1. health and fitness
2. disease
3. cholesterol

Finally...
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Remember that you don’t have to make all the changes straight away.
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Pick one or two that you can achieve and start with those.
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Once you are used to those, move on to further changes.
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There are plenty of cookbooks in the shops and library if you want
some recipe ideas.
Patient Information for the
Gloucestershire Health Community
If you need any further help or information, contact your dietitian:
Name:
Telephone:
How to reduce cholesterol
and triglycerides with diet
and physical activity
GHPI0886_04_08
Author: Liz Jones
Review due: April 2011
Exercise
Physical activity will help your heart to remain healthy and will also help you to
lose weight if you need to do so. You do not need to be an Olympic athlete to
reap the benefits of increased physical activity! Try to do something for at least
20 minutes at a time. Build up slowly to 3 - 5 times a week. In addition, try the
following:
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If you use the bus, get on to it one stop later, or get off the bus a stop
earlier than usual.
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Use the stairs rather than a lift. If you spend a lot of your time at home plan
your day so that you need to use the stairs more often.
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Throw away the remote control for your television and change the channels
manually instead!
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Walk briskly - borrow someone’s dog and be helpful while you get fit
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Join an exercise, swimming or gym class with a friend.
Do check with your doctor before starting an exercise programme if you are in
any doubt as to its suitability
Sample meal plan
Breakfast
Fresh fruit juice Branflakes, oat flakes, porridge or other cereal with low fat milk
and/or wholemeal/granary toast with low fat spread and yeast/meat extract tea
or coffee with low fat milk (and sweetener if desired)
Snack meal
Wholemeal sandwiches or wholemeal pitta with chicken, turkey or fish and salad
filling (made with low fat spread and without mayonnaise etc.) Or wholemeal
toast with baked beans or grilled tomatoes or mushrooms. Fresh fruit. Water/
diet drink or tea/coffee as before.
Main meal
Grilled or stewed chicken, fish or turkey with potatoes, rice or pasta and large
portion of vegetables or salad. Fresh fruit or diet yoghurt or sugar free jelly.
Drinks as before with glass of wine or other alcoholic drink if desired.
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Salt
It is very easy to consume too much salt. A high salt intake is closely linked to
high blood pressure, which can contribute to heart disease. To reduce salt:
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Use less salt in cooking; cut down gradually and you will find that you
become used to eating less salty food.
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Use herbs, spices and lemon juice to flavour foods.
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Don’t add salt at table.
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Cut down on tinned, packet and convenience foods and sauces as these
tend to be high in salt.
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Cut down on salty snacks such as crisps, nuts and savoury biscuits.
Why do I need this diet?
The level of fats - also known as lipids - in your blood
(cholesterol and/or triglycerides) has been found to be too high.
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Studies have shown that high levels of fat in the blood increase the
risk of heart disease. If you already have heart disease it is particularly
important to lower your blood fat levels.
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Following the advice in this leaflet will help to reduce your cholesterol
and/or triglycerides.
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Ask your dietitian if you have any questions or need further
information.
Sugar
Eating a healthy diet
Excess sugar can increase blood triglyceride levels, contribute to weight gain and
cause tooth decay, therefore to reduce sugar in your diet:
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Try to achieve and maintain the ideal weight for your height; your
dietitian will help you to decide what this is.
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Cut down on fat and eat unsaturated (e.g. olive, rapeseed, corn,
sunflower) fats rather than saturated fats (from meat and dairy
products) wherever possible.
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Use starchy foods (without added butter, oil etc.) such as bread,
potatoes, rice and pasta - particularly wholegrain varieties - as the
main part of all meals.
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Eat more fruit and vegetables - aim for five portions a day.
Alcohol
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Reduce your salt intake - by adding less to food and eating fewer salty
foods.
A small amount of any type of alcohol can be beneficial as it increases levels
of good cholesterol (HDL cholesterol) and has been shown to reduce risk of
developing diabetes.
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If you drink alcohol, remain within the recommended amounts.
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If your triglyceride levels are high, cut down on alcohol and sugar.
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Try not to add sugar to drinks or cereal.
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Choose diet drinks/no added sugar drinks.
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Choose reduced sugar jams and marmalade.
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Save sweets, chocolates, cakes and biscuits for special treats.
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If you miss the sweet taste, use sweeteners such as Canderel, Sweetex or Flix
Do not exceed the recommended daily intakes and always have some alcohol
free days - if your triglyceride level is high, your doctor and dietitian may suggest
you reduce to below these levels.
Recommended daily alcohol intakes:
Men
3 units per day
Women 2 units per day
One unit is 1/2 pint beer/lager or a small glass (125ml) of wine or a pub
measure of spirits.
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Myth
New Research
There is no quality evidence
that garlic supplements lower
lipid levels. Do not waste your
money on taking supplements
Research has shown that
taking 47g/d of purified soya
protein will lower cholesterol by
0.6mmol. Why not try soya milk
yoghurts or desserts.
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Weight
Eat or Drink Occasionally
It is important to achieve and maintain a healthy weight for your height.
Your dietitian will discuss a realistic target with you. Being overweight can
increase blood cholesterol levels and put extra pressure on your heart. To
lose weight, try the following:
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Eat three meals a day - missing out meals will just make you feel
hungrier.
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Use fruit, salad vegetables and water or diet drinks to help fill up
between meals rather than crisps, nuts, chocolates, sweets, biscuits
and cakes etc.
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Decrease meat portions and cut off all visible fat.
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Starchy foods (e.g. bread, rice, pasta and potatoes without added fat)
and plenty of vegetables should form the majority of your meals.
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Avoid adding fat (butter, oil etc.) or sugar to food.
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Increase your daily activity levels to help to decrease your weight - see
page on exercise.
Less than twice a week
Avoid
Less than once every two weeks
Breakfast cereals with added sugar
e.g. Frosties Cocopops.
Croissants, any pastry Sweet biscuits / cakes Cream
crackers and other cheese biscuits with fat high on
the list of ingredients.
Chips / other vegetables fried in
polyunsaturated fat.
Any fried in unspecified oil, lard etc. fruit tinned in
syrup (especially if have high triglycerides).
Saturated fats e.g. animal (lard, suet, dripping) and
dairy (full fat dairy products), ordinary margarine
and butter, coconut and palm oils. N.B. Avoid ‘trans’
polyunsaturated or ‘hydrogenated’ fats. Ghee
Fish tinned in unspecified oil.
Fried fish, fish in batter. Scampi, roe.
Kidney and leart. takeaway meals,
convenience meals and sauces.
Fried meat. Sausages, frankfurters, meat pies,
sausage rolls Luncheon meat, pate, salami.
Half fat Cheddar. Medium
fat cheeses e.g. Edam, Feta,
Camembert Maximum 3 eggs /
week (boiled, poached, scrambled
omelette).
Whole milk and milk products. Coconut milk,
condensed milk. Cream of any kind. High fat cheeses
e.g. Stilton, Cheddar, cream cheese. Fried eggs.
Creme Fraiche.
Low catorie ce cream. Ordinary
jelly. Boiled sweets / fruit gums /
mints. Marzipan |
Pastries, chocolate, toffee, fudge. Mousses made
with cream etc. Luxury ice cream.
Crisps and all other similar savoury snacks. Coconut.
Cream - based liqueurs. Sugary drinks - especially if
triglycerides high.
Salad dressings made
with polyunsaturated or
monounsaturated oils.
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Cream / whole milk soups. Ordinary mayonnaise /
salad dressings.
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Advice for lipid lowering diet
Eat or Drink Regularly
Fat
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Cholesterol is a type of fat naturally produced by our bodies. It
is essential for life to maintain body functions e.g., hormones.
Cholesterol is present in the blood in different forms - bad (LDL) and
good (HDL) cholesterol. A high level of LDL (harmful) cholesterol and/
or total cholesterol in our blood increases the risk of heart problems.
Cholesterol is deposited on the artery walls and more cholesterol,
fibrous tissue and red blood cells build up on top of this to eventually
cause a blockage.
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HDL (protective) cholesterol can help to outweigh the damage caused
by the damaging cholesterol. To increase HDL cholesterol levels cut
down on fat intake, take regular exercise, moderate alcohol intake,
maintain a healthy weight and don’t smoke.
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To decrease LDL (damaging) cholesterol and total cholesterol reduce
total fat and saturated fat intake. Eating too much saturated fat
causes the liver to make more cholesterol, which can raise blood
cholesterol levels; it also makes blood stickier and more likely to clot.
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Triglyceride is another type of fat found in the blood stream; high
levels of these fats are also thought to increase the risk of heart
disease, diabetes and pancreatitis. Keep these levels normal by
avoiding excess sugar and alcohol and increasing your intake of oily
fish.
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Eating less fat will tend to reduce the calorie intake of the diet; if you
do not need to lose weight, increase your portions of bread, potatoes,
rice, pasta and cereals.
More than three times a week
Starchy foods
Bread, pasta, rice, porridge oats, unsweetened breakfast cereals,
crispbreads. (Wholemeal /wholegrain varieties are best)
Fruit & Vegetables
ALL TYPES! Fresh or frozen or tinned in own juice.
Don’t over cook the vegetables. Aim for 5 portions a day.
Fats & Oils
Polyunsaturated or monounsaturated oils or margarines e.g.
olive, sunflower, safflower / soya.
Use in small amounts.
Cholesterol lowering spreads e.g. Benecol, Flora
Proactive.
Fish
ALL TYPES! Fresh / tinned in brine or tomato sauce. Especially
good are ‘oily fish’ e.g. herring sardines, pilchards, salmon,
mackerel. Shellfish are OK if not eaten with mayonnaise / salad
dressing.
Beans / Pulses
/Lentils
ALL TYPES! Dried or tinned e.g. baked beans, kidney beans, chick
peas, haricot beans, split peas, butter beans, pearl barley. Include
beans in your diet more often by adding them to soups and
stews - this will also help reduce your meat intake.
Meat
Poultry (remove skin). Lean meat/ mince / ham /bacon /
gammon - keep to a 120g (4 oz) portion. Game.
Dairy Produce &
Eggs
Skimmed / semi-skimmed milk and milk products and soya
products, e.g. yoghurts / fromage frais.
Low fat cheese (beware of ‘light’ cheeses - they can still contain a
lot of fat). Benecol yoghurts & cheese spreads.
Puddings &
Sweets
Nuts & Crisps
Sugar free jelly. Fatless sponge. Meringues.
Drinks
Tea, coffee. Fruit juice. Diet or no added sugar
squash. Alcohol within recommended limits remember the calories and use diet mixers.
Condiments &
soups
Herbs & spices, pepper. Soy sauce (in small
amounts). Mustard and pickles. Soups without
added cream or whole milk.
All nuts and seeds - except coconut and cashew.
Remember nuts are high in calories if you have to watch your
weight and blood pressure.
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How do I reduce my fat intake?
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(See chart for further information)
Saturated fats tend to be from animals and are hard at room
tempurature
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Reduce your intake of foods high in saturated fat e.g. butter, lard,
dripping, hard margarine, coconut and palm oil, meat fat, pies and
pastries, and processed foods.
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Use low fat milks and fat spreads and avoid cream. Choose lower fat
cheeses e.g. Camembert, Feta, Edam, half fat Cheddar, cottage cheese
or cheese spread, and use in moderation (see chart).
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Try not to fry food or add fat in cooking. Where you cannot avoid
it use an unsaturated fat - either monosaturated (olive or rapeseed
oils) or polyunsaturated (corn and sunflower oils) - and use as little as
possible.
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Avoid high fat snacks such as crisps, biscuits, cakes, nuts, bhaji, pakora
and samosas.
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Products such as Benecol (spreads, yoghurts, cheese or cereal bars) or
Flora proactive spread may help to reduce your cholesterol as part of a
healthy diet. Your dietitian will advise you further on the use of these
products.
Unsalturated fats tend to be plant or vegetable based and are soft/
liquid at room temperature
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Unsaturated fat helps to lower cholesterol levels in moderate amounts,
if saturated and total fat is reduced.
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Examples include sunflower and soya oil (and spreads made from
them), corn, safflower, grapeseed, walnut and peanut oil. There are
two types.
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Polyunsaturated fat (PUFA). Try to eat fish twice a week - and try to
have oily fish (sardines, pilchards, salmon, mackerel, herring) at least
once a week. Oily fish contains omega 3 fatty acids, which have been
shown to lower blood fats and to be good at thinning the blood.
Don’t eat oily fish more than twice a week, as it may contain chemicals
that may be harmful if eaten to excess.
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Monounsaturated fat (MUFA) has beneficial effects on blood
cholesterol levels when eaten in moderation. Examples include olive
and rapeseed oil (and spreads made from them) peanut oil, avocados
and most nuts.
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Caution! Remember that unsaturated fats are as high in calories as
saturated fat, so keep quantities used as low as possible.
Cholesterol
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Some foods naturally contain cholesterol e.g. - offal, shellfish, egg yolk.
Eating these will not affect your blood cholesterol levels very much
because your body regulates the absorption of dietary cholesterol.
However, ensure that you do not eat these foods to excess (see chart
overleaf for advice on specific foods).
Fibre
There are two types of fibre - soluble and insoluble - both of which are
beneficial.
Soluble fibre can lower cholesterol by 2 %
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Soluble fibre e.g. - oats, beans and pulses, fruit and vegetables helps
to lower blood cholesterol levels.
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Insoluble fibre e.g. - fruit and vegetables, cereals, brown/ wholemeal
starchy foods has beneficial anti-cancer effects and prevents
constipation.
Fruit and vegetables also contains antioxidants, which help to protect
healthy arteries against damage.
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Aim for 5 portions of fruit and vegetable per day.
One portion = 1 glass of fruit juice, one piece of fruit, a small handful
of dried fruit, a small tin of fruit in natural juice, a tablespoon of
vegetables, a small bowl of salad.
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Increase your intake of wholegrain cereals, pasta and rice and choose
wholegrain varieties of bread e.g. granary, rye, multigrain.
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