Summary Cholesterol and Heart Health

Cholesterol is a fat-like substance that is required for animal life. It is an integral component of every cell in the human body, and is needed for many vital functions.

Although we need a certain amount of cholesterol in our body, as with many things in life, having much more than the 'right amount' is actually potentially harmful. A high level of one form of cholesterol (known as LDL) in the blood is strongly associated with increased risk of heart disease. On the other hand, a high level in the blood of the other major form of cholesterol (HDL) confers some protection against heart disease.

The main dietary factor that increases blood LDL is 'saturated' fat. This is the fat found in foods such as full-fat dairy products, fatty meats, biscuits, pies, pastries and fried takeaways. LDL can be reduced by restricting intake of these foods. It will also help to reduce LDL if you replace full-fat dairy foods with low- or reduced-fat alternatives, replace fatty meats with lean meats and replace butter with unsaturated margarines. If you fry foods, do so only occasionally and use unsaturated cooking oils such as canola, olive, peanut, cottonseed, sunflower, safflower and so on instead of hard fats. But note that some oils of plant origin (especially palm oil and coconut oil) contain saturated fats and so are not heart friendly.

Being overweight and being physically inactive are two other factors that contribute to elevated blood LDL levels. Maintaining (or regaining) optimal body weight and engaging in moderately-vigorous physical activity will also have beneficial effects on your blood cholesterol (exercise increases the helpful HDL while reducing the harmful LDL).

If you drink alcohol, a low or moderate intake of alcoholic beverages (particularly wine) apparently reduces the risk of heart disease, at least partly through increasing HDL. This is not a recommendation to take up drinking alcohol, rather it is advice to people who already drink to do so only in moderation.

Eating plenty of foods of plant origin, such as vegetables (including legumes) and fruit is thought to protect LDL from 'oxidation' (a chemical reaction that is believed to make LDL far more likely to promote heart disease).

It has been shown that eating one or two fish meals per week also reduces the risk of heart disease, although this beneficial effect is probably through mechanisms other than lowering blood cholesterol. Also, consumption of nuts (e.g. about 30 g – about one handful – approximately five days per week) is associated with a substantial reduction in the risk of heart disease.

Even though eggs contain significant quantities of cholesterol, contrary to earlier widespread belief it is now accepted by most nutritionists that eating four or five eggs a week is unlikely to be harmful to heart health for the vast majority of people who do not have high blood LDL (as determined by their doctor).

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Disclaimer: This material is provided on the basis that it constitutes advice of a general nature only. It is not intended to replace the advice of a physician or a dietitian.