The Times - UK (2022-04-09)

the times Saturday April 9 2022

10 Body + Soul

young people on very high protein and

keto-style diets that restrict carbs to less

than 10 per cent of calorie intake and limit

protein to 20 per cent, with fat making up

the rest.

“These diets are a matter of significant

concern, even if there is little harm in the

short term,” Neely says. “Young people

who follow them long term could be set-

ting up problems for the future and in

some cases are displaying dramatic in-

creases in cholesterol.”

In one opinion paper, published in

JAMA, researchers from New York Uni-

versity School of Medicine claimed any di-

et that encourages foods high in saturated

fat and low in fibre and nutrient-rich foods

such as beans, fruits, wholegrains and leg-

umes is concerning because it could cause

an increase in “bad” LDL cholesterol, a

known risk factor for heart disease.

“Protein itself is relatively neutral in

terms of blood lipids,” says Alan Flanagan,

a nutrition researcher at the University of

Surrey. “But the term ‘high-protein diet’ is

more an umbrella term for a high animal

and saturated fat diet, with liberal con-

sumption of fatty meats and foods and that

is the underlying problem.”

W

e used to be so
concerned about
our cholesterol
levels. Should we
eat butter or
marg? Dare we
even put dressing
on our salad? Now most of us are more
concerned with our progress at the gym or
keeping our blood pressure down.
Yet just because it is no longer the focus
of our attention, the threat of raised chol-
esterol has not gone away, according to
health experts. Dr Dermot Neely, a con-
sultant lipidologist and spokesman for
Heart UK, a charity that provides infor-
mation about cholesterol to families and
healthcare professionals, believes this
could be a costly mistake. Ignoring choles-
terol levels from as early as your thirties
not only raises the risk of heart disease and
strokes but, according to a recent study,
could affect your chances of getting
Alzheimer’s disease in later life.
“Too many people have become com-
placent about cholesterol,” Neely says.
“But it remains a pivotal risk factor which
underpins all efforts to reduce cardiovas-
cular disease, and in all cases controlling
cholesterol can dramatically reduce life-
long risk of heart disease.”
Quite how crucial a role cholesterol
levels play in our lifelong health was out-
lined in a study from Boston University
published last month. Its findings, pub-
lished in the journal Alzheimer’s & Demen-
tia, showed that recording your levels
of cholesterol in your mid-thirties can
accurately predict future risk of the
degenerative disease.
Cholesterol is a type of blood fat that
is present in every cell in your body
and is vital for making vitamin D
and bile, which helps to digest the
fats you eat. Some cholesterol
comes from food, but most,
about 80 per cent, is made in the
liver. There are several types of
cholesterol, but the principle
ones are HDL cholesterol, often
known as “good” cholesterol,
and non-HDL or LDL choles-
terol, often known as “bad” choles-
terol. The HDL variety carries chol-
esterol away from the cells, back to
the liver, where it is flushed from the
body. When the amount of non-HDL or
LDL cholesterol exceeds the amount HDL
can remove, it accumulates in the arteries
and can lead to health problems including
heart disease, strokes and dementia.
High cholesterol has no symptoms and
can only be detected by a blood test. NHS
advice is to ask your GP for a test if you are
over 40, overweight or have a family his-
tory of high cholesterol or heart problems.
But, says Neely, it is a good idea to have a
test from your early thirties onwards.
“The NHS GP health checks pro-
gramme and recommendations for chol-
esterol tests are currently under review
and it could soon be recommended that we
start testing at a younger age of 30 years,”
Neely says. “If there is a family history of
early heart disease or a genetic condition
called familial hypercholesterolaemia
[FH] then testing should be much earlier,

Lower your cholesterol: the new

Research shows that keeping cholesterol levels down

is vital — even in your thirties. Peta Bee reports

from early adulthood or childhood in the

case of FH.”

Blood cholesterol is measured in milli-

moles per litre (mmol/l) and the British

Heart Foundation says we should aim for

total cholesterol levels to be no more than

4mmol/l and non HDL-cholesterol (or

“bad” LDL) to be 3mmol/l or less.

Encouragingly, the Boston team suggest

that careful management of cholesterol

from early adulthood can lower the risk of

cardiovascular disease, type 2 diabetes and

Alzheimer’s. “Other important studies

have shown how intervening in choles-

terol at an earlier age can have a much

greater impact to reduce heart disease

over a 30-year follow-up period,” Neely

says. But how best to do it?

Statins, medicines that are used to lower

cholesterol in blood, can reduce LDL

cholesterol by about 30 per cent, some-

times even 50 per cent with high doses. But

there are other measures you can take

yourself. If tests show that you have high

levels of cholesterol, advice from the NHS

suggests you can reduce it through exer-

cise, weight loss, reducing alcohol con-

sumption and eating more healthily,

avoiding fatty foods. Here is what some of

the latest research recommends.

Choose olive or rapeseed

oil (not coconut)

Not all fats are bad. Saturated fats, found in

chocolate, fatty and processed meat,

butter and other full-fat dairy products,

are the type that raise levels of cholesterol.

Replacing saturated fats with unsaturated

fats, found in olive or rapeseed oils,

plant-based spreads, nuts and oily

fish can have huge benefits.

“A lot of studies have found that

if saturated fats are replaced with

unsaturated fats, the type found

mostly in plant foods and oily

fish, this has the biggest effect

on lowering blood cholesterol,”

Neely says.

Last year a team of Harvard

nutritionists, who reported their

findings in the Journal of the

American College of Cardiology,

showed that substituting just over

2 tsp (10g) of butter, margarine and

mayonnaise with olive oil was associated

with up to a 34 per cent lower risk of death

caused by heart disease compared with

those who didn’t make the switch.

“Both olive and rapeseed oil contain

monounsaturated fatty acids known to be

beneficial for cholesterol,” says Rhiannon

Lambert, a nutritionist and the author of

The Science of Nutrition (DK). “Rapeseed

oil has the least saturated whereas olive oil,

especially the extra virgin type, is high in

antioxidants called polyphenols, which

may also offer benefits but may offer

protection by improving the function of

the inner lining of the heart and blood

vessels and increasing protective

HDL cholesterol.”

One plant fat not to make the approved

list is coconut oil. “It contains about 86 per

cent saturated fats, one third more than

butter, which is about 52 per cent,” says

Victoria Taylor, a senior dietician with the

British Heart Foundation. “We don’t yet

know if the saturated fats in coconut oil are

any better for our heart health than

saturated animal fats, so it is best to use

coconut oil sparingly.”

Keep your weight at

a healthy level

When weight increases, cholesterol pro-

duction also increases, pushing blood

cholesterol ever higher.

“If you’ve been advised to lose weight, it

might be good to know that losing 10 per

cent of your body weight can help to lower

your cholesterol and triglyceride —

another type of blood fat— levels, as well

as reducing your blood pressure and risk of

type 2 diabetes, which are all risk factors

for heart disease,” Neely says.

Avoid very high

protein diets

There’s growing evidence, Neely says, of

more cases of raised cholesterol levels in

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