Let’s get straight to the point. High cholesterol is implicated in heart disease and premature death, so lowering it is undoubtedly a smart move. There are two ways to lower cholesterol that are known to work – modify your lifestyle and take drugs that treat high cholesterol.
The high incidence of hypercholesterolemia (high cholesterol) seen particularly in the Western world has come about fairly recently and is almost certainly due to our modern lifestyle. For the vast majority whose cholesterol is too high, simple small modifications to their diet and exercise patterns will restore normal cholesterol levels.
Some individuals are either beyond what can be achieved with lifestyle changes or have an inherited genetic disorder (familial hypercholesterolemia) that limits the efficacy of diet and exercise; these people will normally be put on a lifetime programme of drugs (usually statins) whose potency can be altered to suit the individual.
Before we take a closer look at these two options (lifestyle and medication) it’s helpful to realise that when a doctor, for example, considers your cholesterol level they are in fact weighing up two distinct types of cholesterol, called LDL (“bad cholesterol”) and HDL (“good cholesterol”).
LDL cholesterol is a type of fat (a lipid) that is produced as a consequence of your liver processing what you eat; it gets distributed via the bloodstream to supply energy to just about every cell in the body and is therefore absolutely vital. However, if too much is produced it tends to get deposited in arteries and veins and eventually clogs the system up with predictable consequences.
HDL (High Density Lipoprotein i.e. more protein than lipid) soaks up as much as excess LDL as it can and returns it to the liver for recycling or waste. Your body however contains a much greater proportion of LDL than HDL so it’s an unequal struggle, but it has been found that increasing exercise results in an increase of HDL concentrations in the blood.
The changes to your lifestyle that are recommended to decrease LDL cholesterol stem from medical research that points to smoking, drinking, eating particular kinds of food, eating too much (being overweight) and doing too little (insufficient exercise) being significant factors in most cases of high cholesterol. The obvious conclusion is that refraining from such behaviour will automatically tend to lower LDL cholesterol levels.
So what types of foods are best avoided? The simple answer is anything that contains saturated fat; so hard cheese, butter, red meat, pastries, cakes and biscuits. Conversely you should aim to increase your intake of fruit, vegetables, oat and beans as these foods actively help to lower cholesterol. Switching from butter to a plant sterol based spread (commonly marketed as “cholesterol lowering” spreads) gets the best of both worlds.
If lifestyle modifications alone aren’t able to lower your cholesterol below medically approved limits then you should seek the advice of your doctor who will most likely prescribe one of a group of drugs called statins. These pills are not in any way an alternative to adopting a healthier lifestyle; they are a supplement.
The most commonly prescribed statins are (in ascending order of strength and using both clinical and brand names):
pravastatin (Lipostat); simvastatin (Zocor); atorvastatin (Lipitor); rosuvastatin (Crestor).
Most people who take statins tolerate the drugs extremely well and manifest no side effects, but you should nevertheless be aware that statins, particularly in high doses, have the capacity to cause serious damage to the liver and to muscle tissue. Accordingly, it is likely that if statins become a routine part of your life then so too will occasional blood tests to not only keep an eye on your cholesterol levels (and adjust doses if required) but also to ensure that there are no detrimental side effects that you may not be immediately aware of.
So there you have it. Two effective and medically proven ways to lower cholesterol. The difference between the two is simply a matter of degree – taking prescribed drugs is an additional measure on top of addressing your lifestyle, which in most cases lies at the root of the problem.