Your Lipid Profile & Cholesterol
You may have been directed here after some recent 'cholesterol/lipid' blood results or via information around lower carb diets. It seems that cholesterol, lipids and fats are not straight forward!
KEY POINTS ON FAT:
When we talk about good fat levels we mean:
1) Reducing fat stores around the body, espcially around the abdomen and organs such as the liver
2) Improving our lipid profile - ratio of good to bad fatty acids and cholesterol
If you have your blood results, you can compare them to the guidelines here (to the right on a desktop or below on your mobile). Your Doctor may have calculated your 'QRISK - this algorithm calculates a person's risk of developing a heart attack or stroke over the next 10 years - it is based on a number of risk factors, although the biggest contributor is age.
If your numbers are higher than you would like, or you hope to optimise your cardiovascular health, there are a number of LIFESTYLE FACTORS you might be able to change, which could go a long way to improving your lipid, profile, physical health and also sense of wellbeing:
- Nutrition: eating real food, lowering sugar/starchy carbohydrates and increasing 'good fats', lowering 'bad fats'
- Exercise - improving your cardiorespiratory fitness
- Controlling your blood pressure
- Reducing alcohol consumption
Changing our behaviour is not always easy - your GP surgery will be able to signpost you to more support if you would like it - or click on the links through this website for more ideas. If lifestyle modifications are ineffective or inappropriate, there are medications to improve lipid profiles, such as statins.
WHAT ARE THE GUIDELINES?
It is not about a "low cholesterol", but rather a "good cholesterol" profile. We may not have all the answers, but there is evidence that the following features of a lipid profile are associated with better metabolic and cardiovascular health:
1) Reduced triglycerides
2) Higher HDL
3) Lower LDL and non HDL cholesterol
4) Reduced TC:HDL ratio
What are your blood results? What should they be?
These are guidelines (from patient.co.uk, NICE CKS and Heart UK).
The NHS guidance now is to do non-fasting tests.
Total Cholesterol | < 5mmol/L | < 4 if high BP, diabetes or CVD |
HDL Cholesterol | > 1.2mmol/L women | 1mmol/L men |
LDL Cholesterol | < 3mmol/L | < 2mmol/L if high risk |
Non HDL cholesterol | < 4mmol/L | |
TC:HDL ratio | < 4.5 (lower thought to be better) | |
Triglycerides | Fasting < 1.7mmol/L | Non fasting should be <2.3 (>2.3 thought to be independent risk factor CVD) |
WHO MIGHT CONSIDER USING A STATIN?
We use the QRISK algorithm to help identify patients who may benefit from a medication called a statin, which aims to lower your LDL cholesterol. You may wish to use the statin patient decision guide to help understand what your QRISK means for you and the pros and cons of the medication. Statins may be discussed with you by your medical team if:
- You've already had a heart attack or stroke (most people prescribed a higher dose statin)
- You have familial hypercholesterolaemia (considered if total cholesterol > 7.5 and family history and usually referred to a specialist clinic)
- Your QRISK is > 10% if lifestyle modification is ineffective or inappropriate, especially if you have Type 2 Diabetes or high blood pressure
- You have Type 1 Diabetes, especially if > 40 years old and other risk factors
- You have Chronic kidney disease
If you would like to know more, hopefully this page will be helpful. However, if it is unclear, your GP team would be more than happy to discuss how this fits in to your own health and wellbeing.
See this website from the 'Cholesterol Code' for a cartoon story on cholesterol (2)
Want to learn more about the science of your lipid profile, why statins might not be the only answer and how a low carb diet may affect your lipid profile? Click on the following button
THE IMPORTANCE OF A HEALTHY LIVER!
A healthy pathway of transporting, recycling and disposing of cholesterol and triglycerides to and from the liver is really important. Liver function can be affected by excess body fat (adipose tissue) around the liver and abdominal organs, insulin resistance (such as in diabetes/pre-diabetes), or damage by alcohol and drugs.
This is where your diet and exercise come in!
HOW CAN DIET AND EXERCISE HELP?
Lipids are a good thing for the body! The lipid pathway is complicated and it needs an efficiently run system, especially in the liver.
We can improve our own lipid profile and cardiovascular healthy by:
- Improving the liver's metabolic health
- Eating a real food, lowER carbohydrate, healthy fat diet
- Reducing 'excess energy' being laid down as body fat around the liver and abdominal organs
- Use more energy so we are less 'energy toxic' e.g. be more physically active
Many patients who opt for a "real food, healthy fats, lower carb" approach find their 'lipid profile' improves with reductions in triglycerides, increases in HDL and reductions in the TC:LDL ratio. Combine this with moving a little more, and increasing physical activity and you could really improve your lipid profile, overall cardiovascular risk as well as general sense of wellbeing!
RESOURCES:
1. Adipose tissue: a fat lot of good. Society for Endocrinology.
2. Cholesterol code: A SIMPLE GUIDE
3. www.heartuk.org.uk Blood Fats Explained
5. Nordestgaad et al, 2020 Click here
6. Hyperinsulinaemia as independent risk factor for ischaemic heart disease. N England J Med, 1996
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