HEART UK The Cholesterol Charity

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Madeline Garrison
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1 Healthy Eating Guide Advice for those keen to lower their cholesterol HEART UK The Cholesterol Charity providing expert support, guidance and education

YOUR AT A GLANCE GUIDE TO HEALTHY EATING Dietary advice to help lower your cholesterol (and triglycerides*) and help keep your heart healthy Foods Food group Best choice Occasionally Best avoided!

Wholegrain varieties of bread, chapatti without fat, pitta bread, flour tortillas, pasta, rice, noodles. Wholegrain breakfast cereals. Oats. Couscous. Potatoes, sweet potatoes, yam & plantain.

Sugar and chocolate coated breakfast cereals. Deep-fried chips. Pizza with fatty meat or too much cheese.

Cakes, pastries, pies, steamed puddings, trifle, doughnuts, cheesecake. Cream, chocolate biscuits, shortbread. Breadsticks, crispbreads, oatcakes, plain popcorn, cream crackers and water biscuits.

3 YOUR AT A GLANCE GUIDE TO HEALTHY EATING Dietary advice to help lower your cholesterol (and triglycerides*) and help keep your heart healthy Foods Food group Best choice Occasionally Best avoided! Potatoes, bread, rice, pasta and other starchy carbohydrates Aim to base all meals on foods from this group especially wholegrains. Wholegrain varieties of bread, chapatti without fat, pitta bread, flour tortillas, pasta, rice, noodles. Wholegrain breakfast cereals. Oats. Couscous. Potatoes, sweet potatoes, yam & plantain. Naan bread. Paratha, roast potatoes (cooked in heart friendly oils). Reduced fat oven chips (with less than 5% fat).. Garlic bread, croissant, waffles, puris. Pilau, biryani & fried rice. Sugar and chocolate coated breakfast cereals. Deep-fried chips. Pizza with fatty meat or too much cheese. Fish Beans and pulses Vegetables, fruit & salads Crackers, savoury snacks Biscuits, cakes, pastries, desserts Breads, pasta, rice and noodles. Cereals & potatoes Plain biscuits. Teacakes, crumpets, malt bread. Homemade cakes and puddings using best choice ingredients such as carrot cake, muffins, nut, seed & cereal bars, fruit loafs, fruit-based puddings, meringue and ice creams without dairy fats. Cakes, pastries, pies, steamed puddings, trifle, doughnuts, cheesecake. Cream, chocolate biscuits, shortbread. Breadsticks, crispbreads, oatcakes, plain popcorn, cream crackers and water biscuits. Low fat crisps, baked crisps. Crisps, cheese snacks, cheese crackers, bombay mix. Fruit & vegetables Eat plenty; at least five or more portions everyday. Fresh, frozen, dried, canned fruit and vegetables. Canned in natural juices or water. Vegetable based soups (without cream). Canned fruit in syrup (drain the syrup). Reduced fat coleslaw. Fruit smoothies and fruit juices. Coleslaw. Vegetables fried in batter (e.g. onion rings). Pakoras and samosas. Beans, pulses, fish, eggs, meat and other proteins A portion of cooked beans, peas & lentils is 4 cooked tablespoons. Try to eat fish at least twice a week, inc. one portion of oily fish. A portion of fish is the size of a cheque book. Pulses including baked beans, kidney beans, chick peas, lentils, peas. Rinse if canned in salt/sugar. Soya products : Soya mince, soya beans, tofu, soya nuts. Quorn pieces, quorn mince. All fish cod, plaice, sole, whiting, canned tuna and shellfish FH. Oily fish (fresh & canned) mackerel, sardines, pilchards, salmon, trout, herrings & fresh tuna. Hummus. Vegetarian sausages and burgers. Canned fish in oil (drain oil). Fried fish in batter (remove batter). Fish fingers, fish cakes. Fish in rich creamy or cheesy sauces. Hollandaise, lobster sauce, seafood cocktail sauce.

A portion of eggs is 2 eggs. A portion of nuts & seeds is 2 tablespoons. Choose lean meat. A portion is the size of a pack of cards.

A portion is a matchbox of medium fat cheese (40g) or ½ matchbox of high fat cheese (20g) or 2 small matchboxes of light cheese spread (80g) or a large pot of cottage cheese (200g).

Nut butters with less than 10% fat. All seeds incl. flaxseed, pumpkin, sesame & sunflower. Lean pork, ham, lamb, beef. Extra lean minced beef. Kidney FH. Chicken & turkey without skin.

Low fat natural, fruit & diet yogurts or soya alternatives to yogurt. Yogurts and mini-drinks with plant sterols/stanols. Low fat and reduced fat cheeses.

Monounsaturated or polyunsaturated oils: e.g. olive, rapeseed, sunflower, soya, corn. Spreads made from vegetable and seed oils such as sunflower or olive oil.

Lean bacon, low fat sausages and burgers, mutton, liver FH, chicken in breadcrumbs, meatballs. Read the labels find the lowest fat version. Semi skimmed (2%) milk. Reduced fat evaporated milk.

4 A portion of eggs is 2 eggs. A portion of nuts & seeds is 2 tablespoons. Choose lean meat. A portion is the size of a pack of cards. Dairy foods & alternatives Aim to have 2 3 portions a day in drinks or in meals/snacks. A portion is a medium glass of milk (200ml). A portion is a small pot of yogurt or light fromage frais (150g). A portion is a matchbox of medium fat cheese (40g) or ½ matchbox of high fat cheese (20g) or 2 small matchboxes of light cheese spread (80g) or a large pot of cottage cheese (200g). Oils and spreads Try to eat in small amounts. Replace animal fats with heart friendly oils and spreads. Sugary foods, flavourings, Eggs boiled, scrambled, poached. 3 4 per week FH. Nuts. Nut butters with less than 10% fat. All seeds incl. flaxseed, pumpkin, sesame & sunflower. Lean pork, ham, lamb, beef. Extra lean minced beef. Kidney FH. Chicken & turkey without skin. Veal, venison, rabbit, game, ostrich. Skimmed milk, 1% milk, skimmed milk with plant sterols, soya and oat drinks with added calcium. Low fat natural, fruit & diet yogurts or soya alternatives to yogurt. Yogurts and mini-drinks with plant sterols/stanols. Low fat and reduced fat cheeses. Cheese where milk fat has been partly replaced by vegetable fat. Best choices include cottage, curd cheese, quark, ricotta, half fat edam, extra light cheese spread. Virtually fat free fromage frais. Monounsaturated or polyunsaturated oils: e.g. olive, rapeseed, sunflower, soya, corn. Spreads made from vegetable and seed oils such as sunflower or olive oil. Spreads fortified with plant sterols/stanols. Sugar free jelly, sweetners. Fried eggs & omelettes with minimal cooking oil FH. Nut & seed bars and reduced fat coconut milk. Lean bacon, low fat sausages and burgers, mutton, liver FH, chicken in breadcrumbs, meatballs. Read the labels find the lowest fat version. Semi skimmed (2%) milk. Reduced fat evaporated milk. Half-fat yogurt. Medium fat cheese e.g. half-fat cheddar, edam, brie, camembert, soft goat s cheese, mozzarella, feta, light cheese spread, paneer. Half-cream, half-fat crème fraiche. Fromage frais. Oat and soya creams. Dark chocolate, boiled sweets and gums. Quiche. Scotch eggs. Coconut, coconut cream. Full fat coconut milk. Roasted nuts in oil & salt. Nut and seed butters with over 10% saturated fat. Fatty cuts of meat belly pork, breast of lamb, duck, goose. Frankfurters, streaky bacon, sausages & sausage rolls, pies, pasties, pork pies. Chicken nuggets & Kiev. Full fat cows, sheeps or goats milk. Evaporated or condensed milk. Full fat (4% saturated fat), thick and creamy yogurts. High fat cheese e.g. cream cheese, mascarpone, stilton, cheddar type cheeses. Vegetarian cheddar, gouda, parmesan, full fat cheese spread, fried paneer. Clotted, double, whipping, soured, single cream. Crème fraiche. Partially hydrogenated vegetable oil. Oils which have been reheated several times. Palm and coconut oils. Butter, lard, suet, dripping, ghee, hard margarines. Milk and white chocolate, fudge, toffees,. Fat spreads Oils Cheese and cream Milk & milk alternatives. Yogurts & alternatives Meat & meat products. Poultry & Nuts & poultry products seeds Eggs

condiments, salad dressings, sauces, gravies Pepper, herbs, spices, lemon juice, garlic etc. Chutney & pickles made without oil. Jams, honey, marmalade, sorbets.

Sweet & salty foods, seasonings Use lemon juice, vinegar, herbs, yogurt, olive oil for salad dressings. Thicken sauces/gravies with flour/tomato puree.

5 condiments, salad dressings, sauces, gravies Pepper, herbs, spices, lemon juice, garlic etc. Chutney & pickles made without oil. Jams, honey, marmalade, sorbets. Reduced salt soy sauce and stock cubes. sugar, treacle, golden syrup, Indian sweets. Salt, garlic salt, celery salt. Soy sauce. Oily pickles. Sweet & salty foods, seasonings Use lemon juice, vinegar, herbs, yogurt, olive oil for salad dressings. Thicken sauces/gravies with flour/tomato puree. Use low salt stock/tomato-based sauces as first choice. Low calorie salad creams & mayonnaise. Salad creams, mayonnaise. Rich sauces made with cream or roux. Dressings, sauces, gravies Drinks Drink litres of fluid per day. Tap, mineral and soda water, fruit juice, tea, coffee with low fat milks. Sugar free squash, diet fizzy drinks. Alcohol. Fruit squash, fizzy drinks, drinks with added sugar. Flavoured waters, energy drinks. Water, fruit juice, alcohol, squash, fizzy & hot drinks Labelling Food Group Low Medium HIGH Per 100gms of food Fat 3g or less (1.5g or less) 3g 17.5g (1.5g 8.75g) 17.5g or more (8.75g or more) (per 100mls of drink) Saturates 1.5g or less (0.75g or less) 1.5g 5g (0.75g 2.5g) 5g or more (2.5g or more) Total Sugars 5g or less (2.5g or less) 5g 22.5g (2.5g 11.25g) 22.5g or more (11.25g or more) Salt 0.3g or less (0.3g or less) 0.3g 1.5g (0.3g 0.75g) 1.5g or more (0.75g or more) Key to symbols and notes Wholegrains. Oily fish. Cooking styles. Alcohol. People with a healthy heart tend to eat more wholegrain foods as part of a healthy lifestyle. Oily fish are rich in omega 3 fatty acids which help your heart beat more regularly and prevent your blood from clotting. Aim to eat at least one portion ( g) per week. For less fat steam, microwave, poach, boil, casserole. If stir frying, grilling or roasting use oil sparingly. Oil sprays and non sticks pans are useful. Keep to sensible limits. For men and women no more than 14 units per week Avoid binge drinking. Have drink free days each week Women who are planning a pregnancy, pregnant or breastfeeding should not drink any alcohol. FH Familial Hypercholesterolaemia. If you know you have FH Familial Hypercholesterolaemia you may be sensitive to the effects of foods high in cholesterol (eggs, kidney, liver, shellfish). You should limit your intake of these foods and seek individual dietary advice from a registered dietitian. Plant sterols and stanols, oats, soy protein, nuts. Soluble fibre from pulses, vegetables and fruits. These foods actively lower cholesterol. Fruit and vegetables eat a wide variety five or more portions every day. A portion of fruit and vegetables is: 1 piece of fruit eg 1 apple Fruit smoothies containing 150ml of juice and 80g pulped fruit 1 cereal bowl of mixed salad count as 2 portions 1 heaped tablespoon dried fruit 1 medium glass of fruit juice (150ml) can only count as one 1 handful of grapes, strawberries portion each day 2 pieces of small fruit eg 2 tangerines 3 tablespoons vegetables or fresh fruit salad All oils and fats are high in energy (calories). If you have a tendency to gain weight keep portions modest. * Triglycerides are a type of fat. The amount of triglycerides in the blood rises after a meal and then slowly decreases.

6 The Mediterranean diet A traditional Mediterranean diet helps protect our bodies from heart and circulatory disease and can help manage cholesterol levels too it s full of healthy fats (olive oil, nuts, seeds, oily fish), vegetables, fruits, pulses, wholegrains and wholegrain cereal products. It also contains moderate amounts of white meat and low fat dairy foods. Red meat is eaten less often. Check out how you score on our Mediterranean check list and then decide where you can improve. Tick the boxes that apply to you Yes Sometimes No Do you have at least 5 portions of fruit, vegetables and pulses every day? A portion is roughly a handful. Do you have 3 portions of wholegrains each day? (wholemeal bread & pasta, wholegrain breakfast cereals, brown rice, oats, pearl barley etc.) Do you use olive, rapeseed & sunflower oils and spreads made from these as your main spreading and cooking fats and in salad dressings? Do you eat nuts & seeds each day? (as snacks, cereal and dessert toppings, in recipes) Do you have at least 2 portions of fish or seafood per week, one of which is oily? Do you use onions, leeks, tomatoes and garlic in sauces, stews, casseroles and soups at least twice a week? Do you have at least 2 meat free days each week? Do you include pulses (beans, peas and lentils) in meals at least twice a week? Do you cook most of your meals from basic ingredients? If you answered mostly yes well done, carry on. Where you answered no or sometimes these are areas you can change or improve on. HEART UK The Cholesterol Charity HEART UK is the only charity in the UK dedicated to providing expert support, guidance and education for people with raised cholesterol and other blood fats. Where can I find out more? For lifestyle advice & recipes Please support us It s easy to donate: Send a cheque payable to HEART UK to HEART UK, 7 North Road, Maidenhead, SL6 1PE Visit Our Cholesterol Helpline Ring A lifeline for those worried about cholesterol. Text T: (Monday-Friday 10am-3pm) Urdu, Punjabi and Hindi speaker most Tuesdays. HART20 and the amount 5 or 10 to fundraising@heartuk.org.uk E: ask@heartuk.org.uk Registered Charity No November 2016

HEART UK The Cholesterol Charity

Healthy Eating Guide Advice for those keen to lower their cholesterol HEART UK The Cholesterol Charity providing expert support, education and influence YOUR AT A GLANCE GUIDE TO HEALTHY EATING Dietary