When people learn from their doctor that their cholesterol levels are high, they generally have to change their diet. This does not mean, however, that they can never indulge their palate again. With the right choices, they can continue to eat well and with gusto. Patients taking anti-cholesterol medication should also watch what they eat.

“Diet, along with not smoking and getting more exercise is the basic treatment when cholesterol levels are high,” said Achim Weizel, chairman of the German Society for the Treatment of Lipid Disorders and Associated Diseases (DGFF).

“When someone is really ill, though, this isn’t enough.” Then, medication is necessary because dietary changes can lower cholesterol levels by just 10 to 15 per cent — if at all — as against about 50 per cent with a proven drug.

The body needs cholesterol, a waxy substance found in the fats (lipids) of the blood, to continue building healthy cells. The body produces some of it, and some is ingested via food. The German Heart Foundation noted that cholesterol became dangerous when there was too much low-density lipoprotein (LDL, or “bad” cholesterol) in the blood and too little high-density lipoprotein (HDL, or “good” cholesterol).

This can lead to substantial fatty deposits — and damage — in the walls of arteries, impeding blood flow and increasing the risk of a heart attack or stroke.

Before altering their diet, patients should always ask themselves, “What’s practicable?” Weizel said. Otherwise they will be too likely to abandon their new eating habits and return to the old ones. Both the DGFF and German Heart Foundation recommend eating a Mediterranean diet. “We’re all familiar with it because we all like to go to Italian restaurants,” Weizel said.

This means eating less meat, a lot of vegetables and fish, more vegetable oils, dietary fibre and fruit. It is a good idea to change one’s diet gradually, advises Dagmar von Cramm, a German nutrition expert. First of all, attention should be paid to the fats that are used, she said.

“Substitute saturated fatty acids with unsaturated ones,” von Cramm recommended. “In other words, refrain from animal fats such as butter in favour of vegetable fats with plenty of omega-3 fatty acids, which are found, for example, in fish, good low-fat margarines and rapeseed oil.”

Von Cramm’s second recommendation is to increase the proportion of dietary fibre in one’s meals because fibre binds cholesterol in the intestines, from where it is expelled from the body. Her tip: Eat three handfuls of vegetables daily.

“Don’t eat the vegetables only raw, and don’t eat them like medicine,” she said. “Include them in your meal planning in the form of vegetable dishes, salads or a large side dish.” Wholegrain products are also rich in dietary fibre and should therefore appear on the dining table more often.

Thirdly, von Cramm advised, “Hands off ready-to-serve pastry.” She pointed out that it often contains a lot of unhealthy fats, as do fatty meat, fatty sausage, fatty cheese and rich spreads. She said it was better to bake a cake oneself, particularly with yeast dough since it required little fat. Curd cheese oil dough and Arab phyllo dough are other cholesterol-free alternatives.

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