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  • Q&A with Australian Health Practitioners

    What are the best ways to manage high cholesterol?

    Hi,



    My husband is in his mid 30's and has recently been told by the doctor that he has high cholesterol (not severely high, but over the threshold). This is the first time we have heard of this being an issue. We have a fairly healthy lifestyle however can any one recommend some diet changes or tips to manage this?



    Thank you
  • Find a professional to answer your question

  • 43

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    Darryl @team healthshare

    HealthShare Member

    I also was diagnosed with high cholestoral. Not very high. 6.3 where it should be 5.5. Could anyone suggest any changes that I should be making as well?

  • 14

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    Leading Melbourne Accredited Practising Dietitian -Mark Surdut APD AN. Mark runs a practise in North Caulfield with expertise in Medical Nutrition Therapy. Mark has a … View Profile

    start with oats for breakfast.

    plenty of cooked and raw veg.

    small can 4 bean mix as a snack sometime during the day.



    read some of other posts too.



    take care

    thenutritionist

  • 53

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    Angela Peris

    Registered Nurse

    I am passionate about helping people with Health and Wellbeing - with extensive knowledge and skills on cardiology and critical care nursing I have published … View Profile

    Hi. I once had a total cholesterol of 6.3mmol/L.. which was a shock to me! I didnot want to take medications for it. I manage to get it down to 4.6 within less than 12months (when I checked it again - it was down!) I deligently walked for 30 mins daily. Cut down on Marg, butter, used very little oil in cooking (changed oil to olive oil / peanut oil) avoided all saturated fats & trans fats - no meats / mince meats / biscuits / cakes/ cheese etc. ate a handful of walnits / had a glass of wine (with 2 alcohol free days /week) and I had more legumes like red kidney beans etc. . I also took fish oil capsules.



    I found red kidney beans (not from a can) buy the raw beans soak over night and boil for one hour the next day, is great source of protein. It is so good. You can add to pasta, rice or salads or even have it on its own. Delicious and nutritious! Google about it .. to see how red kideny beans can help diabetics to maintain blood sugar levels and how it can help reduce cholesterol etc.



    What I recommend is, if your cholesterol is high and you don't want to end up on Cholesterol reducing medications - take SERIOUS actions, getting the levels down to less than 4.5 (of course ensure your HDL (good cholesterol) is higer)  and then gradually have some of the things you enjoy in MODERATION! I beleive that you need to take control of your health.



    Eat lots of fresh fruits / veges, red kidney beans or any other legumes / drink plenty of water (aids digestion) walk daily (burns fat) eat more fish, salmon  (increases your HDL). Reduce meats, and pastries / cakes. Stop eating margarine/butter and cheese till you get the levels down to atleast below 5. ( normal is 5.5 - yet cardiologists recommend less than 4.5 to minimise risks of heart disease).



    Stop cigarette smoking as nicotine increases your bad cholesterol. Your bad cholesterol goes and eats up the good cholesterol and increases your total cholesterol.



    Make all attempts to reduce your cholesterol with a serious diet - as it is better than taking cholesterol lowering medication - which can affact your liver.



    A liver cleansing program is also recommended to clean out your liver. Your liver acts like a filter and can get clogged up over the years! When it is cleaned, it can filter what we put in to our bodies better. Like a fuel filter in a car! How often do we change that!!



    Take care



    Angela

  • 12

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    June Johnston

    HealthShare Member

    I find that rolled oats for breakfast, baked beans on toast minus the butter, and then diet high in veges helps, grill your meats if you have them and cut down on size of meats in meals. check your labels before you buy. remember 97% fat free is padded out with sugar substances in some cases. Buy the low GI book it has some great guidelines.   This kind of eating is good for the family, with small adjustments for children they do need some fats.

  • 12

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    Kaye Haslam

    Dietitian, Nutritionist

    As a private practice Dietitian/Nutritionist with over 30 years experience I have a special interest in weight management & related health issues such as Diabetes, … View Profile

    The first step would be weight loss if this is necessary even 5Kg can make a difference.
    Secondly using low fat foods especially those of animal origin.
    Thirdly but equally helpful are the many products now avaialble which contain plant sterols.
    I use these products myself because I also have a familial high cholesterol & they have helped me.

    if you need further information a visit to a Dietitian would be most appropriate. 

  • 15

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    Nicole Senior

    Dietitian, Nutritionist

    I'm an Accredited Practising Dietitian and Nutritionist, consultant, author, speaker and food and health enthusiast. I love talking and writing about food and health.(please note, … View Profile

    Your husband probably has a predisposition toward high cholesterol and needs to take extra care to follow a cholesterol-lowering diet as well as ensuring he stays physically active and maintains regular contact with his doctor as he gets older. Diet is a very powerful tool to lower cholesterol and look after your heart, but he needs more targeted changes rather than just ‘healthy eating’. Here's a summary of strategies with good scientific evidence to back them up:
    1. Eat at least 5 serves of vegetables daily
    2. Enjoy at least 2 serves of fruit daily
    3. Boost the flavour of foods with herbs and spices rather than salt
    4. Ensure at least half your grain foods are wholegrains
    5. Inlcude low GI foods at most meals
    6.Include legumes in at least 2 meals a week
    7. Enjoy 1-2 handfuls of unsalted nuts most days
    8. Enjoy 2 fish meals a week (preferably oily fish)
    9. Enjoy at least 6-8 teaspoons (30-45g) of added healthy oils and spreads daily (eg sunflower, canola, olive)
    10. Include 2g plant sterols daily (this is found in 25g of cholesterol-lowering margarine, or a combination of margarine and plant sterol enriched milk, lite cheese and cream cheese).
    11. Include foods rich in soluble fibre such as oats, barley or psyllium enriched cereals, eggplant, okra - and/or take a soluble fibre supplement
    For more detailed information about putting this into practice as well as delicious recipes check out my book Eat to Beat Cholesterol available in bookshops and online at http://www.greatideas.net.au/advanced_search_result.php?keywords=Eat+to+beat+cholesterol&osCsid=b343aca12386b1245a85f5368ea9dc1c&x=25&y=7
    A visit or three with an Accredited Practising Dietitian is also a good idea in order to set up the right diet for life that suits his (and your) lifestyle and food preferences.

  • 16

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    Samantha Ling

    Dietitian, Nutritionist

    Samantha is an Accredited Practicing Dietitian (APD), consultant and food and nutrition enthusiast. Samantha works in a private practice on the Central Coast, NSW, Rostant … View Profile

    The response rate for this question has been fantastic! Everyone has pretty much summed everything up - like what Nicole explained, increasing your ‘good’ sources of fats is a very good idea, especially in order to increase the amounts of ‘good’ cholesterol.

    In order to reduce your cholesterol levels it may be beneficial to have a general understanding of cholesterol and the role it plays in your body. Generally, there are two types of cholesterol:

    1) Bad Cholesterol (aslo known as LDL-cholesterol) - which is responsible for depositing cholesterol in the walls of your arteries, increasing your risk of high blood pressure and a heart attack.
    2) Good Cholesterol (also known as HDL-cholesterol) - which helps to remove excess cholesterol in your bloodstream and arteries, essentially protecting you against heart disease.

    For these reasons, you want your bad cholesterol to be low and your good cholesterol to be as high as possible. When you had your blood test your doctor would have tested your total cholesterol and both the good and bad cholesterols. The higher your total cholesterol is, the more likely it is that the bad cholesterol is also high, therefore your risk of a heart attack is also increased.

    As Nicole has brilliantly summed up - Lifestyle modification plays an important role in reducing cholesterol levels, such as:
    - Reducing your fat intake (particularly the bad fats known as saturated fat)
      * Swap to low fat dairy products (such as milk, yoghurt, cheese, etc)
      * As cheese is quite high in cholesterol, limit to 1-2 times a week'
      * Trim all visible fat off your meat and remove the skin on chicken
      * Choose lean meat varieties (NOT devon, sausages, frankfurts, salami, liverwurst etc)
      * Limit takeaway to 1-2 times a week
      * Swap butter for margarine
      * Limit the consumption of processed foods, such as biscuits, pastries, pies, sausage rolls, chips/crisps, chocolate etc

    - Increase ‘good fats’ (polyunsaturated and monounsaturated fats) which will help increase your good cholesterol levels
      * Enjoy fish, particularly oily fish such as salmon, tuna, mackeral, sardines etc which are high in good fats at least 2 times a week (alternatively fish oil tablets can be taken - you need 3000mg everyday to get the benefits, which is normally around 3x 1000mg capsules)
      * Use olive oil or canola oil in cooking instead of vegetable oils or butter
      * Try a handful of nuts as a snack instead of crisps etc
      * Look for a breakfast cereal with flaxseed/linseed

    - Increase your fibre intake (fibre competes with cholesterol for digestion)
      * Enjoy 2 serves of fruit everyday (1 serve = 1 apple,1  banana, 1 orange,1 pear, 2 kiwifruit
        etc)
      * Enjoy at least 5 serves of vegetables everyday (1 serve = 1 potato, 1/2 cup cooked
        vegetables, 1 cup salad etc)
      * Swap to wholegrain or wholemeal breads, cereals and pastas where possible
      * Enjoy Oats/Porridge in these colder months (full of beta-glucan which helps reduce
        cholesterol)

    - Increase physical activity (exercise) which will help increase the good cholesterol

    For more information on ways to reduce your cholesterol it may be worthwhile seeing an Accredited Practicing Dietitian. Good luck!

    Samantha Ling
    Rostant Nutrition
    (Find us on facebook @ www.facebook.com/RostantNutrition)

  • 6

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    Dr Amer Gilani

    GP (General Practitioner)

    I am working as a GP for more than 15 years. I have worked in Pakistan, Saudi Arabia and Australia. I can speak English, Urdu, … View Profile

    High Cholestrol at the age of 40 is alarming specially if there is a family history of high cholestrol, high blood pressure and heart problems. Usually it is the life style modification that is first chioce and it realy helps if done properly.

  • psmith01

    HealthShare Member

    can i use canola oil for cooking

  • 12

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    Arlene is a registered practising dietitian, with a private practice in the Eastern Suburbs of Sydney, and has built a strong business over the last … View Profile

    Many people in the civilised world have got high cholesterol. And while your doctor has probably recommended eating better, getting more exercise, and maybe even medication, you may be wondering if there's more you can do. You've heard the old saying that no news is good news? Well, it doesn't apply to cholesterol. Getting it checked on a regular basis is essential to your long-term good health. After all, high cholesterol has been linked to cardiovascular disease, the number one cause of death. Knowing your level, and tracking it as you begin treatment, just makes sense.
    In a nutshell, experts recommend that adults age 20 and over should have their cholesterol checked at least once every five years. You may require more frequent screening if you have certain risk factors for heart disease or if your test results are cause for concern. For those who have cholesterol within the normal range, knocking a few points off their readings can slow fatty buildup in the arteries and possibly reduce any buildup that's already there. The bottom line: In the pursuit of cholesterol control, knowing your numbers is a must.
    Once you've been diagnosed with high cholesterol, your instinct may be to jump right into whatever treatment plan your doctor recommends. Unless your cholesterol has gone through the roof—which may require an immediate intervention—you're better off taking time to think through your situation and your treatment options. By exercising some control up front, you're more likely to develop a cholesterol management plan you can live with.
    A good place to start? Begin with an assessment of your personal risk factors for heart disease beyond high cholesterol. Which ones are within your control? For example, you may not be able to change your age, gender, or family history, but you can improve your eating habits, get more exercise, and quit smoking. These are the sorts of lifestyle changes that should become part of your cholesterol management plan, no matter what other treatments you may choose.
    Likewise, you'll want to learn as much as you can about cholesterol itself. Your body needs cholesterol to perform certain vital functions. In fact, lowering one type of cholesterol, HDL, can be bad for your heart. What's more, while many foods contain dietary cholesterol, most of the blame for elevated cholesterol levels rests squarely on the shoulders of saturated fat and trans fats.
    Of course, you'll also want to educate yourself about the available treatment options. Conventional medicine has much to offer people with high cholesterol—but so do alternative therapies. Before you settle on a specific treatment or combination of treatments (in consultation with your doctor), you should know whether it's effective and safe and how soon you can expect to see results.
    Try drop those extra kilos if you weigh more than you should, slimming down may produce a significant drop in your cholesterol level. Research suggests that being overweight disrupts the normal metabolism of dietary fat. So even though you may be eating less fat, you may not see a difference in your cholesterol profile until you unload the excesskilos.
    In fact, shedding just 2 to 5 kilos may be enough to improve your cholesterol level. Just don't go the crash-dieting route. A slow but steady loss of ½ - 1 kg a week is healthiest and easiest to maintain. Since ½ kilo equals 3,500 calories, you could meet the ½ kg -per-week rate by eating 500 fewer calories per day, burning 500 more calories per day through exercise, or—the best option—a combination of the two.
    Findings from the landmark Framingham Heart Study confirm that such modest weight loss is worth the effort, for reasons beyond cholesterol control. According to the study, taking off—and keeping off—just ½ - 1 kg a year may reduce your risk of high blood pressure by 25% and your risk of diabetes by 35%.
    Incidentally, many of the lifestyle strategies that help rein in unruly cholesterol can also take off unwanted kilos, and vice versa. Be sure to consult your doctor before embarking on any weight loss program.
    Start exercising. Whether your goal is to lower your cholesterol, shed some extra kilos, or both, regular exercise can help you get there. I am not talking about high-intensity workouts, either, though boosting your intensity can elevate HDL cholesterol. Walking and other, more moderate physical activities are good for your heart, too. In fact, one study suggests that walks of any duration may help reduce heart disease risk. For the study, British researchers recruited 56 sedentary people between ages 40 and 66, then divided them into three groups. One group took a long, 20- to 40-minute walk each day; another group walked for 10 to 15 minutes twice a day; and the third group took 5- to 10-minute walks three times a day. Over the 18 weeks of the study, the once-a-day walkers saw their LDL cholesterol drop by 8.3%; the twice-a-day walkers by 5.8%. The researchers concluded that walks of any length can be beneficial, as long as they're done at a moderate intensity—that is, a brisk pace at which you can still carry on a conversation.
    If you're not into walking, any form of aerobic exercise—running, bicycling, swimming, whatever gets your heart pumping—can help lower heart disease risk. Whichever activity you choose, be sure you're doing it for 30 minutes at least 5 days a week.
    If you've been relatively inactive, check with your doctor before launching any exercise regimen. Your doctor may be able to help you choose an activity that suits your current fitness level.
    Get to know good fats as these affect your cholesterol. Peanut butter, avocados, olive and canola oils, and most nuts are high in monounsaturated fat. Research has shown that monounsaturated fat can help lower LDL and triglycerides (another type of blood fat) while raising HDL. It's a much healthier choice than saturated fat, which is found primarily in animal products—meats, butter, full-fat milk and cheese. Saturated fat can elevate your cholesterol level more than anything else you might eat.
    Also included in the good fats category are omega-3 fatty acids, found in abundance in fish such as mackerel, albacore tuna, and salmon. The omega-3s appear to lower levels of VLDL (very low density lipoprotein) and triglycerides. Studies have shown that when people cut back on saturated fat and trans fats (found in manufactured biscuits and cakes) and consumed more fish oil, their LDL dropped. I recommend eating at least 2 servings of baked or grilled fish a week. That said, omega-3s are not a magic bullet. One study showed that when people consumed more fish oil without altering their saturated fat intake, their LDL levels stayed the same or increased. In order to reap the cholesterol-cutting benefits of omega-3s, you need to limit your saturated fat consumption.
    Befriend fibre. It's no secret that in general, vegetarians have lower cholesterol levels and lower heart disease rates than meat eaters. That's in part because vegetarians consume so much fibre, which is found abundantly in plant foods—fruits, vegetables, whole grains, and beans. Fibre comes in two forms: soluble and insoluble. The soluble kind appears to pack the greatest cholesterol-lowering punch. Research has shown that consuming about 15 g of soluble fibre a day can lower LDL cholesterol by 5 to 10%. It works by binding with cholesterol-containing bile acids in the intestines and escorting them out of the body. A specific kind of soluble fibre, pectin, not only lowers cholesterol but also helps curb overeating by slowing the digestive process. Munch on apples and other pectin-rich fruits, and you're likely to eat less, lose weight, and rein in your cholesterol.
    Coincidentally, foods high in fibre tend to be low in saturated fat and cholesterol, as well as calories. Just make sure you don't top your fibre-rich whole grain toast with a huge dollop of butter.

    Prior to going on cholesterol medication make lifestyle changes to ensure whether these are sufficient to lower your cholesterol.

  • 4

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    Erin Miller

    Dietitian, Nutritionist

    Accredited Dietitian and Nutritionist Erin Miller is passionate about health and wellbeing. The Nutrition Network is her home and she opens her doors to assist … View Profile

    Hello,

    By far the best dietary changes you can make are reducing your saturated fat intake from your diet. Saturated fats cause your cholesterol levels to increase and therefore make your blood harder to be transported around your body.
    Overall by reducing your saturated fat content and replacing them with mono or polyunsaturated fats, introduce moderate exercise every day if not second daily and reduce your salt intake.
    Your main sources of saturated fats come from: Take-away, biscuits/pastries, confectionary, visible fat on meats, skin on chicken, processed deli meats and full fat dairy.

    I recommend seeking a local APD to assess your husbands diet and lifestyle and provide specific recommendations to suit him.

    All the best,

    Erin 

  • 3

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    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    I think that the various health professionals who have commented here have offered excellent advice.

    However, there seems to be no convincing scientific evidence that dietary levels of saturated fats are a significant risk factor for coronary heart disease (CHD) and cardiovascular disease (CVD;  CHD inclusive of stroke).

    This comes from a meta-analysis (pooling the results of many studies) - 21 studies were analysed, their subjects were followed for between 5 and 23 years and there were 
    347,747 subjects in total.

    To quote from the Abstract of the paper:

    "
    A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD."

    There is a PDF of the paper here: 
    http://ajcn.nutrition.org/content/early/2010/01/13/ajcn.2009.27725.full.pdf+html

  • 3

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    Mel Haynes

    Nutritionist

    Chef, Scientist and Nutritionist. I specialise culinary nutrition and disease prevention with plant based diets. www.culinetica.com.au View Profile

    There is some excellent evidence that diets which consist mostly of plant based foods is the most effective way to reduce cholesterol and prevent heart disease.(1,2)



    For more info on this you can see:

    http://www.pcrm.org/
    http://www.nutritionfacts.org/   
    http://www.diseaseproof.com/  

    I would also reccomend looking Amla (indian goose berry)  it comes powdered and is cheap and available to indian spice stores.   It has been shown to be very effective at reducing cholesterol. (3)

    1. http://www.sciencedirect.com/science/article/pii/S0002914998007188
    2. http://ajcn.nutrition.org/content/89/5/1588S.short
    3. http://informahealthcare.com/doi/abs/10.3109/09637486.2011.560565

  • 4

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    Stuart Donaldson

    Exercise Physiologist

    Accredited Exercise Physiologist with ESSA providing services to clients in the Hervey Bay region, including entitled DVA clients (Entitled Department of Veterans' Affairs clients may … View Profile

    There are a large number of answers here regarding nutritional modification affecting cholesterol, which it does, but none regarding exercise.

    Exercise (specifically aerobic execise, such as walking) has been shown to improve cholesterol, mostly by increasing HDL (good) cholesterol. HDL helps to reduce the amount of LDL (bad choesterol) in the blood. Your ‘total cholesterol’ may stay the same (or decrease), but your risk ratio (total divided by HDL) will be improved.

    If you are not currently active, start by walking (or doing some other sort of exercise - swimming/cycling) 10-15 minutes per day, gradually increasing this to at least 30 minutes per day (which are the guidelines to be considered ‘sufficiently active for health benefits’) if not 60 minutes per day, every day.

    In addition, making dietary changes as suggested above, attaining a healthy body weight and waist circumference, quitting smoking and reducing alcohol intake will also assist.

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