Let’s get straight to the point. High cholesterol is implicated in heart disease and premature death, so lowering it is undoubtedly a smart move. There are two ways to lower cholesterol that are known to work – modify your lifestyle and take drugs that treat high cholesterol.
The high rates of high cholesterol (or hypercholesterolemia to use the medical term) that are found in Western societies especially are a fairly recent phenomenon and for the most part caused by modern lifestyles. In most cases though, high cholesterol is easily brought under control with quite simple modifications to diet and exercise habits.
Some people are found to either have cholesterol levels so high that lifestyle modifications alone would not be sufficient, or they carry a genetic fault (familial hypercholesterolemia) that would similarly limit the benefit of improved diet and exercise. Such people are generally offered cholesterol lowering drugs called statins which come in a range of strengths and which they can expect to keep taking for as long as they live.
Before we move on to examine these two strategies, it’s worth understanding that when health professionals talk about cholesterol as it affects people, they are generally concerned with two specific types (there are more, but this simplification is reasonably accurate). These are LDL which is often called “bad cholesterol” and HDL which has been labelled “good cholesterol”.
LDL (Low Density Lipoprotein) is composed in the main of lipids (body fats) and is produced by your liver as part of the overall digestion of what you eat. From the liver it is sent through the entire blood stream to supply energy to every tissue in your body. So LDL is crucial in fuelling your body, but unfortunately unused energy (excess LDL) tends to build up as fatty deposits in veins and arteries, storing up problems for the future.
HDL (High Density Lipoprotein) has a higher density of protein than lipids (fats) and can thus absorb excess LDL which it returns to the liver to be either reused or discarded. But your body has considerably more LDL than HDL so HDL can never handle very high levels of LDL cholesterol. Nevertheless, research has shown that increasing the amount of exercise taken results in an increase in the amount of HDL present in the bloodstream.
Where lifestyle changes to combat LDL cholesterol are concerned, these proceed from the observation that excess weight, certain types of food, smoking, drinking and too little exercise are strong contributory factors leading to high LDL cholesterol; therefore avoiding these things will cause the reverse and lower your cholesterol.
So what types of foods are best avoided? The simple answer is anything that contains saturated fat; so hard cheese, butter, red meat, pastries, cakes and biscuits. Conversely you should aim to increase your intake of fruit, vegetables, oat and beans as these foods actively help to lower cholesterol. Switching from butter to a plant sterol based spread (commonly marketed as “cholesterol lowering” spreads) gets the best of both worlds.
Some people however find that modifying their lifestyle is not sufficient by itself to bring their cholesterol levels within acceptable limits and they should consult a doctor, who in most cases will prescribe medication from a class of drugs known as statins. It is worth noting though that these pills are absolutely not a means of avoiding lifestyle changes; they are an additional aid on top of that.
The most commonly prescribed statins are (in ascending order of strength and using both clinical and brand names):
Pravastatin (Lipostat); Simvastatin (Zocor); Atorvastatin (Lipitor); Rosuvastatin (Crestor).
In the vast majority of cases, people who are prescribed statins tolerate them with virtually no side-effects whatever, however it should be borne in mind that they do have the capability to harm muscle tissue and the liver, though this risk is usually minimal for people not on very high doses. For this reason though, if your doctor recommends that you take statins on an ongoing basis it is likely they will also ask for not infrequent blood tests, both to check cholesterol levels and also to spot early signs of any possible internal damage.
So there you have it. Two effective and medically proven ways to lower cholesterol. The difference between the two is simply a matter of degree – taking prescribed drugs is an additional measure on top of addressing your lifestyle, which in most cases lies at the root of the problem.
