Employee Wellbeing - Cholesterol

This factsheet is aimed at raising awareness of Cholesterol and also offers you some simple strategies to reduce it. What is Cholesterol?

 Cholesterol is a lipid (fat chemical) that is made in the liver from fatty foods that we eat. A certain amount of cholesterol is present in the bloodstream. You need some cholesterol to keep healthy. Cholesterol is carried in the blood as part of particles called lipoproteins. There are different types of lipoproteins, but the most relevant to cholesterol are:

  • LDL Cholesterol - low density lipoproteins carrying cholesterol. This is often referred to as 'bad cholesterol' as it is the one mainly involved in forming atheroma - the main underlying cause of various cardiovascular diseases (see below). Usually, about 70% of cholesterol in the blood is LDL cholesterol, but the percentage can vary from person to person.
  • HDL cholesterol - High density lipoproteins carrying cholesterol. Referred to as ‘good Cholesterol’ and may actually help reduce atheroma

What is atheroma and cardiovascular diseases?

Patches of atheroma (also know as hardening of the arteries) are like small fatty lumps that develop within the inside lining of arteries (blood vessels). Over time patches of atheroma can become larger and thicker and narrow the artery thus reducing blood flow. An example of this is Angina. Sometimes, a blood clot (thrombosis) forms over a patch of atheroma and completely blocks the blood flow which can cause a heart attack, a stroke, or other serious problems depending on the artery it affects.

Cardiovascular diseases are diseases of the heart (cardiac muscle) or blood vessels (vasculature). However, in practice, when doctors use the term 'cardiovascular disease' they usually mean diseases of the heart or blood vessels that are caused by atheroma.

In summary, cardiovascular diseases caused by atheroma include: angina, heart attack, stroke, transient ischaemic attack and peripheral vascular disease.

 What is a high cholesterol level?

 The following levels are generally regarded as desirable:

Total cholesterol (TC) - 5.0 mmol/l or less.

Low-density lipoprotein (LDL) cholesterol after an overnight fast: 3.0 mmol/l or less.

High-density lipoprotein (HDL) cholesterol: 1.2 mmol/l or more.

TC/HDL ratio: 4.5 or less. The more HDL, the better, the higher the LDL the greater risk to health

What factors affect the blood level of cholesterol?

 In most cases, your cholesterol level reflects the amount of fat that you eat but this is not always the true as some people make different amounts of cholesterol but eat the same amount of fat. An underactive thyroid gland, obesity, drinking a lot of alcohol, and some rare kidney and liver disorders can raise your cholesterol level. High Cholesterol is sometimes hereditary so if a family member has been diagnosed it is worth getting yourself checked also. However a general rule is if you eat less fat your cholesterol level is likely to go down.

Who should have their cholesterol checked?

 Current UK guidelines advise that the following people should be assessed to find their cardiovascular health risk:

  • All adults aged 40 or more.
  • Adults of any age who have:
    • A strong family history of early cardiovascular disease. 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.
  • A first degree relative (parent, brother, sister, child) with a serious hereditary lipid disorder. For example, familial hypercholesterolaemia or familial combined hyperlipidaemia.

If you already have a cardiovascular disease or diabetes then your risk does not need to be assessed. This is because you are already known to be in the high risk group.

How is cholesterol measured?

 A doctor or nurse will take a sample of blood from your finger and place this on a testing strip. This strip is then inserted into an automated machine which will give the cholesterol reading. Some machines only calculate total cholesterol; others give a breakdown of LDL and HDL. If your cholesterol level is classed as high (see above) you will be recommended to visit your GP.

How can cholesterol be lowered?

Treatment includes a change in lifestyle risk factors these can be: losing weight if you are overweight, regular physical activity, a healthy diet, cutting back if you drink a lot of alcohol, stopping smoking, and a low salt and caffeine intake. If needed, medication can lower cholesterol levels and also be prescribed as a precaution if you are at high risk of developing a cardiovascular disease.

Lose weight if you are overweight

Losing some excess weight can often make a difference to cholesterol levels and has other health benefits too.

Eat a healthy diet for a healthy heart 

  • AT LEAST 1/3 OF THE FOOD WE EAT should be fruit and veg. This equates to between five portions, and 9 portions per day
  • AT LEAST 1/3 OF THE FOOD WE EAT should be starch-based such as cereals, bread, potatoes, rice, pasta – try and eat wholegrain varieties as often as possible
  • INCLUDE some dairy every day, this could be a smaller portion of the high fat varieties or regular portion of the low-fat options (milk, fromage frais, cheese, yoghurt)
  • INCLUDE at least one portion of meat, fish, eggs and beans/peas/lentils per day. Opt for lean cuts of meat, remove all visible fat (including chicken skin) and grill where possible. Pulses are naturally low in fat and an excellent source of protein, fibre, vitamins and minerals. Aim for at least 2 portions of fish per week (at least one of which should be 'oily' (such as salmon or mackerel).
  • LIMIT the amount of food and drink you consume that is high in sugar and fat if you do fry use a vegetable oil such as sunflower, rapeseed or olive.
  • REDUCE salt to the recommended maximum of 6g per day for an adult
  • DRINK plenty of water (at least 2 litre’s per day) and avoid calorie laden drinks

Regular physical activity

If possible, aim to do some physical activity on five or more days of the week, for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, etc. Regular physical activity has been shown to raise levels of HDL cholesterol and prevent patches of atheroma from forming.

Reduce your salt intake

Too much salt can increase your risk of high blood pressure which is not good for your heart. Guidelines recommend that we should have no more than 6 grams of salt per day but our diets often include a lot more than this. Try to gradually reduce the amount of salt you use and you will find that over time your taste buds will adapt.

 Restrict your number of caffeine drinks

Caffeine is thought to have a modest effect on blood pressure. It is advised that you restrict your coffee consumption (and other caffeine-rich drinks) to fewer than five cups per day.

Drink alcohol in moderation

A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. One unit is in about half a pint of normal strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits. However, too much alcohol can be harmful.

  • Men should drink no more than 21 units of alcohol per week (and no more than four units in any one day).
  • Women should drink no more than 14 units of alcohol per week (and no more than three units in any one day).

For help with healthy eating, smoking and exercise please refer to our factsheets or seek the advice of your doctor.

If you are concerned about your cholesterol levels it is recommend you seek medical advice or for further information visit:

www.heartuk.org.uk

www.bhf.org.uk

www.nutrition.org.uk

I hope you have found this fact sheet useful. For further information on cholesterol testing or any of the services offered by Work Well Hub please call us on: 01202 987916 or email Hello@workwellhub.com

 This fact sheet has been adapted from the NHS website – www.patient.co.uk and is for information only and should not be used for diagnosis or treatment of medical conditions. Every care has been taken to ensure the accuracy of information but we make no guarantee to its accuracy.

BlogRenee Clarke