Will I ever eat cheese again?
July 16, 2009 4:57 AM   Subscribe

I've been told I need to lower my cholesterol. Any tips? How can I find out which foods are fine and which are Sometime Foods?

I've been given some advice about cutting out or down on certain things, but is there a way I can find out whether things not on there are fine? Should I just be keeping an eye on saturated fat? I know that there are some foods that claim to actively reduce cholesterol (I have read the studies for one particular product, as I worked on the advertising) but as they are expensive, are they worth it? Also, I've been trying to eat more red meat to keep my iron up, so what's the score with that?
posted by mippy to Health & Fitness (22 answers total) 9 users marked this as a favorite
Response by poster: What might make a difference:
- I take daily medication so a relatively normal diet is good for me
- I prefer tomato-based sauces to cheesy ones, but I do like cheese
- My favourite food is houmous
- I'm a savoury snacker, but of late have massive cravings for sweets - I try and have ice lollies instead of ice cream.
- I make my own lunches and have been trying to go for cheap, low fat alternatives
- I don't smoke, don't drink much, but work in an office and my commute is too far to walk or cycle.
posted by mippy at 5:01 AM on July 16, 2009

Increase the percentage of vegetables across the board, stop eating all processed foods, and exercise. This can be walking at least 4 miles a day, 30 minutes of running, or taking an aerobics class three times a week. Also, the thing with diets is that if you just eat the way your great grandmother ate, you'll do better than cutting things out piecemeal. (This worked for me-- took off 40 points)
posted by nax at 5:04 AM on July 16, 2009

Oatmeal. It's cheap and is proven to help lower blood cholesterol. Worked for me.
posted by iviken at 5:13 AM on July 16, 2009

Response by poster: My great grandmother probably lived off mince and potatoes - that's Irish blood for you. It's good advice, though.

I recently learned to cycle - I can't afford a gym membership just now, and trouble with a once-fractured metatarsal makes em worry about high-impact exercise. I am trying to increase my walking,t hough. I recently cut back on my tea to two cups of black a day (plenty of green, still, though...) I also find it hard to find quick, non-processed things to cook after work, so I can investigate that.
posted by mippy at 5:24 AM on July 16, 2009

Seconding oatmeal for breakfast. It worked for me too with little other change to diet. YMMV
posted by merocet at 5:40 AM on July 16, 2009

My understanding of the recent research is that dietary cholesterol does not affect blood cholesterol levels. The best way to lower cholesterol is to eat whole, nonprocessed foods, and exercise. Soluble fiber, found in oatmeal, apples, and other fruits, grains, and beans, is also supposed to help.

In terms of quick, easy meals, do you have a Trader Joe's nearby? You can buy things like precut vegetables there - a bag of stir-fry mix is about $2, and makes 3-4 big bags of vegetables. A recent all-Trader Joe's quick meal I made was their brown rice mix (in a rice cooker - it's parboiled, so this works fine even though my rice cooker says it only does white rice. Then, I stir-fried (nonstick pan, minimal oil) the stir-fry mix and a bag of precut mushrooms (about $2, as well). I seasoned with soy and oyster sauce, but if you're watching your sodium you could use spices instead. And, I thawed a bag of cooked, frozen shrimp. Trader Joe's also sells precooked chicken, or I'll cook my own from frozen.

The whole meal - rice in the rice cooker, stir-fry with no chopping, shrimp with no preparation - took about 10 minutes of active time to make, and made about 4 big meals. I also eat almonds whenever I eat it, to add healthy fat.

Another really easy dinner for you is hummus, your favorite food, plus precut vegetables, whole wheat pita, and sliced lean mean. That has protein, healthy fat, healthy carbohydrates, and vegetables. Definitely keep snacking on hummus - it's healthy and has the kind of fiber that's supposed to help lower cholesterol.

A third easy, healthy dinner is rice & beans - canned beans are fine, just rinse them to get the excess salt off. Add vegetables (cooked or salad) and fat - salad dressing, nuts, avocado, oil.

I second iviken on the oatmeal-for-breakfast. Oatmeal has soluble fiber, which is supposed to lower cholesterol. Add dried or fresh fruit if you want, add nuts if you can (healthy fat = stay full longer).

For sweets, do you think you would find fruit satisfying? If not, try to stick to small portions of your favorites. It's fine to have anything in moderation.

Definitely try to get some exercise in. You might be able to go for a walk on your lunch break. Summer weekends are a great time to exercise with friends - hikes, bike rides, etc.
posted by insectosaurus at 5:46 AM on July 16, 2009 [2 favorites]

Cutting out saturated fats was really hard, and made me feel like I was always on a diet, until I learned that having raw olive oil, or avocado, daily is actual beneficial in terms of HDLs ("good cholesterol").

It's hard to feel deprived when I've just indulged in some crusty bread dipped in a rich extra virgin olive oil, and I don't feel the need for unhealthy fats any more.

My blood tests are fine now. And, yes, I did start walking every day.
posted by surenoproblem at 5:52 AM on July 16, 2009

Response by poster: I'm in the UK, so no Trader Joe's, but we can buy stir-fry mix from a supermarket for £2 which will do for two meals. I find this to be nice and quick with noodles, so I don't end up snacking. We also get a fruit delivery at work, so as long as it's not all bananas, I can eat some if I like. We also get a lot of sweets from people who have been on holiday...

I am worried about the fat content of houmous - the reduced fat usually has something odd added to it. I am trying to switch to wholewheat bread and pasta, though - ready meals never have wholewheat anything in!

Is oatmeal basically the same as porridge? I stick a teaspoonful of honey in mine,b ut find it's too heavy during the hot weather. I'm getting really bored with the muselis in supermarkets too!
posted by mippy at 6:03 AM on July 16, 2009

I've been diagnosed with raised cholesterol, and here's what the dietician told me:
I should increase the fibre in my food, and eat more nuts, olives, avocados and fish. Except I hate fish, so we compromised by my taking a fish oil supplement every morning. Otherwise, I eat quite healthily.

Nthing others who have said to increase your veg intake (anything dark green), get lots of exercise. Oh, and drink lots of water.

Best of luck!
posted by LN at 6:27 AM on July 16, 2009

I am worried about the fat content of houmous - the reduced fat usually has something odd added to it.

Making your own hummus is pretty easy if you have a food processor or blender, and it stays good for at least a week in the refrigerator. I've been doing it because a small 8-ounce container costs about $5 here, when the constituent ingredients are very cheap (cheaper still if you cook dried chickpeas instead of using canned). Hummus is essentially fat-free unless you add olive oil, but olive oil will not harm your cholesterol levels.

Hazelnut oil and macadamia nut oil have similar fatty acid profiles to that of olive oil, which means that they will not reduce your good HDL levels like corn oil or soybean oil will, and they won't increase your bad LDL levels like saturated fats will.

Because it's something too few people are aware of, I have to point out that undiagnosed hypothyroidism is surprisingly common and causes high cholesterol levels in people who have it.
posted by Ery at 6:33 AM on July 16, 2009

Oat bran muffins! My dad lowered his cholesterol drastically in one month by chonging on these things.
posted by heather-b at 6:36 AM on July 16, 2009 [1 favorite]

When I was dx'd with high cholesterol in 2003, I didn't take meds. Instead, I began following a low-carb, high protein eating plan that - guess what? - includes cheese every single day. Hummus is more of a Sometime Food, due to it's high carb content, but it's fine on occasion. Snacks include cheese, nuts, olives, avocado - savory things.

The conventional advice re: high cholesterol is to avoid fats and increase carbs, but there are studies linking carb consumption (especially fructose, found in all those fruits they tell you to eat) with elevated triglycerides and cholesterol.

End result, both my total cholesterol and my triglycerides were in the mid-300s, but when I cut carbs and increased protein and fats, my cholesterol dropped to 150ish and my triglycerides to under 100. (Do they measure it the same way in the UK? I'm not sure, but by US standards my numbers are excellent.)

IANAD, IANYD, etc., but here's more info to go on.
posted by chez shoes at 6:39 AM on July 16, 2009 [1 favorite]

Response by poster: I had a cholesterol test last year and it came out fine - funnily enough I'm having a test for something hormone-related, so I wonder how connected they are. That said, I know my diet could be a hell of a lot better.

Houmous from Tesco used to contain: chickpeas, tahini, lemon, garlic. Then supermarkets started adding oil, maybe to keep the tahini (and costs) down. Doesn't tahini have a high fat content, though? I was thinking chicken and avocado sandwiches for

I do really want to make some houmous-esque dip for my SO who can't eat legumes, so it would be worth scoring some tahini.
posted by mippy at 7:47 AM on July 16, 2009

I highly recommend reading Clean, by Dr. Junger. I have never been a big fan of cheese (or milk), and after reading this book -- about 6 weeks ago -- I completely eliminated them both from my diet. I have felt better every day than at any other point in my life.
posted by GatorDavid at 8:02 AM on July 16, 2009

Tahini should be cholesterol free; it's sesame seeds and olive oil, which are good fats. But you may want to try this fantastic tahini-free, low fat hummus recipe: http://www.recipezaar.com/Super-Healthy-Hummus-90086
posted by for_serious at 8:30 AM on July 16, 2009

Sorry I missed the "legume-free" hummus request:

Zucchini Hummus (For zucchini, read "courgette")
Pumpkin Hummus
posted by for_serious at 8:46 AM on July 16, 2009

My doctor recommended Benecol, was dismissive of exercise that wasn't going to raise my heart rate significantly (swimming was best, he reckoned), and was (unlike the practice nurse) reassuring about the actual likelihood of high cholesterol killing me in the immediate future. Regarding diet, he said cutting out dairy products religiously was probably not the way to go - small amounts are fine, it's more important to get exercise, and eat more veg, whole grains, olive oil, etc.
posted by nja at 9:56 AM on July 16, 2009

Response by poster: chez shoes - cholesterol is measured in smaller figures, eg. 7.6. Not sure of the equivalents in the US, so I'll take your word for it that your numbers are good!
posted by mippy at 10:14 AM on July 16, 2009

Hummus may have fat - traditional from tahini and olive oil, in a supermarket maybe from canola or sunflower - but it shouldn't have much saturated fat, and no cholesterol. From my reading, I think that tahini and olive oil are healthy, canola and sunflower not great. However, many people consider vegetables healthful.

Oatmeal is exactly the same thing as porridge, just different words. If you're getting bored of museli/weetabix, try it with different things - milk vs. yogurt, different nuts, different fruits, spices like cinnamon or cardamom. The variations are endless.

Yes, hormones can affect cholesterol. When my mom's thyroid medications were off, her cholesterol was too high. Once the thyroid was fixed, the cholesterol went to a healthy number with no dietary change.
posted by insectosaurus at 10:21 AM on July 16, 2009

I am not a doctor or dietician, but I used to have high cholesterol, and I've been interested in the topic for many years. My preference is to look at evidence based medicine. What follows is a digest of many years of looking at studies dealing with cholesterol cardio-vascular disease in general.

Things to avoid in your diet: trans and saturated fat (all forms); dietary cholesterol. These you should try to get as close to zero as possible (actual 0 is not possible). Even stearic acid (a form of saturated fat), which does not raise serum cholesterol, is still associated with deleterious outcomes. The same for coconut oil - despite propaganda to the contrary - it is not good for your CV health.

Keep a good balance of n3 to n6 fatty acids. It should never be more than 1:4, preferably 1:2, or even 1:1. Do not avoid n6 fatty acids, as these will directly lower your LDL. If you consume olive oil, do so in moderation, and only virgin cold pressed. Your fat consumption should be by % from large to small: n3 and n6, dha/epa (from fish such as salmon), olive oil, -----> sfa (as close to 0 as possible).

Be very careful with your sources of protein: try to limit red meat (best would be to eliminate) - consumption of red meat is associated with negative health outcomes, especially CV, but also cancer and all cause mortality. There are other means of getting iron, and ask the doctor exactly why it is s/he wants you to up your dietary iron - check your ferritin levels, if your ferritin levels are within norm, do not try to get more iron, as in general very long lived people have low iron levels and iron is associated with multiple negative health outcomes. In general, limit animal sources of protein and go for pulses and vegetarian sources (except soy - regular consumption of which is associated with vascular dementia). Your protein should be complete, but low in methionine (which is why you should limit even egg whites, which are v. high in methionine). Fatty fish once a week - make sure you don't consume fish high in mercury and other pollutants: a good fish is ocean caught (not farmed) pacific or alaskan salmon; don't overdo the fish, once a week, twice at most (it's high in methionine), modest portions, broiled or canned, not fried, smoked or floating in oil.

Carbs: avoid simple sugars and high glycemic foods; complex carbs are the way to go. Emphasize fruits and vegetables. Interesting fact: CV benefits are more clearly associated with fruits than vegetables. Not all fruit is created equal - some, such as bananas, are poor relative to other fruit: high in calories with relatively poor nutrition bang for the caloric buck. Citrus fruit is great for CV health - though be aware that grapefruit can elevate the levels of various medications you may be taking - as are apples, various berries, stone fruit and generally lower calorie non-tropical fruit. Avoid high caloric starches such as potatoes. Some grains are fine, though limit them (sorry if you are a bread lover). Oatmeal is good.

Try to keep a good proportion of protein, carbs and fat. In general, it's better to go highish protein, lowish carbs, moderate fat. Lower to higher limits: fat - 20%-30%; protein - 30%-40%; carbs - 30%-50%.

Fiber. Consume at least 100g/day of soluble fiber in your diet. Supplement as well, with psyllium (you can buy it without additional ingredients), as psyllium has been shown to lower LDL pretty substantially.

Modest amounts of red wine may be beneficial for CV health, but emphasis is on modest. Most people don't understand how small the amount of alcohol is involved - we are talking 4 ounces, or one drink a day - that's half of a very small glass of wine (and wine that's 12.5% alcohol, not the monstrosities of today that go up to 17%). For women, the upper limit is 1 drink per day, and the actual benefits show up at as little as 3 drinks a week. We are talking tiny amounts. And a very strong caveat: alcohol in general is much more deleterious for women; it is strongly generative of cancer, including breast cancer, and consuming it in any amount, if you are predisposed to BC (family), should be contraindicated. I'd recommend avoiding it altogether, even though it can raise your HDL levels and does provide CV benefits.

Tea and coffee is fine, though coffee must be filtered otherwise it will raise your LDL levels (i.e. avoid the very tasty French press).

Vit & min: get this from food - except for vitamin D3, which you can supplement with. Get enough magnesium in your diet, folate and vitamins B3, and B6. Use nutritional software to make sure that you get all your micronutrients.

Foods to consume every day: fiber (psyllium), nuts (best nuts: walnuts, hazelnuts, almonds)

General rule for lowering cholesterol and for multiple health benefits: keep your calories low; make sure that if you pay with calories, you get a good return on nutrients, i.e. don't consume empty calories, rather nutrient dense foods. Keep the calories LOW - that does not mean tiny portions, only picking foods which have a lot of volume and are filling, but don't have many calories (vegetables mostly). Don't binge. Keep your calories as low as you can stand it without being excessively hungry, and without it negatively impacting your life.

Exercise is very beneficial to overall health and CV health in particular. Aerobic: 30 minutes a day at least 5 times a week, at moderate levels. It'll bump up your HDL. Some strength training with weights, 2-3 times a week, 20 minutes each.

Do this for at least 8 months. If at the end of this, your HDL is still below 40 and/or your LDL above 130, and/or your total above 220, only then consider medication to control your cholesterol.

Remember, the LDL:HDL ratio is important, and so your HDL levels are as important as your LDL. Lower the LDL by all means, but bump up the HDL if it is low.
posted by VikingSword at 12:33 PM on July 16, 2009 [4 favorites]

Response by poster: "Keep a good balance of n3 to n6 fatty acids. It should never be more than 1:4, preferably 1:2, or even 1:1. Do not avoid n6 fatty acids, as these will directly lower your LDL. If you consume olive oil, do so in moderation, and only virgin cold pressed. Your fat consumption should be by % from large to small: n3 and n6, dha/epa (from fish such as salmon), olive oil, -----> sfa (as close to 0 as possible)."

I'm sorry,b ut I don't understand what this means!

I can't afford virgin cold pressed oil and nuts are pretty expensive to have every day. French press is cafetiere, right? Again, filter coffee is only available to me from cafes at £2 per cup, so luckily I don't drink much of it! I'm trying to keep an eye on calories, but taking Depakote means I'm constantly hungry as it is, so I need to work out what's most filling.

I am confused by your comments about supplements - we don't allow advertisers to claim that vitamins have any benefit except for those on very restricted diets
(this is based on analysis by a nutritional consultant) so I am suspicious of the claimed health benefits for these. I try and up my iron because I have heavy periods, so obviously I lose a lot of blood each month.

Really, I don't want to have to 'micromanage' my diet, though I appreciate the detailed advice, because I find the wealth of advice on diets and healthy eating very confusing as it is. REading what should and shouldn't be avoided above is terrifying me - if I can't afford line-caught fish, shoud I not be eating it at all? Are tofu sausages as bad as apple and pork ones?

I think there's a lot of common-sense rules that I can stick to though, so this is what I'm after.
posted by mippy at 4:08 AM on July 17, 2009

Regarding the fatty acid (omega 3 and omega 6) balance, the easy way to do this is to take fish oil supplements each day. There is a LOT of evidence that they are very beneficial to your brain and body. If you're vegetarian, take flax oil instead.

Also, you should try to avoid the corn oil and sunflower oil that is in processed foods. Take your fish oil, use olive oil, eat avocados and nuts and seeds, and you'll be fine.

Filling, cheap, and healthy foods include things like lentils and beans, brown rice, cheap vegetables (often cabbages & whatever is in season), and eggs.

Really, just stick to whole foods, not processed foods, and you should be fine. That's the simplest way to state it (Michael Pollan, an excellent food/nutrition writer, has three rule: Eat food, mostly plants, not too much).
posted by insectosaurus at 12:05 PM on July 17, 2009 [2 favorites]

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