Healthy Cholesterol Levels in Australia

Published November 6, 2022

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What is cholesterol and why is it important?

Cholesterol is a waxy substance, a bit like fat, that’s carried through your bloodstream in packages called lipoproteins. These packages are made of fat on the outside (where the ‘lipo’ part of the name comes from) and protein on the inside (which accounts for the ‘protein’).

Cholesterol is used by every cell in the body and is needed to:

  • Make hormones like oestrogen and testosterone.
  • Maintain healthy nerve cells.
  • Is involved in the synthesis of vitamin D.
  • Produce bile acids. These help you digest the fats from your food and absorb essential nutrients like vitamin D & vitamin A.

Your body needs a small amount of cholesterol to function, but an imbalance between different types of cholesterol or lipoproteins in the blood can be one of the indicators of an increased risk of cardiovascular health issues.

Different types of lipoproteins that transport cholesterol

You may have heard of ‘good’ cholesterol and ‘bad’ cholesterol. These refer to the types of lipoproteins that are used to transport the cholesterol around your body.

These are:

Low-density lipoproteins — Low-density lipoproteins (LDLs) carry the cholesterol out to your body. This is the type of cholesterol that can clog arteries. High levels of LDLs are considered one of the risk factors for cardiovascular health issues.

High-density lipoproteins — High-density lipoproteins (HDLs) collect excess cholesterol from the body and take it back to the liver. Having higher levels of HDL lipoproteins can help reduce your risk of cardiovascular health issues.

What is a normal cholesterol level in Australia?

When your healthcare practitioner checks your cholesterol, they will look at your total cholesterol and your levels of ‘good’ and ‘bad’ cholesterol. They will then use this information along with a detailed consultation to assess your risk for cardiovascular issues.

General cholesterol/lipoprotein targets in Australia are:

  • Total Cholesterol: <4.0 mmol/L (Individuals at high risk) <5.5 mmol/L (General population)
  • Low Density Lipoprotein Cholesterol (LDL): < 1.8mmol/L (Individuals at high risk) < 2.0 mmol/L (General population)
  • High Density Lipoprotein Cholesterol (HDL): > 1.0mmol/L

The inner layer of your blood vessels

One important factor of cardiovascular health is the health of your endothelium.

The endothelium is the active inner layer of your blood vessel. It helps regulate blood vessel tone, the adhesion of circulating blood cells and inflammation.

Damage to the endothelium leads to endothelial cell dysfunction. This dysfunction then increases the amount of bad cholesterol that can permeate the lining of your blood vessel. As more bad cholesterol accumulates a fibrous plaque is formed. These plaques can block blood flow in the vessel or rupture leading to health complications.

What can cause endothelial dysfunction?

Several factors contribute to endothelial dysfunction including genetics and ageing. But there are also lifestyle factors that contribute.

1.   Oxidative Stress

Oxidative stress is when there is an imbalance between ‘free radicals’ in the body which cause oxidative damage and anti-oxidants that help protect your body. As we age we start to produce more free radicals, but not necessarily more antioxidants to help our bodies fight free radical damage. While we can’t prevent getting older, there are lifestyle factors linked to increased oxidative stress that we can help to prevent:

  • Blood pressure issues — Oxidative stress is part of the underlying cause of blood pressure issues. A reduction in antioxidant bioavailability has also been observed in blood pressure issues.
  • Smoking — When exposed to cigarette smoke, endothelial cells release inflammatory and proatherogenic compounds leading to endothelial dysfunction. Direct physical effects of smoke compounds lead to endothelial cell death.
  • Being overweight — Abdominal obesity leads to endothelial dysfunction by enhancing oxidative stress and causing the production of pro-inflammatory compounds.
  • Blood sugar issues — High blood sugar can impair several functions of the endothelial cells leading to endothelial damage.
  • Dyslipidaemia — High cholesterol or high ‘bad’ cholesterol can also lead to oxidative stress. Dyslipidaemia can be genetic or associated with obesity, excess alcohol consumption, sedentary lifestyle.

2.   Chronic Inflammation

Inflammation is another common underlying mechanism of endothelial dysfunction. Chronic inflammation also causes oxidative stress.

Causes of chronic inflammation include:

  • Infections organisms — Some infectious organisms responsible for acute inflammation can resist host defenses and remain in the body for an extended time, eg. Mycobacterium tuberculosis
  • Environmental contaminants — Low-level exposure to an irritant or foreign material that the body cannot break down, eg. silica dust.
  • Acute inflammation — Recurrent episodes of acute inflammation.

How can you protect your endothelium?


Regular exercise has a favorable effect on cardiovascular health. Exercise can also improve the function of the ageing endothelium by modulating oxidative stress and inflammatory processes.

Treat underlying medical conditions

Maintaining a healthy weight, keeping your blood sugar in check and looking after your blood pressure will help reduce oxidative stress and help you protect your endothelium.

Reduce stress

Chronic stress has been shown to activate the sympathetic nervous system, causing an increase in blood pressure, heart rate, and endothelial dysfunction. Reducing stress will help with lowering blood pressure and help protect your endothelium. Stress reduction techniques include meditation, exercise, yoga, mindfulness and gardening.

Stop Smoking

Quitting smoking will reduce inflammatory markers and protect endothelial cells of oxidative damage.

Reduce exposure to environmental pollutants

The higher your level of exposure to environmental pollutants the lower your endothelial function. If you have a pre-existing medical condition such as blood sugar or blood pressure issues that are already impacting your endothelial function, you need to be especially aware of your exposure to environmental pollutions. Keep your windows up when driving and avoid exercising near busy roads and industrial areas. Regularly ventilate your home, use exhaust fans when cooking and showering, limit burning candles and incense.

Enjoy a Mediterranean Diet

Mediterranean diets are rich in:

  • Good fats Good fats including Omega-3 fatty acids, avocado, nuts and olive oil. improve endothelial function and boost ‘good’ cholesterol.
  • Fruits & Vegetables — Vegetables including dark leafy greens and a rainbow of coloured vegetables, have been shown to boost endothelial function when compared to a standard Western diet of refined carbohydrates and fried foods, as well as being full of antioxidants. Fruits are rich in antioxidants and vitamin C which can help protect your endothelium from oxidative stress.
  • Low GI carbohydrates — Eating low GI carbohydrates such as rolled oats and mixed grain bread, helps keep blood sugar in check. High blood sugar damages the endothelium. Low GI carbohydrates also contain more fibre, which can help reduce with healthy cholesterol levels.


  • Alcohol intake — Low to moderate alcohol intake is a part of the Mediterranean diet and has been shown to be protective of the endothelium. Heavy alcohol intake has been shown to damage the endothelium.

Looking after your cardiovascular health involves lowering your bad cholesterol and boosting your good, reducing inflammation and preventing oxidative stress. Following a Mediterranean diet, exercising and reducing stress can help you look after your heart health, maintain a healthy weight and help prevent other lifestyle-related diseases.


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