Did you know that one in two adults have high blood cholesterol levels? Slash them with smart food choices, without giving up all your favourites.
While genetics may be a contributing factor to high cholesterol, for most of us it simply comes down to a combination of lifestyle factors. The two biggest contributors are too much saturated fat in our diet and being overweight. Since high cholesterol can lead to atherosclerosis – the disease that causes heart attacks and strokes – it’s a good idea to take a good look at your diet and make a few easy changes.
Cholesterol is a waxy substance that helps make cell membranes, however it can cause serious problems for your cardiovascular system if it builds up in the blood. High blood cholesterol is a risk factor for atherosclerosis, a condition where the arteries harden, increasing the likelihood of developing heart disease.
Good vs bad cholesterol
The main two types are the ‘bad’ LDL cholesterol and the ‘good’ HDL cholesterol. LDL is considered ‘bad’ because it carries cholesterol from the liver to the blood vessels where it can build up, narrow and eventually block a blood vessel, potentially causing a heart attack or stroke. HDL cholesterol is seen as ‘good’ because it carries cholesterol away from the blood vessels and back to the liver.
What should my cholesterol be?
In general, aim to have your total cholesterol levels less than 5.5 (mmol/L). If you have a family history of cardiovascular disease, are overweight, have high blood pressure, diabetes or are a smoker, you need to get it down to less than 4 overall, with the (bad) LDL cholesterol level less than 2.5. The goal for good HDL cholesterol is 1 or more. See your doctor to have your cholesterol levels checked.
The good news
Because diet and lifestyle factors are to blame for rising cholesterol levels, scientists have established that cutting back on saturated fat and losing excess weight are very effective tools for lowering cholesterol. The most famous study to demonstrate this used the ‘Portfolio diet’, in which participants consumed a diet that was low in saturated fat, and included foods known to lower cholesterol (such as plant sterols, soy protein, soluble fibre and nuts). After one month, participants achieved a 30 per cent reduction in cholesterol – a result similar to that of a common cholesterol-lowering drug.
Food vs drugs
Although drugs are available (and, in some cases, may be required) to treat high cholesterol, they can have side effects and they don’t address other risk factors. Nor do they really get to the source of the problem: diet and lifestyle. Put simply, drugs are not a cure-all. Making lifestyles changes is still the best way to reduce your cholesterol levels.
If you want to give high cholesterol the flick, the best diet to follow is low in saturated fat, contains healthy, unsaturated oils and features heart-friendly foods such as vegetables, whole grains, fruits, legumes, nuts, seeds and fish. This type of diet encourages the liver to make less cholesterol, while at the same time, sweeping cholesterol out of the body. Of course, it’s important to look after your whole heart, not just your cholesterol levels, so limit salt (sodium) to control blood pressure and watch your portion sizes to prevent weight gain.
Eating plant sterols
Plant sterols are natural substances found in seeds, nuts and legumes that help reduce the amount of cholesterol the body absorbs. Foods enriched with high levels of plant sterols, like reduced-fat spreads and milk, are readily available in supermarkets these days.
Scientific studies show that consuming just 2g of plant sterols a day can lower cholesterol by an average of 10 per cent in three weeks. Two grams of plant sterols can be found in 25g of plant-sterol spread or 2 1/2 cups of plant-sterol-enriched milk. Apart from eating less saturated fat and losing weight, including 2g of plant sterols a day in your diet is one of the most effective dietary strategies for lowering your cholesterol. Not to mention that the Heart Foundation gives a big tick to plant sterols, recommending that people at risk of cardiovascular disease regularly consume plant sterols.
Fibre and cholesterol
Soluble fibre helps 'mop up' cholesterol and remove it from the body. Fibrous food such as oats, barley, legumes, fruits, vegetables and psyllium are our body's cholesterol cleaning team. Incorporate soluble fibre into your daily diet by:
starting the day with a high fibre breakfast, such as porridge or muesli;
choosing wholegrain bread for your lunchtime sandwich (preferable containing oats or barley); and
at dinner, ensuring that half of your plate is filled with a variety of vegies.
Vegetables high in soluble fibre include artichokes, carrots, eggplants and broccoli. Fruits high in soluble fibre include oranges, apricots, mangoes, blueberries, apples and pears. All legumes (think lentils, lima, kidney and soy beans) are high in soluble fibre, so try to include them in your diet at least twice a week.
A matter of fat
The golden rule with fats is to replace the ‘bad’ fats (saturated and trans fats) with ‘good’ (unsaturated) fat. the easiest ways to do this are by:
limiting animal fat by choosing lean meats and low-fat dairy;
eating fewer ‘sometimes foods’ such as fast foods, pastries, cakes and biscuits;
including healthy oils and your diet;
using a variety of oils for cooking and dressing salads such as sunflower, olive, canola, soybean, rice bran and sesame oils;
using a margarine spread instead of butter for spreading and baking; ideally a plant sterol spread; and
eating a small handful of nuts each day. Nuts are high in oil, but these are healthy oils. A small handful (30g) of unsalted nuts will help look after your heart. No one kind is better than another, so enjoy a variety of different nuts such as almonds, walnuts, peanuts, Brazil nuts and cashews.
Flick vs tick: Shop your way to lower cholesterol
Don’t buy: Whole milk and yoghurt; full-fat ice-cream, cheese, cream and sour cream
Do buy: Low-fat milk, yogurt and ice cream, such as Pura Light Start, Dairy Farmers HeartActive, Shape, Yoplait Formé, Nestlé Diet, Ski D’Lite and Peters Light & Creamy ice-cream. Look for reduced-fat cheese like Bega So Extra Light cheese, Perfect Italiano Ricotta Extra Light, Dairy Farmers Low Fat Cottage Cheese. Look for evaporated skim milk, and light yoghurt such as Carnation Light & Creamy Evaporated Milk and Black Swan No Fat Greek Style yoghurt.
Don’t buy: White bread
Do buy: Wholegrain bread containing oats or barley like Country Life Heart Wise or Bürgen Oatbran & Honey.
Don’t buy: Fatty chops, sausages or bacon, regular mince, salami or cabanossi
Do buy: Lean meat, lean ham, lean mince, skinless chicken and kangaroo sausages, such as: Macro Meats Kangaroo meat, Hans 97% Fat Free Ham, Don Shaved Light Leg Ham, Inghams turkey mince, Macro Meats Kanga Bangas and Lilydale free range chicken breast fillets and thigh fillets.
Don’t buy: Low-fibre breakfast cereals high in added sugar and/or salt.
Do buy: Porridge, muesli, oat flakes or cereal with added psyllium. Try Uncle Tobys oats, Morning Sun Natural Muesli, and Lowan muesli.
Don’t buy: Biscuits, cakes, shortcrust pastry, croissants, pies or tarts
Do buy: Dried fruit and nuts, filo pastry, fruit buns, raisin toast, muesli bread and fruit scones.
Don’t buy: Butter
Do buy: Margarine spreads (especially plant sterol-enriched spreads), like Flora pro-activ, Logicol, Nuttelex Pulse, Flora salt reduced and MeadowLea salt reduced.
Reading food labels
All packaged foods must contain a nutrition information panel (NIP) which lists the saturated fat content. Use the NIP to compare products and find those with less saturated fat and sodium, and more fibre. Another option, if you are confused or short on time, is to look for the Heart Foundation Tick.
The Tick is a quick and easy signpost for healthier choices within food categories at the supermarket. Foods with the Tick are better choices, although there may be other foods with similar nutrition content without the Tick. There are now some take-away and fast food options which have met the Tick’s strict nutrition criteria to help you make healthier choices when eating out. You can find Tick approved choices at McDonalds, Crust Pizza, Pizzacutters, Melbourne Zoo and the Rod Laver arena (Melbourne).
‘Cholesterol-free’ on a label doesn’t mean the food will lower your cholesterol. If you have high cholesterol, the most important thing to limit in your diet is saturated fat, not dietary cholesterol. That’s why foods with a ‘cholesterol-free’ label aren’t necessarily the best choice, and cholesterol-rich foods, such as eggs and prawns, are back on the menu for people with high cholesterol.