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Cholesterol and your health

Cholesterol is a fatty substance produced by the liver from saturated fat and carried around the body in your blood. You need cholesterol for essential processes in your body such as making vitamin D and hormones like oestrogen and testosterone. However, too much cholesterol in the blood can lead to health problems such as coronary heart disease and stroke. This is why it’s important to understand what you can do to help keep your blood cholesterol levels in check.

Cholesterol and cardiovascular disease 

If there is too much cholesterol in your blood, it may build up in your arteries and contribute to fatty deposits called plaques. This process is called atherosclerosis and can lead to a narrowing and stiffening of the arteries over time.

Cholesterol and your heart health from Bupa Australia on Vimeo.

This can reduce blood flow so less oxygen and nutrients can be delivered to organs or tissues. If it happens:

  • In the coronary blood vessels of your heart – you may develop coronary heart disease. This, in turn, can lead to angina (chest pain) and heart attacks (if the artery becomes completely blocked). In fact, coronary heart disease remains the single biggest killer of men and women in Australia.
  • In one of the arteries in your brain – you may experience a stroke if the artery becomes blocked.
  • In an artery in your arm, leg or kidney – you may develop peripheral vascular disease.

All these conditions come under the umbrella of cardiovascular disease. This term is used to describe the collection of conditions that affect the heart and blood vessels. Almost half (48 percent) of Australian adults have high cholesterol levels. This puts them at increased risk of developing cardiovascular disease.

‘Good’ cholesterol vs ‘bad’ cholesterol 

Cholesterol is transported around the body by special proteins in the blood. When cholesterol is linked to these proteins it forms complexes called lipoproteins.

  • Low-density lipoproteins (LDL) carry cholesterol to your cells. If you produce too much cholesterol so it builds up in your blood, you will have high levels of LDL-cholesterol that may cause atherosclerosis. This is why LDL cholesterol is considered ‘bad’ cholesterol.
  • High-density lipoproteins (HDL) transport excess cholesterol from your cells back to your liver. Your liver either re-uses the cholesterol or removes it from your system. HDL cholesterol is considered ‘good’ cholesterol because it is being removed from your body and not contributing to the build-up of plaques in your arteries.

Triglycerides

You may also have heard of, or had a blood test for, your triglyceride levels. Triglycerides are a type of fat from the food you eat that is used and stored by your body as energy for your cells. Like cholesterol, they are carried around the body in your blood and excess amounts can contribute to fatty plaques in your blood vessels.

What is a healthy cholesterol level? 

Below are the Australian guidelines for fasting blood cholesterol levels to help reduce your risk of developing cardiovascular disease.

What is a healthy cholesterol level table

If your cholesterol levels are currently between 4.0-5.5 mmol/L, this is still considered within the limits of the normal range. However, you may wish to talk to your doctor, and make simple changes to your lifestyle habits. Changes such as eating less saturated fat, increasing physical activity and/or losing excess weight to help improve your cholesterol levels.

A total cholesterol level greater than 5.5 mmol/L suggests you have an increased risk of cardiovascular disease. Talk to your doctor about what can help manage your cholesterol levels, whether it's changes to your lifestyle habits or even medication.

How can I help keep my cholesterol levels healthy? 

All areas of your lifestyle in some way contribute to your health and wellbeing, and this includes your heart health. Poor lifestyle habits can increase your risk of developing heart disease, as well as other health problems such as type 2 diabetes and some cancers.

You can take some simple steps around these areas to help keep your cholesterol levels healthy and maintain good heart health.

Eat healthily

In general, low levels of LDL cholesterol and high levels of HDL cholesterol in your blood improve your chances of preventing cardiovascular disease. Foods that are high in cholesterol, such as animal livers, egg yolks and prawns, only have a small effect on the levels of LDL cholesterol in your body. Unhealthy levels of LDL cholesterol generally happen when your liver makes too much cholesterol from saturated fat from your food.

Here are some simple dietary changes you can do to improve your cholesterol levels and lower your risk of cardiovascular disease.

  • Limit foods rich in saturated fat – don’t eat too much red meat or fatty meats such as sausages and deli products like salami, and full-fat dairy foods. Remove fat from meat before cooking – NOT after cooking. Choose low-fat or reduced-fat dairy products such as low or reduced fat milk and yoghurt. Try to limit snack foods such as potato crisps, sweet biscuits, donuts and cake to once a week or less.
  • Avoid trans fats – these raise ‘bad’ LDL cholesterol’ and lower ‘good’ HDL cholesterol levels at the same time. Trans fats are created during food processing so avoid eating too many fatty takeaways and processed cakes, pies, pastries and biscuits.
  • Replace saturated with unsaturated fats – poly- and mono- unsaturated fats can help keep levels of blood cholesterol healthy. These fats can be found in oily fish, seed oils, olive oil, nuts and avocados. Use polyunsaturated and monounsaturated oils or spreads (olive oil, sunflower oil and canola oil) when cooking or baking instead of butter and ghee
  • Focus on foods rich in dietary fibre, and healthy protein-containing foods – foods that seem to lower cholesterol include oats, barley, flaxseed, psyllium, lentils, and soy products.

Exercise regularly

The Australian Physical Activity and Sedentary Behaviour Guidelines recommend most adults aim for 2 ½ –5 hours a week (at least 30 minutes a day most days of the week) of moderate-intensity activity. Moderate-intensity means it gets you huffing and puffing and includes activities such as brisk walking or swimming. If you are over 65, aim for at least 3½ hours of moderate-intensity activity weekly.

If you like you can do more vigorous activities such as competitive sports, aerobics or jogging. Then you can do less – between 1¼ and 2 ½ hours a week is recommended. Generally, the more active you can be the better.

If you’re starting a new exercise program, or if you’ve been inactive for a while or have any other health concerns, check with your doctor first to make sure the activity is appropriate for you.

Aim for a healthy body weight

If you’re carrying extra weight, losing 5-10 percent of your body weight can have a significant effect on reducing that risk. The key to weight loss is generally to use up more energy through physical activity and regular exercise than you take in from food and drink.

Quit smoking

Smoking affects the health of your blood vessels as it can increase the speed at which cholesterol gets into the walls of the arteries. Smoking also increases the likelihood of blood clots forming, which can lead to heart attacks or stroke.

Absolute cardiovascular disease risk 

There are many factors that affect your risk of developing cardiovascular disease in addition to your cholesterol levels. These can include:

  • older age and family history
  • smoking (including second-hand smoke)
  • being overweight, especially if you have excess fat around your abdominal area
  • having diabetes
  • having an inactive lifestyle
  • having high blood pressure
  • drinking excessive amounts of alcohol
  • experiencing issues with social and emotional wellbeing – research supports a link between depression, socially isolation and lack of quality social support with the risk of developing coronary heart disease
  • eating an unhealthy diet.

The more risk factors you have and/or the more severe they are, the more likely you are to experience a heart attack or other cardiovascular problems. This is because the effect of each risk factor is cumulative. A single risk factor may be of little concern, but when added to other risk factors it can put you at serious risk.

The cumulative effect of risk factors is called ‘absolute risk’ and means that you can’t look at your cholesterol levels in isolation. Your doctor can assess your absolute risk and help you make simple changes to your lifestyle to help manage your risk factors. They can also provide you with medication if needed.

When should I get my cholesterol checked? 

Generally, you should have your cholesterol and triglyceride levels checked every 5 years once you reach 45 years of age (or from 35 if you are Aboriginal or a Torres Strait Islander). It’s just a simple blood test taken after fasting for 12 hours.

If you have any of the risk factors for cardiovascular disease described earlier, you are likely to need more frequent tests – every 1–2 years. Visit your doctor for an assessment of your absolute risk for cardiovascular disease. They will let you know how often you should check your cholesterol and triglyceride levels.

Further information 

National Heart Foundation of Australia
www.heartfoundation.org.au

Sources 

American Heart Association. Women and cholesterol [online]. Last updated May 2013; accessed 12 May 2014]. Available from: www.heart.org

Australian Government. Measure Up. Types of fat and the role of cholesterol [online]. [Last updated October 2010; accessed 9 May 2014]. Available from: www.measureup.com.au

Australian Institute of Health and Welfare (AIHW). Australia’s health 2012, no.13. Cat. no. AUS 156. Canberra: AIHW.

Harvard School of Public Health. Fats and cholesterol: out with the bad, in with the good ©2014 [online]. [Accessed 9 May 2014] Available from: www.hsph.harvard.edu

Kris-Etherton PM, Hu FB, Ros E, Sabate J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms (review article). J Nutr 2008; 138: 1746S–1751S

Merck manual for health care professionals. Overview of coronary artery disease [Online]. ©2004–2013 [Last updated May 2013; accessed 7 May 2014]. Available from: www.merckmanuals.com/professional/index.html

National Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk, 2012. Available from: www.heartfoundation.org.au

National Heart Foundation of Australia. Cardiovascular conditions: angina [online]. [Accessed 7 May 2014]. Available from: www.heartfoundation.org.au

National Heart Foundation of Australia. Fats: cholesterol [online]. [Accessed 9 May 2014]. Available from: www.heartfoundation.org.au

National Heart Foundation of Australia. Women and heart disease [online]. [Accessed 8 May 2014]. Available from: www.heartfoundation.org.au

Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice, 8th edition, 2012. Available from: www.racgp.org.au

State Government of Victoria. Better Health Channel. Heart disease and food [online]. [Last updated February 2014; accessed 8 May 2014]. Available from: www.betterhealth.vic.gov.au

State Government of Victoria. Better Health Channel. Peripheral vascular disease [online]. [Last updated September 2013; accessed 8 May 2014]. Available from: www.betterhealth.vic.gov.au

Last updated: 28 May 2014

Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the information. Bupa Australia is not liable for any loss or damage you suffer arising out of the use of or reliance on the information. Except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.