The CalorieKing Cholesterol Guide

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Cholesterol. It’s in eggs. It’s in meat. It’s in your bloodstream right now. Should you be concerned or is all the fuss about nothing?

Well, if your plan is to be healthy, strong and independent, even in your latter years, it’s wise to understand how your cholesterol level affects your health.

What is cholesterol?

The word “cholesterol” can refer to two different things:

  • Dietary cholesterol, which is the cholesterol contained in food.
  • Blood cholesterol, which is referred to when you talk about “cholesterol levels” in your body. Blood cholesterol is a natural fat produced by your liver and found throughout your body. It is a soft, white, waxy substance.

Though often thought of in negative terms, cholesterol is very important to your overall health. For example, cholesterol is used to maintain healthy cell walls, and to make hormones, vitamin D, and bile acids.

The problem with cholesterol

The problem with cholesterol is that your liver already makes around 1000 mg of it per day, which is almost all your body needs to maintain these vital functions. So, due to a combination of dietary, lifestyle and genetic factors, many Australians have an excess blood-cholesterol level.

A high blood-cholesterol level increases the risk of atherosclerosis – the thickening of arteries that can reduce or block blood flow to the heart, brain, eyes, kidneys, sex organs and other body parts. This in turn increases the risk of heart attack, stroke, blindness, kidney failure, impotence and other blood circulatory problems.

According to the Australian Institute of Health and Welfare, there are two different types of blood cholesterol:

  • Low-density lipoprotein (LDL), often referred to as “bad” cholesterol. High levels of LDL cholesterol are the main way that cholesterol contributes to atherosclerosis.
  • High-density lipoprotein (HDL), also called “good” cholesterol. High levels of HDL have a protective effect against heart disease by helping to reduce atherosclerosis.

Triglyceride is another form of fat that is made by the body. Its levels can fluctuate according to dietary fat intake and under some conditions excess levels may contribute to atherosclerosis. Excessive triglyceride levels can also lead to pancreatitis – inflammation of the pancreas, which is very serious.

What makes blood-cholesterol levels unhealthy?

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Saturated fat

Although dietary cholesterol increases the overall amount of cholesterol in your blood, saturated fat is the main contributor to a high LDL blood-cholesterol level. When you eat saturated fats you stimulate the production of LDL cholesterol in your body, which raises your blood-cholesterol level.

Saturated fat is found in animal foods (beef, pork, lamb, dairy foods), tropical oils (palm, palm kernel, and coconut,and in hydrogenated vegetable oils and is listed on all nutrition information panels.

Trans  fat

Trans fat causes increases in LDL cholesterol and triglyceride levels and a reduction in HDL cholesterol, making it something best avoided.

Although trans fats have gained a lot of attention in the media lately, the Heart Foundation says that Australians consume more saturated fat than they do trans fats. Therefore, saturated fat intake has a greater overall impact on our health. CalorieKing advises members to restrict their intake of saturated and trans fats to less than 10 per cent of their daily calories.

Trans fat can be found in processed foods made with partially hydrogenated vegetable oils such as vegetable shortenings (Copha, Kremelta), crackers, commercial cakes and biscuits, snack foods, and fried foods.

In the past, some margarine-style spreads were high in trans fats. This is no longer the case in Australia and some spreads now have no trans fat at all.

There is currently no legal requirement for trans fat to be listed on a product’s nutrition information panel. So, to find out if a product contains trans fat, look for  “partially hydrogenated vegetable oils” or “hydrogenated oils” listed in the ingredients section of the pack.

Dietary cholesterol

Dietary cholesterol is any cholesterol obtained through your diet and not produced by your liver. Although dietary cholesterol increases the level of LDL cholesterol and the overall amount of cholesterol in your blood, it does not contribute as significantly to a high blood-cholesterol level as saturated and trans fats do. The Heart Foundation does, however, advise that there is some evidence that “dietary cholesterol contributes to the development of coronary heart disease”.

Dietary cholesterol is found primarily in animal-based foods such as eggs, dairy products, meat, poultry, fish (although fish contains much less cholesterol than other animal products), shellfish, liver, kidney, sweetbread, and brains.

Genetic predisposition

Unfortunately, for some people, a strong genetic predisposition means their blood-cholesterol level is always fairly high. Such people must take extra care to minimise the amount of cholesterol and saturated fat in their diets. Of course, the opposite is also true; some people who eat high-fat and high-cholesterol diets still have low blood-cholesterol. Such people need to watch their fat intake for other health reasons.

When to have your blood-cholesterol levels checked

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If you are over 45 years old or are at high risk of coronary heart disease, it’s recommended you visit your doctor to arrange for a cholesterol test.

The test most people take is a fasting blood-test called a lipoprotein profile. This test measures total cholesterol, LDL and HDL cholesterol, triglyceride levels and glucose levels.

If, after reviewing your cholesterol test results, your doctor believes your cholesterol and triglyceride levels are not optimal, he/she will discuss treatment options with you. In most cases, this will mean dietary and lifestyle changes, as detailed below. If your triglyceride levels are high, you will be advised to limit your alcohol consumption, as alcohol is very effective at raising triglyceride levels.

If you have coronary heart disease and have already been hospitalised with heart problems, in addition to dietary and lifestyle changes, the doctor may also recommend you start on medication.

How to lower your LDL cholesterol level

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The Heart Foundation advises that any lowering of a person’s total cholesterol and LDL cholesterol levels is beneficial to their health. You can lower your LDL cholesterol level in the following ways:

Through your diet

  • Reduce saturated and trans fat intake to no more than ten percent of your calories.
  • If you are at low coronary risk it is ok to eat a moderate amount of cholesterol-rich food but if your doctor advises your total cholesterol level is higher than five or you have other risk factors for coronary heart disease, you should restrict the quantity of cholesterol-rich food you eat.
  • Choose to eat polyunsaturated and monounsaturated fats instead of saturated and trans fats.
  • Use margarine-style spreads instead of butter or dairy blends. Look for spreads which have less than one per cent trans fat and that are also low in saturated fat.
  • Some spreads are enriched with plant sterols, which have been shown to lower cholesterol levels. However, you need to eat about a tablespoon of these spreads per day for three weeks to see a 10 per cent reduction in your LDL cholesterol level. Also, as plant sterols lower the amount of vitamin A in your blood, it is advisable to add an extra serve of yellow or orange fruit or vegetables to your daily diet to counteract this effect. For more information about plant sterols,click on the references at the end of this article.
  • When choosing meat, opt for lean cuts, trimmed of all visible fat and buy skinless chicken.
  • Have fish at least twice a week.
  • Choose low-fat dairy products and limit cheese and ice cream to no more than twice a week.
  • Trans fats are found in many fast foods, fried foods, pies, pastries, and commercial cakes and biscuits, so avoid these foods.
  • Get into the habit of always reading food labels. Companies will attempt to hide bad fats by using clever marketing. For example, the package may say “cholesterol free” but the product may have high amounts of saturated or trans fats.
  • Make sure you are eating enough carbohydrates (40-60 percent of your calories should come from carbohydrates) as they can help to lower your LDL cholesterol level.
  • Eat high-fibre foods such as wholegrain cereals, breads, and rice, fruits and vegetables, and legumes. Fibre, especially soluble fibre, can help lower cholesterol by pushing it out of your body before it reaches the bloodstream.
  • Eat plenty of fruits and vegetables. These contain vitamin E, vitamin C, beta-carotene and antioxidants which all help prevent cholesterol from moving out of the bloodstream and into the lining of the blood vessels.

With regular exercise

The other most effective way to lower your cholesterol levels is through exercise. CalorieKing recommends members get at least 150 minutes of exercise per week. Put another way, it is useful for your overall health to do thirty minutes of exercise on most days of the week. Why not use your daily 10-15 minute breaks at work to take a stroll around neighbouring streets or take out ten minutes of your lunch time and do the same.

By quitting smoking

Smoking contributes to atherosclerosis and puts you at greater risk for heart disease. Quitting smoking is not an easy thing to do, but for the sake of cholesterol levels, blood pressure, and lung and heart health, it’s well worth it. Talk to your doctor about support programs and nicotine replacements to help you in the quitting process.

With medication

Occasionally, medication is required when cholesterol reaches extremely high levels. However, lifestyle changes are still equally important even when taking medication. Make sure you talk to your doctor about the risks involved with taking cholesterol-reducing medications, particularly if you plan to become pregnant. Also be aware that compounds in grapefruit can interfere with some cholesterol medications, so ask your pharmacist for advice when taking any medications.

Cholesterol Mini-Counter

Cholesterol is found only in foods of animal origin. Plant foods contain no cholesterol.

Cholesterol

(mg)

Yoghurt: 200g tub 10
Cheese: Cheddar, 30g, 1 thick slice

Cheddar, reduced-fat, 30g,1 thick slice

30

8

Ice Cream: 1 regular scoop, 50g

Soft serve, 1 serving, 100g

16

91

Eggs (chicken), 1 extra large, 56g

1 medium, 44g

238

187

Fats: Butter, 1 Tbsp

Cream, whipped, 1 heaped Tbsp

Margarine spreads, regular, 1 Tbsp

46

21

0

Meat: Steak, fillet, lean, grilled, 100g

Chicken, breast quarter, rotisseried

82

75

Fish: Canned, Tuna in brine, 100g

Crayfish, cooked, 100g

Prawns, shelled, boiled, 1 cup,100g

43

116

250

Offal: Brains (Lamb), simmered, 100g

Kidneys (Lamb), simmered, 100g

1890

550

Fruit, Vegetables, Avocado, Nuts, Seeds, Grains 0

References :

This article was compiled in consultation with Calorie King experts and in reference to the following sources:

Australian Institute of Health and Welfare, ‘Australia’s Health 2006,’  www.aihw.gov.au/publications

Heart Foundation, ‘Trans Fats, Frequently Asked Questions, September 2007,’ www.heartfoundation.org.au

Heart Foundation, ‘Dietary Fats Position Statement (1999),’ www.heartfoundation.org.au

Heart Foundation, ‘Lipid Management Guidelines 2001 – Summary Paper,’ www.heartfoundation.org.au

_’Fats – butter or margarine?’ Better Health Channel, www.betterhealth.vic.gov.au

_’A Good Spread,’ Choice, January/February 2005, www.choiceextra.com.au/images/pdfs/0501Spreads.pdf

Heart Foundation, ‘Position Statement Phytosterol/stanol-enriched foods’ www.heartfoundation.org.au

Calorie King
CalorieKing's mission is to provide the best information, tools and education to Australians to help them conquer their weight.

CalorieKing is the brainchild of Allan Borushek, registered dietitian, co-found here at food.com.au and author of "Allan Borushek's Pocket Calorie & Fat Counter", Australia's best-selling calorie counter for over 30 years.

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