According to The Heart Foundation, heart disease is the single biggest killer of Australians. Although there is not ONE risk factor for heart disease, there is a lot you can do to lower your risk. Along with a healthy diet, other important lifestyle choices that have been found to reduce the risk of heart disease include not smoking, being physically active, managing stress levels and maintaining a healthy body weight.

The problem with high fat in your blood

The two main types of fatty substances that circulate in our blood include triglycerides and cholesterol. Triglycerides are fats that circulate in the blood after you eat. They store unused calories and provide your body with energy, but high levels are usually associated with excess body fat, especially around the abdomen, and with type 2 diabetes and pre-diabetes. Having high triglycerides is considered a risk factor for heart disease and pancreatitis (inflammation of the pancreas). 

Cholesterol is used to make steroid hormones such as oestrogen, testosterone and the stress hormone cortisol. It is needed to make bile salts, a necessary component for digestion of fats, and it also helps make vitamin D. 

Too much low density lipoprotein (LDL) in your blood, also known as ‘bad' cholesterol, may leave fatty deposits (plaque) on the lining of arteries, causing blockages and leading to heart disease and stroke.

Lowering your triglycerides and cholesterol naturally

The most important thing you can do to manage the levels of fats in your blood is exercising more and eating a heart-healthy diet.

But what is a heart-healthy diet?

Overall, it is a diet that includes a minimum of processed foods, limited alcohol, and as much fresh food as possible - abundance of colourful fruits and vegetables, whole grains, nuts and seeds and legumes, as well as fish, and modest amounts of other meats and dairy. This type of diet is rich in fibre and provides healthy sources of carbohydrates, fat and protein.

Dietary fats and heart health

For many years we have been told to eat a low-fat diet for heart health, which unfortunately led to many people replacing healthy fats with sugar and refined carbohydrates such as white bread. This has resulted in increased rates of obesity and type 2 diabetes.

We all need certain amount of fat in our diet to be healthy; however, choosing the right type of fat is essential for our health.

Rather than focusing on lowering total fat in your diet, it is best to replace foods that are considered ‘bad’ fats with ‘good’ fats.

Numerous studies demonstrate that replacement of saturated fat with monounsaturated and polyunsaturated fats (nuts, seeds, avocadoes, olives) and omega-3 fats (fish) reduces LDL cholesterol.

The heart Foundation recommends lowering dietary saturated fat intake to no more than 7% of energy intake. Sources of saturated fats include meat (lamb, pork, fatty beef, processed meats, chicken with skin), dairy products such as whole-fat milk, cream, butter, lard, hard cheese, many baked goods and fried foods, palm oil, palm kernel oil, and coconut products - oil, cream and milk.

The worst type of fat is trans fat. Trans fats increase LDL cholesterol and triglyceride levels, and reduce HDL cholesterol (also known as the ‘good’ cholesterol). Trans fats are found in margarine, shortening, baked products, including pies, pastries, cakes, biscuits and buns, and deep-fried foods.

Fibre and heart health

Dietary fibre comes from plants.

The body cannot break down fibre. However, some fibres are fermented and digested by gut bacteria, thus resulting in increased amount of bacteria in our colon. Indeed, high-fibre diets are associated with higher diversity and abundance of gut bacteria, which reduce levels of total cholesterol, LDL cholesterol and triglycerides, as well as contribute to blood sugar control, softer stool, and weight control.

The foods that contain dietary fibre are fruits, vegetables, legumes (beans, peas, lentils), nuts, seeds, and whole grains (such as oats, barley, and brown rice). Although it is advisable to obtain fibre from food, a sudden increase in fibre can lead to abdominal discomfort.

Regular consumption of fibre reduces the risk of heart disease, type 2 diabetes, and colorectal cancer

Fibre supplements can also help reduce the levels of fats in your blood. For example:

• Psyllium is a soluble fibre that is sold over the counter. It is derived from the husk of the seed of the Plantago plant, a flowering plant grown in areas such as China, India, and the Mediterranean. Psyllium lowers cholesterol by forming a very viscous gel that slows the emptying of the stomach, and delays the absorption of some nutrients, such as fats, in the small intestine. It appears that 7 g or more per day of psyllium fibre have been found to lower cholesterol and reduce the risk of heart disease.
   
• Alpha-cyclodextrin (trade name FBCx®) is one of the most powerful dietary fibres for decreasing blood cholesterol and triglycerides. It is a natural soluble fibre derived from corn. This fibre interferes with cholesterol or triglyceride absorption by binding to dietary fats and creating a fibre-fat complex that is then excreted in the stool intact. One gram of alpha-cyclodextrin has been shown to bind as much as nine grams of dietary fat. It is also considered very safe and well tolerated.

The bottom line

If you have been diagnosed with high cholesterol and/or high triglycerides, dietary and lifestyle changes are the best place to start.

• Go Mediterranean:  include extra virgin olive oil, vegetables, fruits, whole grains (oats, barley, brown rice and quinoa), legumes, and fish, as well as some dairy products (mostly cheese or yogurt), a small quantity of meat and poultry, and red wine in moderation.
• Increase your fibre intake
• Start an exercise program
• Manage your stress

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References

Amar, M.J.A. et al., 2016. Randomized double blind clinical trial on the effect of oral α-cyclodextrin on serum lipids. Lipids in health and disease, 15(1), p.115. Available at: http://www.ncbi.nlm.nih.gov/pubmed/27405337

Comerford, K.B. et al., 2011. The Beneficial Effects α-Cyclodextrin on Blood Lipids and Weight Loss in Healthy Humans. Obesity, 19(6), pp.1200–1204. Available at: http://doi.wiley.com/10.1038/oby.2010.280

Harvard Health, 2015. Know your triglycerides: Here’s why. Available at: https://www.health.harvard.edu/heart-health/know-your-triglycerides-heres-why

McRorie, J.W. & McKeown, N.M., 2017. Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber. Journal of the Academy of Nutrition and Dietetics, 117(2), pp.251–264. Available at: http://www.ncbi.nlm.nih.gov/pubmed/27863994

Linus Pauling Institute, Oregon State University 2012. Fibre. Available at: http://lpi.oregonstate.edu/mic/other-nutrients/fiber

The Heart Foundation, 2017. What causes a heart attack? Available at: https://www.heartfoundation.org.au/your-heart/know-your-risks/heart-attack-risk-factors