High Cholesterol

Also known asHypercholesterolaemia · Hypercholesterolemia · High LDL · LDL Cholesterol · High Blood Cholesterol · 高胆固醇 · 胆固醇高 · Kolesterol Tinggi

What it is

Cholesterol is a fatty substance made by the liver and also found in some foods, and the body needs some of it. When LDL cholesterol (the "bad" kind) is too high, it can build up in artery walls, narrow them and raise the risk of heart disease and stroke. High triglycerides, another blood fat, add to the risk.

High cholesterol causes no symptoms, so the only way to know is a blood test. Some people inherit very high levels (familial hypercholesterolaemia), so a test is worthwhile if heart disease runs in your family.

How food and lifestyle can help

For most people the type of fat eaten matters more than the cholesterol in food. Swapping saturated fat for unsaturated fat and eating more soluble fibre can lower LDL noticeably, and works alongside any medicine you are prescribed.

Foods and nutrients to focus on

1. Oats, barley, beans, lentils and chickpeas, rich in soluble fibre (legumes and grains).
2. A handful of nuts and seeds most days.
3. Olive, rapeseed (canola), soybean and sunflower oils in place of butter, ghee, coconut or palm oil (fats and oils).
4. Oily fish such as salmon, sardines or mackerel twice a week, a source of omega-3.
5. Vegetables and fruit, and tofu or tempeh in place of some meat.
6. Foods fortified with plant sterols or stanols can lower LDL by around 7 to 10% at about 2 g a day.

Foods and drinks to limit

1. Fatty and processed meat (sausages, bacon, fatty cuts), butter, ghee, cream and full-fat cheese.
2. Coconut and palm oil, which are high in saturated fat.
3. Trans fats from partly hydrogenated oils in some fried foods, pastries and biscuits.
4. Deep-fried foods, and a lot of sugar and alcohol, which push triglycerides up.

Good to know

1. Egg yolks and shellfish fit into most people's diets; follow your doctor's advice if you have been told to limit them.
2. Grapefruit (and pomelo) in large amounts can interact with some statins, such as simvastatin and atorvastatin. Ask your pharmacist.
3. Red yeast rice supplements contain a statin-like substance; do not combine them with a statin.

When to see a doctor

1. You have never had your cholesterol checked and you are over 40, or heart disease or stroke runs in your family.
2. Your LDL is high despite changes to your diet, or a doctor has suggested medicine.
3. Chest pain, breathlessness or pain spreading to the arm or jaw is an emergency: call your local emergency number.

This page is general information, not medical advice. If you have a medical condition or take medicines, check changes to your diet with your doctor or a registered dietitian.

NHS — High cholesterol, used for the main facts: https://www.nhs.uk/conditions/high-cholesterol/