Having raised levels of blood cholesterol is known to be a major risk factor in developing heart disease and suffering premature death. Accordingly, the smart thing to do is to lower your cholesterol to safe levels and there are two methods that will reliably achieve this. These are 1) making a number of lifestyle changes and 2) using cholesterol lowering medication.
Hypercholesterolemia (as high cholesterol is technically called) is a fairly common complaint in Western society but has in fact only come about relatively recently, due in large part to features of the typical modern lifestyle. For most people whose cholesterol levels are abnormally raised, quite modest changes to their diet and exercise patterns are all that is required to bring their levels back within acceptable limits.
Some people are found to either have cholesterol levels so high that lifestyle modifications alone would not be sufficient, or they carry a genetic fault (familial hypercholesterolemia) that would similarly limit the benefit of improved diet and exercise. Such people are generally offered cholesterol lowering drugs called statins which come in a range of strengths and which they can expect to keep taking for as long as they live.
Before we take a closer look at these two options (lifestyle and medication) it’s helpful to realise that when a doctor, for example, considers your cholesterol level they are in fact weighing up two distinct types of cholesterol, called LDL (”bad cholesterol”) and HDL (”good cholesterol”).
LDL (Low Density Lipoprotein) is composed in the main of lipids (body fats) and is produced by your liver as part of the overall digestion of what you eat. From the liver it is sent through the entire blood stream to supply energy to every tissue in your body. So LDL is crucial in fuelling your body, but unfortunately unused energy (excess LDL) tends to build up as fatty deposits in veins and arteries, storing up problems for the future.
HDL, which stands for High Density Lipoprotein, has the capacity to mop up excess LDL which it returns to the liver for reuse or excretion. However, since your body has a great deal more LDL than HDL, HDL alone is limited in how much excess LDL cholesterol it can deal with, though research has revealed that HDL levels increase as a consequence of taking more exercise.
The changes to your lifestyle that are recommended to decrease LDL cholesterol stem from medical research that points to smoking, drinking, eating particular kinds of food, eating too much (being overweight) and doing too little (insufficient exercise) being significant factors in most cases of high cholesterol. The obvious conclusion is that refraining from such behaviour will automatically tend to lower LDL cholesterol levels.
So what types of foods are best avoided? The simple answer is anything that contains saturated fat; so hard cheese, butter, red meat, pastries, cakes and biscuits. Conversely you should aim to increase your intake of fruit, vegetables, oat and beans as these foods actively help to lower cholesterol. Switching from butter to a plant sterol based spread (commonly marketed as “cholesterol lowering” spreads) gets the best of both worlds.
If lifestyle modifications alone aren’t able to lower your cholesterol below medically approved limits then you should seek the advice of your doctor who will most likely prescribe one of a group of drugs called statins. These pills are not in any way an alternative to adopting a healthier lifestyle; they are a supplement.
The statins most usually prescribed are (in order of their potency and showing both clinical and brand names) as follows:
pravastatin (Lipostat); simvastatin (Zocor); atorvastatin (Lipitor); rosuvastatin (Crestor).
Most people who take statins tolerate the drugs extremely well and manifest no side effects, but you should nevertheless be aware that statins, particularly in high doses, have the capacity to cause serious damage to the liver and to muscle tissue. Accordingly, it is likely that if statins become a routine part of your life then so too will occasional blood tests to not only keep an eye on your cholesterol levels (and adjust doses if required) but also to ensure that there are no detrimental side effects that you may not be immediately aware of.
So in conclusion, there are two proven and medically approved means to lowering your cholesterol; the difference between them being just a matter of degree since cholesterol lowering medication provides an extra boost that adds to rather than replaces the primary strategy of improving your lifestyle.
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