Foods to lower your cholesterol | Dr Sarah Berry

[Music] hello and welcome to Zoe shorts the bite-sized podcast where we discuss one topic around science and nutrition I'm Jonathan wolf and today I'm joined by Dr Sarah Berry and today's subject is food to lower cholesterol [Music] to Jonathan around half the adult population in the UK and the US have high cholesterol and many people are completely unaware that they have high cholesterol medication to reduce cholesterol is projected to be worth almost 20 billion dollars by 2027. now we all know that statins are one of the most prescribed drugs globally but there may be other ways that we can reduce our blood cholesterol levels specifically the food that you eat so Sarah with your years of experience in the field I'm sure you have some terrific insight into how dietary changes can reduce cholesterol yeah there's some fabulous research out there showing just how much diet can impact our blood cholesterol levels then 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 every year that's around seven percent of all deaths so clearly high cholesterol is a global health issue yeah that's right Jonathan and Beyond deaths the latest data from America's Center for Disease Control and prevention states that nearly 94 million American adults could be considered to have high blood cholesterol levels and I know we've discussed cholesterol before on this show but if you're like me you find it all a bit complicated and about 10 minutes after Sarah explains it you forget the whole thing so Sarah could you just start again and remind us what is cholesterol so cholesterol is made 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 and I know we discussed on a previous podcast that you can go and listen to if you're interested that there is also cholesterol in some of the foods we eat and we call that dietary cholesterol because it's cholesterol we get from our diet now Sarah I might not have remembered all the details of how cholesterol worked but I do remember that you explained on that podcast that the latest science actually shows that dietary cholesterol is not very important for affecting the cholesterol in our blood for for most people yeah that's right well remembered Jonathan thank you Sarah now on that podcast you also explained that some cholesterol is actually good while other cholesterol is considered to be bad can you explain this this again so low density lipoprotein that we also call LDL cholesterol is your bad cholesterol and simply put this transports cholesterol from your liver around your 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 return cholesterol to the liver in order to be removed from the circulation and our bodies have a really complex process that maintains the balance of these good and these bad cholesterol in our blood for most people now we do know that the ratio of good to bad cholesterol and particularly the amount of bad cholesterol so this LDL cholesterol it's really important in terms of our General 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 okay I think I've got it this time Sarah so when we talk about reduce steam cholesterol what we really mean is reducing this bad cholesterol this LDL while increasing the good cholesterol which is the HDL in our blood have I have I got that right at last yeah well done top marks all right thank you I think it's important to emphasize to people um not just to look there for the total cholesterol because a change in your diet might not show right in a huge change in your total cholesterol but you might actually see that you're reducing some of your bad cholesterol while slightly increasing your good cholesterol so can our diet change our cholesterol levels or our drugs really the only things that can have a big impact so the best way to to illustrate I think just how effective food and our diet can be at low in cholesterol comes from the portfolio studies and these are key nutrition science experiments showing the power of food in relation to our health and the concept of the portfolio diet isn't very straightforward what you do is replace certain foods in your diet with other foods and ingredients that have been shown to lower cholesterol and it's centered around four key elements it's centered around soy protein plant sterols tree nuts and soluble fiber and did it work absolutely so it was shown to reduce cholesterol by 30 now this is similar to the level of reduction that we see in cholesterol um lowering from medication like statins so 30 that sounds pretty incredible so does Zoe recommend this diet to people with high cholesterol so it is an incredible dietary pattern to follow but there's a catch with a portfolio diet that it's really difficult to follow so it's therefore more of a science experiment showing us what actually is the potential of food in terms of low in cholesterol rather than something that's really practical I think in the long term now I think there's a more realistic dietary pattern that's also been shown to be effective in reducing cholesterol and this is the Mediterranean diet so I love the concept of the Mediterranean diet which I think was invented by a bunch of nutritional scientists living a long way away from the Mediterranean because I've spoken to a lot of nutritional scientists now and every single one has a slightly different definition of what's in it which is probably not surprising when you think that people living in Italy and Greece and Morocco and Israel all think they're eating a Mediterranean diet and if you go on holiday to these places their eating is a very different diet however I think everyone agrees Sarah that it's about eating plenty of fruit and vegetables sort of whole grains nuts and olive oils and then I think people start to argue a lot more about you know fish and lean meat and dairy products and the exact proportions yeah that's right Jonathan and while it's not quite as drastic at the portfolio portfolio die to reducing or cholesterol it's a really sustainable diet that lets you enjoy food that would be cut out if you followed a more restrictive diet like the portfolio and so Sarah you know to be clear for people who are listening to this while eating foods like eggs that are high in cholesterol won't necessarily raise your cholesterol there really are foods that can make your cholesterol go up or or down and if so can you explain sort of what those foods are yeah so we know that actually dietary cholesterol so cholesterol that's in the food that we consume actually has only a really small impact on our blood cholesterol levels but what we do know is that saturated fat rich foods and particular types of saturated fat actually can have quite a potent effect on raising our blood cholesterol and these are the kind of fats that are found in red meats for example lots of ultra processed foods such as pastries and also in some Dairy such as butter and what about carbohydrates because lots of people will be listening to this and saying oh well so I've got high cholesterol so I'm not going to eat any fat and therefore my cholesterol is going to go down which sounds really logical is it correct no um so this is a big mistake I think that lots of people make and unfortunately there's lots of really poor misinformation out there around people with high cholesterol being told to follow a low-fat diet what we do know is that if you consume healthy fats and healthy oils you can actually improve your circulating blood cholesterol levels so rather than worrying about the amount of fat that you're consuming you should be thinking about the types of fat so the types of fat that we know increase cholesterol like I've just said are the saturated fats but we know that the poly and monounsaturated fats that are found in many vegetable oils nuts and seeds for example can actually reduce our blood cholesterol levels now the problem is is if you take out the fat from Foods so that you choose low fat versions of foods it's got to be replaced with something because fat is actually the component of food that gives the lovely creamy mouth feel it carries much of the flavor so if you strip out the fat you've got to replace it with something that still confers that nice mouth fill and that great flavor to the food quite often refined carbohydrates or sweeteners or other kind of ingredients are added back into the food and we know that these are really bad for us because we know that they impact your liver which is involved in the production like I said earlier of cholesterol but also they increase another type of fat that circulates in your blood which is called triglycerides and we know that this is really unfavorable in terms of cardiovascular disease if it's elevated as well amazing thank you Sarah so I think now that we understand a bit more that you know what what we eat can cause high cholesterol and it could actually be you know a carbohydrate you know or a fat can you be a bit more specific about what a listener should do to change their diet if right now you know maybe the um you know their doctor has told them that they have high cholesterol or they know that it's in their family and are there any sort of smart swaps that they could do without completely changing the way that they eat absolutely and I think it's making simple smart swaps as you call them Jonathan that are personalized to your body but also your preferences that are ones that people will most likely stick to and therefore lead to sustained improvements in blood cholesterol and actually your blood cholesterol can change really quickly from dietary changes so we see changes in our studies it's as little as 10 days to 14 days in blood cholesterol so that should really motivate people that you know quick changes but sustainable changes will really have an impact and the kind of things that you could do is to try and eat less red meat and less processed foods because these have the types of fat that we know increase your blood bad cholesterol you could introduce many fiber-rich foods such as beans and vegetables and also plant-based protein sources that we know will lower your cholesterol and spreads are also a good substitute for butter since most spreads are made from vegetable oil so they contain these healthy unsaturated good fats that I've talked about the 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 suggesting that it's the cholesterol in some food such as red meat that explains why you know red meat for example is bad for us yeah and with regards to cholesterol Jonathan saturated fats are what's increasing the bad cholesterol in our blood not that dietary cholesterol yes and so there sort of there could have been this confusion right when they looked at it because some of those Foods happen to have high cholesterol as well and so we now understand I think this is right Sarah like we understand better the mechanisms today and therefore you know the high uh cholesterol in the egg or the meat is now no longer being blamed for it but actually the red meat still in the dock still in trouble uh we just understand that it's sort of different properties of the red meat they're causing us us problems absolutely so if we think of liver for example liver is high in cholesterol but also high in saturated fat if we eat lots of liver we'll have an increase in bad cholesterol but it's actually not the cholesterol in the liver that's going to cause this it's the saturated fat in the liver that will cause this foreign well look Sarah I think it's a brilliant way to come around and we've had a slightly longer podcast than usual because I think it's such an important topic and it is complicated if you're going to sort of sum this up for somebody listening and saying okay so I am worried about my cholesterol you know what should they do so I think that there's really clear evidence to show that our diet can significantly alter our cholesterol there's clear evidence to show that it's the type of fat that's important and not the amount of fat that's important to consider so please don't follow a low-fat diet but please change to really healthy oils and also be motivated in knowing that a dietary change can actually induce a change in your cholesterol and as little as two weeks and I'd like to pick up on um the first part of what you're talking about which is sort of the the misinformation and it's something I've talked about before that when I was growing up my dad was told that he had very high cholesterol he was living in the states at the time and he was told to eat a very low fat and therefore of course very high carb diet and I think today you know we know you know every nutritional scientist I talk to says oh yeah we know that isn't the the right advice um and yet I still hear stories from friends and family that you know they get a note from um you know their physician you know the NHS here in the UK whatever it is saying uh you know you've got a high cholesterol and therefore here's this guidance on what you should eat and is basically saying you should be eating all of this low-fat um uh food you should be avoiding all of these high fats you know like olive oil and nuts and things like that um what's your take on this Sarah my thoughts are that's the wrong advice to be giving to people we now clearly know that the amount of fat in our diet is not what the problem is it's the type of fat that's the problem and pushing people to high carbohydrate diets we know it's really not good for our heart health so anyone that has high cholesterol I would really encourage you not to cut down the amount of fat you're consuming but I would encourage you to think about the type of fats and so this takes us back to what we mentioned earlier so increasing the amounts of these healthy oils so the mono and polyunsaturated oil so these are vegetable oils extra virgin olive oil and reducing the saturated types of fat that you find in for example Ultra processed foods and red meats thank you Sarah and just before I wrap up I'd really love to talk about um individually personalized responses I think one of the things we do in this podcast is we try really hard to make sure that all the advice is sort of available for everybody and don't 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 just so striking and I guess we've had more than 50 000 people um do these um these tests which I think Sarah you can describe in a minute which is the same as the tests we originally did on sort of thousands of people in these Labs where we look at your responses to um the sort of standardized meal and we see this amazing variation in response to high fat meals which seems to have some very big implications for what's right you know for me as an individual could you maybe touch on that a little bit and explain um what's going on there yeah so one of the things that we test at Zoe is people's blood fat responses to a high fat meal so we give people uh these muffins that contain 50 grams of fat and we look at how quickly and for how long circulating levels of blood fat change and we measure this from a measure called triglycerides and what we know is that the fat in the meal that we consume increases the levels of blood triglyceride levels and we know that people respond hugely differently in terms of how much their triglycerides go up and how long they stay elevated this is even despite them having exactly the same meal to other people and we see about a tenfold difference in how one person responds versus another person responds and we know this is down to loads of different factors we know that it's partly down to our genetics we know it's partly down to our gut microbiome which are the trillions of bacteria that are living in our gut we also know it's partly down to our age or our sex or even you know how much we weigh but there's loads of different factors that shape how we respond to high fat foods and how our circulating levels of fat change following us consuming these high fat meals and I think what's interesting is it's not just if you have high cholesterol therefore you're in the third of people who have this bad response or if you have low cholesterol you're definitely in the in the good response actually it's very different so basically without doing this test you don't really know um what's going to happen obviously you know there are people who have very um uh High fasting fat levels and they're probably you know so you have some idea of certain people but in general um this response to food is actually a sort of different measure isn't it than just the um the sort of the high cholesterol levels that you would get tested by your doctor yeah so when you go to a doctor and they test your cholesterol levels they actually do what's called a full lipid test and that isn't just your cholesterol so it isn't just your HDL and LDL cholesterol they also always test something called your triglycerides and we know that triglycerides are equally as important as cholesterol is in our health and this is something that's been really understudied and it's really interesting because we know that diet can play a huge role in changing our triglyceride levels and this is what we've been testing a lot with the work that we've been doing at Zoe amazing and I think um for me you know this is one of the big takeaways in the same way we talk a lot about blood sugar which is as you understand your own sort of fat control it has a lot of influence on what you do it doesn't mean you need to give up fats you know olive oil is you know extra virgin olive oil is generally good for everybody but certainly thinking about the amount that you want to take and certainly thinking about what's going to happen if you're starting to eat these less um healthy fats you see this very big change and so you could have somebody actually who has high cholesterol but actually who's fat control is pretty good they then go and they're they're told to move to this low-fat diet and actually they swap they've been able to deal with this fat well it turns out actually the blood sugar control is really bad and they're switching something that's much much worse right that their liver is then struggling with and and it's really terrible advice and so um I think it's one of the most striking things that's come out of um of Zoe for me over the last five years yeah if there's one thing that I could say to people is do not go on a low-fat diet amazing and we've been lucky to have one of the world's foremost experts on fats uh uh and nutritional science today Sarah if out of today learning more about cholesterol means you'd like to understand more about the right diet for you based upon how your body responds to food you might want to try Zoe's personalized nutrition program to improve your health and if so you can get 10 off by by going to join zoe.com podcast I'm Jonathan wolf and I'm Sarah Berry join us next week for another Zoe podcast foreign [Music]

Channel: ZOE

Views: 323,590

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Id: 5Hi7CfTsx04

Length: 20min 15sec (1215 seconds)

Published: Mon Jan 16 2023