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Cholesterol
By Gaye Rutherford

While most of us would have been told or read somewhere that high cholesterol is bad for our health, a lot of us might not know what cholesterol is, or what we can do to keep our cholesterol at a healthy level.

About cholesterol
Cholesterol is included under the ‘fats’ umbrella, but unlike most common dietary fats isn’t used as an energy source. Instead it serves a number of very important roles in the body – including being the key building block for some important hormones, for vitamin D (we actually make vitamin D when our skin is exposed to sunlight!), and for the outer surfaces of all the cells in our bodies. We get our cholesterol in two ways – our bodies make it, and it’s also in animal products that we eat. Animal foods that contain a lot of cholesterol include brains, liver, offal, eggs, butter, cream, cheese and meat.

Up to a point our bodies can reduce the amount of cholesterol we make to compensate for increased dietary intakes of cholesterol – but eventually too much fat in the diet leads to a build up of ‘bad’ cholesterol in the blood. The ‘bad’ cholesterol (called LDL cholesterol) causes fatty deposits to build up in blood vessels making it harder for our blood to flow. These fatty deposits can also lead to the formation of scarring and plaques (like scabs) on the inside of our blood vessels. When these plaques form in blood vessels that have a lot of pressure in them or near bends in blood vessels (eg in the heart itself), they are susceptible to being knocked off. If this happens, a clot can suddenly form, blocking off the blood vessel and leading to heart attacks or strokes.

In addition to this ‘bad’ cholesterol we also have a smaller amount of ‘good’ (HDL) cholesterol – this is involved in mopping up some of the bad cholesterol. Your risk of heart disease is increased both by having too much LDL cholesterol and too little HDL cholesterol.

What causes high blood cholesterol?
The main cause of high blood cholesterol is eating high levels of saturated fat. Some of the richest sources of saturated fats in our diets are meats, poultry and full fat dairy foods like butter and cheese, and certain plant fats used extensively in manufactured foods (eg coconut oil and palm oil). Interestingly, diets high in saturated fat increase blood cholesterol levels even if very little cholesterol is found in the diet itself. And as with many aspects of life, there are huge variations in individual responses to dietary cholesterol and saturated fat intakes – some people are able to eat quite high levels without problems, but not others. Your family history is usually a useful indicator – if close family members have high blood cholesterol, you are much more likely to develop high blood cholesterol than someone without a family history of high levels.

Managing your blood cholesterol
The National Heart Foundation has a number of excellent tips for reducing high blood cholesterol levels, or stopping them from rising in the first place. These include:

	Use margarine spreads instead of butter or dairy blends This is because butter and dairy blends are very high in saturated fat. In contrast, margarines are made from oils like canola, sunflower and olive oils that are high in polyunsaturated fats that do not have the detrimental effect on blood cholesterol that saturated fats have. While these polyunsaturated fats are a better choice, remember they are still fats and as such high in kilojoules, so they are best used only in moderation. A new range of margarines has also been produced for persons with high cholesterol levels – these include Meadow Lea’s Logicol® range. Logicol contains plant sterols which reduce the amount of dietary cholesterol absorbed into the bloodstream (more passes out as a waste product). Bear in mind if you are going to try these products that they tend to be quite a lot dearer than regular margarines, and that you need to eat around 2-3 serves of them a day to get the benefit. And they are also not recommended for infants, children, and pregnant or breastfeeding women.
	Choose low or reduced fat milk and yoghurt Like butter, full fat dairy products are also high in saturated fat – but not so the low or reduced fat alternatives. If you do eat full fat cheese and ice cream, try to limit this to twice a week. Soy beverages are another good choice, but try to choose soy products that have added calcium in them (otherwise you may not meet your calcium needs if you are replacing dairy products with soy ones). Just a note for parents – this recommendation to avoid full fat dairy products doesn’t apply to children under the age of two, as up until two years of age babies and toddlers need full fat products for proper growth and development (at least we get to enjoy them for some years of our lives, even if we don’t tend to remember it!).
	Use lean meats Trim any fat from meat and don’t eat the skin off chicken. Fatty meats like sausages and salami are not good choices – instead opt for lean ham, chicken, roast meats or fish.
	Make vegetables and grain-based foods the major part of your meals Vegetables and grain foods like breakfast cereals, breads, pasta and rice are low in saturated fat and stacked full of fibre, vitamins and minerals. Have fun with your meals – try to include as many different coloured vegetables as you can.
	Try to limit take away foods to once a week Those burgers, pies, pizza, pastries and creamy pasta sauces are high in saturated fat, so try to cut back on these if you eat them often – just once a week is a good goal. Thankfully our take-away options are improving – look for takeaways that contain lots of vegies, steamed rice, vegetable-based pasta sauces and salads.

Beyond looking after your diet, the three best things you can do to keep your blood cholesterol down, are to achieve a healthy body weight, be active every day, and stop (or better still don’t start!) smoking. And have your blood cholesterol levels regularly checked by a doctor – don’t wait until your body tells you in not a nice way that your levels are too high.