‘Good’ and ‘bad’ cholesterol
Not all cholesterol is the same. Two important types of cholesterol are low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol — they are named after molecules called lipoproteins that carry cholesterol in the blood.
LDL cholesterol is often called ‘bad’ cholesterol because it is the type of cholesterol involved in atherosclerosis. High levels of LDL cholesterol in the blood are linked to heart disease.
On the other hand, HDL cholesterol is known as ‘good’ cholesterol. HDL cholesterol carries cholesterol from the body to the liver for removal. High levels of HDL cholesterol in the blood are associated with a reduced risk of heart disease.
You can achieve a healthier balance of LDL and HDL cholesterol levels through a number of lifestyle changes, including:
- reducing the total amount of fat in your diet;
- replacing saturated fat and trans fat with polyunsaturated or monounsaturated oils;
- avoiding foods that are high in cholesterol;
- choosing foods high in starch and fibre;
- maintaining a healthy weight;
- becoming more physically active; and
- avoiding smoking.
Lowering your total fat intake
Foods high in fat often contain large amounts of saturated fat, and this is a major cause of elevated LDL (‘bad’) cholesterol in the blood. The following are steps towards reducing fat in your diet.
- Always read the labels of food that you are buying to see which are low in fat. Look for the Heart Foundation’s tick of approval, or check the nutrition label.
- Be aware that processed meats such can be very high in saturated fats.
- Choose skim or low-fat milk, as well as reduced-fat cheeses, yoghurts and sour cream.
- Meat products can be high in saturated fat. Eat only moderate portions of meat.
- Remove the skin from poultry, but avoid duck and goose as they are high in fat.
- Bake, grill, steam or microwave food rather than frying it.
- Avoid deep fried takeaway food, pizzas and creamy pasta sauces.
Reducing saturated fat and trans fat intake
It’s advisable to reduce your intake of saturated fat because too much saturated fat in the diet can lead to elevated LDL (‘bad’) cholesterol levels.
If you are taking steps to reduce total fat you will also be well on the way to reducing your intake of saturated fat and trans fat. However, lowering the amount of saturated fat and trans fat in your diet can also be achieved by replacing these fats with polyunsaturated or monounsaturated fats.
- Fish contains polyunsaturated fatty acids, which may help heart health, and for this reason the Heart Foundation recommends that you eat at least 2 (preferably oily) fish meals per week.
- Avoid commercially produced baked goods such as croissants, muffins, pies and pastries, as these can contain hidden saturated fats and trans fats. Alternatively, make your own using polyunsaturated or monounsaturated alternatives.
- You may need to change the type of oil that you use in cooking and food preparation. Palm, palm kernel, and coconut oils contain large amounts of saturated fat, even though they are vegetable oils.
- When shopping, read food labels and avoid foods containing ‘partially hydrogenated vegetable oils’ or ‘hydrogenated oils’, as these are terms for trans fats.
- ‘Good’ vegetable oils that have high quantities of polyunsaturated fat include safflower, sunflower, corn, soybean and sesame, peanut and canola oils. Oils containing monounsaturated fats are also recommended; examples include olive and canola oils.
- A number of margarines are lower in saturated fat and higher in unsaturated fats than butter. The Heart Foundation recommends one to one-and-a-half tablespoons of margarines containing plant sterols per day, as these margarines can help reduce the amount of cholesterol (total and LDL) you absorb. However, you should still take measures to reduce the amount of saturated fat in your diet.
- Margarine and oils made from polyunsaturated fats are also a major source of vitamin E, an important antioxidant that has been shown to prevent oxidation of LDL cholesterol, a key step in the artery-blocking process. However, research to date suggests that taking high-dose vitamin E supplements does not reduce the risk of developing heart disease.
Avoiding dietary cholesterol
Dietary cholesterol is found only in animal products, so one way to avoid it is to eat more plant products instead. If you have high cholesterol levels, or if you have or are at risk of heart disease, the Heart Foundation recommends:
- restricting the amount of organ meats such as brains, liver and kidney in your diet.
- limiting the amount of egg yolks you consume — egg yolks are high in cholesterol. In cooking, whole eggs can be replaced with egg whites or egg substitutes.
However, when it comes to lowering cholesterol levels, reducing the amount of saturated fat you eat is thought to be more important than avoiding the cholesterol-containing foods mentioned above.
Increasing dietary fibre
Try to put more complex carbohydrates (starch and fibre) into your diet as these are low in fat and contain little or no cholesterol.
- Fruits, vegetables and wholegrain cereals are naturally low in fat and calories, but high in starch and fibre.
- Dried beans and peas are an excellent source of fibre and protein that can be used in casseroles, soups, and stews.
Healthy weight
People who are obese are more likely to have high levels of LDL (‘bad’) cholesterol than people who are a healthy weight. (If you’re not sure what category you fit into, use our Body Mass Index (BMI) Calculator)
- Fat is high in calories, so reducing your fat intake will help you to eat fewer calories.
- You can achieve a healthy weight by decreasing the number of calories that you consume and increasing the number of calories that you burn off through physical activity.
- Trimming 500 calories a day (3500 calories a week) through a combination of diet and/or physical activity can help you to lose about 1/2 a kilogram per week.
Physical activity
Physical activity is important to balance levels of LDL (‘bad’) and HDL (‘good’) cholesterol.
- Being active can help increase your HDL (‘good’) cholesterol levels.
- Increasing your physical activity can also help you lose weight, reduce your blood pressure, and improve both your cardiovascular and mental health.
- The Heart Foundation recommends 30 minutes of moderate activity each day. Three 10 minute sessions daily will achieve the same result if you can’t make the time for one session
- Always start any exercise program gradually and build up progressively.
Avoiding smoking
Smoking cigarettes is damaging to your heart and blood vessels. The good news is that quitting smoking can bring your HDL levels back to normal within months and can return your risk of heart disease to that of a non-smoker within a few years.
The Heart Foundation recommends that people with abnormal cholesterol levels should avoid smoking.
