Elevated plasma cholesterol levels are called hypercholesterolemia. Cholesterol (or rather, its complex molecules – lipoproteins) in the body occurs mainly in two fractions, it is the so-called bad cholesterol (LDL-C) and the so-called good cholesterol (HDL-C).
In practice, most attention is paid to the LDL-C fraction, whose plasma concentration in healthy adults should not exceed 115 mg/dl. Hypercholesterolemia in itself is not a disease, but an abnormal condition of the body, and is quite common among Poles. Estimates put it at about 58% of Polish adults with LDL cholesterol above normal (with men suffering slightly more often from hypercholesterolemia).
Why is it so important to control LDL cholesterol levels?
The main reason is that excess LDL cholesterol is deposited in the human body in the arteries, leading to the formation of atherosclerotic plaques and the consequent reduction of their lumen, or so-called atherosclerosis. This dangerous condition can lead to more dangerous consequences such as heart attack or stroke. In addition, elevated levels of the LDL fraction in secondary hypercholesterolemia can be the result of other diseases, among which are hypothyroidism, nephrotic syndrome, chronic kidney disease and liver disease.
The mainstay of treatment of diagnosed hypercholesterolemia is medication – most often statins. However, current recommendations of cardiovascular societies do not overestimate the impact of lifestyle modification: introducing physical activity, giving up stimulants, lowering body weight and, most importantly, following a proper diet. The recommended diet is the Mediterranean diet. An effective diet for lowering cholesterol can be recognized by several components – the most important recommendations are:
– including in the menu products rich in fibre, the soluble fraction of which reduces total and LDL cholesterol. It is important to consume whole grain cereal products – coarse groats, wholemeal bread and pasta, oatmeal, as well as legumes and fruits and vegetables;
– replacing saturated fatty acids with mono- or polyunsaturated ones. Replacing 1% of energy from saturated fat can lower LDL cholesterol by up to 2 mg/dl, studies show. In practice, this means giving up animal fats (lard, fatty meats, full-fat dairy products and butter) and tropical oils (palm and coconut) in favor of plant-based, healthy fats (olive oil, canola oil, flaxseed oil, avocados, seeds and seeds, nuts);
– exclusion of trans fatty acid isomers from the diet. Studies have proven that higher consumption of such fats is associated with an increase in the risk of ischemic heart disease by as much as 23%! What should be excluded from the diet? So-called industrially hydrogenated fats, which are found en masse in fast-food dishes, ready-made confectionery products, baking margarines and French fries. Above all, choose products that are as little processed as possible;
– Introduce into the diet at least twice a week sea fish (especially oily ones), which are an excellent source of omega-3 fatty acids.
As you can see, already small changes in our daily menu can have a significant impact on blood cholesterol levels. Such a diet does not have to be boring and monotonous at all – below are my five breakfast suggestions that will help lower cholesterol:
Breakfast 1 – Sandwiches with avocado and salmon paste
| Breakfast 1 weight – 303.0 g | energy – 395.2 kcal | protein – 19.4 g | fat – 17.6 g | carbs – 47.0 g | |
| Sandwiches with avocado and salmon paste | |
| salmon, smoked – 50 g (0.25 packet) avocado – 70 g (0.5 pieces) turmeric – 1 g (1 to taste) lemon juice – 6 g (1 tbsp) onion – 20 g (0.3 small pieces) natural yoghurt 3% fat – 40 g radish – 50 g (1 small portion) wholemeal rye bread – 66 g (2 slices) | Avocado and salmon paste: Blend the ingredients. Season to taste with salt, turmeric, lemon juice and pepper. Eat with radishes. |
BREAKFAST 2 – Cinnamon oatmeal with apple and nuts
| BREAKFAST 2 weight – 399.0 g | energy – 474.0 kcal | protein – 30.4 g | fat – 14.6 g | carbs – 63.5 g | |
| Cinnamon oatmeal with apple and nuts | |
| oatmeal – 40 g (4 tbsp) apple – 180 g (1 medium piece) cinnamon – 1 g (to taste) walnuts – 12 g (3 pieces) ground flaxseed – 16 g (2 tbsp) Skyr, Icelandic type, natural yoghurt – 150 g (1 cup) | Cook the flakes in water or pour boiling water over them, add grated apple, yoghurt. Mix. Add the remaining ingredients. Oatmeal can also be prepared overnight in the fridge – soak flakes in water or yoghurt overnight, add remaining ingredients in the morning. |
BREAKFAST 3 – Salad with bulgur groats, chicken and vegetables and oil
| BREAKFAST 3 weight – 355.0 g | energy – 451.6 kcal | protein – 30.7 g | fat – 16.3 g | carbs – 50.4 g | |
| Salad with bulgur groats, chicken and vegetables and oil | |
| bulgur groats – 50 g (0.5 bag) chicken breast meat, skinless – 100 g (1 portion) lemon juice – 12 g (2 tbsp) balsamic vinegar – 10 g (1 tbsp) mustard – 10 g (1 tbsp) olive oil – 8 g (1 tbsp) avocado – 35 g (0.25 pieces) cherry tomato – 100 g (5 pieces) rocket – 30 g (2 handfuls) | Cook the porridge, let cool. Marinate the chicken in your favourite spices (e.g. curry, marjoram, pepper, lovage, herbes de Provence) and grill without fat or bake in the oven. Slice finely. Prepare dressing: mix olive oil with vinegar, mustard and lemon juice. Dice the vegetables and avocado. Mix together, season as desired. |
BREAKFAST 4 – Sandwiches with Provence cottage cheese paste
| BREAKFAST 4 weight – 362.0 g | energy – 486.5 kcal | protein – 31.9 g | fat – 16.5 g | carbs – 54.0 g | |
| Sandwiches with Provence cottage cheese paste | |
| herbes de Provence – 2 g (1 pinch) lean cottage cheese – 100 g (1 portion) cucumber – 40 g (1 ground cucumber) salt – 1 g (1 pinch to taste) pepper – 1 g (1 pinch to taste) onion – 35 g (0.5 small pieces) natural yoghurt 3% fat – 20 g (1 tbsp) pickled green olives – 25 g (10 pieces) sun-dried tomatoes in oil – 40 g (4 pieces) rocket – 30 g (2 handfuls) graham rolls – 60 g (1 piece) olive oil – 8 g (1 tbsp) | Blend the cottage cheese, oil, tomatoes, olives, cucumber, yoghurt and onion to a smooth cream. Season. Serve on bread, sprinkled generously with arugula. |
BREAKFAST 5 – Satiating morning green smoothie
| BREAKFAST 5 weight – 576.0 g | energy – 442.3 kcal | protein – 20.5 g | fat – 14.2 g | carbs – 66.6 g | |
| Satiating morning green smoothie | |
| almond drink, unsweetened, uht – 120 g (0.5 glass) skyr yoghurt, Icelandic type, natural – 75 g (0.5 cup) dry chia seeds – 10 g (1 tbsp) sunflower seeds – 15 g (1 tbsp) apple – 180 g (1 medium piece) raspberries – 100 g (1 medium serving) oatmeal – 20 g (2 tbsp) fresh young spinach – 50 g (2 handfuls) cinnamon – 1 g (1 to taste) Xylitol – 5 g (1 teaspoon) | Blend the smoothie ingredients. Add sweetener if necessary. |
Literature:
- Czapla, M., & Jankowski, P. (2022). Żywienie w chorobach serca. Warszawa: Wydawnictwo Lekarskie PZWL.
- Jarosz, M., Rychlik, E., Stoś, K., & Charzewska, J. (2020). Normy żywienia dla populacji Polski i ich zastosowanie (pp. 68-437). Warsaw, Poland: Narodowy Instytut Zdrowia Publicznego-Państwowy Zakład Higieny.
- Banach, M., Burchardt, P., Chlebus, K., Dobrowolski, P., Dudek, D., Dyrbuś, K., … & Cybulska, B. (2021). WYTYCZNE PTL/KLRwP/PTK/PTDL/PTD/PTNT DIAGNOSTYKI I LECZENIA ZABURZEŃ LIPIDOWYCH W POLSCE 2021. Lekarz POZ Suplement.