Heart disease is the leading cause of death in Ireland today, but the good news is that 80% of heart disease is preventable simply by changing your lifestyle.  People with coeliac disease may have an increased risk of heart disease – untreated coeliac disease can often lead to higher cholesterol levels.  However, there are lots of other things that can affect your risk of getting heart disease.  These include having high cholesterol. High blood pressure and high blood glucose (sugar).   Let’s take a look at what you can do to keep your cholesterol levels healthy.

Cholesterol is a type of fat that is found in your blood.  At normal, healthy levels, cholesterol helps your body to work properly by making important hormones.  There is only a problem with cholesterol when you have too much.  When your blood has too much cholesterol, it can start to stick to the walls of your arteries.  If too much cholesterol sticks, then blood can’t get through and this may lead to a heart attack, a stroke, or problems like angina. Once any cholesterol has lined your arteries, you cannot remove it, but you can stop it from getting worse.  This is why it is important to look after your cholesterol and to work on lowering your levels straightaway if they are too high – don’t wait!

Luckily there is a lot you can do to have a healthy cholesterol level.  One of the best ways to look after cholesterol is to look after what you eat.  There are some foods that will increase cholesterol levels and others that will help to reduce them. 

What are healthy Cholesterol levels?

A little bit more about LDL (‘bad’) cholesterol

For most people LDL cholesterol should be less than 3.0.  However, if you already have heart disease (e.g. if you have had a heart attack or surgery for heart disease) or if you have other risk factors like high blood pressure, then you need to aim for even lower levels of LDL cholesterol.  The table below sets out the figures to keep in mind:

What Foods do I need to reduce?

Cholesterol in your blood comes from two main places.

Firstly, you can eat cholesterol in certain foods.  Eggs, crustaceans (like prawns, lobster and crab) and liver all have cholesterol in them. However, this type of cholesterol is only responsible for a small amount of the cholesterol found in your blood.

The second place cholesterol comes from is saturated fat:  This is where most of the cholesterol in your blood comes from.  When you eat saturated fat, your liver makes cholesterol from it, and this is why saturated fats raise blood cholesterol levels.

Saturated fat is the type of fat found mainly in animal foods like cream, butter and the fat on meat.  It is also found in biscuits, cakes, pastries and scones, because we use saturated fat to make them.  Saturated fat is also found in processed meat like sausages, black & white pudding, pâté and so on.  You can look at labels to see how much saturated fat there is in your food.

What can I do to reduce saturated fat?

Eat less butter and cream and limit cheese to 30g a day.  Remember that dairy foods like milk and yoghurt are important sources of calcium in your diet so it is not healthy to cut out these foods.  Do choose low-fat or skimmed milk and low-fat yoghurts.  Remember low fat milk and yoghurt have the same (or slightly more) calcium as full fat milk and yoghurt.

Choose low fat cooking methods – swap frying for grilling, boiling and baking.  Try steaming more moods and choose healthier fats for roasting such as rapeseed oil instead of lard or butter.

Trim the visible fat from meat and remove the skin from chicken.  Most of the fat in chicken is just under the skin!

What about coconut oil?

Coconut oil is a very popular oil that is high in saturated fat and it does raise cholesterol.

What fats should I use?

Healthier fats to choose are olive oil and rapeseed oil and spreads that are made from them.  You can use olive or rapeseed oil in cooking or dressings.  Just remember that these fats have as many calories as any other type of fat so only use a small amount to help keep weight healthy.

What foods help to lower cholesterol?

Gluten Free Oats: Eating gluten free porridge is a great way to help to lower cholesterol.  If you don’t like porridge, try adding dry oats to muesli or other cereals or look for oatcakes.

Beans and lentils: These high fibre foods can help keep cholesterol levels healthy.  Try to have beans or lentils 3-4 times a week.  Try gluten free baked beans, chickpeas, or kidney beans in salads, soups made with lentils and chilli-con-carne.  Just check your Coeliac Food List for gluten-free lentils.

Plant sterols/stanols:  Plant sterols/stanols are natural substances found in some foods – such as almonds, soy bean oil, and sesame seeds.  Studies show that taking 1.5-2.4g of plant sterols/stanols per day can reduce cholesterol by 7-10% in about 3 weeks.  Plant sterols and stanols work by blocking the amount of cholesterol your body absorbs from the food you eat.  Plant stanols or sterols can be found added to yoghurts, spreads and yoghurt drinks.

Just remember that although these ingredients can help to lower cholesterol,  they are not miracle workers – you will still need to eat healthily to get the best benefit. (FYI: These foods are not recommended for pregnant women or for children).

What other foods should I choose?

Fish:  Although fish will not help to lower cholesterol, it has lots of benefits for your heart.  Omega-3 fats, which are found in oil-rich fish such as salmon, trout, mackerel, herring and sardines, are very beneficial for your heart.  Did you know that eating fish once a week can cut your chances of a fatal heart attack by over 30%?  Omega-3 fats are found in fresh, frozen, tinned, fried and smoked fish.  Tuna is the one exception – fresh tuna has omega-3s but tinned tuna generally doesn’t.  However, tinned salmon, tinned mackerel and tinned sardines are all good sources of omega-3s.

What about omega-3s from nuts and seeds?

Did you know there are three main types of omega-3s?  There is DHA and EPA, the types of omega-3s found in fish.  Then there is ALA, which is the type of omega-3 that is found in nuts and seeds like flaxseed and walnuts.  ALA helps to lower cholesterol.  Foods like flaxseed and chia seeds are high in ALA – adding them to cereals, salads and yoghurt can all help to lower cholesterol.

What if my triglycerides are high?

If your triglycerides are high, start by following the advice for lowering cholesterol.  However, there are a few extra things that you will need to do:

Sugar:  Sugar and sugary foods increase triglycerides so reducing these foods will help.  Cut back on sugar-sweetened drinks like soft drinks and limit fruit juice to one glass a day or less.  Also stop adding sugar to food – stop adding sugar to tea and coffee as well as cereal.  Cut back on sweet foods like cakes, biscuits, sweets and chocolate.

Alcohol:  Alcohol also increases triglycerides.  If you have high triglycerides have no more than one alcoholic drink per day and try to have at least 3 alcohol-free days every week.

Oil-rich fish will help to lower triglycerides – aim to have oil-rich fish such as salmon, trout, mackerel, herring or sardines once or twice a week.

Is there anything else I can do?

Exercise:  Being physically active is one of the most important things you can do for your heart.  Exercise helps to increase your HDL (good) cholesterol, lower blood pressure and strengthen your heart muscle.  Did you know that if you walk for 30 minutes per day that you reduce your chances of having heart disease by 30%.  If you increase this to 1 hour a day, you reduce your chances of having heart disease by 50%. Any exercise is good as long as you are breathing a little faster- you should be able to talk but not sing! – and you should be getting warmer.  Walking is excellent exercise but cycling, swimming, running, aerobics, skipping, anything will help.  Do check with your doctor before you start any new intense exercise.