How can I lower my cholesterol?

Too much cholesterol in the blood can lead to heart disease and stroke. You can reduce your cholesterol by eating healthful foods, losing weight if you need to and being physically
active. Some people also need to take medicine because changing their diet isn’t enough. Most heart and blood vessel disease is caused by a build up of cholesterol, plaque and other fatty deposits in
artery walls. The arteries that feed the heart can become so clogged that the blood flow is reduced, causing chest pain. If a blood clot forms and blocks the artery, a heart attack can occur. Similarly, if a blood clot blocks an artery leading to or in the brain, a stroke results.

It is important that you make changes to your eating patterns. Focus on low-saturated-fat, trans fat-free, low-cholesterol foods such as these:
• A variety of deeply coloured fruits and vegetables
• A variety of fibre - rich grain products like whole grain bread, cereal, pasta and brown rice.
• Fat-free, 1 percent and low-fat milk products
• Lean meats and poultry without skin
• Fatty fish
• Nuts, seeds, and legumes
• Unsaturated vegetable oils like canola, corn, olive, safflower and soybean oils
What should I limit? Trans fats and saturated fats
• Whole milk, cream and ice cream
• Butter, egg yolks and cheese — and foods made with them
• Organ meats like liver, sweetbreads, kidney and brain
• High-fat processed meats like sausage, bologna, salami and hot dogs
• Fatty meats that aren’t trimmed
• Duck and goose meat (raised for market)
• Bakery goods made with egg yolks, saturated fats and trans fats.
• Saturated oils like coconut oil, palm oil and palm kernel oil
• Solid fats like shortening, partially hydrogenated margarine and lard
• Fried foods
What are some cooking tips?
• Use a rack to drain off fat when you broil, roast or bake.
• Don’t baste with drippings; use wine, fruit juice or marinade.
• Broil or grill instead of pan-frying.
• Cut off all visible fat from meat before cooking, and take all the skin off poultry pieces.
• Use a vegetable oil spray to brown or sauté foods.
• Serve smaller portions of higher-fat dishes, and serve bigger portions of lower-fat dishes like pasta, rice, beans and vegetables.
• Make recipes or egg dishes with egg whites or egg substitutes, not yolks.
• Instead of regular cheese, use low-fat cottage cheese and other fat-free or low-fat, low sodium
cheeses.

To add to the excellent post above, the rule of thumb is to have more foods that come from a vegetable and less foods that come from an animal. Cholesterol is often synonymous with saturated fat, which is animal fat (found in poultry, meat and dairy). Vegetables do not contain much cholesterol, and are high in fiber, which helps to absorb cholesterol in the gut.

Certain seafoods are also high in cholesterol, such as calamari and prawns, so limit these too.

To raise your HDL, or “good cholesterol”, ensure plenty of regular exercise, and ensure that the fats you consume are mainly “good fats” or mono-unsaturated (in fish, avocadoes, nuts, and olive oil).

Your weekly food choices might consist of the following:
small amount of lean red meat once or twice a week
two fish meals a week
at least one vegetarian meal a week
one lean poultry meal once or twice a week

Additionally, it is important to manage any other risk factors for heart disease (ie blood pressure, smoking, and weight).

Very good posts already, thank you.

I also want to raise the awareness that genes play a major role in determining the cholesterol level.

It means there are individuals that eat the recommended foods yet still with elevated cholesterol and individuals that eat the worst type of food possible with remarkably low cholesterol level.

Therefore whilst it is generally encouraged to eat correctly, it is prudent to dicuss with your GP regarding the rationale, pros & cons of other therapies for lowering your cholesterol if lifestyle modification are deemed insufficient.

This may be in the form of prevention of cardiovascular disease (need to take into account family history, smoking and other metabolic disorders such as hypertension, diabetes, obesity). Or for treatment of established cardiovascular disease (such as previous heart attack, stroke, peripheral vascular disease).

Regards,

Dr Kevin Lee

Consultant Physician Endocrinologist

http://www.facebook.com/kevinleeFRACP

http://www.banyoclinic.com.au/dr-kevin-lee-endocrinologist/

Adding to what Dr Lee wrote (which I agree with), there is a class of medications called statins which may be worth considering. The statins work by blocking the action of an enzyme which has an important job in making cholesterol - their effect can be to lower blood cholesterol levels.

The use of statins is controversial but they are an option which may be worth discussing with your GP - as always, ask him/her lots of questions, listen to the answers and, if you are not convinced, get a second opinion from another GP and then make up your own mind.

All the best.