contradictory but there is a very important distinction.

"Good" cholesterol (or HDL cholesterol) makes up about 20% of the blood cholesterol. It is know known that high levels of HDL Choleserol gives some protection against cardiovascular disease but low levels of HDL Cholesterol increase the risk of cardiovascular disease.

"Bad" cholesterol (or LDL cholesterol) can be deposited in blood vessels leading to narrowing and blockage. If this happens in one of the coronary (heart) arteries it can cause a heart attack or if it occurs in an artery to the brain it can cause a stroke.

Cholesterol and Triglyceride is a fat that always circulates in the blood, especially after a meal high in saturated fat.

High triglyceride levels are associated with obesity, diabetes, low HD cholesterola dn high LDL choelsterol.

Triglyceride levels can be lowered by:

  • eating less total fat
  • eating less sugar/carbohydrates
  • losing weight if necessary
  • decreasing alcohol intake
  • increasing the amount of aerobic type exercise you do
  • Do not add salt to your food without tasting it first
  • Add less salt during cooking.
  • Avoid salty foods and snacks.
  • Avoid convenience foods.
  • Remember everyday foods for example breakfast cereals and fish fingers can contain a lot of salt so read food labels.

Some people, (about 1 in 500), have very high levels of bad cholesterol. This runs in families and is due to an inherited gene, which disturbs the way LDL cholesterol is removed from the blood. This is called familial hypercholesterolaemia (FH).

Where does cholesterol come from?

The body produces its own supply of cholesterol, mainly in the liver, but lesser amounts can come from the diet in foods of animal origin such as meat, dairy products and eggs. Thre are two groups of fat, namely unsaturated fat and saturated fat. saturated fat is often visible and solid at room temperature (e.g. fat on meat).

Unsaturated fat include monosaturated fats, polysaturated fats and omega-3 fats and our diet should contain equal amounts of these. However, a Western diet usually contains a lot more saturated fat than the other kinds of fat.To eat healthily we not only have to reduce the quantity of fat we eat but more importantly our diet should contain the right porportions of the correct kind of fat.

The following chart summarises the effects of the different groups of fats:

 

Risk Factors
Smoking
Alcohol
An unhealthy diet
Not enough exercise
Being overweight
High blood pressure
Stress
Cholesterol

 

 

 
UNSATURATED FATS

Saturated
Fats

 Monounsaturated fats Polyunsaturated fatsOmega-3 fats
What do they doMonounsaturated fats can help lower LDL levels and do not lower HDL cholesterol level (the "protective" cholesterol)Polyunsaturated fats can help lower LDL cholesterol, but they also lower HDL cholesterol.Omega-3 fats are a particular type of polyunsaturated fat. They can help prevent blood clotting and help reduce triglyceride levels.Saturated fats increase LDL cholesterol levels.

 

Choosing healthier fats

The chart below shows how to choose healthier fats and so improve cholesterol levels in the blood.

 

 
 
UNSATURATED FATS

Saturated
Fats

 Monounsaturated fats Polyunsaturated fatsOmega-3 fats
Which foods are they found in?

Monounsaturated fats are found in:

  • olive oil
  • walnut oil
  • rapeseed oil
  • avocado





Some margarines and spreads are made from monounsaturated fats

Polyunsaturated fats are found in:

  • cornflower oil
  • sunflower oil
  • soya oil
  • fish oil





Some margarines and spreads are made from polyunsaturated

Omega-3 fats are found in:

  • fish oil
  • Oily fish such as herring, kippers, mackerel, pilchards, sardines, salmon, trout and fresh tuna.

Our bodies can also make omega-3 fats from rapeseed oil and from the oil in walnuts and soya.

Saturated fats are found in:

  • butter
  • hard cheese
  • lard
  • dripping
  • suet
  • ghee
  • coconut oil
  • palm oil

 

Cholesterol is not the only factor which influences the development of narrowed blood vessels and it must n ot be regarded in isolation. Other risk factors such as smoking, high blood pressure, diabetes, lack of exercise, age, sex and ethniciticy should also be considered.

Taking these factors into account some people may need to be treated with medication. Statins are a group of medicines which lower bad cholesterol. They have been shown to reduce the developement and progression of vascular disease.

There are also hidden fats in foods such as cakes, biscuits and confectionery. Moreover, convenience foods often contain fat which has been hydrogenated by the manufacturer. These are called trans fats and are bad for you. Do read food labels and avoid food where listed ingredients incude the work hydrogenated.

 
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