Heart healthy recipes See the nutrition section for my recommended recipes for lowering cholesterol.

​​​​Your cholesterol-lowering plan.

• Stub it out - smoking produces a chemical that stops good HDL cholesterol from transporting fatty deposits safely to the liver.
  
• Get moving - Exercise helps increase good HDL cholesterol - 150 minutes of physical activity (puffed, but not breathless!) a week.
  
• Shed the pounds - If you are overweight, particularly with fat around your tummy, it's important to lose some weight as this will help increase your HDL levels.
  
• Get your fats right - The good fats are the essential fatty acids, omega 3,6 and 9. Omega 3 should dominate, as these have the best effect upon cholesterol levels, reducing LDL and elevating HDL. There are other benefits for the heart, such as reduction of clotting risk and blood pressure. Use Olive oil and coconut oil for cooking,(avoid processed and fatty meats, and too much dairy).
  
• Be carbohydrate smart - The other result of the exodus away from fatty foods is that we are now consuming a lot more carbohydrates. This needn't be a disaster, but unfortunately we're eating too many refined carbohydrates such as white bread, white rice, pasta, sugar, sweets and chocolate. These are rapidly digested and release their sugars very quickly, causing a huge surge in blood sugar. These can have very serious consequences, so our bodies have very effective mechanisms to manage it. The first part is the secretion of insulin. which tells our cells to take in sugar more rapidly, so it can be used for energy. It is a very effective, very rapid system. However, only a fixed amount of glucose can enter the cells at one time. When the capacity to take in glucose is exceeded (which is very possible after eating fast-release carbs), another mechanism kicks in to get the blood sugar levels down, in which excess sugar can be converted into (bad) LDL. This results in elevated cholesterol levels. Luckily, good quality carbohydrates such as those you find in whole grains, pulses and lightly cooked vegetables will have a stabilizing effect on blood sugar, and avoid all this.
• Eat more fibre - As well as keeping us regular, fibre is important for keeping cholesterol in check. Certain fibres, especially soluble fibres, such as those found in apples, seeds and pulses, physically bind to cholesterol in the digestive tract, and carry it away through the bowel, preventing it from being absorbed.
  
• ​Choose soya - Have at least 15g soya protein a day. Studies show it helps regulate cholesterol.
  
• ​Up your fortified foods - With plant sterols or stanols, included in special spreads, milks, yoghurts and drinks. Research shows that 1.5-2.4g of plant sterols or stanols a day help to reduce LDL cholesterol levels by 7-10% alongside a healthy diet.
  

(Sources for this article: Food is better medicine than drugs - Patrick Holford; The Medicinal Chef - Dale Pinnock)

How is your heart health?

Check yourself out on this simplified cardiovascular questionnaire.

1) Is your blood pressure above 140/90?

2) Is your pulse above 80?

3) Is your cholesterol above 5.5?

4) Is your cholesterol/HDL ratio above 5?

5) Is your homocysteine level above 9?

6) Do you get out of breath climbing stairs or inclines?

7) Do you sometimes get chest pains?

8) Do you smoke more than 5 cigarettes a day?

9) Do you exercise less than twice a week?

10) Are you overweight?

11) Do you have cardiovascular disease?

12) Does your mother, father, or any brothers or sisters suffer from cardiovascular disease or high cholesterol?

13) Do you eat less than three servings of fruit and vegetables most days?

14) Do you eat fried food, meat or other high fat foods most days?

15) Do you rarely take vitamin supplements?

16) Do you consider your lifestyle stressful?

Score 1 for every "yes" answer. If you answered yes to:

Less than 4: you have few indicators of risk. The ideal score is "0" and therefore you should address any "yes" answers if possible.

5 to 8: you have a high risk of cardiovascular disease and need to take action to change your lifestyle and diet to reduce your risk.

More than 8: you are in the very high risk category for cardiovascular disease and should both see your doctor and a nutritional therapist to actively reduce your risk with dietary changes as well as supplements.

Cholesterol levels

There are three cholesterol readings you can have: your total cholesterol, your LDL ('Bad') cholesterol, and your HDL ('good') cholesterol.

You want to have a low LDL (ideally below 2.7mmol/l), a high HDL (ideally above 1.5mmol/l), and a total cholesterol between 3.9mmol/l and 5.2mmol/l.

The Problem with Statins.

As well as blocking LDL cholesterol, statins also reduce the production of an enzyme known as Co-enzyme Q10 which is, ironically, essential for heart health. A deficiency in Co-enzyme Q10 has been associated with fatigue, muscle weakness and soreness and heart failure.

Other side effects reported on statins are, transient amnesia, dizziness, headache, extreme fatigue, swelling of the ankles, muscle aches and suppressed immunity.

Cholesterol's role in the body.

Cholesterol is a vital substance. All our steroidal hormones, such as oestrogen and testosterone, are made from it. It is a major structural component of our cell membranes, and a precursor for vitamin D. However, too much of it can be a problem. Another issue is whether the balance between the two types, HDL and LDL, is favourable.  There are many factors that can affect cholesterol levels, but the most profound is diet - thankfully, the one we have most control over on a day-to-day basis.

More people die prematurely from diseases of the heart and arteries than anything else in the UK - accounting for a third of all deaths before the age of 75. Yet both of these are largely preventable diseases with highly familiar risk factors, such as poor diet, smoking , obesity and lack of exercise.

If you've been diagnosed with some form of heart disease - angina, hypertension (high blood pressure), thrombosis, a stroke or heart attack - your doctor is unlikely to focus on these risk factors. Instead, you'll probably be prescribed a cocktail of drugs to lower your cholesterol, bring down your blood pressure and thin your blood. You're likely to get these drugs even if you don't have any symptoms of a cardiovascular problem, but have a measureable risk factor such as high blood pressure or high cholesterol.

Achieve the right levels of good and bad fats.

For the last few decades, we've all had it drummed into us that we should be cutting the amount of fat we eat to look after our hearts. However, dietary fats are a vital component of good health, and eating the right fats in the right amounts can actually improve our cholesterol levels by increasing high-density lipoproteins (HDL, the carrier protein that transports cholesterol away from the cells and back to the liver for breakdown and removal), and reducing our levels of low-density lipoprotein (LDL, the carrier protein that transports freshly made cholesterol from the liver, out into the body tissues). When we reduce our total intake of fat, we reduce our LDL, and our HDL too, which is equally as bad for the heart in the long run.

Helping your Heart (the natural way)

The cardiovascular drugs.

There are several categories of heart medications, each designed to affect the different aspects of cardiovascular health that are measured. The main ones are:

• Cholesterol-lowering drugs, including statins
  
• Blood pressure-lowering drugs, including thiazides (diuretics), beta-blockers, ACE inhibitors, calcium channel blockers, and nitro-vasodilators
  
• Blood thinning drugs to make clotting less likely, such as warfarin and aspirin.
  

If you have cardiovascular disease, or are at risk or developing it, the chances are you're on more than one of these medications already. All of them interfere with some aspect of your body's chemistry and none is necessary if you address the underlying causes of heart disease.

This month I will focus on cholesterol lowering.