Will weight loss help reduce high cholesterol levels at menopause?

During menopause, women experience numerous changes in the body, the buildup of cholesterol and body fat being common. Between ages 44-65, increased cholesterol levels have been reported to affect 77% of women (2). Weight loss can be a preventative, maintainable solution to lowering cholesterol. In this blog, you’ll explore the risks of high cholesterol and the role of weight loss and lifestyle changes in reducing cholesterol.

Gloved hands draw blood from an arm with a turquoise tourniquet. The setting is a medical environment with a calm, clinical mood.

What is cholesterol?

Cholesterol is the waxy fat substance produced by the liver (5). Too much can block blood vessels, increasing the risk of heart problems or stroke (19). The two types of cholesterol are:

Low-Density Lipoproteins (LDL)

Referred to as ‘bad’ cholesterol. High levels increase the risk of cardiovascular disease, such as stroke or heart attack (20), as well as hypertension (high blood pressure) (2,7).

High-Density Lipoproteins (HDL)

Known as ‘good’ cholesterol (17). Increased levels of HDL are associated with lower risk of heart disease (21), as it picks up excess LDL cholesterol in the blood and transports it to the liver, where it is broken down and flushed out the body (21).

There’s also another type of fat you may have heard of:

Triglycerides

These are a type of fat that accumulates in the body, serving as a building block for cholesterol. The risk of heart disease increases when there is a combination of high triglyceride levels and low HDL and/or high LDL levels (16). Triglycerides only become problematic when they are too high.

Why does cholesterol increase during menopause?

When a buildup of LDL occurs, it can cause ‘hypercholesterolemia’—a buildup of fat deposits, known as plaque (23), increasing the risk of blocked arteries and reduced blood flow (5) contributing to health problems like heart disease and stroke. Women are at higher risk of high cholesterol and often show no symptoms (2). Menopause is associated with increased total cholesterol, particularly increased LDL and decreased HDL (1), making it important to monitor cholesterol during menopause and perimenopause (7).

The hormone oestrogen has protective effects on the heart, playing a role in the reduction of LDL cholesterol in the blood (2). Reductions in oestrogen during perimenopause and menopause may increase LDL levels, continuing into later life.

Before menopause, women have a lower incidence of coronary heart disease than men of the same age (14). However, after menopause, due to an increase in cholesterol and triglycerides levels, a woman’s risk of heart disease becomes like that of a man.

Cholesterol Guidelines for Females (20+ years) (17, 18, 24 & 25).

Result	Healthy level	Borderline	High
Total cholesterol	Below 5 mmol/L	5.18 - 6.18 mmol/L	6.21 or higher
HDL (good cholesterol) Higher levels may not offer additional protection	Above 1.2 mmol/L for women Levels of around 1.4 are thought to offer best protection	N/A	N/A
Non-HDL This is all the ‘bad’ cholesterol added together	Below 4 mmol/L Ideally as low as possible (18)	Above 4 mmol/L	Above 4 mmol/L
LDL cholesterol	Below 3.0 mmol/L	3.4 - 4.1 mmol/L or more	4.1 - 4.9 mmol/L or more

It’s recommended to check cholesterol levels every 5 years, and more regularly during and after menopause (4).

Why does weight gain affect cholesterol?

During menopause, the body's fat distribution shifts from the hips to the waist, increasing visceral fat around the abdomen (1). Excess fat around the tummy can elevate triglyceride levels, which negatively impacts cholesterol levels (5). Additionally, carrying extra abdominal weight can affect insulin sensitivity, increase free fatty acids in the liver, and promote inflammation, all of which disrupt the regulation of HDL cholesterol (5). Obesity and being overweight can raise LDL levels, making weight management key in controlling cholesterol (4).

What causes high cholesterol?

Multiple factors affect cholesterol: dietary choices, smoking, alcohol, weight, and genetic factors such as family history and ethnic background (2). Below are dietary and lifestyle recommendations proven to lower cholesterol levels.

What can I do to lower cholesterol?

Consuming five a day: Eating fruit and vegetables provides fibre, vitamins, and minerals that contribute to a healthy balanced diet and aid in weight loss and maintenance (26).
Reducing saturated fats: Consuming too much saturated fat can lead to increased LDL (bad) cholesterol levels. Reducing foods such as fatty meats, dairy products, butter, cheese, whole milk, cream, and ice cream can help reduce saturated fat intake. Women should consume no more than 30g per day (28). Reducing consumption and portion sizes of these foods may help cut back on calories, supporting weight loss at menopause.
Prioritising unsaturated fats: Moderate amounts of unsaturated fats improve cholesterol levels. Foods like olives, avocados, nuts, and seeds, as well as omega-3-rich foods such as oily fish, flax seeds, chia seeds, and walnuts, can protect the heart and blood vessels from disease (27, 29).
Plant proteins & wholegrains: Including soy foods, oats, and barley (2) and other plant-based foods provides sterols and stanols (compounds that promote reductions in cholesterol) (3).
Soluble fibre: Soluble fibre reduces cholesterol absorption. Eating 5 to 10g of soluble fibre per day can decrease LDL (10). Brussel sprouts, avocados, flax seeds, and black beans are good sources of soluble fibre (11). Fibre also helps you to feel full for longer, which can prevent overeating and support weight loss at menopause.
Plant sterols and stanols: These compounds have a chemical structure like cholesterol. Including plant sterols and stanols in your diet can reduce cholesterol absorption in the gut, lowering total cholesterol and LDL levels (12). Fortified foods like margarine, milk, yoghurt and yoghurt drinks can provide 0.75g to 2g per serving, meeting the daily recommendation (12). The British Dietetic Association recommends no more than 3g per day for optimal cholesterol reduction (13).

Conclusion

Weight loss can help reduce high cholesterol levels. A combination of diet and lifestyle habits can keep the heart and circulatory system efficient and help lower cholesterol levels.

This blog was written by Megan Connor (ANutr), find her on @_mealsbymeg_.

References

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