There are a few things that can lead to high cholesterol: what you
eat, how physically active you are, and your genetics. You can't do
anything to change your genetics, but you can make positive lifestyle
changes that will help to control your cholesterol.
What is cholesterol?
Cholesterol is a waxy fat-like substance that's naturally made in
your body, by your liver. It's needed to make hormones and Vitamin D.
Cholesterol is also used to make a substance that helps to digest some
of the food you eat.
Two types of cholesterol - HDL and LDL: There are
two types of cholesterol that is usually measured in your blood: HDL and
LDL. The "good" kind of cholesterol is called: HDL cholesterol. Ideally
this number should be as high as possible. LDL cholesterol is referred
to as the "bad" cholesterol so the goal is to keep this number low. Most
people who have high cholesterol have too much LDL. It is this type of
high cholesterol that health care providers are concerned about.
Why do I have high cholesterol?
If you have high cholesterol it means your body is making too much
of it or you are eating too many foods that are high in cholesterol,
saturated fat and/or trans fat. If a person's body makes too much
cholesterol, it causes them to have a higher than normal "cholesterol
level".
What foods and drinks contain cholesterol?
There's cholesterol and saturated fat in animal products that we eat
and drink, such as milk, butter, meat, poultry, ice cream, and eggs.
Trans
fats, which are artificially made by food manufacturers, can show up in
foods such as french fries, donuts, pie crust, and cookies. Check the
nutrition facts label to see if any amount of
trans fat is listed and try to avoid foods that contain any if you can.
Do I need cholesterol?
Everyone needs to have some cholesterol in their blood, but having
too much can lead to heart disease. Keeping your cholesterol levels
within the normal range is one thing you can do to lower your chances of
developing heart disease as an adult.
How can I lower my cholesterol?
If you have high cholesterol you can work towards lowering it by
losing weight if you are overweight, exercising, not smoking, and
choosing healthy foods and drinks.
- Read the Nutrition Facts Label on food products you buy
- Pick foods that are low in saturated fat, trans fat, and cholesterol.
- Choose healthy fats such as olive oil, vegetable oil, nuts, avocado, and margarine.
- Eat more whole grains such as: whole grain
bread, whole-wheat pasta, brown rice, and oatmeal. Foods such as oats
that have soluble fiber in them grab onto cholesterol in your digestive
system and drag it out before it has a chance to get into your blood.
- Eat more fiber: fruit, veggies, beans and whole grains. You should aim for 25-28 grams of fiber per day.
Girls ages 9-18 should get 30% of their calories each day from fat,
but only 7% from saturated fat (about 12.4-14 grams per day) and should
limit cholesterol in food to less than 200 mg/day.
What if I don't want to change what I eat?
It can be overwhelming to think about making changes to the way that
you're used to eating. It's a good idea to start with small changes
that are the easiest to make and then go from there. For example, you
could start by eating oatmeal for breakfast or by switching from eating
meat every day to eating fish twice a week.
Here's a chart of other things you can swap out to help keep cholesterol levels under control.
| Instead of |
Eat |
| Hamburger |
Veggie burger |
| Ice cream |
Frozen yogurt |
| 3 eggs |
1 egg and 2 egg-whites |
| 2 slices pepperoni pizza |
1 slice vegetable pizza with a side salad |
| Mayonnaise on your sandwich |
Hummus on your sandwich |
| Butter |
Plant-based spreads such as Benecol®, Smart Balance®, or Olivio® |
| Creamy salad dressing |
Oil and vinegar based dressing |
| Cereal with high sugar content |
Oatmeal or high fiber cereal |
| Cheese and crackers |
Trail mix (nuts and raisins) |
Remember
- Everyone has some cholesterol in their body, and it's necessary for making hormones.
- High cholesterol can be caused by what you eat as well as your genetics.
- Limiting the amount of saturated fat in your diet and being physically active are ways of decreasing your cholesterol level.
List of High-Cholesterol Foods to Avoid on Your New Diet
When beginning a low-cholesterol diet, it is helpful to refer to a list of high-cholesterol foods (and high-saturated fat foods) to avoid. Diets high in saturated fat and cholesterol can contribute to high total cholesterol and high LDL ("bad") cholesterol level in the body, increasing your risk for coronary artery disease caused by atherosclerosis (plaque build-up in the arteries).
Remember that it is never too late to adopt healthier eating habits. Use this handy sheet on which foods to limit in your diet to start improving your diet today!
EGGS AND MEAT
Limit whole eggs.
The American Heart Association recommends consuming no more than one
whole egg daily. Use egg whites or egg substitute for recipes calling
for more than one whole egg. (Note that you do not have to eliminate
eggs entirely.)
Limit high-fat cuts of beef;
top loin, T-bone, tenderloin, porterhouse, brisket, rib-eye, and flank
steak. Choose meats labeled "choice," "select," and "lean."
Avoid "organ" meats such as liver and sweetbreads, which have as much as 375 mg of cholesterol per 3 ounce serving.
Limit processed and luncheon meats such as bologna, ham, hot dogs,
sausage, and packaged lunch meats; they are are high in saturated fats
and sodium.
Avoid duck and goose (lean, skinless breast or leg are lower-fat choices). Avoid frying in duck or goose fat.
DAIRY
Limit your intake of whole-fat dairy products such as butter and
whole milk, as well as 2% fat dairy products (such as yogurt and
cheeses).
If you are used to drinking whole milk, or using full-fat dairy
products, try switching to low-fat or 1% milk and dairy products. Once
you feel comfortable with low-fat or 1%, try skim milk or non-fat dairy
products.
OILS
Cut back on foods containing partially hydrogenated vegetable oils
to reduce trans fat in your diet. Check the food labels of packaged
foods for the terms "hydrogenated" or "partially-hydrogenated oil." If
these terms appear as one of the first five ingredients, it would be
advisable to avoid or limit those products.
SIDES
Limit French fries and other fried dishes made with partially hydrogenated or saturated fats. Try baked sweet potato "fries" for a healthier alternative.
DESSERTS
Limit cakes, cookies, crackers, pastries, pies, muffins, and
doughnuts (especially those made with made with partially hydrogenated
or saturated fats). When baking at home, consider low-fat recipes to make your desserts more cholesterol-friendly.
Keep in mind that your new cholesterol-friendly diet does not have to
be as restricted as you may have expected it to be. Although it does
involve limiting or avoiding the foods listed above, there are plenty of
new foods and recipes to ADD in as well.
Your cholesterol is too high. Well,
perhaps not specifically you, but thousands of Britons have this news
broken to them by doctors every day. We all have an amount of this
special type of fat in our blood. It is essential for many bodily
functions, but most of us – 60 per cent – have too much.
High
cholesterol is a key factor in developing heart disease, which claims
three times more lives than breast cancer and twice as many as lung
cancer. The good news is that lowering your cholesterol is the biggest
thing you can do to reduce your risk.
It’s
something TV personality Gabby Logan, for one, is keen to promote. ‘A
key risk factor for heart disease is high cholesterol but you can
protect yourself with simple changes to lifestyle and diet,’ says Gabby,
who is supporting the British Heart Foundation Love Your Heart
campaign.
The big six: TV sports presenter Gabby Logan,
right, is backing the drive to lower Britain's cholesterol using these
six food groups
But just how can you do this?
Much of the health advice on the matter, including that on the NHS Eat
Well site, is vague, leading to many misconceptions and myths.
So
can diet alone be used to bring down high cholesterol – or should we
leave it all to statins? The answer for very many people is yes, you CAN
reduce your levels significantly through making changes in your diet.
Should we stop eating eggs? Aren’t they high in cholesterol? In fact,
the answer is no. No food is prohibited, so you can still eat cheese,
red meat and chocolate, within the limits of a low-fat diet.
Confusingly, countless foods
carry labels claiming they can protect your heart or cut cholesterol.
They work, but you have to take them in a specific way to reap the
benefits. To find out what we should – and shouldn’t – be eating to
lower cholesterol levels, we spoke to leading diet and heart health
experts.
Now turn over for
our brilliantly simple step-by-step guide – which includes building six
food types into your diet – and you may be able to lower your reading
by up to 20 per cent in three months . . .
1. SMART FOODS
WHAT
These
include Flora pro.activ and Benecol yogurt shots, as well as other
products containing stanols and sterols. These naturally occurring
molecules, which are found in plants, block the absorption of dietary
cholesterol, which is then excreted with other waste.
PROOF
Studies
have shown that plant sterols reduce cholesterol levels by seven to ten
per cent within three weeks, as part of a diet low in saturated fat.
DOSE
You
need to consume 2g in one go alongside your biggest meal of the day,
each day, to get the full effect. The best form is the yogurt shot
drinks that provide this amount of plant sterols alongside just under 40
calories and 1.4g of fat. You
need to eat six teaspoons of fortified margarine to get the same amount
of sterols, which delivers 150 calories and 18g of fat, although low-fat
margarines with sterols are now also available.
EXPERT ADVICE
Drink
with your main meal as sterols reduce the amount of fat absorbed. ‘A
shot with your morning coffee or little bits of margarine through the
day will not produce the same benefits,’ says Catherine Collins,
principal dietician at St George’s Healthcare NHS Trust.
2. FIBRE
WHAT
The
high fermentable-fibre content of beans and pulses means that they
cannot be digested easily by the gut. This fibre binds to cholesterol so
that it is removed through waste. High-fibre bread can be added to the
diet to boost fibre intake further.
PROOF
A
meta-analysis of 67 studies on dietary fibre and cholesterol levels
revealed that consuming more fibre helped reduce ‘bad’ LDL cholesterol
by a small but significant amount.
Fibrous
foods such as beans also trick the body into absorbing less saturated
fat, which can help control weight and protect arteries from heart
disease.
DOSE
Eighteen
grams a day. Around 5g will come from oat-based products and you can
get the rest from just a slice of high-fibre toast and two tablespoons
of beans. Fruit and veg will also boost fibre intake.
EXPERT ADVICE
Just swapping white bread for wholemeal can lower cholesterol levels, a manageable step for everyone.
‘It’s easy for most people to add fibre to their diet,’ says Linda Main, of the cholesterol charity HEART UK.
3. NUTS
WHAT
Most
nuts, including almonds, walnuts, pecans and peanuts, are good for
lowering cholesterol. However, avoid salted varieties, especially if you
have raised blood pressure. It is not clear how nuts lower cholesterol,
but it might be because they contain plant sterols as well as
monounsaturated fats that protect blood vessels from damage. They are
also high in fibre and Vitamin E.
PROOF
In
2010, an American analysis of 25 studies on nut consumption and blood
fat levels found that eating a portion every day (eight to ten nuts, or
a small palm-full) reduced overall cholesterol by five per cent and
was particularly good for people with high levels of ‘bad’ LDL
cholesterol.
DOSE
Between 25g and 50g of nuts daily.
EXPERT ADVICE
Linda
Main says: ‘Nuts are very filling, so not only do they reduce
cholesterol, but they can stop you snacking on too many other fatty
foods afterwards. While nuts are in theory very calorific, it is
unlikely all the energy is available to the body.’
4. SOYA
WHAT
Soya
milk, soy nuts, tofu and soya yogurts may help the liver to take ‘bad’
LDL cholesterol out of the bloodstream. Using soya to replace dairy and
meat can also displace saturated fat from the diet.
PROOF
There is some evidence, including a 2011 study, that soy protein can help reduce total cholesterol.
Although
the effects were modest, some experts say that because soy products
such as tofu often replace meat in the diet, they reduce the intake of
saturated fat from other sources.
DOSE
Experts
recommend having at least two to three portions a day. That is
equivalent to half a litre of soya milk and a soya yogurt. The reduction
in cholesterol may be as much as five per cent, but scientific proof
for this is limited.
EXPERT ADVICE
Start
with one portion a day and slowly build it into the diet from there.
‘If you don’t like soya, follow the other tips instead,’ advises
Catherine Collins.
5. HEALTHY OILS
WHAT
Olive oil and rapeseed oil, which contain mainly monounsaturated fats, neither increase nor decrease cholesterol levels.
However,
they help to make the artery walls stronger, meaning that they are
less likely to be damaged by cholesterol. These fats are also cleared
easily by the body.
PROOF
Studies
suggest that replacing saturated fat such as lard and butter with these
oils results in a fall in cholesterol. It may also stop LDL causing
inflammation in the arteries, a key risk factor for cardiovascular
disease.
DOSE
Two
tablespoons a day used in cooking. A 2002 study found that consuming
this amount of olive oil each day decreased total cholesterol by eight
per cent in six weeks. Generally, studies suggest that virgin olive oil
is best.
EXPERT ADVICE
Polyunsaturated
fats from sunflower oils were considered to be as good as olive oils,
but recently it has emerged that having too much of them causes
oxidation, meaning they may increase furring of the arteries. However,
remember that polyunsaturated fats are still better than butter and
lard.
6. OATS
WHAT
Oats
contain compounds called beta glucans, which give them their paste-like
consistency. The beta glucans form a thick gel inside the digestive
tract and bind to cholesterol in the gut, helping to prevent
cholesterol from being absorbed by the body. The gel and cholesterol
are then excreted as waste.
PROOF
Analysis
of 12 studies involving more than 1,000 people showed that adding beta
glucans each day to your diet via porridge, other oat-based cereals and
oatcakes reduced cholesterol by up to five per cent within three
months.
DOSE
Three
grams of beta glucans a day. This is equivalent to a small bowl of
porridge, three oatcakes and two slices of oat bread. This would also
contribute about 5g of your daily fibre intake (see panel, left).
EXPERT ADVICE
‘Studies
show beta glucan is good for heart health and it’s easy to eat more
oats,’ says Linda Main. ‘There are now even breads with added oat bran.
But people need to try to eat three portions a day on a regular basis
to have an effect. HEART UK have an Ultimate Cholesterol Lowering Plan
fact sheet that explains it all.’
Harness the power of the six foods: Eat Your Way
to Lower Cholesterol, by Ian Marber and Dr Laura Corr, published by
Orion, £16.99
Q&A 'If cholesterol is so bad, why do we have it?'
Why do we need cholesterol if it can be so bad for our bodies?
Cholesterol
is a fatty substance produced by the liver and used to build cell
walls, create a protective glove around nerves and to make other
chemicals such as hormones.
Cholesterol
gets round our bodies by combining with protein to form a protective
coating around tiny balls of fat absorbed from our diet – termed
lipoproteins. The purpose of this coating is to hold fat together, so we
don’t have ‘oil slicks’ of fat in our bloodstream.
The
two lipoproteins usually measured are low-density lipoprotein (LDL) and
high-density lipoprotein (HDL). LDL is like a juggernaut – big clumps
of fat and protein that trundle along the arteries and can only be
cleared from our system by the liver. As it travels, fat can break away
and enter the artery walls, becoming embedded. This build-up – called
atherosclerosis – causes artery walls to narrow so blood cannot get
through, resulting in blood clots that can trigger a heart attack or
stroke.
HDL is known as
‘good cholesterol’. It is much smaller in size and hoovers up fat
deposits from the artery wall as it moves around the body. This is why
it’s important to know how much LDL and HDL are in your blood, as the
ratio between these two types of fat is what really matters when it
comes to risk.
What causes levels to rise?
They
are controlled by our genes and diet. In the West, more people have
high cholesterol than in countries with a low-fat diet, such as Japan.
Eating foods high in saturated fat, such as butter, cream, processed
meat such as sausages and fast food, means that our cholesterol goes up.
How is cholesterol measured?
The
ratio between LDL and HDL is what matters. A blood test at your GP
surgery can measure this. The result gives volume of cholesterol in a
measurement called millimoles per litre of blood – or mmol. The target
is to have an LDL reading below 3mmol and a total cholesterol reading
(which takes into account the HDL and LDL) of 5mmol. People at high risk
of heart disease – those with high blood pressure, who are overweight,
older and may have family history of the disease – are told to get their
total cholesterol lower, to 4mmol, with an LDL of 2mmol. The higher you
score, the more chance of suffering heart disease in the next decade.
Scores for total cholesterol above 8mmol will mean the person is at
medium to high risk of cardiovascular disease (CVD), depending on age
and blood pressure. Even a reading of 5 or 6mmol may be too high if you
have other risk factors, such as rheumatoid arthritis.
Good news: You do not have to give up on steak, red wine and dessert to lower your cholesterol
How often do I need to get a test?
After
the age of 40, your GP should check your cholesterol every five years.
If you have a family history of premature heart disease or raised
cholesterol, you should tell your GP as soon as possible and would be
eligible for tests before the age of 40.
Does a high reading mean I’m going to have a heart attack?
CVD
can lead to heart attacks and stroke. It becomes a bigger worry the
older you are, if you smoke, have high blood pressure, a family history
of heart problems and don’t exercise. It’s the combination of
cholesterol with these other things that triggers alarm bells.
Will I need to take statins?
If
your total cholesterol is above 5mmol, most doctors will tell you to
review your diet. If it is a lot higher, they may tell you to take
statins because these drugs are likely to reduce cholesterol by 20 to 40
per cent – a massive drop. Doctors will prescribe statins to anyone
with a 20 per cent chance of developing cardiovascular disease in the
next decade. They will work out this risk based on a range of personal
details. But they will still say you need to improve your diet as well.
So how much can diet alone help?
Diet
can reduce cholesterol levels by ten to 20 per cent, which
significantly decreases heart-disease risk. Studies show that for the
average person, the drop is 13 per cent. For some of us, this may be
enough.
How long does it take to work?
To
slash cholesterol by as close to 20 per cent as possible, you’ll need
to adopt ALL of the healthy eating elements mentioned above for at
least three months. If you don’t see changes after three months, talk
to your doctor. For some, a healthy diet does not have a great effect.
Once your cholesterol has reduced, you’ll have to keep up the good
work and stick to your new eating plan.
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