Diet and Cholesterol

Dear Ask The Doctor: I am in my mid 30’s and have a strong family history of high cholesterol. My doctor has told me my cholesterol is on the high side and I should change my diet. What should I change in my diet?

Dear Gary: This is a common question. Dietary changes can have a large impact on your cholesterol in combination with other lifestyle improvements. In order to understand what diet changes are needed, it helps to understand how cholesterol and diet are related.

Cholesterol is essential for the normal functioning of your body. Every cell in your body requires some cholesterol to work properly. Some experts believe that 80% of your cholesterol needs are produced by your liver and 20% of your cholesterol needs comes from your diet. This means any excess cholesterol you eat that your body doesn’t need floats around in the blood and is ready to do damage to your blood vessels.

With this in mind we can modify your diet in 2 ways:

1. Reduce the cholesterol you eat.
2. Reduce things in your diet that your body uses to make cholesterol.

Foods that have high levels of cholesterol include egg yolks, organ meats, shrimp, squid and fatty meats. If you have high levels of cholesterol, these foods should be eaten in moderation. Consult your physician, dietician or national food guide to see how much is the right amount. There are also some foods that help to directly lower cholesterol. These include whole grains, fruits and vegetables, lentils, and certain fish and nuts. It is a good idea to consult your dietician regarding appropriate quantities of each food type for you.
The above changes in selection of foods will affect your levels of cholesterol that are a result of direct dietary intake (20%). An even bigger effect will be realized by understanding what your body uses to make cholesterol.Cholesterol is made by the liver using dietary fat. By adjusting the type of fats you eat, you will have a large impact on your cholesterol levels:

Monounsaturated fats: These have been shown to improve blood cholesterol levels. They're found in olive oil, canola oil, peanut oil, non-hydrogenated margarine, avocados and some nuts such as almonds, pistachios, cashews, pecans and hazelnuts.

Polyunsaturated fats: These fats can lower cholesterol levels. One type of polyunsaturated fat is omega-3, which can help prevent clotting of blood and reducing the risk of stroke. The best sources of omega-3 fat are cold-water fish such as mackerel, sardines, herring, rainbow trout and salmon, as well as canola and soybean oils, omega-3 eggs, flaxseed, walnuts, pecans and pine nuts.

Another type of polyunsaturated fat is omega-6. It helps lower cholesterol, but in large amounts it's thought to have a harmful effect.Eat it in moderation. It is found in safflower, sunflower and corn oils, non-hydrogenated margarine and nuts such as almonds, pecans, brazil nuts and sunflower seeds. It is also in many prepared meals.

Saturated fat: This can raise cholesterol levels Foods high in saturated fat include fatty meats, full-fat dairy products, butter, hard margarines, lard, coconut oil, ghee (clarified butter), vegetable ghee, and palm oil.

Trans fats: Like saturated fat, Trans fat raises cholesterol levels. Try to limit products that list vegetable oil shortening or partially hydrogenated oil in the ingredients. Trans fat is found in partially hydrogenated margarines, deep-fried foods from fast-food outlets (fries, doughnuts), and many packaged crackers, cookies and commercially baked products.

Generally speaking, eat more mono and poly unsaturated fats and eat less saturated and Trans fats. It is best to consult a dietician or your national food guide to see how much of each fat is the right amount for you. A lot depends on your weight, other medical conditions, current cholesterol levels and genetics. Other life style changes such as exercise and smoking cessation will enhance your dietary effects on cholesterol.