"My latest tests revealed that I had too much cholesterol. But I don't understand the difference between good and bad cholesterol. How do I know what I can eat and in what quantities? I am prepared to change my lifestyle but I would also like to find a good balance between pleasure and health."

Understanding cholesterol:

Cholesterol is vital to life. It helps build cell membranes and make certain hormones. It is one of the constituents of bile which helps digestion.
Cholesterol is characteristic of the animal kingdom. We ingest cholesterol everyday by eating meat or animal products (butter, lard, goose fat, pork delicatessen foods, offal). Besides this food source which provides around 30% of cholesterol, we also produce around 70% of the cholesterol in our body. The liver is the main organ that produces and uses cholesterol. The concentration of cholesterol in the blood varies according to the level of use by the cells.

"Good" and "bad" cholesterol:

There is good and bad cholesterol but it is in fact the same cholesterol conveyed by different means. The LDL transporter takes cholesterol from the liver to the cells that will use it. The HDL transporter brings back cholesterol from the cells to the liver where it will be eliminated by bile then recycled. When there is too much LDL, it becomes dangerous, hence the name of "bad" cholesterol. When the HDL is high, it is beneficial and protective and it evacuates cholesterol from the cells to the liver: it is thus known as "good" cholesterol.

Monitoring the cholesterol rate to stay in shape:

The dosing of cholesterol in a blood test lets you know if your cholesterol level poses a threat to your arteries and your heart.
Excess cholesterol is deposited on the artery walls. Gradually, this will form cholesterol plaque (atheroma) and make the artery narrow and thus hinder the blood flow. When this plaque thickens, it becomes fragile and it may break up, causing the formation of a clot that will block the artery. The heart is therefore no longer irrigated normally and the muscle deteriorates, which can provoke the risk of a heart attack.

To prevent these complications which can become irreversible for your health, it is therefore necessary to limit excess cholesterol.

The causes of excess cholesterol:

This excess has two major causes:

• The cholesterol rate may be too high as the liver produces too much. The major cause is excess weight around the girth but heredity can also play a role.
•  A problem with the receptors can also cause excess cholesterol. The cause may come from your diet and/or be hereditary. For example, excess saturated fat resulting from the diet increases the entry (absorption) of cholesterol in the organism which increases the amount of cholesterol in the bloodstream.

What should be done in the case of excess cholesterol?

If your blood tests reveal excessive cholesterol levels - and especially bad cholesterol -, you need to normalize the level as this will reduce the risk of cardiovascular disease.
The first stage consists in watching your diet by trying to reduce excess saturated fat to reduce the LDL rate. At the same time, it is necessary to increase HDL cholesterol by consuming food with a high monounsaturated and polyunsaturated fatty acid content. The most commonly known monounsaturated fatty acid is oleic acid, present in olive, rapeseed and sesame oil.
Polyunsaturated fatty acids are divided into two major families: omega 3 and omega 6, both vital to the organism. The organism cannot produce them so food intake is the only source to satisfy requirements.
Several studies have shown that a sufficiently high intake in omega 3 limits cardiovascular risks or repeat heart attacks.
It is also recommended to eat fruit and vegetables. These are a source of fibre and vegetal sterols which also help to limit excess cholesterol levels.

To fight cholesterol effectively, you should therefore balance your diet, but you should also try to reduce other risk factors of cardiovascular disease such as smoking, high blood pressure, sedentary lifestyle, excess weight, diabetes.

"Yoplait" advice:

Choose yoghurts without added cream, fromage frais and 0% petits suisses. If you also have a weight problem, low calorie dairy products are ideal as they are a source of calcium and protein and help you reduce food intake as they calm your hunger pangs.

To help you compose menus adapted to your specific needs, here is a recap table of food to be chosen or avoided, classified into groups.

FOOD GROUP	RECOMMENDED FOODS	FOODS TO BE AVOIDED
Milk and dairy products	Skimmed or semi-skimmed milk  Plain yoghurt or 0 % fruit yoghurt with artificial flavouring  0 % or 20 % Fromage frais  0 % or 20 %Petits suisses  Cheese < 25% fat in dry matter	Full-fat milk  Full-fat yoghurt  40 % fromage frais  Cream dessert, liégeois  40 %Petit suisse  Cheese >25% fat in dry matter
Meat, fish and eggs	Poultry without its skin, white meat, lean cuts  Fish at least twice a week, preferring oily fish: mackerel, sardines, herring …  Eggs: twice a week	Fatty meat (mutton) and cuts (rib steak, pork chop...), pork delicatessen foods (sausages, pâté)  Fried fish  Beware of certain seafood like cuttlefish
Vegetables	As much as you want
Fruit	As much as you want  Oleaginous fruit (walnuts, almonds, hazelnuts) in small quantities
Starch and bread	Pasta, rice, couscous, potatoes, etc.  Pulses  Wholemeal bread	Chips, crisps  Certain pre-cooked dishes  Crackers, brioche, Viennese pastries  Nibbles
Fat	Margarine in small quantity  Oil (rapeseed, olive, walnut) in small quantity  Light fresh cream (low calorie)	Butter  Mayonnaise  Fresh cream
Drinks	Water	Spirits
Sugar and sweet products	Black chocolate in small quantity  Sorbets	Pastries  Milk chocolate  Ice cream  Dessert cream
Spices and condiments	All	Reduce salt

Here is a day's low cholesterol menu plan:

A small amount of bread (French stick, wholemeal, granary, country-style, etc.) and as much water as you want can accompany your main meals.

Breakfast:

• Light tea or coffee with skimmed or semi-skimmed milk
• Two slices of wholemeal bread thinly spread with margarine
• Two kiwis

Lunch:

• Tomato salad seasoned with 1 tablespoon rapeseed oil
• 150 g coley fillet parcels
• Basmati rice and courgettes
• 0% Panier aux Fruits yoghurt

Dinner:

• Green salad with walnuts, cubed cooked ham, 150g potatoes and seasoned with 1 tablespoon olive oil
• 0 % Calin fromage frais
• An apple