cholesterol diet considerations

Overview

Cholesterol is a waxy, fat-like substance made by your liver and found in some foods. Your body needs it to build cells, but too much in your blood can clog your arteries and raise your risk of heart disease and stroke. The food you eat can affect how much cholesterol is in your blood.

Yes, high cholesterol is very common. Nearly half of adults in the UK have high cholesterol.

It can affect anyone, but it becomes more common with age. People who eat a diet high in saturated fats, do not exercise enough, are overweight, or have a family history of high cholesterol or heart disease are at greater risk.

Symptoms

Common symptoms

• High cholesterol usually has no symptoms, so you can have it without knowing.

Symptoms in children

• Most children with high cholesterol have no symptoms. Children with very high inherited cholesterol may develop fatty skin bumps called xanthomas, but this is rare.

Symptoms in older adults

• Older adults may not have symptoms, but they are more likely to have other conditions like high blood pressure or diabetes that increase the risk of heart disease and stroke.

Causes

Main causes

• Eating foods high in saturated fats and trans fats, such as fatty meats, full-fat dairy, fried foods, and many processed snacks, can raise your LDL (bad) cholesterol.
• Physical inactivity, smoking, and carrying excess weight can also contribute to high cholesterol.
• Some people inherit a condition called familial hypercholesterolemia, which causes very high cholesterol levels even with a healthy lifestyle.

Risk factors

• A diet high in saturated and trans fats
• Lack of regular physical activity
• Obesity or a body mass index (BMI) in the overweight range
• Smoking or exposure to tobacco smoke
• Age over 40
• Family history of high cholesterol or early heart disease
• Having diabetes, high blood pressure, or kidney disease

When to see a doctor

See a doctor urgently if:

• If you have symptoms of a heart attack or stroke, call your local emergency number right away (999 in the UK, 112 in Europe, 911 in the US). These are medical emergencies.

Book a routine appointment if:

• If you are over 40 and have not had a cholesterol check, ask your doctor about it.
• Talk to your doctor if you have a family history of high cholesterol or heart disease.
• If you have diabetes, high blood pressure, or are concerned about your weight, get your cholesterol checked and discuss your diet.

Diagnosis

High cholesterol is found with a blood test called a lipid panel or lipid profile. It measures your total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides, which are another type of fat in the blood.

Tests that may be done

• Lipid panel (blood test)
• Physical exam and a review of your medical and family history
• Your doctor may use a risk calculator to estimate your risk of heart disease over the next 10 years

What to expect at your appointment

The test is done by taking a small sample of blood from your arm. You may be asked to fast (not eat or drink anything except water) for 9 to 12 hours before the test, but not all tests require this. Ask your doctor for specific instructions. The results are usually ready within a few days.

Treatment

Treatment for high cholesterol focuses on lowering your LDL (bad) cholesterol and raising your HDL (good) cholesterol. For most people, lifestyle changes come first, especially changing what you eat. If your cholesterol stays high, or you have other risk factors, your doctor may prescribe medicine.

Self-care at home

• Eat a heart-healthy diet low in saturated fats and trans fats, and high in fibre.
• Get regular physical activity — aim for at least 150 minutes of moderate activity per week, like brisk walking.
• Quit smoking and avoid second-hand smoke.
• Maintain a healthy weight.
• Manage stress and get enough sleep.

Medical treatments

If lifestyle changes are not enough, your doctor may prescribe a cholesterol-lowering medicine. The most common type is called a statin, but other types are also used. These medicines help your liver make less cholesterol and remove more from your blood. Your doctor will choose the medicine and dose based on your cholesterol level and overall risk. Always take medicines exactly as prescribed, and tell your doctor about any side effects.

When is surgery considered?

Surgery is not a typical treatment for high cholesterol. However, people with very severe inherited high cholesterol may have a procedure called apheresis, where a machine filters cholesterol from the blood. This is only done in specialist centres.

Living with this condition

Living with high cholesterol means building heart-healthy habits you can keep for life. It is not about being perfect — it is about making better choices most of the time.

Lifestyle tips

• Check nutrition labels and choose foods with less saturated fat.
• Eat more fruits, vegetables, whole grains, and legumes like beans and lentils.
• Choose lean proteins like poultry without skin, fish, and beans.
• Limit processed meat, fried foods, and sugary treats.
• Cook at home more often so you control the ingredients.

Diet and exercise

A heart-healthy diet includes lots of vegetables, fruits, whole grains, nuts, and healthy fats like olive oil. Limit butter, cheese, fatty meats, and tropical oils like coconut and palm oil. Pair this with regular physical activity, such as brisk walking, cycling, or swimming, for at least 30 minutes on most days. A registered dietitian can help you create a plan that works for your tastes and budget.

Mental health and emotional wellbeing

Learning that you have high cholesterol can feel stressful. It's normal to feel worried or overwhelmed. Changing your diet and lifestyle can be challenging, but small steps add up. If you feel anxious or depressed, talk to your doctor. You can also ask about support from a counsellor or a health coach.

Prevention

You can help prevent high cholesterol by eating a heart-healthy diet, staying active, keeping a healthy weight, not smoking, and limiting alcohol. Even if you have a family history, these habits can help reduce your overall risk.

Screening programmes

Regular cholesterol testing is part of prevention and early detection. In many places, people are offered a test every 5 years from age 40, or earlier if they have risk factors. Ask your doctor how often you should be tested.

Complications

If left untreated

• Coronary heart disease, which can cause chest pain (angina) and heart attacks
• Stroke, when a blood vessel in the brain is blocked or bursts
• Peripheral artery disease, which causes leg pain and poor blood flow in the limbs

Long-term outlook

The outlook for high cholesterol is good. With a healthy diet, regular activity, quitting smoking, and, if needed, medication, most people can lower their cholesterol and protect their heart and brain. Making changes now can add years to your life.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.