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How can I reduce my blood cholesterol level?

You can reduce your blood cholesterol level by modifying your lifestyle and diet. This includes maintaining a healthy weight through exercise and having a healthy balanced diet. If your blood cholesterol level does not achieve a desirable range despite lifestyle and diet modification, your doctor may prescribe cholesterol-lowering medication.

Tips to lower your cholesterol

  1. Keep total fat intake between 25 to 35 per cent of calories for adults, with most fats coming from sources of polyunsaturated and monounsaturated fats.
  2. Consume no more than 5 to 6 per cent of calories from saturated fats and no more than 300 mg cholesterol per day.
  3. Keep trans fat consumption minimal. It should contribute less than 1 per cent of daily energy intake.
  4. When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low fat or fat-free. Choose fish, skinless poultry and lean meat.
  5. Aim for at least ‘2+2’ – 2 servings of fruits and 2 servings of vegetables per day. Foods high in fibre, e.g. plant foods and whole grains, can help reduce your risk of heart disease.

    Additionally, foods that are rich in soluble fibre, e.g. oats, barley, beans and pectin-rich fruit may help to reduce cholesterol in the body, hence lowering your risk of heart disease.
  6. Maintain a healthy body weight. Being overweight or obese increases your chances of having a low HDL-C, a high LDL-C and high triglycerides*.

    Triglycerides*, which are produced in the liver, are another type of fat found in the blood and in food. Increased levels of triglycerides in the blood may be due to being overweight/obese, sedentary lifestyles, cigarette smoking, excess alcohol intake, and a diet very high in carbohydrates (60 per cent of calories or higher).
  7. Exercise regularly – aim for 150 minutes of physical activity each week. Regular physical activity can help you manage your weight and therefore help lower your LDL-C and triglycerides, and raise HDL-C, improve the fitness of your heart and lungs, and lower blood pressure.
  8. Stopping smoking as it raises triglycerides and increase HDL-C.
  9. ​​​Avoid alcohol. However if you are planning to drink, restrict alcohol intake to no more than 2 standard drinks for men and 1 standard drink for women in a day.

What is trans fat? Is it really bad for my health?

Trans fat is found mostly in foods that have been hydrogenated. Hydrogenation is a process in which hydrogen is added to unsaturated fat to make it more stable and solid at room temperature. The main sources of trans fat in the diet are partially hydrogenated (hardened) oils found in foods such as cookies, crackers, pastries and fried foods. These fats are added for taste, texture and to maintain freshness or extend shelf life. The main concern with trans fat is that it raises the risk of coronary heart disease by increasing LDL-C cholesterol and lowering HDL-C cholesterol. Trans fat also occurs naturally in dairy products and some meat products, however these naturally occurring trans fats have not been shown to increase risk of heart disease.

What are plant sterols? Are they safe and good for me?

Plant sterols, sometimes called phytosterols, are naturally occurring chemicals found in plants. They are also found naturally in some vegetable oils, nuts, grain products, fruits and vegetables. The plant sterols used in food products are taken from soybean and tall pine-tree oils, combined with a small amount of canola oil. Although the details are not fully understood, plant sterols have a similar chemical structure as cholesterol. Some studies have shown plant sterols have an LDL-cholesterol lowering effect.

The American Heart Association’s (AHA) Therapeutic Lifestyle Changes diet3 recommends an intake of 2g of plant sterols a day for an LDL-cholesterol lowering effect. Plant sterols in the form of supplements should be minimised. This is because excessive consumption of plant sterols may affect the absorption of fat-soluble vitamins.

Related Readings:

  1. Health Promotion Board
  2. American Heart Association
  3. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]). NCEP Guidelines 2002.

The original article was first published in The Graduate, a National University of Singapore Society publication. Original title: "Cholesterol and Your Heart". Updated in 2015 by Ms Gina Lin, Dietitian, Department of Dietetics, Singapore General Hospital (SGH), a member of the SingHealth group.

See page 1 to learn about the types of cholesterol and how they can affect you.

Ref: Q15