High Cholesterol. Should we really worry about blood test results or take the results lightly?

[healtywealthy]

I had a blood test recently and the Dr said that my cholesterol levels are high 5.8 (non-fasting) and they will repeat a fasting one in a years time. In the meantime he sent me the NHS link for lifestyle changes. In the actual report I can see other figures too LDL, HDL etc. I've not done much research myself, however talking to people I've heard various things. Eat Chicken. Don't eat Chicken. eat chicken twice a week. Eat Tofu. Don't eat egg yolk. I looked a little on NHS website which says increase exercise eat wholegrain things etc.

Contradicting advise from one Pharmacist was that blood tests aren't all that and do make some changes but don't worry so much that you become stressed and then suffer more due to that.

Where do I go from here? What can I eat and not eat? Also to add I had a large breakfast about 25 min before the test so would that have given a higher reading? Thank you in advance :-)

Your big breakfast won’t have affected the total cholesterol result, it may affect your triglycerides if you have a few fatty meals & hit the alcohol but won’t instantly affect the overall level that quickly.
5.8 isn’t overly high.
If your HDL is over 1.2 then you have enough good cholesterol to balance out the overall figure.
The ratio between the 2 needs to be below 4.5.
If triglycerides are high it’s an issue.

I think the key thing is to look at your diet so that your cholesterol is lower and isn’t higher by next year.

Reducing weight, increasing exercise, limiting alcohol and making dietary changes will all help.
Eggs are fine, skinless chicken is fine.
Eat whole grains, lean cuts of meat, fresh fruit and veg. Avoid UPF -sausages, pizza, ready meals, jar sauces etc. limit fatty takeaways, cook from scratch use limited fats etc.

https://www.heartuk.org.uk/low-cholesterol-foods/choose-low-cholesterol-foods

thank you all. @SloppyJays Here are my results :

Serum cholesterol 5.8

Serum triglycerides 1.4mmol/L

Serum HDL cholesterol level 1.43 mmol/L

Calculated LDL Chol level 3.73 mmol/L

Se non HDL cholesterol level 4.37mmol/L

Serum cholesterol/HDL ratio 4.06

Thanks. Silly question but does cooking with limited fats mean I will be eating mostly steramed or boiled veg and meat? I usually eat alot of home made curries and chappati

Do you have a family member with high cholesterol? It could be hereditary which means that diet won’t help - you need statins

Mine was 5.6. Review after a year. Don't eat meat or drink alcohol..

It needs context - how old are you, are you overweight, what’s your blood pressure, do you have family history of heart problems? 5.8 isn’t ideal but it’s not terrible; same for a ratio of 4. Long term lifestyle changes might help; but it might be genetic. Main thing is you don’t want it to get worse.

Current advice is pretty straightforward and focussed on generally healthy lifestyle advice - get some exercise, lose weight if you are overweight, eat more fruit and veg and less meat and saturated fat.

So to a big extent it depends on what your current lifestyle is. If your curries are made with a lot of ghee or coconut oil then swop those for olive oil or vegetable oil and use less; swop out some of the meat for pulses or more veg. If you don't exercise at all then start doing a bit.

I spend a lot of time speaking with patients about cholesterol and statins.

I think with those results my advice would be, you're not in the area where I would be strongly suggesting statins, lifestyle changes would be beneficial.

Obviously this is very blanket info as I don't know your medical history so couldn't comment specifically.

Legumes, lentils and vegetables are your best friends.

Hard cheese is a strong culprit for raised cholesterol but don't dismiss it entirely because you need calcium for bone protection.

The obvious things to really reduce to a treat are things like pastry, processed meats, butter etc.

Exercise increase are always beneficial to cardiac health unless you're specifically told otherwise.

If curries are your thing then be mindful of hidden fats in things like ghee, coconut etc.

thanks all. @ArseMenagerie my mum and nan have high cholesterol. one sister also has it at similar levels to mine.

@olderbutwiser I'm 41, blood pressure is fine. Diabetes result taken recently with full blood count was fine. full blood count is fine. Previously Dr said PCOS without the syndrome as saw cysts on ovaries when checking mittelschmerz pain, Chin hair is there, periods sometimes heavy. two kids. currently I am Overweight, on NHS BMI scale I am half way in the middle of the overweight section. So, there is 7 kg to lose to come to normal weight.

Cut sugar since one month which is helping me keep full for longer, I'm no longer needed snacks. Can just go with three meals, 2 snacks in between.

to add more veg to diet, I think they say half of the plate should be veg. any good tips how to cook them? should I invest in a steamer? Thanks

@healtywealthy I am in a similar situation except my cholesterol levels are higher than yours:

Total: 7.6
LDL: 4.95
HDL: 1.76
TC: HDL ratio 4.3
Triglycerides: 2

I think mine is familial as my mother was 8.8 in her mid 60s, I'm 63. Pitch perfect BP, no signs of diabetes, no heart disease in my family which is long lived. Mine may also be elevated by a drug for osteoporosis. Like you, I am a little overweight but not obese.

My Q3 risk is low (google and you can work this out for yourself). My consultant has suggested a statin, I have suggested an attempt to address with diet and exercise for three month first.

I have read quite widely and have implemented the following.

White pasta, rice and bread replaced with wholemeal.
No saturated fats: butter, lard, ghee, etc. Replace with olive oil, rapeseed oil, Benecol, etc.

No refined sugars (combining the deletion of saturated fat and sugar that means no cake, biscuits, pastry, pies, etc)
No processed meats: sausages, ham, salamis, etc
Chicken breast and turkey breast
Red meat once a week only
Fish, especially salmon, mackerel, fresh tuna (not tinned).
Very limited cheese, especially hard cheese

Semi skimmed or skimmed milk
O% natural Yoghurt, cottage cheese, low fat quark and low fat Creme fraiche
Garlic, small portions of nuts are good.

More pulses, veg, fruit and more reliance on herbs and spices.

No alcohol and no pop.

Veg is good steamed or roasted. For roasted get some virgin olive fry light. You can cook veg how you like, just don't add too much olive oil and certainly no butter.

I have also started taking plant sterol.

I had fasting bloods and to get them again next month as my cholesterol was raised although I wasn’t told the level. I expect I may end up on statins when I go back as I am overweight and doing shit at losing weight. I have vitamin b12 and folate deficiency too and think I read that those can cause raised cholesterol so now I’m having that treated will see if it makes a difference

For understanding risk, What matters (much more than total) is the ratio. Your total:HDL ratio (calculator here) is on the threshold to being high. Your TG:total ratio is also on 'wrong' side of good threshold (above 2).

The good news is there's so much you can do in your lifestyle to shift the balance back to being healthier. You've had dietary advice so mine is to exercise (move) more.

thank you all. Will just losing weight help? I mean if diet continues to be the same and my weight gets to the normal range instead of the overweight is that still good? Or are the diet changes necessary? My question is that is this problem more in overweight people or do people with normal weight still experience high cholesterol? in other words is high cholesterol linked with heavy weight?

It will differ for everyone because as others have said the context to your other health factors, genetic disposition and current lifestyle will all contribute to it

As an example, I started a very low calorie diet last October, lost lots of weight and then in Feb had weight loss surgery and have lost a total of 7 stone in 11 months (not that quick in comparison to others)

As my calorie intake is so low,, I dont eat much fat but I dont really actively try to eat 'low fat' foods or check saturated fats so this is probably higher than medics would advise.
I also cant fit much food in and have to prioritse protein so theres not much room for large volumes of veg and fibre.

In a year, my cholesterol is exactly the same, 5.6, however last September it was a ratio of 6.2 and this month it is a ratio of 5.06, not great still but a good improvement.

So I might think about omega supplements and I have been trying to increase the amounts of veg although with such little space its hard.

I also do not take exercise and this needs drastic attention.

I think with some small improvements I would hope I get my ratio to less than 4

I was told a brisk walk straight after the evening meal would help.

I haven't tried it 😬

Well evening is the only time I have to do any exercise and as soon as I get home from work I get changed into my pjs and I cant be arsed then to get changed again to go out. Im also incredibly lazy but Im worried about muscle mass and bone density given Im now old so I need to get with it and do something

I love recommendations like "have a brisk walk after the evening meal". I usually fi ish work at about 7.30pm, get home at about 8pm, cook and we have dinner at about 8.45/9pm. I am not going for a brisk walk during the late evening - it's a bit dark and bridlewayish where we live.

They have no comprehension that some people work long hours and very hard. I can manage a brisk walk after lunch and am making time for it.

@healtywealthy you need to lose weight AND eat a low cholesterol diet AND exercise. I was slim in my 20s/30s and had high cholesterol then - not as high as now and ratios were better. I think mine is familial as my mother's was 8.8 when she was 64 (sameish age as me now) and she has always been teeny tiny. Never more than 8st 4lb at 5'4".

They have no comprehension that some people work long hours and very hard. I can manage a brisk walk after lunch and am making time for it.

You are doing well then

Upon retirement, my parents ate exactly the same meals - mostly "healthy" ones as my mum had suffered heart problems and had had a bypass. Their check ups and blood tests always came up with Dads unmedicated cholesterol levels perfect. But despite diet, losing weight and exercising etc, Mum had to take statins to get them anywhere near acceptable readings.
My diabetic husband has taken statins for years, no side effects and his cholesterol levels are now at an acceptable level. I started on statins a couple of years ago, and they lowered my levels. But on a recent review, it was suggested that given the familial history, my treatment for cholesterol should be more aggressive. So the dose was doubled. Result? Cholesterol is where doctors want it and no side effects.
Moral of the story.....keep on taking the tablets!

I'm mid 60's and as part of cardiac tests following diagnosis of Atrial Fibrillation, I had a cardiac CT. My cholesterol has always been raised however my calcium score on the CT was zero. So despite raised cholesterol I have no built up of plaque deposits.

I'm a terror for real butter, and put cream on my porridge and eat chocolate. I don't drink alcohol, and I'm not much of a veg eater. Fruit yes and fibre yes. Otherwise I'm not very observant. I walk about three kilometers a day.

I don't worry about it, never did.... obviously.

The recommendation of lots of oats tickles me. In a crumble perhaps, porridge yes, but the butter in the former and honey, sugar and cream with the latter doesn't stack. Somewhere I think I have a recipe for mackerel or herring with oats. Could I? Hmm.

Mine was 5 (normal but I take a medication that raises it so being borderline is not ideal at 43). I got it down to 3.66 in five months.

The changes I made were getting an exercise routine (a small amount of cardio and 3 strength sessions), I cut out added sugar, I swapped butter for olive oil (or avocado on toast), reduced cheese, snack on nuts but keeping to a small handful. I don't calorie restrict. I was quite surprised by the impact of exercise - that bought me down about 1 point when my diet was the same.

I dont put honey and cream with my oats. Im not massively keen on oats and prefer a protein breakfast but I eat them for fibre purposes. I make them with semi skimmed milk (overnight) and mix baked apple and peanut butter in them. No separate sugar and the peanut butter has no sugar in it.