Let's not get it wrong here. Before you panic and swear never to eat another mouthful of any sort of fat, it's important to understand that cholesterol is essential to the body.
Problems not only arise if you have too much in your blood but they can also be caused if you have too little.
Cholesterol is needed by the body to ensure that the protective walls of every single human cell functions as it should. It's also part of our natural chemical factory which helps manufacture other vital substances like hormones and vitamin D. Cholesterol is made in the liver and travels around the body through the arteries, from which it passes to the cells which need it.
Unfortunately, here's where it gets a bit more complicated, but it's really important to understand how this bit works.
There are two forms of cholesterol: HDL (high-density lipoproteins) the good guys, which return unused cholesterol to the liver; and LDL (low-density lipoproteins) the bad guys, which encourage the artery walls to absorb too much cholesterol, narrow the arteries and can damage those that supply the heart, causing heart disease.
The amount of cholesterol in your blood is measured in millimols per litre of blood and is usually written as mmol/l and the average in the UK is 6.2 for men and 6.1 for women and more than a third of the population between 35 and 64 have levels above 6.5. Less than 20 per cent of the population know their cholesterol level, but as this figure is so important and simple blood tests are widely available at your doctor's surgery or a pharmacy, here's how to interpret the readings.
7.8 mmol/l or more High risk
6.5 - 7.8 mmol/l Moderate risk
5.2 - 6.5 mmol/l Average risk
5.2 mmol/l or less Low risk
A significant reduction of raised cholesterol levels can cut your risk of heart disease by 25 per cent. Here are 10 ways to do it:
1. Eat less saturated fat
Saturated fats increase the amount of LDL cholesterol in your blood, and most of them are found in the fat around your lamb chop, beef steak, crackling on your pork and in the skin of poultry. Even lean meat contains substantial amounts - especially if the animals have been intensively reared. You can remove all the visible fat, but for overall lower fat content, choose organic meat and poultry. Just because you can't see it, doesn't mean it isn't there and nearly all meat products have a very high saturated meat content. These include sausages, pate, Scotch eggs, meat pies and pasties, commercial burgers etc. And lard, dripping, butter and cheese also contain high levels. But don't forget that dairy products are a major source of calcium. Watch out for coconut and palm oils, widely used in food processing and high in saturated fats. Don't forget that Danish pastries, croissants and many other bakery products are also rich in saturated fats.
2. Eat more mono-unsaturated fats
They're found in olive, walnut and rapeseed oils - and in the flesh of avocados. These fats reduce the LDL cholesterol level without affecting the amount of HDL.
3. Use modest amounts of poly-unsaturated fats
Sunflower, safflower - and, best of all, rapeseed - oils also help reduce LDL cholesterol, but they lower the levels of protective HDL. Rapeseed, however, has the least effect on HDL.
4. Have much more of the omega-3 fats
These help to prevent blood clotting and are highly protective against heart and arterial disease. They occur in all oily fish - like salmon, sardines, herrings, mackerel, kippers, trout, anchovies and fresh tuna.
5. Get your daily oats
Although the Scots have the highest level of heart disease in the UK, the food most commonly associated with Scotland is one of the best things to eat to help control cholesterol. The soluble fibre in oats makes porridge a daily must both for both prevention and treatment of raised cholesterol. Don't add salt or cream, but make it with half milk and half water. It's the cheapest and healthiest of all the breakfast cereals. Also add oats to soups, stews, casserole as well as home-made biscuits and bread. Another traditions Scottish dish is herrings rolled in oats - a double whammy against high cholesterol.
6. Eat much more of all the wholegrain cereals
Wholemeal bread and pasta, brown rice, barley, couscous, buckwheat and rye are all excellent sources of fibre, which help control cholesterol levels.
7. Don't worry about cholesterol in foods
Eggs, liver, kidneys, some shellfish and avocados are some of the foods which contain cholesterol, but for most people this type of cholesterol is much less important than the amount of saturated fat in their diet. Only those with extremely high levels or with the genetic condition which means they manufacture far too much cholesterol, should not over-indulge.
8. Get up the apples and pears
These two wonderful British fruits are both rich in pectin - not only a setting agent for jams, but a special soluble fibre which helps the body get rid of cholesterol. One of each a day really could keep the doctor - and the heart specialist - away.
9. Five a day is the healthy way
Eating a minimum of five portions of fresh fruit and vegetables a day is a powerful weapon in the fight against cholesterol. If you're not sure what five portions means, it's around 500g (1lb) in weight - excluding potatoes. They're great for your health, too - as long as they're not all chips.
10. Beans means . . .
All beans help to reduce cholesterol levels. And there's growing evidence that soya beans are among the most important. Of all the beans, they contain the most natural plant hormones, which have a beneficial effect on cholesterol metabolism. Kidney, borlotti, Lima, butter, black-eye and flageolet are all good, too. Even baked beans are a rich source of protective plant hormones.
As well as these ten top food tips, there are two remarkable supplements which have been shown to have dramatic effects on blood cholesterol. It's now 15 years since I attended the first international garlic symposium in Berlin, where the early results of using whole garlic tablets in the treatment of patients with high cholesterol were first discussed.
Many more studies have been published since then and most experts throughout the world now agree that eating at least one clove of garlic a day or taking a standardised garlic tablet (one of the best is made by a German company, Kwai, and widely available at health food stores and chemists in this country) can significantly reduce cholesterol levels and the stickiness of blood.
The most recent scientific advances have focussed on a group of natural substances in plants known as phytosterols. These amazing chemicals occur in virtually all plants, but they're easily destroyed when food is processed. The most common is called Beta-sitosterol; if you get enough of these natural substances from food, they block the absorption of dietary cholesterol and the cholesterol manufactured by the liver.
Our southern European neighbours eat far more vegetables and have much less heart disease than we do. We would need 14 times more vegetables per head to bring our average national cholesterol level down to theirs. The latest research shows that simply consuming 2g a day of plant sterols can reduce the dangerous LDL levels by enough to reduce our risk of heart disease by 25 per cent.
It's these substances that are now being added to some margarines and yogurts, but less expensive and more convenient is the newest supplement Lestrin, which has been shown to reduce cholesterol in some patients from 7.5 to 5.5 in four weeks. Interestingly, the best results were achieved in those who had the worst diets and found it difficult to make appropriate changes to their eating habits.
Of course there are other factors which affect your risk of heart disease. Top of the list is smoking, then high blood pressure, lack of exercise and obesity. The more risk factors you have, the greater your risk of being among the one in five women or one in five men who die prematurely every year in the UK.
These are the foods highest in cholesterol
Egg yolk 1500 mg/100g
Fish roe 895
Dried shrimp 505
Fried eggs 435
Fried liver 330
Boiled prawns 280
Soft margarine 275
Butter, unsalted 230
Liver pate 169
Sausage and egg muffin 145
Some of my books...
- Superfoods, Superjuices, Superhealth
- Eat Well Live Longer
- Superfood Pocketbook
(100 Top Foods for Health)
- The Omega 3 Cookbook
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