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Mumsnet hasn't checked the qualifications of anyone posting here. If you have medical concerns, please seek medical attention; if you think your problem could be acute, do so immediately. Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice.
IN answer to your question, I believe the dietary advice the NHS is using is outdated. I went to a talk by a heart surgeon recently. He was extolling the virtue of statins as diet has very little effect on cholesterol levels but that statement is based on the typical low fat, chemical shitstorm products like margarine, etc diet. Anecdotally low carb high fat might see better results but no cast iron evidence as yet. Have a look at Diet Doctor for LCHF advice as that is run by doctors and some of them are heart specialists
I was under the impression that diet accounts for 30% of the cholesterol problem and the remaining 70% is genetic. So by cutting back on some dietary cholesterol it will help but not miraculously so. My favourite beef cut is the tenderloin...very lean ;)
I suggest you don't follow the internet. Ask yourself what to eat and what not to. Check your cholestrol level regularly. Most importantly, quit salt (any form of salt) and red meat. This is just enough to reduce cholestrol. Hope it helps.
The NHS says that low saturated fat intake is linked to lowering LDL, the more risky type of cholesterol, not all cholesterols. It's easy to find stories online of people whose LDL soared after switching to low carb diets, btw.
Has he stopped smoking, stopped alcohol, tried losing weight, increased exercise with no change, already?
Statins stabilise plaque within the vessel wall preventing plaque rupture thus helping to prevent heart attack and stroke. Merely reducing blood cholesterol levels does not have that effect. I can understand why people are reluctant to take statins but please make sure you are fully informed. Read research papers that support the use of statins as well as the articles that don’t then make your mind up. If your cholesterol is very high and your GP thinks it may be genetic then ask if you can be referred to a Lipid clinic for genetic testing and further specialist advice.
There is growing evidence that high cholesterol may be linked to frequent, large fluctuations in insulin. Sorry, i don't have a link, but I'm sure Google can help.
Anecdotally: my cholesterol was climbing. I was obese, otherwise healthy, did not smoke, barely drank alcohol. After 2 months on HFLC my cholesterol had dropped from 6.7 to 4.5. A year later, 20kg down, still HFLC, it had risen to 5.3. I worried about this, but the GP said that the LDL:HDL ratio was even better than previously, so he was not concerned.
So I think that NICE guidance doesn't qualify as "incentivised" - these are evidence based guidelines so they are saying that if you have familial hypercholesterolemia then you are more likely to live past 50 if you take a statin. Haven't read it to know exactly what it recommends for children but if my child was 10yo and needed a statin according to NICE then I would want them to have it.
A link between HFLC controlling insulin production and therefore cholesterol sounds interesting but I haven't looked into this properly to know. I imagine that most people with high cholesterol will need a statin if they want to reduce their risk of stroke and heart attack.