To find out more about healthy lifestyles , try one of the following links: 

Cholesterol Busters Good Health DHS Better Health Channel Heart Health Information (Australian) Healthy Eating Information Web-Centre (Monash University)

There are ten main risk factors for heart disease. Most of these risk factors can be reduced with lifestyle modification.

You can reduce some risk factors by making changes to your diet if required:

High blood cholesterol level High blood triglyceride level Overweight/obesity/abdominal obesity Diabetes mellitis Hypertension

Other risk factors you can reduce include:

Cigarette smoking Inactivity

Small changes to each of these risk factors can make a big difference overall in reducing the risk of heart disease.

Risk factors we can not change include:

Family history Male Age

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Cholesterol is a type of fat made by the liver. Although our body needs some cholesterol, high levels of cholesterol increase the risk of heart disease.

We make two main types of cholesterol:

LDL-Cholesterol is undesirable as it deposits cholesterol into the artery walls which can lead to blockage. High LDL-cholesterol levels are associated with heart disease.

HDL-Cholesterol takes cholesterol out of the artery wall so has a cleansing effect. This helps protect against heart disease.

Recommendation of the National Heart Foundation:
 

Total Cholesterol - Less than 5.5 mmol/L LDL-Cholesterol - Less than 3.5 mmol/L  HDL-Cholesterol - Greater than 1.0 mmol/L

For those with a history of hear disease, the recommendations by the National Heart Foundation are slightly lower:
 

Total Cholesterol - Less than 4.5 mmol/L LDL-Cholesterol - Less than 2.5 mmol/L  HDL-Cholesterol - Greater than 1.0 mmol/L

 

LDL-Cholesterol
Increased by:

Saturated fat Trans fatty acids abdominal obesity

Decreased by:

polyunsaturated oil monounsaturated oil soluble fibre

Recommendation for reducing LDL-Cholesterol:
 

Avoid saturated fat and trans fatty acids. If fat is required, a small quantity of monounsaturated or polyunsaturated oil is preferred. Eat Foods high in soluble fibre daily Reduce the body fat that may be stored around the abdominal region.

Antioxidants may prevent LDL-cholesterol from adhering to the blood vessels, so have a protective role in the prevention of heart disease. Antioxidants, including dietary sources of vitamins Beta-carotene, C and E, should be consumed daily.

HDL Cholesterol

Increased by – exercise (> than 30 minutes per day i.e. walking)

The benefit of regular exercise on increasing HDL-cholesterol is well supported. However, there is conflicting research regarding the effect of diet on HDL cholesterol levels.

Dietary Cholesterol

Blood cholesterol levels are determined predominantly by our own cholesterol production not by dietary cholesterol. The quantity we make is influenced by genetic factors and the amount of saturated fat we eat. Products labeled “cholesterol free” are not necessarily good choices. If these products are high in saturated fat, they may increase blood cholesterol levels. Dietary cholesterol, if taken with saturated fat, will also increase cholesterol levels (eg, bacon and eggs). If saturated fat is minimised, small quantities of high cholesterol containing foods can be included.

How many eggs? If you have high cholesterol, limit eggs to no more than 3 per week. Boiled, poached or scrambled eggs are preferable to fried eggs or omelettes which are higher in fat.

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It is important to note that all fats are equal contributors to weight/body fat gain. There are several types of fat which each have different effects on blood levels.

Saturated Fat

These fats increase total and LDL cholesterol level.
To reduce saturated fat, avoid/limit:

fatty meats bacon sausages luncheon meats chicken skin salami strassburg pressed ham mayonnaise butter full cream milk cream cheese

cream cheese dips frozen yoghurt cream sour cream pastries sausage rolls pies pasties danishes croissants donuts biscuits

cake chips copha lard ghee dripping margarine palm oil coconut milk/cream fried food chocolate carob

Note: Low fat dairy and lean meat products are excellent alternatives.

Trans fatty acids

Trans fatty acids occur naturally in animal products and also in “solidified” or “hydrogenated” oils. They are produced in the manufacture of margarines. Trans fatty acids:
 

increase total and LDL cholesterol levels decrease HDL cholesterol levels

To limit trans fatty acids avoid:

fatty animal products margarine deep fried food

NB. Margarines are not a “healthy” choice afterall.
Exceptions include Becel, Flora and Olivio margarines.
 

Polyunsaturated Oil

Omega-6

Omega-6 polyunsaturated fats decrease total and LDL cholesterol levels therefore improve the LDL:HDL ratio. While they still contribute to weight gain, polyunsaturated oils are a preferred choice in place of saturated fat or trans fatty acids as they are able to lower cholesterol.

Dietary choices include:

Polyunsaturated margarines 

vegetables & seed oils:	Nuts:
Safflower Sunflower Corn Soybean Cottonseed	Walnuts Almonds Brazil

Omega-3

Omega 3 polyunsaturated oils do not effect cholesterol levels but are beneficial in reducing blood triglyceride levels. They also decrease the risk of blood clots forming by reducing the “stickiness” of blood components.

Dietary sources include:

Fish (include at lease three serves of fish per week) Green leafy vegetables Linseed oil

Monounsaturated oil

Monounsaturated oils decrease total and LDL cholesterol levels therefore improve LDL:HDL ratio. Like omega 6, they also contribute to weight gain so should be used in moderation but are a preferred choice over the saturated fats or trans fatty acids.

Dietary sources include:

Monounsaturated margarine Oliveoil/spray Canola oil/spray Sunola oil Avocado Olive

peanuts/oil cashews almonds

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There are two main types of dietary fibre – soluble and insoluble. Both are beneficial to our body. Soluble fibre can reduce both total and LDL cholesterol levels whereas insoluble fibre assists bowel function. Dietary fibre has an additional advantage, as it bulks up our food intake creating a “full” feeling, so may assist in weight/body fat reduction.

Dietary sources of soluble fibre:

Baked beans Split peas Bortolli beans Canneloni beans Oat bran Rice bran Kellogg’s Guardian

Lentils Chick peas Blackeye beans Broad beans Barley bran Untoasted muesli porridge

Kidney beans Soy beans Lima beans Soup mix Psyllium Oats

Practical ways to increase your soluble fibre intake:
 

Baked beans on toast, in jaffles, in a jacket potato or on muffins. Use wholegrain bread instead of white bread ie. Taylors, Ploughmanns Use oatbran English muffins Reduce the quantity of meat in casseroles, stews bolognaise sauce. Use red kidney beans and lentils instead. Add beans, lentils, oats to rissoles, hamburger and meatloaf. Add 3 or 4 bean mix or chickpeas to salads When making soup, add lentils, pearl barley, soup mix, split peas Oatbran, barley bran, rice bran or psyllium can be sprinkled over breakfast cereal.

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Antioxidants can protect against heart disease. They may prevent LDL cholesterol from adhering to the blood vessel walls so stop “plaque” formation. Antioxidants include Vitamins A (Beta-carotene), C and E, so can be obtained from food.

Beta-carotene

Dietary source include:
 

pumpkin capsicum carrots carrot juice sweet potato spinach broccoli

broccoli lettuce chilli sauce tomato mango canteloupe apricots

plums nectarines watermelon pawpaw peaches

Recommendation:
Aim to include at least five different vegetables daily, including one orange and one green vegetable.

Vitamin C

Dietary sources include:

oranges mandarins grapefruit lemon berries

kiwi fruit guava mango pineapple capsicum

broccoli brussel sprouts cabbage potato cauliflower

Recommendation:
All fruit contain Vitamin C, so aim for at least three pieces of fruit per day.

Vitamin E

Dietary sources include:
 

wheatgerm polyunsaturated oil

seeds

nuts

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Abdominal fat increases your risk of heart disease as it effects blood cholesterol and triglyceride levels, blood sugar levels and blood pressure. This is why the male population tends to have an increased risk of heart disease compared to women, women tending to have fat distributed mainly around the hips and thighs. Monitoring body weight on scales is limited in that it is difficult to determine if the change is due to fluid, fat or lean body tissue. A waist measurment not only reflects body fat, it is a predictor of heart disease.

Is your waist measurement more than: 

A small reduction in waist measurement of as little as  5-10cm can make a significant difference to other risk factors by reducing cholesterol and triglyceride levels, improving blood pressure and blood sugar control.

Guidelines for weight reduction

Eat regular meals and snacks

Eating three meals daily and and having a small snack between meals provides the body with energy. It also stimulates the body's metabolism so that the body has an increased ability to burn up stored body fat. Skipping meals is not conducive to weight loss. Inadequate meals or snacks will slow down the metabolic rate so you lose the ability to burn body fat.

Limit fat intake

The body very efficiently stores any dietary fats as body fat (almost gram for gram). Small changes to fat intake will make a substantial difference to body fat over time. Fat intake can be reduced by using low fat cooking methods, making use of the wide variety of low fat foods available and limiting foods with high fat content.

Increase carbohydrate and fibre intake

Aim to have carbohydrate make up at least 75% of each meal. Carbohydrates are low in energy and are filling, so meals are satisfying without large amounts of fat ar calories. Carbohydrates also stimulate the body's metabolism and enhance the body's ability to burn body fat.

limit alcohol

Alcohol contains many empty calories and may contribute to weight gain. To achieve weight loss, alcohol intake needs to be limited.

Increase physical activity

Reduction in body fat requires both dietary change plus increased physical activity. Eating less without physical activity may lead to loss of muscle not body fat. The loss of muscle will reduce the body's metabolic rate, increasing the risk of weight gain. Physical activity will reduce body fat by energy expenditure and activity is not required; walking is ideal. At least 40 minutes daily will compliment healthy eating in achieving steady weight loss.

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Triglycerides are a type of fat which may be stored as body fat or transported in our blood.

Recommended blood levels to reduce the risk of heart disease are:

To reduce blood triglyceride levels;
 

Achieve or maintain a healthy body weight – particularly avoid body fat around the abdominal area. Limit Alcohol intake Increase dietary sources of omega 3 fatty acids. (ie. 3 serves of fish per week)

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Good control of diabetes reduces your risk of heart disease, circulation problems, eye and kidney damage.

Dietary guidelines for people with diabetes are similar to those for all Australians.

Guidelines:

Keep to a healthy weight Reduce added fats and limit high fat foods Eat more starch and dietary fibre from wholemeal/wholegrain breads and cereals Eat plenty of fruit, vegetables, legumes and lentils Avoid concentrated/high sugar foods (eg. soft drink) Drink alcohol in moderation

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High blood pressure increases your risk of stroke and heart disease, as well as eye and kidney damage.

To prevent and manage high blood pressure:

1.Weight

Maintain your ideal weight ie. Waist measurement less than 100cm for men and 90cm for women.

2. Potassium

Potassium may help lower blood pressure and is found in fruit and vegetables as well as wholegrain products and legumes. Aim to eat at least 2-3 serves of fruit and 5 serves of vegetables daily.

3. Exercise/Physical activity

Take time to relax and get 30-40 minutes of daily exercise

4. Alcohol

Limit alcohol intake as excessive quantities may increase blood pressure.

Recommendation: 

Men:  less than 4 standard rinks daily Women: less than 2 standard drinks daily

5. Salt

Avoid adding salt in cooking or at the table. Make use of herbs, spices, garlic, rice, vinegar or lemon juice for flavour instead. Choose reduced salt foods where available.

6. Smoking

Be a non-smoker; you may need support for this.

7. Medication

Ensure all prescribed medication for blood pressure are taken. Have your blood pressure checked at least every 3-6 months.

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Alcohol may increase:

Body fat Blood pressure Blood triglyceride levels

Recommendations:

Men – No more than 4 standard drinks daily Women – No more than 2 standard drinks daily

Standard drink

1 pot of beer 120ml red/white wine 30ml spirit/liquer 60ml port/sherry 1 can light beer

Note:

Some medications react badly with alcohol. Check with your doctor about any new medication. Alcohol can cause the blood sugar level of people with diabetes to fall quickly so should be consumed with food (preferably starchy).

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To maintain a healthy body weight, added fats and fats hidden within food should be limited ie. Limit the following sources of fat.
 

ADDED FATS

butter margarine oil lard dripping copha mayonnaise dressing cream sour cream

HIDDEN FATS

marbled, streaky fatty meat, poultry skin fatty mince meat, sausage mince processed meat, bacon, sausages, salami, strass, chicken loaf full cream milk, cheese, ice-cream yoghurt nuts, peanut butter, tahini chocolate, carob corn chips, crisps, twisties, cheezels etc cake, biscuits, pastries, croissants pies, pasties, sausage rolls, quiche take away/fast foods, fried foods avocado, olives rich sauces (cream, oil, cheese, butter)

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Dining out is a pleasurable and important part of our life. Healthy choices are possible in most cuisines.
 

BISTRO
Select:	Avoid:
grilled lean meat or fish salad without oil fruit salad bread/bread roll	deep fried meals battered meals (ie. schnitzel) salad with cream based dressing creamy sauces cheese cake, mousse pies, pastries, quiche
ITALIAN
Select:	Avoid:
minestrone soup antipasto (no fatty meats)  pasta with tomato/lean meat sauces  gelati green salad	Italian sausage garlic bread pasta with oil or cream sauce  lasagne tiramisu avoid extra cheese
ASIAN
Select:	Avoid:
vegetable/noodle soups stir fry/steamed dishes with lean meat, fish, chicken rice paper rolls steamed/boiled rice/noodles chicken or lean beef salad	spring rolls satay battered meals fried rice/noodles coconut milk dishes
VEGETARIAN
Select:	Avoid:
vegetable soups ricotta/cottage cheese meals vegetables/fruitLentils/legumes risotto	vegetable pasties cheese creamy sauces
GREEK
Select:	Avoid:
tzatziki dip dolmades (stuffed vine/cabbage leaves) stuffed vegetables lean beef, lamb, chicken kebabs	baklava Greek salad pastry
MIDDLE EASTERN
Select:	Avoid:
hommos tabouleh yoghurt and vegetable dips souvlaki (no oil on bread) kebabs grilled lean meat and chicken· Lebanese bread	oil based meals
JAPANESE
Select:	Avoid:
sushi sashimi pot boiled dishes sukiyaki	tempura battered, fried meals
INDIAN
Select:	Avoid:
vegetable and seafood curries lentils, dahl plain rice	coconut milk·  ghee·  samosas·  deep fried meals
THAI
Select:	Avoid:
sour soups seafood dishes chilli sauces steamed dishes lean beef and chicken dishes plain rice	Coconut/oil based sauces Fried meals
MEXICAN
Select:	Avoid:
chilli con carne  taco tortilla enchilada with beans bean based dishes burrito	large serves cheese· sour cream nachos guacamole  fried tortilla

Take Away Food

Most of us eat some take away food. Many foods are high in fat and low in fibre. There are some better choices which can be included in a healthy eating pattern. The following is a guide to better take away food choices.
 

Select:	Avoid:
BBQ chicken (no skin)	Fried chicken
Vegetarian pizza with thick crust, less cheese no fatty meats	Fatty meat or cheese pizza with thin crust
baked potato	chips
sushi	tempura
steamed/boiled rice	fried rice
sandwich - lean meat (ie chicken, tuna, salmon, ham) lots of salad. Avocado instead of margarine, or skip it	pies, pasties, sausage rolls, quiches
bagel, wholemeal roll	croissant, danish pastry, focaccia  hamburger with the lot ie. cheese, egg, bacon McDonalds hamburger
steak sandwich/plain hamburger with grilled lean meat and salad	pre-prepared salads such as coleslaw or potato salad with oil or cream based salad dressings
salad with lemon juice and herbs, pepper, tabouleh	Chinese meal in batter, deep fried
braised Chinese vegetables with lean meat, fish, chicken Chinese soup	cake, doughnut
low fat yoghurt	ice cream
mineral water, fruit juice, smoothie	thickshakes, soft drinks
skim milk cappuccino	cappuccino
gelati, Vitari, Colombo, gise
fresh fruit, fruit salad

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