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6 ways to help lower your cholesterol

5 Mar 2021

Your cholesterol measurement is a key indicator of your heart disease risk. If it's on the high side, there are proven lifestyle measures that can help reduce it. Dr Rhianna McClymont, Livi Lead GP, shares her advice

Heart disease is a common health problem rarely talked about, yet it kills twice as many people across Europe each year as Covid-19 has to date.

One of the biggest risk factors for heart and cardiovascular disease (or CVD — a general term for conditions affecting the heart and blood vessels) is high cholesterol. The good news is that there are many simple lifestyle steps you can take to help reduce your cholesterol levels.

Dr Rhianna McClymont, Livi Lead GP, explains what cholesterol is, why it’s important and what you can do to reduce your cholesterol levels.

What is cholesterol and why is it so unhealthy?

Cholesterol is a fat which is made in the liver. It’s also found in some foods. But current research shows that for most healthy people, cholesterol in food, like eggs, has a much smaller effect on blood levels of total cholesterol and harmful LDL cholesterol compared to the more harmful effects of saturated fats found in foods like butter and fatty meats.

Cholesterol itself is not unhealthy and every cell in your body needs it. But if there’s too much circulating in your blood, it can clog up and damage blood vessels. Experts agree that reducing cholesterol can be a crucial step in reducing your risk of CVD.

Who is at risk?

‘Statistically, young men are more likely to have problems with high cholesterol than young women,’ says Dr McClymont. ‘However, after menopause, when women lose the protective effect of the hormone oestrogen which declines at this time, this reverses and women become more likely to have raised cholesterol levels, especially LDL cholesterol.’

Should I have my cholesterol checked?

When someone has high cholesterol, there are no outward signs of a problem, so getting tested may be the only way to know.

Your doctor can measure your cholesterol using a blood test . If you’re over 40, it will be tested using a finger prick test as part of your routine NHS Health Check (you should receive a letter from your doctor about this).

‘The NHS recommends everyone over the age of 40 has a cholesterol test,’ Dr McClymont says. But your heart disease risk depends on other factors as well. ‘GPs will look at your age, sex, weight, blood pressure, history of diabetes and your family history of heart problems.’

Some genes are associated with high cholesterol and an inherited condition called familial hypercholesterolemia.

How much cholesterol is too high?

‘Aim for a total cholesterol of below 5mmol/l,’ Dr McClymont advises. But not all cholesterol is the same, she explains. HDL cholesterol is often described as ‘good cholesterol’ and thought to protect against heart disease, while ‘bad’ LDL cholesterol increases the risk. An easy way to remember which is which, is to think of HDL as happy and LDL as lousy.

‘An important aspect of cholesterol can be the ratio of total cholesterol (TC) to good cholesterol (HDL). Ideally, this should be as low as possible,’ Dr McClymont says. Calculate this by dividing your TC number by your HDL number. So for example, if your TC is 4.5 mmol/L and HDL is 1.2 mmol/L, the ratio is 3.75. The lower the ratio, the lower the risk of heart disease.

How to reduce cholesterol through diet and lifestyle changes

These simple changes to your diet and lifestyle have proven to lower cholesterol levels.

1. Cut back on saturated fats

Eating a diet high in saturated fats increases the risk of high cholesterol. These fats are found in meat, cheese and other animal-based foods, as well as some vegetable oils like palm and coconut oil.

A review of the evidence, which looked at 15 studies with more than 56,000 participants, found cutting saturated fat intakes reduced the risk of CVD by 17%.

Eating omega-3 fatty acids (found in oily fish like salmon and herring) may stop cholesterol from building up on artery walls so it can be helpful to include a serving a week in your diet. Do note, though, that there is different advice for women who are breastfeeding or pregnant and for children and babies.

Switching to unsaturated oils like rapeseed, sunflower and olive oils and reducing the amount of overall fats and oils you use can help reduce your risk of CVD by as much as 30%. Buy leaner cuts of red meat, and try to eat less of it and switch to low or lower-fat dairy products. Grill, poach or steam food instead of frying it, whenever you can.

2. Eat more fibre

Studies show that eating 3g of soluble fibre a day — the amount you would get from 3 apples or 3 bowls of porridge (28g servings) — can help lower cholesterol.

You can increase your fibre intake by eating more fruit, vegetables, wholegrain cereals, beans and other pulses, and switching to wholegrain versions of pasta, bread and other foods.

Oats are particularly helpful because, along with fibre, they contain natural sugars called beta-glucans, which are also proven to help lower cholesterol.

3. Get moving

Studies show that doing 120 minutes a week of aerobic exercise helps to increase protective HDL cholesterol and reduces the risk of CVD by 5.1% in men and 7.6% in women. Aerobic exercise is anything that gets your heart pumping and makes you out of breath. And, it can be done in small chunks throughout the day if it’s inconvenient to do your daily exercise quota at once.

4. Quit smoking

Apart from all the other health dangers, like raising your risk of death from all cancers, studies show smokers have lower levels of healthy HDL cholesterol than non-smokers. But a rise in HDL cholesterol can occur less than 3 weeks after giving up smoking.

There are lots of free smoking cessation resources available. Nicotine replacement products like patches or gum, for example, can help curb cigarette cravings and there are other options such as support groups or one-to-one counselling. . A Livi doctor can talk you through all the help available.

5. Swap the junk food for home cooking when you can

Processed foods are often high in saturated fats, refined grains, added sugars and salt, which all increase the risk of high cholesterol and other CVD risk factors, including weight gain.

Cook from scratch wherever possible, and check labels. As a general rule, the longer the list of ingredients, and the less familiar their names are as foods, the more highly processed the product will be.

6. Consider the Mediterranean style of eating

A more plant-based Mediterranean-style diet has been shown in research to help reduce blood cholesterol by 13%-15%. For a more Mediterranean approach, aim to include brightly coloured fruits, vegetables and wholegrains in your diet as well as healthy servings of fish and healthy fats like olive oil.

What about cholesterol-lowering drugs?

If diet and lifestyle aren’t enough to reduce your cholesterol, your doctor may consider prescribing a statin. ‘These drugs block the production of LDL cholesterol and are offered to anyone with a history of CVD, or who hasn’t managed to reduce their risk with lifestyle changes,’ says Dr McClymont.

Some people experience side effects like muscle aches. But Dr McClymont says: ‘Many people who have side effects to one particular statin, tolerate another slightly better. Speak to a GP if you are experiencing problems.’

Dr Rhianna McClymont
Lead GP at Livi
Last updated:

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