For the past 2-3 decades we have been advised to lower our fat intake in order to reduce obesity, diabetes, heart disease and some forms of cancer.
This measure has helped to reduce our heart disease by 53% over the last 23 years (Australia dropped 64%) but we are still third fattest of all OECD countries (Australia is 5th).1
Weight control is key to better health but with so many diets available it can be confusing to know where to start.
Christmas tends to be a time of overconsumption so what can we all do to rope in these stats, better the Australians and build healthier lives?
1.See your GP for a check up
Find out your blood cholesterol, blood glucose and blood pressure status.Aim for Total cholesterol <4 mmol/L; LDL (bad) cholesterol < 2.0 mmol/L; Triglycerides <1.7 mmol/L and HDL (Good) cholesterol >1 mmol.2
Also check your weight and Body Mass Index to give you a goal to focus on over the summer period if yours is deemed too high.
2.Lower saturated fat and trans fat
This goal to lower your total and LDL cholesterol is still valid and can be achieved if we trim off the visible fat from ham, cut back on sausage and bacon in the turkey stuffing, swap the cream and ice-cream for yoghurt, and make smaller pieces of shortcake and Christmas mince pies. Also try to avoid highly processed foods such as crisps, cakes and biscuits as these can be a major source of unhealthy trans fat.
3.Change the type of fat
Dietary fat should sit between 25-35% of total energy depending on your health goals. Increasing fat towards the higher level of 30% can help reduce Triglyceride and the bad LDL cholesterol levels, particularly in Type 2 diabetes, provided these fats come from polyunsaturated fat.3This tends to be in line with the traditional Mediterranean diet which also lowers Triglycerides.
So this Christmas try to eat fatty fish like salmon more frequently, whole grain breads and cereals, oils in cooking and salad dressing; margarines in place of butter and, raw unsalted nuts and seeds rather than crisps and fried snacks.
4. Eat high quality protein
Choose lean red meats and keep serving sizes down to around 60-90g cooked meat per serving 4 as this is a good source of iron, zinc and Vitamin B12. Aim for 3 red, 2 white and 2 non meat meals/week. Avoid processed meats such as bacon, sausages and luncheon meat and if buying ham this Christmas buy a few slices rather than a ham on the bone. Take care when barbecuing as eating charred meat can increase the risk of cancer. 5
Vegetarian meals with higher protein include legumes, soy and beans and fat reduced milk and milk products. Vegans may find it helpful to consult a dietitian for an assessment to ensure an adequate intake of nutrients and particularly energy during periods of rapid growth or if involved in vigorous exercise.6
5. Limit added sugar
The World Health Organisation (WHO) last year advised a reduction in added sugar intake.
They recommend levels of < 10% of total energy for adults and children (50g) and < 5% for good health (25g) excluding the sugar found in whole fruit, milk and vegetables. 7
As there is a direct correlation between added sugar and raised blood lipids 8 it is important to mindful this Christmas of the sugar that you add to desserts, cakes, cooked fruit, beverages and confectionery and try to cut back.
Studies looking at Fructose have found that this does increase Triglycerides when levels exceed 60g/day for up to 4 weeks. 3 However very few people consume pure fructose to this degree. Most of our fructose does seem to be highest in fruit and in particular dried fruit. So for people concerned about their weight and cholesterol levels then these two things need to be watched over Christmas and summer months when fruit is plentiful and Christmas cakes, pies and puddings are more freely available. Dietary guidelines recommend 2-3 servings of fruit/day.
6. Eat more plant based foods but with care
While many carbohydrate foods may contain natural (intrinsic) and added (extrinsic) sugar they are also an important source of starches and dietary fibre essential to good health.
Fruit, vegetables, bread and cereals provide energy to fuel activity and growth and are a source of vitamin C and B group vitamins important for nerve health and cellular metabolism.
Dietary guidelines to lower elevated lipids recommend the use of whole grains, high fibre, low GI and GI Load and less refined carbohydrates (such as confectionery, white bread, rice, pasta, crackers etc).
Dietary fibre contributes bulking agents to our diet which speed the transit time of waste products through our gut reducing the risk of bowel cancer and aiding weight and cholesterol management.
Some dietary fibres also contribute a prebiotic function supporting the growth of beneficial microbiota keeping our bowel healthy, reducing inflammation and aiding the immune system. 11
Prebiotic’s can be found in wheat bran, oats, barley, onion, leeks, garlic, apple, asparagus, banana, flaxseed etc
There are limits however as to how much fibre one can take. The hulls of seeds, nuts, grains and legumes contain phytate which in excess can reduce the absorption of iron, calcium and zinc. 10 Genetic improvements of the zinc and iron content of grains is being undertaken and phytate can also be reduced by methods such as fermentation, soaking and germination.
Some people may also experience gut discomfort, abdominal pain, bloating and altered bowel habit with higher levels of prebiotic. Athletes for example requiring very high carbohydrate intakes (often > 60% of energy) may need to reduce their dietary fibre intake if this becomes a problem. Children and the elderly also need less than adults. A Dietitian can help you find the level right for you.
If you are interested in learning more about your bowel movements the Bristol Stool Chart 11 can help you recognise changes in bowel function and if concerned then discuss this with your doctor or Dietitian before taking any form of dietary supplementation.
7.Pay attention to the combinations of food you eat
Studies of the DASH diet (Dietary Approaches to Stop Hypertension) containing 55% of total energy as carbohydrate found that Triglycerides could still be held in check if the carbohydrate was taken as 8-10 servings of fruit and vegetables, whole grains, low fat dairy foods, lean red meat, fish, poultry, nuts and beans and limitations were placed on Discretionary foods. 12
We tend to focus on one food or nutrient when discussing health rather than remembering it is often the combination of foods which may matter most. So this Christmas try to increase your variety of food groups listed above.
8.Keep well hydrated
Fluids are essential to carry nutrients for cellular growth and remove waste. Dietary fibre absorbs moisture as it traverses the gut and swells keeping the bowel contents moving and preventing constipation. Thus fluid intake is an essential component of bowel health and needs extra vigilance during hot summer months.
The type of fluids consumed are also important. Limit sugar sweetened beverages and diet soft drinks in favour of more still tap water and fat reduced milk to assist weight management and aid bone health. Carbonated drinks can contribute gas to the bowel causing bloating and abdominal discomfort, another good reason to avoid these. 13
Alcohol can be a major source of sugar and calories in the diet and even in small amounts can increase triglycerides.14 So this Christmas try to cut back and investigate some of the low alcohol drinks now on the market.
9. Limit salt intake
Salt increases blood pressure and the risk of stroke and can reduce bone density. 15
This Christmas avoid cured meats such as ham, bacon and sausages and highly processed foods such as crisps, salty crackers, extruded nibbles, pastry and fried foods. See our recipe and article section for healthier meal and snack ideas.
10. Exercise more
With few exceptions people are encouraged to increase their physical activity to control diabetes, obesity, heart disease and improve mental health. 16
So monitor your current efforts, set your self a daily goal, particularly if travelling over Christmas and try to bring exercise into your group activities. Swimming, dancing, cycling, biking, playing backyard cricket every bit counts. If you can make exercise part of your social engagements then you are helping your friends to also become more active, keeping you company in a longer, healthier life.
Wishing you all a safe and healthful Christmas.
More articles by Lea on similar topics
1 Broughton,C. NZ Heart disease deaths higher than OECD average. Feb 2 2016 http://www.stuff.co.nz/national/health/76476289/new-zealand-heart-disease-deaths-higher-than-oecd-average
2 Understanding your cholesterol results. Health info https://www.healthinfo.org.nz/patientinfo/269148.pdf
3 American Heart and Stroke Associations Triglycerides:Frequently asked questions https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_425988.pdf
4 Eating and activity guidelines statements for NZ adults 2015
5.National Cancer Institute. Chemicals in meat cooked at high temperatures and cancer risk. https://www.cancer.gov/about-cancer/causes prevention/risk/diet/cooked-meats-fact-sheet
6 Rogerson,D. Vegan diets: practical advice for athletes and exercisers. J.of International Soc. of Sports nutrition Sept 2017 14:36
7.WHO calls on countries to reduce sugar intake among adults and children. WHO 2015 http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
8 Welsh, J.A. Sharma,A. Abramson,J. Vaccarino,V.Gillespie,C. Vos,M.B Caloric sweetener consumption and dyslipidaemia among US adults. JAMA 2010 April 21; 303(15):1490-7
9.Muir,J. Gibson,P. Morrison,M. McNamara,L. Vietich,P. Study comparing the effects of diets low and moderate in natural prebiotic fibre on gut flora profile and sense of well being in healthy Australian adults. ACTRN12617000205336
10. Prynne,C. McCarron,A. wadsworth, M.E, Stephen, A.M Dietary fibre and phytate; a balancing act. Results from 3 time points in a British Birth Cohort. Br.J.Nut 2010 Jan:103(2):274-280
11.The Bristol Stool Chart
12. Chiu, S. Bergeron, N.Williams, P.T. Bray G,A. Sutherland, B. Krauss R.M. Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial. American Journal of Clinical Nutrition, 2015https://www.sciencedaily.com/releases/2016/01/160111092407.htm
13 Stanhope K.L. Medici, V. Bremer A.A. Lee, V. Lam, H.D. Nunez, M. Chen, G.X. Keim, N.L. Havel, P.J. A dose-response study of consuming high-fructose corn syrup–sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. Amer. J. Clin. Nut March 24 2015. http://ajcn.nutrition.org/content/early/2015/04/22/ajcn.114.100461.abstract
14.Klop,B. do Rego, A.T.Alcohol and plasma triglycerides Curr. Opin. Lipidol 2013 Aug 24 (4) 421-6 https://www.ncbi.nlm.nih.gov/pubmed/23511381
15 Turlova, E. Feng,Z. Dietary salt intake and stroke Acta Pharmacol.Sin 2013 Jan 34 (1);8-9
16.MOH How much exercise is recommended ? https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/physical-activity/how-much-activity-recommended