Good & bad cholesterol
Q What balance of good and bad cholesterol should I have in my blood?
A The ideal balance is 3.0 mmol/l or less LDL cholesterol and 1.2 mmol/l or more HDL cholesterol. The preferred total is cholesterol level is less than 5mmol/l.
Eating the delicious Mediterranean way
- The Mediterranean diet is not only wonderful in terms of fantastic flavours but it is also based around lots of fresh fruits and vegetables every day (ideally aim for the 5-plus portions). Eat with your eyes so that you include a variety of colours and types to glean a good spectrum of vitamins and bioactives – beneficial substances our hearts love.
- Fat-wise, you’re generally better off with vegetable rather than animal fats (butter, cream, cheese and fatty, poor-quality meats increase LDL). Olive oil is the classic Mediterranean choice, but try rapeseed, hempseed, and avocado and nut oils, such as walnut oil, in dressings. These contain omega fatty acids, which help to reduce your risk of heart disease even further. If you're a real butter fan, then just keep to a little. With cheese, cut the rind off soft cheeses such as Brie or Camembert as this reduces the saturated fat level; serve with something rich in fibre, such as sticks of celery, a crisp English Apple or a thin wholegrain or oat biscuit.
- A piece of lean meat can be pretty low in calories while being extremely satisfying. Lean meat also contains some monounsaturated fats, including the beneficial long-chain omega-3 fatty acids, as well as being a very good supplier of minerals like iron and zinc. A lean meat meal once or twice a week is fine. The poorer-quality fatty cuts need to go, as they can deal you a very hefty dose of LDL-producing saturated fat.
- Have oily fish (sardines, salmon, tuna, mackerel) a couple of times a week. They’re a very good source of omega-3 fatty acids, which, although they don’t have much of a direct impact on either LDL or HDL levels, have benefits that reduce your overall risk of heart disease.
For the rest of your week, go for meals based around chicken, white fish, game, lentils and beans – think of Italian dishes such as Ribollita (a hearty stew made with vegetables, beans and bread). Eat wholegrains such as porridge (which our hearts love in particular, as oats are wonderfully rich in a special type of soluble fibre). If you're not much of a porridge fan, think about Bircher muesli or homemade or shop-bought oat biscuits. Wholemeal bread is another good choice. There are so many different varieties of good bread, from the lighter loaves to the darker Pumpernickel-style breads, which I prefer.
Q Should I eat cholesterol-lowering spreads and drinks?
A You could consider one of the butter-like spreads rich in plant stanols or sterols, which can reduce cholesterol levels. But I have to say I don’t like the taste much, and you do need around 2g of either stanols or sterols each day (equivalent to 3–5 slices of bread spread with one of these margarines) to lower cholesterol by about 10 per cent over time. I don’t recommend my patients use them unless they’re particular fans, as I think it’s far better to look at being more creative with the food you’re eating to achieve your healthy heart goal.
Be salt savvy
- Smoked foods (mackerel, herring, salmon, bacon and ham) are high in salt, so watch how much you eat of these. Make them a treat, not the norm.
- Avoid processed foods, if possible, and check labels for the salt content.
- Swap high-salt (and sugary) breakfast cereals for porridge and natural wholegrains, such as rye or wholegrain bread.
- Use alternative seasonings, such as fresh garlic, black pepper, fresh chilli, fresh herbs and spices and lemon or lime juice.
- Try avoiding all sweet foods other than fresh fruits. Go cold turkey on them all and within 48 to 72 hours, you’ll be through the 'danger zone' and won’t need half as much willpower to resist them.
- Some people find vanilla good for breaking the sweet craving – if you sniff a vanilla pod or bottle of essence, the urge for sweets goes.
- Keep a food and emotions diary for couple of weeks and see if you’re eating more than you need, either through habit or emotional eating.
- Serve yourself less and eat it slowly and you may find your body weight reduces.
Alcohol & heart disease