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Cholesterol

Every one is worried about it and, worse still, every body is confused about it. One day you hear that eggs are out and the next they're in. One day you should not have any fats and the next you should have olive oil. Your cholesterol is high, the doctor puts you on a really strict diet and month later it's still too high.

That's enough to drive you nuts and throw the whole thing to the wind. Many of my patients come to me come to me confused and discouraged but after a few months we get onto and under that coveted 5!

It's not that I am that clever (even though I am) it's just that my approach has to do with logic and balance. To know how to beat cholesterol, we need to understand what the problem is.

What Is It?

In healthy people blood flows freely though the arteries to supply oxygen to the heart muscle. The trouble begins when the blood carries too much LDL (Low Density Lipoprotein) aka the BAD cholesterol. The more LDL; the more chance of them sticking to the walls of the coronary arteries (which are only about 3 to 4 mm in diameter). Over time these deposits become larger, restrict blood flow and form barriers on which debris from damaged blood vessels, blood cells, other components of the blood and also immune cells pile up on these barrages. When they eventually cause total obstruction of the blood flow, poof: heart attack!

Where Do The  LDL Come From?

From your diet of course, you knew that. What you did not know is that it does not just come from the diet, some people who may have a low fat diet have high cholesterol. After a serious illness that damages the liver, the bad cholesterol often goes up even in people who were healthy up to then. Smoker also tend to have higher cholesterol because smoking releases fatty acids from the body into the blood stream and also because smoking weakens the liver, thus preventing it from doing its job of emulsifying the fats in your gut.

So let's have a look at ways to avoid and lower high cholesterol.

THE BAD

We want to avoid saturated fats because they are the guilty ones; which make LDL and cause the problem. The classic saturated fats are:

Animal fats such as the stuff that coagulates into a solid mass in the fry pan when it is cold.

Beef dripping, lard . Don't ever cook with those they are guaranteed to clog up your arteries.

Deep fried foods . They are inevitably cooked in saturated fats. Things like battered fish, battered savs, potatoes fritters, pineapple fritters (when I hear all this battering I want to call the police!) are like sponges which absorb even more bad fats.

Biscuits. It always makes me laugh when I see vegetarians get stuck into packets of biscuits. You know this thing called “shortening”? Well, it is nothing but animal fat every time you eat a biscuit you are downing a third of its weight in pure fat!

Coconut oil, palm oil. Some take away places boast that they are using vegetable oils. Inevitably they are coconut or palm oil which are super saturated.

Margarine. Hands up if you thought that butter was bad and margarine was good. Sorry, incorrect! Margarine may be made of unsaturated oils but the process of hydrogenation, which turns these liquid oils into a solid spreadable form, makes it saturated (besides the many chemicals involved into making it look half way like butter is anything but good for you).

Eating too many fat chops, sausages or fatty mince will increase bad cholesterol.

But it is not just the fats that are bad sugar is the other culprit.

Sugar! I hear you protest. What's that got to do with fat and LDL?

Sugar forces the liver to jump to attention and as a result takes away from the liver's role in fat break down. In my clinic time and time again people who could not budge their cholesterol finally see it drop when they cut down their sugar.

Smoking,   as we saw earlier can create cholesterol all by itself.

Too much salt is not good because it hardens the blood vessels and contributes to the build up of those dreaded occlusions.

THE GOOD

So what are the good oils, which give us HDL (High Density Lipoproteins) that is the good cholesterol your body needs.

Well every body's favourite these days is olive oil . Use the light one for cooking and the more virgin one on your salad.

Where people get confused is with quantity. Just because it's good for you does not mean that you should guzzle litres of it.

For a family of four, for instance, you would use a two to three tablespoons if you were to sauté some onions or garlic or seal some chunks of meat for a casserole or if you were to make a stir fry. In a salad you would use one tablespoon of oil and a tablespoon or less of vinegar or lemon juice, depending on taste. A salad for one person would only need one teaspoon of oil.

Other oils which are also very good are: Macadamia, Grapeseed, Canola, Sunflower .

Every so often you might want to deep-fry something at home. In this case use one of the above oils, don't let the oil burn and don't reuse it too often (in fact you should not use it more than twice). A good compromise for chips is to boil potatoes in their skin, peel, cut in wedges and then pan fry them with a little salt, pepper and herbs if you wish. They are delicious and don't suck up much oil.

What do we do about the margarine! I hear you moan. Have no Fear, Granny is Here. Let one block of unsalted butter go soft, then stir into it one cup of your favourite oil. Macadamia works very well. Pour the mix in a container and keep in the fridge. You now have Olibutt or Macabutt or Canobutt easy to spread, delicious, low in LDL and full of vitamins A, D and E (cheap too!)

As far as meat is concerned, remember to choose lean meats and to have them in small servings, not more than three times per week. If you have not tried kangaroo or goat yet, go on!

THE ABSOLUTELY FABULOUS

Green veges: The best ones are the leafy slightly bitter ones, such as: endive, witlof, chicory. A dark green lettuce leaf will have a positive effect on your liver and therefore on lowering cholesterol levels but the white heart lettuce leaf, sweet as they are, are absolutely useless.

More veges: Of course eat more veges in general, the high fibre content and the high mineral content of vegetables is an absolute must for a healthy diet.

Onion, garlic: they contain flavonoids and polyphenols that are necessary for good circulation and healthy blood vessels. Have them in your food, not in little capsules.

Tea: Green tea also has flavonoids and helps with digestion of fats. In fact green tea is the tea to drink with food. Ordinary tea and coffee actually destroy a lot of vitamins and iron in your stomach, which is why you should not drink them with a meal.

Cereals and grains: Of course only the whole meal variety are healthy. Keep the white stuff for when you go out. Whole grain cereals are rich in the B vitamins and they help remove homocysteine (which is a dangerous compound) from the blood.

Fish:  Is rich in Omega-3 which is the good oil we all want in our bodies because it increases the good cholesterol. The fish richest in Omega-3 is Swordfish at a whopping 1667 mg per 100g. Atlantic Salmon, Silver Perch, Blue Mackerel and Gem Fish are in the very high list.

Bonito, Trout, Tailor, Sardine, Warehou, and Mullet are in a very good high range. Goldfish is also in that range and it has more Omega-3 than Eel! (But don't go eating your pet, mullet is cheaper!) I was disappointed to learn that in fact Tuna is in the low range (only 244mg/ 100g) and I was devastated to find out that my favourite fish, Barramundi is also low in Omega-3 (still more than any meat!). In the shell fish range Sydney Rock Oysters are the highest and I am sure you will be happy to know that Prawns have twice the amount of Omega 3 than Lobster!

Herbal teas:  If you can replace some of your tea and coffee with Dandelion root and/or Chicory root coffee (made in the plunger like any other fresh coffee) you will improve your liver function, your bile flow and therefore lower your cholesterol.

Fruit:  Having at least two pieces of fresh fruit per day will insure that your colon works well and you do not build up toxins in your system. Toxins are harmful to the liver that then cannot do its job properly. Berries such as blueberries and blackberries (handy in your supermarket freezer) are in fact very high in bioflavonoids, which you know by now are terrific for keeping your veins and arteries supple.

MYTH SMASHING

We have all heard it: a little wine is good for you and in fact it may reduce cholesterol. I have scores of patients who come to my clinic with this excuse and, guess what, their cholesterol remains high, no matter how much olive oil and fetta cheese they try to gobble. If your cholesterol is already high wine will definitely not reduce it. Anything that puts a strain on the liver will make the cholesterol worse. Sorry! Of course if your cholesterol is low then a little wine with dinner will certainly do no harm.

On the other hand, a little vinegar will do you a lot of good. I know, you are not impressed! The best way to have the vinegar is with oil in a salad dressing and the only time to have your salad is as the last course. You see the combination of oil, vinegar and the fibre from the salad cause the gall bladder to release bile in your duodenum to break down fats in food. Now, if you have your salad first up, it's a waste of good bile because there is no food for it to break down but if you have it after the main course then the bile can break down the fats this main course contained.

THE TREATMENT

Now I can hear some of you say: “Well, that's all very well if you want to prevent high cholesterol but what happens if you already have high cholesterol.”

Of course all of the above apply because the first thing you want to do is to get it any higher and when you have reached your goal, you want to prevent it going high again. So, do get on the above regime.

Here are a couple of very simple supplements you can take which have helped score of people. They are all cheap and very safe.

Bran It is not enough to just increase your fibre content. Bran actually has a role in binding fats in the gut. If you can get four type of bran: wheat, oat, barley and rice bran all the better. Have two table spoons a day altogether. You can have it with a little yogurt or put in your soup or casserole after it has finished cooking.

Lecithin Is another cheap but excellent supplement. It is rich in choline and inositol that are well known for their role in fat absorption, strengthening of the circulatory system, digestion improvement and positive effect on the nervous system. Have one teaspoon a day (by itself, in yogurt, in a drink…)

Niacin is also known as niacinamide, nicotinamide, nicotinic acid or vitamin B3- It is the specific vitamin to help lower cholesterol. You need to take no more than 50 mgr twice/day but you will need to take it for a while (depending on how fast your LDL go down). In some people niacin causes flushing: they suddenly go red and think they are going to the menopause (even if they are males!). If you are a niacin ‘flusher', the best thing to do is to take it after a meal and to only have half the amount for a week or two.

Herbs As explained before, getting into the habit of drinking herbs that are beneficial to the liver (dandelion and chicory coffee) is a great thing to include in your daily routine.  When you steam dark green veges it is also a good idea to drink the cooking water instead of pouring it down the sink. Just bottoms up! For more specific herbs you should go and consult a herbalist/naturopath because remember that herbs are medicines and you should not take them nilly willy just because there is a fad about anyone of them.

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