by Clarissa Petrova
Having raised levels of blood cholesterol is known to be a major risk factor in developing heart disease and suffering premature death. Accordingly, the smart thing to do is to lower your cholesterol to safe levels and there are two methods that will reliably achieve this. These are 1) making a number of lifestyle changes and 2) using cholesterol lowering medication.
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 people are found to either have cholesterol levels so high that lifestyle modifications alone would not be sufficient, or they carry a genetic fault (familial hypercholesterolemia) that would similarly limit the benefit of improved diet and exercise. Such people are generally offered cholesterol lowering drugs called statins which come in a range of strengths and which they can expect to keep taking for as long as they live.
Before we move on to examine these two strategies, it’s worth understanding that when health professionals talk about cholesterol as it affects people, they are generally concerned with two specific types (there are more, but this simplification is reasonably accurate). These are LDL which is often called “bad cholesterol” and HDL which has been labelled “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 statins most usually prescribed are (in order of their potency and showing both clinical and brand names) as follows:
pravastatin (Lipostat); simvastatin (Zocor); atorvastatin (Lipitor); rosuvastatin (Crestor).
The vast majority of people tolerate statins easily and suffer no side-effects at all, but it should be noted that they can damage both muscles and the liver, especially when taken in high doses and for this reason you may find that reasonably regular blood tests become a feature of your life due to the need to both monitor the effect of statins on your cholesterol levels and to watch for symptoms of internal damage.
So in conclusion, there are two proven and medically approved means to lowering your cholesterol; the difference between them being just a matter of degree since cholesterol lowering medication provides an extra boost that adds to rather than replaces the primary strategy of improving your lifestyle.