Heart Disease and Cholesterol

Cardiovascular disease (heart disease) is the number one killer in Canada. It is also the most costly disease in Canada, putting the greatest burden on our national health care system.

Some important facts of high colesterol and heart disease

If you have high blood cholesterol, you are more likely to have a heart attack or a stroke. You are at a higher risk for high blood cholesterol and heart disease if someone in your immediate family (parent, brother or sister) has high blood cholesterol. High blood cholesterol is especially dangerous for people who smoke, and for people with high blood pressure.

What is cholesterol and why does it matter?

Cholesterol is a waxy substance made naturally in the body. Your body needs some cholesterol to work properly, and it can make all it needs. Cholesterol may cause problems if your body makes too much or if you get too much in your food. The extra cholesterol can lead to blocked arteries. If an artery that supplies blood to your heart becomes blocked, a heart attack occurs. If an artery that supplies blood to your brain becomes blocked, a stroke occurs.

"Good" cholesterol and "bad" cholesterol

Not all cholesterol is harmful. There is a "bad" kind and a "good" kind. The "bad" kind is called LDL (Low-Density Lipoprotein) cholesterol, and the "good" kind is called HDL (High-Density Lipoprotein) cholesterol. The bad cholesterol tends to block the arteries, but the good kind helps to clear out this bad cholesterol inside the arteries.

Understanding your cholesterol levels:

When you have your blood cholesterol checked, the lab will report on three types of cholesterol and also triglycerides. Triglycerides are the most common fats in the diet and in the blood. If you have a high reading of LDL or triglycerides, or a low reading of HDL, you may have a higher risk of having heart disease. Both cholesterol and triglycerides are measured in millimoles per litre, or mmol/L for short. If you already have heart disease or other risk factors, your doctor may advise you to lower these levels even further. For example, the ideal level of LDL-cholesterol for people with heart disease is less than 2.5 mmol/L.

You can reduce your risk of cardiovescular disease:

Work with your doctor:

  • To control your blood cholesterol.

  • To control the other factors that can lead to heart disease.

Individuals can manage their risk factors by eating a healthy diet, maintaining a healthy weight, being physically active, being smoke-free, knowing and controlling cholesterol and blood pressure levels, reducing stress, managing diabetes, and limiting alcohol intake.

Eating habits help to control cholesterol:

  • Eat less fat and cholesterol

  • Choose leaner meats, poultry, and fish.

  • Have some meals with no meat. Use meat as a side dish rather than as a main course.

  • Reduce meat portions to the size of a deck of cards.

  • Eat no more than one egg yolk a week.

  • Choose skim dairy products such as skim milk, cottage cheese with 1% M.F. on the label and yogurt with less than 1% M.F. on the label. For hard cheeses, choose cheese with less than 15% M.F. on the label and eat less.

  • Cook with little or no fat.

  • Use vegetable oils such as olive, canola, corn, sunflower, safflower, and peanut oil in small quantities.

  • Avoid store-bought baked goods such as croissants, muffins, and donuts.

  • Eat more vegetables, fruit, whole grains such as oats or barley, and legumes such as dried peas, dried beans, and lentils.

A Canadian-led global study, funded by the Heart and Stroke Foundation, examined close to 30,000 people from 52 countries. It showed that the most important predictors of heart attack are:

  1. Cigarette smoking

  2. Abnormal blood lipid ratios

  3. High blood pressure

  4. Diabetes

  5. Abdominal obesity

  6. Stress

  7. A lack of daily consumption of vegetables and fruit

  8. A lack of daily exercise

Collectively, these eight factors account for a full 90 percent of all first heart attacks in the world.

Why eat these foods?

The focus of a diet to improve cardiovascular health should be on increasing dietary intake of fibre, fruits, and vegetables, fish and fish oils. Fibre can be obtained from beans, pectin rich fruits, whole grain products and vegetables. These can lower LDL cholesterol levels and improve insulin sensitivity. In addition, fruits and vegetables provide valuable dietary antioxidants. These are particularly valuable in light of several studies that suggest that taking supplementary beta-carotene and vitamin E (in vitamin pills) did not show the same benefits. Substituting non-fat dairy products and reducing salt intake was also shown to be beneficial. Finally, two meals of fish per week are recommended to reduce risk of coronary heart disease.

Make wise food choices to achieve and maintain a healthy body weight. Being overweight increases your chances of having high blood pressure, diabetes and high blood cholesterol, all risk factors for heart disease.

From Dietitians of Canada:

As a general rule of thumb for a healthful meal, cook with little or no fat and fill your plate with: ½ of colourful vegetables ¼ of whole-grain products ¼ of leaner meat or alternatives (kidney beans, chick peas, lentils, tofu, etc) Complete your meal with a fruit and/or a lower fat dairy product.