‘It’s about what you’re not eat­ing’

You can re­duce choles­terol lev­els by 30pc just by chang­ing your diet, writes di­eti­cian Orla Walsh

Irish Independent - Health & Living - - CHOLESTEROL SPECIAL -

HIGH choles­terol is one of the risk fac­tors for heart disease — and di­etary changes have been shown to be very ef­fec­tive at re­duc­ing lev­els of this fat. In fact, most peo­ple could ex­pect a 30pc re­duc­tion in their choles­terol lev­els by mak­ing a few changes.

For some peo­ple, the im­prove­ments are even greater. With a choles­terol-low­er­ing diet, it’s about adding in choles­terol-low­er­ing foods to your diet rather than re­mov­ing choles­terol-in­creas­ing foods. Or, to put it an­other way, it’s about what you’re not eat­ing. For ex­am­ple, in­creas­ing plant stanols/ sterols, tree nuts, plant fi­bres and soya pro­tein could re­duce your choles­terol by a whop­ping 33pc.

There is ev­i­dence that the fol­low­ing food com­po­nents lower choles­terol by:

• Plant sterols/stanols: 7pc-10pc

• Tree nuts: 3pc

• Plant fi­bres: 5pc-10pc

• Soya pro­tein: 3pc-10pc

One area of con­fu­sion that has many peo­ple stumped is sat­u­rated fat. Once con­sid­ered a ‘bad fat’, it now ap­pears that this sort of state­ment is not only un­help­ful, but may even be in­ac­cu­rate. The thing is that sat­u­rated fat is merely an um­brella term for a group of fats. There are lots of dif­fer­ent fats fall­ing un­der this sat­u­rated fat cat­e­gory, and it would be wrong to la­bel them all as ‘bad’.

It’s im­por­tant to stress the point that nu­tri­tional science is evolv­ing, with new dis­cov­er­ies be­ing made all the time. There­fore it would be more ac­cu­rate to de­liver each piece of nu­tri­tional in­for­ma­tion with the tag line “based on the most cur­rent ev­i­dence”.

In the past, re­search has fo­cused on the im­pact of in­di­vid­ual nu­tri­ents on mark­ers of health. The prob­lem with this is that we don’t eat in­di­vid­ual nu­tri­ents — we eat food. For in­stance, we don’t eat vi­ta­min C, we eat or­anges. We don’t eat se­le­nium, we eat Brazil nuts. Or, in this in­ci­dence, we don’t eat sat­u­rated fat, we eat foods that con­tain sat­u­rated fat, in­clud­ing milk, yo­ghurt, cheese and but­ter.

What has come to the at­ten­tion of re­searchers is that the ‘food ma­trix’ mat­ters. Foods are more than just ve­hi­cles that de­liver par­tic­u­lar nu­tri­ents to the body. They are a pack­age of nu­tri­ents which in­ter­act or act to­gether to in­flu­ence our body and health.

It also mat­ters when we eat food, and what we eat with it. Where nu­tri­tional science is now head­ing, it is look­ing at how these par­tic­u­lar foods af­fect our body, rather than the im­pact that the in­di­vid­ual nu­tri­ents that they con­tain may have on our body.

This is a much more ap­pli­ca­ble ap­proach than over-fo­cus­ing on sin­gle spe­cific nu­tri­ents. It also ac­knowl­edges the over­all nu­tri­tional value and health ef­fect of the food within a healthy diet. This may min­imise the mis­un­der­stand­ings within nu­tri­tional science and help curb the nu­tri­tional myths that the gen­eral pub­lic are plagued with.

Since do­ing this, some in­cred­i­bly in­ter­est­ing dis­cov­er­ies have been made. For in­stance, re­cent re­search sug­gests that not all sat­u­rated fats have the same ef­fect on heart health. Sat­u­rated fats found in dairy fat may even re­duce the risk of heart disease.

For ex­am­ple, cheese is a nu­tri­tious food which pro­vides the body with cal­cium, phos­pho­rus, vi­ta­min B12, pro­tein, vi­ta­min A and zinc. Cheese also con­tains sat­u­rated fat and salt, which means that it shouldn’t be good for us and should raise our choles­terol lev­els and risk of heart disease. How­ever, this ap­pears to not be the case.

A sci­en­tific pa­per was pub­lished in 2017 de­tail­ing re­search con­ducted in Uni­ver­sity Col­lege Dublin, which looked at the pat­terns of dairy food in­take, body com­po­si­tion and mark­ers of meta­bolic health in Ire­land. The crux of it was that Ir­ish peo­ple who ate a lot of cheese did not have higher choles­terol lev­els than those who didn’t.

Those who ate large amounts of cheese con­sumed higher amounts of sat­u­rated fats. How­ever, the re­searchers found that those eat­ing large amounts of cheese did not have higher blood lev­els of LDL ‘bad’ choles­terol. In­ter­est­ingly, the sci­en­tists also found that higher dairy in­take was as­so­ci­ated with lower body mass in­dex (BMI), lower per­cent­age body fat, lower waist cir­cum­fer­ence and lower blood pres­sure.

These are all pos­i­tive as­so­ci­a­tions which are likely to have mean­ing­ful re­sults on the risk of heart disease. The other in­ter­est­ing thing that they no­ticed was that the peo­ple who reg­u­larly con­sumed low-fat milk and yo­ghurt tended to have higher in­takes of car­bo­hy­drates and that this ‘low fat’ di­etary pat­tern group had greater LDL ‘bad’ choles­terol lev­els.

There­fore, con­sid­er­ing all of this, if you’re con­cerned with your blood choles­terol lev­els, make changes to your diet. It can make a huge dif­fer­ence. Fo­cus on adding choles­terol low­er­ing foods into your diet, rather than re­mov­ing foods. The risk is to do with what you’re not eat­ing.

It might be bet­ter to stick to the orig­i­nal ver­sions of foods, rather than eat the adapted ver­sions. Per­haps na­ture is de­liv­er­ing us the food we should eat, as we should eat it.

There are lots of dif­fer­ent types of sat­u­rated fat, and it would be wrong to la­bel them all as ‘bad’ fats

Nuts are a nat­u­ral way of low­er­ing choles­terol; (below), cheese con­tains sat­u­rated fat but is still good for heart health

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