Despite a modest decline in the total cholesterol (TC) levels of Australian men and women between 2004 and 2008, the risk of developing heart disease (cardiovascular disease or CVD) remains a constant concern.1
The 2011 Australia’s Cholesterol Crossroads report found that over 30% of both men and women have total cholesterol levels that are too high, while 56% of all men and 54% of all women have high levels of low-density lipoproteins (LDL cholesterol) putting them at risk of heart disease.1
Whether someone with high cholesterol needs medication or not, health professionals should discuss risk factors and lifestyle approaches that can reduce cholesterol levels. Dietary modifications, physical exercise, quitting smoking and weight control can assist in achieving desirable lipid levels.1
Dietary changes can include:
- Reducing energy intake;
- Decreasing saturated fat intake; and
- Replacing saturated fats with polyunsaturated or monounsaturated fats and carbohydrates (excluding sugars and syrup).1
Plant sterols (also known as phytosterols) have received considerable attention in recent years, as an effective cholesterol-lowering food additive. Margarines containing phytosterols are no longer exclusive to this market.
Phytosterols added to milk, yogurt, bread and cereal can help to lower LDL cholesterol.3 Milk has been shown to be the most effective source with a 15.9% lowering of LDL cholesterol for people who drank 500mL of milk fortified with 1.6 g/day of phytosterols for three weeks.3
These phytosterol enriched foods may be used in addition to a balanced diet, including lean meats (or meat alternatives), vegetables, fruit and reducing intake of fried foods, sugars and refined carbohydrates like white bread, pasta potatoes and rice.
Regular exercise, quitting smoking and reducing alcohol intake are also strongly recommended.
The following key recommendations have been developed for GPs. You should be aware of these as a health consumer and discuss them with your doctor:
- Comprehensively assess all cardiac risk factors including modifiable lifestyle factors
- Identify absolute CVD risk
- Discuss dietary modification and lifestyle approaches as part of a wider cholesterol management plan 2
Baker IDI Heart and Diabetes Institute www.bakeridi.edu.au
Heart Foundation www.heartfoundation.org.au
1. Carrington MJ and Stewart S. Australia’s Cholesterol Crossroads:
January 2011, Baker IDI Heart and Diabetes Institute, Melbourne, Australia. www.bakeridi.edu.au
2. National Vascular Disease Prevention Alliance. Guidelines for the assessment of absolute cardiovascular disease risk. 2009 www.nhmrc.gov.au
3. Clifton PM et al. European Journal of Clinical Nutrition (2004) 58, 503–509.