EATING PLAN FOR HIGH CHOLESTEROL (HYPERLIPIDEMIA)Thisplanwilllimityourintakeofsaturatedfat,transfatandcholesterolwhileincreasingfruit,vegetablesandwholegrains.

Cholesterol Defined A serum lipid test is a measure of your blood cholesterol levels. Your blood sample will be measured for four different components. The total cholesterol, triglycerides, low density lipoprotein (LDL or bad cholesterol) and the high density lipoprotein (HDL or good cholesterol) are reported to your doctor. These levels are compared to target values appropriate for reducing your risk for heart disease. If your values are not at target, improving eating habits, becoming more active, avoiding smoking and taking medications can improve your cholesterol values.

10 Tips to Help Reduce Your Cholesterol Levels1. Eatplentyofvegetablesandfruits-7servingsormoreeachday2. Eatwholegrainfoodsrichinsolublefibreoats,psylliumandbarley3. Include2Omega3richfishmealsperweeksalmon,trout,sardines4. Include2beanbasedmealsperweekkidneybeans,chickpeas,lentils5. Eatnutssuchasalmondsandwalnutssmallportions5timesaweek6. Improvethequantityandqualityoffatsyoueat7. Oilsarebestforaddedfatusesmallamounts,avoidfrying8. Beactivemoveyourbody30minuteseachday9. Ifyouareoverweight,worktoreduceyourweightby10%10. Ifyourtriglyceridesarehigh,limitsugarsandalcohol.

Cholesterol Facts Highcholesterolcanincreaseyourriskofheartdisease. Cholesterolinyourbloodcomesfromwhatyourliverproducesand

whatyouconsumeinyourdiet.Highlevelsofcholesterolinyourbloodcanentertheliningofyourarteriesandformdepositsorplaques.Theseplaquescangrowovertimeandblocktheflowofbloodinyourarteries.Thisputsyouatriskforaheartattackorstroke.

Makingchangestoyoureatingtoloweryourintakeofsaturatedfat,transfatandcholesterol,whileincreasingfibre,canloweryourcholesterolbyasmuchas35%.

Build a healthy heart from the ground up an eating plan based on fruit, vegetables, whole grains, nuts and legumes with lean protein choices is the foundation for managing your cholesterol.

Healthier Eating Guidelines for Lowering Cholesterol Focus on Quantity and Quality of Fat

Quantity1/4to1/3ofyourcaloriescancomefromfat.Thismeansthatyoucaneatbetween50to70gramsoffateachday.Thenumberoffatgramsthatarerightforyoumaybelessormorethanthisdependingonyourgender,activitylevelandweightgoals.ARegisteredDietitiancanhelpdeterminehowmuchisrightforyou.

Qualityunsaturatedfatssupportahealthycholesterolprofile.Thesefatsareliquidorsoftsolidatroomtemperature.Oilslikeoliveoil,canolaoil,soyoilandnon-hydrogenatedmargarinesaregreatqualityfats.Useinmoderation.Oneteaspoonofoil,thesizeofyourthumbtip,adds5gramsoffat.

Limit saturated and trans fats, or hard fats, to 15 grams or less per day.Thesefatsarefoundinfullfatdairyproducts,meats,poultryskin,lard,palmkerneloil,hydrogenatedoilsandbakedgoodsmadewiththesefatsandoils.

Eat less cholesterol aim for less than 300 mg of cholesterol per day. Cholesterolisfoundonlyanimalfoods.Reducingportionsofmeat,avoidinghighfatcutsofmeatandchoosinglowerfatdairychoiceswillhelp.

EggsRecentstudieshaveshownthateatinganeggadaywillnotincreasecholesterolorriskforheartdisease.However,ifyouhavediabetesyoushouldlimityoureggconsumptiontonomorethan6eggsperweek.

Nuts such as almonds, walnuts, pecans and pistachios can help lower cholesterol.Studiesshow1.5ozorabout36almonds5daysperweekhelpedreducebadcholesterol.Ifyouareworkingtoloseweightasmallerportionof10-12nutsisrecommended.

Fibre yes, for your heart!Fibreisfoundinplantbasedfoods.Vegetables,fruit,wholegrains,nuts,seeds,beans,peasandlentilsareallgreatfibresources.Functionalorsolublefibrehelpstoreducecholesterolbybindingwithcholesterolinyourstomachandbowel.Thischolesterolistheneliminatedinyourstool.Studiesshowweshouldinclude10to25gramsofthisfibreeachday.Hereisalistofthesolublefibrefoodsandthegramsoffibretheyprovide.

Heart Health Mixture=1/3groundflax,1/3oatbran,1/3psyllium.Use2tbspeachdayaddedtoyourfood.Itmixeswellwithyogurt,hotcerealandsaladdressing.

Salt Shake the HabitTips to reduce salt (sodium) intake: Home prepared fresh or frozen foods are best. Ifusingcannedfoods,lookforlabelssuchasnoaddedsaltorlow

sodium. Avoid adding salttoyourfoodandomitfromrecipeswherepossible. Season your food with herb and spice blends. Checkingredientliststoavoidthosewithsalt. Limit condiments such as ketchup, mustard, soy sauce etc. Use Nutrition Facts Labels. Bestchoiceshavelessthan200mgsodiumperserving.Avoidpackagedfoodwithmorethan

400mgofsodiumperserving.Checklabelscarefully. Use ingredient lists-foodslistingsaltorsodiumatthebeginningofthelistormultipletimesinthelistarehighinsalt. Restaurant foods are often high in sodium. TrytoavoidfastfoodbutdousetherestaurantsNutritionInformationto

identifylowersodiumoptions.Wheneatingout,askyourserverifthemealcanbepreparedwithoutaddedsalt.Requestsaucesontheside.

Item Soluble Fibre (g) Item Soluble Fibre (g)

Barley (1/2 c) 1 Navy Beans (1/2c) 2

Oatmeal (1/2 c) 1 Chickpeas (1/2 c) 1

Oat bran (1/2 c) 2 Carrots 1

Apple 1 Brussels Sprouts 3

Citrus (oranges) 2 Psyllium Seeds (1 Tbsp) 5

Pears 2 Metamucil (1 tsp) 2

Kidney Beans (1/2c) 3 All Bran Buds (1/3c) 2

Omega-3 Fats Omega3sareunsaturatedfatsfoundincoldwaterfattyfish(salmon,mackerel,arcticchar,sardines,troutandherring)andinplantfoodsincludingwalnutsandflaxseeds.Thefishomega-3sarecommonlyknownasEPAandDHA.Theplantomega-3sareknownasALA.ALAisconvertedtoEPAandDHAinyourbody.Foodshouldbeyourfirstchoicetoachieveyouromega3s(seebelow).Aimtoeat2mealsincludingfisheachweekandusetheHeart Health Mixtureasnotedonthepreviouspage.Ifyouhaveheartdiseaseoryourtriglyceridesarehigh,yourdoctorordietitianmayrecommendanOmega3supplement.

If you have High TriglyceridesInadditiontotheguidelinesformanagingyourcholesterol,youmaybenefitfromthefollowingrecommendations: Alcohol: Men-limittolessthan2drinksperdayor14perweek.Womenlimitto1drinkadayor9perweek. Dependingonyourtriglyceridelevel,yourdoctormayaskthatyoufurtherreducethisamount. Sugars -reduceaddedsugare.g.tablesugar,syrup,jam,honey,molasses.Limitjuice,pop,candies,sweets,chocolate

andbakedgoods. Ifyouhavediabetes,workwithyourhealthcareteamtoimproveyourbloodglucose(sugar)control Omega 3 supplementsadding2000to4000mgofEPA+DHAfromfishoil.Thisshouldbedoneunderthesupervision

ofyourdoctor Niacin by prescriptionthisBvitaminmayberecommendedtoloweryourtriglycerides.ItalsohelpsraiseHDL(good

cholesterol)

Reducing alcohol can promote weight loss and help decrease triglyceride levels.

Decoding Food LabelsTheNutritionFactstablefoundonthesideofpackagedfoodcanhelpyoumakebetterfoodchoices.Alwayschecktheservingsizefirstandconsiderthisinrelationtohowmuchofthefoodyouusuallyeat.

Lookforchoiceswithlessfat,saturatedfat,cholesterolandsodium.Lookforchoicesthatgiveyoumorefibre.Learn more about using food labels to make healthy choices on the web:Health Canada www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/cons/index-eng.phpHealthy Eating Is In Store for You www.healthyeatingisinstore.ca

OMEGA 3 CONTENT OF FOODS

Fish (2.5 oz) EPA/DHA (mg) per serving

Nuts/Seeds/Oils ALA (mg) per serving

Enriched Foods Total Omega -3 (mg) per serving

Herring 1600 Almonds (1/4 c) 150 Milk + DHA (1 c) 20

Mackerel 1490 Wheat Germ (27 g) 190 Soy beverage + flax 700

Salmon 1300 Canola Oil (1tsp) 430 Eggs + DHA (2) 800

Sardines 1050 Soybeans 760 Omega 3 yogurt (3/4 c)

500

Trout 870 Flaxseed, ground (1Tbsp)

1600

Arctic Char 680 Tofu (3/4c) 2020

Tuna, white (canned)

650 English Walnuts (1/4 c) 2300

To Reduce Weight Eatsmallerportionsoffoodsandrememberthebalanceoffoodsonyourplate:1/4protein,1/4starch(including

potatoes),1/2vegetables Eat3mealsperday,nomorethan6hoursapart.Dontskipmeals.Snackwithfruitbetweenmeals. Choosefoodslowerinfatandsugar.Eatingstrategiesincludinglowglycemicindexchoicescanbehelpful.

Learnmorefromaregistereddietitian. Aimforamaximumweightlossof1-2lbs(0.5-1kg)perweek. Waistlossisasimportantasweightloss.FortipsonhowtotrimyourwaistseeourWaistingAwaynutrition

factsheet.

ForamoredetailedplanforweightlosspleasereadWaistingAway-HealthyWeightManagementavailableinourclinicoronthewebatwww.ottawacvecntre.com

Portions to Live By Oneservingofwholegrainsis1/2cup

cooked,notthe3ormorecupsservedinmostrestaurants!Toomuchofagoodthingisnotagoodthing.

FormoredetailsonhealthyportionsseeEating Well with Canadas Food Guideon-lineatwww.healthcanada.gc.ca/foodguide.

Prepare for Success Cookwithoutaddingfatbake,broil,roast,barbeque,grill,steam Limitpanfryingandavoiddeepfatfrying Tryusing1/3lessfatthanyourrecipecallsfor Addflavourtofoodwithherbsandspicesthinkgarllic,lemon,gingerandmore Refrigeratesoupsandstewsandskimofffatwhensolid Useasprayofoiltopreventstickingandaddflavour

Food and Medication InteractionsReviewyourmedicationswithyourDoctor,DietitianorPharmacist. Cautionwithgrapefruit,grapefruitjuice,pomelosandSevilleorangesCertainmedicationsforcholesterol

andheartdiseaseinteractwiththesefoods.

Supplements for Cholesterol Control CheckwithyourDoctor,DietitianorPharmacistbeforestartingasupplement. Heart Healthy Mixture=1/3groundflax,1/3oatbranand1/3psyllium.Use2Tablespoonsperdayadded

tofoodsorbeverages. Omega 3 supplements

ifyouhaveheartdisease:1000mgperdayasEPA+DHA ifyourtriglyceridesareelevated:2000to4000mgperday(underthesupervisionofyourdoctor).

PlantSterolsconsuming2gramsofplantsterolsperdayfromenrichedfoods,suchasmargarinewithplantsterols,hasbeenshowntoreduceLDLcholesterol.

Redyeastricecanbeeffectiveatloweringcholesterolbuttheseproductsareunregulated.Theircontentisunreliableandthereforetheyarenotrecommendedforuse.

Supplementsofgarlic,soyandlecithindonotappeartoreducecholesterolbasedoncurrentresearch. Lecithindoesnotappeartoreducecholesterol. CoenzymeQ10evidencetodatedoesnotshowthatCoQ10reducesmusclepainassociatedwithcholesterol

loweringmedications.

Protein

Fruit

Protein

Vegetables

StarchStarch

Breakfast Lunch & Supper

Move your body, lower your bad cholesterol, raise your good cholesterol Includingatleast30minutesofbriskactivity,suchaswalking,four(4)ormore

daysperweekcanloweryourLDLandraiseyourHDL. Startwithabrisk10minutewalkafewtimesperdayandincreasegraduallyfromthere. Gentlestretchingexercisesincreaseyourflexibilityandreleasetensioninyourmusclesandjoints.Aimfor4ormore

stretchingsessionsperweek. Strengthexercisesimprovemuscleandbonedensitykeepingyoustrongandstable.Includethese2-4timesper

week. Remembertostartslowlyandconsultyourphysicianbeforestartinganew

exerciseprogram

Keeping active can lower your blood sugar, cholesterol, blood pressure, help you feel better, relieve tension and stress, improve your muscle tone and help you lose weight!

Eating Plan for High CholesterolCholesterolloweringmaximum15mgofsaturatedfatperday,300mgofcholesterolReadfoodlabelsforlessfat,saturatedfat,cholesterolandsodiumandmorefibre.

Vegetables and Fruit Freshandfrozenarebest Unsweetenedcannedfruit,unsaltedcanned

vegetables Limitfruitjuicewithelevatedtriglycerides Lowsodiumvegetablejuice Avocadosandolivesinmoderationforhealthyfat

Vegetablespreparedwithbutter,creamorsauce;batteredanddeepfried

Fruitpackedinheavysyruporsugar;sweetenedfruitjuice,fruitdrinks,sportsdrinks

FOODS TO CHOOSE FOODS TO LIMIT OR AVOID

Whole Grains bread,buns,rolls,pitabread,Englishmuffinsand

tortillas lowfatcrackers,breadsticks,melbatoast,soda

crackers(unsaltedtops) Unsweetenedhotorcoldcerealoats,oatbran,

psylliumforsolublefibre Brownrice,barley Wholegrainpasta Lowfatbakedgoodsaddoatbran,groundflaxto

boostfibre

Avoidwhiteproducts Cheeseoreggbread,croissants,sweetrolls Crackersover5gramsoffatperserving,commercial

crumbcoatings Sweetenedcereals Pastawithbutter,creamorcheesesauce,chowmien

noodles,ramennoodles Commercialmuffins,cakes,donuts,Danish,high-fat

cookies

Milk and Alternatives Anywith1%MilkFat(MF)orless Cheesewithlessthan20%MFoccasionaluse

Allmilkproductswhicharemorethan1%MF Cheese21%MForhigher

Beverages Water,sodawater,mineralwater Sugar-freesoftdrinks Coffee,Tealimitto4cupsperday Cerealbeverages(e.g.Postum,Ovaltine)

Regulartonicwater Regularsoftdrinks,lemonade,sweetenedicedtea,

regulardrinkcrystalmixes Flavoredinstantcoffee Liqueurs,Cocktailmixes

Note: Underlined foods are commonly higher in salt (sodium) limit use in cases of hypertension or other condition requiring salt restriction.

FOODS TO CHOOSE FOODS TO LIMIT OR AVOID

Meat and Alternatives Fishandshellfish:fresh,frozen-unbattered,cannedinwater Poultry:chicken,turkeywithoutskin Meat:leancuts,fattrimmed

Beef:round,rump,sirloin,extralean/leanground Veal:round,rump,tenderloin Lamb:leg,loin,shank,leanground Pork:tenderloin,backbacon,ham DeliMeat:ham,roastbeef,pork,turkey,turkeyorreducedfatwieners

WildGame:moose,venison,rabbit Legumes:chickpeas,kidneybeans,lentils,limabeans,

soybeans,splitpeas,tofu Eggs:ifyouhavediabetes,limitto6perweek Nuts:unsaltedalmonds,walnuts,pecans,pistachios

limit1/4cperday Peanutbutter:naturalornon-hydrogenatedorlight Seeds:flax,pumpkin,sesame,sunflower

Fishcannedinoil,commerciallyfried,frozenbatteredfish Poultry:duck,goose,friedorbatteredchicken,chicken

wings Meat:fattymarbledmeats,ribs,medium/regularground

meat,organmeats,bacon,sausage(unlesslowfat),cannedmeats

Delimeat:pate,bologna,salami,high-fatluncheonmeats,wieners

Peanutbutterwithhydrogenatedoil

Fats and OilsLimitaddedfatsto3teaspoonsperday. Oils:olive,canola,corn,peanut,sesame,soy,sunflower Margarine:non-hydrogenatedsoft(regularorlight) Saladdressing/Mayonnaise:lowcalorie,caloriereduced,

oil-free,homemadewithrecommendedoils Lowfatsourcream,creamcheese Gravy:defatted

Hydrogenatedorblockmargarine,butter,lard,shortening,suet

Saladdressingsmadewithcheeseorregularsourcream Tropicaloils:palmkernel,coconut Fullfatgravy,creamsauces

Sweets Sugar:substitutes(e.g.sucralose,),lowsugarjams,jellies,

syrups Sugarfree:candies,gelatins,gum Bakedgoods:lowinsugar,fatandhighfibre Frozendesserts:lowfat,lowsugaricecream,icemilk,

frozenyogurtandsherbet Cocoapowder

Sugaruseinmoderation Regularjams,jellies,syrups Regularcandies,gelatins,gum Bakedgoods-regularcakes,pies,cookies-avoidwhitefoods FrozenDesserts:regularicecream,icemilk,frozenyogurt,

sherbet Chocolatebars,chocolate

Snack Foods Popcorn:hotairpoppedorlowfatmicrowave Pretzels,bakedchips,ricecrispsandcakes

Popcornregularandhighfatmicrowave,cornchips,potatochips,cheesies

Miscellaneous Condiments(ketchupetc),herbs,spices,vinegar,pickles Soups:preparedwithskimmilkorfat-freestock,bouillon,

broth,consomm

Soups-cream

Eating Plan for High Cholesterol, August 2010DanielleAldous,BSc,RD(FromOriginal,2005:HeleneCharlebois,BSc,RD&JasnaRobinsonDI)ContinuingMedicalImplementationInc.

Ottawa Cardiovascular Centre502-1355BankStreetOttawa,ONK1H8K7Phone: (613)738-1584Email: admin@ottawacvcentre.com

Other Nutrition Fact Sheets Available: EatingPlanforHypertensionEatingPlanforCongestiveHeartFailureEatingPlanforType2DiabetesWaistingAwayHealthyWeightManagementPotassiumModifiedEatingPlanPlease visit www.cvtoolbox.com for more information