Eat Well Live Well with High Cholesterol: Low-Cholesterol Recipes and Tips

LOWER CHOLESTEROL THE HEALTHY WAY

High blood cholesterol is one of the major risk factors for heart disease, which can lead to heart attack or stroke. Simply put, the higher the cholesterol level, the greater the risk. Best estimates rank cardiovascular disease (CVD) as the leading cause of death in the Western world. The expectation is that CVD will become an even greater health problem, along with obesity and diabetes, by the end of the next decade.

The good news in all of this is the lower you get your blood cholesterol, the lower your risk of CVD and the less chance you have of becoming a health statistic.

There is plenty you can do to achieve a lower blood cholesterol level, the most important being improving your diet and lifestyle. Diets to lower cholesterol have come a long way in the last 20 years. Bland high-fiber meals devoid of fat are out, flavorsome and colorful meals using the right fats are in. So take the opportunity to change your life—enjoy the recipes in this book with family and friends, lower your cholesterol and live a longer healthier life.

What is cholesterol?

Cholesterol is a waxy, fatty substance made naturally, in amounts determined by your genetic make-up, by the liver. We all need a certain amount of cholesterol to make hormones, coat our nerve cells so signals travel properly, and form the outer membranes of our body’s cells. Cholesterol is not bad for us when we have it in the right amounts.

Our body also gets small amounts of cholesterol from the foods we eat, such as shellfish, meat, chicken, eggs, butter, cheese and whole milk. Foods with saturated and trans fats can upset the body’s cholesterol balance by causing your liver to make more cholesterol than it otherwise would.

Because cholesterol is a fat and can’t dissolve in the blood, it must get to and from the cells via transporters or carriers known as lipoproteins, of which there are two types.

Low-density lipoprotein or LDL cholesterol: This is found in the greatest amounts and is the one you most need to worry about.

LDL’s main job is to take cholesterol from the liver to the body cells where it is needed. Too much LDL causes a build-up of cholesterol on the inside of blood vessel walls which is not good for your health.

High-density lipoprotein or HDL cholesterol: This is the cholesterol you want to have more of. HDL tidies up excess cholesterol, picking it up from your blood vessels and taking it back to your liver.

The trouble with too much LDL cholesterol

Too much LDL cholesterol in your blood causes the excess to be deposited in the blood vessels. Over time, the cholesterol, along with other substances, builds up in the vessel walls, causing them to narrow and then harden—think of the sludge you might get clogging up your drain pipes at home. This process is known as atherosclerosis.

Cholesterol deposited in the blood vessels is also more susceptible to a process known as oxidation. When LDL is oxidized, it becomes more irritating to the blood vessel, causing inflammation, which then accelerates the process of atherosclerosis.

Depending on your genes, diet and lifestyle, atherosclerosis can start as early as childhood and can become quite advanced by the time you reach middle age.

Atherosclerosis is involved in the progression of a number of diseases:

Coronary heart disease occurs when the blood vessels to the heart are affected by atherosclerosis and can lead to angina (chest pain) or a heart attack.

Cerebrovascular disease is caused by narrowing or blockages in blood vessels to the brain and can result in a stroke.

Peripheral vascular disease is the result of narrowing or blockage of the blood vessels in parts of the body other than the brain or heart, such as the legs, arms, stomach, kidneys or other organs.

These diseases of the heart and blood vessels caused by atherosclerosis are collectively known as CVD, the number one cause of death for men and women in Western countries.

Your cholesterol target

If your blood cholesterol is high, your doctor will give you advice on the best level for which to aim. Regardless of how high your blood cholesterol is, the lower you get your LDL cholesterol, the better off you’ll be.

The American Heart Association recommends you keep blood cholesterol levels in the following range¹:

What affects cholesterol levels?

In the Western world, there are a number of factors that may cause your cholesterol to rise. Some of these you can change, some you can’t.

These are the factors you can’t change

Your age and gender: Blood cholesterol tends to rise as we get older and is usually higher in men than women, until after menopause. A woman’s cholesterol may quickly catch up to that of men of a similar age after menopause.

Your inheritance: High blood cholesterol can run in families and your genes may put you at greater risk.

How common is high cholesterol?

Thirty to fifty per cent of adults in Western countries have high blood cholesterol. Despite knowing about the harmful effects of high cholesterol and understanding how easy it can be to lower it, the numbers of people with high blood cholesterol has changed little in some countries since the 1980s.

These are the factors you can change

Your weight: The world’s population has become dramatically heavier over the past 20 years. Rates of overweight and obesity in Western nations have climbed to as much as 60 percent. And as our weight increases, so too is the likelihood that LDL cholesterol will be higher and HDL will be lower than is ideal.

Your diet: Eating a diet high in saturated fat is one of the most significant causes of high LDL cholesterol. Major sources of saturated fat in our diet include butter, cream, cheese and other full-fat dairy products, the fat associated with meat and poultry (especially from skin), sausages, salami and other processed meats. Significant amounts are also found in many baked goods (cookies, cakes, pies, pastries), fried takeout foods and snack foods (chocolate, potato chips, corn chips and cheese-flavored snacks).

How much you move: Being more physically active will not only lower your LDL cholesterol but improve your risk-factor profile for CVD by lowering blood pressure, reducing insulin resistance, helping with weight control and improving mental health. Being more physically active will also lower your risk of developing type 2 diabetes, osteoporosis, obesity, breast and colon cancer, and depression.

What about triglycerides?

If you’ve had a cholesterol test, it is likely that the results included information about triglycerides: these are a type of fat found in your blood. Triglycerides come from the fats in the food you eat and are also made in the body—especially if you eat too many calories—your body then turns them into triglycerides (fat).

The link between high triglycerides and CVD remains uncertain, but when triglycerides are high, your risk of heart problems usually rises, especially if your LDL cholesterol is also high.

Triglyceride levels tend to be high if you smoke, drink alcohol to excess, are obese, don’t exercise enough or eat too many refined carbohydrates. Type 2 diabetes and liver and kidney diseases also increase your chances of having high triglycerides, as can your genes.

Ideally, you should aim to keep your triglycerides less than 150 mg/dL. Do this by following the advice given in this book, giving up smoking, drinking less alcohol and eating less refined and more whole grain and low-GI carbohydrates.

Risk factors for cardiovascular disease

If you have high blood cholesterol, have you considered how high your risk of CVD is and what your chances are of having a heart attack or stroke? These are important questions that everyone with high cholesterol should know the answers to. The most accurate answer—your risk in percentage terms—is best calculated by your doctor. However, you can get a rough idea by considering how many of these risk factors apply to you:

High total and LDL cholesterol

Low HDL cholesterol

High triglycerides

Cigarette smoking

High blood pressure (for example, over 140/90 mmHg)

Overweight and obesity

Inactivity

Diabetes or pre-diabetes

Stress, depression and social isolation

Over 45 years of age

Family history of heart disease (parent or sibling affected at less than 60 years of age)

Kidney transplant or kidney disease

Aboriginal or Torres Strait Islander descent

Maori or Pacific Islander descent

Asian or from the Indian subcontinent

African or Mexican American

In general, the higher your LDL cholesterol level and the more risk factors you have, the greater your chances of developing CVD and having a heart attack or stroke. Fortunately, by living a healthier life you can make a real difference to many of your risk factors. In short, give up smoking, take charge of your diet and get out of the house and move more.

The issue of weight

Being overweight increases your risk of high cholesterol and CVD as well as many other health problems. Overweight is defined as having a body mass index (BMI) of 25 or more. If you know your weight and height you can work out your BMI:

Maintaining a healthy weight

Following is a list of all the good reasons why you should aim to keep your weight down using a heart healthy diet and regular exercise: Heart health benefits

Lower LDL cholesterol

Higher HDL cholesterol

Lower triglycerides

Lower blood pressure

Improve insulin resistance and control blood glucose if you have diabetes

Reduce your risk of CVD

General health benefits

Reduce risk of type 2 diabetes

Lower risk of some cancers

Improve sleep apnea

Reduce joint pain in arthritis

Control gout

Lower risk of gall bladder disease

Improve asthma

Relieve reflux

Improve fertility

For most people their BMI is a good indicator of body fat levels and health risks. But there are some—such as athletes and those of some ethnic groups (for example, Pacific Islanders and South-East Asians)—who are the exception.

Where on your body you store your fat makes a big difference to your CVD risk. Fat stored around your tummy (apple shapes) puts you at greater risk than fat stored on your hips and thighs (pear shapes).

Checking your waist size is easy using a tape measure at the level of your belly button. Women should aim for a waist less than 31½ in and men less than 37 in. A waist size greater than this makes you a bigger candidate for a heart attack or stroke.

Healthier eating habits to lower blood cholesterol

Better eating habits and a healthier lifestyle—which includes being more active as well as giving up smoking—are two of the biggest steps you can take to lower your blood cholesterol. This is why your doctor will usually give you a chance with these before prescribing you any medication. These changes are also the best way to avoid getting high cholesterol.

Once you have commenced your plan to lower cholesterol, don’t forget to visit your doctor and keep track of your progress. Anyone with high cholesterol and at high risk of CVD should have their blood cholesterol checked every year. The benefits of the changes you will make are well proven, but there’s no better motivator than to see improvements in your LDL and HDL cholesterol for yourself.

Fast food, be it takeout or made at home from highly-processed ingredients, is high in saturated fat, low in fiber and contains fewer vitamins and minerals. When eaten regularly, this sort of food slows you down and makes you more likely to suffer health problems, particularly high cholesterol.