Experts reveal the truth about cholesterol – and how it impacts your health

Many people think all cholesterol is bad, but that is not the case.

With so many conflicting messages and advice out there, it can be hard to make sense of it all. So experts have broken down the essentials: what cholesterol is, how it can impact our health and what can help.

Whether you’ve been told you have high cholesterol or you’re just curious about what’s going on inside your body, here’s what you need to know:

What is cholesterol?

Ruth Goss, a senior cardiac nurse at the British Heart Foundation, explains “cholesterol is used by all the cells in your body to keep them healthy”.
“It’s carried around your body to the cells that need it by proteins in your blood. When cholesterol and proteins combine, they’re called lipoproteins.”

Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are the two main types.

“LDL is unhealthy and can cause plaque to build in arteries, increasing the risk of stroke,” highlights Dr Donald Grant, GP and senior clinical adviser at The Independent Pharmacy.

“Whereas, HDL aids in removing excess cholesterol from the body to maintain healthy amounts.”

What factors can increase your risk of high LDL levels?

One of the biggest risk factors is familial hypercholesterolemia, which is a genetic condition where your liver can’t process cholesterol properly, according to the British Heart Foundation’s website.

“If you do have familial hypercholesterolemia you need to start on statins or some other cholesterol-lowering medicines because you cannot reduce that risk on your own,” says Dr Jeff Foster, private and NHS GP and director of men’s health service Manual.

Body weight also affects cholesterol levels.

“Obese or overweight individuals are at a higher risk of producing LDL cholesterol, increasing their risk of heart attacks,” notes Grant. “Obesity can also lead to insulin resistance, lowering HDL cholesterol.
“Additionally, chronic inflammation, caused by being overweight can also increase the strain on the heart and negatively impact cholesterol levels.”

Are there any prominent signs of high LDL levels?

In some cases, particularly those with very high levels or certain genetic conditions, you might see xanthomas (fatty bumps on the skin), xanthelasmas (yellowish patches around the eyes), or corneal arcus (white rings around the coloured part of your eye), according to the British Heart Foundation’s website.
However, most people don’t tend to show visible symptoms.

“It’s often a hidden risk factor for serious conditions like heart attacks and strokes, meaning it can be there without us knowing until it’s too late,” says Goss. “That’s why it’s so important to get your cholesterol level checked – you can ask your GP to check your levels with a simple blood test.”

How often should you get your cholesterol levels checked?

“Generally, adults should aim to get their cholesterol checked every five years, however, this can change depending on risk factors such as a family history of poor cholesterol or age,” says Grant. “It’s usually part of the NHS Health Check, sent to people aged 40-71 every five years.”
However, Foster thinks it’s a good idea to get your levels tested much earlier.
“Start getting your cholesterol checked from the age of 20,” recommends Foster. “It sounds really young, but high cholesterol is a cumulatively damaging process.

“If you have high cholesterol in your 20s, every year that you have high cholesterol builds on the risk from the year before, so you are simply adding and adding to that risk.

What are statins and how can they help?

“Statins are an effective treatment that can lower the amount of LDL in an individual’s body, reducing their risk of major heart events,” says Grant. “The treatment restrains enzymes in the liver to slow the production of cholesterol.

“Usually, they’re recommended for people with poor cardiovascular health or high LDL cholesterol.”
Statins come as tablets that are taken once a day and the dose depends on why you need the medicine, your cholesterol levels, and other medicines you’re taking.

According to the NHS website, many people who take statins experience no or very few side effects and those who do experience some side effects are usually minor, such as diarrhoea, a headache or feeling sick.

Does diet affect our cholesterol levels?

“The types of cholesterol found in your body, such as non-HDL cholesterol, are different from the dietary cholesterol found in food,” clarifies Goss. “Many people think that eating foods high in dietary cholesterol, like egg yolks and shellfish, raises blood cholesterol levels.

“However, research shows that dietary cholesterol has a minimal impact on blood cholesterol levels.

“It’s far more important to focus on reducing your intake of saturated fats, which are known to increase cholesterol levels in your blood.”

What other lifestyle changes can make a big difference?

“As the condition is linked so closely to cardiovascular health, boosting fitness can improve heart health and reduce LDL while increasing HDL cholesterol,” says Grant. “In general, people should aim for around 30 minutes every day.”

“It’s also essential to avoid smoking and alcohol, as both bad habits contribute to high levels of LDL cholesterol.”