Cardio-protective Diet for You - NDR-UK

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Guidelines for blood fat levels Most centres have their own guidelines for target cholesterol levels. Ask your doctor, nurse or dietitian what these are and compare them to your own levels in the table below. Your measurements Measurement Local guidelines Your results Total Cholesterol LDL HDL Ratio TC: HDL Triglycerides Cardiovascular risk assessment Your consultant, specialist nurse or dietitian is likely to give you an annual ‘Cardiovascular risk assessment’. They will consider information including your age, gender, family history, lifestyle and blood fat levels to calculate your risk of developing cardiovascular disease within the next ten years. Ask your healthcare team for more information if you are interested in knowing more. Medication for cholesterol and triglycerides If your cholesterol remains high after you have made diet and lifestyle changes, your doctor and dietitian may suggest you take medication to help lower your cholesterol. Usually a statin will be prescribed, but fibrates or ezetimibe may be used. If your GP decides to start you on statin medication, it is important to ask your HIV consultant or pharmacist if this is suitable as some statins may interact with your anti-retroviral therapy. Your doctor may also consider switching your ARV if it is known to raise cholesterol levels. Improving your diet can reduce your cholesterol levels and lower risks of developing heart disease A better diet could improve your cholesterol levels and help decrease your risks of developing heart disease. Even small changes in your cholesterol are likely to help improve your long-term health. Fat Not all fats are equal. The effect of different types of fat on your cholesterol levels are described below. To lower your cholesterol levels, it is important to try and reduce the overall amount of fat in your diet – healthy fats should also only be used in small amounts. • Saturated Fat A reduction in total saturated fat intake can reduce your cholesterol levels. Generally saturated fat is found in products which come from animals. Foods very high in saturated fat include fatty cuts of red meat, the skin from poultry, full-fat dairy products like full-fat milk or ice cream, animal-based cooking fats like butter, ghee, lard, dripping and products 120404Heart Health for HIV DRAFT 2
made from these including pastries, pies, samosas. There are a few plant-based foods high in saturated fat, including coconut cream, coconut oil and palm oil (or red oil). Sources of saturated fat and how to reduce your intake Saturated fat How to reduce these Visible white fat on meat. • Reduce red meat and choose lean cuts. Poultry with its skin. • Reduce processed meat products such as sausages, burgers, salami, meat balls. • Remove visible fat before cooking. • Grill meat to allow fat to drain off. • Remove skin from poultry. Butter, ghee, dripping, lard, palm kernel oil, palm oil, coconut oil. Mayonnaise, tartar sauce, Marie rose sauce. Full-fat milk Cheese Cream and full fat crème fraiche Coconut oil, coconut cream Pastries, pasties, pies • Dry fry mince and drain off the fat before cooking. • Swap to a plant-based spread instead of butter or ghee on bread, chapattis and in baking. • Use small amounts of unsaturated oils in cooking instead of butter or lard. • If certain dishes require a specific oil than try to limit these. • Try to use alternative flavourings like lemon juice, vinegar, natural yoghurt, fat-free dressings. • If you must continue to use these, swap to low-fat version and use sparingly. • Swap to skimmed or semi-skimmed. • Try to keep to a small portion, about 30g or the size of a small matchbox. • Try to only have cheese occasionally and don’t routinely use it as an extra on top of pasta or baked beans. • Choose softer pasteurised cheeses like goat’s cheese or brie instead of Cheddar or stilton. • Avoid full-fat cream-based sauces with meat, poultry, fish and pasta – choose vegetable and tomato alternatives. • Use low-fat alternatives in cooking, for example lowfat crème fraiche instead of cream. • Try low-fat natural yoghurt, fromage frais or crème fraiche with desserts. • Use light versions and sparingly. • If eating foods that frequently use coconut such as South Indian or Thai cuisine, try to use alternatives without such as dishes tom yum soup. • Choose filo pastry rather than short crust if baking at home. • Try making your own pastry using an unsaturated spread (suitable for baking). • Make pastry toppings rather than a whole pie to 120404Heart Health for HIV DRAFT 3
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