Foods to lower your cholesterol | Dr Sarah Berry

Hello and welcome to Zoe Shorts, the short podcast where we discuss a topic related to science and nutrition. I'm Jonathan Wolf and I'm joined today by Dr. Sarah Berry and today's topic is

cholesterol

-

lower

ing

foods

for Jonathan, about half of the adult population. in the UK and US have high

cholesterol

and many people are completely unaware that they have high cholesterol. Cholesterol-

lower

ing drugs are projected to be worth almost $20 billion by 2027. We all now know that statins are one of the most prescribed medications worldwide. But there may be other ways we can lower our blood cholesterol levels, specifically the

foods

you eat, so Sarah, with her years of experience in the field, I'm sure has excellent insight into how changes in the diet they can reduce cholesterol.

Yes, there are some fabulous ways. There is research that shows how much diet can affect our blood cholesterol levels. So let's get into it. Let's start with some really shocking numbers. Sarah, the World Heart Foundation, states that high cholesterol causes 4.4 million deaths each year, which clearly accounts for around seven percent of all deaths. High cholesterol is a global health problem, yes, it's true. Jonathan and Beyond Deaths. The latest data from the US Centers for Disease Control and Prevention indicates that nearly 94 million American adults could be considered to have high blood cholesterol levels, and I know we've talked about cholesterol before. on this show, but if you're like me, you'll find it all a bit complicated and about 10 minutes after Sarah explains it, you forget everything, so Sarah, could you start again and remind us what cholesterol is so that the cholesterol is produced in our liver? and our bodies actually need it to produce things like vitamin D, bile acids, hormones and also create all the new cells in our body.

I know we discussed this in a previous podcast that you can listen to if you're interested. There is also cholesterol in some of the foods we eat and we call it dietary cholesterol because it's the cholesterol we get from our diet now Sarah. I may not have remembered all the details of how cholesterol works, but I do remember you explaining on that podcast that the latest science actually shows that dietary cholesterol is not very important in affecting the cholesterol in our blood for most people. people, yeah, that's well remembered, Jonathan, thanks Sarah, now in that podcast you also explained that some cholesterol is actually good, while other cholesterol is considered bad.

Can you explain this again? So low-density lipoprotein which we also call LDL cholesterol is the bad cholesterol and simply put, it transports cholesterol from the liver throughout the body. You also have another type of cholesterol called high-density lipoprotein, also called HDL cholesterol, which is

your

good cholesterol and again, in really simple terms, what this does is it returns cholesterol to the liver to be removed from circulation and our bodies have a really complex process that maintains the balance of these good and bad cholesterols in our blood for most people. We now know that the ratio of good to bad cholesterol and particularly the amount of bad cholesterol, so this LDL cholesterol is really important in terms of our overall health and if we have high levels of this bad LDL cholesterol, that can contribute to things like hardening. of our arteries and ultimately lead to heart disease.

Well, I think I got it this time, Sarah, so when we talk about lowering vapor cholesterol, what we really mean is lowering this bad cholesterol, this LDL, while increasing the good cholesterol, which is the HDL in our arteries. I have blood, I have, I finally understood well, yes, well done, the best grades, good, thank you. I think it's important to stress to people not to just look at total cholesterol because a change in

your

diet might not show up correctly in a large amount. change in your total cholesterol, but you may actually see that you are reducing some of your bad cholesterol while slightly increasing your good cholesterol.

Can our diet change our cholesterol levels or are our medications really the only things that can have a big impact, so what's best? To illustrate, I believe how effective foods and our low cholesterol diet can be comes from portfolio studies and these are key nutrition science experiments that show the power of foods in relation to our health and the concept of portfolio diet. It's not very simple, what you have to do is replace certain foods in your diet with other foods and ingredients that have been shown to lower cholesterol and it focuses on four key elements, it focuses on soy protein, plant sterols, nuts and soluble fiber, and it absolutely worked that way.

It was shown to reduce cholesterol by 30 now this is similar to the level of reduction we see in cholesterol, um reduction with medications like statins, so 30 that sounds pretty incredible, Zoe recommends this diet to people with high cholesterol, so which is incredible. dietary pattern to follow, but there is a problem with a portfolio diet that it is really difficult to follow, so it is more of a scientific experiment that shows us what the potential of foods really is in terms of low cholesterol rather than something that be really practical, I think. In the long term, I now believe that there is a more realistic dietary pattern that has also been shown to be effective in lowering cholesterol and this is the Mediterranean diet, so I love the concept of the Mediterranean diet which I believe was invented by a group of nutritional scientists They lived a very far distance from the Mediterranean because I have spoken to many nutritional scientists and each one has a slightly different definition of what is in it, which is probably not surprising when you think that people who live in Italy, Greece, Morocco and Israel all They think they follow a Mediterranean diet and, if you go on vacation to these places, their diet is a very different diet.

However, I think everyone agrees, Sarah, that it's about eating lots of fruits and vegetables, whole grains, nuts and olive oils, and then I think people are starting to discuss a lot more about fish, lean meat and dairy and the exact ratios, yes, that's right, Jonathan, and while it's not as drastic on the wallet, dying to lower cholesterol, it's a really sustainable diet that allows you to like foods that would be eliminated if you followed a more restrictive diet like the wallet, so Sarah you know you need to be clear to people listening to this that eating foods like eggs that are high in cholesterol will not necessarily increase your cholesterol.

There really are foods that can make your cholesterol go up or down and if so, can you explain what those foods are? Yes, so we know that dietary cholesterol, that is, the cholesterol found in the foods we eat, actually has only a very small impact. about our blood cholesterol levels, but what we do know is that foods high in saturated fats and particular types of saturated fats can actually have a pretty powerful effect on raising our blood cholesterol and this is the type of fat which are found in red meat, for example, in a lot of ultra-processed foods like cakes and also in some dairy like butter and what about carbohydrates because a lot of people will hear this and say "well, I have high cholesterol, so I'm not going to eat fat and therefore my cholesterol is going to go down, which sounds very logical, is that right?

No, so I think it's a big mistake that a lot of people make and, unfortunately, there's a lot of misinformation about people? with high cholesterol who are told to follow a low-fat diet what we do know is that if you consume healthy fats and oils you can improve your levels of cholesterol circulating in the blood, so instead of worrying about the amount of fat what you consume, you should think about the types of fats. So the types of fats that we know raise cholesterol, as I just said, are saturated fats, but we know that poly and monounsaturated fats found in many vegetable oils, nuts and seeds, for example, can actually lower cholesterol. our cholesterol levels in the blood.

The problem is that if you remove fat from foods and choose low-fat versions of foods, you have to replace it with something because fat is actually the component of foods that gives the delicious creamy mouthfeel and takes up much of of flavor, so if you remove the fat, you have to replace it with something that still imparts that nice flavor to the food and that great flavor to the food. Very often refined carbohydrates or sweeteners or other types of ingredients are added to food and we know that these are really bad for us because we know that they affect the liver which is involved in the production, as I said before, of cholesterol but they also increase other types of fat. that circulates in the blood called triglycerides and we know that this is really unfavorable. in terms of cardiovascular disease if it's also elevated that's amazing thank you Sarah so I think now that we understand a little bit more you know what we eat can cause high cholesterol and it could actually be a carbohydrate you know or a fat .

Be a little more specific about what a listener needs to do to change their diet if right now you know maybe you know your doctor has told you that you have high cholesterol or you know it's in your family and there's some kind of Smart Swaps that could do without completely changing the way they eat and I think it's about making simple smart swaps, as you call them Jonathan, that are personalized to your body, but also to your preferences, which are the ones that people are most likely to follow and, Therefore, leading to sustained improvements in blood cholesterol, and in fact, blood cholesterol can change very quickly due to changes in diet, which is why we see changes in our studies, they are as few as 10 to 14 days in blood cholesterol, so that should really motivate people to know the rapid changes, but Sustainable changes will really have an impact and the type of thing you could do is try to eat less red meat and fewer processed foods because these have the types of fat that we know increase bad cholesterol in the blood.

You could introduce many foods rich in fiber. foods like beans and vegetables and also plant-based protein sources which we know will lower cholesterol and spreads are also a good substitute for butter as most spreads are made from vegetable oil so that contain these good, healthy unsaturated fats that I've talked about. about poly and monounsaturated fats, although Jonathan, this is quite a controversial area and I remember from our previous episode that many of the foods that are high in cholesterol are also high in saturated fat and this may have led to some of the Previous misinformation suggests that It is the cholesterol in some foods like red meat that explains why you know that red meat, for example, is bad for us, yes, and regarding cholesterol, Jonathan, saturated fats are what They increase the bad cholesterol in our blood, not the dietary cholesterol, yes, and that's how it is.

There could have been this confusion right when they saw it because some of those foods also have high cholesterol and now we understand. I think this is correct, Sarah, since today we understand the mechanisms better and therefore you know the high level. Now cholesterol in eggs or meat is no longer blamed, but in reality red meat, still in the dock, is still in trouble. We simply understand that it is different properties of red meat that are causing us problems. If we think about the liver, for example, the liver is high in cholesterol but also high in saturated fat.

If we eat a lot of liver, we will have an increase in bad cholesterol, but it is not actually the cholesterol in the liver that will cause this, but the saturated one. fat in the liver that will cause this strange well, look Sarah, I think it's a brilliant way to turn things around and we've had a slightly longer podcast than usual because I think it's a very important topic and it's complicated if you're going to do it. do. I kind of sum this up for someone who listens and says, "Okay, so I'm worried about my cholesterol.

You know what they should do?" I think there is very clear evidence that our diet can significantly alter our cholesterol. There is clear evidence to show that it is the type of fat that is important and not the amount of fat that is important to consider, so don't follow a low fat diet, but switch to really healthy oils and also be motivated knowing that a change in diet can actually induce a change in your cholesterol and as little as two weeks and I'd like to pick up on the first part of what you're talking about, which is kind of information.wrong and it's something I talked about before when I was a kid.

Dad was told that he had very high cholesterol, he lived in the United States at the time and he was told to eat a diet very low in fat and therefore very high in carbohydrates, and I think today you know, we know you know to all nutritional scientists. talking to says oh yeah we know that's not the right advice and yet I still hear stories from friends and family that you know they got a note from um, you know their doctor, you know the NHS here in the UK, whatever it is. say uh you know you have high cholesterol and so here's this guide on what you should eat and it basically says you should eat all these low fat foods um uh you should avoid all these high fats you know. olive oil and nuts and stuff like that, um, what's your take on this, Sarah?

What I think is that it is the wrong advice to give people. We now clearly know that the amount of fat in our diet is not the problem, but the type of fat. That's the problem and pushing people to follow high carbohydrate diets we know is really not good for our heart health, so anyone who does it has high cholesterol. I really recommend that you don't reduce the amount of fat you consume, but I do recommend that you think about the type of fats and this brings us back to what we mentioned earlier, which is increasing the amounts of these healthy fats. oils, so monounsaturated and polyunsaturated oil, these are vegetable oils, extra virgin olive oil and reducing the types of saturated fats found in, for example, ultra-processed foods and red meat, thank you Sarah and just before we wrap up, I'd really love to talk about individually tailored responses.

I think one of the things that we do on this podcast is we try really hard to make sure that all the advice is available to everyone and not to say Hey, you have to go and do these tests, but I think in this particular case it feels wrong. Not to talk about the differences that we see because I think they're very surprising and I think we've had over 50,000 people doing these tests I think, Sarah. I can describe in a minute that it's the same thing as the tests that we originally did on thousands of people in these labs where we looked at their responses to the type of standardized food and we saw this surprising variation in response to high-fat foods that seems to have very important implications. about what's right, you know, for me as an individual, could you touch on that a little bit and explain what's going on there?

Yes, one of the things we test at Zoe is people's responses to fats in the blood. a high-fat meal, so we give people these muffins that contain 50 grams of fat and we look at how quickly and for how long the circulating levels of fat in the blood change and we measure that from a measure called triglycerides and What we know is that fat in the food we eat increases blood triglyceride levels and we know that people respond very differently in terms of how much their triglycerides rise and how long they stay elevated, even though they eat the exact same food as other people and We see a tenfold difference in how one person responds versus another and we know that this is due to many different factors.

We know it is partly due to our genetics. We know it's partly due to our gut microbiome, which is trillions of bacteria. that live in our gut, we also know that it is partly due to our age or our sex or even how much we weigh, but there are many different factors that determine how we respond to high-fat foods and how our circulating fat levels change afterwards. We eat these high-fat foods and I think the interesting thing is that it's not just if you have high cholesterol, therefore you are in the third of people who have this bad response or if you have low cholesterol you are definitely in the good response.

It's actually very different, so basically without doing this test you don't really know what's going to happen, obviously, you know that there are people who have very high levels of fasting fat and you probably know that, so you have an idea of ​​certain people. , but in general, this response to food is actually kind of a different measure, isn't it just the kind of high cholesterol levels that your doctor would have you tested for? Yeah, so when you go to a doctor and they give you a test. your cholesterol levels actually do what's called a comprehensive lipid test and that's not just your cholesterol so it's not just your HDL and LDL cholesterol, they also always test for something called triglycerides and we know that triglycerides are so important. like cholesterol.

It's in our health and this is something that has been very little studied and it's really interesting because we know that diet can play a very important role in changing our triglyceride levels and this is what we have been testing a lot with the work that we we've been What I'm doing at Zoe is amazing and I think for me, you know this is one of the big takeaways in the same way that we talk a lot about blood sugar, which is when you understand your own type of control. of fat, has a lot of influence on what you do.

Doesn't that mean you should give up fat? Do you know what olive oil is? You know extra virgin olive oil is generally good for everyone, but certainly think about how much you want to take and certainly think about what will happen if you do? When you start eating these less healthy fats, you see a very big change and then you could have someone who actually has high cholesterol but actually has pretty good fat control, and then they go and tell them to get down to this level. -fat diet and they actually swap, they have been able to deal with this fat well, it turns out that actually their blood sugar control is really bad and they are swapping something that is much worse, just what their liver is struggling with and it is Really terrible advice, and so I think it's one of the most surprising things that's come out of Zoe for me in the last five years.

Yes, if there's one thing I could tell people it's not to follow a low-fat diet. incredible and we were lucky enough to have today one of the world's leading experts in fat and nutritional science, Sarah, if learning more about cholesterol from today means that you would like to understand more about the right diet for you based on how your body responds to food, you may want to try Zoe's personalized nutrition program to improve your health and if so, you can get 10 off by joining the zoe.com podcast. I'm Jonathan Wolf and Sarah Berry, join us next week. another foreign zoe podcast