Decoding Our Cholesterol Profile Results

We all have cholesterol, a natural waxy, fat-like substance found in every cell of our body. It’s a type of lipid (fat), and although it often gets bad press, cholesterol is essential to life and has several vital roles in our body.

Cholesterol is a key component of cell membranes, helping maintain their structure, permeability, and fluidity. Without it, our cells wouldn’t function properly. Also, cholesterol is used to make essential micronutrients such as vitamin D. It produces several essential hormones, including sex hormones like oestrogen, testosterone, and progesterone, and the stress hormone, cortisol. Finally, cholesterol is used by the liver to make bile acids, which help digest fats in the small intestine. Without cholesterol, we wouldn’t absorb important fat-soluble vitamins like A, D, E, and K.

Our bodies actually make most of the cholesterol we need — in fact, the liver produces around 75% of it — and the rest comes from certain foods.

Notably, as a lipid, cholesterol repels liquids and cannot dissolve in our blood, requiring assistance to circulate throughout the body. That help comes in the form of proteins in the bloodstream — these combinations of fat and protein that transport cholesterol are referred to as lipoproteins. There are two main types of lipoproteins which are commonly called High-Density Lipoprotein (HDL) Cholesterol and Low-Density Lipoprotein (LDL) Cholesterol.

So if cholesterol is so vital for us why is high cholesterol a problem? The issue isn’t cholesterol itself — it’s when we have too much of the wrong kind, especially LDL cholesterol. Excess can accumulate in artery walls, forming fatty plaques that narrow or block blood flow. This can lead to heart attacks, strokes, or peripheral artery disease.

Raised cholesterol is often silent — it has no symptoms — which is why regular testing is so important, especially if we have risk factors like high blood pressure, smoking, diabetes, or a family history of cardiovascular disease (CVD).

As more of us take steps to monitor our health, cholesterol testing has become a routine — and essential — part of understanding our risk of heart disease and strokes. Whether we’ve had our results through the NHS or privately, it’s common to be left wondering what all the numbers actually mean, and what we should do with them.

Let’s demystify our cholesterol profile, looking at what the healthy targets are in the UK. When we receive our cholesterol results, according to the British Heart Foundation we typically see the following markers:

Total Cholesterol (TC)

This is the overall amount of cholesterol in the blood. This shows the total amount of cholesterol in our blood. This is our good cholesterol and bad cholesterol together. It’s sometimes called serum cholesterol or TC. As this figure is influenced by both HDL 'good' and LDL 'bad' cholesterol it is only of use when viewed as part of the cholesterol profile.

• Healthy range: Below 5.0 mmol/L

LDL Cholesterol (Low-Density Lipoprotein)

This is the 'bad' cholesterol and carries cholesterol from the liver to the cells. If too much LDL cholesterol is delivered or not used properly, it can build up in the walls of our arteries. Over time, this leads to atherosclerosis — narrowing and hardening of the arteries, which increases the risk of heart disease and stroke.

• Target: Below 3.0 mmol/L

Non-LDL Cholesterol (Low-Density Lipoprotein)

Captures all the harmful types of cholesterol, including LDL, that can build up on artery walls, narrowing them over time therefore increasing the risk of CVD.

• Target: Below 4.0 mmol/L

HDL Cholesterol (High-Density Lipoprotein)

This is the “good” cholesterol that helps carry cholesterol away from the cells and back to the liver, where it’s either reused or removed from the body. Higher levels of HDL are associated with lower cardiovascular risk, as it helps clear excess cholesterol from the bloodstream.

• Ideal level: Above 1.0 mmol/L (men) or 1.2 mmol/L (women)

  
  

Non-fasting Triglycerides

Triglycerides are essential for providing energy to the body and storing excess calories, but high levels can increase the risk of heart disease. Non-fasting triglycerides show the amount of fat in our blood when eating or drinking normally. Results can vary depending on what we ate and drank before the test. High levels can contribute to the hardening of arteries.

• Healthy range: Below 2.3 mmol/L

Fasting Triglycerides

Triglycerides are a type of fat (or lipid) that is the main form of fat found in the blood and is also the main component of body fat. Fasting triglycerides show the amount of fat in our blood after not eating for 10-14 hours. It’s more accurate than the non-fasting test and is only carried out if our non-fasting triglycerides result is high. High levels can contribute to the hardening of arteries.

• Healthy range: Below 1.7 mmol/L

If we have already had a heart attack or a stroke our recommended levels may be lower.

If we find that our cholesterol profile is not ideal we can take advice from our GP or health care professional. They may very well use the QRISK3 tool, which looks at factors like age, sex, ethnicity, weight, blood pressure, and medical history to calculate our overall risk of developing cardiovascular disease in the next 10 years. A slightly raised cholesterol level may not result in medication recommendations. Instead, they may suggest adjustments to our diet and lifestyle.

Can the types of food we eat contribute to these results? So, when understanding the role of dietary cholesterol – it's easy to get confused! Understandably, many of us associate dietary cholesterol with high blood cholesterol. Eggs, in particular, have been the subject of concern for decades. Although some foods contain cholesterol – such as shellfish, eggs, and offal – this has much less effect on our blood cholesterol than the cholesterol we make in our body ourselves in response to a high saturated fat diet. While it’s true that eggs contain cholesterol, current evidence shows that for most people, dietary cholesterol does not significantly raise blood cholesterol or increase the risk of cardiovascular disease (CVD).

What matters more is saturated fat in the diet — found in butter, fatty cuts of meat, full-fat dairy, pastries and pies. Scientific evidence shows that reducing these may have a more direct impact on lowering LDL cholesterol and therefore reducing the risk of CVD. For this reason, the Scientific Advisory Committee on Nutrition (SACN) recommends the maximum amount for saturated fat intake is no more than 20g per day for women and no more than 30g per day for men.

Other fats, the polyunsaturates, are thought to actively promote the 'good' HDL cholesterol thereby mopping up the 'bad' LDL cholesterol. Oily fish are a great source of polyunsaturated fats as are vegetable oils, nuts, and seeds. Replacing saturated fats with polyunsaturated fats is a key dietary strategy for managing our cholesterol levels.

Some foods can actively lower our blood cholesterol: Soluble fibre is a type of dietary fibre which dissolves in water in the gut to form a gel. This in turn soaks up cholesterol like a sponge and carries it out of our body where it cannot do any damage.

In short, cholesterol is absolutely essential. But like many things in health, balance is everything. We need enough cholesterol to function properly, but not so much that it causes long-term damage to our arteries and heart.

Cholesterol isn’t something we need to fear — it’s something we can manage. Understanding our results empowers us to make informed choices, whether that means adjusting our diet, moving more, losing weight, reducing alcohol, or having a conversation with our doctor about medication.

So, if we’ve just received our numbers, let’s not ignore them. Let’s use them. They’re a window into our heart and artery health — and an opportunity to invest in our future wellbeing.

If you would like help with your cholesterol profile, diet and lifestyle please come and see me at Bridgford & Bingham Nutrition.

Happy eating,

Nina Thomas

BSc (Hons), MSc, ANutr

Registered Associate Nutritionist & Food Scientist

Bridgford & Bingham Nutrition              

21 Brickyard Lane

East Bridgford

Nottingham

NG13 8NJ

Call: 07958 765337

​www.bridgfordbinghamnutrition.co.uk