Ka Wai Ola - Office of Hawaiian Affairs, Volume 6, Number 3, 1 March 1989 — ʻAi Pono, E Ola [ARTICLE+ILLUSTRATION]

ʻAi Pono, E Ola

By Terry Shintani, M.D.

The First Three Steps to Lower Cholesterol

i Last month, we discussed the most important diet-related factor we ean change to increase our lifespan and the survival of the Hawaiian people. That factor is our cholesterol level. 1 We discussed the importance of knowing our ehoJesterol levels and went f over an outline of some of the ways to lower our eho-

Iesterol levels. This month, we'll go over the first three steps in a little more detail. How do we lower our cholesterol levels? Of course, diet is the main factor. Decreasing cholesterol intake is the first step. The best way to identify foods with cholesterol is to ask the simple question "is it plant or animal?" Almost without exception, if it comes from an animal, it has cholesterol, and if it comes from a plant, it does not. For example, meat, ehieken, dairy food, eggs, fish and shrimp all have cholesterol and their intake should be decreased. Kalo (taro), rice, cereals, vegetables, fruit, and nuts have no cholesterol and intake of these types of foods should be increased. One way to remember this distinction is to recognize that cholesterol is made in the liver, and no plant has a liver. This is why liver has one of the highest cholesterol contents of any food. Besides decreasing cholesterol intake, a second step in reducing cholesterol levels is to decrease the intake of saturated fats. This is important because saturated fats increase cholesterol levels almost as effectively as cholesterol itself. Saturated fats are found mainly in meat, poultry and dairy products. Try to cut back on or eliminate these foods. If you must eat from these categories,

start with fish because fish is relatively low in saturated fat and some of them are high in polyunsaturates including the recently touted "omegathree" fatty acids whieh may help reduce the risk of heart disease. By contrast, oils from vegetable sources are generally low in saturated fats and high in polyunsaturates. However, it is helpful to read labels carefully . Don't be fooled by the label "cholesterol free" because many of these foods are high in saturated fats. While all vegetable oils are cholesterol free, certain vegetable oils such as coconut and palm oils are high in saturated fats. In fact coconut oil is nearly 90% saturated fat and palm oil is approximately 45% saturated fat whereas eom, sesame, olive, and soybean oils are approximately 14% saturated fat. You'll find palm and coconut oils in prepackaged crackers, cookies, and nondairy coffee creamers. You may even be able to tell if something has coconut oil by the "fuzzy" after-taste that it may produce. And remember in reading labels that "hydrogenated" means the same as "saturated." Oils are hydrogenated or partially hydrogenated into saturated fats so that they stay solid at room temperature the way lard does. So even if you have a cholesterol-free substance, it may be

high in saturated fat whieh is not healthy for your heart. A third step in reducing cholesterol is to reduce total fat from your diet in general, not just saturated fat. Most Americans eat about 42% of their calories as fat. The current dietary goals for the U.S. suggest that we decrease our intake to 30%. The American Heart Association suggests that it may even be prudent to go as low as 20%. Studies of populations on very low-fat diets from 10 to 15% indicate that their cholesterol levels ean average as low as 125. The ancient Hawaiian diet as demonstrated by the Moloka'i Diet Study was about 10% fat. A low fat diet is also prudent for reasons beyond heart disease. Studies suggest that being on a low-fat diet may reduce the risk of certain cancers including eolon cancer and breast cancer. Remember that health is not an all-or-nothing proposition. Any step you take in the right direction is positive. And if you slip-up and go on a binge, enjoy it and then return to your cho!esterollowering diet on your next meals. Keeping a positive attitude is essential to longterm dietary change. Heart disease takes years to develop so you have many opportunities to fight it. Just keep these three tips in mind and use them whenever you ean. Also remember that the survival of the Hawaiian people depends, in part, on the survival of eaeh Hawaiian. And what eaeh individual does influences the people as a whole. With this in mind, we ean stay on track more easily with the knowledge that what we do not only helps us individually but also helps all the Hawaiian people. Dr. Shintani, physician and nutritionist, isdirector of preventive health services at the Waianae Coast Comprehensive Health Center. A majority of the center's patients are native Hawaiian.

Three steps to lower your cholesterol levels: 1. Reduce your intake of high cholesterol foods such as meat, ehieken, dairy food, eggs, fish and shrimp. 2. Decrease your intake of saturated fats found in both animal products (meats, dairy food, etc.) and certain vegetable oils, such as coconut and palm oil. 3. Reduce total fat from your diet in general.