Risks of high cholesterol in men and how to get it under control

It seems obvious but looking after your heart is vital to your long-term health. 

If you don’t, the results can be devastating — cardiovascular disease (a term used to refer to a group of disorders that affect the heart and blood vessels) is the leading cause of illness and death worldwide.

In Australia, cardiovascular disease (CVD) affects around 1 in 17 Australian males and becomes more common as you get older. It causes more than one in four deaths.

How much you move, and the food and drink you consume, play a big part in helping reduce your CVD risk, and your cholesterol levels also play a role.

Most people know cholesterol is important in some way, but what exactly is it, how does it affect you and what should you do about it? 

Let’s investigate.

What is cholesterol?

Cholesterol is a fatty molecule that is needed for our bodies to function. It is made by our liver or comes from our diet, and is transported in our blood in particles called low-density lipoprotein (LDL) or high-density lipoprotein (HDL). 

LDL transports cholesterol to the cells and tissues of the body, whereas HDL carries cholesterol from the tissue to the liver. Often, LDL is called ‘bad cholesterol’ and HDL is called ‘good cholesterol’.

Various factors affect blood cholesterol levels including your diet and lifestyle, body weight and genes.

Why is high cholesterol bad for you?

If you have too much LDL in your blood, you can develop fatty deposits in your blood vessels which makes it harder for blood to flow through the arteries. If the deposits break apart, they can form a blockage that leads to a heart attack or stroke. 

How is cholesterol tested? 

Cholesterol is measured with a blood test called a lipid panel or lipid profile. 

The test measures total cholesterol, HDL and LDL, as well as triglycerides, which are another type of fat in the blood. 

Usually, you’ll be asked to fast (not eat anything) and only drink water for about 10 hours before the test.

If your LDL levels are high, your doctor will recommend lifestyle changes to reduce your levels or prescribe medication (or both).

What are the signs and symptoms of high cholesterol?

According to the Heart Foundation, high cholesterol generally doesn’t have obvious symptoms, which is why it’s important to get a blood test and regular check-ups. 

If you are 45 or older (35 or older, if you are Aboriginal or Torres Strait Islander), see your doctor for a cholesterol test. If you have a family history of high cholesterol, speak to your GP about your heart disease risk.

Lifestyle changes that can help

There are some easy lifestyle changes you can make to reduce your ‘bad’ cholesterol. Heart disease takes years to develop, so taking steps to reduce your levels now will be beneficial now and in the future.

According to Healthdirect, Australia’s virtual public health information service, some lifestyle changes you can make are: 

• Reduce your intake of saturated and trans fats

Saturated fat is usually solid at room temperature. It’s found in animal products such as meat and dairy, but also in palm oil, coconut oil and full-cream milk. Read more about saturated fat-rich foods here.

Trans fats (or, trans fatty acids) are found in store-bought baked goods, snack foods and deep-fried foods. There is strong evidence that trans fats increase levels of LDL in the blood while decreasing levels of HDL (‘good’) cholesterol.
 

• Replace saturated fats with healthier fats 

Replace foods that contain mainly saturated fats with foods that contain unsaturated fats — such as polyunsaturated and monounsaturated. For example, instead of butter and cream in cooking, use olive oil, nut butters or avocado

Healthy unsaturated fats are found in nuts (such as almonds and walnuts), olives, oily fish like salmon and sardines, avocado, seeds (flaxseeds, sunflower seeds, chia seeds) and oils made from plants and seeds (olive oil, peanut oil, canola oil, soybean oil).
 

• Eat more soluble fibre 

Soluble fibre can reduce the absorption of cholesterol into your blood and it slows down digestion, making you feel fuller for longer. Foods that are high in soluble fibre include oats, lentils, peas and beans, barley, and fruits and vegetables such as apples and carrots.
 

• Increase your physical activity

Physical activity increases levels of HDL (so-called ‘good’ cholesterol). Any type of fitness work is helpful, but vigorous aerobic exercise is best.

Moderate-intensity exercise is a level that increases your heart rate and breathing but allows you to keep talking. Vigorous intensity exercise makes your heart rate higher and makes you breathe more heavily.

Resistance training (using weights, resistance bands or your own body weight) and muscle-toning exercises can increase HDL. Aim to do this twice a week.
 

• Limit your alcohol intake 

Aim to limit your intake to no more than 10 standard drinks per week and no more than four per day.
 

• Quit smoking

Smoking reduces HDL and speeds up the rate at which fatty plaques form in the walls of your arteries. It also makes your blood more likely to clot. Stopping smoking is one of the best ways to improve your heart and blood vessel health.
 

• Reduce your weight if you’re overweight

Talk to your doctor about how to lose weight if they recommend it.

Why high cholesterol is particularly problematic for the Aboriginal and Torres Strait Islander community 

Unfortunately, CVD is even more of an issue for Aboriginal and Torres Strait Islander people than it is for non-Indigenous individuals. It is the largest contributor to the health gap between Indigenous and non-Indigenous Australians, is the leading cause of death among Aboriginal and Torres Strait Islander people, and affects them at relatively younger ages.

According to Australian Indigenous HealthInfoNet, this is partly because the “risk factors for cardiovascular disease are common among (Aboriginal and Torres Strait Islander) people. Many of the cardiovascular diseases share risk factors such as tobacco smoking, physical inactivity, being overweight and obese, diabetes and high cholesterol.”

Because of this, Aboriginal and Torres Strait Islander people should have their cholesterol levels checked earlier than non-Indigenous Australians; it’s recommended Aboriginal and Torres Strait Islander individuals be tested every five years starting from the age of 35, which is 10 years earlier than non-Indigenous people.