SOUNDBITESReducing your cholesterol by 1 per cent can lower your risk of heart disease by 2 per cent. This may not sound gigantic, but it's possible for most people to reduce their cholesterol by 5-10 per cent just by eating healthily.
The other option, if your cholesterol is high, is to swallow cholesterol-lowering medication for the rest of your life. Making small but significant changes to the diet is really worth the effort.
As you get older it is advisable to have regular medical check-ups to monitor your blood cholesterol level. A high cholesterol is only one risk factor of many for heart disease but never-the-less it's an important one. Your GP can test you and tell you if it's high but before you panic, clarify with your doctor whether it's your LDL cholesterol or your HDL cholesterol level that's high. Low density lipoprotein (LDL) is the baddie. Problems develop when LDL cholesterol undergoes a chemical process called oxidation and it starts to build up on the artery walls, causing them to narrow.
Conversely, HDL cholesterol (the goodie) removes cholesterol from the circulation, and protects against heart disease. Your goal is to have a low level of LDL and a high level of HDL. The good news is replacing some saturated fat (e.g. butter and cream) with monounsaturated fat (e.g. olive oil) will improve the ratio of good HDL cholesterol to bad LDL cholesterol in your blood.
When your arteries narrow due to the oxidized LDL, the accumulated material forms a hardened plaque. This means that less blood can flow through the artery to the heart and you may get chest pain (angina), particularly during exercise.
Sometimes a large blood clot can form as a result of the plaque rupturing. This can completely stop the blood supply from reaching the heart. This is a heart attack. Blood clots form when the blood cells stick together. Again there are certain foods that can increase or decrease the tendency of these blood cells to stick together e.g. oily fish makes blood cells less sticky.
Some people get very concerned about a few foods that contain large amounts of cholesterol such as eggs, shellfish and liver. However, the cholesterol in these foods does not usually make a great contribution to your blood cholesterol level. In fact, if you have high cholesterol, the key is to focus on reducing the total amount of fat you eat as well as the amount of saturated fat and trans fat you eat.
Fats: Reducing the total amount of fat you eat will reduce the amount of fats in your blood. Replacing some saturated fat (animal fat in butter, cream etc) with a little polyunsaturated fat (vegetable oil such as sunflower and safflower) and monounsaturated fat (such as olive and rapeseed oil, nuts and avocados) will improve the ratio of good HDL cholesterol to bad LDL cholesterol in your blood.
Fish and fish oils: Eating oily fish (such as salmon, trout, fresh tuna, sardines, herring and mackerel) regularly can help to reduce the risk of heart disease and also to improve the chances of survival after a heart attack. We don't know exactly how but it's thought that the protective omega 3 fats in oily fish keep the heartbeat regular, reduce the level of triglycerides (another group of fatty substances) in the blood, and prevent blood clots from forming in the arteries by making the cells less sticky. If you don't eat fish, fortified eggs (such as SuperEggs) may be a useful way of boosting your intake of omega 3 fats. The hens' diet is supplemented with fish oils resulting in the fortified egg. If your cholesterol is high, it's best to stick to three fortified eggs per week.
Soluble fibre: This is a type of fibre found in foods such as oats and cereals made from oats such as porridge, fruits and pulses (peas, beans and lentils). It has been shown to lower the bad LDL cholesterol by reducing the amount of cholesterol absorbed from the intestine.
Fruit and vegetables: Eating at least five portions of fruit and vegetables a day will reduce the risk of heart disease, probably by helping to prevent the oxidation of the bad LDL cholesterol. This prevents plaque from building up on the inside walls of the arteries.
Salt: Reducing the amount of salt you eat will also help keep your blood pressure down. Look out for hidden salt in certain breads, breakfast cereals, processed meats and cheese, dried soups and sauces, salty crisps and nuts. Gradually add less salt to your plate. Use cholesterol-lowering garlic instead to add flavour to meals. Try herbs and spices and ask your GP or practice nurse if Lo-Salt is a suitable alternative for you.
Alcohol: Too much alcohol can damage the heart muscle, increase blood pressure and also lead to weight gain. However, moderate drinking (between one and two units of alcohol a day) can help protect the heart in men aged over 40 and women who have gone through the menopause.
Functional foods: The term "functional foods" is used to describe any food that contains an ingredient that gives the food health-promoting properties over and above its usual nutritional value. The active ingredients in functional margarines (such as Benecol and Flora Pro-Activ) are plant stanol or sterol esters. These are naturally occurring substances found in many grains such as wheat, rye and maize. They have a similar structure to cholesterol and so they compete with it in the gut and inhibit the absorption of cholesterol. These spreads may be helpful for people with raised blood cholesterol levels, if they are used to substitute a standard spread and eaten as part of a healthy diet.
The food we eat plays a vital role in maintaining a healthy heart but there are many other factors that are equally associated with a healthy heart. Factors such as whether we smoke, have high blood pressure and are overweight are vitally important. So, make small manageable changes to stay physically active, lose weight if you are overweight and protect your heart with a healthy, well-balanced diet. Enjoy.
Paula Mee is an independent food and nutrition consultant. She is co-presenter of RTÉ Television's Health Squad programme.