Diet & Managing High Cholesterol

Dietary advice for a healthier heart

Consuming Right Amount

The benefits of heart healthy eating

Along with regular physical activity, being committed to keeping a healthy diet is one of the most important things you and your patients can do to contribute positively to overall health.

A diet rich in fruit and vegetables, wholegrains, fish and nuts, and low in saturated fat and salt will help reduce risk factors. Such changes can help cardiovascular health and also have a number of other positive health effects.

Healthy eating guidelines

National and international dietary guidelines for promoting a healthy diet and lifestyle are aimed at improving the general health of the population.

Dietary Guidelines for Australian Adults

The dietary guidelines promote general health at a population level and are based on the following basic principles:

  1. Enjoy a wide variety of nutritious foods1
    To ensure an adequate intake of essential nutrients, eat a variety of foods, in moderation, and focus on fruit, vegetables, wholegrains, lean meat, reduced-fat dairy and unsaturated fats.
  2. Eat plenty of vegetables, legumes and fruits1
    There is strong evidence of a protective effect of diets rich in fruit and vegetables. We should aim to eat two serves of fruit and five serves of vegetables every day.

    Fruit and vegetables provide dietary fibre, and an important source of vitamins, minerals and phytonutrients. They are also relatively low in energy, so are a useful inclusion in a weight control diet.
  3. Eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain1
    Wholegrain bread, and other wholegrain products such as breakfast cereals, pasta, noodles and rice, are important sources of carbohydrates, vitamins, minerals and dietary fibre.

    Diets rich in wholegrains provide dietary fibre, tend to be lower in fat and saturated fats and are associated with good health.
  4. Include lean meat, fish, poultry and/or alternatives1
    This food group provides protein, iron, zinc and B vitamins. Lean cuts of meat and poultry are recommended to reduce saturated fat intake. To obtain essential omega-3 fatty acids, at least two oily fish meals per week are recommended.
  5. Include milk, yoghurt, cheeses and/or alternatives1
    Reduced fat milk, yoghurt and cheese provide protein, calcium and other nutrients. A general guide is to include 3 serves of reduced-fat dairy each day. For those unable to eat dairy, alternatives such as calcium-fortified soy milk are available.
  6. Drink plenty of water1
    Water should be consumed most often as it does not contain additional energy. A variety of other drinks also count towards fluid intake, such as reduced-fat milk, tea and juice.
  7. Limit saturated fat and moderate total fat intake1
    Fats are an essential part of the diet: they provide energy and flavour, and contain essential fatty acids and fat-soluble vitamins. Although it has been generally recommended to limit fat intake, it is the type of fat people eat that is an important determinant of cardiovascular health. The recommended target for total fat intake around 30% of total energy intake.

    It is important to reduce intake foods high in saturated fat and replace them with foods high in polyunsaturated or monounsaturated fats.
  8. Choose foods low in salt1
    High salt intakes are associated with hypertension. Salt intake is measured as sodium and the current NH&MRC upper limit for sodium is 2300mg per day2 (around 6g salt). A reduction in sodium intake can have significant effects on blood pressure, so not adding salt in cooking, and choosing low salt foods (containing <120mg sodium/100g), reduced salt foods, and foods with the Heart Foundation Tick is recommended.
  9. Limit your alcohol intake if you choose to drink1
    Excess consumption of alcohol is related to a number of chronic diseases. Alcohol can also add extra kilojoules to the diet. Those choosing to drink should aim for no more than 2 standard drinks per day (for men and women) and no more than 4 standard drinks on any occasion3
  10. Consume only moderate amounts of sugars and foods containing added sugars1
    Many foods (such as soft drinks, confectionery and sweet biscuits) have high amounts of added sugar and can be high in energy, as well as being low in nutrients. Some nutritious foods like fruit, milk and yogurt also naturally contain sugars, which is why a moderate sugar intake is recommended.
  11. Prevent weight gain1
    Being overweight increases the chances of developing a wide range of diseases. Being more active helps to achieve and maintain a healthy body weight. Health authorities recommend taking part in moderate physical activity for at least 30 minutes on most, but preferably all days of the week4
  12. Care for your food – prepare and store it safely1
    Storing food safely is important to prevent food-borne illness.
  13. Encourage and support breastfeeding1
    Breastfeeding is the best way of feeding infants.

    A diet based on many different foods should be more interesting and therefore, more enjoyable, than a diet containing a restricted range of foods.

Dietary guidelines for heart health

The National Heart Foundation of Australia has developed specific guidelines for population heart health5,6.

  • Reduce saturated fat intake to <7% total energy intake and trans fatty acids to <1% of total energy intake
  • Reduce saturated fat intake by replacing with polyunsaturated and monounsaturated fat.
  • Polyunsaturated fat intake
  • Consume 8-10% of total energy as n-6 PUFA
  • Consume at least 2g Vegetable Omega 3 (ALA) per day
  • Consume 500 mg of Marine Omega 3 (EPA + DHA combined) per day. People with documented CHD are recommended to consume 1000mg/day
  • Those with a high absolute risk of CVD, elevated LDL cholesterol, hypercholesterolaemia or type 2 diabetes are recommended to consume 2-3g of plant sterols per day from plant-sterol enriched foods.
  • Eat a variety of foods, including vegetables, fruit, wholegrains, low or reduced-fat dairy, vegetable and seed oils, oily fish, lean meats, nuts, seeds and legumes.
  • Choose mainly water to drink, and if you choose to drink alcohol have no more than two standard drinks per day

The role of health care professionals

Healthcare professionals are ideally placed to advise patients on heart healthy diet and lifestyle choices. Motivating patients to make these heart healthy choices consistently will be beneficial for their overall health.