Simple steps to lower cholesterol

Has your doctor said you have high cholesterol (called hypercholesterolaemia)? Then you will know you need to change your diet and lifestyle to lower cholesterol and your risk of heart disease. Even if your doctor prescribed a cholesterol-lowering drug to bring levels down, you'll still need to change your diet and become more active for your cardiovascular health. These simple tips can help you maintain healthy cholesterol levels.

Cholesterol, good and bad

Your body needs a small amount of cholesterol to function properly, but we can get too much saturated fat and cholesterol in our diet, both raise levels of LDL 'bad' cholesterol. Too much LDL cholesterol can cause plaque to build up in arteries, leading to heart disease. HDL 'good' cholesterol, on the other hand, helps clear bad cholesterol from your blood. You should lower LDL cholesterol and raise HDL cholesterol, starting with your diet.

Portion control: Give yourself a hand

More people are eating super-sized meals, with portions that are twice the size recommended for good health, and that can contribute to weight gain and high cholesterol. Here's an easy way to practise portion control for a meal: use your hand. One serving of meat or fish is about what fits in the palm of your hand. One serving of fresh fruit is about the size of your fist, and a serving of cooked vegetables, rice or pasta should fit in your cupped hand.

Serve up heart-healthy food

Load your diet with fruit and vegetables, at least 5-a-day', in the words of the government's healthy eating campaign. It will help maintain healthy cholesterol levels. Antioxidants in these foods may provide the benefit, but more research is needed. It may be that when we eat more fruit and veg, we eat less fat. Either way, you'll also help maintain healthy blood pressure and a healthy weight. The British Heart Foundation says there’s evidence that adding plant stanols and sterols in your diet may help achieve healthy cholesterol levels. Some foods are enriched with these, such as spreads and yoghurts.

For heart health, look to the sea

A heart-healthy diet has fish on the menu twice a week. Why? The NHS says "There is evidence that omega-3 fatty acids, primarily those found in oily fish, when eaten as part of a healthy diet, can help maintain a healthy heart and reduce risk of heart disease." Omega-3 fatty acids help lower blood levels of triglycerides, a type of fat in the blood. They may also help slow the growth of plaque in arteries. Choose oily fish, such as salmon, fresh tuna, trout and sardines and avoid fried fish.

Start your day with wholegrains

A bowl of porridge, wholegrain cereal or muesli has benefits that last all day. The fibre and complex carbohydrates in whole grains help you feel fuller for longer, so you’ll be less tempted to overeat at lunch. They may also help reduce LDL 'bad' cholesterol and can be an important part of your weight loss plan. Other examples of whole grains include wild rice, popcorn, brown rice, barley and whole-wheat flour.

Go nuts for cardiovascular health

Need a snack? A handful of nuts is a tasty treat and are high in monounsaturated fat, which studies show has a role in maintaining healthy cholesterol levels. The British Nutrition Foundation says studies show that people who eat about 30g (about an ounce) of nuts a day have a lower risk of heart disease. Nuts are high in fat and calories, so only eat a handful, and make sure they're not covered in salt or chocolate.

Unsaturated fats protect the heart

We all need a little fat in our diet, about 25% to 35% of our daily calories, but the type of fat matters. Unsaturated fats, like those found in olive, rapeseed, sunflower and safflower oils, may help maintain healthy cholesterol levels. Research suggests saturated fats, like those found in butter, palm oil and trans fats raise LDL cholesterol.  Even good fats have calories, so eat in moderation.

More beans, fewer potatoes

You need carbohydrates for energy, but some do your body more good than others. Whole grains, such as brown rice, quinoa, whole-wheat pasta and beans have more fibre and raise sugar levels less. Research shows they may lower the risk of diabetes and high cholesterol. Other carbohydrates, like those found in white bread, white potatoes, white rice and pastries, quickly boost blood sugar and when eaten too much, may increase the risk of obesity.

Move it!

150 minutes of physical activity across a week can help raise HDL cholesterol and may lower LDL cholesterol, although more exercise is even better. It also helps you maintain an ideal weight, reducing your chance of developing clogged arteries. Government guidelines say you can break up the exercise into chunks – for example 30 minutes in one go, five days a week. Adults are advised do some physical activity every day and muscle strengthening activity twice a week.

Walk it off

If you're not used to exercising, or hate the thought of going to a gym, just go for a walk. It's easy, healthy and all you need is a comfy pair of shoes. Aerobic or cardiovascular exercise, such as walking, lowers risk of stroke and heart disease, helps you lose weight and keeps bones strong. If you're just starting out, try a 10-minute walk and gradually build up from there.

Work out without going to the gym

If exercise sounds like a dirty word to you, here's some good news: you can boost your heart health by building physical activity into your day. Any kind of cardiovascular activity counts, gardening, dancing or using the stairs instead of the lift. Even housework can qualify as exercise, as long as you're doing serious cleaning that gets your heart rate up, and not just light dusting.

Take charge of your health

If you have high cholesterol, you and your doctor may have agreed a number of methods to lower cholesterol levels. You may be working on your diet, losing weight, exercising more, and maybe taking cholesterol-lowering drugs. There are other actions you can take, too, to make sure you stay on the right track.

What to do when eating out

If you're eating healthy food at home to keep cholesterol in check, don’t spoil it when you eat out. Restaurant food can be loaded with saturated fat, calories and salt. Even healthy options may come in super-size portions. Try these tips to stay on track:

• Choose baked, steamed and grilled foods, not fried
• Ask for sauces to be kept separate
• Practise portion control, surprise the waiting staff by asking for half your meal to be put in a doggy bag before you start the meal instead of at the end

Look for hidden traps

A close look at nutrition labels is essential for a healthy cholesterol and heart diet. Try these tips:

• Check serving sizes. The nutrition info may look good, but does the package contain two servings instead of one?
• If it says 'whole grain', read the ingredients. Whole wheat or whole grain should be the first one.
• A food with '0 grams cholesterol' could still raise your LDL cholesterol. Saturated fat is the other culprit to watch for.

Don't get stressed

Chronic stress can raise blood pressure, adding to your risk of atherosclerosis, which occurs when plaque from cholesterol builds up in arteries. And research shows that for some people, stress could directly increase cholesterol levels. Reduce your stress levels with relaxation exercises or meditation. Focus on your breathing and take deep, refreshing breaths. You can use this strategy to melt away stress wherever you are.

When losing means winning

Losing weight is one of the best things you can do to fight cardiovascular disease. Being overweight affects the lining of your arteries, making them more prone to collect plaque from cholesterol. Losing weight, especially stomach fat, which is linked to narrowing of the arteries, helps maintain healthy cholesterol levels. Aim to keep your body mass index (BMI) between 18.5 and 24.9.

Follow your doctor's advice

Managing your cholesterol is a lifelong process. See your GP for checkups to keep tabs on your health. Follow your doctor's recommendations on diet, exercise and medication. Working together, you and your doctor can lower your cholesterol levels and keep your heart strong.

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