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Having too much cholesterol in your blood can increase your risk of high blood pressure, heart disease and stroke. Most of us know that a healthy diet can reduce the risk – but with so much talk about ‘good fats’ and ‘bad fats’, what exactly is a healthy diet?What is cholesterol?Cholesterol is a substance used to carry fats, such as essential fatty acids, around the bloodstream. It helps the body to create certain hormones and cell membranes and digest fats. Most cholesterol in our blood is made by the liver, from saturated fats in our food. Only a small amount comes from foods that are naturally high in cholesterol, such as egg yolks, prawns and offal.What’s the difference between ‘good’ and ‘bad’ cholesterol?Cholesterol is carried round the bloodstream by two types of protein, known as lipoproteins. One type – low density lipoproteins (LDLs) – are sometimes referred to as ‘bad’ as they can encourage the artery walls to harden and ‘fur up’. This process, called atherosclerosis, is a major factor in high blood pressure, coronary heart disease and stroke. The second type – high density lipoproteins (HDLs) – are often referred to as ‘good’ because they protect against atherosclerosis by transporting LDL cholesterol away from the arteries to the liver for processing.Why is my cholesterol level important?A high level of cholesterol in the bloodstream is linked to a higher risk of coronary heart disease (CHD).It’s not the total blood cholesterol that’s important, but the ratio of LDL to HDL cholesterol. If most cholesterol is present in the HDL form there’s little need to worry – you’re unlikely to have a heart attack. This is because high levels of HDL cholesterol protect against CHD – the molecules are too large to seep into artery walls to fur them up, while LDL cholesterol molecules are small enough to be taken into artery walls where they become trapped and add to the furring-up process.These days, a blood test can show the ratio of LDL to HDL cholesterol and therefore whether you need to tackle your cholesterol level or not.What causes a raised cholesterol level?At one time, people at risk of CHD were advised to avoid cholesterol-rich foods. This is no longer the case as these foods?do not normally have much effect on blood cholesterol levels.?It is much more important to lower your intake of foods high in saturated fat (such as pastries, pies, crisps, chocolate) as these have more effect on cholesterol levels.?What other factors might there be?Some experts now believe that hardening and furring-up of the arteries is not only linked to raised levels of LDL cholesterol, but also to a lack of antioxidants (e.g. vitamins C and E) in the diet.?Antioxidants protect circulating fats from damage which, if not checked, can contribute to the furring-up of arteries. Good sources of antioxidants include fruit, vegetables, green and black tea and red wine (in moderation!)Foods rich in soluble fibre, e.g. oats, pulses, fruit and veg, may also help reduce raised cholesterol levels as fibre prevents some fats and cholesterol from being absorbed into the bloodstream.If you have a family history of atherosclerosis, CHD or high blood cholesterol levels, you may have inherited genes that mean you process saturated fat less well than other people. So it’s important to follow any advice doctors give you about eating less saturated fat.The average adult needs to reduce their saturated fat intake by at least a quarter, but this doesn’t mean cutting out all fats. Some are actually beneficial to your heart and cholesterol level.Are men or women more at risk?The average blood cholesterol level for men and women in the UK is similar and, compared with other countries, quite high. The ‘desirable’ level is less than 5 millimoles per litre (mmol/l). In the UK, the average is 5.5mmol/l. CHD is less of a problem for women before the menopause, as the hormone oestrogen benefits the circulation. However, after the menopause women are just as likely to develop problems due to raised LDL cholesterol as men.Will slimming lower my cholesterol level?Men with a waist circumference larger than 40ins/102cm and women with a waist larger than 35ins/88cm are at a substantial risk of having shortness of breath, high blood pressure, high cholesterol levels and diabetes than those with slimmer waistlines. Even slight waist reductions of 2ins/5cm – 4ins/10cm can significantly reduce your cholesterol levels, and getting down to a healthy weight for your height can significantly reduce the risk of a heart attack.How do cholesterol- reducing foods work?Products such as the Benecol range of spreads and yogurts, and Flora pro.activ spreads, milk and yogurts contain plant substances similar to cholesterol. They work by competing for absorption of dietary cholesterol in the gut without themselves being absorbed. They have a natural cholesterol-lowering action and can reduce raised cholesterol levels by up to 14% when used regularly as part of a healthy balanced diet. You often need to eat two or three servings every day to see the benefits if your cholesterol level is high, and if your diet is healthy and you are not at risk of developing raised blood cholesterol you may not need them.Benecol 63% Fat Spread 7 Syns per 25gBenecol 34% Low Fat Spread 4 Syns per 25gBenecol Cream Cheese Spread 2 Syns per 25gFlora ProActiv Light Spread 4 Syns per 25g100g bottle Flora ProActiv Probiotic Mini Drink 2 SynsProducts made with soya protein also have cholesterol-reducing properties. None of these foods are Free when Food Optimising: count them as you would any spreads, milk or snacks.Other tips to tryExercise is a very good way of lowering a harmfully raised cholesterol level, and of helping to lose weight as fat is burned for fuel. The more exercise you do, the more beneficial the effects.Some people say garlic powder tablets can help to lower high blood pressure, reduce high blood fat levels and thin the blood enough to reduce the risk of heart disease by up to a quarter.Omega-3 fish oils can also have a beneficial effect on blood fat levels and can reduce your risk of a fatal heart attack. Aim to eat one or two servings of oily fish (e.g. fresh tuna, salmon, herrings, sardines and mackerel) per week. If you don’t like oily fish, try taking a fish oil supplement (available in odourless capsules).Would you benefit from cholesterol screening?If you are at risk of raised blood cholesterol levels, your doctor should be happy to check this for you. Those who would benefit from cholesterol screening include anyone who is seriously overweight, has diabetes or high blood pressure. It will check you LDL and HDL Levels - (continued)Other indicators of an increased risk include:a family history of heart disease (especially below the age of 50 years)a family history of blood fat (lipid) disorders. Food Optimising is designed to give you a healthy, balanced diet, and if you follow the eating plan you’ll not only lose weight but will also be following the best advice on eating for a healthy heart.Most fresh fruit and vegetables that are high in vitamins and antioxidant compounds are Free Food – this means they can be eaten whenever you like, and as much as you like!Fibre-rich foods, which slow absorption of dietary fats, are included on the eating plan as Healthy Extra ‘b’ choices. These include wholemeal bread, high-fibre cereals and dried fruits.Olive oil, which can help lower LDL cholesterol and raise HDL cholesterol, is a Healthy Extra ‘b’ choice.Preparing food in the low-fat ways that Food Optimising recommends, and trimming fat off meat, ensures that you are naturally limiting your fat intake.Oily fish that are?high in essential fatty acids, such as fresh tuna, pilchards, sardines, salmon, kippers and mackerel, are all?Free Foods.Polyunsaturated fats (found in vegetable and fish oils) and monosaturated fats (such as olive oil) can have beneficial effects on blood cholesterol by helping lower LDL cholesterol levels if used in place of saturated fats.Foods that can be high in ‘hidden fats’ such as full-fat burgers, sausages and cheese are counted as Syns so are naturally limited when Food Optimising.Foods that contain some hydrogenised vegetable fats (known as ‘trans fats’) are thought to play a part in raising ‘bad’ LDLs and lowering ‘good’ HDLs. Many processed foods contain trans fats, including margarine, cakes, pastries and pies. All of these are counted as Syns so your intake of them will be lower when you are Food Optimising.If you are very overweight, losing 10% of your body weight can help to reduce your blood pressure and improve cholesterol levels significantly, an achievement Slimming World rewards with ‘Club 10’ membership ................
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