Patient's often ask is my cholesterol all right or simply what is my cholesterol number?
This is not quite as straightforward as it might seem.
Your cholesterol level is one of several things that can increase your risk of heart disease so when we are trying to work out if you are at high risk of heart disease we look at cholesterol and many other factors.
. The following all affect your risk of heart disease.
- Lack of physical activity (a sedentary lifestyle).
- An unhealthy diet - including eating too much salt.
- Excess alcohol.
Some risk factors are treatable or partly treatable :
- High blood pressure (hypertension).
- High cholesterol blood level.
- High triglyceride (another type of fat) blood level.
- Kidney diseases that affect kidney function
Other risk factors cannot be changed:
- A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65.
- Being male.
- An early menopause in women.
- Age. You are more likely to develop atheroma as you get older.
- Ethnic group. For example, people who live in the UK whose family came from India, Pakistan, Bangladesh or Sri Lanka have an increased risk.
We can calculate your personal risk based on what we know about you. In fact you can do this yourself and you may want to click on this very useful website which provides a simple to use tool for self-assessment. In order to get them most out of this tool you will need to know what your cholesterol levels are. You can always ring up the surgery and ask for this. If you are between the ages of 40 and 74 you will be called in for a routine health check when your cholesterol will be measured. If you are in good health and below the age of 40 there really is little point in bothering about your cholesterol. We would not advise asking for a cholesterol test just for the purposes of using this tool!!
For many people even if the cholesterol level is a little high there is no need for any medical treatment and the following lifestyle changes will all contribute to lowering your risk of heart disease.
- Stop smoking if you smoke.
- Eat a healthy diet.
- Keep your salt intake to under 6 g a day.
- Keep your weight and waist in check.
- Take regular physical activity.
- Cut back if you drink a lot of alcohol.
Changing from an unhealthy diet to a healthy diet can reduce a cholesterol level. However, dietary changes alone rarely lower a cholesterol level enough to change a person's risk of cardiovascular disease from a high-risk category to a lower-risk category. However, any extra reduction in cholesterol due to diet will help. A healthy diet has other benefits too apart from reducing the level of cholesterol.
Briefly, a healthy diet means:
- AT LEAST five portions, or ideally 7-9 portions, of a variety of fruit and vegetables per day.
- A THIRD OF MOST MEALS should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.
- NOT MUCH fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low-fat, mono-unsaturated or polyunsaturated spreads.
- INCLUDE 2-3 portions of fish per week - at least one of which should be oily (but if you are pregnant you should not have more than two portions of oily fish a week).
- LIMIT SALT to no more than 6 g a day (and less for children).
- If you eat meat, it is best to EAT LEAN MEAT, or poultry such as chicken.
- If you do fry, choose a VEGETABLE OIL, such as sunflower, rapeseed or olive.
Foods that contain plant sterols or stanols can reduce total blood cholesterol level and LDL cholesterol by about 10%. There does not seem to be much evidence, however, that this has an effect on preventing cardiovascular disease. The National Institute for Health and Care Excellence (NICE) therefore does not recommend that these products be used routinely until more information is available.