What is Cholesterol? How do you get started on managing your cholesterol levels?

What is cholesterol? Why do we worry about cholesterol levels? What are the different types of cholesterol we have? And what can we do about our cholesterol levels with our diet and lifestyle?

Today I will be delving into the 3 steps to managing our cholesterol levels. This 3 step approach is based on the Heart UK programme called the “ultimate cholesterol lowering plan”, which is an approach that first of all looks at our mindset when it comes to making lifestyle changes, then strives to build on our heart healthy diet basics, and lastly focusses on 4 key food groups that have been linked to a reduction in our cholesterol levels.

In today’s article I will review first of all what cholesterol is and focus on the different cholesterol results you might get from your doctor or healthcare professional after a blood test. I will then look at the mindset element to making diet and lifestyle changes that can help us to better manage our cholesterol levels.

What is Cholesterol?

Why do we worry about cholesterol levels? What are the different types of cholesterol we have? And what can we do about our cholesterol levels with our diet and lifestyle?

What is cholesterol?

Cholesterol is a soft substance, somewhat like wax, that is found in your blood and cells. We need cholesterol to help us produce cell membranes and to produce hormones. However, too much cholesterol in our blood has been linked to increased risks of heart disease and strokes.

Making small changes to our diet now can help us to reduce our blood cholesterol levels and possibly make a difference to our health in the future.

Why are we worried about having high cholesterol levels?

When there is too much cholesterol building up in the blood, it can start sticking to the lining on the inside of your arteries. This can make them narrower and make it harder for the blood to pass through. We call this atherosclerosis. At times, these arteries can become so narrow that they completely block. If this happens to an artery in one of the blood vessels supplying blood to your heart, this can cause a heart attack. If a blood vessel to the brain becomes blocked, this can lead to a stroke.

Where do we get cholesterol from?

Almost three quarters of the cholesterol in our blood is made by our own liver and cells. The remaining quarter of cholesterol will come from our diet. It is this one quarter of our cholesterol that we are hoping to reduce through changing our eating habits.

What are the different types of cholesterol on my blood test?

Cholesterol is carried around our blood in a little transport protein called lipoprotein. We have two types of these:

LDL-cholesterol

Low-Density Lipoprotein, also known as LDL, is the “bad” type of cholesterol. LDL is the bad cholesterol because it is sticky, and sticks to the lining of your arteries.

Think L for “Lousy”.

HDL cholesterol

High-density Lipoprotein, also known as HDL, is the “good” type of cholesterol. HDL cholesterol helps to gather up the cholesterol left behind in your arteries and brings it back to the liver where it is broken down.

Think H for “helpful”.

Triglycerides

Triglycerides are a type of fat made by the body, often as a result of a diet very high in carbohydrates, and a sedentary lifestyle. Excess alcohol and smoking can also increase our triglyceride numbers. This type of fat has also been linked to increased risks of heart disease and stroke.

LDL and HDL cholesterol, along with triglicerides and Lp(a) cholesterol make up your Total cholesterol (sometimes abbreviated as “TChol”) levels.

We usually hope to reduce our total cholesterol and LDL cholesterol levels, and we hope to increase our HDL cholesterol levels.

So what are healthy cholesterol levels?

Healthy total cholesterol levels

We want our total cholesterol to be less than 5.

Healthy LDL cholesterol levels

Our LDL levels, remember, the bad cholesterol, is best to keep below 3. However, for those of us who already have heart disease, type 2 diabetes or organ damage from type 1 diabetes, we hope to keep our LDL below 1.8. And if we don’t have any of these health concerns, but we do have another risk factor for heart disease such as high blood pressure, then we should aim for an LDL level below 2.5.

Healthy HDL cholesterol levels

Then looking at HDL cholesterol, that helpful cholesterol. We want our HDL levels to be over 1 for men and 1.2 for women.

Healthy triglyceride levels

And finally, our Triglycerides are best kept below 1.8.

What can I do to have healthy cholesterol levels?

Heart disease is very common in Ireland, but thankfully research suggests that up to 80% of heart disease can be prevented through diet and lifestyle changes.

As I discussed earlier, the recommended changes to improve our cholesterol levels can be divided into three stages, and I will have a video for you for each stage.

The three stages are:

Get into the right mindset!
Build on a strong heart-healthy foundation
Add in one of more of the specific cholesterol lowering foods.

Today we will delve into how our mindset can help us on the right path to heart health.

Stage 1: Get into the right mindset

Making changes to your diet and lifestyle can be a big challenge. By getting into the right frame of mind before we even start, we are setting ourselves up for success from the get-go.

Firstly, ask yourself: Why am I hoping to improve my cholesterol levels?

What are your motivations to make this change? What are you hoping to achieve as a result of making this change? Are you hoping to keep yourself fit and healthy as you get older? Are you worried about some of the possible risks linked to high cholesterol levels? Why is making these changes so important to you?

Next, ask yourself what may get in the way of making these changes?

Think about your routine, your cooking skills, the way you plan and prepare your meals, any potential social occasions. What barriers have stopped you from making these changes so far? I love getting my clients to visualise their barriers before they kickstart any new goal, as it makes that obstacle look much smaller whe they face it in real life!

Now consider possible ways that you can overcome these barriers.

For each barrier you identified earlier, think of two or three strategies that you can use to get around them. Preparing ahead and being prepared when you come face-to-face with these obstacles will make them easier to overcome!

And lastly, consider some of the changes you need to make.

We will review these in more detail in our next stage, but its worth reviewing your current habits before we get started so we know where we want to focus our attention most.

Here is a handy checklist of the key heart healthy habits to consider. You can check this out when reviewing where you are now, and where you are hoping to go in the next while when it comes to diet changes.

Heart Healthy Habit	Yes	Occasionally	No
Do you eat at least 5 portions of fruit and vegetables every day (a portion is about what would fit into your hand)?
Do you have at least 2 meat-free days a week?
Do you eat a plant-based protein food everyday? This includes beans, nuts, peas, soya, lentils or a Quorn product for example?
Do you eat at least two portions of fish a week (of which one is an oily fish such as salmon, sardines, mackerel, trout or herring)?
Do you try to eat very little processed meats (such as ham, salamis, sausages, rashers, tinned meat, corned beef etc)?
Do you eat wholegrain foods everyday (such as brown bread, brown pasta, wholegrain breakfast cereals, oats, brown rice etc)?
Do you use plant-based oils such as olive oil, sunflower oil or rapeseed oil instead of coconut oil, butter, other hard animal fats or palm oil?
Do you choose low fat dairy foods such as low-fat milk, yoghurt and lower fat cheese (or plant-based milk-alternatives) instead of the high fat dairy options?
Do you avoid snacking on fatty and sugary snacks such as chocolate, crisps, biscuits, cakes, pastries etc?
Do you usually avoid high fat and salty fast foods and takeaways such as fish, chips, kebabs, creamy curries, fried chicken, tacos and sandwiches with mayo?
Do you usually choose water or diet/sugar free drinks instead of sugar-sweetened drinks or fruit juice?

In my next article, I will discuss these heart healthy habits in more detail! I will review what makes a diet heart healthy and will give you practical swaps to make to help build a solid heart healthy diet foundation.

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