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Mention the word cholesterol and most people think of furred-up arteries, heart disease and strokes. But it's not all bad, and if you have got a problem there are some simple and very effective steps you can take.
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In the last few years, thousands of people have improved their health by lowering their cholesterol. They've chosen tasty, low-fat foods, taken a little more exercise and switched from butter or margarine to cholesterol-lowering spreads. Some have used medicines to bring their cholesterol down.
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It's a fatty substance that all animals make. So it's in meat, butter and all dairy products. Plants don't make it, so it isn't in vegetables.
Allan explains that we all need some cholesterol to keep our cells healthy and in good repair.
'We couldn't survive without cholesterol, in fact we wouldn't ever have been born. We get some from our diet, and we make some in our liver, mainly while we're asleep at night,' he says.
So cholesterol isn't all bad. It's the way it's packaged in the body that counts.
Cholesterol goes around the body in the blood, in two forms – one bad and one good. As LDL-cholesterol, it gets into the walls of arteries and clogs them up, leading to heart attacks and strokes. But, as HDL-cholesterol, it sweeps the bad cholesterol out of arteries and reduces a person's risk of those dangers.
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Few of us know our cholesterol levels - good or bad. If you've already had a heart attack or stroke, diabetes, or other signs of arterial disease, your doctor should have tested your cholesterol.
You can also get a cholesterol test at many chemist shops. Some stores are offering free tests. Some tests don't distinguish between good and bad cholesterol. They give you a result for total cholesterol. This should be below five.
Other tests give you an LDL result, which should be below three, and an HDL result, which should be over one.
But, as Allan Gaw explains, many specialists now believe there are no 'ideal' cholesterol levels, and that LDL levels should simply be as low as possible, and HDL levels as high as possible.
'It's useful to have a cholesterol test because, if you're trying to change your levels, it's helpful to see what progress you're making. But we now know that some people need to pay special attention to their cholesterol, even if their starting level isn't too bad.'
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To find out if you could have a cholesterol problem, answer yes or no to these questions:
- Are you a man over 45 or a woman over 55?
- Do you smoke?
- Do you have high blood pressure?
- Are you overweight?
- Are you of South Asian origin (Bangladesh, India, Pakistan and Sri Lanka)?
- Do you take less than 30 minutes exercise, three times a week?
- Is there heart disease in your family?
- Does anyone else in your family have a cholesterol problem?
If you've answered yes to two or more of these questions, you may benefit from changing your cholesterol levels.
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'It's useful not to eat too many foods that contain a lot of cholesterol, like eggs, red meat and some seafood. But it's even more important to reduce the overall amount of fat that we eat, especially animal fat,' Allan explains.
That means eating fish and white meat instead of red meat, avoiding full-fat milk and cheeses, using sunflower or olive oil to cook with, and including at least five portions of fruit and vegetables in your daily diet.
If you use milk, yogurt and spreads that contain plant sterols or stanols instead of products that contain animal fat, you can lower your LDL levels by about 10%. These plant extracts – in products such as Flora pro.activ and Benecol - reduce the amount of cholesterol that you absorb from your food into your bloodstream.
But don't think this is a short cut to healthier living because there's more to improving your cholesterol balance than slapping plant spread on your toast. For further information about changes to your daily diet go to the Help and info page.
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'Exercise not only helps us to control our weight, it also helps to raise HDL levels,' says Allan. 'Just being more active is a good start – walking to the shops instead of taking the car, using the stairs instead of taking the lift.'
More and more people are wearing pedometers to remind them to be more active – 10,000 steps per day is a good target. And it doesn't take as long as you might think!
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Smoking is linked to heart attacks, strokes and lung disease, but there's a specific reason it's bad for cholesterol.
'Toxins from cigarette smoke attack the arteries but, in addition to that, they affect the cholesterol balance. People who smoke generally have low levels of HDL,' Allan explains.
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An estimated one in 10 people are now taking drugs called statins to lower their cholesterol levels. Most of these people have already had a heart attack or stroke, or they have arterial disease or diabetes.
Statins reduce LDL levels by 20-60%, and most increase HDL levels a little too. They work by reducing the amount of cholesterol that your liver makes.
Until recently, you could only get statins on prescription from your doctor. But some men and women can now buy a low dose of statin, called Zocor Heart-Pro, from their pharmacist. It can reduce their LDL level by about 27%. You'll have to talk to your pharmacist and complete a questionnaire to be sure that you need Zocor Heart-Pro before you can buy it.
'We are the first country in the world to make a statin available without a prescription, and it's a mark of just how safe and important these drugs are,' says Allan Gaw.
But, as he points out, 'Looking after your cholesterol isn't just about taking drugs. It's about looking at your whole lifestyle – eating healthily, taking regular exercise and quitting smoking. We all talk about it, but people who've done it really have reduced their risk of heart attacks and strokes and have quite simply added years to their lives.'
For further reading, weblinks and useful contacts go to the Help and info page.
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