Cholesterol – what you really need to know.

By Chronic Disease, Diet, Food for thought, Health


The word probably brings up some negative connotations immediately when just reading it! This is understandable, due to the (typically) bad reputation cholesterol has – being linked to heart attacks, stroke and other cardiovascular diseases.

In this post, we dive into exactly how cholesterol is made, what cholesterol is, what the dangers of cholesterol are and what can we do to minimise our risk.

What is cholesterol?

Cholesterol is essentially a type of fat that is the main component of our cell membranes and other essential structures.

Many of us believe that cholesterol is made from just our diet, but in fact, this is a misconception.  A recent Harvard article [1] suggests that only 20-25% of the cholesterol in our bloodstream comes directly from our diet. The other 75-80% comes from raw materials already within our bodies such as fats, sugars and proteins.

Cholesterol is so vital to our everyday functioning that our liver and intestines will make an extra supply if we don’t consume enough through our food. 

 To put it into perspective, an adult who eats 200-300 milligrams (mg) a day (that’s the equivalent of one egg yolk!), will make up the additional 800 mg a day, mainly through the liver.

Cholesterol is a fat that the body packages up with other lipids into tiny protein-covered particles called lipoproteins (simply meaning lipid plus protein), which essentially move cholesterol and other fats throughout the body. If we were to hold a chunk of cholesterol in our hands it would look like a whitish-yellow powder that looks somewhat like the scrapings of a wax candle. 

So why the bad reputation? Well… too much cholesterol (especially the bad type!) can accumulate in the walls of the blood vessels causing all kinds of problems.

Let’s make sense of a cholesterol test!

Total cholesterol:
This is the sum of all the cholesterol in all the lipoprotein particles in your blood. It includes HDL, LDL and VLDL.

LDL cholesterol:
This is the dangerous blood lipoprotein particle.

HDL cholesterol:
HLD fights the plaque build-up in the heart’s arteries. The Framingham Heart Study [2] suggests that every 1 mg/dL increase in HDL cholesterol reduces the risk of cardiovascular disease by 2% to 3%.

For most people, if your total or LDL cholesterol is high your doctor may recommend a statin.

LDL particle size:

Not all LDL particles are created equally when it comes to heart disease. For example, not everyone with high LDL will develop heart disease. In fact, some people with normal LDL do. A possible explanation for this is the size and density of LDL particles. Small, denser LDL can more easily get into artery walls where it becomes oxidised, leading to the sequence of events that result in atherosclerosis. Larger LDL particles are more likely to bounce off the artery walls and not penetrate (these are therefore considered less dangerous).

If you’re particularly concerned about which type of LDL you have in your blood, advanced testing is now available (“Advanced lipoprotein testing”) which will give a more detailed view of not only the amount of cholesterol but also the size and number of particles in each category.


What is the relationship between cholesterol and inflammation?

As we’ve discussed in previous posts, inflammation plays a vital role in our immune system’s defence. However, inflammation can also initiate the process of plaque build-up in the arteries and thus can promote the formation of artery-blocking clots (these are the cause of most heart attacks and many strokes).

How does cholesterol travelling in the bloodstream cause a heart attack?

Here is the short explanation!
The plaque builds up within the artery wall, a fibrous cap tops the plaque, this plaque ruptures and a clot blocks the artery. Dangerous stuff.

What about cholesterol and food?

The 1960s onwards saw a great influx in the avoidance of cholesterol-rich foods (such as eggs, dairy and some types of seafood). However, with more recent research (for example 40 studies in 2015 in The American Journal of Clinical Nutrition as documented in the Harvard ‘Managing your cholesterol’ report [3]) there has been no clear evidence linking dietary cholesterol to a higher risk of coronary artery disease and stroke. Subsequently, there is a growing consensus among experts that there isn’t enough evidence to set limits on how much cholesterol we should consume. This is not to say we shouldn’t limit the amount of saturated fat and other nasties in our diet and opt for a diet rich in quality fruits, vegetables, fish and whole grains.

Lowering our cholesterol is an important factor in overall health. In fact, experts stress that the most important dietary change you can make to lower cholesterol numbers is to follow a healthy diet such as above.

This will help in two ways:

1. High fibre foods help reduce the cholesterol in our bloodstream by making dietary cholesterol harder to absorb from the gut.

2. The more you reach for the healthy option, the less you consume foods high in saturated fat and refined carbohydrates (both of which boost cholesterol levels). *This crowding out theory is a key foundation in the Sano programs!



The most important thing to consider in this space is understanding your cardiovascular risk, which encompasses more than just cholesterol levels.



There are some factors that you don’t have any control over that influence your cardiovascular risk, and some factors that you do have control over. It’s important to understand both!

Factors you don’t have control over are:

Being over 45 (men), being over 55 (women).

A family history: a father or brother who developed heart disease before age 50 to 55, or a mother or sister who developed it before age 60 to 65.

Being a premenopausal woman.


Although we can’t change these risk factors, it’s important to be aware of them and how at risk we might be.


Risk factors that are within your control:

High blood pressure: above 140/99 mm Hg.

Cholesterol-clogged arteries (atherosclerosis). This can take the form of chest pain with exertion or can have absolutely no symptoms at all.


High triglycerides, high LDL cholesterol (or both).

Low HDL cholesterol.

Metabolic syndrome (which is a group of cardiovascular risk factors which can develop with another condition called pre-diabetes).

Being overweight (with a BMI of 25+) Click here for an online BMI calculator. 

Lifestyle factors such as smoking, lack of physical exercise, a diet high in saturated and trans fats, highly processed carbohydrates.

Chronic stress.

Social isolation, depression and/or anxiety.


Protective measures:

The number one recommendation is healthy eating and exercise. Changing these two habits can drastically alter our life’s course and health outcomes.


Some things to consider for a healthier life:

Lowering your total cholesterol by 10% can decrease heart attack by 20% to 30%

Walking (2 x weekly) can reduce your chances of dying early from cardiovascular disease by 45%

Cutting your sodium intake down by 1200mg per day can reduce the need for blood pressure treatment by half and can reduce deaths from stroke by 22%

Cholesterol and family histories:

Cholesterol isn’t always caused by poor lifestyle choices and habits, in some cases, genetic disorders (familial combined hyperlipidaemia and familial hypercholesterolemia being the most common) can be the culprit of high levels. If you have a genetic risk factor such as the above, this puts you at risk for early heart disease. These genetic disorders can be managed through diet and exercise and medication.

It isn’t just heart health that you’ll be benefiting when keeping cholesterol in check, a large study found that moderately elevated cholesterol levels in middle age increase the risk of developing dementia in old age!

How to test cholesterol:

A cholesterol test is known as a lipid profile or lipid panel. It measures total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels. The most accurate results come from a fasting lipid profile. As mentioned previous, advanced testing is also available but not necessary for most.

When to test:

The American Academy for paediatrics recommends testing children aged 9-11 and once again when ages 17-21. This is because the process of atherosclerosis begins in childhood so we want to have a clear picture as early as possible. This includes identifying those with genetic conditions.
Early testing can prompt lifestyle modifications for new healthier habits.



For adults, there are a few things to keep in mind when going to the doctor for your cholesterol test (these could skew your results)

Have you had the flu or any illness shortly before the blood test?

Has your diet changed recently (in the weeks leading up to the test)? As alcohol and carbohydrate intake can raise triglycerides.

Did you fast before the test? Remember that if you didn’t, it’s best to be honest as your results will be incorrect.

Thinking has recently changed in regard to dietary changes to bring down cholesterol levels. Previous we thought that reducing the intake of dietary cholesterol and fat was the goal, however, now we encompass many different aspects of the healthy living (not just avoiding fat or cholesterol).

In a nutshell: favour the good fats, limit saturated fat, avoid sugary drinks and processed meat, fill up on whole foods, limit alcohol and focus on increasing your exercise to at least 2.5 hours of moderate-intensity exercise per week.

Finally, remember to practise mindfulness, get adequate, restful sleep and adopt other stress reduction habits. Stress plays a huge role in many diseases – this is something you can regulate and have control over.



[1] [3] Managing your cholesterol. A Harvard Medical School Special Health Report. Medical Editor Jorge Plutzky, MD. Report available for purchase at
[2] Framington Heart Study
In 1948, FHS scientists and participants embarked on an ambitious project to identify risk factors for heart disease. Today, the study remains a world-class epicentre for cutting-edge heart, brain, bone, and sleep research.

Inflammation and chronic disease

By Chronic Disease, Diet, Exercise, Health, Inflammation
“There’s evidence that inflammation, promoted in part by such factors as obesity, smoking, and a sedentary lifestyle, contributes to a variety of diseases.”
Harvard Health Publishing


Acute inflammation is a part of the body’s natural healing process in response to pathogens, infections, wounds and tissue damage.

Common causes of acute inflammation (injury, infections, tissue damage, foreign bodies, hypersensitivity, autoimmunity) provoke the release of white blood cells and inflammatory molecules that can result in fluid build-up, pressure, redness, heat and pain. Once the pathogen has been eliminated, tissue repair usually begins. Thus, homeostasis is restored [1].

Chronic inflammation, however, plays a role in a wide variety of diseases.  



Recent scientific inquiry suggests that many factors may contribute to chronic inflammation; an unbalanced diet of processed, sugary foods, genetics, exposure to toxic contaminants and poor lifestyle factors (including sedentary work and poor dental hygiene) [2].

Various medications are available to combat the symptoms of acute inflammation (e.g. pain and swelling), however in the case of chronic inflammation, treatment is not as straightforward. Chronic inflammation can affect various organs, and no single therapy is currently available to address these complex impacts.



Let’s take a closer look at some of the conditions and diseases in which inflammation plays a central role.



Fat tissue contains macrophages (the white blood cells instrumental in chronic inflammation) and produces cytokines (chemical messengers that are key to the development of inflammation). Reducing excess fat stores through diet and exercise can decrease inflammation in the body.


Both Type 1 and Type 2 diabetes have significant potential health implications such as cardiovascular disease, kidney disease, eye damage, nerve damage and more. As the body attempts to remove the abnormal fat distribution caused by diabetes, it triggers the release of inflammatory substances that damage the arteries and can lead to cardiovascular disease and other chronic conditions.



Cardiovascular disease:

The build-up of fatty, cholesterol-laden plaque inside the arteries of the heart leads to the most common type of heart disease, coronary artery disease. Recent research has suggested a strong link between inflammation and atherosclerosis and has discounted the prevailing hypothesis that a diet high in fat can leave globs of cholesterol on the inner surface of the arteries, blocking them [3]. Almost 50% of heart attacks occur in people who have healthy cholesterol levels leading us to question the role of cholesterol in heart disease.

“Several studies have shown that, among people with normal cholesterol numbers, those with increased CRP (inflammation) levels have a several-fold higher risk for heart problems.” [4]

Inflammatory Bowel Disease:

Inflammatory Bowel Disease is characterised by an abnormal response to intestinal bacteria that leads to chronic inflammation. Those with inflammatory bowel disease are at higher risk of developing eye and skin conditions, chronic inflammation in the lungs and airways, blood clots and liver complications.

Other diseases associated with inflammation:

Rheumatoid arthritis

What exacerbates inflammation?

o Obesity
o Processed food
o Too much saturated fat
o Sleep deprivation and lack of quality sleep
o Smoking
o Chronic stress
o An inactive lifestyle
o Air pollution and environmental contaminants 



Treatment methods for inflammation:



Nonsteroidal anti-inflammatory drugs (NSAIDs)
Disease-modifying antirheumatic drugs (DMARDs)
Fish oil supplements


Lifestyle modifications:


Healthy food choices – choose foods that reduce inflammation.


Consume fruits and brightly coloured vegetables:

They contain high levels of antioxidants and polyphenols (potentially protective compounds).

Nuts and seeds:

Research has shown that consuming nuts and seeds can lead to reduced markers of inflammation.


The polyphenols in coffee and green tea and the flavonoids in cocoa are thought to have anti-inflammatory properties.


A review in the May 2016 British Journal of Nutrition supported the notion that dietary polyphenols may lower inflammation.  Foods high in polyphenols include dark leafy vegetables, red grapes, onions, turmeric, cherries, and plums.

Omega 3 fatty-acids:

Olive oil, flaxseed oil, fatty fish (sardines, wild-caught salmon and mackerel) reduce inflammation in the body.  They can also help prevent Alzheimer’s disease as they can cross the blood-brain barrier, reducing inflammation in the brain. 


Maintaining a healthy weight can have a significant, positive impact on inflammation by reducing the number of macrophages when reducing fat tissue. Because fatty tissue actively produces hormones and inflammatory chemicals, reducing excess weight is vital.



No smoking: 

Smoking is associated with a whole host of health implications. Recent research has shown a link between nicotine and inflammation [5].

Get quality sleep: 

An irregular sleep pattern can be linked to high blood pressure, diabetes, and coronary artery disease. Those who are sleep deprived can have higher blood levels of stress hormones that promote inflammation. Remember, it’s not the number of hours of sleep you’re getting – it’s the quality of sleep that matters. This has been shown in the largest sleep study ever conducted with over 1.1 million participants [6].



Reducing alcohol intake:

Moderate intake of beer and wine can help reduce inflammation.


[1] [2] [3]
Access the full report for more information.
Understanding Inflammation, Harvard Health Publishing, Harvard Medical School. 

The link between diet and depression

By Diet, Food, Food for thought, Health, Mental Health
“In Australia, it’s estimated that 45 percent of people will experience a mental health condition in their lifetime. In any one year, around 1 million Australian adults have depression, and over 2 million have anxiety.”   Beyond Blue


The impact of depression on both a personal and global level is hugely significant and far-reaching. Today, treatment options for depression include various medication prescribed by a doctor, various forms of therapy and self-care.

A recent article from Harvard Medical School detailed an overlooked aspect of self-care – diet. Diet and lifestyle factors have an overwhelming body of evidence supporting the prevention of cardiovascular disease, cancer, dementia, and mental health disorders, including depression, yet we sometimes pay more attention to medications and therapy as the go-to solutions for mental health outcomes [1].



We can see that diet impacts every aspect of our health and in particular, our mental health. So, we need to sit up and take notice! It isn’t merely about recovery but also prevention, and working towards living the best life you possibly can.

The 20th Century has seen our world, and subsequently, our eating habits change rapidly. From the introduction of high fructose corn syrup to processed and sugary foods being more readily available, we can see a sharp decline in the consumption of good-quality, nutrient-dense, natural, whole foods. We are living a fast-life with fast-food becoming a norm. Rushed eating, readily available (cheaper) processed options and an unawareness of the impact of a healthy diet have led to this growing reliance on fast-food.



Several recent research analyses examining multiple studies support this link between diet and the risk of depression.


“A dietary pattern characterized by a high intake of fruit, vegetables, whole grain, fish, olive oil, low-fat dairy and antioxidants and low intakes of animal foods was apparently associated with a decreased risk of depression. A dietary pattern characterized by a high consumption of red and/or processed meat, refined grains, sweets, high-fat dairy products, butter, potatoes and high-fat gravy, and low intakes of fruits and vegetables is associated with an increased risk of depression.” [2]


The impact of diet can impact more than just the individual. A recent study of more than 20,000 mothers and their children found that the children of mothers who ate an unhealthier diet during their pregnancy had a higher level of behaviours that are linked to mental disorders.

It is essential to view diet as a key element in the prevention of mental illness.


Remember to:


–  Eat an abundance of fruits, veggies, whole grains (in unprocessed form), seeds and nuts.

–  Add in some lean proteins like fish and unsweetened yoghurt.

–  Avoid added sugars or flours (like bread, baked goods, cereals, and pasta).

–  Minimise animal fats and processed meats.


Remember moderation and quality are essential!



Check out Harvard ‘Health Dietary Styles‘ for further reading.

Why yoga cultivates your health and wellbeing

By Exercise, Food for thought, Health, Meditation, Stress Reduction

“There is always room for change, but you have to be open to that change.”


Yoga is an ancient discipline that has gained huge popularity within our modern, western world. Originally stemming from a tradition that dates back more than 2500 years, yoga is an integration of philosophies, movement and breath focusing on creating a more flexible, calm and balanced whole.

The stereotype of the hippy, green juice-drinking yogi sells this ancient practise short. Yoga is much more than an alternative workout and it’s easier than it may initially seem. Essentially, at the core of it all, yoga starts with simple stretching and breathing that clears the busy mind.



Yoga is said to have originated in India during the Golden Age (roughly 26,000 years ago). The actual Sanskrit word, when broken down, means “to control” or “to unite”. As you delve into your yoga practise this is the aim, to unite the various parts of ‘you’. It is indeed a practice. One of the best things about yoga is that we aren’t searching for ‘perfect’, we are merely practising opening and calming the body. It’s a lifelong pursuit.

Recently, there have been a growing number of scientific studies that delve into the extensive health benefits of a regular yoga practise.


To highlight a few:


–  Reduce stress and anxiety

–  Clear the busy mind

–  Improve self awareness

–  Mindfulness

–  Improve overall well-being

–  Improve flexibility

–  Reduce neck stiffness

–  Improve posture and lower back pain

–  Increase flow in everyday life situations

We believe that yoga is an essential nourishment for the busy mind and body. No matter where you are, or how little time you have, there’s always an opportunity to move your body, to increase your energy and to calm your mind.

So how do you get started and build a regular yoga practise?


Simply google your local yoga studio and sign up for a welcoming beginners class or find a quiet space at home and try out some free online yoga classes.


Yoga doesn’t need to be expensive, time consuming or hard. Go at your own pace and enjoy.


(Hint: it’s just a respectful way of saying hello or thank you in the yoga world!)


The profound consequences of lack of sleep

By depression, Food for thought, Health, sleep

“Not getting enough sleep can have profound consequences on a daily and potentially long-term basis for your health and mental well-being.”


We live in a fast-paced society that often praises hard work, long hours and productivity. Lack of quality sleep not only impacts on our health and wellbeing but also on our performance, both at work and at home.



Short-term effects:


Mood changes

Judgement Impairment

Reactivity to situations

Reduces the ability to retain information

Increases the risk of serious accident or injury


Long-term effects:


Increased risk of chronic disease

(obesity, diabetes, cardiovascular disease and mortality)

Reduction in quality of life



Sleep & Obesity:


During sleep, our bodies secrete hormones that help to control appetite, energy metabolism, and glucose processing. Insufficient sleep is associated with lower levels of leptin (a hormone that alerts the brain that it has enough food), higher levels of ghrelin (a biochemical that stimulates appetite) and an increase in cortisol (often referred to as the ‘stress hormone’).

The above can potentially lead to food cravings, overeating and a lack of energy for exercise – a dangerous combination.



Sleep and cardiovascular disease and stroke:


Studies have shown that just one night of inadequate sleep can lead to increased blood pressure in people who have existing hypertension. This relationship may point towards a correlation between poor sleep and cardiovascular disease and stroke.

One study found that sleeping too little (less than six hours) or too much (more than nine hours) increased the risk of coronary heart disease in women.

Additional research studies have shown that regularly sleeping more than nine hours is also associated with poor health.



Sleep & alcohol:


Studies have shown that alcohol use is more prevalent among people who have poor sleep habits or insomnia.

Whether it’s an ‘old-wives tale’ to have a shot of whiskey before bed or a regular favourite activity to have a ‘nightcap’. How does alcohol actually affect sleep?

Alcohol is indeed a mild sedative so can enhance the initial phases of sleep, however, this sedative quality is only temporary. As alcohol is processed by the body, it begins to stimulate the parts of the brain that cause arousal, hence the common occurrence of waking frequently after consuming alcohol before bed.



Sleep & productivity:


American Insomnia Study undertaken by Harvard Medical School found that lack of quality sleep is costing the average US worker 11.3 days, or $2,280 in lost productivity every year. On the flip side, adequate sleep can promote better problem solving skills and an increase in productivity. 


How can we improve our sleep?


These statistics are daunting, however, there are always positive steps we can take to improve our health – starting with quality sleep. Please see below a list of recommendations from The National Sleep Foundation to improve your quality of sleep (and your health):

–  Stick to a sleep schedule. Go to bed and wake at the same time every day (including weekends) this will help your body clock to regulate.

–  Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.

–  If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.

–  Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.

 Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool and comfortable. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner’s sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.

–  Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up.


Happy (deep) snoozing!



Make small changes – Get big results

By Food, Health, Meditation, movement


“People can achieve remarkable changes in their lives one small step at a time. The day-to-day choices you make influence whether you maintain vitality as you age or develop life-shortening illnesses and disabling conditions like heart disease, diabetes, high blood pressure, and stroke.”
Edward M. Phillips, Director of the Institute of Lifestyle Medicine, Harvard Medical School.

With small changes to your daily routine, you can achieve lasting, dramatic results. Some of us know what we have to do to improve our health… but still, we don’t take action. Why is this? A special health report from Harvard Medical School explains why.

The study showed that it took on average 66 days for an action to become automatic (a habit). This is a good point to remember when adopting a new behaviour – it doesn’t happen overnight.



Below are the 7 tips from Edward Phillip’s article ‘Simple Changes, Big Rewards: A Practical, Easy Guide for Healthy, Happy Living’ (2010):


–  Dream BIG: this is inspiring to those around you!

–  Break big dreams into smaller steps towards success: bite off manageable chunks

–  Understand why you should or shouldn’t make a change: what is holding you back?

–  Commit yourself: make written/verbal promises to friends/family or publicly (there’s nothing like a public Facebook declaration to help you stick to your goals!)

–  Give yourself a medal: health changes are often incremental so celebrate your small successes along the way! * Tip: download the app ‘attaboy!!’ for a little confidence boost.

–  Learn from the past: when things don’t work as planned take a moment to think about why… then congratulate yourself for having taken that step in the first place.

–  Be thankful for what you’ve done: even if you don’t quite reach your goal – give yourself a pat on the back because you attempted it and that means you’re on the road to change.



What happens when you hit a wall, run off course, fall off that wagon?


 These suggestions will point you in the right direction:

–  Always have a plan: don’t rely on ‘winging it’, have an action plan and stick to it.

–  Set off at a reasonable pace: Avoid injuries by going at a careful pace and slowly implementing new exercise.

–  Envision a happy outcome: rather than a mantra of “I must meditate everyday” (which, lets face it, could lead to disappointment if you fall off course). Instead, look at things through a positive frame:  “meditating everyday makes me feel calmer”

–  Expect lapses: embrace them as part of the process!

–  Live in the grey zone: Throw away ‘all or nothing’ thinking – don’t let little slip ups snowball. So, if you  eat that piece of chocolate cake, or forget to pack a healthy lunch, just reframe your thinking to simply ‘begin again’ right away, don’t view it as a hall pass to overeat for the rest of the day.

–  Accept full responsibility for making the change: remember that you are the only one who can really motivate ‘you’, so be your own cheerleader… it’s up to you.


Enjoy the process and stay positive. Focus on the things you’ve achieved and the progress you make along the way.



You’ve got this!