How to lower your cholesterol – a doctor's guide

Last updated:
Reviewed by:
Dr Rhianna McClymont, Lead GP at Livi
Your cholesterol measurement is a key indicator of 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.

Need to speak to a GP today?

Book appointment

In the UK, around twice as many people are living with heart and circulatory diseases (known as CVD) than with cancer and Alzheimer’s disease combined. One of the biggest risk factors for CVD is high cholesterol.

The good news is there are lots of simple lifestyle steps you can take to help lower your cholesterol levels.

Dr McClymont explains why cholesterol levels are important and what you can do to stay healthy.

Why is high cholesterol so unhealthy?

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

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 of high cholesterol?

‘Statistically, young men are more likely to have problems with high cholesterol than young women,’ says Dr McClymont.

‘However, after menopause, when women’s oestrogen levels start declining, they become more likely to have raised cholesterol levels, especially LDL cholesterol which is known as the ‘bad’ cholesterol.’

Should I have my cholesterol checked?

There are not any obvious or visible high cholesterol symptoms, so getting tested is the easiest way to know for sure.

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.

What should your cholesterol be?

‘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 your risk of heart disease.

How to lower cholesterol through 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 intake 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 one serving a week in your diet. Remember 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 you use can help reduce your risk of CVD by 30%. Choosing leaner cuts of red meat (and eating less of it), and switching to low or lower-fat dairy products helps too. It’s also a good idea to grill, poach or steam food instead of frying, 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 pasta and bread.

Oats are another example of cholesterol reducing foods, because they contain natural sugars called beta-glucans, 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 more convenient.

4. Quit smoking

Its proven that 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.

If you need help to quit smoking, there are lots of free resources available. Nicotine replacement products like patches or gum, for example, can help curb cigarette cravings and there are other options like support groups or one-to-one counselling.

5. Swap the junk food for home cooking

Home cooked foods are always the best option when considering a diet to reduce cholesterol. Processed foods are often high in saturated fats, refined grains, added sugars and salt, which all increase the risk of high cholesterol and CVD risk factors, like weight gain.

Cook from scratch wherever possible, and check food 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 a Mediterranean-inspired diet

A more plant-based Mediterranean style of eating has been shown to help reduce blood cholesterol by 13%-15%. This approach involves a variety of 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.

While some may experience side effects to statins like muscle aches, many of these people can tolerate another statin better.

Always speak to a GP if you are experiencing problems with your medication.

Speak to a GP about your cholesterol

It can be hard to know whether your cholesterol levels are too high. A GP can help you with any concerns.

Book appointment

Get expert advice and tips

Sign up to get the best of our health content delivered right to your inbox.