Take up the cholesterol challenge with food

By Lovely Ranganath, Dietician, Al Zahra Hospital, Sharjah

What is cholesterol and why is it important? Cholesterol is a waxy substance that is essential to the body. It nourishes the cell’s membranes, insulates the nerves, helps produce some hormones, and aids the liver in digesting food but your blood cholesterol level has a lot to do with your chances of getting heart disease.

High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack.

How does cholesterol cause heart disease? When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hardening of the arteries” so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone – younger, middle age, and older adults; women and men; and people with or without heart disease.

What affects Cholesterol levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

• Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matter. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.

• Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL (bad cholesterol) and total cholesterol levels, as well as raise your HDL (good cholesterol) and lower your triglyceride levels.

• Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.

Things you cannot do anything about can also affect cholesterol levels. These include:

• Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.

• Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

Changing diet habits with respect to the various foods to lower cholesterol.

Look at your overall eating pattern and begin to plan. The goal is to limit saturated fat and cholesterol. You don’t have to cut out all the high-saturated fat and high-cholesterol foods in your diet. Make substitutions gradually and plan your meals ahead.

(1)  Shop for foods that are low in saturated fat and cholesterol. If you stock your kitchen shelves with foods that are low in saturated fat and cholesterol, it will be much easier to adjust your eating habits.

(2) Food groups – you must eat a variety of foods each day to get the nutrients you need. One way to do this is to choose foods from different food groups, which are categorized by the nutrients they provide. The number and size of portions should be adjusted to reach and maintain your desirable weight.

*Choose the LEANEST meats, poultry, fish and shellfish. Remember, all of these foods contain some saturated fat and cholesterol. Therefore the amount you eat is also important. For variety, consider dried beans or legumes as a main dish.

*Beware processed meats because 60-80% of their calories come from fat - much of which is saturated. Some examples of these are bacon, salami, sausage, bologna and hot dogs.

*Organ meats like liver, sweetbreads, and kidneys are high in cholesterol.

*In general, poultry is low in saturated fat, provided the skin is removed.

*Most fish is lower in saturated fat and cholesterol than meat and poultry. Shellfish varies in cholesterol content – some is relatively high and some is low.

*Dairy products that contain fat are also high in saturated fat and cholesterol. Since dairy products are often added to foods like casseroles, cakes or pies, you might eat a significant amount of them without knowing it.

*Milk provides many essential nutrients. And both 1% and skim milk provide the same nutrients as whole milk or 2% milk, while providing much less saturated fat and cholesterol and fewer calories.

*Cheese:  Often, when people cut back on meat, they replace it with cheese, thinking they are cutting back on their saturated fat and dietary cholesterol. They couldn’t be more wrong. Because they are prepared from whole milk or cream, most cheeses, while high in calcium, are also high in saturated fat and cholesterol. Ounce for ounce, meat, poultry, and most cheeses have about the same amount of cholesterol. But, cheeses for the most part have much more saturated fat.

-         Natural and processed hard cheeses are highest in saturated fat.

-         Low-fat and imitation cheeses may have less saturated fat.

-         Read the label and choose low-fat cheeses that have between 2 and 6 grams of fat per ounce. Best cheeses include cottage cheese (low fat), farmer cheese (made with skim milk).

*Ice cream: is made from whole milk and cream and therefore contains a considerable amount of saturated fat and dietary cholesterol. You do not need to eliminate ice cream, but do eat it in small amounts and less often. Try frozen desserts like ice milk, yogurt, sorbets and popsicles, which are low in saturated fat.

*Eggs: Egg yolks are high in cholesterol. Eat no more than two to three yolks a week including those in processed foods and many baked goods. Egg whites contain no cholesterol and can be substituted for whole eggs in recipes.

*Fats and oils:  In your cooking, limit the amounts you use of saturated fats such as butter, lard, solid shortenings.

-         Instead of using butter as a spread or in recipes, substitute soft tub margarine.

-         Choose liquid vegetable oils that are highest in unsaturated fats like safflower, sunflower, corn, olive, sesame, and soybean oils for your cooking and in your salad dressings.

-         Choose soft tub margarines and oils that have more polyunsaturated fat than saturated fat.

-         Hydrogenated Fats: Saturated fats are often found in commercially prepared products. Remember, some vegetable oils (like coconut, palm) are saturated, and other vegetable oils can become saturated by hydrogenation – a process that solidifies them. They are called hydrogenated vegetable oils. Read the labels before deciding which products to buy.

Since avocados, olives, nuts, and seeds are high in fat, they are often grouped with fats and oils. Although the fats in nuts and seeds are mostly unsaturated fat, they are very high in calories.

*Fruits and vegetables contain no cholesterol and are very low in fat and low in calories (except for avocados and olives, which are high in fat and calories). By eating fruits as a snack or dessert and vegetables as snacks and side dishes, you can increase your intake of vitamins, minerals, and fiber and lower your intake of saturated fat and dietary cholesterol.

*Breads, Cereals, Pasta, Rice, Dried peas and beans:  are all high in complex carbohydrates and low in saturated fat. Try these foods as main dishes, casseroles, soups, or other one-dish meals without high-fat sauces. Also, try recipes that use small quantities of meat, poultry, fish, or shellfish as flavoring or seasoning in casseroles rather than as the main ingredient.

-         Cereal products, both cooked and dry, are usually low in saturated fat- with the exception of those that contain coconut or coconut oil, like many types of granola. (Most granolas are high in fat).

-         Breads and rolls are also low in fat (for more fiber, choose the whole-grain types). However, many other types of commercially baked goods are made with large amounts of saturated fats. Read the labels on these products to determine their fat content. Ones like croissants, biscuits, doughnuts, muffins, butter rolls are especially high in saturated fat. (Remember, you can make your own muffins and quick breads using unsaturated vegetable oils and egg whites. Two egg whites may be substituted for one egg yolk).

*Sweets and snacks: are often high in saturated fat, cholesterol and calories. Examples of these foods are commercial cakes, pies, cookies, cheese crackers, and some types of chips. Once again, the key is to read labels carefully since some of these products may contain unsaturated fats and be low in total fat and calories.

As an alternative, try fruit for dessert. And for your next snack, try a piece of fruit, some vegetables, or a low-fat snack like unbuttered popcorn or breadsticks.

*Read Food Labels – Study the Food Ingredients: All food labels list the product’s ingredients in order by weight. The ingredient in the greatest amount is listed first. The ingredient in the least amount is listed last. To avoid too much total or saturated fat, limit your use of products that list a fat or oil first or that list many fat and oil ingredients. 

The names of common saturated fat and cholesterol sources in foods are: animal fat, eggs, egg yolks, palm kernel oil, bacon fat, ham fat, palm oil, beef fat, hardened fat or oil, butter, hydrogenated vegetable oil, chicken fat, cocoa butter, vegetable shortening, coconut, whole milk solids, coconut oil, cream.

Here’s one fun way to educate yourself about the cholesterol content in a food. All you do is count the legs a particular food has! Cereals, beans, fruits, vegetables do not have legs and so they are cholesterol free. Chicken has two legs, red meat (lamb, beef, etc) has four legs, shrimps, prawns have lots of legs and so they contain large amounts of cholesterol!!

If you want additional help in planning a lifetime approach to low-saturated fat, low-cholesterol eating, make an appointment with a qualified dietician since dieticians can help you design an eating plan particular to your own needs and preferences.

Photo courtesy: doctorsecrets.com & bodybuilding.com

Ms Lovely Ranganath, Dietician, M.Sc (Food Science & Nutrition), Dip. Fitness & Nutrition, Al Zahra Hospital, Sharjah and Al Zahra Medical Centre, Dubai will be regularly writing on Diet and Nutrition on womenone.org.