It’s often thought of as the demon in our diets but cholesterol isn’t all bad – on the contrary, this waxy substance is essential for normal body functions such as vitamin D production, sex hormone synthesis, brain health and neurotransmitter formation. However, it’s when levels get out of control that problems can arise, with numerous studies linking high cholesterol readings to heart disease. Although there are other significant factors at play such as high blood pressure and other inflammatory markers, there’s no denying that cholesterol levels are certainly part of the cardiovascular jigsaw puzzle. So how do you know if you’re at risk? When analysing risk factors, it’s worth looking not only at levels of LDL (the so-called ‘bad’ cholesterol thought to be linked to narrowing of the arteries) but also the ‘good’ kind known as HDL, which removes excess cholesterol from the blood. The most accurate reading is the total cholesterol level which is made up of LDL and HDL combined. While everyone’s risk factors differ, a healthy level for women is less than 5.00mmol/l total cholesterol. James Thompson, GP and founder of Ask Doc James says: The lowdown: GPs usually prescribe a group of medicines called statins to help lower cholesterol. Statins work by reducing the LDL in your blood while increasing HDL. Cholesterol clear-up: Usually your doctor will prescribe Simvastatin. This drug works by blocking the action of the particular enzyme needed for cholesterol synthesis. There are a few documented side effects, including headaches, muscle ache, abdominal pain, insomnia, liver dysfunction and rash. Significant muscle inflammation can also occur in very rare circumstances. Blood tests looking for liver dysfunction after starting the tablet should be organised by your doctor. Normally, once you’re on a statin, your cholesterol will normalise and there will be no need for further cholesterol treatment. However, if you’re diabetic or have cholesterol that is difficult to treat, your doctor may add in other tablets like fibrates, which help to lower triglycerides, a type of fat in the blood which can also increase your risk of heart disease. Amanda Hamilton, TV health expert, nutritionist and author says: The lowdown: Our cells can make cholesterol from fat, but also from refined carbohydrates. Diets high in saturated fat and processed carbs have most often been associated with raised blood cholesterol, so it’s a good idea to clean up your diet. Cholesterol clear-up: Limit saturated fat found in red meat, butter and cream as well as pies, pastries, cakes and ready meals. Foods high in soluble fibre, such as oats, beans and apples, help bind excess cholesterol in the gut and remove it from the body. Almonds, which are high in monounsaturated fat, vitamin E and plant sterols, are thought to block cholesterol re-absportion in the gut. Try eating a handful daily.