By Vicky Weng, Senior Community Dietitian CHSP Dietetic Service for Bankstown Fairfield Liverpool areas.
 
Cholesterol is a type of fat carried around in our blood. It is produced by our body naturally, and we can also get it from some foods. Having high levels of cholesterol in the blood is a risk factor for heart disease, so it’s important to manage our cholesterol.

There are 2 different types of cholesterol: 
· High density lipoprotein (HDL cholesterol) is called the ‘good’ or ‘helpful’ cholesterol because it helps to keep cholesterol from building up in the arteries.
· Low density lipoprotein (LDL cholesterol) is called the ‘bad’ or ‘lousy’ cholesterol because it is the main source of cholesterol build-up and blockage in the arteries.

Total cholesterol is a reading of the helpful and lousy cholesterol. Triglycerides are another form of fat in the blood that can also raise the risk of heart disease.
 
When there is too much cholesterol in the blood, it builds up in the walls of the arteries (plaque). Over time, this build up causes ‘hardening of the arteries’  – the arteries become narrowed and blood flow to the heart is slowed down or blocked. People may suffer chest pain and a heart attack. People with diabetes or high blood pressure are more at risk of heart disease and need to keep their cholesterol levels lower.
 
Do eggs increase blood cholesterol and the risk of heart disease?
The simple answer is No.
 
Eggs provide many vitamins and minerals, including Vitamin A, D, B6 and B12, Iron, and Zinc. Eggs have the highest quality protein of all food sources. About 70% of the fat in eggs is the good fat— the unsaturated fats including omega-3 fat that have benefits for the heart and blood vessels. Research shows that eggs have little to no effect on cholesterol for most healthy people. The fats that mainly affect blood cholesterol are saturated and trans fats. One egg has about 5g of fat—but most of it is the “good” fat that we need. Eggs have no trans-fat at all. Two eggs provide about 12g of high quality protein. Protein is essential for building and maintaining muscles, fighting infections and healing wounds. The protein in eggs is easily absorbed and used by the body. Egg yolks are one of the few foods with vitamin D.  Vitamin D is needed to help absorb calcium from food, help keep bones and muscle strong. Eggs are an ideal food for older people as eggs are cheap; easy to buy, store and cook; and taste good! Most people can eat up to six eggs a week without increasing their risk of stroke and heart disease. This includes people with diabetes who follow a healthy balanced diet.
 
What is the latest scientific evidence on fats and the relationship in lowering blood cholesterol?

• Eat more fruit, veggies and wholegrains to boost fibre intake.  
• Replace foods high in saturated fats (i.e., butter, coconut and palm oils, and many biscuits, cakes, pastries and processed meats) with foods high in unsaturated fats (such as nuts, seeds, nut pastes, tahini, avocado and foods made with unsaturated oils).  
• Sterol-enriched margarines are very effective in cholesterol lowering with an average reduction in LDL-Cholesterol of about 10% over a 3 week period. Margarines in Australia do not contain trans-fat.
• A Mediterranean diet supplemented with extra virgin olive oil or nuts has been proved to reduce the risk of major cardiovascular events compared to a low fat diet in people at high risk of CVD.
• As well as quitting smoking, become more active to help reduce stress levels.

 
What are good sources of fat?

• Olives, nuts, seeds, avocado
• Tahini
• Eggs
• Oily fish
• Oils made from olives, nuts and seeds (i.e., olive oil, canola oil, sunflower oil, safflower oil)

 
Is Coconut oil good for our heart?
Coconut oil contains 92% saturated fat. There is little evidence to support coconut oil being called a 'superfood'. Coconut oil raises total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL). While the increase in HDL may seem good, it’s overshadowed by the increase in LDL. Dr Lawrence Eyres’ evidence report in 2014 on the saturated fat in coconut oil found that it acts similarly to saturated fats in other foods. That is, it raises LDL cholesterol.
 
Tips to include the healthy fat in the meal plan:

• Include fish or seafood in the weekly menu, 2–3 times a week; Choose herring, tuna or other types of fish for salads, curries, on sandwiches, in soups.
• Try tinned fish in oil for affordable omega 3’s such as salmon, tuna and sardines. Add it to some whole egg mayonnaise, spinach and put it on a roll or wrap for a healthy meal.
• Mash boiled eggs with canned salmon and ricotta cheese for a high calcium sandwich filling or as a topping for wholegrain crackers.
• Mix beaten eggs with grated cheese, pepper and parsley and stir through cooked wholemeal pasta for a quick and easy meal. Serve with a green side salad.
• Use avocado for an extra good-fat boost on salad or toast.
• Use tahini—a sesame seed paste for salad dressings or on crackers.
• Sprinkle some nuts over salad, toss through stir fries or roast vegetables.
• If you can’t eat nuts because of dental problems, use nut butters (e.g. peanut butter, cashew butter, almond butter etc), oils, ground nuts (e.g. almond meal).
• Make healthy fried rice by mixing cooked, chopped vegetables, ham (alternatively you can use chicken or tofu), and chopped boiled egg with cooked rice. Stir fry in sesame oil, add a splash of soy sauce and cook until heated through

 
References:
Expert Scientific Roundtable Report: What is a healthy balance of fats and oils? August 2017. https://dietitianconnection.com/app/uploads/2017/08/Expert-Roundtable-Summary-Report.pdf
 
Eggs and Heart Healthy Eating – A Dietary Position Statement. National Heart Foundation. https://www.heartfoundation.org.au/getmedia/654eedf8-c9fd-45b2-aa16-cb34fcd24305/Nutrition_Position_Statement_-_Eggs.pdf
 
Eyres L. Coconut oil and the Heart – Evidence Paper. September 2014. National Heart Foundation.
https://assets.heartfoundation.org.nz/documents/shop/submissions/coconut-and-the-heart-evidence-paper.pdf?1602476192