From as young as 35 years old our cholesterol levels start to increase. Heart disease remains the number 1 cause of age-related diseases and a reduced healthy life expectancy.

Keeping a check on your cholesterol is a good indicator of your overall metabolic health and the impact your diet and lifestyle are having on your insides.

Yet cholesterol is often misunderstood. Despite its reputation, cholesterol is a fundamental lipid with pivotal roles, including the formation of cell walls and the creation of vital hormones like testosterone and oestradiol.

Originating in the liver and influenced by our diet, cholesterol's story isn't black and white. It's composed mainly of HDL, the "good" cholesterol that guards against heart ailments, and LDL, which, at elevated levels, can be a heart health adversary. 

Your total cholesterol number alone doesn't give the full picture; the intricate balance and ratio between HDL and LDL truly matters. 

A high total cholesterol might be misleading if HDL levels are also high, which can be heart-protective. Conversely, a seemingly normal total cholesterol can mask low beneficial HDL levels. Looking at your cholesterol profile to understand the nuances of each component for a comprehensive heart health assessment.

Top tip: When checking cholesterol levels make sure to do so on after fasting overnight. If your levels are high there are lots of simple and enjoyable lifestyle changes you can make before considering medication.

A high LDL level is often considered an indicator of poor health because LDL cholesterol plays a central role in the formation of atherosclerotic plaques. When LDL levels are elevated, there is a greater chance for cholesterol to be deposited in the arterial walls. Over time, these deposits harden and lead to the narrowing and stiffening of the arteries, a condition known as atherosclerosis. This process reduces blood flow and increases the risk of cardiovascular events such as heart attacks and strokes. Furthermore, if an atherosclerotic plaque ruptures, it can trigger a blood clot, further obstructing blood flow and potentially leading to acute heart or brain events. 

LDL cholesterol, or low-density lipoprotein, acts as the body's delivery truck, transporting cholesterol, triglycerides, and other fats to tissues that need them. However, when its levels rise too high, LDL gains the moniker "bad cholesterol" for a reason: it can deposit fats within artery walls. These deposits, over time, can narrow and harden the arteries, setting the stage for atherosclerosis and elevating the risk of heart disease. Monitoring and managing LDL levels is essential to ensure these internal roadways stay clear and heart health remains optimal.

Top tip: If LDL cholesterol levels and triglyceride levels are both raised it is time to take action. This is often referred to as a pre-diabetes state. If your levels are high there are lots of simple and enjoyable lifestyle changes you can make before considering medication. Intermittent fasting can be particularly helpful.

Triglycerides are a type of fat found in the blood, sourced from the foods we eat and also produced naturally by our bodies. While they play a key role in providing energy for cellular functions, elevated triglyceride levels can signal health concerns. 

High triglyceride levels are linked to the accumulation of fatty deposits in arteries, increasing the risk for atherosclerosis, much like LDL cholesterol. Moreover, elevated triglycerides are often associated with conditions like obesity, insulin resistance, and metabolic syndrome, which collectively up the ante for heart disease and stroke. In essence, consistently high triglyceride levels serve as an alarm bell, indicating potential metabolic imbalances and a heightened risk for cardiovascular ailments.

Top tip: If triglyceride levels are raised, be careful with your alcohol intake. The liver is responsible for metabolising alcohol. When alcohol is consumed, especially in significant amounts, the liver prioritises processing it. During this process, the liver increases the production of triglycerides.

The cholesterol-to-HDL ratio is a well-studied ratio used to assess the risk of cardiovascular diseases. It's derived by dividing the total cholesterol by the HDL (High-Density Lipoprotein) cholesterol. Here's why it's significant:

• More comprehensive: Instead of just focusing on total cholesterol or HDL alone, the ratio provides a wider view of cardiovascular risk. 
• Lower ratios indicate a lower risk of heart disease, whereas higher ratios suggest a higher risk.
• Better Predictor: Some studies have suggested that the cholesterol-to-HDL ratio is a better predictor of heart disease risk than LDL or total cholesterol levels alone.
• Top Tips if it is raised:
• A ratio below 4:1 is generally considered desirable. The lower the ratio, the better.
• Boost Your HDL: Regular physical activity, maintaining a healthy weight, quitting smoking, and moderate alcohol consumption can help increase HDL levels.
• Reduce Saturated and Trans Fats: Opt for a diet low in saturated and trans fats to manage total cholesterol levels.
• Regular Monitoring: Regularly check your cholesterol levels 3 times over a course of a year to make sure they are improving.

High-sensitivity C-reactive protein (hs-CRP) is a protein found in the blood, and its measurement is a significant marker for inflammation in the body. Here's why it's crucial:

• Cardiovascular Disease Indicator: Research has shown that elevated hs-CRP levels are linked to an increased risk of heart diseases, including heart attacks. It acts as a predictor for cardiovascular events beyond traditional risk factors like cholesterol levels.
• Systemic Inflammation Marker: While CRP is produced by the liver in response to inflammation, hs-CRP can detect even minor elevations, providing a sensitive marker for low-grade inflammation that may not present with obvious symptoms.
• Association with Other Diseases: Elevated hs-CRP levels have been associated with conditions like metabolic syndrome, diabetes, and even certain cancers. Chronic inflammation, marked by a consistently high hs-CRP, is often underlying these conditions.
• Influence on Treatment: For individuals with moderate cardiovascular risk, an elevated hs-CRP can be the deciding factor for healthcare professionals when considering the commencement or intensification of treatment, such as statin therapy.
• Lifestyle and Inflammation: Factors such as poor diet, lack of exercise, smoking, and obesity can raise inflammation levels. By measuring hs-CRP, one can gauge the inflammatory impact of their lifestyle and make necessary changes.

Top Tips:

• Healthy Diet: Consume a diet rich in anti-inflammatory foods like fruits, vegetables, nuts, seeds, and fatty fish.
• Stay Active: Regular exercise can help reduce inflammation. Aim for at least 30 minutes of moderate activity most days of the week.
• Limit Processed Foods: Reduce intake of processed, sugary, and fried foods, which can exacerbate inflammation.
• Manage Stress: Chronic stress is a contributor to inflammation. Find stress-reducing techniques that work for you, be it meditation, deep breathing exercises, or hobbies.