The UK's biggest killer isn't cancer, you may be surprised to know, but coronary heart disease.

High cholesterol (LDL) is one of the major contributing factors towards it because it contributes to the narrowing of the arteries, heart attacks, strokes and mini-strokes.

So far, we may not be telling you anything you don't already know. But do you know that three in five people have high cholesterol? Considering high cholesterol is something that can be lessened and can be massively impacted by what you eat and how active you are, it seems like incredibly high figures.

healthy heart

One way of explaining it is that people either don't quite know what cholesterol is, or are unaware that they even have high cholesterol. We caught up with the experts to find out.

Dr Paul Zollinger-Read, chief medical officer for Bupa and HuffPost UK blogger, explains: "“Cholesterol is a type of fat that’s made by your body. In fact, it’s found in every single cell in your body. A small amount of the right cholesterol, known as high-density lipoprotein (HDL), is essential for good health. However, having a high level of low-density lipoprotein (LDL), known as ‘bad’ cholesterol, can increase your risk of cardiovascular disease, such as heart disease and stroke."

High cholesterol causes fatty deposits, adds Dr Zollinger-Read, which are known as plaques, to build up inside your blood vessels. "Over time, your blood vessels that supply your heart may narrow. This means there is a reduced blood flow to your heart and therefore not enough oxygen getting to your heart muscle.

“Because of this, you might develop angina. Worse still, if a fatty plaque breaks off, it may cause a blood clot that can block the blood flow to your heart or brain to cause either a heart attack or stroke."

The biggest problem, says Dr Robert Cramb, head of the board of trustees at HEART UK (Hyperlipidaemia Education & Atherosclerosis Research Trust UK) is that most people don’t know they have high cholesterol. "There are no clear outward symptoms; it’s a silent killer. The first sign you could have that your cholesterol level is too high might may be a heart attack."

High cholesterol can be tested for very easily at your doctor's surgery with a blood test.

And although you shouldn't panic - don't be under the illusion that high cholesterol is an older person's condition or that men are at higher risk. Dr Ross Walker, consultant cardiologist said: "Women are at the same risk as men but this tend to occurs 10 years later because of protection from hormones until menopause.

"With the increasing rates of obesity, now becoming endemic in younger populations, we are seeing the condition known as metabolic syndrome which is the combination of tendency to diabetes, high blood pressure, specific cholesterol abnormalities such as a high cholesterol, high triglyceride and low HDL cholesterol (good cholesterol), along with abdominal obesity. All of these factors together markedly increase the risk for all forms of vascular disease."

cholesterol

Dr Walker also says that while you may not be offered a cardiac assessment due to age, you should take into account other factors. "If there are other associated risk factors such as high blood pressure, diabetes, cigarette smoking or a family history of a first degree relative who suffered a heart attack or another vascular problem before the age of sixty, then these assessments should be performed earlier. If there is evidence of vascular disease then the cholesterol should be aggressively treated."

The question is however, that lifestyle aside, are some people more pre-disposed to high cholesterol than others? Dr Cramb believes that some people are more genetically prone to it but that unlike other genetic conditions, it is easily detectable and treatable. "Of the estimated 120,000 people in the UK with Familial Hypercholesterolemia (FH) - an inherited condition which leads to extremely high cholesterol levels - only 15-20% have been formally diagnosed."

The people most at risk regardless of genetics, however, are smokers, anyone who is overweight, and diabetes sufferers.

So, what can you do to reduce cholesterol? Dr Cramb says: "Maintaining a healthy diet can reduce you cholesterol levels between 5-10% so it’s important to eat well and regularly exercise helps your heart to be healthy. Eating healthily doesn’t mean that you need to cut out food from your diet – you just need to watch your portion sizes and balance the types of foods that you consume.

"Cut down on saturated fats because these contribute to high cholesterol. You could also try cholesterol busting foods that can help to lower cholesterol such as those fortified with plant sterol, stanols, oats and soy proteins. Stopping smoking will also help you lower your other blood fats and cholesterol."

We spoke to top nutritionist Alice Mackintosh at The Food Doctor, who explained: "The majority of cholesterol in the body is synthesized in the liver. Whilst this will happen naturally, the balance between different types of cholesterol is quite dependent on diet. High levels of sugar in the diet have been associated with the ‘bad’ HDL type cholesterol, whilst diets low in sugar, or low GI, are associated with more balanced cholesterol levels.

"This is for a number of reasons. Firstly, low GI foods tend to contain more soluble fibre, which reduces excess cholesterol by preventing its re-absorption in the bowel. Secondly, insulin can drive the production of cholesterol in the liver; and tolerance to insulin which can occur in those with a high sugar diet is associated with higher total cholesterol levels in the body.

"As a low GI diet limits insulin production by ensuing foods in the diet don't increase blood sugar over a certain threshold, this may be protective against high cholesterol. "

ALICE'S DIET AND LIFESTYLE SUGGESTIONS:

  • 1
    Garlic
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    Garlic has been found to help reduce cardiovascular risk factors by reducing total serum cholesterol although this is dependent on dose and type of garlic used. It is important to use raw garlic, and crush/macerate the flesh to obtain the essential oils, or to supplement with good quality garlic extract. Anti-oxidants in garlic known as alliin and allicin may also help to prevent oxidation of lipids, reducing risk of atherosclerosis. Ajoenes also lowers blood viscosity and may inhibit blood clotting factors and platelet aggregation, reducing the risk of blood clots.
  • 2
    Citrus Fruits
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    Vitamin C in citrus fruits helps to reduce oxidation of cholesterol. Limonine, a powerful essential oil found in the pith of citrus fruit has also been found to help reduce cholesterol.
  • 3
    Turmeric
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    Turmeric has also been found to help reduce cholesterol due to the presence of curcuminoid, a substance known to have a positive impact on bad cholesterol levels.
  • 4
    Stress
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    Long term stress can also increase cholesterol levels. Cortisol, our ‘stress hormone’ is derived from cholesterol, meaning that continually high levels drive cholesterol up to meet demands for production of stress hormones. To help combat this, exercise is an excellent stress buster and also helps reduce cholesterol by improving cardiovascular function. Try different types of exercise. Yoga and Pilates are also excellent if you need to aid relaxation. Acupuncture is also excellent for helping manage stress. Sleep is also important, and things such as meditation can also help.

Dr Walker recommends a supplement called BergaMet, that costs £42 for a month's supply, and comes from bergamot oranges grown on the southern Ionic strip of Calabria in Italy. "BergaMet kickstarts the metabolism and at times has an effect on reducing high cholesterol but always has an effect on making the overall cholesterol profile more healthy."

DR WALKER'S LIFESTYLE RECOMMENDATIONS TO REDUCE CHOLESTEROL:


  • 1. Have no addictions – you cannot be healthy and smoke, you cannot be healthy and drink too much alcohol and you cannot be healthy and use any illegal drugs

  • 2. Try to achieve good quality sleep

  • 3. Good quality eating and less of it
  • 4. Three to five hours every week of exercise
  • 5. The best drug on the planet – happiness


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  • 4. Maintaining Normal Blood Glucose Levels

    Having chronically <a href="http://diabetes.webmd.com/blood-glucose" target="_hplink">high levels of glucose</a>, a kind of sugar, in the blood can lead kidney and blood vessel damage, according to WebMD. Insulin, a hormone in the body, is responsible for helping the body's cells to <a href="http://www.medicinenet.com/insulin/article.htm" target="_hplink">use glucose in the blood</a>. However, if the body doesn't have enough insulin or isn't able to use it properly, then <a href="http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html" target="_hplink">blood sugar levels may rise</a>, according to the American Diabetes Association. High blood sugar is considered a diabetes complication. Tests to check for high blood glucose can help show whether a person has diabetes, and are used to <a href="http://diabetes.webmd.com/blood-glucose" target="_hplink">monitor someone with diabetes</a> over time, WebMD reported.

  • 1. Not Smoking

    While not entirely surprising, it doesn't make the message any less important: <a href="http://www.nhlbi.nih.gov/health/health-topics/topics/smo/" target="_hplink">Smoking kills</a>. The habit is considered the No. 1 cause of preventable death and sickness in the U.S. Specifically, <a href="http://www.nhlbi.nih.gov/health/health-topics/topics/smo/" target="_hplink">smoking cigarettes harms the heart</a> in that it damages heart and blood vessel function, thereby upping the risk of atherosclerosis (where your arteries harden), according to the National Institutes of Health.

  • 2. Being Physically Active

    Aerobic exercise is good for the heart in that it makes you take in more oxygen, helps you <a href="http://www.mayoclinic.com/health/aerobic-exercise/EP00002/NSECTIONGROUP=2" target="_hplink">keep to a healthy weight</a>, reduces plaque buildup in the arteries and helps to lower blood pressure, according to the Mayo Clinic. According to the Centers for Disease Control and Prevention, adults are recommended to get at least <a href="http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html" target="_hplink">150 minutes of aerobic exercise</a> a week (moderate to intense level), and also do muscle-strengthening at least twice a week.

  • 3. Maintaining Normal Blood Pressure Levels

    <a href="http://www.nhlbi.nih.gov/hbp/bp/bp.htm" target="_hplink">Blood pressure measurements</a> are written in terms of systolic over diastolic. Systolic pressure is "as the heart beats," according to the National Institutes of Health, while diastolic pressure is the relaxation of the heart between heartbeats. A person with a normal blood pressure level has a systolic blood pressure reading of 120 millimeters of mercury or less, and a diastolic blood pressure reading of 80 millimeters of mercury or less. A person is <a href="http://www.nhlbi.nih.gov/hbp/detect/categ.htm" target="_hplink">considered hypertensive</a> (has high blood pressure) when the systolic blood pressure is between 140 and 159, and the diastolic blood pressure is between 90 and 99.

  • 5. Maintaining Normal Total Cholesterol Levels

    <a href="http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm" target="_hplink">High cholesterol</a> is a known risk factor for heart disease, because it causes hardening of arteries going to the heart, according to the National Institutes of Health. When part of the heart is deprived of blood, it could trigger a heart attack. The <a href="http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm" target="_hplink">optimum total cholesterol level</a> is 200 or fewer milligrams of cholesterol per deciliter of blood, while having a total cholesterol level of 200 to 239 milligrams per deciliter is considered borderline high. High total cholesterol is having 240 milligrams of cholesterol per deciliter of blood, or more, according to the National Institutes of Health.

  • 6. Having A Healthy Weight

    Calculating your body mass index (BMI, a ratio of weight to height) is a good starting point for knowing if you're at a <a href="http://www.cdc.gov/healthyweight/assessing/index.html" target="_hplink">healthy weight</a>, according to the Centers for Disease Control and Prevention. According to the BMI chart, having a BMI of 18.5 or below is considered "underweight" and a BMI of 18.5 to 24.9 is considered "normal" or healthy weight. A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 and above is considered obese. <a href="http://www.nhlbisupport.com/bmi/" target="_hplink">Click here to calculate your BMI</a>. <a href="http://www.cdc.gov/healthyweight/assessing/index.html" target="_hplink">Waist circumference</a> can also give clues to your weight; a man may be at risk for health problems from obesity if his waist circumference is more than 40 inches, the CDC reported. For a non-pregnant woman, it's more than 35 inches.

  • 7. Eating A Healthy Diet

    While there are obviously differences in opinion depending on who you ask as to what you should or shouldn't eat for optimal health, there are some <a href="http://www.mayoclinic.com/health/heart-healthy-diet/NU00196" target="_hplink">heart-healthy nutrition rules</a> that remain true across the board. The Mayo Clinic reports that eating a diet low in cholesterol and "bad" fats (saturated and trans fats), with low-fat proteins (like lean meats, fish and beans), whole grains (with lots of fiber), and little sodium is good for your heart. For more nutrition advice, <a href="http://www.mayoclinic.com/health/healthy-diet/NU00200" target="_hplink">click over to the Mayo Clinic</a>.