Home
Bupa members

Support and offers for individual members and customers

High cholesterol Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about high cholesterol

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How do the fats in my food affect my cholesterol levels?

Fat is a good source of energy but eating too much of the wrong types of fat increases your cholesterol levels and therefore your risk of heart disease.

Explanation

Some fat is an essential part of a healthy diet but it's important that you don't eat too much of it and that you're careful about the type of fat that you eat.

The fat in your blood is turned into cholesterol by your liver. The cholesterol then enters your blood to be transported around your body. Not all cholesterol is bad for you; there is a harmful form and a protective form. The harmful form of cholesterol is known as LDL or low-density lipoprotein. The protective form of cholesterol is known as HDL or high-density lipoprotein.

You should reduce the amount and type of fat that you eat to help reduce your cholesterol level. There are different types of fat in food.

  • Saturated fats - these increase cholesterol levels. Examples of foods high in saturated fat include cakes and biscuits, pastry, meat products and hard cheese.
  • Trans fats - these have a similar effect on cholesterol levels as saturated fats. Foods containing hydrogenated vegetable oil, which must be listed in the ingredients list on the label, might contain trans fats. Trans fats currently don't need to be labelled separately on food labels. They can be found in biscuits and cakes, fast food and some margarines.
  • Mono-unsaturated fats - these help lower harmful cholesterol levels. Examples of foods high in mono-unsaturated fats include olive oil and rapeseed oil.
  • Polyunsaturated fats - these lower both harmful and protective cholesterol levels. Examples of foods high in polyunsaturated fats include sunflower oil and soya oil.

When you're shopping for food, compare the labels so you can pick those with less total fat or less saturated fat. Try and choose lower fat versions of dairy foods, such as semi-skimmed or skimmed milk, and reduced-fat yoghurt, whenever you can.

There is a particular type of polyunsaturated fat called omega-3 which can help to reduce your cholesterol levels. You can get omega-3 fats from:

  • oily fish, such as kippers, mackerel, sardines and salmon
  • certain oils, such as rapeseed, walnut and linseed oil
  • fish-oil supplements

You should aim to eat at least one portion of oily fish per week, although you should limit this to a maximum of two portions per week if you're pregnant or breastfeeding.

If you're worried about high cholesterol, ask your GP for advice.

Further information

Sources

  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:120
  • What is a healthy diet? British Heart Foundation. www.bhf.org.uk, accessed 9 September 2008
  • Cholesterol. British Heart Foundation. www.bhf.org.uk, accessed 9 September 2008
  • Fats. Food Standards Agency. www.eatwell.gov.uk, accessed 9 September 2008
  • Polyunsaturated fats and monounsaturated fats. Food Standards Agency. www.eatwell.gov.uk, accessed 9 September 2008
  • Fish and shellfish. Food Standards Agency. www.eatwell.gov.uk, accessed 27 May 2008
back to top

My GP has prescribed me a statin but my partner is using a different one. Are all statins the same?

All statins available in the UK have similar cholesterol-lowering effects and a low chance of any side-effects. Your GP will prescribe you a statin at a particular dose which he or she thinks is suitable for reducing your cholesterol levels.

Explanation

There are five different types of statin available in the UK. Examples include atorvastatin (Lipitor), fluvastatin (Lescol) and simvastatin (Zocor). All statins work in the same way. They lower the level of cholesterol in your blood, especially low-density cholesterol (LDL) or "bad" cholesterol. Statins do this by blocking a key step in the series of reactions needed to make cholesterol from very simple chemicals in your liver cells. As a result, your liver cells detect low levels of cholesterol and suck up cholesterol from your blood, reducing the levels of cholesterol in your blood.

Some cholesterol is still needed by your body so you wouldn't want a statin to remove it all, but the reduced levels in your blood will reduce your risk of heart disease, including heart attacks.

The dose of statin you take will affect how much cholesterol will be removed from your blood. Different statins may require different doses to remove the same amount of cholesterol from your blood. These doses may also have different effects on your cholesterol levels over different periods of time. Your cholesterol levels will be regularly checked and the dose of your statin may be modified by your GP.

As with any medicine, you may have some side-effects when taking statins, but these are generally mild and similar for all types of statin. Tens of thousands of patients have used this type of medicine for periods of five years or more without any problems.

Your GP will prescribe you a statin which he or she thinks is suitable for reducing your cholesterol levels. If your GP decides to change the type or dose of statin that you're using, he or she will explain the reasons for this to you.

Further information

Sources

  • Statins - all the same? HEART UK. www.heartuk.org.uk, accessed 11 August 2008
  • Statins for the prevention of cardiovascular events. National Institute for Health and Clinical Excellence (NICE), 2008, Technology Appraisal 94. www.nice.org.uk
  • Joint Formulary Committee, British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:140-142
back to top

What is the "normal" level of cholesterol that I should have in my blood?

Cholesterol plays an important role in your body's cells. However, too much cholesterol in your blood can increase your risk of heart problems. If you're not receiving any medicines to reduce your cholesterol levels, you should aim for a total cholesterol level of 5mmol/L or less. If you're at risk of developing heart disease, then your GP may advise you to aim for a total cholesterol level under 4mmol/L.

Explanation

Most cholesterol is made by your body and this fatty substance plays an essential role in how every cell in your body works. Cholesterol is transported around your body attached to a protein in your blood. This combination of fat and protein is called a lipoprotein and there are several types of lipoprotein, depending on how much protein there is in relation to fat. Nearly three-quarters of your body's cholesterol is transported in your blood as low-density lipoproteins (or LDL). LDL is considered to be the "bad" type of cholesterol as it causes cholesterol to be deposited in your blood vessels. Smaller amounts of cholesterol are transported in high-density lipoproteins (or HDL) and very low-density lipoproteins (or VLDL). HDL is considered to be the "good" type of cholesterol as it helps prevent cholesterol building up in your blood vessels. VLDLs are rich in triglycerides, a different type of fat from cholesterol, which mostly come from fats in your food.

Generally, the levels of cholesterol in your blood are considered by your GP as part of your overall cardiovascular risk. The following fat levels are generally regarded as being desirable if you're not receiving any cholesterol-reducing medicines.

  • Your total cholesterol should be 5mmol/L or less and your total cholesterol/HDL cholesterol ratio should be 4.5 or less.
  • You should aim to have an LDL cholesterol level (while fasting) of 3mmol/L or less, while your HDL cholesterol level should ideally be 1.2mmol/L or higher.
  • The level of triglycerides in your blood when fasting should ideally be 1.5mmol/L or less.

It's important to remember that there are different types of fat in food, each of which can affect your cholesterol levels.

  • Saturated fats increase your cholesterol levels. Foods typically high in saturated fat include cakes and biscuits, pastry, meat products and hard cheese.
  • Trans fats have a similar effect on cholesterol levels as saturated fats. Trans fats can be found in biscuits and cakes, fast food and some margarines, although they don't need to be shown on food labels.
  • Mono-unsaturated and polyunsaturated fats can help to lower your cholesterol level. Olive oil and rapeseed oil are both high in mono-unsaturated fats. Sunflower oil and soya oil are both high in polyunsaturated fats.

You should aim to reduce your cholesterol level by reducing the overall amount and type of fat that you eat. When you're shopping for food, compare the labels so you can pick those with less total fat or less saturated fat. Try and choose lower-fat versions of dairy foods, such as semi-skimmed or skimmed milk and reduced-fat yoghurt, whenever you can.

If you want to cut down on fats in your diet, you can compare the labels of different food products and choose those with less total fat and less saturated fat. Foods high in fat typically have more than 20g fat per 100g, whereas low-fat foods have 3g of fat or less per 100g. For saturated fat, which increases cholesterol levels, a high level is more than 5g of saturates per 100g. Food low in saturated fats contain 1.5g saturates or less per 100g.

Further information

Sources

  • Cooper A, Nherera L, Calvert N et al. Clinical guidelines and evidence review for lipid modification: cardiovascular risk assessment and the primary and secondary prevention of cardiovascular disease. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners, 2008
  • Cardiovascular protective drug therapy. JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice, Heart 2005; 91(Suppl V):V1-V52. www.heartjnl.com
  • Lipids management - background information. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 9 September 2008
  • Cholesterol. British Heart Foundation. www.bhf.org.uk, accessed 3 September 2008
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007:322-323
  • Fats. Food Standards Agency. www.eatwell.gov.uk, accessed 9 September 2008
  • Polyunsaturated fats and monounsaturated fats. Food Standards Agency. www.eatwell.gov.uk, accessed 9 September 2008
back to top

Related topics

back to top

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

Rate this page

Feedback

Have you found the information in this factsheet helpful? Do take a couple of moments to give us your feedback.