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When there is more cholesterol in the body than is needed, it is a problem. The higher the blood cholesterol the higher the risk of developing heart disease. Lowering and controlling your blood cholesterol level reduces the risk of heart attack.

Cholesterol is a natural fatty, waxy substance that is found in the body that plays an important role in the formation of organs, tissues and hormones. It is necessary to have some cholesterol in the blood. Most of the cholesterol in the body is made by the liver while some is found in foods. However, this is only a small amount of total cholesterol levels. Saturated fat is used by the body to make cholesterol and a diet high in saturated fat is the main reason for too much cholesterol in the blood.

There are different types of cholesterol. Since fats do not dissolve in the blood they attach themselves to protein molecules to be carried. These combine protein- fat molecules are called ‘lipoproteins’. There are two main types:

1.HDL - high density lipoprotein

2.LDL - low density lipoprotein

HDL carries excess cholesterol back to the liver to be excreted. It is often called “good” cholesterol.
LDL can contribute to the fatty deposit that block arteries and is therefore called “bad” cholesterol.

Desirable levels of both types of cholesterol help to prevent heart disease.

Cholesterol can be measured by a simple blood test. The amount of cholesterol present in the blood is measured in units called “milligrams per deciliter” (mg/dl). There are no hard or fast rules about what is high, but the following is a useful guide.

Total Cholesterol	Below 200 milligrams per deciliter
LDL Cholesterol	Below 130 milligrams per deciliter Below 100 milligrams per deciliter in person with diabetes or cardiovascular disease
HDL Cholesterol	Above 40 milligrams per deciliter in men Above 55 milligrams per deciliter in women

Triglycerides are another type of fat found in the blood. This is a simpler type of fat than cholesterol. Blood triglyceride levels will rise following a fatty meal. Other factors which can raise triglyceride levels are alcohol and sugars. A desirable level of blood triglyceride is below 150 milligrams per deciliter.

Eating unhealthy foods, such as those containing saturated fats (animal products), trans fats, as found in baked goods and red meat, and dairy products made from whole milk can all increase blood cholesterol levels.
Obesity, defined as having a body mass index (BMI) of more than 30, increases the risk of high blood cholesterol levels.
Regular exercise increases the “good” cholesterol or HDL as well as reduces the dangers of LDL.
Smoking damages the walls of the blood vessels, making them prone to collecting fat. Smoking decreases “good” cholesterol or HDL.
With age, there is an increased risk of high cholesterol. The liver is less able to get rid of LDL.
Diabetes increase very-low-density lipoprotein (VLDL), which is a dangerous type of cholesterol, and decreases HDL.

High blood cholesterol is affected by a number of factors including weight and food. Making some changes to your diet and lifestyle can help bring blood cholesterol down.

Suggested steps for reducing blood cholesterol levels

Weight Loss	Carrying extra body fat can mean the body produces more cholesterol. Aim for a healthy weight for your height or a body mass index (BMI) of less than 23 (Body mass index = weight in kilogram/(height in meters)²). Weight circumference in a man should not exceed 90 centimeters (44 inches) and in women not more than 80 centimeters (42 inches).
Saturated Fat	Reduce saturated fat intake - this fat is turned into cholesterol by the body and is the most important to cut down. Sources include fatty meats, full fat dairy products, cream, butter, fried food, fast foods, pastries, biscuits, cakes, potato chips, chocolate, palm oil and coconut oil.
Mono-unsaturated and polyunsaturated Fats	Use mono-unsaturated and polyunsaturated fats where possible. Sources of mono-unsaturated fats are olive oil, canola oil, margarine, peanut oil and some nuts. Sources of polyunsaturated fats are sunflower, safflower, soybean, margarine, oils, some nuts and seeds.
Cholesterol Intake 300 milligrams or less per day	Restrict foods high in cholesterol. Rates of cholesterol in meat (milligrams/100 grams) are: egg yolks (1480), chicken liver (746), kidney (480), brains (2054), prawns (150) and oyster (470).
Protective foods	Some foods can protect against getting high cholesterol. Include more of these in the diet, for example, fish (try to eat 2-3 times a week), fruit and vegetable, wholegrain breads and cereals and legumes (beans, peas, lentils).
Exercise	Exercise daily or almost daily, for at least 30 minutes at a time, such as fast walking or swimming. This can help manage cholesterol to an extent.
Medication	There are many medications to control blood cholesterol levels and they work in different ways. Please talk to your doctor before taking any cholesterol medications as these must be overseen by a doctor.

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