Cholesterol Awareness Week: Sustainable lifestyle changes key to lowering cholesterol levels
October 14th marks the start of National Cholesterol Week, a nationwide initiative that aims to raise awareness of both the causes and effects of high cholesterol. In the UK, three in every five people are affected by high cholesterol, a worrying figure when you consider that half of all heart attacks are caused by raised cholesterol levels.
Blood cholesterol levels are influenced by a number of factors, including diet, weight, genetics, stress levels, lack of exercise and smoking. While all these causes should ideally be addressed in order to effectively manage your cholesterol, simple changes to your diet can have a significant effect. Robyn Coetzee, Specialist Dietitian at London Bridge Hospital (www.londonbridgehospital.com) offers a detailed breakdown of which foods to avoid, or introduce, into your diet to positively impact your cholesterol.
Foods to avoid:
“Saturated fats should be limited as high intakes increase your LDL (bad) cholesterol levels which lead to a build up of fatty cholesterol deposits in your blood vessels”, explains Robyn. Saturated fats are commonly found in:
· Animal products (such as suet, lard, sausages, bacon, fatty beef, chicken skin)
· High-fat dairy products (e.g. cream, butter, cheese and whole milk)
· Some vegetable fats (such as hydrogenated vegetable fat, palm oil, coconut oil, cream and milk)
“Try to avoid foods with a high saturated fat content such as cakes, pies, pastries, crisps and chocolate”, adds Robyn. “Choose lean cuts of meat and trim away any visible fat, and choose lower fat alternatives to whole milk, cheese and cream.”
“Trans fats are produced when vegetable and animal liquid oils are manufactured into solid fat. The final product of this process is called hydrogenated fat. These trans fats raise LDL (bad) cholesterol, triglycerides, and lower HDL (good) cholesterol”, explains Robyn. Trans fats can be found in:
· Biscuits, cakes and pastries
· Cooking margarine and shortening
· Fast food
It is worth noting that trans fats are not always listed in an item’s ingredients, however hydrogenated fat or hydrogenated vegetable oil usually is. Therefore if an item lists either of these ingredients, you can assume there are trans fats in the product.
“Simple sugar increases triglycerides, which cause a build-up of plaque in the arteries and put you at an increased risk of heart attack. Limit the amount of food high in simple sugar such as cakes, biscuits, chocolate and sweets.” Too many of these foods can also contribute to weight gain which in turn raises cholesterol levels.
Excess alcohol can lead to weight gain, which can then cause an increase in blood cholesterol and triglycerides. “Achieving a low to moderate intake of alcohol can reduce your risk of heart disease. Small amounts of red wine may protect the heart, but large amounts are damaging”, Robyn clarifies. “If choosing to drink alcohol, the recommended maximum alcohol intake for men is 3-4 units per day and for women, 2-3 units per day. The best intake for people at risk of heart problems is no more than 1-2 units per day”.
Food cholesterol is a waxy substance found in animal products such as egg yolks, prawns, shellfish, offal, fish roe and caviar. Robyn explains, “Foods high in cholesterol actually have little effect on increasing blood cholesterol levels, so may be eaten in moderation by people with normal cholesterol levels. However, people with high cholesterol, diabetes or other cardiovascular risk factors may need to significantly limit cholesterol containing foods”.
Foods to target for lower cholesterol levels
Increasing daily exercise and avoiding saturated fat in your diet will achieve the biggest drop in blood cholesterol. However, consuming the following foods could help to lower your overall cholesterol levels:
“Unsaturated fats and oils mainly come from plants. They should be used in small amounts in place of saturated fats, and may help lower cholesterol levels. Watch out for palm and coconut oils, as they are the only oil from plants that are high in saturated fats.”
- Monounsaturated fats – Found in vegetable oils such as olive, rapeseed, peanut and walnut. Also found in avocadoes and nuts e.g. almonds, brazil nuts, hazelnuts, brazil nuts, peanuts and walnuts.
- Polyunsaturated fats – Found mainly in vegetable oils such as soya, safflower, sunflower, sesame and corn oil.
Omega-3 Fatty Acids
“These reduce your risk of heart disease by lowering the production of blood cholesterol and other blood fats, and help to prevent blood clotting and reduce triglyceride levels”.
The best sources of omega-3 fatty acids are:
- Dark-fleshed or oily fish, e.g. sardines, herrings, pilchards, mackerel, salmon, tuna, trout, swordfish, whitebait, anchovies, crab, sprats and kippers.
- Rapeseed oil, flaxseed oil and walnut oil that your body can use to make omega 3 oils.
For heart health, it is advisable to have at least two 100g portions of fish per week, with at least one portion being an oily fish.
“Foods rich in fibre have been shown to help lower blood cholesterol levels. They are low in fat and filling, so eating these foods makes it easier to control your weight.”
High fibre foods include:
- Fruit and vegetables
- Wholegrain cereals and breads
- Wholemeal flour
- Brown pasta and rice
- Breakfast cereals based on wheat and bran
- Pulses like beans, peas and lentils
“Aim for at least five servings of fruit and vegetables per day, and try to incorporate other high fibre foods such as breads, cereals and legumes into your diet on a daily basis” explains Robyn.
“Soy products are generally low in fat and a good source of protein which can work as a replacement for meats that are high in saturated fat.”Substituting meat for soy protein will reduce your saturated fat intake, while the product has itself been found to reduce LDL cholesterol and increase HDL cholesterol. However Robyn notes;“While studies have shown that 25g of soy protein is required to have a significant cholesterol lowering effect. This is the equivalent of about 1 glass of soy milk, a soy yoghurt and a serving of tofu in one day which can be difficult to achieve.”
Plant Stanols and Plant Sterols
“Plant stanols and plant sterols have been proven to significantly reduce LDL cholesterol but again, these need to be consumed in sufficient amounts. Some products that are fortified with plant stanols or sterols are also high in calories, e.g. margarines or spreads, which, when consumed in the quantities required to have a significant effect on cholesterol can hinder weight loss”. Robyn highlights thatlower calorie options do exist, such as fortified milk or yoghurt drinks, so if you are choosing to use these products then ensure that you pick the right product for you.
There are various dietary patterns that can be followed to maintain healthy cholesterol levels while having significant benefits to heart health. Robyn Coetzee expands: “The Portfolio and Mediterranean diets are examples of this and focus on a high intake of fruit, vegetables, legumes and fish, a low consumption of meat and meat products, a reduced intake of saturated fat – replacing this with mono and polyunsaturated fats – and a moderate intake of alcohol. The Portfolio diet also incorporates soy protein and plant sterols.”
Achieving a healthy cholesterol level requires more than just short-term modifications, but rather sustained lifestyle changes. Therefore it is important to make changes that suit your lifestyle, are easy to implement and are sustainable in the long-term. Finding ways to incorporate the above advice into everyday life is most likely to yield results, lowering your risk of heart attack or stroke.