With cholesterol levels in adults remaining alarmingly high, dietitians are urging all Australians to base their food choices on the facts, rather than the claims made by food manufacturers. Many foods claim they are good for cholesterol, but often fail to give consumers the whole story about their actual effect.

Fifty percent of adult Australians are affected by high cholesterol levels (above 5.5mmol/L), a figure that has largely remained unchanged since 1980¹. Accurate information about the most effective foods to manage cholesterol is important if we are to improve this statistic.

Cholesterol is an important building block in the structure of cells and the production of hormones. However, when levels in the blood become too high they can cause fatty deposits inside blood vessels and this represents a significant risk to the cardiovascular system. While genes play a part, diet also has a strong influence on cholesterol levels. The body can make its own cholesterol in the liver, but blood cholesterol levels increase from too much saturated fat in the diet.

Accredited Practicing Dietitian and best-selling author of the Australian Healthy Shopping Guide, and the Australian Healthy Cooking Guide, Caron Milham says when it comes to choosing foods that lower your cholestrol, it’s a case of buyer beware at the supermarket.

“We need to look at the facts behind marketing claims to ensure the foods we buy deliver the health benefits we want. We need to look beyond claims like ‘cholesterol free’ on some vegetable oils or crisps as vegetable oils don’t actually contain cholesterol – only products with animal fat contain cholesterol. Moreover, the amount of saturated fat in food affects blood cholesterol levels much more than the amount of cholesterol it contains,” said Milham.

“Most people can lower their cholesterol by choosing an active lifestyle, achieving and maintaining a healthy body weight, and eating better. This means eating less food high in saturated and, trans fats and cholesterol and replacing some of these fats with foods high in polyunsaturated and monounsaturated fats such as healthy oils, nuts and seeds. It also means eating more vegetables, fruits, wholegrain breads and cereals, legumes, oily fish or fish oil, and choosing reduced fat dairy products and lean meats and poultry.”

“In addition, plant sterol enriched foods, like some margarine spreads, and increasing foods high in soluble fibre, like oats, legumes, fruit and vegetables, can also help lower cholesterol absorption because they prevent some of the cholesterol from being absorbed or reabsorbed.”

Plant sterols (also known as phytosterols) are found naturally in everyday foods like fresh fruits and vegetables, vegetable oils, seeds, nuts and grains, however they are present in very small amounts. Very large and unrealistic amounts of these foods would be needed to achieve a significant effect on cholesterol levels.

A recent review of food and cholesterol studies supports the effectiveness of plant sterols when compared to other foods. The effectiveness of plant sterols in combating cholesterol is also supported by the Heart Foundation in their recent Position Statement on Dietary fats and dietary sterols for cardiovascular health².

Fish, especially oily fish, is a healthy food for the heart, however contrary to popular belief, fish has no effect on cholesterol. The benefit of oily fish is it contains long chain omega-3 fats which have been shown to reduce blood clots, maintain smooth heart rhythm (reduce arrhythmia) and calm inflammation.

Whilst oats are a nutritious addition to a cholesterol-lowering diet, their effects are not as great as plant sterols. Oats contain a type of soluble fibre called beta-glucan which lowers cholesterol absorption; however the scientific evidence supports a lowering of only 2-5% for doses up to 3 g/d (found in 3 bowls, or 81g raw oat based cereals).

The makers of Flora pro-active tell us that eating three bowls of oat cereal a day will only give half the results of one rounded tablespoon of Flora pro-activ, a plant sterol enriched spread³. A more realistic one bowl a day will have even less of an effect. For more information visit the website www.foodforcholesterol.com.au

In March 2008, CHOICE surveyed products containing plant sterols and found that spreads are the most cost-effective way of getting your daily plant sterols.

“People at risk of heart disease and in particular those who have high blood cholesterol levels can benefit from eating products enriched with plant sterols. Research shows that if you lower your blood cholesterol levels, you lower your risk of heart disease and stroke.”

CHOICE says eating 2–3 g per day of plant sterols in the form of enriched spread, yoghurt, milk or a combination of these products, can help lower your cholesterol.

“Products enriched with plant sterols can work together with cholesterol-lowering drugs such as statins, as well as cholesterol-lowering diets, to lower blood cholesterol levels even further. But they’re not meant to replace your medication. And if you’re taking cholesterol-lowering medication, check with your doctor first before using foods enriched with plant sterols at the same time.”

Something else to keep in mind when eating products enriched with plant sterols is that they have been shown to lower blood levels of the antioxidants beta-carotene and lycopene.

“So if you’re regularly eating products enriched with plant sterols, also eat additional fruit and vegetables — orange-coloured ones in particular — to help compensate for any loss.”

For more information visit the website www.choice.com.au

References:
1. Australian Institute of Health and Welfare (AIHW). High blood cholesterol. Available at http://www.aihw.gov.au/riskfactors/cholesterol.cfm
2. Heart Foundation (Australia) Position statement Dietary fats and dietary sterols for cardiovascular health (2009). Available at http://www.heartfoundation.org.au/Professional_Information/Lifestyle_Risk/Nutrition/Pages/default.aspx
3. Ripsin CM, Keenan JM, Jacobs DR, Elmer PJ, Welch RR, Van Horn L, Liu K, Turnbull WH, Thye FW, Kestin M, et al. Oat products and lipid lowering. A meta-analysis. JAMA 1992; 267:3317-3325.