Fish and cholesterol: suggestions for a balanced diet

• A balanced diet to control cholesterol
• Fish, the heart’s best friend
• Lean fish and fatty fish: the differences
• Which fish to eat and how
• Which fish you should avoid

Choosing the right foods in your daily diet has great impact on your health, allowing you to, for example, maintain the right body weight and avoid excess cholesterol, which damages your arteries.

A balanced diet to control cholesterol

Here are the recommendations for a healthy diet.

• Reduce consumption of fatty meat and cheese and replace the foods that contain saturated fats with those that contain polyunsaturates.
• Replace condiments of animal origin (butter) with those of vegetable origin, like extra virgin olive oil or oils made from seeds.
• Reduce consumption of trans-unsaturated fats, which are present in some industrially made products, like margarine.
• Reduce consumption of salt to less than 5 g per day.
• Consume at least 40-45 g of fiber per day, preferably from whole grain products like bread, pasta and rice.
• Consume at least 200 g of fruit and vegetables per day, the equivalent of 2-3 portions for each category.
• Eat fish 1-2 times per week (fatty fish at least once).
• Eat unsalted nuts, 30 g per day
• Limit your consumption of alcohol to 2 glasses per day for men and 1 glass per day for women.
• Avoid drinking soft drinks with sugar and alcohol-based beverages.

Fish, your heart’s best friend

The first findings concerning the benefits of fish for the heart were from studies conducted on the Inuit, who live in Greenland and whose diet is rich in fish and other seafood. The Inuit suffered less from heart disease. Further studies confirmed that people who eat more fish have a lower risk of cardiovascular illness.
Fish has a beneficial effect on the heart and blood vessels, thanks to its high content of Omega-3 polyunsaturated fats; eating at least one portion of fish per week reduces cardiovascular risk. Omega-3 fatty acids, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), are beneficial to the heart in multiple ways, thanks to their effect on the values of cholesterol and triglycerides in the blood. In fact, they reduce the level of triglycerides and increase the level of HDL, the so-called “good” cholesterol.

Omega-3 fatty acids:

• lower arterial blood pressure
• reduce the risk of arrhythmia
• increase vasodilation
• reduce platelet aggregation
• reduce inflammation

Like meat and eggs, fish supplies your body with proteins of high nutritional value. In addition, proteins from the flesh of fish are easier to digest than those from the meat of mammals.

In addition, the peptides derived from the proteins present in fish also have beneficial effects on the lipid profile and on blood vessels:

• lowering LDL (“bad” cholesterol) and total cholesterol
• lowering arterial pressure
• acting as antioxidants
• reducing inflammation

In order to prevent damage to the cardiovascular system, it is recommended that you eat at least 2-3 portions of fish per week. Each portion should weigh about 100 g.

Lean fish and fatty fish: the differences

Some fish contain more fat than others: the proportion varies from 0.5% to 27%, and can vary depending on the fish’s age and biological cycle. The most commonly found fats are phospholipids and Omega-3 fatty acids.
Fish are subdivided into:

• fatty (like salmon and tuna)
• semi-lean (like orata)
• lean (for example, cod).

Which fish to eat and how

The fish that contain the most Omega-3 are fatty fish like:

• salmon
• mackerel
• white meat tuna
• trout
• sardines

Some of these species are commonly found in our waters, and their consumption is recommended because their flesh contains much Omega-3.

In the West, fish is more often eaten cooked than raw. It is important to cook it properly in order to maintain its beneficial properties. One study on walleye, a lean fish that is rich in Omega-3 fats, found that if steamed, boiled or baked, the product maintained a good Omega-3 content. Boiling and steaming appear to deliver greater nutritive value than frying. Another study – on anchovies – confirmed that oven baking, as well as grilling, are the best cooking methods for maintaining the nutritional properties of this type of fish.

Which fish you should avoid

But not all kinds of fish are recommended. Some fish and seafood can contain harmful substances, like organic mercury, which is present in environmental pollutants. The fish that contain the greatest quantity of mercury are the top predators, large fish that eat other fish. These include swordfish, sharks and rays, pike and tuna. It is recommended that children and fertile, pregnant or lactating women not consume more than one portion (100 grams) of these a week.

The Mediterranean diet is a recommended nutritional regimen, including fruit, vegetables and legumes and a reduced consumption of red meat, dairy products and alcohol. Fish also plays an important role in this diet.

Remember that a healthy lifestyle is fundamental for your wellbeing and in preventing heart disease, even if there are no risk factors. In addition to proper nutrition, you should also engage in regular physical activity, avoid smoking or stop as soon as possible. Also, remember that high cholesterol does not manifest itself with specific symptoms, so it is advisable to consult your physician to evaluate your exposure to cardiovascular risk.