What is Cholesterol?

There are two main types of cholesterol. LDL cholesterol is known as “bad cholesterol” and can increase the risk of heart disease. Too much LDL cholesterol can lead to a build up of plaque in your arteries. HDL cholesterol, “good cholesterol”, helps remove LDL cholesterol from your arteries.

To improve your heart health, aim to raise HDL (good cholesterol) and lower LDL (bad cholesterol).

Sources of Cholesterol

Some cholesterol is made by your body, in your liver and circulates in your blood. Dietary cholesterol comes from some of the foods you eat. It is found in animal foods like meat, poultry, milk products, eggs and seafood. By reducing your intake of saturated and trans fat, you can lower your dietary intake of cholesterol as well.

Ways to increase HDL cholesterol:

• Avoid foods with trans fats
• Consume sources of omega-3 fats daily
• Eat small amounts of healthy fats daily
• Moderate alcohol intake
• Exercise for 150 minutes per week
• Maintain a healthy body weight

Ways to decrease LDL cholesterol:

• Limit your red meat intake
• Avoid foods with trans fats
• Increase your intake of soluble fibre - aim for 10g /day
• Choose lower fat dairy products
• Choose lean meats and skinless poultry
• Include soy foods in your diet - aim for 30g /day
• Include healthy fats in your diet, approximately 2-3 tbsp of unsaturated fats per day
• Maintain a healthy body weight - reducing your weight by even 5% can reduce cholesterol

What are triglycerides?

Triglycerides are a type of fat found in your blood that are affected by what you eat and drink. Your body uses alcohol, extra calories or sugar to produce triglycerides.

Ways to decrease triglycerides:

• Increase your intake of omega-3 fats from fish sources such as salmon, mackerel and trout
• Limit sugar and sweets
• Limit alcohol intake
• Select foods that are lower in saturated and trans fats
• Eat balanced meals every 4 to 6 hours
• Eat whole fruits instead of drinking juice

Types of Fats

Monounsaturated Fat: a healthy fat found naturally in olive and canola oil, non-hydrogenated margarines, avocados and nuts

Polyunsaturated Fat: a healthy fat that includes omega-3 and omega-6 fats

• Types of omega-3 fats:
• ALA (alpha-linolenic acid) - sources include flax seeds, walnuts, soy products, omega-3 enriched products (eggs, milk, margarine), canola oil and soybean oil
• EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) - sources include mackerel, anchovies, salmon, trout, sardines and herring
• Omega-6 fats are found in vegetable oils (corn oil, safflower oil, sunflower oil) as well as nuts and seeds such as almonds, pecans, sunflower seeds and sesame seeds

Saturated Fat: an unhealthy fat that is naturally found in foods from animals such as fatty cuts of meat, the skin on poultry and higher fat milk products, as well as tropical oils such as coconut oil and palm kernel oil

Trans Fat: an unhealthy fat that is manufactured and is often found in commercial baked goods, hydrogenated oils, fried foods and processed foods. Trans fat naturally found in foods is different than manufactured trans fat and does not increase your risk of heart disease.

Important Nutrients and Foods to Manage Cholesterol

Heart healthy eating can help improve your cholesterol levels and reduce your risk of heart disease.

Eat a diet rich in:

1) Fibre and whole grains

• Aim to eat at least half of your grain products as whole grains (e.g. rolled oats, barley, brown rice, quinoa and whole grain breads)
• Aim to eat 25g-35g of fibre per day from foods that contain soluble and insoluble fibre
• Be sure to drink plenty of fluids (8-10 cups per day) when increasing your fibre intake
• Increasing soluble fibre in your diet can help to lower the risk of heart disease by reducing bad cholesterol levels, including:
• Legumes such as dried or canned beans, peas, lentils
• Whole grains such as oat bran and barley, cereal with psyllium fibre, oatmeal
• Fresh fruits such as citrus fruits, apples, apricots, pears, prunes, strawberries
• Vegetables such as artichokes, broccoli, Brussels sprouts, carrots, corn, squash

2) Vegetables and fruit

• Eat plenty of vegetables and 3-4 servings of fruit daily

Include sources of unsaturated fats

• Monounsaturated and polyunsaturated fats are types of heart healthy fats that should be included in your diet
• Foods that have unsaturated fats include: olive, canola, soybean, peanut and other vegetable oils, soft non-hydrogenated margarines, nuts and seeds, avocados, fatty fish such as mackerel, herring, trout, salmon and sardines
• Include omega-3 fats - a type of polyunsaturated fat found in fatty fish, flaxseed, walnuts, soybean oil and canola oil

Limit saturated fat and trans fat

• Limit your intake of foods that contain saturated and trans fat as these fats can raise your bad cholesterol and trans fat can also decrease your good cholesterol
• Saturated fat is found in: high fat processed meats (such as sausages, bologna, salami and hot dogs), fatty meats (such as prime rib and regular ground beef), full fat dairy products (such as whole milk and high fat cheese), cream, butter, lard, palm oil and palm kernel oil
• Trans fat is found in: shortening, commercial baked goods, fast foods, fried foods, partially hydrogenated oils and frozen prepared foods such as meat pies and pizza
• The cholesterol in food can raise the body’s cholesterol levels in some people but saturated fat and trans fat have a larger impact on cholesterol levels in your body compared to cholesterol in food

Limit red meat

• Aim to limit red meat intake to less than twice a week, no more than 4 oz (120g) per serving

Nutrition Tips to Manage Cholesterol

• Replace saturated fats with unsaturated fats and not with foods high in sugar
• Include small amounts of vegetable-based fats or unsaturated fats such as:
• canola, safflower, sunflower, soybean, peanut and olive oil
• unsalted nuts and natural nut butters (such as peanut butter, almond butter)
• soft, non-hydrogenated margarine made from unsaturated oils
• avocado
• Aim to eat fish at least twice per week
• Include more plant-based foods in your diet, such as beans and soy foods, in place of meat and/or hight fat dairy for protein
• Include foods that contain plant sterols which are found in nuts, whole grains, fruits and vegetables as well as foods with added plant sterols such as certain yogurts and margarines

At Home

• Prepare foods using healthy cooking methods: baking, steaming, roasting, broiling, grilling and stir frying in small amounts of unsaturated oil or fat
• Place sauces and dressing on the side
• Snack on whole fruit or chopped vegetables instead of candies, chocolate, store bought cookies, cakes, pastries, donuts, pies or ice cream
• Include vegetables and fruit at each meal and leave the skin on for added fibre

At the Grocery Store

• Compare food labels and select foods high in fibre and low in saturated fat, trans fat and sodium
• Choose whole grains such as quinoa, rolled oats, brown rice, barley and bulgur
• For packaged foods, look for products with the words ‘whole grain’ listed as the first ingredient in the label’s ingredient list
• Buy vegetable protein foods such as beans (black beans, kidney beans), chickpeas, lentils and tofu
• Buy different types of fatty fish such as salmon, tuna, mackerel and sardines
• Try to select individual foods that provide less than 0.2g of trans fat per serving
• Look for products that are high in fibre such as bread with at least 2g of fibre per serving and cereals that contain at least 5g of fibre per serving
• Avoid foods that contain hydrogenated or partially hydrogenated fat in their ingredient list

Speak to our pharmacist for more information on managing your cholesterol.

Understanding Nutrition Labelling

When reading a nutrition label, consider the following:

• Look at the reference serving size on the package (under the Nutrition Facts title) and calculate the amount of any nutrient on the label (e.g. saturated fat, fibre) by comparing it to the amount you are actually eating.
• Example: If you look on a nutrition label and the reference serving size is ½ cup and the label indicates it contains 2g of saturated fat, eating 1 cup will mean you consume 4g of saturated fat (2g per serving x 2 servings).
• % Daily Value (% DV) classifies nutrients on a scale from 0% to 100% and tells you if there is a little (5% DV or less) or a lot of a nutrient (15% DV or more) in one serving of a packaged food. You can also use this percentage to compare the nutrient content of different foods.
• Choose products with higher % DV of fibre.
• Choose products with lower % DV of sodium, saturated fat and trans fat.
• Recommendations for total fat intake are about 40g to 90g per day.
• Limit saturated fat to less than 20g per day and trans fat to less than 2g per day.

Healthy Behaviours to Manage Cholesterol

Physical Activity

Regular physical activity is a key element for maintaining good heart health. Everyone should aim for 150 minutes of moderate (e.g. brisk walking, biking) to vigorous (e.g. jogging, aerobics) activity each week. This amount is equal to 30 minutes of activity at least 5 days per week.

Limit Tobacco Use

The use of tobacco products is associated with many health risks, including heart disease. Individuals who use tobacco are encouraged to reduce the amount used or quit completely. A combination of medication, counseling and simple lifestyle changes can all be integrated into a successful quit plan. Speak with your healthcare provider for information and support on reducing tobacco use.

Limit Alcohol Consumption

Excess alcohol consumption is associated with health risks. Canada’s low-risk alcohol drinking guidelines provide limits to support a healthy lifestyle.

The guidelines are as follows:

• Aim to limit alcohol to no more than 2 drinks per week
• Visit Canada’s Guidance on Alcohol and Health for more information

What is considered a standard drink? The guidelines identify a drink as:

• 341 ml (12 oz) of beer or cider at 5% alcohol content
• 142 ml (5 oz) of wine at 12% alcohol content
• 43 ml (1.5 oz) of spirits at 40% alcohol content

Want to have more information about Cholesterol? Speak to your Metro Pharmacist.