Instead of eating at fast-food places , Harry Richardson now takes his lunch to work. Today he has raw almonds, a lentil and rotini soup, whole grain rye bread and sardines. Mr. Richardson is about to turn 50, but recently found his cholesterol levels were getting a little high. Not quite high enough to need cholesterol-lowering drugs, but worrying enough that his doctor suggested some dietary changes.
"It's part of a lifestyle approach," says the registered massage therapist from Toronto. He's exercising more, trying to stay in shape too.
These are exactly the rights things to do, according to Shauna Ratner, a dietician at the Health Heart Program at Providence Healthcare in Vancouver. She counsels people on what foods to eat (and which ones to avoid) to help battle undesirable cholesterol profiles.
She advises lowering fat intake in general, especially saturated fats. These fats are easy to identify - they tend to be solid at room temperature: meat fat (such as lard), dairy fat (in butter and cheese), coconut oil, and others. Transfats, also a no-no, are found in hydrogenated vegetable oils and fatty dairy products and are known to increase LDL cholesterol (the 'bad' cholesterol).
But are there foods that actively battle cholesterol? Yes, according to a scientist who discovered that it's possible to keep cholesterol in check through diet. Dr. David Jenkins is a professor of medicine and nutrition science at the University of Toronto and came up with the Portfolio Diet - consisting of a combination of foods known to battle cholesterol.
The Portfolio Diet consists largely of vegetables, fruit, nuts and legumes. It was devised using foods that, individually, had already been shown scientifically to lower cholesterol.
Meat, egg yolks and dairy products are the only dietary sources of cholesterol - making them bad guys right from the start. But this doesn't mean you have to become vegetarian to get your cholesterol down, Dr. Jenkins said. Start with meals with non-meat protein sources such as veggie burgers or beans, choose low-fat dairy products, use soft margarines that consist of unsaturated fats, and cook with canola oil. Increase vegetables, and decrease the bad-guy foods.
The Portfolio Diet first appeared in the public consciousness in 2003 when Dr. Jenkins published a study in the Journal of the American Medical Association (JAMA), focused on subjects who had elevated cholesterol, and who were randomized into one of three dietary interventions, including one group taking statins - cholesterol-lowering drugs. Cholesterol levels were measured before and after the study.
The group that benefited most was the subjects whose diet was heavy in cholesterol-lowering foods. Indeed, cholesterol levels in participants dropped as much as they would've had they been taking statins, Dr. Jenkins said.
Key foods that help lower cholesterol are soy, nuts, various beans, grains such as oats and barley, and canola oil. While upping these foods in your diet is an excellent idea, they won't lower cholesterol unless you decrease your intake of cholesterol-raising foods. Eating a handful of nuts with your burger and fries won't help. "You need to substitute a healthier choice in place of the burger and fries," Dr. Jenkins said.
"What you get out of the diet depends on how hard you work at it. If you give it a mild effort, you'll get only a mild benefit," Dr. Jenkins said.
It's not like taking a pill. Each food helps lower cholesterol only a small amount - eating them together, and throughout the day, is what makes the difference.
Diet alone isn't enough for everyone. Some people with very high levels of cholesterol still need medication. If diet doesn't get the numbers down, stick with it anyway - it still contributes to overall heart health, Dr. Jenkins said.
Products such as Metamucil (a high fibre supplement), or supplements containing psyllium fibre or niacin also have an effect - though check with a doctor first before starting niacin, as is can have side-effects.
How do foods lower cholesterol?
There are three key mechanisms by which specific foods help lower cholesterol, Dr. Jenkins said.
Suppressors: Some foods suppress cholesterol production by the liver. A key food known to reduce cholesterol production is soy.
Fibres: Some foods contain "sticky fibre" which literally grabs onto cholesterol and helps wash it out of the body. Oat bran, oats, barley, beans, and psyllium are examples of "sticky fibre" foods.
Sterols: Some foods contain plant sterols, compounds which block cholesterol from being absorbed by the body. Sterol-containing foods include plant oils, nuts, seeds and leafy vegetables. Some over-the-counter supplements also contain sterols.
Mixed approach: Nuts use all three mechanisms to help lower cholesterol. Studies have shown almonds, hazelnuts, walnuts, and pistachios to be effective in helping lower cholesterol.