Doctors often have cholesterol levels measures in the blood. Cholesterol is a fatty, wax-like substance made in the liver. It is used to make cell membranes in the brain and nervous system and is also needed for making sex hormones, digestive juices and vitamin D. Too much cholesterol in the blood, however, is bad news.
Cholesterol and other substances combine to make plaque. This plaque builds upon the arteries and makes them less elastic. As the plaque thickens, blood becomes more difficult to pump through. If this layer thickens to the point where blood is unable to squeeze through, and occurs in an artery leading to the heart, a heart attack results. If the artery leads to the brain, the person suffers a stroke. Most of us have a substantial layer of plaque on our arteries by the age of 30.
You may have heard of “good” cholesterol and “bad” cholesterol. Cholesterol is carried in the blood attached to vehicles called lipoproteins. Low density lipoproteins (LDL) are the bad guys. These travel in the blood, dropping off cholesterol. This causes an increase in the risk of heart disease. High density lipoproteins (HDL) are the good guys. These travel in the blood and pick up cholesterol to take back to the liver. In the liver, the cholesterol is broken down and eliminated.
A good blood cholesterol profile would have low amounts of LDL’s and high amounts of HDL’s. Although this can be achieved through exercise and diet, a significant increase in HDL’s may be more difficult for people with disabilities to achieve.
Studies have shown that spinal cord injured people have lower HDL’s in the blood than sedentary able-bodied people. Spinal cord injured athletes have higher HDL’s than those spinal cord injured who do not exercise, but their HDL’s were still much lower than able bodied athletes.
So what does a disabled person do to prevent a heart attack? Diet can have a major impact on LDL and other fat parameters in the blood.
When most people are told their cholesterol is too high, they think of cutting out eggs and butter since these foods are high in cholesterol. Cutting down on foods high in cholesterol may have little effect on blood cholesterol. This is because the liver naturally makes its own cholesterol. When you eat less cholesterol, the liver adjusts and makes more. Generally, large amounts of fat in the diet does more harm.
The first step in lowering blood cholesterol and the risk of heart disease is to cut down on the total amount of fat in the diet. The average North American gets more than 40% of his’/her calories from fat. This should be cut down to 30% or less.
Saturated fat, in particular, should be decreased. Saturated fats are solid at room temperature and are found mainly in animal products; palm oil, palm kernel oil and coconut oil are the exceptions.
Replace butter with soft margarine and switch from whole or 2%milk to 1% or skim. Buy leaner cuts of meat that have less marbling (the white streaks in meat). Fifty to seventy percent of the calories in cheese and ice cream are fat, and most of this is saturated. Try one of the low fat cheeses (less than 10% M.F.) and have a frozen yogurt for dessert.
Polyunsaturated fat (sunflower, saflower and corn oil) and monounsaturated fat (olive, peanut and canola oil) are almost neutral. The monounsaturated fats may actually help to lower blood cholesterol slightly. These unsaturated fats are liquid at room temperature and are found mainly in vegetable oils.
Margarines are vegetable oils that have gone through a chemical process called hydrogenation. This treatment makes the unsaturated liquid oil into a solid. Unfortunately, when this is done, the structure of the unsaturated fat is changed slightly and the body responds to the new fat as it would to saturated (i.e. increasing blood cholesterol). Some margarines are made slightly differently. By doing so, the polyunsaturated fat structure remains unchanged. When buying a margarine, look for a soft margarine (this will have undergone less hydrogenation) and one that states on the label that it contains more than 50% polyunsaturates. Fleischmanns and Becel meet this criteria.
Don’t be fooled by a label that says 100% vegetable oil. Read the ingredients to make sure this is not a hydrogenated vegetable oil. Many cookies, crackers, processed foods and granola-containing snacks have hydrogenated fats. Since ingredients are listed in the order of their amounts, if hydrogenated fat (or any other fat) is listed close to the top, look for another brand.
Lowering dietary cholesterol intake may help in lowering blood cholesterol in some people, but read the label carefully. Cholesterol is found only in animal products. That vegetable oil with “no cholesterol” in large print never had any cholesterol to begin with. Since saturated fat also has a greater effect than dietary cholesterol, check the ingredient list for any saturated fats. In Canada, we are fortunate to have stricter labelling laws than most countries. If a label boasts “no cholesterol” it must also be low in saturated fat. The amounts of each must also be included on the label.
Many nutrition conscious consumers are opting for “light” products. Again, beware, light can mean anything from light in fat to light in sugar, salt, taste and colour!
Watching your fat intake may appear to be hard work and is some times depressing, particularly when many of the best tasting foods are also high in fat. However, a person can become accustomed to a low fat diet and still enjoy good food. The trick is to be creative with other ingredients such as herbs and spices. Investing in a good low fat cookbook such as “The Lighthearted Cookbook” by Anne Lindsay or “Eat Well, Live Well” by Helen Bishop MacDonald may also be helpful. After a period of adjustment, high fat foods may cause your stomach to turn rather than grumble!