Chang­ing be­hav­iour can avoid life-long choles­terol med­i­ca­tion

The Weekend Australian - Travel - - Health - SHARON NA­TOLI

WHEN di­ag­nosed with high blood­c­holes­terol lev­els, pa­tients need the chance to mod­ify their lifestyle be­fore be­ing pre­scribed choles­terol-low­er­ing med­i­ca­tions, ac­cord­ing to the re­sults of a study pub­lished in the Au­gust is­sue of the Mayo Clinic Pro­ceed­ings (2007;82(8):951-7).

Re­searchers found some pa­tients were placed on med­i­ca­tion be­fore they’d had the chance to try lifestyle changes, with some say­ing they would def­i­nitely have pre­ferred the op­por­tu­nity to make changes to diet and ex­er­cise habits. As a re­sult of the find­ings, the re­searchers rec­om­mended more GPs con­sider sug­gest­ing lifestyle changes be­fore pre­scrib­ing choles­terol-low­er­ing med­i­ca­tion.

To qual­ify for choles­terol-low­er­ing med­i­ca­tion through the Phar­ma­ceu­ti­cal Ben­e­fits Scheme in Aus­tralia, pa­tients not clas­si­fied as fit­ting into high-risk cat­e­gories are re­quired to un­dergo six weeks of di­etary ther­apy and lifestyle change be­fore be­ing pre­scribed drugs.

This is con­sid­ered an ap­pro­pri­ate pe­riod in which GPs can as­sess whether a per­son is able to change their lifestyle, and whether th­ese changes will have an im­pact for them in­di­vid­u­ally. We see many clients highly mo­ti­vated to change and im­prove their choles­terol level in or­der to avoid med­i­ca­tion life-long. This six-week pe­riod is cru­cial.

A sig­nif­i­cant body of ev­i­dence demon­strates the con­sid­er­able im­pact di­etary changes can have on a per­son’s choles­terol level. Re­search by a group in Canada pub­lished in the Amer­i­canJour­nalofClin­i­cal Nu­tri­tion shows that by com­bin­ing key di­etary rec­om­men­da­tions made for choles­terol low­er­ing, an in­di­vid­ual can re­duce blood choles­terol lev­els by up to 30 per cent — a sim­i­lar re­sult to statin med­i­ca­tion (2005;81(2):380-7).

Fac­tors re­quired dif­fer­ence are:

Eat less sat­u­rated and trans fats — high amounts of th­ese fats are found in deep-fried take­away foods, cakes, bis­cuits, pas­tries, fatty meats and full-cream dairy prod­ucts.

In­clude small amounts of foods rich in un­sat­u­rated fats — ap­pro­pri­ate choices in-

to make this


of clude avo­cado, nuts, seeds, olive, veg­etable and seed oils.

Eat foods that con­tain plant sterols — th­ese in­clude cer­tain mar­garine spreads, milks and yo­ghurts that have high lev­els of plant sterols added. Aim for 2-3 serves of th­ese foods a day.

Eat more sol­u­ble fi­bre — found in oats, psyl­lium, legumes, stone fruits, ber­ries, beet­root and whole­grains.

In­clude plant sources of omega-3 fats — found in flaxseed, lin­seed, canola oil and wal­nuts.

Eat a hand­ful of raw or dry roasted nuts five times a week.

In­clude soy foods reg­u­larly — ap­pro­pri­ate choices in­clude soy milk, soy yo­ghurt, tofu, tem­peh and soy beans.

Other as­pects of lifestyle that can also make a sig­nif­i­cant dif­fer­ence to choles­terol lev­els in­clude los­ing weight if you are over­weight, giv­ing up smok­ing, keep­ing ac­tive and man­ag­ing stress.

If you’ve been di­ag­nosed with high choles­terol, dis­cuss with your GP the pos­si­bil­ity of a six-week trial to change your diet, im­prove lifestyle and re­duce your level be­fore com­menc­ing choles­terol-low­er­ing med­i­ca­tion.

The mag­ni­tude of dif­fer­ence di­etary changes can make is of­ten un­der-es­ti­mated, and if you’re a mo­ti­vated in­di­vid­ual who is com­mit­ted to long-term lifestyle changes, you may be sur­prised to see just what a dif­fer­ence diet can make to your health. Sharon Na­toli is an ac­cred­ited di­eti­tian and di­rec­tor of Food & Nu­tri­tion Aus­tralia

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