You may have been advised to keep your cholesterol levels in check. We asked a nutritionist to give us her top tips for managing blood cholesterol, as well as explaining exactly what cholesterol is and what it does within the body.
What is cholesterol?
Cholesterol is a waxy fat, 75% of which is made in the body by our liver and the rest comes from the food we eat. For decades, cholesterol was believed to be the enemy when it came to heart health, but the latest research suggests it may not be as simple as we once thought.
Being a fat, cholesterol has to be transported by a carrier in the blood – these carriers are protein complexes called lipoproteins. You’re probably familiar with them because they’re often confusingly referred to as ‘bad’ cholesterol – Low Density Lipoproteins (LDL) – and ‘good’ cholesterol – High Density Lipoproteins (HDL). As with most things, it’s not as simple as that – these lipoprotein carriers are not cholesterol, and both LDL and HDL will be present in a variety of different forms – the smaller, denser of which appear to pose the greater risk. Your unique mix of LDL and HDL and their sub-types may depend on your genes, as well as your lifestyle.
Discover our full range of health benefit guides including how much fat should I eat and saturated fat – what you need to know. As well as cholesterol-friendly recipe inspiration.
Why do we need cholesterol?
Although most of us have grown up to fear cholesterol, we do actually need it for our bodies to function properly – in fact it’s fundamental to life. That’s because cholesterol is crucial for forming cell walls, producing hormones like oestrogen and testosterone, helping repair nerves, producing bile so we can digest and absorb the fats in our diet and to make the ‘sunshine vitamin’, vitamin D. What is more, cholesterol improves our memory and helps us feel good because it makes the mood-boosting hormone, serotonin.
How do I know if I have healthy cholesterol?
Your blood fats, including cholesterol level, can be measured by a simple blood test carried out by your GP. You can read more about how to get your cholesterol checked on the NHS website.
You should ask your GP for a cholesterol test if you have not had a test before and you’re over 40, if you’re overweight, high cholesterol or heart problems run in your family, or you have a condition called familial hypercholesterolemia.
What are blood triglycerides?
Cholesterol is not the only type of fat in your blood. If you’ve had a blood test to check your cholesterol levels, you’re likely to have also been told your triglyceride level. Triglycerides are the main form of fats in the body and we use them to store energy in our cells. Too much of this fat in your blood is an important, independent risk factor for heart disease.
Does the fat in the food I eat cause high cholesterol?
Alongside cholesterol, fat has long been treated as the enemy. Saturated fat is frequently vilified as it has been linked to cardiovascular disease and high cholesterol. Red meat, butter, cheese, burgers and sausages, are high in saturated fat, as are ghee, coconut and palm oils. A diet high in saturated fat can increase blood fats, including triglycerides, as well as increase your risk of obesity, type 2 diabetes and stroke. However, recent studies are now suggesting that the saturated fats in some foods such as dairy products, like cheese and yogurt, do not appear to be as harmful as we once thought.
This may be because of other nutrients in dairy, like calcium, or the fermentation process which may modify the way our bodies handle the fat in these foods.
What dietary aspects should I be focusing on for heart health?
Increasing evidence points to overeating sugary, refined carbs as a cause of inflammation, raised insulin levels, high blood pressure and higher cholesterol and triglyceride levels. You’re likely to have also heard of man-made fats called trans fats – these are unsaturated fats in our diet that behave more like a saturated fat, only worse because the body can’t recognise them. They are found in processed foods and takeaways and are the worst type of fat for raising cholesterol levels. You can avoid them by cooking as much as possible from scratch and checking labels for hydrogenated, partially hydrogenated and semi hydrogenated vegetable fats or shortening.
What should I look for on food labels?
When buying packaged foods make sure you are aware of what constitutes a high fat product by checking the nutritional panel for the following:
Total fat:
High: more than 17.5g of fat per 100g. Packaging may be colour-coded red.
Low: 3g of fat or less per 100g. Packaging may be colour-coded green.
Saturated fat:
Look out for ‘saturates’ or ‘sat fat’ on the label: this tells you how much saturated fat is in the food.
High: more than 5g saturates per 100g. (Packaging may be colour-coded red)
Low: 1.5g saturates or less per 100g. (Packaging may be colour-coded green)
If the amount of fat or saturated fat per 100g is in-between these figures, that’s a medium level, and packaging may be colour-coded amber.
Can my diet help manage my cholesterol levels?
There are some foods that are especially beneficial for heart health, so you should aim to include these in your diet on a regular basis.
Here are some suggestions:
1. Healthy, heart-friendly fats
Eating moderate amounts of fat is essential for health – the Mediterranean-style diet is a useful plan to follow because it includes healthy fats along-with lean proteins and plenty of fruit and vegetables. The med diet is especially rich in a heart-friendly type of fat called mono-unsaturated fat – this fat is found in foods like nuts, seeds, avocado and olive oil.
It’s important to remember to stick to Reference Intakes (RI) – the guideline daily amounts for nutrients like fats. Aim to have no more than about 1/3 of the fat in your daily diet being saturated, with the remainder being healthy fats including the monounsaturated and polyunsaturated fats found in olive oil, rapeseed oil, avocado, unsalted nuts and seeds.
More like this
Try these recipes using healthy fats:
Almond nut butter
Fish tagine with saffron & almonds
Avocado salad
Cauliflower, olive & lentil tagine
2. Dairy foods in moderation
There’s no need to be overly concerned about fermented dairy such as kefir, yogurt and cheese. That’s because the fats in these foods aren’t as harmful to blood cholesterol as we first thought – so enjoy in modest amounts.
Get inspiration from these tasty recipes:
Raspberry & kefir overnight oats
Healthy salmon bowl
3. Aim for 2-4 portions of oats or barley daily
There’s plenty of evidence to show that oats and barley help manage cholesterol levels. They’re rich in a soluble fibre called beta-glucan, which attaches to cholesterol and inhibits its absorption. A daily intake of about 3g of beta-glucan is considered an adequate amount to make a difference.
Recipes to try:
Apple & linseed porridge
Banana oat pancakes
Barley & broccoli risotto with lemon & basil
Irish soda bread
Seeded oatcakes
4. Fruit and vegetables
As a minimum you need to include 5 portions of fruit and vegetables a day, these are high in dietary fibre – certain types of which may help manage cholesterol. Beans, peas and lentils are useful sources as well as soya beans and sweet potatoes.
Learn more about the benefits of dietary fibre:
Get cooking with these recipes:
Lentil ragu
Puy lentil salad with soy beans, sugar snap peas & broccoli
Bean & barley soup
5. Foods rich in sterols and stanols
You may have seen ‘functional foods’ with added stanols in your local health food store. They are available as yogurts, spreads and milks. Plant stanols and sterols are compounds that block our absorption of cholesterol – one of the richest known fruit sources of phytosterols is avocado. Providing about 57mg per a half a fruit, including avocado as well as nuts like pistachios, in your regular diet may help manage your cholesterol.
Eat more avocado and nuts:
Black beans & avocado toast
California quinoa & avocado salad
Avocado & black bean eggs
Minty carrot, pistachio & feta salad
6. Oily fish
Eat oily fish up to twice a week or more regularly if you have a history of heart problems and you are not planning or are likely to become pregnant. Omega-3 fats found in oily fish may help lower harmful blood triglycerides – include herring, mackerel, pilchards, sardines, salmon, trout and fresh tuna.
Not keen on fish? Check out some other good sources of omega-3 fats.
Try these oily fish recipes:
Tuna steaks with cucumber relish
Basil & lemon chickpeas with mackerel
Grilled mackerel with harissa & coriander couscous
Lemon-rubbed salmon
What lifestyle factors help reduce cholesterol?
Don’t forget, as well as your diet, your day-to-day lifestyle plays a big part in heart health. In particular, smoking, being overweight (especially carrying extra weight around the middle), stress, inactivity, a low intake of fruit and vegetables, a diet high in refined carbs and sugars and too much alcohol all contribute to your risk of heart disease.
Furthermore, having high blood pressure, diabetes or a family history of early heart disease puts you at a greater risk – so make it your business to know your numbers.
Find more top healthy lifestyle tips:
Stress relief: How diet and lifestyle can help
How much should I weigh?
How to drink responsibly
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Heart-healthy portions
Cheap ways to get your 5-a-day
Top 10 tips for a healthy heart
Spotlight on… heart disease
What is fibre?
How much fibre should I eat a day?
Kerry Torrens BSc. (Hons) PgCert MBANT is a Registered Nutritionist with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the two decades she has been a contributing author to a number of nutritional and cookery publications including BBC Good Food
All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact your local health care provider. See our website terms and conditions for more information.
