Your Health A-Z

Best ways to keep your cholesterol in check

High cholesterol levels can cause heart disease but there are lifestyle changes you can make to keep your cholesterol under control.

Cholesterol is an essential fatty substance produced by the liver that is necessary for our hormones to function properly. However, excessive cholesterol levels can be dangerous as it leads to cardiovascular diseases like heart attacks or strokes.

Types of cholesterol

There are two main types of cholesterol found in the blood – HDL, ‘healthy’ high-density lipoproteins, and LDL, ‘lethal’ low-density lipoproteins which block blood vessels and ultimately cause heart disease.

Factors that influence cholesterol

Our genes can play a role in determining our cholesterol levels but so can poor diet, being overweight, smoking and being inactive. Although we consume 20% of our total cholesterol from our diet and the rest is manufactured by the body, we can benefit from making lifestyle changes for our overall health.

Controlling cholesterol

Recommended therapeutic lifestyle changes:

  • Eat less saturated and trans fats found in butter, cream, hard margarines, ghee, fatty red meat, chicken skin and commercially baked/processed foods.
  • Choose ‘healthy’ fats like those found in omega-3 rich fish (like salmon and mackerel), nuts, seeds and avocados.
  • Eat more fibre-rich foods like fruit, vegetables, whole grains and oats.
  • Avoid frying foods – rather grill, bake or steam.
  • Get active: aim for 30 minutes of moderate physical activity, five days a week as being active can help to raise ‘good’ HDL cholesterol.
  • Stop smoking and avoid second-hand smoke.
  • Cut down on alcohol – the recommended limit is 1 unit (120ml wine or 340ml beer/cider) per day for women and 2 units per day for men.

Controversy: cholesterol in food vs Western diet

While it’s been a firm belief that one of the main causes of heart disease is the impact of food on our cholesterol levels, there are some internationally acclaimed cardiologists who believe that it is not cholesterol in our food but rather oxidative stress and inflammation from diets rich in sugar, refined carbs and polyunsaturated oils (found in processed foods and seed oils) that are the real demons. So while cholesterol itself is not dangerous, what you do and your lifestyle choices are key to keeping the substance levels healthy.

Traditional treatment

Statins are commonly prescribed to treat high LDL cholesterol levels as they may play a role in lowering good and bad cholesterol levels and preventing heart attacks. But some scientists believe there is a lack of evidence that statins can benefit everyone, especially women and the elderly. The American College of Cardiology and American Heart Association states that statins do benefit certain groups of people:

  • People who have cardiovascular disease – those who have had heart attacks or strokes
  • People who have very high LDL cholesterol levels – over 190mg/ dL 4.9 (Under 100mg/dL 2.6 is optimal)
  • People who have diabetes

Reviewed by Dr MJ Nienkemper, cardiologist at Mediclinic Vergelegen

Important notes:

Heart attack warning signs 

Symptoms in women are often different than in men. Women are more likely to experience nausea, dizziness and anxiety.

Symptoms may include:

  • Heavy pressure, tightness, crushing pain or unusual discomfort in the centre of the chest.
  • Sweating, sickness, faintness or shortness of breath may be experienced.
  • This may feel like indigestion, spread to shoulders, arms, neck or jaw and/or last for more than 15 minutes. It may stop or weaken and then return.
  • There may be a rapid, weak pulse.

Sharp stabbing pain in the left side of the chest is usually NOT heart pain

What to do in an emergency

Get to the nearest emergency unit as quickly as possible. Hospitals with cath labs will be able to remove the clot mechanically. Hospitals without cath labs will give medication to dissolve the clot, and then transfer you to a cath lab if needed. If someone else has a heart attack near you, call an ambulance (084 124). If he or she stops breathing, do CPR on the person until an ambulance arrives.

References:

  • Heart and stroke foundation
  • http://www.heartfoundation.co.za/what-exactly-cholesterol-and-how-do-i-lower-my-cholesterol-levels
  • Mayo clinic
  • http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772
  • http://articles.mercola.com/sites/articles/archive/2011/12/17/stephen-sinatra-on-cholesterol-statins-coq10-ubiquinol.aspx
  • https://medlineplus.gov/magazine/issues/summer12/articles/summer12pg6-7.html
  • Controversy comments from an unpublished article by Dr Peter Hill, PhD, Dip Pharm, a Visiting Fellow at Rhodes University, a member of the American College of Nutrition, a director and co-founder of Met-S Care Corporation and a director of Future Foods Technologies.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.