Cholesterol – The good, the bad and the necessary
6 March 2025
JOHANNESBURG - Many of us only think about cholesterol when a doctor flags it during a routine check-up or when experiencing severe symptoms. It's not something you can feel or see, but left unchecked, high cholesterol can silently put you at risk of heart disease, stroke, and other severe health conditions.
There are two main types of cholesterol:
- Low-density lipoprotein (LDL) or "bad cholesterol" contributes to forming fatty plaques in the arteries, increasing the risk of heart disease and stroke.
- High-density lipoprotein (HDL) or "good cholesterol" helps remove excess LDL cholesterol from the bloodstream, reducing the risk of cardiovascular problems.
- High triglyceride levels – another type of fat in the blood – can further elevate the risk.
Recent research suggests that high cholesterol is more common in South Africa than we thought. A study on adults with diabetes and high blood pressure found that more than three-quarters (76.7%) had abnormal cholesterol levels, with women being the most affected. The most common issue was high triglycerides (a type of fat in the blood), affecting over 62% of participants. Additionally, some South Africans, particularly those of European colonial descent, are more likely to have a genetic condition called familial hypercholesterolaemia (FH), which causes dangerously high cholesterol levels.
These findings highlight the importance of regular cholesterol screenings and proactive management strategies. If you've been feeling sluggish, gained a little weight, or have a family history of heart disease, now is the time to act.
Cholesterol and COVID-19: why it matters more than ever
A history of COVID-19 can double the long-term risk of heart attack, stroke or death, according to a new study from the Cleveland Clinic and the University of Southern California. The study, published in Arteriosclerosis, Thrombosis, and Vascular Biology Journal, found that patients with any type of COVID-19 infection were twice as likely to experience a significant cardiac event for up to three years after their initial diagnosis than those with no history of COVID.
During the pandemic, many South Africans adopted sedentary lifestyles, consumed unhealthy diets, and experienced heightened stress levels, leading to weight gain and metabolic disturbances. These factors have made cholesterol management an essential post-COVID health priority.
The only way to determine cholesterol levels is through a lipid profile test, which measures total cholesterol, LDL, HDL and triglycerides. Cholesterol screenings promote early detection and prevention of chronic diseases. Medshield's wellness benefits offer an annual Health Risk Assessment, which includes Cholesterol Screening, Blood Glucose Testing, Blood Pressure Measurement, Body Mass Index (BMI) Assessment, Mammogram Screening and Voluntary HIV Counselling and Testing. Medshield encourages members to undergo these preventative wellness tests to identify if they are at risk sooner. Medshield's healthcare practitioner networks provide these tests, including Clicks Pharmacies and Dischem Pharmacies.
How to lower cholesterol naturally
The good news? Cholesterol is manageable. With small, consistent changes to your lifestyle and support from Medshield's wellness benefits, you can keep your cholesterol in check and protect your heart for years to come. Managing cholesterol levels involves lifestyle changes, dietary adjustments, and medical support when necessary.
- Dietary changes – South Africa's dietary habits include high consumption of processed and fried foods, making it essential to transition to whole, nutrient-rich foods for better cholesterol management. Foods like oats, beans, lentils, and fresh fruits aid the lowering of LDL cholesterol, while avocados, nuts, seeds, and olive oil support higher HDL cholesterol levels. Fatty fish such as salmon and sardines help lower triglycerides and support heart health. Avoid processed foods, fried items, and baked goods, as they contribute to high LDL cholesterol.
- Physical activity and exercise – Moderate aerobic exercise such as brisk walking, cycling, and swimming for at least 150 minutes per week can help regulate cholesterol by raising HDL and lowering LDL. Strength training exercises twice a week will also improve cardiovascular health.
- Maintain a healthy weight – Our country has one of the highest obesity rates globally, with post-pandemic weight gain exacerbating the issue. Being overweight, especially around the abdominal area, contributes to higher LDL cholesterol levels. Reducing body weight by 5-10% can significantly improve cholesterol levels and heart health.
- Stop smoking and limit alcohol – Smoking lowers HDL cholesterol and damages blood vessels, increasing the likelihood of plaque buildup in the arteries. Quitting smoking can significantly improve cholesterol levels within weeks. Alcohol consumption should be kept within recommended limits to prevent increased triglyceride levels and liver-related complications.
- Manage stress and sleep quality – Chronic and inadequate sleep can increase inflammation and trigger unhealthy eating habits, negatively impacting cholesterol levels. Incorporate relaxation techniques such as meditation, deep breathing exercises, or yoga throughout your day, maintain a consistent sleep schedule and avoid electronic screens before bedtime to ensure better quality sleep.
Lifestyle changes may not always be sufficient for managing high cholesterol. In such cases, healthcare providers may prescribe cholesterol-lowering medications, especially if:
- LDL cholesterol remains high despite dietary and lifestyle adjustments
- There is a strong family history of heart disease
- The individual has diabetes or other high-risk conditions
Medshield members can access chronic medication benefits that cover cholesterol management treatments if clinically appropriate. It ensures cost-effective and continued access to prescribed medications.
Take charge of your heart health
Cholesterol is a key factor in heart disease, yet it is preventable and manageable with the right interventions. The best approach combines lifestyle modifications, annual health assessments, and, when necessary, medical treatment.
Maintaining a heart-healthy diet, engaging in regular physical activity, quitting smoking, and limiting alcohol consumption are also crucial steps. Additionally, managing stress, prioritising quality sleep, and following medical guidance, including prescribed treatments, when necessary, can significantly reduce the risk of cholesterol-related complications.
For more details on Medshield's available benefits, visit www.medshield.co.za.
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