A Google search on the best diet to improve people’s health may sometimes be confusing.

Looking at the various types of diets claiming fast weight loss, one even wonders what the truth is. Various studies have been carried out to identify which diets support a healthy lifstyle. These diets need to include a variety of items from the major food groups: fruits, vegetables, whole grains, low-fat dairy products and lean protein, including beans and other legumes, nuts and seeds, and healthy fats.

Food portions are a major issue in weight gain, so healthy diets should provide guidelines on how much food to choose from each group; after all, this involves adapting a lifestyle, so it needs to fit one’s taste, way of life and budget.

Statistics show that hypercholesterolemia is a common condition among the Maltese population. Cholesterol is a fatty sub­stance known as a lipid and is vital for the normal functioning of the body. It is mainly made by the liver but can also be found in some foods. Cholesterol is carried in your blood by proteins. When the two combine, they are called lipoproteins.

The two main types of lipoprotein are: high-density lipoprotein (HDL), which carries cholesterol away from the cells and back to the liver, where it’s broken down or passed out of the body as a waste product (this is why HDL is referred to as ‘good cholesterol’, therefore higher levels of it are better); and low-density lipoprotein (LDL), which carries cholesterol to the cells that need it, but if there is too much of it for the cells to use, it can build up in the artery walls, leading to disease of the arteries (for this reason, LDL is known as ‘bad cholesterol).

Cholesterol can build up in the artery walls, restricting the blood flow to various organs including the heart and brain. Evidence strongly indicates that high cholesterol can increase the risk of: narrowing of the arteries (atherosclerosis); heart attack; stroke; and peripheral arterial disease.

If one has high cholesterol levels, they need to adopt a healthy diet and perform regular exercise, as these both can help bring it down. This does not exclude the need for medicines.

1. Decrease trans fats and saturated fats

Scientific evidence shows a relationship between trans fats and heart disease. Trans fats are created by adding hydrogen to a liquid fat to help it solidify. Food manufacturers started using trans fats because they extend the shelf life of packaged baked goods, which can be reused and are relatively cheap.

Saturated fats and dietary cholesterol, which are mainly fats coming from animal pro­ducts, are unhealthy and should be reduced. These in­clude meat pies, sausages and fatty cuts of meat, butter, ghee and lard, cream, hard cheeses, cakes and biscuits, and foods containing coconut or palm oil.

Reducing fat in your diet can help lower your risk of heart disease

2. Eat more polyunsaturated and monounsaturated fats

Polyunsaturated and mono­unsaturated fatty acids help lower the bad type of cholesterol and low-density lipoproteins, and hence are healthy fats. Most plant-derived oils, including canola, safflower, sunflower, olive, grapeseed and peanut oils contain both. Fatty fish (such as salmon, tuna, trout, herring and mackerel), seeds such as sunflower and pumpkin seeds, nuts such as almonds and cashews, avocados and soybeans are also good sources.

3. Increase the amount of fruits and vegetable consumption

Fruits and vegetables have ingredients that lower cholesterol. These include fibre and cholesterol-blocking molecules called sterols and stanols. These include leafy greens, yellow squashes, carrots, tomatoes, strawberries, plums and blueberries. Aim to eat at least five portions of different fruit and vegetables a day

4. Increase fibre intake

Increasing fibre intake helps lower your risk of heart disease, with high-fibre foods also tending to lower cholesterol. Adults should aim for at least 30g of fibre a day. Good sources of fibre include: wholemeal bread, bran and wholegrain cereals; fruit and vegetables; potatoes with their skins on; oats and barley; pulses such as beans, peas and lentils; and nuts and seeds.

5. Avoid refined sugars and grains

Whole grains are another good source of fibre, including wholewheat flour and brown or wild rice. Reduce sugars from the diet.

6. Reduce total fat

Reducing the total amount of fat in your diet can also help lower your risk of heart disease. Instead of roasting or frying, consider: grilling; steaming; poaching; boiling; or microwaving.

7. Get active

An active lifestyle can also help lower your cholesterol level. Activities can range from walking and cycling to more vigorous exercise such as running and energetic dancing. Doing 150 minutes of moderate aerobic activity every week can improve your cholesterol levels.

Cholesterol control is useful in reducing the risk of heart attack, stroke and peripheral artery disease. It is one part of the risk reduction strategy, which includes stopping smoking, weight control, diabetes control, blood pressure control and regular exercise.

Prof. Charmaine Gauci is the Superintendent of Public Health.

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