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Health Chatter: Cholesterol - What you need to know

Updated: Mar 7, 2022

Cholesterol is mostly made by the liver but can also be found in some foods. It is vital for the normal functioning of the body. However, having too much in your blood can have a harmful effect on your health, increasing your risk of serious health conditions such as heart attack and stroke.

Good and bad cholesterol

When your blood proteins combine with cholesterol they form lipoproteins. There are two main types of lipoprotein. These are:

  • High-density lipoprotein (HDL) – this carries cholesterol away from the cells back to the liver, where it is broken down and passed out of the body. This is why it is often referred to as ‘good cholesterol’.

  • Low-density lipoprotein (LDL) – this carries cholesterol to the cells that need it. If there is too much of this for the cells to use, it can build up in the artery walls, leading to disease of the arteries. This is why it is often referred to as ‘bad cholesterol’.

What can cause high cholesterol?

  • A diet high in saturated fat

  • Smoking – a chemical found in cigarettes called acrolein stops HDL transporting cholesterol away from the body

  • Drinking too much alcohol

  • Having diabetes or high blood pressure

  • Having a family history of stroke or heart disease

  • There is also an inherited condition called hypercholesterolaemia, which can cause high cholesterol despite a healthy diet

How to prevent & lower high cholesterol levels

Exercise Regular exercise will increase the levels of HDL in your body which will help to expel excess cholesterol from the body.

It will also help you to maintain a healthy weight and lower your blood pressure. 150 minutes of moderate intensity exercise every week is recommended to help lower your cholesterol.

Walking, swimming and cycling are good forms of this type of exercise.

Silhouette of person cycling at sunset
Cycling is a great form of moderate intensity exercise

Diet Maintain a healthy, balanced diet that’s low in saturated fat and high in fruit, vegetables and whole grains.

Foods high in saturated fats include things like meat pies and sausages, butter, cream, hard cheese, cakes and biscuits, coconut oil & palm oil.

Look at the labels on the food you buy. Government recommendations suggest a maximum daily intake of saturated fat as 30g of saturated fat per day for a man and 20g of saturated fat per day for a woman.

Replace these foods with those that contain unsaturated fats as they have been shown to increase the levels of HDL and therefore reduce blockage in your arteries. These include foods such as oily fish (mackerel, salmon), avocado, nuts and seeds, and sunflower, rapeseed and olive oil.

Give up Smoking Your GP can refer you to a NHS Stop Smoking Service, which will provide you with dedicated help and support.

Find online support at

Drink less alcohol Always stay within the recommended limits for alcohol - no more than 14 units a week spread out over a number of days.

Avoid binge drinking, and include drink free days during the week.

When should your cholesterol levels be checked?

Routine testing of cholesterol levels is not necessary, but your GP might suggest you get a test if you are at risk of high cholesterol.

For example:

  • If you have been diagnosed with Coronary Heart Disease or stroke

  • If you have a family history of early cardiovascular disease or a close family member who has a cholesterol related condition

  • If you are overweight

  • If you have high blood pressure or diabetes

  • If you smoke

Cholesterol tests can be carried out by either taking a blood sample from your arm, or by a finger prick test. A finger prick test is usually carried out during your NHS Health Check if you are over 40.

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Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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