A friend emailed today with questions about cholesterol. I thought I'd post my reply if anyone else was interested.
Cholesterol is so much fun! First thing to ask, if you don't know, is what are your LDL, HDL, and Tri-glyceride numbers. LDL is the bad cholesterol and HDL is good. You can have high total cholesterol because your HDL numbers are high, which is a different situation than high LDL. Your body makes more HDL when you exercise and that tends to also lower your LDL levels. I have seen the biggest drop in my cholesterol after moving here. The only thing I can think that I've done differently is change my amount of exercise, but I haven't run a full blown experiment or anything.
After exercise, watching the fat (amount and types) you eat and the kinds of foods can make a huge difference. My doctor originally told me to try to eat no more than 30 g of fat a day, but I could have one day a week "off". It's kind of tough, to be honest. I have since learned that advice can be tweeked a bit. There are some foods high in fat that are actually good for lowering cholesterol- salmon (and other high fatty fish like tuna and halibut), almonds, avocados, and flax seed for example. The suggestion as far as fish is to eat it at least twice a week. I personally can not stand salmon, so that's automatically out for me. Consumption of saturated fats leads to higher cholesterol levels, so keep those as low as possible or cut them out completely.
Flax seed is the best non-fish source of Omega-3 fatty acids (the stuff that is in the fish). You can buy it ground or whole. There is some debate as to the effectiveness of the whole seed. Apparently the outer shell is so hard that the seeds pretty much pass right through your digestive tract undigested. You can buy it ground at most grocery stores. DO NOT buy it whole and grind it in your wheat grinder. It is so high in oil that it will totally gum up and ruin your grinder. Get a separate coffee grinder or something like that. I just buy mine ground and keep it in the fridge. I like it sprinkled on oatmeal. I used to mix it in bread, etc, but I've been told that heating it destroys the omega-3's. I don't know if that's true or not. I mean, you cook fish, don't you! The cool thing with the flax seed is that you can replace eggs and oils when you bake with the flax seed. I don't have any at the moment, but there is a reddish/brown box of flax seed that has directions on the box. It's the Red Mill brand or something like that. You can also buy supplement capsules of omega-3's. I just learned this week that studies show they can make a difference for women, but the same results haven't been proven for men. I have no idea why.
There are foods that help lower your cholesterol without omega-3's. I like this, because for the first time it's a restrictive diet that has a lot of foods I actually like. The biggest help is oats/oatmeal (listen to the Cheerios commercials!). Other foods include avocados, tomatoes, cucumbers, almonds, walnuts, soy products (one of the reasons I use TVP), olives and olive oil. Cinnamon has been found to help lower cholesterol and regulate blood sugar, but you need something like 1 tsp. a day. In the winter I eat a lot of oatmeal with flax seed and cinnamon, but 1 tsp. of cinnamon is a lot! You can get capsules of cinnamon, but I've never tried them. Whole grains are good, as well. Since oats are so good for cholesterol, you can replace 1/2 the flour in, say, cookies with ground oat flour. It's white like regular flour and is a lighter flour than whole wheat, so my family almost never notices. The added bonus is that they get half whole grain flour instead of just all white flour. I can tell a little difference in taste, but I think it's just because I know there is something different. You can't replace all of the regular flour with oat flour because the oat flour doesn't have any gluten in it and the cookies or bread won't hold together.
The best oils to use are olive and canola oils. I always replace the oil in cakes with applesauce and have been experimenting with replacing butter/Crisco with yogurt in cookies. I've also used smashed pears instead of applesauce and I've seen prune/plum sauce in the baking aisle, but never used it. In general, you can replace up to half the butter/Crisco with 1/2 the amount of fat free yogurt or sour cream. For example- if you have a recipe that calls for 1 cup of butter, you can replace 1/2 cup of that butter with 1/4 cup of yogurt or sour cream. In general, butter is really high in saturated fats and margarines are lower. Most margarines tend to have trans fats, too. They're finding that trans fats are pretty bad for you, so check labels on any margarines you buy. I've been buying Smart Balance 50/50 Butter blend with Omega-3. It's made with 50% butter, so has some saturated fats, but is also made with soybean, flax seed, and fish oils. There are no trans fats in it. I don't know if it's any better than any other brand, but I think it tastes pretty good and works well when I bake with it. Try different brands and see what works for you.
Eggs, as I'm sure you know, are high in cholesterol. The yolk is where all the fat and cholesterol is stored, so removing the yolks helps reduce your cholesterol intake. In general, you can replace a whole egg with 2 egg whites. You can also use an egg substitute, but I'm too cheap and have never tried them. You do need some of the yolks (the fats), though, to get the right consistency and taste. Replacing the eggs with flax seed at least replaces some of the oils, but probably wouldn't work so well in something like an omelet! I have recently learned that you can replace eggs in some baked goods with knox gelatin, but I haven't had the chance to try it out, yet. Talk with your doctor about eggs, too. I have been told that your cholesterol intake isn't as bad for you as the cholesterol that comes as your body makes it from the fats you eat. So, eating whole eggs may not be as bad for you as you'd think.
As for meats, go for very lean red meats, white chicken and turkey, fish, or pork. I've heard shrimp is supposed to be good for lowering cholesterol, but I can't stand that, either, so I haven't paid much attention. I think almost all meats have at least some cholesterol and fat, so if you're looking to drastically cut your intake you can cut out your meat intake. I've been trying different recipes that use beans instead of meat and replacing some ground meats with TVP. Most of them come from Light & Tasty (recently renamed Healthy Cooking) magazine. I have a subscription, but you may be able to find it at your library. I like it a lot. You can see some of the recipes on line, but I didn't find that very helpful.
So, that's about it. I'm by no means a professional, but have learned a little over the past couple of years. Feel free to leave a comment if I've said something wrong or if you have another idea. I'd love to learn more.