Controlling your cholesterol

Heart disease remains the country’s biggest killer. However, for many people their risk of developing it can be dramatically reduced or delayed by making some simple lifestyle changes.

As World Heart Day approaches on September 29 and the spotlight is shone on this leading cause of death for men and women it may be a good time to think about how we can look after our hearts.

Many factors contribute to heart disease, such as smoking, eating a poor diet or not taking enough exercise. High cholesterol is a well recognised risk factor for the condition, also.

Cholesterol is something many people are aware of but may not fully understand, says Claire Kerins, a cardiac dietitian with the local heart and stroke charity Croi.

“Cholesterol is a fatty substance, which is essential to the normal functioning of your body,” she explains. “A certain amount is healthy as it forms part of the cell walls and is necessary to make hormones. However, if there is too much cholesterol in the blood it is unable to get rid of it and it is deposited along the walls of arteries, forming atheroma (fatty material ). Over time, a gradual build-up of atheroma can narrow the arteries that supply the heart with blood. This process is called atherosclerosis and may eventually cause symptoms of angina or result in a heart attack or stroke.”

A high level of cholesterol is one of the major risk factors for heart disease. Knowing what your cholesterol levels are is an important first step in reducing your risk of heart disease or stroke.

For the general population:

Total Cholesterol: 5mmol/L or less

LDL - Bad Cholesterol: 3mmol/L or less

HDL - Good Cholesterol: Greater than 1 mmol/L

Triglycerides: Less than 1.7mmol/L

If you have a history of heart disease or stroke or have diabetes, your recommended target levels will be lower:

Total Cholesterol: 4mmol/L or less

LDL - Bad Cholesterol:2mmol/L or less

Eating better

High cholesterol may be caused by the foods we eat or it can be genetic or related to other illnesses, outlines Ms Kerins. Whatever the cause it is important that we take action to bring our cholesterol levels under control. For many people, making changes to their lifestyle, such as eating better, losing weight, and exercising, will be enough to lower cholesterol. Others may require medicines. Often, a combination of these approaches can be the right choice.

How effective are drinks and spreads which claim to lower cholesterol? “Plant stanols or sterols are plant extracts that, when eaten, inhibit the absorption of cholesterol in the gut thus reducing the amount of dietary cholesterol absorbed. Adding just 2g of these to your diet each day can reduce LDL cholesterol by 10 to 15 per cent. You can get this amount from fortified foods such as mini drinks, spreads, milks and yogurts from brands including Benecol®, Flora pro.activ, Danone Danacol or several supermarket own label products.

“For these products to be effective in the long term, you must take the product every day, as per the product guidelines. These work for some people but not for all. Be aware that they are more expensive than normal products so please talk with your doctor, dietician or nurse to determine if these products will be of benefit to you.”

Medication

While some people can reach their target cholesterol levels by making healthy lifestyle changes, others will need to take medication, says Ms Kerins. “In addition, people who have known heart disease, ie, those who have had a heart attack, stroke, bypass surgery or angioplasty, will also need to be on medication to keep their cholesterol normal. If you are on cholesterol lowering medications, you will be taking this medication for life, so do not stop taking it without seeking the advice of your doctor first.”

She recommends that everyone over 40 years should have their cholesterol checked annually. However if you have a family history or other risk factors for heart disease you may want to consult with your GP sooner. In addition, if you know you have high cholesterol you may want to have it checked more frequently, eg, every three months until it reaches target levels.

Effective ways to reduce your blood cholesterol levels include cutting down on saturated fat found in full fat dairy, red-meat and confectionery and increasing your fibre intake by eating plenty of fruit and vegetables and foods such as oats, beans and pulses. Keeping to a healthy weight and shape and being physically active can also help.

Simple steps to reduce your cholesterol

* Change over to low fat dairy, eg, low fat milk, cheese, yoghurt and spreads.

* Reduce your red meat intake to a maximum of three times per week. Choose lean cuts of meat.

* Grill/bake/steam or boil instead of frying.

* Cut down on cakes, crisps, confectionery and other high fat snacks.

* Increase your fruit and vegetable intake - remember frozen vegetables are as good as fresh.

* Switch to wholegrains. Switch to wholegrain bread and cereal and begin to eat more brown rice and wholegrain pasta.

* Snack on nuts. Go for unsalted nuts as a healthy snack. However limit these to one handful per day.

* Try to eat fish - one of which should be oily - twice a week. Examples of oily fish are salmon, trout, herring, mackerel and sardines.

* Aim for at least five sessions of aerobic exercise per week, such as walking, swimming or cycling for at least 30 minutes.

* Drink alcohol in moderation. Try to stay within the recommended weekly limits of 14 units for women and 21 units for men. One unit equals half a pint of beer, one small glass of wine or one single measure of spirits.

* If overweight, try to lose weight. Losing even a small amount can have dramatic effects on your cholesterol levels.

* If you smoke, Stop! Smoking lowers your levels of good cholesterol.

* Try to manage your stress - it is not easy but put some time aside each day to relax.

 

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