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It’s an established medical fact that high levels of cholesterol are likely to lead to heart disease and an early grave, so whatever you can do to keep your cholesterol levels within acceptable limits is unquestionably a good idea. Where lowering cholesterol is concerned then, there are 2 courses of action that are proven to work: alter the way you live and take cholesterol lowering drugs.

Hypercholesterolemia (as high cholesterol is technically called) is a fairly common complaint in Western society but has in fact only come about relatively recently, due in large part to features of the typical modern lifestyle. For most people whose cholesterol levels are abnormally raised, quite modest changes to their diet and exercise patterns are all that is required to bring their levels back within acceptable limits.

Some individuals are either beyond what can be achieved with lifestyle changes or have an inherited genetic disorder (familial hypercholesterolemia) that limits the efficacy of diet and exercise; these people will normally be put on a lifetime programme of drugs (usually statins) whose potency can be altered to suit the individual.

Before we take a closer look at these two options (lifestyle and medication) it’s helpful to realise that when a doctor, for example, considers your cholesterol level they are in fact weighing up two distinct types of cholesterol, called LDL (“bad cholesterol”) and HDL (“good cholesterol”).

LDL cholesterol is a type of fat (a lipid) that is produced as a consequence of your liver processing what you eat; it gets distributed via the bloodstream to supply energy to just about every cell in the body and is therefore absolutely vital. However, if too much is produced it tends to get deposited in arteries and veins and eventually clogs the system up with predictable consequences.

HDL (High Density Lipoprotein) has a higher density of protein than lipids (fats) and can thus absorb excess LDL which it returns to the liver to be either reused or discarded. But your body has considerably more LDL than HDL so HDL can never handle very high levels of LDL cholesterol. Nevertheless, research has shown that increasing the amount of exercise taken results in an increase in the amount of HDL present in the bloodstream.

Where lifestyle changes to combat LDL cholesterol are concerned, these proceed from the observation that excess weight, certain types of food, smoking, drinking and too little exercise are strong contributory factors leading to high LDL cholesterol; therefore avoiding these things will cause the reverse and lower your cholesterol.

So what types of foods are best avoided? The simple answer is anything that contains saturated fat; so hard cheese, butter, red meat, pastries, cakes and biscuits. Conversely you should aim to increase your intake of fruit, vegetables, oat and beans as these foods actively help to lower cholesterol. Switching from butter to a plant sterol based spread (commonly marketed as “cholesterol lowering” spreads) gets the best of both worlds.

If changing your lifestyle still doesn’t reduce your cholesterol to medically recommended limits then you really ought to see a doctor, who will almost certainly suggest that you start taking one of a class of drugs generically termed statins. These are not however a way of getting out of switching to a healthier lifestyle; they are simply the next step on top of that.

The following is a list of the most frequently prescribed statins, in order from weakest to strongest and giving both the clinical and most common brand names:

pravastatin (Lipostat); simvastatin (Zocor); atorvastatin (Lipitor); rosuvastatin (Crestor).

The vast majority of people tolerate statins easily and suffer no side-effects at all, but it should be noted that they can damage both muscles and the liver, especially when taken in high doses and for this reason you may find that reasonably regular blood tests become a feature of your life due to the need to both monitor the effect of statins on your cholesterol levels and to watch for symptoms of internal damage.

So there you have it. Two effective and medically proven ways to lower cholesterol. The difference between the two is simply a matter of degree – taking prescribed drugs is an additional measure on top of addressing your lifestyle, which in most cases lies at the root of the problem.