Understand cholesterol and control it with diet and exercise

Edited excerpts from the Observer Food Monthly collaboration with Dr Ali Khavandi and Dara Mohammadi

Good versus bad

Cholesterol is another wrongly maligned component of our diet. Because it’s a waxy substance it can’t dissolve in our blood, so it’s packaged into little ferries along with fat and protein to be transported to where it is needed for things like making hormones. It’s cholesterol’s inclusion in these transportation ferries where the misunderstanding about its role in ill-health comes from.

Low-density lipoprotein, or LDL, cholesterol ferries are known as “bad cholesterol”. These are the packages of cholesterol, fats and proteins made in the liver and sent off around the body. En route, and under specific conditions, they can get trapped in the lining of your arteries and leave fatty deposits that can lead to cardiovascular disease.

Then there’s “good cholesterol”, or high-density lipoprotein (HDL) cholesterol ferries. On their way back to the liver to be unpacked and excreted, these ferries help to pick up the fatty deposits and thus lower your risk of disease. Whether your total cholesterol, therefore, is high or low is an oversimplification – it’s the balance of good and bad cholesterol ferries that’s important.

Think of this balance, known as your lipid profile, as a gauge of your general health. The canary down the proverbial coalmine is a bad profile: high levels of bad LDL cholesterol, high levels of trigylcerides (another type of fat in your blood) and low levels of good HDL cholesterol. The good news is that many people can reverse a bad profile by changing their diet and lifestyle rather than by popping more pills.

Counter to what you might have heard, cholesterol in your diet from things such as eggs and prawns is almost irrelevant. Instead, watch out for excess sugar and refined, low-fibre carbohydrates (both cause spikes in your blood sugars, your liver responds to the surge by packaging the sugar into triglycerides and bad cholesterol and sending them out into the body). Avoid trans fats, eating more saturated fats than unsaturated fats from whole food sources, and drinking too much alcohol.

To improve your profile you can actively introduce foods with lots of soluble fibre: pectin in gummy fruits and beta-glucan in porridge protect the rest of the food you’ve eaten from digestive enzymes, meaning it’s digested more slowly and you get fewer sugar spikes. Prioritising unsaturated fats from whole foods such as nuts and oily fish will reduce your bad cholesterol and increase your good cholesterol. And in case you thought you could eat your way along a delicious path to a healthy heart: exercise is key, so get those walking shoes on and earn that brunch.

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