Cholesterol

Cholesterol blood tests results

Healthy cholesterol levels include:

• a high level of HDL-cholesterol (1 mmol/L or more)

• a low level of LDL-cholesterol

• low total cholesterol.

The amount of cholesterol in your blood is affected by whether you have eaten on the day of a blood test, and what you have eaten. A single screening test (e.g. a blood sample taken after eating) cannot accurately diagnose unhealthy cholesterol levels. If a screening test is abnormal, a doctor may order more tests.

Risk factors for unhealthy cholesterol levels

• Ageing (risk increases for men aged 45 years or older and women aged 55 years or older)
• Family history of heart disease before age 55
• Menopause
• Poorly controlled diabetes
• Excess body weight
• Lack of physical activity
• Poor diet
• Smoking Other factors (e.g. high blood pressure) increase the risk of cardiovascular disease in people with unhealthy cholesterol levels.

Fats in foods

Eating some fats is essential for health, but some fats are healthier than others.

Healthier fats are monounsaturated fats and polyunsaturated fats (including omega-3 fatty acids). Unhealthy fats are saturated fats and trans fats. (The names of these groups describe the chemistry of the fats.). It is more important to aim for a diet that is low in unhealthy fats than to avoid eating cholesterol. For example, eggs can be part of a healthy diet, even though they are high in cholesterol.

Some foods can lower your cholesterol levels. Plant sterols and soluble fibre reduce the amount of cholesterol that is absorbed from your food into your bloodstream. Healthy fats reduce the amount of ‘bad’ cholesterol in the blood.

Fats are high in energy (calories), so eating too much fat – even healthier fats – will make you put on body fat.

Foods that contain healthier fats

• Oils (olive, peanut, canola, safflower, corn, sunflower, cottonseed, peanut, flaxseed)
• Avocados
• Nuts
• Seeds
• Fish (fatty cold-water fish like salmon, mackerel and herring)

Foods that contain unhealthy fats

• High-fat cuts of beef, lamb or pork
• Chicken meat with visible fat or with the skin on
• Full-fat dairy products
• Palm oil
• Coconut oil
• Lard
• Ghee
• Commercially baked or fried foods that contain ‘hydrogenated’ or ‘partially hydrogenated’ oils (e.g. pastries, cookies, doughnuts, cakes, snack foods.

Cholesterol-lowering foods

Foods with added plant sterols (also called phytosterols).

In Australia, plant sterols are added to:

• Margarine spreads

• Breakfast cereals

• Low-fat yoghurts

• Milks

(Note: Plant sterols are not meant to replace cholesterol-lowering medicines. If you are already taking cholesterol lowering medication, you should keep taking it.)

Foods naturally rich in plant sterols:

• Vegetable oils

Foods rich in soluble fibre:

• Oatmeal

• Psyllium husks

• Kidney beans

• Some fruits

Foods rich in omega-3 fatty acids:

• Fatty fish

• Nuts (plain, not covered in chocolate, sugar or salt)

How to reduce your risk of cardiovascular disease

Ask your doctor about your risk. Follow your doctor’s advice, including long-term cholesterol-lowering medicines if these have been prescribed for you. Follow lifestyle advice from the National Heart Foundation of Australia:

• Achieve and maintain a healthy body weight.

• Choose polyunsaturated or monounsaturated oils and margarine spreads instead of saturated fats (e.g. butter).

• Eat plenty of wholegrain bread and cereals, brown rice, wholemeal pasta, vegetables, fruits, legumes (e.g. chick peas, kidney beans and lentils).

• Choose lean meats and poultry.

• Include oily fish in your diet.

• Choose reduced-fat, low-fat or no-fat dairy products.

• Include plant sterol-enriched foods.

• Limit cholesterol-rich foods if your doctor has advised you to.

• Limit alcohol intake to no more than 2 standard drinks per day.

• Do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week.

• Stop smoking

For information and help to quit, ask your pharmacist and/or call the Quitline on 13 QUIT.

Further resources

www.heartfoundation.org.au