Health Tips

Background knowledge: What are the different types of cholesterol?¹⁹

• LDL: Low density lipoprotein. Also known as the "bad" cholesterol, LDL is the main source of blockages in the arteries.
• HDL: High density lipoprotein. Also known as the "good" cholesterol, HDL helps get rid of "bad" LDL cholesterol.
• Total cholesterol: The combined amount of LDL cholesterol and HDL cholesterol in your blood.
• Triglycerides: A type of fat found in your blood.

1. Foods labelled with “no-cholesterol” or “low-cholesterol” are not necessarily heart-healthy.⁶

The Dietary Guidelines for Americans 2015 removed the prior recommendation to limit consumption of dietary cholesterol to 300 mg per day. High-quality studies have shown that the amount of cholesterol ingested has only a modest impact on the amount of cholesterol circulating in the blood and does not seem to increase the risk of heart disease. However, the guidelines still advised eating as little as possible of dietary cholesterol while maintaining a healthy eating pattern. So when it comes to patients with significantly elevated cholesterol levels and known heart disease or those with a high risk of cardiovascular disease, it is always recommended to implement heart-healthy diets to prevent worsening of the conditions.¹⁶

With that being said, being aware of how much cholesterol is in the food that is being taken in is important. Apart from foods derived entirely from plants like vegetables, fruits and grains that do not contain cholesterol, learning how to check the cholesterol content from a food nutrition label can be a good skill to learn. There are foods being marketed as “low-cholesterol” that actually contain high levels of saturated or trans fats, which can raise blood cholesterol as well. Trans fats, which can be found in fried foods, baked goods, cookies, stick margarines and many more, will actually increase the level of bad cholesterol (LDL) and this increases your risk for heart disease and stroke.^9,11,17

You should take note of how much saturated fats, trans fat and total calories are in a serving, and not to overlook the serving size as well, to estimate how much you should be eating.

2. Blood cholesterol should not only be a concern for people over 40s.¹⁸

The American Heart Association recommends that all adults aged 20 and older have their cholesterol (and other risk factors) checked every four to six years. An individual’s cholesterol levels can be affected by a few factors, such as poor dietary habits, lack of exercises, hereditary factors and other lifestyle factors. Aging can be one of the major factors, but it does not dictate the disease.

A lipid panel is a blood test that the doctor would use, which will show the result of both your total cholesterol and the level of LDL, HDL and triglycerides circulating in your blood. This test can be done to access your overall risk for heart disease and is a tool for the doctor to determine the most optimum treatment or management for your condition.¹⁵

3. Is eating eggs really bad for my cholesterol level?⁵

The confusion over eggs stems from their cholesterol content. One large egg contains 213 mg of cholesterol, accounting for two-thirds of the recommended daily limit. However, eggs also contain a moderate amount of fat, about 5 grams, mostly monounsaturated and polyunsaturated fat which may help lower the risk of heart disease.

The main thing that we should keep in mind is that what you eat affects how much your body produces, not blood cholesterol level itself. It is good to cook them without adding salt or oil (hard- boiled, poached or scrambled without butter is preferred). Frying eggs can increase the fat content by around 50%.¹

That said, some experts suggest keeping your intake to about four eggs per week⁷, especially if your diet includes other sources of saturated fat and cholesterol, like meat or dairy, and if you have certain medical diagnoses. For healthy individuals with less risk of developing cardiovascular diseases, one or two eggs per day are safe to consume⁸_.

4. Butter vs margarine: Which is better?^12,13

Generally, if needed to make a choice, it is safe to say that margarine is chosen over butter when it comes to heart health. This is because margarine is made from vegetable oils, which contains unsaturated fats (polyunsaturated and monounsaturated fats), and these fats help to reduce LDL level. On the other hand, butter is made from animal fat, which contains more saturated fat and is bad for cholesterol.

However, some margarine can contain transfat. We can judge by the texture of the margarine. In general, the more solid the margarine, the more transfat it contains.² Read the nutrition labels and look for the least amount of saturated fat and transfat on the spread to guide you on which will be the best choice. The best choices are soft or liquid margarines that have no or very little trans fats and less than 3 grams of saturated fat per serving.

The bottom line is olive, canola and safflower oils are healthier choices overall than butter and most margarines. If you just can't let go of the buttery flavour in your food, margarine is a better choice overall as long as you choose the right type of margarine!

5. High cholesterol does not just happen in obese/overweight people, thin people can have it too.¹⁰

A person with any body type can have high cholesterol, even for a person with a skinny body. Just as what was previously mentioned, high cholesterol level is determined by a few factors, such as poor diet, lack of exercising, smoking, alcohol consumption and others. It is quite common to hear that even a person who is struggling to gain weight can have extremely high cholesterol levels. This is why high cholesterol level is termed as a silent killer.³ Therefore, it is safer to get your regular check-up at the doctor and adopt a healthy lifestyle.