How to reduce cholesterol and tr by fjwuxn

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									Finally...
l   Remember that you don’t have to make all the changes straight away.




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l   Pick one or two that you can achieve and start with those.                                     Patient Information for the
                                                                                            Gloucestershire Health Community
l   Once you are used to those, move on to further changes.




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l   There are plenty of cookbooks in the shops and library if you want




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    some recipe ideas.
If you need any further help or information, contact your dietitian:



Name:




                                                                             r   s
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Telephone:

                                                                              How to reduce cholesterol



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                                                                              and triglycerides with diet
                                                                                and physical activity




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                              GHPI0886_04_08
                              Author: Liz Jones
                            Review due: April 2011
           Exercise
           Physical activity will help your heart to remain healthy and will also help you to




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           lose weight if you need to do so. You do not need to be an Olympic athlete to
           reap the benefits of increased physical activity! Try to do something for at least
           20 minutes at a time. Build up slowly to 3 - 5 times a week. In addition, try the




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           following:




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           l   If you use the bus, get on to it one stop later, or get off the bus a stop
               earlier than usual.




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           l   Use the stairs rather than a lift. If you spend a lot of your time at home plan




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               your day so that you need to use the stairs more often.
           l   Throw away the remote control for your television and change the channels




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               manually instead!
           l   Walk briskly - borrow someone’s dog and be helpful while you get fit




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           l   Join an exercise, swimming or gym class with a friend.
           Do check with your doctor before starting an exercise programme if you are in
           any doubt as to its suitability




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           Sample meal plan




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           Breakfast




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           Fresh fruit juice Branflakes, oat flakes, porridge or other cereal with low fat milk
           and/or wholemeal/granary toast with low fat spread and yeast/meat extract tea
           or coffee with low fat milk (and sweetener if desired)




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           Snack meal




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           Wholemeal sandwiches or wholemeal pitta with chicken, turkey or fish and salad
           filling (made with low fat spread and without mayonnaise etc.) Or wholemeal
           toast with baked beans or grilled tomatoes or mushrooms. Fresh fruit. Water/
           diet drink or tea/coffee as before.

           Main meal
           Grilled or stewed chicken, fish or turkey with potatoes, rice or pasta and large
           portion of vegetables or salad. Fresh fruit or diet yoghurt or sugar free jelly.
           Drinks as before with glass of wine or other alcoholic drink if desired.
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Salt                                                                                    Why do I need this diet?
It is very easy to consume too much salt. A high salt intake is closely linked to
                                                                                        The level of fats - also known as lipids - in your blood




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high blood pressure, which can contribute to heart disease. To reduce salt:
                                                                                        (cholesterol and/or triglycerides) has been found to be too high.
l   Use less salt in cooking; cut down gradually and you will find that you




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    become used to eating less salty food.                                              l    Studies have shown that high levels of fat in the blood increase the




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l   Use herbs, spices and lemon juice to flavour foods.                                      risk of heart disease. If you already have heart disease it is particularly
                                                                                             important to lower your blood fat levels.
l   Don’t add salt at table.
                                                                                        l    Following the advice in this leaflet will help to reduce your cholesterol




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l   Cut down on tinned, packet and convenience foods and sauces as these                     and/or triglycerides.
    tend to be high in salt.




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                                                                                        l    Ask your dietitian if you have any questions or need further
l   Cut down on salty snacks such as crisps, nuts and savoury biscuits.                      information.




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Sugar                                                                                   Eating a healthy diet




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Excess sugar can increase blood triglyceride levels, contribute to weight gain and      l    Try to achieve and maintain the ideal weight for your height; your
cause tooth decay, therefore to reduce sugar in your diet:                                   dietitian will help you to decide what this is.
l   Try not to add sugar to drinks or cereal.                                           l    Cut down on fat and eat unsaturated (e.g. olive, rapeseed, corn,




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l   Choose diet drinks/no added sugar drinks.                                                sunflower) fats rather than saturated fats (from meat and dairy
                                                                                             products) wherever possible.
l   Choose reduced sugar jams and marmalade.
                                                                                        l    Use starchy foods (without added butter, oil etc.) such as bread,




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l   Save sweets, chocolates, cakes and biscuits for special treats.
                                                                                             potatoes, rice and pasta - particularly wholegrain varieties - as the




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l   If you miss the sweet taste, use sweeteners such as Canderel, Sweetex or Flix            main part of all meals.
                                                                                        l    Eat more fruit and vegetables - aim for five portions a day.
                                                                                        l    Reduce your salt intake - by adding less to food and eating fewer salty
Alcohol




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                                                                                             foods.
A small amount of any type of alcohol can be beneficial as it increases levels          l    If you drink alcohol, remain within the recommended amounts.
of good cholesterol (HDL cholesterol) and has been shown to reduce risk of




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developing diabetes.                                                                    l    If your triglyceride levels are high, cut down on alcohol and sugar.

Do not exceed the recommended daily intakes and always have some alcohol
free days - if your triglyceride level is high, your doctor and dietitian may suggest
you reduce to below these levels.
                                                                                            Myth                                    New Research
                                                                                            There is no quality evidence            Research has shown that
Recommended daily alcohol intakes:
                                                                                            that garlic supplements lower           taking 47g/d of purified soya
Men     3 units per day           Women 2 units per day                                     lipid levels. Do not waste your         protein will lower cholesterol by
One unit is 1/2 pint beer/lager or a small glass (125ml) of wine or a pub                   money on taking supplements             0.6mmol. Why not try soya milk
measure of spirits.                                                                                                                 yoghurts or desserts.
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Weight                                                                          Eat or Drink Occasionally             Avoid
                                                                                Less than twice a week                Less than once every two weeks
It is important to achieve and maintain a healthy weight for your height.




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Your dietitian will discuss a realistic target with you. Being overweight can   Breakfast cereals with added sugar    Croissants, any pastry Sweet biscuits / cakes Cream
                                                                                e.g. Frosties Cocopops.               crackers and other cheese biscuits with fat high on
increase blood cholesterol levels and put extra pressure on your heart. To
                                                                                                                      the list of ingredients.
lose weight, try the following:




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                                                                                Chips / other vegetables fried in     Any fried in unspecified oil, lard etc. fruit tinned in




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l   Eat three meals a day - missing out meals will just make you feel           polyunsaturated fat.                  syrup (especially if have high triglycerides).
    hungrier.
                                                                                                                      Saturated fats e.g. animal (lard, suet, dripping) and




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l   Use fruit, salad vegetables and water or diet drinks to help fill up
                                                                                                                      dairy (full fat dairy products), ordinary margarine
    between meals rather than crisps, nuts, chocolates, sweets, biscuits
                                                                                                                      and butter, coconut and palm oils. N.B. Avoid ‘trans’




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    and cakes etc.                                                                                                    polyunsaturated or ‘hydrogenated’ fats. Ghee
l   Decrease meat portions and cut off all visible fat.
                                                                                Fish tinned in unspecified oil.       Fried fish, fish in batter. Scampi, roe.




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l   Starchy foods (e.g. bread, rice, pasta and potatoes without added fat)
    and plenty of vegetables should form the majority of your meals.




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l   Avoid adding fat (butter, oil etc.) or sugar to food.
l   Increase your daily activity levels to help to decrease your weight - see
    page on exercise.




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                                                                                Kidney and leart. takeaway meals,     Fried meat. Sausages, frankfurters, meat pies,
                                                                                convenience meals and sauces.         sausage rolls Luncheon meat, pate, salami.




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                                                                                Half fat Cheddar. Medium              Whole milk and milk products. Coconut milk,
                                                                                fat cheeses e.g. Edam, Feta,          condensed milk. Cream of any kind. High fat cheeses
                                                                                Camembert Maximum 3 eggs /            e.g. Stilton, Cheddar, cream cheese. Fried eggs.
                                                                                week (boiled, poached, scrambled      Creme Fraiche.
                                                                                omelette).




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                                                                                Low catorie ce cream. Ordinary        Pastries, chocolate, toffee, fudge. Mousses made
                                                                                jelly. Boiled sweets / fruit gums /   with cream etc. Luxury ice cream.
                                                                                mints. Marzipan |




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                                                                                                                      Crisps and all other similar savoury snacks. Coconut.


                                                                                                                      Cream - based liqueurs. Sugary drinks - especially if
                                                                                                                      triglycerides high.

                                                                                Salad dressings made                  Cream / whole milk soups. Ordinary mayonnaise /
                                                                                with polyunsaturated or               salad dressings.
                                                                                monounsaturated oils.


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Advice for lipid lowering diet                                                              Fat
                     Eat or Drink Regularly                                                 l   Cholesterol is a type of fat naturally produced by our bodies. It




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                     More than three times a week                                               is essential for life to maintain body functions e.g., hormones.
                                                                                                Cholesterol is present in the blood in different forms - bad (LDL) and
Starchy foods        Bread, pasta, rice, porridge oats, unsweetened breakfast cereals,
                                                                                                good (HDL) cholesterol. A high level of LDL (harmful) cholesterol and/




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                     crispbreads. (Wholemeal /wholegrain varieties are best)
                                                                                                or total cholesterol in our blood increases the risk of heart problems.




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Fruit & Vegetables   ALL TYPES! Fresh or frozen or tinned in own juice.                         Cholesterol is deposited on the artery walls and more cholesterol,
                     Don’t over cook the vegetables. Aim for 5 portions a day.
                                                                                                fibrous tissue and red blood cells build up on top of this to eventually




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                                                                                                cause a blockage.
Fats & Oils          Polyunsaturated or monounsaturated oils or margarines e.g.
                     olive, sunflower, safflower / soya.                                    l   HDL (protective) cholesterol can help to outweigh the damage caused




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                     Use in small amounts.                                                      by the damaging cholesterol. To increase HDL cholesterol levels cut
                     Cholesterol lowering spreads e.g. Benecol, Flora                           down on fat intake, take regular exercise, moderate alcohol intake,
                     Proactive.                                                                 maintain a healthy weight and don’t smoke.




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Fish                 ALL TYPES! Fresh / tinned in brine or tomato sauce. Especially
                                                                                            l   To decrease LDL (damaging) cholesterol and total cholesterol reduce
                     good are ‘oily fish’ e.g. herring sardines, pilchards, salmon,
                                                                                                total fat and saturated fat intake. Eating too much saturated fat




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                     mackerel. Shellfish are OK if not eaten with mayonnaise / salad
                     dressing.                                                                  causes the liver to make more cholesterol, which can raise blood
                                                                                                cholesterol levels; it also makes blood stickier and more likely to clot.
Beans / Pulses       ALL TYPES! Dried or tinned e.g. baked beans, kidney beans, chick
/Lentils             peas, haricot beans, split peas, butter beans, pearl barley. Include   l   Triglyceride is another type of fat found in the blood stream; high
                     beans in your diet more often by adding them to soups and




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                                                                                                levels of these fats are also thought to increase the risk of heart
                     stews - this will also help reduce your meat intake.
                                                                                                disease, diabetes and pancreatitis. Keep these levels normal by
                                                                                                avoiding excess sugar and alcohol and increasing your intake of oily
Meat                 Poultry (remove skin). Lean meat/ mince / ham /bacon /




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                     gammon - keep to a 120g (4 oz) portion. Game.                              fish.




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                                                                                            l   Eating less fat will tend to reduce the calorie intake of the diet; if you
Dairy Produce &      Skimmed / semi-skimmed milk and milk products and soya                     do not need to lose weight, increase your portions of bread, potatoes,
Eggs                 products, e.g. yoghurts / fromage frais.                                   rice, pasta and cereals.
                     Low fat cheese (beware of ‘light’ cheeses - they can still contain a




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                     lot of fat). Benecol yoghurts & cheese spreads.

Puddings &           Sugar free jelly. Fatless sponge. Meringues.




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Sweets
Nuts & Crisps        All nuts and seeds - except coconut and cashew.
                     Remember nuts are high in calories if you have to watch your
                     weight and blood pressure.
Drinks               Tea, coffee. Fruit juice. Diet or no added sugar
                     squash. Alcohol within recommended limits -
                     remember the calories and use diet mixers.
Condiments &         Herbs & spices, pepper. Soy sauce (in small
soups                amounts). Mustard and pickles. Soups without
                     added cream or whole milk.

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How do I reduce my fat intake?                                                   3   Caution! Remember that unsaturated fats are as high in calories as
(See chart for further information)                                                  saturated fat, so keep quantities used as low as possible.




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Saturated fats tend to be from animals and are hard at room                      Cholesterol
tempurature                                                                      l   Some foods naturally contain cholesterol e.g. - offal, shellfish, egg yolk.
                                                                                     Eating these will not affect your blood cholesterol levels very much




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l   Reduce your intake of foods high in saturated fat e.g. butter, lard,
    dripping, hard margarine, coconut and palm oil, meat fat, pies and               because your body regulates the absorption of dietary cholesterol.




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    pastries, and processed foods.                                                   However, ensure that you do not eat these foods to excess (see chart
                                                                                     overleaf for advice on specific foods).
l   Use low fat milks and fat spreads and avoid cream. Choose lower fat




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    cheeses e.g. Camembert, Feta, Edam, half fat Cheddar, cottage cheese
                                                                                 Fibre




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    or cheese spread, and use in moderation (see chart).
                                                                                 There are two types of fibre - soluble and insoluble - both of which are
l   Try not to fry food or add fat in cooking. Where you cannot avoid
                                                                                 beneficial.
    it use an unsaturated fat - either monosaturated (olive or rapeseed




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    oils) or polyunsaturated (corn and sunflower oils) - and use as little as    Soluble fibre can lower cholesterol by 2 %
    possible.                                                                    l   Soluble fibre e.g. - oats, beans and pulses, fruit and vegetables helps




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l   Avoid high fat snacks such as crisps, biscuits, cakes, nuts, bhaji, pakora       to lower blood cholesterol levels.
    and samosas.                                                                 l   Insoluble fibre e.g. - fruit and vegetables, cereals, brown/ wholemeal
l   Products such as Benecol (spreads, yoghurts, cheese or cereal bars) or           starchy foods has beneficial anti-cancer effects and prevents
    Flora proactive spread may help to reduce your cholesterol as part of a          constipation.




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    healthy diet. Your dietitian will advise you further on the use of these
                                                                                 Fruit and vegetables also contains antioxidants, which help to protect
    products.
                                                                                 healthy arteries against damage.




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Unsalturated fats tend to be plant or vegetable based and are soft/




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liquid at room temperature                                                       l   Aim for 5 portions of fruit and vegetable per day.
                                                                                     One portion = 1 glass of fruit juice, one piece of fruit, a small handful
l   Unsaturated fat helps to lower cholesterol levels in moderate amounts,           of dried fruit, a small tin of fruit in natural juice, a tablespoon of
    if saturated and total fat is reduced.                                           vegetables, a small bowl of salad.




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l   Examples include sunflower and soya oil (and spreads made from               l   Increase your intake of wholegrain cereals, pasta and rice and choose
    them), corn, safflower, grapeseed, walnut and peanut oil. There are              wholegrain varieties of bread e.g. granary, rye, multigrain.
    two types.




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1   Polyunsaturated fat (PUFA). Try to eat fish twice a week - and try to
    have oily fish (sardines, pilchards, salmon, mackerel, herring) at least
    once a week. Oily fish contains omega 3 fatty acids, which have been
    shown to lower blood fats and to be good at thinning the blood.
    Don’t eat oily fish more than twice a week, as it may contain chemicals
    that may be harmful if eaten to excess.
2   Monounsaturated fat (MUFA) has beneficial effects on blood
    cholesterol levels when eaten in moderation. Examples include olive
    and rapeseed oil (and spreads made from them) peanut oil, avocados
    and most nuts.
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