Cholesterol: how to lower cholesterol
JOHN MURTAGH'S PATIENT EDUCATION, FIFTH EDITION © MCGRAW-HILL

Why bother?

Heart disease is the number one killer in Australia.

It is mainly caused by clogging up of the arteries by a

fatty substance known as atheroma, which comes from

having too much ‘fat’ in the blood.

This serious process is called atherosclerosis—the condition

that can lead to heart attack or stroke.

There are two types of fat that cause damage if their levels are

too high—cholesterol and triglyceride.

A special blood test taken after fasting for at least 12 hours

can tell if one or both of these fats are too high.

 

Triglyceride

If your triglyceride level is too high, fixing the problem is

usually quite straightforward because it is mainly due to

being overweight.

It is caused by having too many calories in the diet, especially

from sugar and other carbohydrates and high-calorie drinks

(e.g. soft drinks and alcohol, in particular beer).

The aim is to get your weight down to an ideal level.

 

Cholesterol

High cholesterol is a bigger problem, and if your level

is too high it is important to reduce it. Cholesterol is a

white fatty substance made mainly in the liver by animals,

including humans. We get high levels mainly through

our diet, by eating saturated fats especially from animal

foods (therefore it is a rare problem in vegetarians) and

trans-fats found mainly in processed products.

 

There are 2 main types—HDL ‘good’ cholesterol and LDL ‘bad’

cholesterol. We aim to raise HDL and lower LDL. Most

people can lower the level through changing their diet.

 

Occasionally the level is so high in some people that,

in addition to the diet, special medicine is necessary

to reduce it to the right level. The prescribed drugs are

very effective.

 

Note: Although cholesterol is present in animal food, it

has been shown that it is necessary to reduce the amount

of all the saturated fats (plant and animal) in our diet

and to lose excess weight in order to get our cholesterol

down.

 

Foods rich in starch (such as bread, rice and pasta)

and foods rich in starch and fiber, known as complex

carbohydrates, also help.

 

Golden rules

• Keep to your ideal weight.

• Take a high-fiber diet.

• Eat fish at least twice a week.

• Beware of ‘fast’ foods: limit to once a week.

• Avoid deep-fried foods.

• Take regular exercise.

• Always trim fat off meat.

• Avoid biscuits between meals.

• Drink more water.

• Do not smoke.

• Limit alcohol intake.

• Limit cheese and ice-cream to twice a week.

• Keep LDL/HDL ratio less than 4.

 

The low-cholesterol diet

 Foods to avoid

  • Eggs  - whole eggs, egg yolks

  • Milk - whole milk and its products—butter, cream, cheese, ice-cream, yoghurt, condensed milk, full-fat soy milk
  • Organ meats-  brains, liver, pate, liverwurst, kidney, sweetbread —

  • Seafood - prawns, squid (calamari), fish roe, caviar, fish ‘fingers’, canned fish in oil (e.g. sardines)
  • Meat - fatty meats—bacon, ham, sausages, salami, canned meats, pressed meats, meat pastes, hamburger mince
  • Poultry - duck, goose, skin of chicken and turkey, pressed chicken

  • Bakery food pies, pasties, pastries, cakes, doughnuts, biscuits, bread with cheese/bacon/ham toppings
  • Fast food fried chicken, chips, fish, dim sims, spring rolls, etc., hot-dogs, pizzas, fried rice
  • Nuts roasted nuts, peanut butter (can have in very small amounts)

  • Oils and fats saturated fats—lard, dripping, suet, copha, cooking (hard),  margarine, coconut and palm oils, mayonnaise
  • Miscellaneous gravies, potato crisps, caramel, chocolate (including carob), butterscotch, ‘health food’ bars, fudge, coffee whitener and other cream substitutes, toasted breakfast cereals (especially with coconut), fried noodles
  • Cooking methods frying, roasting in fat

 Suitable foods

  • egg whites
  • low-fat milk, skim milk and its products  —cottage and ricotta cheese, buttermilk, non-fat yoghurt
  • fresh fish, scallops, oysters, canned fish in water, lobster and crab (small amounts)
  • rabbit, veal (without fat), lean cuts of beef, lamb and pork (in moderation)

  • chicken (without skin), turkey (lean and without skin), preferably free-range

  • bread and crumpets (especially wholemeal), crispbreads, water biscuits, homemade items (pies, etc) if proper ingredients used.

  • pecan nuts, hazelnuts, walnuts, almonds, seeds (in moderation), peanuts, cashews, brazil nuts, macadamias
  • Fruit and vegetables — all types (very important)

  • polyunsaturated fats—some margarines (less than 0.9% trans-fats)  some salad dressings (olive oil/French style); vegetable oils—olive,walnut, corn, soya bean, sunflower, safflower, cotton seed (all in moderation)
  • rice, pasta, cereals, jelly, herbs, spices, canned spaghetti, baked beans, Vegemite, tea, coffee, honey, jam, alcohol (small a amounts)
  • cooking - using vegetable oils (as above), baking, boiling, grilling, stewing