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Cholesterol

Updated 29 October 2018

Cholesterol and your diet

Do you have high cholesterol? Changes to your diet can lower your cholesterol levels. In turn, this can reduce your chances of having a heart attack or stroke.

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If you have high cholesterol, dietary considerations involve not only the amount of cholesterol in the food you eat, but also the nature and amount of fatty acids and carbohydrates (specifically the simple sugars and starches) you consume. Your total energy consumption is also important.

There are two types of cholesterol-carrying particles of major interest for vascular disease: LDL (low-density lipoprotein) and HDL (high-density lipoprotein).

LDL is the “bad” cholesterol – its concentration is associated with higher risk of disease. HDL, in turn, is thought to contribute to the removal of cholesterol from your bloodstream, making it the “good” kind.

Here are some quick tips on what you can do in terms of your diet to help keep your cholesterol levels down:

  • Eat fewer foods with saturated and trans fats. Saturated fat comes mostly from animal products, and is solid at room temperature. This would include butter and the fat on meat. Trans fats are created when oils are partially hydrogenated to make them more commercially viable. Foods to avoid would include full-cream dairy products, hard margarines, butter, fatty meat, processed meats such as sausages, and coconut and palm oils.
  • Eat more mono-unsaturated fatty acids. Found in avocadoes and olive oil, these are high in kilojoules, so consume them only in moderate amounts. These fats should preferably replace other fats in the diet, and may be increased even further provided there’s no weight gain and that other essential foods aren’t displaced from the diet.
  • Check food labels. Many processed and baked products contain undesirable amounts of fat, but this isn’t always obvious. Get into the habit of checking the ingredients in products such as chocolate, sweets, cakes, desserts, biscuits and baked goods. Many pre-prepared foods and processed meats contain significant amounts of fat and also high sodium levels. The latter can increase your blood pressure. Go for products that contain zero trans fats.
  • Eat more foods with omega-3 fatty acids. These fatty acids can help reduce blood pressure, thereby reducing your chances of developing blood clots, and benefiting heart health in general. They may also influence mood and brain function favourably. Fatty fish such as mackerel, herring, sardines and salmon are good sources of omega-3 fatty acids. It’s recommended that you eat these twice a week.
  • Add nuts to your diet. Although nuts are high in kilojoules, many of them can improve blood cholesterol and keep your blood vessels healthy. Eat just over 40g of nuts per day. Dietitians recommended walnuts, almonds, peanuts, pecans, pistachio nuts and hazelnuts. Make sure they’re not salted or coated with sugar.
  • Eat more plant-based foods. These are mostly low in saturated fat, provide fibre for healthy digestion, and contain health-boosting antioxidants. On the list dietitians recommend are oat bran, oat porridge and cereals, barley, beans, chickpeas, kidney beans, split peas, aubergines, citrus fruits, soya beans, other soya-based foods, broccoli, apples, strawberries, mangoes and sweet potatoes. Plant sterols and stanols are naturally found in many of the foods mentioned above, and have the ability to lower cholesterol.
  • Reduce intake of simple sugars. By sweetening foods, the simple sugars often lead to significant increases in energy consumption and the increased storage of energy in adipose (fat) tissue. The production of fat in the liver is also affected. Though the effect on blood cholesterol may be small, there are measurable increases in blood triglyceride and decreases in HDL cholesterol levels when too much sugar is consumed. Furthermore, obesity (as a result of increased energy consumption) predisposes to the development of diabetes.

Reviewed by Prof David Marais, FCP(SA), Head of Lipidology at Groote Schuur Hospital and the University of Cape Town, January 2018

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