Want to live longer? - Have a dance

The Health Promotion Department is encouraging caterers to start offering cholesterol-free dishes on their menus, director Mario Spiteri said.

Speaking in an interview, Dr Spiteri said the department had an ongoing campaign to promote a healthier lifestyle, promoting exercise as this leads to a decrease in cancers and heart disease.

The department has already published a recipe book containing several health recipes. The next step was to encourage caterers and restaurant owners to introduce cholesterol- free items on their menus.

"Vegetarian dishes are now available in most restaurants but these are still unsuitable for people having high cholesterol levels. Such people would dine out too if they had the right items on the menu and cholesterol-free items are not necessarily more complex or expensive to produce," he said.

The department has qualified nutritionists and was willing to guide caterers about cholesterol-free items and to vet menu items to certify that they were cholesterol free, he said.

Dr Spiteri said people who did not know whether their cholesterol levels were within limits should have a blood test. This could be done either at government health centres or privately.

Two types of cholesterol are produced by the liver: HDL, a good cholesterol, and LDL, which is harmful when produced in excessive quantities.

LDL, which is not used by the body, is destroyed by the HDL type, but when the amounts are excessive, the HDL cannot cope and the harmful cholesterol is deposited in veins and arteries, provoking strokes or heart attacks. Heart disease in Malta is the most common cause of death and the importance in reducing cholesterol cannot be over-emphasised, Dr Spiteri said.

Many internet sites dealing with how to control cholesterol state that regular physical activity improves cholesterol levels as it helps to lower LDL and raise HDL. Exercise can also help one lose weight, if overweight. It does not need training like a long distance runner to benefit, doing any physical activity for just a few minutes each day is better than none at all.

Simple tips include taking a walk at lunch time or after dinner, using the stairs instead of the lift, getting off the bus one or two stops early and walking the rest of the way or parking farther away from where one needs to go to, riding a bicycle or doing garden work or going dancing.

Aerobic activities, or vigorous activities, like brisk walking, running, swimming, or jumping rope are especially good for the heart and can burn off extra calories. Aerobic activities can condition the heart if done for at least 30 minutes, three to four times a week.

Most people do not need to see a doctor before they start being active, especially if they start off slowly and work up gradually to a sensible plan.

But medical advice should be sought beforehand if one has pains or pressure in the chest or shoulder area or if one tends to feel dizzy or faint.

For those suffering from high cholesterol levels, giving up smoking and a lower fat diet is recommended. Most recipes can be modified to make them lower in fat by substituting ingredients.

Vegetable oil such as corn oil, canola oil, or peanut oil can be used instead of solid fats such as butter. Skimmed milk should be used instead of normal milk.

Studies have shown that cholesterol produced by the body from saturated fats which people eat are worse than the cholesterol found naturally in egg yolk.

Smoking is particularly damaging because it helps thicken the blood, aggravating the problem.

Nutritionist Yvette Azzopardi said it was very important for people to be of the right weight as the more overweight or obese one was, the greater the health risks.

The Health Interview Survey produced by the Health Information Department showed that 29 per cent of the female population are overweight and 21 per cent are obese. The figures for males show that 41 per cent are overweight and 25 per cent are obese.

Ms Azzopardi stressed the importance of physical activity:

"If people can't find 30 minutes in which to do some vigorous exercise daily, they should split it up into three 10-minute intervals. If you incorporate it in your daily routine, it will not be difficult to keep," she said.

Ms Azzopardi said cholesterol was only found in animal food and in food or drink derived from animals, such as milk.

People should eat fish at least twice weekly, especially oily fish such as tuna. herrings and salmon. White fish was also good and should be eaten regularly, but the oily fish have substances that helped to reduce the harmful cholesterol. It was enough to eat meat once a week, while vegetables, legumes and fruit should be eaten regularly.

"Dairy products, which have a lot of fat, should not be eliminated. Those suffering from high cholesterol should go for skimmed milk and light versions. Ice creams, chocolates and shortcake biscuits should be an occasional part of the diet, not regular features," she said.

Fresh fruit was very good and dried fruit was good too, except for those suffering from diabetes. Fibre, which we get from eating cereals, is very good and an important component of a healthy diet.

Although people can have high blood cholesterol levels because they eat a lot of junk food, some can have high levels because of heredity. A good diet and regular exercise were usually sufficient to keep levels down, but medical advice can be sought as medicines can be taken as a last resort, she said.