Control Your Cholesterol With These Simple Steps

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This article was inspired by my own diagnosis of hypercholesterolaemia at the tender age of 29. Faced with a new chronic health issue despite being relatively young, I decided to try and manage my cholesterol with lifestyle changes only, before resorting to medication. I wrote this article as a means to document my own journey, and hopefully provide some insight to others going through the same thing.

Note: This article should not be taken as medical advice. Each individual has different health needs and you should consult your doctor before making any lifestyle changes.

Jump to Section:
1. What is Cholesterol?
2. General Lifestyle Changes
3. Reducing your total cholesterol or your LDL (‘bad’) cholesterol
4. Increasing your HDL (‘good’) cholesterol
5. Reducing your triglycerides
6. Medication
7. Further Reading

So what is cholesterol?

Cholesterol is a fatty substance found in your body that’s important for your body to build cells and make vitamins and hormones. Everyone has some cholesterol, and it’s not inherently bad, but too much of it can be a problem. High cholesterol levels can cause plaques to build up in your arteries, which makes them narrower and puts you at increased risk of heart attacks and strokes – a condition known as atherosclerosis. 

Where does it come from?

There are 2 sources of cholesterol.

  1. It’s produced by your liver – this is all the cholesterol your body actually needs for its vital functions
  2. Dietary sources from food that comes from animals. For example, meat, poultry, and dairy products all contain cholesterol.

The Good (HDL), the Bad (LDL), and the Ugly (TG)

So now we know what cholesterol is and where it comes from, what are the different types of cholesterol?

The Good – HDL cholesterol

HDL carries LDL (bad cholesterol) from your arteries back to your liver, where the LDL is broken down. HDL is known as the ‘good’ cholesterol because healthy levels may protect you from heart attacks and strokes.

The Bad – LDL cholesterol

LDL is the cholesterol that is deposited in your arteries causing atherosclerosis. It is known as the ‘bad’ cholesterol because high levels put you at an increased risk of heart attacks and strokes.

The Ugly – Triglycerides

Triglycerides (TG) are another type of fat that stores excess energy from your diet. High TG levels can also cause atherosclerosis, so they’re just as bad as LDL cholesterol.

Ideally you want your HDL cholesterol to be high, and your LDL cholesterol and TG to be low. Once your doctor has picked up that you have high cholesterol, your doctor can do a blood test called a Fasting Lipogram to figure out exactly where the problem lies.

Control Your Cholesterol with these Simple Tips

As with most chronic health conditions, it’s important to implement lifestyle modifications first before starting medication for it, where possible. In many cases, lifestyle modification alone can be sufficient to control the condition. Even if medication ultimately is required, this should be taken in conjunction with lifestyle changes – you won’t control your cholesterol by just taking pills while having the same unhealthy diet.

Now that we’ve cleared that up, on to the good stuff. I’ve broken this post down into different sections with different ways to control your cholesterol, according to individual needs:

Which dietary changes you require can vary depending on which type of cholesterol is high, although with considerable overlap – your doctor will be able to tell you after doing a blood test (fasting lipogram) and advise on which changes you need. 

General Lifestyle Changes:

Weight loss – even as little as 2-5 kg weight loss already starts to improve raised blood cholesterol levels. This is great for reducing LDL cholesterol, reducing TG levels, and improving HDL cholesterol – a great way to improve your entire cholesterol profile.

Be active – moderate to intense exercise multiple times per week.

Stop smoking.

Stop drinking.

Reducing your LDL (‘bad’) or total cholesterol

These are general changes which anyone with high LDL or total cholesterol can benefit from.

Choose healthier fats

Cut down on unhealthy sources of fats high in saturated and trans fats which can raise cholesterol levels. These can be found in foods such as fatty and processed meats, chicken skin, butter, ghee, cream and hard cheeses, coconut or palm oil, pies, pastries, biscuits, crackers, fast foods and deep-fried fires. Replace these with healthier fats rich in mono- and polyunsaturated fats such as plant oils, peanut butter, nuts and seeds, avocado and fish.

Eat high fibre foods.

Soluble fibre especially helps to lower cholesterol levels and can be found in foods such as oats, lentils, beans, vegetables and fruit. Increase daily dietary fibre intake by choosing high fibre whole-grain options, eating at least 5 fruit and vegetables daily and including a wide variety of legumes such as beans, peas, lentils and soya.

Eat food high in dietary cholesterol in moderation

Certain foods, notably eggs, organ meats, shellfish and red meat in general contain cholesterol. However, dietary cholesterol in food does not typically make a great contribution to blood cholesterol. It is more important to eat foods low in saturated and trans fats. Most people that eat a generally healthy diet can consume roughly 7 eggs a week and do not need to avoid occasionally eating high-cholesterol foods like shellfish or liver. In cases where cholesterol levels are very high or uncontrolled, a doctor or dietitian may suggest limiting these foods.

Add plant sterols or stanols

When used as part of a healthy diet, plant sterols or stanols can help to lower cholesterol levels by up to 10-15% by reducing the absorption of cholesterol in the small intestine.

Increasing your HDL (‘good’) cholesterol

Better carb intake

Reduce total carbohydrate intake, especially refined carbohydrates like white bread, white rice, pastries, and biscuits.

Replace refined carbohydrates with healthy fats like mono- and polyunsaturated fats such as avocado, olive oil, nuts and seeds. Choose carbohydrates that have a lower glycaemic index and are higher in fibre.

Only consume alcohol in moderation, if at all. 

Limit added sugars such as sweets, chocolates, sweetened soft drinks, fruit juices, flavoured water and sweetened dairy products.

Reducing your triglycerides

Reduce alcohol intake.

Reduce total carbohydrate intake, especially refined carbohydrates like white bread, white rice, pastries, sweets and biscuits.

Limit added sugars such as sweets, chocolates, sweetened soft drinks, fruit juices, flavoured water and sweetened dairy products.

Choose foods high in omega 3 fats, especially naturally oily fish such as sardines, pilchards, mackerel and salmon, which should be eaten at least twice a week. Plants products such as walnuts, flaxseed, canola are also good sources. If this is not possible, a medical professional may recommend omega 3 supplements.

Reduce intake of saturated fat and replace this with sources of mono- and polyunsaturated fats such as avocado, olive oil, nuts and seeds.

Medication

Sometimes lifestyle and dietary changes are just not enough, and medication can be initiated in this case. Note that as with many chronic health conditions, I believe lifestyle changes should be implemented first before resorting to medication, and when medication is started it should be in addition to lifestyle changes already in place, rather than a complete replacement. As always, speak to your doctor about which medication is right for you as well as possible side effects.

Statins  

Statins are a class of medication that reduce LDL cholesterol and improve mortality rates in patients with cardiovascular disease. This is the main class of drug that would be used to lower cholesterol. The FDA has a great page for more information on Statins.

Omega 3 and 6 supplements

Omega 3 and 6 are “healthy” fatty acids, and are a useful supplement to take if you find it difficult to get enough of the “good fats” in your diet i.e. mono- and poly-unsaturated fats.

Other medications that can be used include fibrates, ezetimibe, and several others.


It can be a daunting task to control your cholesterol, but with a healthy diet and some lifestyle changes, and a bit of motivation, it can be done.

For some further reading, here is a great page from the American Heart Association: What is Cholesterol?

They also have a helpful section on Healthy Eating to get you started on a better diet.

And in case you missed it, here is the FDA’s informative page onStatins.

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