Trying to lower your cholesterol, here are some key facts and nutrition tips that might help you find your way:

What is cholesterol?

Cholesterol is a fatty substance (lipid) that is made in the cells of your body. Many cells make cholesterol, the liver makes about one quarter of the total. You need some cholesterol to maintain your health. Cholesterol helps to build the structure of your body’s cells, make hormones like oestrogen and testosterone, produce vitamin D and helps your metabolism work efficiently.
Types of cholesterol

Cholesterol is carried in your blood by proteins, and when the two combine they are called lipoproteins. There are harmful and protective lipoproteins known as LDL and HDL, or bad and good cholesterol:

  • Low-density lipoprotein (LDL): LDL carries cholesterol from your liver to the cells that need it. If there is too much cholesterol for the cells to use, it can build up in the artery walls, leading to disease of the arteries. For this reason, LDL cholesterol is known as “bad cholesterol”.
  • High-density lipoprotein (HDL): HDL carries cholesterol away from the cells and back to the liver, where it is either broken down or passed out of the body as a waste product. For this reason, it is referred to as “good cholesterol” and higher levels are better.

The amount of cholesterol in the blood (both LDL and HDL) can be measured with a blood test. The recommended cholesterol levels in the blood vary between healthy adults and those at higher risk.

Triglycerides (fats carried in the blood from the food we eat for example meat, dairy and cooking oil. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.) The higher the triglyceride level the lower the HDL.

The NHS says for healthy adults your cholesterol levels should be:

  • Total cholesterol < 5.0 mmol
  • LDL cholesterol < 3 mmol
  • HDL level >1 mmol for men and 1.2 for women
  • Triglyceride level <2 mmol
  • TC: HDL ratio < 4 This is the total cholesterol divided by the HDL. A total above 6 is considered high risk.

Diet and cholesterol

The Mediterranean diet as it has been proven to support good heart health, the basic principles include:

  • Low red meat, but high fish/shellfish (x4 per week), moderate eggs and low fat dairy
  • High in unsaturated and polyunsaturated fats and low in saturated fat
  • Very high fresh fruit and vegetable intake (including high use of herbs and garlic)
  • High in wholegrains and fibre generally
  • A small amount of red wine (125ml daily)

Reduce consumption of saturated fat which raises levels of ‘bad’ cholesterol, for example:

  • Red and processed meat
  • Full fat dairy (milk, butter, cream)
  • Junk food (pizzas, fish & chips, burgers, take away)
  • Pastry items, cakes, biscuits, chocolate, ice cream

Avoid trans and hydrogenated fats – Trans fats are fats that have been modified (by hydrogenation) in order to increase the shelf life of products. They are considered the most dangerous type of fats to eat as they both raise your LDL (“bad”) cholesterol and lowers your HDL (“good”) cholesterol. They are mostly found in fried foods and cheap spreads biscuits and cakes.

Limit omega-6 fats and too high a proportion (in relation to omega 3) has been shown to contribute to cardiovascular risk.

Include plenty of omega-3 and omega-9  in your diet as they can regulate cholesterol levels and promote healing (so may help prevent plaque build-up and repair any previous damage). They include:

  • Omega-3 rich: Oily fish: salmon, trout, anchovy, fresh tuna, mackerel, herring, sardines, Cornish sardines. Nuts and seeds: hemp, flax (linseeds), walnuts and pumpkin seeds (and their oils).
  • Omega-9 rich: Olives, avocados, almonds, cashew nuts and their oils, canola oil.

Limit red meat consumption and include lots of fish and shellfish, moderate amounts of chicken, eggs and dairy. Include vegetarian proteins in your diet, beans and pulses, nuts and seeds and fermented soy products such as tofu (which have been shown to confer cholesterol lowering benefits).

Increase fibre – start the day with porridge, snack on celery, nuts and carrots, change to whole grains, add pulses to soups and stews, have an extra portion of vegetables – these all help to remove used cholesterol from the body.

Increase vegetables – dark green leafy vegetables and yellow, orange and red vegetables provide antioxidants – nutrients which help to reduce oxidation (the normal body process by which energy is made). Oxidation can damage cholesterol, leading to atherosclerosis which is the formation of plaque in the arteries. Add finely shredded raw vegetables or lightly steamed vegetables to both lunch and dinner. Garlic also has cholesterol reducing properties.

Have a moderate amount of red wine (125ml is a tiny old fashioned French glass, more than this has negative implications for health), preferrably in a social environment as being engaged in a social structure has also been show to have a positive influence on heart health.