No deprivation, we can continue to consume saturated fats but sparingly
A cholesterol level that exceeds the authorized threshold does not necessarily mean taking statins, the reference cholesterol-lowering drugs. Because this “overdose” is due, most of the time, to a diet that is too rich. The cause: excessive consumption of saturated fatty acids which are mainly found in foods of animal origin (butter, fresh cream, cheese, red meat, cold cuts, lard), certain tropical vegetable oils (palm and coco), and quantity of so-called ultra-processed industrial products (frozen pizzas, nuggets, etc.).
The danger ? ” These saturated fatty acids promote the deposition of cholesterol on the walls of the arteries (we speak of atherosclerotic plaques), clog them and reduce blood flow, increasing the risk of cardiovascular diseases such as heart attack, stroke and arteritis », summarizes Pr Jean-Michel Lecerf, endocrinologist, head of the nutrition department of the Institut Pasteur de Lille and author of the book Cholesterol deciphered (Solar Health).
Where am I?
Hypercholesterolemia is silent and asymptomatic, except for a stroke, the last stage of this disease. It is generally only on the occasion of a blood test, prescribed by the doctor, that one realizes it. For this reason, a lipid assessment is recommended every five years, from the moment certain risk factors are met (rich diet, weight gain, sedentary lifestyle).
Two proteins are responsible for transporting cholesterol in the blood. On the one hand, the high-density lipoproteins (HDL), attached to the good cholesterol, bring the excess cholesterol accumulated in the organs to the liver so that it can be eliminated. On the other hand, low density lipoproteins (LDL), corresponding to bad cholesterol, leave the liver and distribute excess cholesterol to the organs. The total cholesterol level includes HDL and LDL levels as well as a fifth of the level of triglycerides, fats made from the foods we eat. In the absence of cardiovascular risk, it is considered that the total cholesterol level must be less than 2 g/l. The HDL level must be greater than 0.4 g/l. But it is above all the LDL level that the doctors analyze: it must not exceed 1.6 g/l.
Nevertheless, this last threshold is examined on a case-by-case basis and can be revised downwards depending on the patient’s sex, age, body mass index (BMI), cardiac history, lifestyle. (smoking, sedentary lifestyle, etc.) and possible illnesses.
More fiber and omega 3
When the level of “bad cholesterol” or LDL cholesterol slightly exceeds the set threshold, “ the official recommendations propose in first intention to review the composition of the patient’s menus “, explains Dr. Laurence Benedetti, nutritionist. Changing food mode does not amount to increasing deprivation by eliminating all animal fat. ” It’s the best way to eat in an unbalanced way, throwing yourself on everything else and/or compensating with an excess of sweet foods. “Warns Dr. Lecerf. The idea is to continue to consume saturated fats, but sparingly: a knob of butter in the morning, a maximum of four eggs per week (the cholesterol in the egg is concentrated in the yolk), cold meats once a week…
” For a long time, the medical profession focused on the hunt for saturated fatty acids. But the discourse has evolved in recent years. From now on, we favor the benefits of protective nutrients that will lower the LDL cholesterol level, but also reduce the cardiovascular risk as a whole. “, explains the specialist. It is therefore advisable to increase the fiber intake, because it reduces the absorption of cholesterol in the intestine, and to fill up with antioxidants, because they protect the arterial walls. Similarly, the diet should focus on “good fats”, in particular polyunsaturated fatty acids of the omega 3 type, which have a positive effect on blood lipid levels.
Adopt the Cretan diet
Also known as the Mediterranean diet, it is the reference in terms of food beneficial to the heart and the arteries. Particular sign, it gives pride of place to fruits and vegetables, rich in fiber and antioxidants, which are found at every meal. It is necessary to arrive at five portions per day: green vegetables and/or raw vegetables for lunch and dinner + 2 fruits per day. Other sources of fibre: whole grains (bread, pasta, rice) and legumes (lentils, dried beans, split peas, soy).
In practice, whole grains, or even semi-whole grains for irritable bowels, between one and three times a day: a slice of bread in the morning and a third of a plate of rice for lunch, for example. Legumes must be on the menu two or three times a week: count 60 g of dry weight per serving for women and 80 g for men. The Mediterranean diet is, of course, made up of fish, especially oily fish such as mackerel, sardines and herring, which provide omega 3s. We therefore put these proteins from the sea on the plate at least twice per week.
On other days, meat foods should be eaten in moderation, at one meal, preferring lean meats (poultry, rabbit) to red meats (beef, pork, lamb or mutton).
Did you say phytosterols?
Obviously, who says Cretan diet also says olives. Like all oilseeds, they contain phytosterols, plant lipids. “ Their molecular structure being close to that of cholesterol, these lipids compete with it and prevent it from crossing the intestinal wall. It therefore does not pass into the blood and is eliminated in the stool. “says Dr. Benedetti, who advises his patients to include foods naturally rich in phytosterols in their diet. Which means walnuts or almonds as snacks (much better than cookies!) and virgin vegetable oils of olive, walnut and rapeseed in salads.
All the studies show that a daily intake of 2 g of phytosterols, ten times the usual intake, lowers blood LDL cholesterol levels by an average of 8 to 12%. It works in 70 to 80% of patients, the others being non-responders, for genetic reasons. The fact remains that the use of products industrially enriched with phytosterols (yogurt, margarine, etc.) is not recommended by the National Agency for Food, Environmental and Occupational Health Safety (ANSES).
” No study has demonstrated their benefit on the regression of atherosclerotic plaque and on cardiovascular risk. “, comments Dr. Lecerf. In addition, taking these products reduces blood levels of carotenoids, natural protective antioxidants that would protect against heart attacks. On the dairy side, lean products such as skimmed or semi-skimmed milk and yogurts (two per day) have a privileged place. On the other hand, the consumption of cheeses will be limited to 30-40 g per day, in order to moderate the calorie intake.
Cholesterol is good!
Don’t just see him as an enemy. It is indeed essential for the proper functioning of the body: maintenance of cell membranes, synthesis of vitamin D, sex and adrenal hormones, including cortisol. And cholesterol also participates in the production of bile acids, necessary for the digestion of fats.
Butter or margarine? A podcast to better understand
No salads! The podcast of Female Version, which dismantles preconceived ideas in the field of food, devotes an episode to the butter-margarine match. To listen if you finally want to know what margarines are worth and if you can substitute them for butter, especially in cases of excess cholesterol or cardiovascular disease.
Also to discover: The Nordic diet is proven to lower cholesterol levels
Three months to get results
These good eating habits require you to (re)go behind the stove, in order to control your consumption, abandoning prepared meals, except to scrutinize their composition. Diversified and balanced, this new way of approaching daily meals ” can lower LDL cholesterol levels by 10-30% within three months “, says Professor Lecerf. This avoids the use of drugs or reduces the doses. What about food supplements based on red yeast rice? They contain natural statins which have the same side effects as their synthetic counterparts, in particular digestive disorders (nausea, diarrhea, etc.), cramps and muscle pain. So we forget.
If the nutritional therapy passes only by food, it must be accompanied by other measures. In addition, it is therefore useful to lose weight if necessary, to practice regular physical activity (at least 30 minutes of walking per day) and to stop smoking. Of course, this change in lifestyle, if it proves to be effective, will have to be maintained over the long term. It would be a shame to put an end to the virtuous circle that has begun…