Cholesterol often gets a bad rap. What comes to your mind when you hear the word “cholesterol”? Cardiovascular diseases? Blocked arteries? Sure, cholesterol is linked to adverse health conditions, but it’s also an essential part of the human body. Sounds like a conflicting statement, right? In this article, we’re going to discuss how cholesterol can be both good and bad for the body.

What Is Cholesterol?

Cholesterol is a blood fat created in your liver and derived from certain foods. It plays an essential role in the human body. It creates the outer membranes of our cells and allows them to function properly plus it is also needed for digestion and vitamin D formation.

Cholesterol is transported in the blood while attached to proteins. Cholesterol and other blood fats are known as lipids. When lipids and proteins become attached they’re known as lipoproteins. There are two main types of lipoprotein; low-density lipoproteins and high-density lipoproteins. 

Low-Density Lipoproteins (LDL)

LDL is also known as our bad cholesterol. If there’s too much LDL in the blood it can lead to a fat build-up within the artery walls. If the arteries are obstructed by LDL the heart has to work harder to pump blood around the body. The additional stress and strain of the heart increase the risk of cardiovascular damage, thus increasing the risk of health problems such as heart attacks and strokes. 

High-Density Lipoproteins (HDL) 

HDL is also known as our good cholesterol; it contains a lot of protein and little cholesterol. High-Density Lipoproteins helps take LDL back to the liver where it is broken down and excreted from the body. The removal of excess LDL helps reduce the risk of health problems. 

In addition to LDL and HDL, there are a few other types of lipoproteins. These include very-low-density lipoproteins, intermediate-density lipoproteins, and chylomicrons. 

Very Low-Density Lipoproteins (VLDL)

VLDL contains a lot of fat and very little protein. They transport triglycerides and cholesterol around the body. Excess VLDL leads to a fat build-up within the artery walls.

Intermediate-Density Lipoproteins (IDL)

IDL’s are similar to VLDL’s, but when some of the triglycerides have been removed. Similarly, excess IDL’s can lead to a build-up of fat within the artery walls, thus increasing the risk of cardiovascular diseases. 


Chylomicrons are responsible for carrying triglycerides from the gut to the liver. They are broken down in the liver and converted to lipoproteins. 

High Cholesterol Risks

The key thing to understand is that too much bad cholesterol can lead to adverse health conditions including heart attacks and strokes. 

As we’ve mentioned, excess LDLs can build up in the artery walls. If they’re not removed, these fatty areas can lead to plaque formation in a process known as atherosclerosis. Atherosclerosis leads to the stiffening and narrowing of the arteries. 

Imagine your arteries are like pipes. If a pipe becomes narrower more pressure is needed to push fluid through them. More frequent pressure puts more strain on those pipes, thus making them more susceptible to damage. This is exactly what happens with our arteries. 

Additionally, blood clots can form over the plaque and lead to a complete blockage of the artery. Without a good blood supply, areas of the body are deprived of oxygen and this is how a heart attack or stroke can develop. 

Heart attacks and strokes aren’t the only diseases that can occur from clogged arteries. Other cardiovascular diseases can occur including angina, or chest pain, coronary heart disease, mini-strokes, or transient ischaemic attacks (TIA’s), heart failure, vascular dementia, and peripheral arterial disease (PAD). All of which can have debilitating effects acutely and chronically. 

What Contributes To High Cholesterol?

There are a number of controllable and uncontrollable factors that can contribute to high cholesterol. 

Uncontrollable Factors

High cholesterol can be caused by your genetics. Familial hypercholesterolaemia is a rare genetic condition which can result in high cholesterol regardless of your lifestyle. Other genetic conditions may also contribute to high cholesterol. As we age, our risk of high cholesterol increases. Women are more likely to have high cholesterol due to the protective effects of oestrogen. Finally, South Asian inheritance is also linked with high cholesterol. 

Controllable Factors

Whilst there are factors that we can’t control, there are some which we can. Eating a diet high in saturated fats, smoking, high alcohol consumption, and inactivity is linked to high cholesterol. There are also several health conditions linked to high cholesterol. These include; high levels of visceral fat, being overweight, type II diabetes, underactive thyroid, liver disease, kidney disease, and menopause. Certain medications and stress are also linked to raised levels.

How To Reduce Cholesterol 

Now we know the effects of high bad cholesterol, how can we help our clients keep their risk of cardiovascular diseases low? 

Encourage clients to reduce their saturated fat intake and increase their unsaturated fats. Foods high in saturated fat include; fatty meats, cakes, biscuits, and dairy. Foods high in unsaturated fat include; nuts, seeds, avocados, oily fishes, and olive oil. Additionally, encourage clients to use healthier cooking practises such as grilling, steaming, microwaving, and poaching. 

Performing regular physical activity also helps reduce HDL. Encourage clients to perform a minimum of 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity exercise. Clients should also be encouraged to keep their daily activity levels high by taking the stairs or walking regularly. 

If your client meets the requirements for a free cholesterol health check at their surgery or pharmacy then encourage them to find out their readings. Raised cholesterol typically demonstrates no symptoms, meaning clients can go many years without even considering it. Catching any raised levels early means lifestyle interventions are likely to be more successful before the need for medication is required.


Cholesterol plays an important role within the body and we do need it. However, we need to implement healthy lifestyle practices to ensure we continue to balance the ratio of good and bad LDL’s over time, preventing the risk of health conditions associated with an accumulation of cholesterol. Talk about cholesterol since this silent condition can go unnoticed by many!

If you’d like to learn more about raised cholesterol and how to safely exercise clients living with this condition then have a look at our Healthy Heart Training.