Managing your cholesterol

Finding out that you have high cholesterol levels can be daunting.
Finding out that you have high cholesterol levels can be daunting.

We need cholesterol, and our bodies get it from two different sources: from the food we eat (animal-based) and from what we make ourselves – mostly in the liver.

But too much of a good thing can be dangerous, as high cholesterol levels (LDL – the low density lipoprotein) can lead to heart attacks and strokes. We do need a certain amount of cholesterol in order to function in a healthy way, but when it exceeds a certain level, it becomes a health hazard.

People with familial hypercholesterolaemia (a genetically inherited condition) have very high levels of LDL and ought to take medication (most commonly statins, proven to lower the risk of heart attacks and strokes). But even for these patients, lifestyle changes can be beneficial.

Triglycerides are also present in the diet and can be made in the body as well. They circulate in chylomicrons (made in the gut) after a meal and in VLDL made in the liver. They are influenced by many lifestyle factors as well as genes. 

Finding out that you have high cholesterol and/or triglyceride levels can be daunting, especially if you have to make substantial changes to your everyday life in order to lower these levels. Making these changes, however, will always be easier than dealing with the consequences of serious health issues.

Here are some practical tips and ideas on what you can do:

  • Get moving. Thirty minutes per day, five days a week, of moderate exercise (such as walking, swimming or cycling) is recommended by the Heart and Stroke Foundation. Join a walking club or find an exercise companion – it’s easier to stay motivated when you’re not on your own. Perform exercise that you enjoy to ensure that this is sustainable.
  • Choose the fats you eat. Avoid saturated fats (found mostly in red meat and dairy products) and trans fats (typically in fried and processed foods and commercially baked products). Choose lean meats, and switch to using olive and canola oil. Get into the habit of checking food labels – some products such as coffee whiteners contain high levels of fats you are trying to avoid. Fatty fish twice a week is a good idea, as it contains heart-healthy fats.
  • Further dietary recommendations. It is recommended that you eat foods high in fibre, and also change cooking methods from frying to grilling or steaming. It is also recommended that women should not have more than one alcoholic drink a day, and for men, not more than two drinks per day Note that this refers to the standard quantities served in bars.
  • Quit smoking. Do whatever it takes to achieve this – and also try and avoid exposure to second-hand smoke. Within a year of stopping smoking, your risk of heart disease is half of that of a smoker, says Mayo Clinic. There is often a concern that quitting smoking results in weight gain but the benefit of cessation is better than the harm from mild weight gain. However, body weight control should form part of the decision to quit smoking for your health.
  • Manage your stress levels. Several recent studies point to a link between high stress levels and increased risk of vascular disease, though not necessarily raising cholesterol levels. Life is stressful, and much of the stress cannot be avoided, but it is essential that everyone should find a healthy stress-release mechanism that works for them, whether it is exercise, yoga, meditation, a hobby, or learning a new skill – anything that helps counteract the stresses of daily life.

Reviewed by Prof David Marais, FCP(SA), Head of Lipidology at Groote Schuur Hospital and the University of Cape Town, January 2018

Image credit: iStock

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