Hannah's cholesterol update...

By Hannah Sherwood

For those of you who read the cholesterol feature in September’s issue of HFG, you will have seen my mug shot alongside how I discovered that I have high cholesterol at the age of 23. Quite a shock, as I am generally in good health, have a healthy diet, am not overweight and exercise regularly. So what happened next?

My cholesterol journey so far

First step: discovery at a cholesterol seminar I attended for work that I had high cholesterol.

Second step: fasting blood test to confirm the cholesterol reading.

Third step: lipid clinic…

At the lipid clinic I was weighed and measured and had my blood pressure taken by a nurse before seeing the doctor. The doctor ran through how I’d ended up at the clinic today and remarked (yet again) at how I was the youngest patient he’d seen with high cholesterol. There was heavy focus on my lifestyle and family medical history, and after explaining how my dad has high cholesterol, as does my sister (who panicked after I told her my level and had hers checked immediately), it was becoming more probable that I have familial hypercholesterolaemia (FH), the type of cholesterol you inherit or have from birth.

What is FH?

For one in 500 of the population, a specific genetic defect causes high cholesterol. On all cells of the body, and mainly in the liver, there is a receptor that allows low-density lipoprotein (LDL) cholesterol (the bad kind) to be cleared from the bloodstream. People with FH have a defect in the gene of this LDL-cholesterol receptor. This causes LDL cholesterol to accumulate in the blood and ultimately in the walls of your arteries. Siblings and children of a person with FH have a 50% risk of getting the defect.

The tests

The doctor checked for fatty deposits (lumps) around my achilles and the knuckles on my hands, as well as my eyes. These cholesterol deposits are among the symptoms of FH. He checked my heartbeat, which was good, and checked for a pulse in my feet, which was also fine and meant that the blood flow was OK. I had my blood taken again to check for any secondary causes of hypercholesterolaemia.

What now?

My cholesterol needs to be brought down to a healthier level. A healthy LDL figure for most people is less than 3mmol/L, for people at high risk, like me, it’s less than 2mmol/L – but mine is 5.8! I was told there's nothing I can do lifestyle or diet-wise that will make a big enough difference, so I need to take statins for life. I was prescribed atorvastatin (1 tablet a day). I'm booked in for a check up in three months to see if the statin is working, and also to check that my body – most importantly my liver – agrees with it.

The bottom line

I was a bit disheartened – being 23 and feeling fit and healthy, the diagnosis seemed unfair. But, as the doctor warned me, having high cholesterol means I’m 10 times more likely to have a heart attack than someone with normal cholesterol levels, so I now see finding out as a blessing in disguise. It means I’ll be able to monitor it and bring it down far earlier than if I’d found out in 10, 20 or 30 years’ time. Who knows what state my arteries might have been in by then?

For more about cholesterol, plus diet tips go to http://www.healthyfood.co.uk/ 

Why should we increase our fibre intake?

By Gulshinder Johal, British Dietetic Association spokesperson

There was more positive news about fibre this week, with a new study revealing that a fibre-rich diet helps heart attack patients live longer. Why should the fibre we eat make such a difference?

A team of researchers from the Harvard School of Public Health in America found that patients who ate the most fibre were 25% less likely to die within nine years of having a heart attack than those patients with the lowest fibre intake. Those patients also had a 13% decrease in risk of dying from heart disease.

The study found that every 10g increase in fibre was associated with a 15% decrease in risk of death. With more people surviving heart attacks, looking at the lifestyle of patients and their dietary habits could help improve outcomes.

In this latest study, the authors looked at the different sources of fibre and found that higher cereal fibre consumption was associated with these decreased health risks. 

Possible mechanisms for the effect were lower inflammation in the body, lower levels of the more harmful 'HDL' cholesterol and improved glycaemic control. 

What does fibre do?

High-fibre foods can play a key role in keeping our diets healthy and balanced, while preventing the risks associated with diseases such as diabetes, coronary heart disease, high blood pressure and stroke. The fibre in some cereals, fruits and beans, known as soluble fibre, binds with cholesterol, preventing its re-absorption by the body thereby improving heart health. It can be found in foods such as cereal products, fruits, vegetables, pulses, beans, nuts and seeds.

So how much should we be eating? 

The NHS says that the UK population consumes approximately 14g fibre per day – well short of the 18g per day target.

Think wholegrain

Eating wholegrains is an easy way to increase dietary fibre because they contain all three parts of the grain – the bran, germ and endosperm – which makes them an excellent source of fibre, as well as iron, magnesium and vitamin E. 

Wholegrain foods include: whole oats, wholegrain breakfast cereals such as Weetabix, Shreddies, wholegrain muesli and Shredded Wheat, wholegrain bread, brown rice, whole wheat, oatmeal, barley, bulgur, and popcorn

Also get into the habit of:

* swapping white foods for brown foods, so choose wholemeal bread, wholemeal pasta and brown rice over white varieties.

* substituting white flour for brown flour in baking.

* adding lentils, beans or pulses to stews, soups and casseroles.

* checking labels: beware foods that are marketed as high fibre, such as biscuits, flapjacks, cakes and savoury snacks, as some could be very high in fat and sugar.

* having your five daily portions of fruit and vegetables as this alone could provide as much as 20g fibre per day.

One word of caution: increase your intake of fibre gradually, as a sudden rise can lead to bloating and wind!

Any other tips for better heart health?

Remember that fibre is one change of many that could improve our heart health. Looking at our overall lifestyle and addressing low fruit and vegetable intake, high salt consumption, low physical activity levels, oil-rich fish consumption and saturated fat levels will all contribute to optimum heart health.

Is coconut oil healthy?

By Liz Atkins

At Healthy Food Guide we get a lot of enquiries about coconut oil. Is it better for you than other oils, is it really full of antioxidants, can it help you lose weight, and do all those coconut-crazed celebrities know something the rest of us don’t? It certainly seems to be taking up a lot of supermarket shelf space at the moment…

So the facts are these: coconut oil is high in saturated 

fat – a typical level tablespoon has 135kcal and 15g fat, 

of which 13g are saturated (it also has small amounts of monounsaturates and polyunsaturates). We shouldn’t be eating more than 20g saturates a day if we want to reduce the risk of raising bad (LDL) cholesterol in the blood, and thus the chances of heart disease.

But here the waters get a little muddied... Virgin coconut oil is high in lauric acid, a type of saturated fat that’s sub-classified as a medium-chain fatty acid. This, say scientists, can lead to a rise in both bad and good (HDL) cholesterol levels in our blood. So, despite being rich in saturated fat, virgin coconut oil may actually have a neutral - or even beneficial - effect on overall blood cholesterol levels. At least, that’s what early research is suggesting. But it’s far from conclusive.

Research into other health benefits, including its effect on weight loss, is limited. Virgin coconut oil does appear to contain some antioxidants but, if you’re eating a balanced, varied diet that includes plenty of fruit and veg each day, you shouldn’t be going short on these.

Sadly, like all other oils, it’s high in calories, so if you’re watching your weight, you need to restrict the amount you use. Skinnier-than-average celebrities, remember, tend to eat very little of anything, coconut oil included. The government recommends sticking below 70g total fat and 20g saturated fat each day.

Still curious?

If you want to try it, we recommend you go for virgin coconut oil, which comes from the fruit of the ripe coconut flesh. It’s an unrefined fat, ie no chemicals are used and it’s not heated to high temperatures. Avoid both refined and partially hydrogenated coconut oil: they’re likely to contain trans fats, which appear to be even more damaging to our bodies than saturated fats.

Tina tries…

In our new series on shaping up, Healthy Food Guide’s art director Tina Betts starts on her journey towards a proper exercise plan to supplement her day-to-day walking…

By Tina Betts

How did it happen? I’m 43, and things are starting to sag. I haven’t changed my eating and drinking habits, so age is starting to catch up with me. I inherited my ‘walk everywhere’ gene from my Dad. I don’t have a car, so think nothing of whizzing down to Sainsbury’s with my trolley bag. But despite frequent trolley dashes, there’s a big but – my big butt, in fact! I’m lucky that I’ve always been a healthy weight, but it’s starting to creep up, the muffin top is rising steadily and there’s no way I’m going to fit into my dream 40th birthday dress again, at least not the way things are going.

My fear of exercise means I’ve never liked the gym or classes. It’s the classic ‘I was always the last to be picked’ for the team at school. It’s made me a tad anxious in sporting environments.

But that all changed a few weeks ago. As part of a work feature, I tried a yoga class for the first time with my work colleagues. And I could see the attraction of exercising as a group. In fact, I rather enjoyed it. And so, Tina tries… was born. It’s a week by week log of my mission to get fit - and get me back into that party dress.

My first stop was the Health Check at Nuffield Health at their flagship centre at London’s Cannon Street (it’s really more hip hotel than soulless gym). All members go through checks before starting their fitness plan.

Nuffield Health’s senior wellbeing adviser Katarina Berceliova took me through my body MOT, checking my BMI, resting heart rate, blood glucose levels (all healthy) and quizzed me about my sleep patterns (fine) and lifestyle habits (cholesterol and alcohol quotas not so fine). Generally, at 5ft 5in and 9 stone 3lb, my BMI at 21.2 is very good and my blood pressure spot on. But I know I need to do something about my fitness levels – I’ve reached the age where you can’t take anything for granted. 

I came away feeling optimistic with three main Wellbeing Action points: to monitor my blood cholesterol, up my water consumption and increase my activity and fitness levels.

Come back next week to read about my first ever session with my personal trainer. I have to admit, just those words make me nervous…