What is cholesterol?

Cholesterol is a naturally occurring, waxy substance, with many vital roles in the body. These include the synthesis of certain hormones, vitamin D, digestive aids, and forming part of cell membranes. 

Collectively, cholesterol and other fats in your blood (known as triglycerides) are called lipids. Each performs unique biological roles and contributes differently to your risk for disease. While there are many medical terms that describe various types of cholesterol abnormalities, the one most commonly used is dyslipidaemia.

Why is high cholesterol dangerous?

High cholesterol can double your risk of cardiovascular disease (CVD) by contributing to atherosclerosis, a build-up of plaques within your arteries. These plaques are made up of excess cholesterol together with fat, calcium, and other substances. Plaques contribute to CVD in a variety of ways, including reducing blood flow to various parts of the body, making the heart work harder and decreasing oxygen supply to tissue. 

Enlarged plaques may entirely block an artery, stopping oxygen supply and resulting in the death of the affected muscle or tissue as in the case of a heart attack or stroke. Partial blockage to the heart muscle can cause chest pains (angina) that may also be felt in the neck, shoulders, arms, jaw, or back.

Both heart attack and stroke are life-threatening, and everyone should be aware of their symptoms, as rapid treatment is necessary. Refer to our later section for these symptoms.

Atherosclerosis is known as a silent killer because it causes few or no symptoms, explaining why high cholesterol is often only diagnosed when a major cardiovascular event, such as a heart attack, occurs. Regular check-ups are therefore important – even if you live a healthy life. 

What is the difference between ‘good’ and ‘bad’ cholesterol?

Cholesterol is insoluble in blood and must be transported around the body by special molecules called lipoproteins. The two most well-known ‘types’ of cholesterol are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL cholesterol tends to accumulate within arterial walls, which is why it is often referred to as ‘bad’ cholesterol. HDL cholesterol is more efficiently transported to the liver and excreted, and may even help to remove LDL cholesterol from the arteries, helping to lower cholesterol levels. This is why it is often referred to as ‘good’ cholesterol.

What are triglycerides (TGs)?

Most fat in the body exists as triglycerides (TGs). They can be stored (increasing your weight), but a large proportion circulate in the blood stream, transporting fat to various parts of the body. TGs may be formed from fat or carbohydrate, explaining why a high carbohydrate diet is in many cases as detrimental as a high fat diet. A raised TG level is a major risk factor for atherosclerosis and CVD, and could also indicate the presence of other disease conditions, including insulin resistance, diabetes and liver disease.

What causes high cholesterol?

Cholesterol levels are affected by numerous factors.  Some are related to an unhealthy lifestyle, but others may result from genetics, increasing age, or other diseases. Atherosclerosis can begin in childhood and risk factors should be managed from an early age. The likelihood of CVD increases with an increase in risk factors.

Lifestyle factors that can contribute to CVD include poor diet, lack of exercise, tobacco, alcohol, certain drugs and even stress. These are generally within our control and are therefore known as modifiable risk factors.

Non-lifestyle factors are termed non-modifiable as they are beyond our control. These include:

  • Pre-existing disease: metabolic syndrome, insulin resistance, diabetes, thyroid disorders and kidney disease.
  • Genetics and family history: South Africa has one of the highest incidences of familial hypercholesterolaemia in the world, and in some communities can affect as many as 1 in 75 people. A family history of heart disease also increases the risk of CVD.
  • Gender: Although woman often consider CVD a man’s disease, deaths caused by CVD are second only to HIV/AIDS for both genders.
  • Age: cholesterol levels generally increase with age. This is especially true for post-menopausal woman.
  • Cholesterol recycling efficiency: the body recycles cholesterol through the liver via bile. This is transported to the intestines, where up to half is reabsorbed. A high reabsorption rate will result in increased cholesterol levels.
  • Psychological issues: conditions such as chronic stress, depression, anxiety, and schizophrenia have been associated with increased risk for CVD and dyslipidaemia.

What are the symptoms of a heart attack or stroke?

Rapid intervention decreases the risk of permanent damage, disability and/or death. Seek immediate medical attention if you notice any of the following symptoms in yourself or those around you, especially if they occur in combination. 

Symptoms of a heart attack include pain or discomfort, especially in the left or centre of the chest, upper parts of the body such as the arms, back, neck, jaw, or stomach, shortness of breath, cold sweat, nausea or light headedness.

Symptoms of a stroke include sudden numbness in the face, arms, or legs. This is especially diagnostic if the numbness is confined to one side of the body. Other symptoms include severe headaches, confusion, dizziness, loss of balance and difficulty seeing with one or both eyes.

When should I find out what my cholesterol levels are?

Due to the high presence of familial hypercholesterolemia in South Africa, it is important that people are tested from an early age. Healthy people over the age of 20 should test their cholesterol levels at least every four to six years. More frequent testing should be done as you age, if you are overweight, practice an unhealthy lifestyle, or have a family history of CVD. The sooner dyslipidemia is diagnosed and treated, the lower your risk of CVD in the future. So whether you are young or old, thin or fat, man or woman, you should know your blood cholesterol levels. 

How do I get my cholesterol level tested, and what do the results mean?

Preliminary screening for cholesterol abnormalities can be done in a point-of-care environment using a finger prick blood sample, which measures total cholesterol. Select clinics now also offer lipogram screenings which measure the different types of cholesterol and TGs. Although total cholesterol can give you an indication of your risk, a full lipogram is important to accurately test your CVD risk and plan an effective intervention strategy. While it is usually required that you fast for 9 hours before doing the test, recent research has suggested that this is not actually necessary. 

Cholesterol target levels are based on an individual’s CVD risk, which is calculated according to the presence of the previously mentioned risk factors.

How do I lower my cholesterol?

Lifestyle changes are an important strategy to reduce your risk for CVD, even if you take cholesterol-lowering medication. An early, proactive approach may slow, reduce, or even reverse arterial plaque build-up, thereby further reducing your risk for CVD. These strategies may also prevent the development of other conditions such as metabolic syndrome and cancer. 

According to The World Health Organisation (WHO), a 10% reduction in total cholesterol may halve the risk of CVD, and each mmol/L reduction in LDL-C shows a significant reduction in CV related death and disability and is therefore a goal of treatment. 

General guidelines for lowering your cholesterol and reducing your risk of CVD are:

1. Eat a healthy diet

Diet is a significant risk factors in a wide range of diseases. Download free copy of our Cholesterol-modifying dietary guidelines here.

In order to stick to a heathy diet, you should:

Know your fats:

Dietary fat intake is one of the most significant contributors to dyslipidemia. 

Avoid saturated and trans-fats as well as foods high in cholesterol. Saturated fats include animal fats, especially red meat and dairy, and some plant based fats like coconut and palm oil. Many vegetable oils, fried and processed foods, such as French fries, pies, and fast food are also high in trans-fats. 

Poly- and mono-unsaturated fats, may be able to reduce your total cholesterol levels. These fats come from plant based foods, such as olive oil, flax seed oil, avocados and nuts, and extend to fatty fish like salmon, sardines, and mackerel. Many of these are also high in Omega 3 fatty acids, which may improve your lipid profile. 

Read food labels:

Just because a product is labelled as “low fat”, does not mean that it is healthy. If a food item claims to have no trans-fat, check the ingredients list for hydrogenated or partially hydrogenated vegetable oil, which is just a different name for the same thing. Many low fat foods are also high in sugar, which can be just as detrimental. Excessive amounts of salt can also increase CVD risk.

Avoid diets high in carbohydrates, especially those with a high glycaemic index

Reducing total saturated fat content in your diet is important, but replacing these calories with carbohydrate has been shown to have little to no benefit in terms of cardiovascular health, and is more likely to lead to other conditions such as diabetes and obesity. This is especially true for refined carbohydrates and sugar which may also have an adverse effect on TG levels. Rather replace these calories with healthy fats and protein, and where carbohydrate is used, make sure it is low GI and whole grain.

Eat a diet high in natural, plant based foods

Plants have a wide variety of health benefits. Not only are they a rich source of vitamins and minerals, but they also contain numerous molecules which can help to manage cholesterol and CVD, including polyphenols, fibre, and phytosterols, all of which have been shown to lower cholesterol and the risk for CVD. For example, a diet high in fibre can reduce your cholesterol levels by up to 10%. 

In order to maximise the benefit you get from eating plants, make sure that they are raw, or only lightly cooked, and unpeeled where possible, as many of their beneficial compounds can be broken down by heat and occur in the coloured parts or skins of fruits.

It is suggested that at least 5 servings of vegetables and fruit are eaten per day. Despite the health benefits of fruit, they are also high in sugar, and so should not be eaten excessively.

2. Exercise, remain active, and reduce your weight

Exercise and maintaining an active lifestyle are extremely important in all aspects of your health. Physical activity lowers LDL-C, raises HDL-C, improves heart fitness, and other metabolic parameters which reduce your CVD risk. Movement in general is also important, as long periods of inactivity can be just as dangerous as no exercise at all. It is recommended that adults accumulate at least two and a half hours of moderate intensity exercise per week, while children and adolescents get at least an hour a day, and that bouts of inactivity are broken up by movement at least once every hour.

Excess weight is extremely dangerous and adds to your risk for numerous diseases, including insulin resistance, metabolic syndrome, cancer and CVD. Achieving and maintaining a healthy weight may help to lower LDL-C and TG levels, as well as increase HDL-C. A waist circumference over 102cm (men) and 88cm (woman) increases the risk for a wide range of diseases, independent of weight.

3. Stop unhealthy habits

This is especially true in the case of smoking. If you are a smoker, you should quit immediately, and if you are not, avoid any exposure to second hand smoke. Excessive alcohol consumption has also been linked to CVD. Alcohol intake should be limited to no more than two units per day for men and one for woman (1 Unit = 120 ml Wine, 50 ml Dessert wine, 200 ml Beer, 280 ml Lite Beer, 1 Tot  Distilled Liquor, 20 ml Cream-Based liqueur). 

4. Consult your doctor and remain aware of any other medical or psychological conditions you might have

Treatment and prevention strategies depend on your specific lipid profile and risk factors. Working with your doctor will help provide the optimal solution with regard to your unique lifestyle and risk factors.

In many cases, lifestyle changes alone are not sufficient, and medication may be required. There are a variety of cholesterol-lowering medications available, the most common is a group of drugs known as statins. Each type has been shown to improve cholesterol levels and decrease the risk of heart disease. Cholesterol-lowering drugs have a number of side effects and can interact with other medications and medical conditions, requiring close monitoring by a medical professional. For this reason, have a number of side effects and can interact with other medications and medical conditions, requiring close monitoring by a medical professional. For this reason, they are usually only prescribed in high-risk cases where cholesterol levels become unmanageable or where cardiovascular disease is already present.

5. The role of RyChol:

Plant-based ingredients have also been shown to lower lipid levels significantly. RyChol, from the Medical Nutritional Institute (MNI), has been developed to combat high cholesterol.

What does RyChol do?

Independent research has shown that RyChol’s unique blend may help to stabilise blood cholesterol and triglyceride levels by targeting multiple biological pathways.

What does RyChol contain?

RyChol contains a blend of plant-derived (phytochemical) ingredients that have each been recognised to help reduce blood cholesterol levels in a unique and individual manner. Its multi-modal pharmaceutical action is achieved through the selective inhibition of various biochemical pathways involved in saturated fat digestion, cholesterol absorption, as well as cholesterol excretion. The ingredients contained in RyChol are plant-sterols, apple polyphenols, barberry root extract and coenzyme Q10.

  1. Plant- or phytosterols are naturally-occurring plant fats that are structurally similar to cholesterol and compete with cholesterol absorbtion in the intestines.
  2. Apples contain several biologically active polyphenols that include the flavonoids and phenolic acids that have been shown to help inhibit the digestion of saturated fat in the digestive tract, thereby helping to reduce the absorption of fat (triglycerides).
  3. Coenzyme Q10 is a fat-soluble anti-oxidant found in meat, fish and dairy, and to a lesser degree, in grains, nuts and certain plants. It is present in most cells, primarily in the mitochondria, where it plays a critical role in ATP production, the body’s most basic energy unit.
  4. Barberry root extract contains a botanical chemical called berberine that is naturally found in the roots, stems and bark of various plants Berberine has been demonstrated to lower cholesterol levels by increasing cholesterol clearance through the liver. This is achieved through a process called ‘up-regulation’ whereby increased numbers of liver LDL receptors are produced, thereby leading to the accelerated clearance of LDL cholesterol from the system.

Who may benefit from taking RyChol?

RyChol can be used by individuals with a high blood cholesterol level before prescription medication is required. RyChol can be used in combination with most cholesterol-lowering drugs where indicated. Response to treatment is largely determined by good compliance such as ensuring you take the correct dose every day. Check your cholesterol profile after 12 weeks of treatment. As raised cholesterol tends to be a chronic condition, continued use of RyChol may be required.

Medication does not negate the need for a healthy lifestyle. Addressing lifestyle factors efficiently will ensure that you take the lowest dose possible, and that your disease risk is lowered in many other ways too. 

Can RyChol be used in conjunction with the statins?

Yes, trials done on some of the individual ingredients contained within RyChol, such as phytosterols and berberine, have indicated favourable results when used in conjunction with statins

What role does MNI play?

1. Products

MNI has developed several natural, plant-based products which aid in combatting risk factors associated with cardiovascular disease (CVD). These can be used individually or in combination with most prescription medications or each other.

  • RyChol is formulated to combat high cholesterol.
  • AntaGolin aids in reducing insulin resistance and body weight, and stabilising blood sugar levels.
  • NeuroVance and NeuroVance Focus are brain supplement that reduces stress, a significant contributor to CVD, as well as giving you greater mental function, allowing you to stick to lifestyle changes that you have decided to implement.
  • RheumaLin is a natural anti-inflammatory formulated to assist in neck, back and joint pain which is frequently experienced by those who suffer from conditions which increase systemic inflammation, such as diabetes, obesity and the metabolic syndrome.
  • FlamLeve is a natural anti-inflammatory formulated to assist with reducing inflammation and pain, it protects your body from inflammatory damage usually experienced by individuals suffering from conditions which increase systemic inflammation such as diabetes, obesity and the metabolic syndrome

2.  Meal plans

Our insulin-friendly (C.A.P.E) meal plan, designed specifically to combat insulin resistance and obesity which are both significant contributors to CVD, can also be applied to cholesterol reduction as unhealthy fats are reduced and healthy fats increased. Download your free copy here.

3.  Online information and resources

MNI provides information and training to healthcare practitioners and a number of free information resources to the public, increasing awareness of the most important diseases you or your family might face. 

4.  MyMNI

MNI recognises that individuals react differently to lifestyle, disease conditions and their response to intervention strategies. You can get more information from the Frequently Asked Questions sections on our website.  

5.  Loyalty reward program

In line with our goal to aid you in managing your risk for various chronic diseases and assist in compliance, MNI offers a FREE MNI product for every 5 of the same MNI products purchased. 

To qualify for your free MNI product, all you need to do is send the slips of your 5 MNI products together to loyalty@mnilifestyle.co.za. Read more about our Loyalty Program here.


  1. http://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html
  2. http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp#.V6sVA_l97Z4
  3. http://www.heartfoundation.co.za/
  4. http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/ Global Health Observatory (GHO) data
  5. South African Dyslipidaemia Guideline Consensus Statement: A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA) South African Family Practice 2015; 57(2):22-31