A recent addition to the pages of Good Times magazine is “Your Health Questions,” in which we find experts to answer questions submitted by our readers about health, nutrition, and well-being.
By Wendy Haaf
What kind of diet is appropriate for people with high cholesterol?
“The main thing to consider is the type of fat you’re consuming,” says Shelby Dowdell, a registered dietitian with the West Lambton Community Health Centre in Sarnia, ON. “Focus on unsaturated fats, which are found in such foods as olive oil, nuts, seeds, and fish, as opposed to saturated fat, which are in foods such as lard, butter, and coconut oil,” she says.
“You also have to be careful with a lot of meats, such as red meat—you should limit those to two times a week or less,” she adds. Replacing calories from saturated fats with those from the unsaturated variety helps lower levels of LDL (bad) cholesterol.
“Besides fat, fibre,” Dowdell says—specifically the soluble type—“is important for lowering cholesterol. Oats, legumes and beans, whole grains, and fruits and vegetables are all great sources.”
You can accomplish both of these aims more easily if you cook from scratch more often and limit processed foods and restaurant meals. If you’re carrying some extra weight, paring back portion sizes can help you shed a small amount, which will also help lower your cholesterol. (If you need a bit of help changing your cooking and eating habits, a registered dietitian can provide you with advice tailored to your personal palate and lifestyle. In some provinces, one-on-one consultations with a dietitian are free of charge, through services such as HealthLink BC and Telehealth Ontario.)
However, if you’re unable to hit the cholesterol target your doctor has recommended, despite having overhauled your eating pattern and lifestyle, don’t beat yourself up.
“The degree to which a person can bring his or her cholesterol down entirely with diet varies from person to person,” explains Dr. Rob Hegele, a professor of medicine and biochemistry at Western University’s Schulich School of Medicine & Dentistry and director of the Blackburn cardiovascular genetics laboratory at the Robarts Research Institute in London, ON. So it’s worth keeping in mind that your new habits will benefit your overall health regardless of how much of a dent they make in your cholesterol level.
Finally, it’s important to point out that in some situations, it may not be appropriate to wait six months to see how much of a benefit you get from diet and lifestyle changes alone (including exercising regularly, moving more overall, and sitting less). If you’ve already had a heart attack or been diagnosed with a condition such as diabetes or peripheral arterial disease, your chances of experiencing a serious complication in the near future often merit starting a cholesterol-lowering medication immediately. “High-risk people who would probably benefit immediately from going on a cholesterol pill tend to be undertreated,” Hegele says.
On the other hand, he adds, when high cholesterol is the only risk factor, sometimes family physicians are too quick to prescribe medication, because this involves less time and counselling. “When there’s no imminent reason,” Hegele says, “for a lot of people, lifestyle modifications alone may turn out to be enough to bring their cholesterol levels down to within an acceptable range.”