Sunday 26 January 2020

Dietitian Orla Walsh: 'Cholesterol - It's about what you're not eating'

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

Nuts are a natural way of lowering cholesterol
Nuts are a natural way of lowering cholesterol
Cheese contains saturated fat but is still good for heart health

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

Cheese contains saturated fat but is still good for heart health
Cheese contains saturated fat but is still good for heart health

• 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.

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