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Printed at: 01:01:59 / 01-03-2021

Lowering your Cholesterol – Paediatrics

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High cholesterol

Cholesterol is a waxy substance which is mainly made in the body. It plays an important role in how every cell works and is used to make other vital chemicals. However, too much cholesterol in the blood can increase your risk of getting heart disease and circulatory diseases such as heart attack or stroke. Proteins carry cholesterol around the body in the blood and together they are called lipoproteins.

There are two main types:
Low-density lipoproteins (LDL) are known as the ‘bad’ type of cholesterol and they carry cholesterol from your liver to the cells that need it.
High-density lipoproteins (HDL) are known as the ‘good’ type of cholesterol and they carry the excess cholesterol away from the cells and back to the liver to be broken down.
Too much ‘bad’ cholesterol (LDL) and too little ‘good’ cholesterol (HDL) in your blood can cause fatty material to build up in your artery walls.

Triglycerides
Triglycerides are another type of fatty substance in the blood. Similarly to cholesterol, high levels of triglycerides will also increase your risk of heart disease and stroke. Eating a healthy balanced diet, reducing your sugar and alcohol intake, consuming oily fish and losing weight if you are overweight will help to lower your triglyceride levels.

What causes high cholesterol?
A common cause of high blood cholesterol levels are eating too many foods which are high in fat, particularly saturated fat, being overweight and not being active enough. If you have diabetes this also increases your risk of having raised cholesterol.

How can I reduce my cholesterol levels?
Eating a healthy balanced diet and reducing overall fat intake will help to reduce your cholesterol levels and can protect against high blood pressure and becoming overweight.

1. Cut down on saturated fats e.g.

• butter • sausages • ghee
• hard cheese • biscuits • coconut oil
• whole milk and cream • cakes • palm oil
• fatty cuts of meats • pies and pastries • dripping or lard

Compare food labels and choose products that are lower in saturated fat. Foods are high in saturated fat if they contain more than 5g of saturates per 100g. Foods containing 1.5g or less per 100g are low in saturated fat.

2. Avoid foods containing trans fats
These fats increase LDL cholesterol and lower HDL cholesterol. They are most likely to be found in processed foods like biscuits, cakes, fast food, pastries, some margarines and spreads and may be listed as ‘hydrogenated oils’ or ‘hydrogenated fat’ in the ingredients label. In recent years, many manufacturers have removed trans fats from their products due to the health implications.

3. Replace saturated fats with monounsaturated and polyunsaturated fats

Monounsaturated fats
These fats help to protect your heart by lowering the levels of LDL cholesterol and maintaining the HDL cholesterol levels in your blood. Good sources of monounsaturated fats can be found in:

• olive oil
• avocado
• pistachios
• rapeseed oil
• almonds
• peanuts
• unsalted cashews
• hazelnuts
• seeds

Polyunsaturated fats
These fats also help to lower the level of LDL cholesterol. The two main types of polyunsaturated fats are omega-3 and omega-6 which are essential fatty acids which cannot be made by the body. Good sources of polyunsaturated fats can be found in:

• corn oil
• sunflower seeds
• mackerel*
• sunflower oil
• sesame seeds
• pilchards*
• soya oil
• herring*
• sardines*
• walnuts
• fresh tuna*
• salmon*
• pine nuts
• trout*
• some spreads

*Oily fish are the richest source of Omega 3 fats, these fats also help reduce triglycerides levels in the blood and protect against heart disease.

Foods to lower your cholesterol
Foods that are high in soluble fibre are especially good at reducing the amount of cholesterol that is absorbed into the bloodstream. Good sources of soluble fibre include:

• Wholegrains such as oats, whole barley, brown rice and bulgur wheat.
• Soya products such as soya beans, calcium fortified soya milk and yoghurts, tofu, miso and textured soya protein.
• Pulses such as baked beans, kidney beans, chickpeas, lentils.
• Vegetables such as aubergine and sweet potatoes especially with the skins on.
• Fruit such as apples and pears.

What about foods high in cholesterol such as eggs?
The cholesterol found in some foods – such as egg yolk, liver and kidneys, shellfish such as prawns and fish roes (fish eggs) – has much less of an effect on the level of cholesterol in your blood compared to the amount of fat you are eating. If you need to lower your cholesterol level, it is much more important that you reduce the amount of foods you eat that are high in saturated fat.

Maintain a healthy lifestyle to lower your cholesterol
You can help to reduce your cholesterol levels by maintaining a healthy lifestyle that includes at least 60 minutes of moderate to vigorous intensity physical activity each day (5-18yrs). Healthy eating tips to help lower your cholesterol level:

➢ Grill, steam, poach and oven bake your meals.
➢ Use a spray oil when stir-frying and avoid deep frying
➢ Choose higher fibre options e.g. wholemeal or seeded bread
➢ Choose leaner cuts of meat, remove any visible fat and the skin from poultry before cooking
➢ Aim for at least 2 portions of fish a week, including 1 portion of oily fish
➢ Choose lower fat dairy products and reduce your cheese intake by grating it to make it go further
➢ Use 0% fat crème fraiche instead of cream
➢ Include at least 5 portions of fruit and vegetables every day

Here are some simple low cholesterol meal ideas:

Breakfast
▪ Porridge made with skimmed milk and an apple
▪ Poached egg on wholegrain toast, grilled mushrooms, tomatoes and baked beans
▪ Baked beans on wholegrain toast
▪ Wholegrain toast spread with peanut butter or an olive oil spread, soya yoghurt and a pear

Lunch/main meals
▪ Jacket potato/sweet potato with baked beans
▪ Falafel burger in a wholemeal bread bun with salad
▪ Salmon and peas with wholewheat pasta
▪ Wholegrain sandwich with filling of either: low fat cheese, turkey, hummus, tuna, egg, avocado or mackerel
▪ Wholewheat pasta bolognaise using soya mince
▪ Wholemeal pitta with skinless chicken, tomato and cucumber
▪ Chickpea and tomato stew with quinoa
▪ Lentil and vegetable curry with brown rice
▪ Vegetable/lentil soup with a wholemeal roll
▪ Sardines on wholemeal toast

Snacks
▪ Fruit eg; apple or pear
▪ Nuts eg; almonds or cashews
▪ Low fat yoghurt or milkshake using skimmed milk
▪ Healthy sundae of soya yoghurt, oats and fruit
▪ Avocado on wholemeal toast
▪ Vegetable sticks and hummus