Isn't it possible to keep fresh fish in the fridge for a week?

Most fridges in our homes are set at about 3°C and fish spoils quickly at this temperature, so eat it within 24 hours. Stored on ice (0°C) fresh fish may last a week.

What types of food have low or high levels of fat and cholesterol in them?

There are some of the main foods in the high fat groups.

Foods high in total fat

• Fried food

• Whole milk, cream, high-fat cheeses (such as Cheddar)

• Fatty meat and meat products, e.g. sausages and pâté

Foods high in saturated fat

• Fatty meat and meat products

• Foods cooked in lard, butter or hard margarines

• Cakes and pastries made with butter and hard margarines

• Palm and coconut oil

• Fatty poultry (duck, goose); poultry with the skin on

Foods high in total and LDL (bad) cholesterol

• Egg yolks (eat only three to four eggs a week at the most)

• Liver and other organ meats (kidney, brain, heart, sweetbreads)

• Shellfish (but these are lower in saturated fat than most meats and poultry so are fine to eat in moderation - see the question above on fish oils)

Foods high in polyunsaturated fat

• Some nuts and seeds (e.g. chestnuts, walnuts, not coconut)

• Oily fish

• Many soft margarines and vegetable oils (check the labels)

Foods high in monounsaturated fat

• Olive oil and olives

• Rapeseed oil

• Margarines and spreads made from olive oil

What sort of foods should I eat to cut down on my fat intake?

Basically, avoid full fat dairy produce, deep-fried foods, pastry, biscuits and puddings. See Table 9.2 for a comprehensive list of the healthiest foods to eat as regards fats, and those to eat in moderation, occasionally or best left alone. Don't panic - all the good things haven't been removed, it is just a modification as part of a new way of living. For cutting down on dairy foods:

• Change whole milk dairy products to semi-skimmed or skimmed;

• Change butter or hard margarine to poly- or monounsaturated margarine;

• Change lard or hard vegetable fats to pure vegetable oils (such as corn oil or olive oil, high in polyunsaturates and monounsaturates respectively), but remember that all fats are high in calories;

• Change cream to low fat yoghurt or fromage frais;

• Change ice-cream to frozen yoghurt, sorbets or low fat frozen desserts;

• Change high fat cheeses (such as Cheddar, cream cheese) to lower fat cheeses (half fat Cheddar, Edam, Brie, Camembert, cottage cheese and lower fat soft cheese).

Eat no more than 170 g (6oz) of cooked lean meat a day. If you do want to eat red meat:

• Eat the leaner cuts and always cut the fat off at the table;

• Avoid burgers, pork, meat pies, bacon and full fat sausages;

• Switch to chicken or turkey (but do not eat the skin);

• Switch to game meats instead of duck or goose which are fatty meats;

• Avoid processed meats (sausages, hot dogs, salami, pâté);

• Avoid high cholesterol organ meats (offal, e.g. liver, kidneys, sweetbreads).

Cut down on egg yolks (no more than three or four per week) or consider the use of egg substitutes or egg whites in cooking.

Eat fish that is low in saturated fat two or three times a week (you can include shellfish in moderation - see above). Try more oily fish than white fish.

Avoid purchased baked goods like cakes (substitute bread or muffins - but check the label) or meat pies.

Eat plenty of fresh fruit and vegetables, but avoid coconut, olives (not the oil) and avocados, which are high in calories and may cause weight gain).

Change from croissants to wholemeal bread.

Substitute chestnuts or walnuts for peanuts, but remember that all nuts contain a lot of calories.

According to the TV ads, some margarines seems to be a good way of lowering cholesterol - do they really work?

Research has shown that Benecol, which contains special plant extracts, lowers cholesterol by 10-14%. Similar results are reported with Flora Proactiv. Although these products lower cholesterol, there is no evidence that they reduce heart risk in the same way that statin drugs do (see Treatment in the section Risks of high cholesterol levels in Chapter 2). They are helpful when you have a borderline raised cholesterol, because you may be able to avoid drugs; but, if you have heart disease already, these products should be used with drugs - you will then benefit from the drugs, but the doses might be lowered. I do recommend them as part of healthy living, but price may be a problem for some people, and you will get benefits from supermarket spreads that are high in either poly- or monounsaturated fats, if the costs worry you.

A liquid yoghurt drink a day maximises the benefit of Flora Proactiv or Benecol.

My friend in America is taking nicotinic acid (niacin) for her cholesterol - is it available here?

Nicotinic acid is available, but not often used because of its side effects, especially flushing. It can also affect the liver and make any stomach ulcers worse. It can react with alcohol and upset control in people with diabetes, so doctors have to monitor anyone on this drug very carefully. Occasionally, it can make angina pain worse.

A new formulation (Niaspan) has been launched. Nicotinic acid raises the good cholesterol (HDL) by up to 24%. Doctors will probably try it on those who have a low HDL in spite of being on statins, and therefore it is given in combination with these. Treatment will be introduced carefully and the dose gradually increased. Niaspan claims to cause less flushing than other types. Typical doses are 3 75, 500, 750 and 1000 mg, to a maximum of 2 g, taken daily at night. Flushing may be reduced by taking soluble aspirin 30 minutes beforehand and taking Niaspan with food.

Someone told me that nuts were good for reducing coronary disease - should I eat them regularly?

Nuts (though not coconut), eaten about four times a week, have been linked to a reduction in heart attacks. Walnuts and almonds lower cholesterol. Therefore, nuts as part of a healthy lifestyle may reduce the risk of heart disease. Eat them with cereals, as a snack, or with a salad. Beware of added salt and remember that they have a high calorie content. If you use nuts in cooking, remember some visitors may be allergic to them.

Are there better ways of cooking I could try?

Yes; instead of frying or roasting you could try grilling, barbecuing, braising, poaching, steaming, stir-frying or sauteing with minimal fat; baking, casseroling or microwaving also reduce the use of fats.

• Grill on a rack so that the fat drips away. Special fat-reducing portable grills are a healthy choice.

• If you have a roast, don't cook the meat in its own juice or make gravy from the juices. Cook the joint on a roasting rack and baste the meat with vegetable oil, lemon juice or a little olive oil.

• If you use a polyunsaturated margarine or oil for cooking, use as little as possible. Oil sprays are a way of avoiding excess in cooking.

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