Inside your Heart Health Check - Part 3 - How to lower your cholesterol
Resources I give my patients to help them lower their cholesterol.
Here is the information and resources I give my patients to help them lower their cholesterol.
Cholesterol resources
The Portfolio Diet
Search Canada Portfolio Diet if you cannot click on the link.
This is less a diet and more a ‘pattern of eating’.
Taking on the portfolio approach to eating can lower LDL by 17-30%.
There are four main food groups eaten daily:
Plant sterols - They reduce cholesterol being absorbed by the gut.
Soluble fibre and increasing fibre to 70g of fibre-rich foods daily
Plant-based proteins - They support removing cholesterol from your blood stream
Nuts contribute to reducing LDL.
Download the Portfolio Diet infographic
A 2 page PDF document outlining the portfolio approach to eating to help lower cholesterol. By the Canadian Cardiovascular Society, The University of Toronto and St Michael’s Hospital Toronto.
The Zoe Podcast
How to eat to lower your cholesterol in 10 days with Dr Sarah Berry.
Search '“Zoe Podcast how to lower your cholesterol in 10 days YouTube” if you cannot click on the link.
An engaging, interesting way to better understand cholesterol and understand more about eating patterns to help reduce cholesterol.
One to sit down with a cuppa, with your family and work together to make a plan to make changes with your diet.
The Mediterranean Diet
Search “Mediterranean Diet Queensland Health” and “Queensland Health Eating for a health heart” if you cannot click on the links.
This is the most studied diet for heart health.
This is a detailed PDF document from Queensland Health that I find particularly useful for patients who want more clarity on this approach.
This is a second document from Queensland Health that has a self-monitoring check-list to see how you’re doing.
The Mediterranean diet is a great diet to adopt because of the variety of foods, and even though it is mediterranean based, the variety of foods means it can often be easily adapted to other cultural cuisines.
A plant-based diet
Can lower LDL by 15-30%.
Plant foods contain no dietary cholesterol, and are naturally high in fibre and healthy fats.
You don’t need to go fully plant-based, but reducing meat intake significantly can have big difference. Note the similarities of this with the mediterranean diet and especially the portfolio approach.
The DASH diet
Search “Kaiser Permanente DASH eating plan” if you cannot click on the links.
It was originally designed to lower blood pressure, but it also reduces LDL cholesterol. It focuses on:
Fruits, vegetables, and wholegrains
Low-fat dairy
Lean proteins
Cutting down on salt and saturated fat
The DASH eating plan PDF from Kaiser Permanente in USA is helpful.
You don’t need to follow just one plan.
My recommendations for eating patterns overall:
Reduce fried food to reduce transfats
Be mindful to try and reduce saturated fats
Increase monounsaturated fats
Increase fibre
Increase plant-based sources of protein (because it also contains fibre, and less harmful fats)
Reduce sugar intake - note: not carbs. Fructose in sugar can contribute to reduce liver metabolism of cholesterol and indirectly increase triglyceride output.
Reduce ultra-processed foods - they are much more likely to have the wrong combination of ingredients and higher amounts of substances to avoid listed above.
Increasing your intake of: plants, nuts and legumes to help you achieve this, and switching butter for extra virgin olive oil.
It’s never about perfection, but consistency.
Even moderate changes consistently followed over time produce meaningful results.
Start with the meal that you have the most control of and get consistent with this one first. Bring in more variety on this to avoid boredom too.
Once you have this one right, then you can start to move onto other meal times.
Usually the most difficult ones are where you don’t prepare your food and/or where there are many mouths to feed with a variety of dietary preferences.
But it’s also an opportunity to improve the dietary intake of your family.
Learn more about the specialist test - lp(a) in the following article:
CT Coronary Calcium Scores
More information about the CT Coronary scan is included in this article:
I find this information helpful for patients as a starting point to better understand this test.
Key points to remember:
It is a screening test, not diagnostic.
It helps doctors to better understand your risk of future heart events, but only gives us information about the past.
It looks primarily at hard plaque formation, rather than hard and soft.
There is a margin of error - 95% accuracy rate (1 in 20 inaccuracy rate).
It does not give you a guarantee that you won’t have a heart attack
There is radiation exposure, but the amount is reducing significantly per scan, and this is not a scan you will do frequently.
For some people the risk of earlier heart attacks remains high despite healthy actions.
There is a possibility that you have a higher risk of heart attacks based on your family history.
You might have other reasons outside of what is outlined in these articles that increase your risk of heart attacks.
You may have genetically determined very high cholesterol that requires treatment.
Re-test your cholesterol.
The earliest I would typically re-test cholesterol is 3 months, to allow time for the full dietary change effects to occur.
This article is all about giving you the confidence to make improvements.
Thank you for taking control of your health!
I’m happier seeing my patients avoiding heart attacks than having them.