NUTRIWAY - Cholesterol – the good and the bad
High cholesterol levels are not something to turn a blind eye about because they can have serious implications for your health. In fact, 17% of all deaths in New Zealand can be directly related to high cholesterol levels. The average cholesterol of New Zealanders is 5.7mmol/L which is a grave concern because it means that the majority of New Zealanders are at a greatly increased risk of developing coronary heart disease because they have a cholesterol level above 5.5mmol/L. Nearly 1 in 4 New Zealanders have cholesterol levels higher than 6.5mmol/L.

What is Cholesterol?
Cholesterol is a group of essential fats that are produced in the body by the liver. They are also found in some of the foods we eat. Cholesterol is essential to build cell membranes, produce Vitamin D and make hormones such as oestrogen, testosterone and adrenal hormones. However, exceeding the ‘right amount’ of cholesterol can be harmful. Having your cholesterol levels checked regularly, and discussing the results with your doctor may help you avert serious heart health issues.

There are two main types of cholesterol:
  • LDL – low density lipoprotein – ‘bad’ cholesterol
  • HDL – high density lipoprotein – ‘good’ cholesterol
What’s the right cholesterol level?
High cholesterol levels increase your risk of heart disease.

Cholesterol levels are measured in millimoles of cholesterol per litre of blood (mmol/L). Total cholesterol should be less than 5.5 mmol/L. Higher cholesterol levels are an indication of a greatly increased risk of developing coronary heart disease. If your total cholesterol level is 6.5 mmol/L your risk of heart disease is about four times greater than that of a person with 4.0mmol/L.

Low-density lipoprotein (LDL) is ‘bad’ cholesterol and is a key marker for heart-disease risk. LDL should be no higher than 2mmol/L. LDL contributes to blocked arteries and increased risk of heart disease.

High-density lipoprotein (HDL) is considered as ‘good’ cholesterol. It helps remove LDL particles from blood. HDL should be above 1mmol/L. HDL helps to protect the arteries from a build up of fatty deposits. High levels are strongly associated with a lower risk of coronary heart disease.

Your doctor may suggest a range of other blood tests, including triglyceride levels to assess your personal risk of heart disease. Triglycerides are a measure of the amount of fat circulating in the blood. Triglycerides should be less than 1.5 mmol/L. High triglyceride levels are an additional risk factor for heart disease.

Managing Risk Factors
It is advisable to have regular blood cholesterol tests. If the test results indicate an increased risk of coronary heart disease, discuss options of managing the risks with your doctor to determine what will work best for you.

Your doctor may suggest lifestyle changes or a combination of lifestyle and medication to reduce your risk factors.
  • Diet
    Foods containing high levels of cholesterol and saturated fats increase the risk of heart disease. If you have high LDL or total cholesterol, manage your diet by reducing saturated fats from cheese, pastries, biscuits and fast foods. Replace these with foods such as fish, nuts, vegetables and flax seed which contain monounsaturated and polyunsatured fats. Fish contains omega 3 fats, and the Australian Heart Foundation recommends 500 mg of Omega 3 every day.
  • Dietary Supplements
    Supplements may help you to achieve an optimum intake to manage cholesterol levels. For example, supplements containing omega 3 fish oils, soluble and insoluble fibre, and herbal extracts such as green tea can help to maintain healthy cholesterol levels.
  • Exercise
    Regular exercise has been shown to reduce ‘bad’ LDL cholesterol and triglyceride levels while increasing ‘good’ HDL cholesterol. For example, at least 30 minutes of brisk walking daily may help.
  • Weight
    Being overweight is a risk factor for heart disease as it can lead to higher LDL and blood triglyceride levels. A healthy lifestyle with an appropriate diet and exercise can help to reduce your weight. Body Mass Index (BMI) and Waist to Hip Ratio calculators can provide useful indications of your risk for heart disease.
  • Family history
    A family history of elevated cholesterol or cardiovascular disease are risk factors for heart disease that you can’t change by yourself, but you should not ignore. We suggest that you consult your doctor to discuss your overall risk factors, get advice on healthy lifestyle choices and possibly using prescription medicines to control high LDL cholesterol levels.
  • Menopause
    With menopause, women’s LDL levels often rise. If this happens, talk to your doctor for specific advice about reducing your own risk factors.
  • Stress
    It is well established that stress can raise LDL levels over time. Take some time to relax and try to avoid continual stress in your day. Physical activity is a good way to help reduce stress levels. Maybe try yoga or meditation as well.
  • High Blood Pressure
    High blood pressure is another risk factor. Talk to your doctor about options for controlling this risk.
  • Smoking
    Tobacco smoking increases the risk of coronary heart disease, as well as a range of other diseases and conditions. Exposure to second-hand smoke also increases the risk of coronary heart disease and respiratory problems among adults and children. If you are having difficulty with stopping smoking, it’s best to seek professional assistance.

While heart disease is still the largest cause of death and disability in New Zealand, research is making significant progress. Much more is known about how to reduce and control risk factors, and advice is readily available. It is up to each individual to be aware of the risk factors, and make lifestyle changes where appropriate to help ensure an optimum quality of life.