A recent survey commissioned by BergaMet found that, when asked how they manage high cholesterol, a third (31%) admit that they rely on medication alone and had not implemented any lifestyle changes since receiving their diagnosis.
But having a low cholesterol diet is the key to having a healthy lifestyle and many people are finding themselves in a situation that can be avoided.
GP Dr Sarah Jarvis comments: “The idea that 31% manage high cholesterol with medication and don’t give a thought to their diet is a real concern to me. I always explain to my patients that statins should be used to complement a healthy diet rather than replacing it!
“To put this into perspective, doubling the dose of any statin reduces the LDL (‘bad’) cholesterol by about 6%, while losing 10kg drops it by about 15%. Likewise, regular exercise increases HDL (‘good’) cholesterol so improves the ratio of total cholesterol and reduces the risk of heart attack and stroke.”
This isn’t just scary GP talk, having high cholesterol can be extremely damaging to your health. The good news is, you can do things to change it. Altering your diet, increasing your activity, as well as taking some form of medication all help to lower cholesterol.
But what is cholesterol? Where does it come from? How do you reduce it? We asked the experts everything you need to know.
What is cholesterol?
Cholesterol is a complex molecule carried around the body by various forms of lipoproteins. In the right quantities, cholesterol is vital to the body. It plays a beneficial role as it forms part of the outer membrane that surrounds every cell.
It is used to insulate nerve fibres (and helps nerve signals travel through the body) and produces hormones such as cortisone, progesterone and testosterone, which carry chemical signals around the body, aid digestion and transport fat.
There are 2 types of cholesterol that make up the total amount of cholesterol in the blood. LDL - (low density lipoprotein) is the harmful type of cholesterol.
If levels of it are too high or it is misused by the body's cells, it is deposited in the blood vessels and creates cardio-vascular risks. HDL - (high density lipoprotein) is protective antiatherogene cholesterol, which acts against the deposit of cholesterol in the blood vessels.
This is what becomes dangerous to your health and can lead to heart problems and high blood pressure and increased chance of strokes.
What’s the cause of cholesterol?
Although the main cause of high cholesterol is endogenous synthesis, in other words the production or the misuse of cholesterol by the body itself. About 30 percent of the cause of cholesterol has to do with diet.
However, Dietician Helen Bond, says that it’s importance to differentiate between a few things.
“It’s important to know that the cholesterol we get from food (found in prawns, eggs, liver and kidneys) has very little influence on cholesterol levels in the blood; eating too much saturated fat has a much bigger impact.
“So, if you are trying to lower your cholesterol, it’s more important to cut down on saturated fat, which is found in fatty meats and meat products such as sausages and pies, high fat dairy foods like cheese, cream, butter, cakes, biscuits and pastries. Even worse are trans fats (in hydrogenated vegetable oils) which are usually found in biscuits, cakes, fast food and pastries,”she says.
So the food factors that influence its synthesis are not only the quantity of food ingested that contain it (eggs, dairy products, sea food, meat) but also the restriction, frequency of meals and the type of fat eaten.
Fats have an essential role, not only their quantity but also their type. Generally, saturated fatty acids and trans fatty acids (that come from partial hydrogenation of vegetable fat substances present in pastries and fried food), increase overall cholesterol, especially LDL.
Unsaturated Fats (vegetable oils, oily fish and other oil-producing foods) lead to a decrease in cholesterol, especially LDL.
Other food factors reduce cholesterol in the blood: fibre as well as all vegetable produce in general (fruit and vegetables, whole grains and cereals, seeds and nuts).
Epidemiologic studies have shown that other factors influence cholesterol: firstly, exercise, weight loss, reduction in triglycerides and quitting smoking all increase HDL cholesterol. Other than this, the consumption of antioxidants (found in vegetable and plant produce, oils and fish) can make LDL cholesterol less fatty.
Finally, note that the production of or the lack of use of cholesterol by the body can be caused by medical or hereditary factors.
How do you lower your cholesterol through your diet?
There are several ways of reducing total cholesterol, particularly LDL (bad cholesterol).
Helen gives us her top 12 tips to alter your food intake for a low cholesterol diet.
1. Big up your fruit and veg:
It’s no big surprise that increasing your intake of fruit and vegetables will help lower your cholesterol.
Helen says: “Increase your intake to at least your five a day (400g) of a mixture of different coloured fruits and vegetables. A high intake of fruit and veg has been associated with a lower incidence of heart disease, elevated cholesterol levels, blood pressure and obesity. Fruits and vegetables are low in calories, rich in soluble fibre.”
2. Minimise Processed meat:
This will be a hard one for all you red-blooded humans out there but Helen says that altering your meat consumption can make a real difference.
“The major culprit here is saturated fat, one of the biggest contributors to high cholesterol levels. Limit your intake of all processed meat products including salami, ham, sausages, burgers, kebabs and meat pies to no more than two servings per week. You can still enjoy meat, just go for good-quality, lean cuts such as lean steak or skinless chicken breasts,” she says.
3. Go Nuts:
Like what we did there? Well, Helen says that nuts are high in all sorts of good nutrients and fats, so don’t feel guilty nibbling on those brazil nuts anymore.
“Nuts are high in heart-healthy monounsaturated fats, soluble fibre and plant sterols. They’re a good source of nutrients such as magnesium, vitamin E and potassium, which helps to blunt the effects of salt on blood pressure.
“Including just a small handful (around 30g) of nuts in your daily diet can help to reduce both total and LDL cholesterol. Contrary to what you might believe, people who eat nuts don’t tend to gain weight because they’re so filling.”
4. Go to work on an egg:
Some people get a bit nervous about having a lot of eggs in their diet but Helen says there is no need to worry.
“We now know that even though eggs are a source of dietary cholesterol they have very little influence on blood cholesterol levels. According to the Food Standards Agency there’s no recommended limit on how many eggs you should eat. It’s fine to enjoy eggs as part of a balanced diet. Studies have shown people who have two eggs for breakfast or lunch feel fuller for longer and go on to consume fewer calories during the day.”
Plenty of reasons to get scrambling!
5. Go Oaty:
If you enjoy porridge for breakfast then you’re already one step ahead here.
“Oats contain high levels of beta-glucan, a soluble fibre that has been shown to lower both total and LDL cholesterol when consumed in amounts of around 3g a day. Two or three portions of oats and barley (which is also a good source) will provide 3g of beta-glucan, which could be porridge for breakfast, a snack of oatcakes or oat biscuits and a couple of slices of hearty oat bread,” says Helen.
6. Reduce alcohol:
Well you must have known that this tip might appear somewhere in here. Although a casual glass of red at the end of a bad day can seem pretty tempting, Helen says that it’s a good idea to cut your intake.
“Alcohol may raise HDL levels in those who drink moderately but remember that alcohol is full of empty calories. Booze is also a common contributor to weight gain, one of the biggest risk factors for high total and LDL cholesterol.
“It is best to stick within the Department of Health guidelines of no more than two to three units of alcohol a day for women and three to four for men with two alcohol-free days a week,” she suggests.
7. Don’t forget your pulses
You might not think that beans sound the most appetizing of options but if you whip up a Mexican black bean dip or a casserole with plenty of borlotti beans you’ll be laughing at your former cynical self!
“Beans and pulses, are high in soluble fibre, which can help to lower LDL cholesterol. Try to eat 80-100g serving per day.
“There are many varieties available, ready cooked with no need for soaking/boiling. Add chickpeas,lentils, borlotti beans and kidney beans to soups, salads, stews, curries and risottos,” suggests Helen.
8. Oily fish once a week:
It’s wise to get the idea that fish is incredibly good for you into your head pretty fast. It saves a lot of time. Helen says that oily fish are the way forward for a low cholesterol diet.
“Oil-rich fish, such as salmon, trout, fresh tuna, sardines, herring and mackerel, are the best dietary source of omega-3 essential fatty acids.
“They lower blood pressure, reduce clotting tendency and lower triglycerides (another type of blood fat). Aim for at least one 140g portion a week.”
9. Choose wholegrain foods:
Another breakfast serving, whole grain foods are great for lowering your cholesterol. You should also opt for whole meal bread or brown rice and pasta.
Helen says: “Try to have up to 1-2 servings of whole grains daily. In addition to soluble fibre, whole grain foods also provide other heart protective nutrients especially those found in the germ - the most commonly removed part of the grain in processed cereals: unsaturated fats, phytochemicals, minerals such as iron and zinc as well as E and B vitamins can be found there.”
10. Don’t Forget Soya foods:
There are some great soya products on the market nowadays so don’t let the mere mention of soya make you recoil. You can get almond and hazelnut soya products as well as soy chocolate, so soy-mple!
Helen says: “Soya Consuming 15g to 25g a day as part of a diet low in saturated fat can significantly reduce LDL by 4.3-10%. Start with 1-2 servings soya foods daily - a handful (28g) of soya nuts, 30g soya mince or a glass (250ml) of soya milk.”
11. Plant stanols and sterols It isn’t quite so obvious what plant stanols and sterols actually are but Helen explains.
“Naturally found in small quantities in plants such as nuts, seeds, grains, fruits and vegetables. An intake of 1.5g to 2.4g a day can lower cholesterol by 7-10% in 2-3 weeks.
“To obtain the effective dose by consuming foods naturally containing stanols and sterols, will not be possible - therefore a more convenient way is to consume foods like Benecol and Flora pro.activ foods (spreads, yogurt, yogurt drinks and milk) that have been fortified with these compounds,” she says.