Food, Heart Disease and Cholesterol
Reducing heart disease and reducing cholesterol are not the same.
I would suggest you reduce all the foods that promote heart disease and increase the ones that protect against it and don’t worry too much about cholesterol.
Foods that Promote Heart Disease
Trans Fats –These are found in processed foods, cooking oils, fried foods, confectionary, popcorn, mayonnaise, pies, pizzas and margarines. Anything food that can sit in a wrapper on a supermarket shelf with a long expiry date will likely contain trans fats.
(eg one sugary drink a day increases the risk of heart disease & stroke by 50%
and one diet drink daily increased the risk of heart attack and stroke by 43%)
(this is thought to be due to the lactose, not the fat, so using skimmed & semi-skimmed milk will be a worse choice),
(Some but not all studies implicate meat but this is a lesser risk).
Note saturated fats are not a cause of heart disease and protects against stroke.
Foods that Help Prevent Heart Disease
Oily fish: mackerel, herring, sardines (not salmon which is mostly farmed)
Fruits, Vegetables, Herbs & Spices
No drug comes close to giving these benefits
See leaflet: FOOD, LIFESTYLE AND THE HEART for more detailed information.
Many people worry about cholesterol. However, this is mainly a risk factor in middle-aged males.
In the over 80s high cholesterol is definitely good news and associated with a lower mortality.
Women have, on average, higher cholesterols than men but this is not a significant risk factor.
Triglycerides are the more important risk factor in women (these go up with consumption of sugar and refined carbohydrates).
Some countries with higher average cholesterol than the UK have markedly lower mortality from heart disease (France, Switzerland) and some with lower cholesterol have much higher mortality from heart disease (Russia).
Low Cholesterol is Dangerous
But this gets little publicity.
A British study in 1995 found those with a cholesterol below 4.8 had the highest all-cause mortality.
18 studies have linked raised cholesterol with longevity in the elderly.
The Honolulu Heart Program followed 3572 elderly Japanese /American men for 20 years and found those with low cholesterol on two occasions measured 20 years apart had the highest mortality.
An Austrian study of 150,00 people found low cholesterol was associated with a higher mortality in all groups apart from young men.
Cholesterol went up 20% in Japan between 1958 and 1999: strokes went down 600% and heart disease went down 30%.
Of 137,000 patients admitted to hospital in the USA the majority had low cholesterol. The average was 4.8 (low).
And Some History
In the mid-twentieth century two of the major figures in the search for the cause of heart disease were Ancel Keys (who believed, wrongly as it turned out, that saturated fat was the cause of heart disease) and Dr John Yudkin (who believed sugar was the cause).
They strongly disagreed on almost everything but the only thing they did agree on was low cholesterol was dangerous.
“At levels below 5.2, decreasing cholesterol concentrations tends to be associated with increasing rates of non-coronary deaths.”
“If you wish to increase the number of people dying from accidents, violence, cancer and strokes then give them a diet low in cholesterol and fat.”
HDL and LDL
HDL is sometimes labelled good cholesterol and LDL bad cholesterol. This is an oversimplification but it is generally better to
have a good (higher) HDL/LDL ratio.
People often ask how they can change these.
Firstly cut out the trans fats (see above). Trans fats reduce HDL and increase LDL.
Sugar and refined carbohydrates increase triglycerides (harmful), cholesterol and reduce HDL.
It is sugar and refined carbohydrates not fat that raise cholesterol.
Some nutrients increase HDL. These include: Vitamin C, Vitamin B3, Vitamin E (see Food, Lifestyle and the Heart), carnitine and DHA (from oily fish). Beta blockers lower HDL
Magnesium lowers LDL and raises HDL.