DH high cholesterol - diet advice please

[MrsAvocet]

My DH (mid 50s) has been recently told he has high cholesterol. He's been told to lose weight (which he definitely needs to) and "improve his diet". If it doesn't improve he'll be put on a statin.
I'm at a bit of a loss on the "improve diet" thing though, and he wasn't given any practical advice on what was actually needed. I think the GP was assuming that he lives on kebabs and deep fried sausage rolls or something, but we honestly don't. We've got a DS with multiple allergies so I cook most things from scratch and I would have said we had a pretty healthy diet, though DH does have a habit of snacking a lot, especially when bored or stressed which I think is at the root if his weight problem.
He definitely needs to cut out the chocolate and biscuits in between meals but I am at a bit of a loss about improving family meals. We do use real butter which I've replaced with the Flora cholesterol lowering stuff, but we're talking a couple of slices of toast a day worth of butter so I can't see that making a radical difference.
We do eat too much meat, which I've been trying to reduce anyway but it's a bit tricky as DS is allergic to a lot of vegetarian protein sources, but I'll do what I can to make more meat free meals.
I've searched for low cholesterol recipes online and they really aren't that different to what I'd normally cook. DH's family are from a Mediterranean country so I cook quite a few recipes from there which I thought were supposed to be good for the heart anyway.
We have a takeaway or eat out maybe once a month so could cut that out but I'm reluctant to completely ban takeaways as it's something the kids enjoy once in a while.
So I'm a bit stumped. I have to admit I am a bit offended as the inference from the GP was it's all diet related, and as I do the vast majority of the cooking that makes it my fault. But I am also a bit worried that if I can't make major changes to our diet he should go on the medication straight away rather than wasting time tinkering with minor diet changes.
Sorry, I've gone on a bit, but any advice or good recipe ideas would be welcomed. Thanks in advance.

To be honest, I think a tendency to high cholesterol has more to do with your DH's genes than your cooking, and it sounds like your meals are generally healthy, but there are a few things that can help to lower cholesterol:

• oats - will he have porridge for breakfast? The soluble fibre in oats can help to mop up some of the harmful low-density cholesterol.
• apples - they can also lower cholesterol. An apple a day... Actually, a high intake of fruit and vegetables (at least five different kinds per day) will help. Try to have half of the dinner plate covered in vegetables!
• Drink more water

High cholesterol foods include sea food, red meats etc. Also saturated fats, so cut out cakes, pastries, cheese, puddings etc.

Eat a high proportion of fibre, fruit & vegetables. Check what he eats while you aren't around. Takeaways etc.

If you cook healthy low fat meals it's those snack biscuits that are to blame - for the weight and the cholesterol. Can he substitute with something low fat and low calorie? I know it's easier said than done...

He should eat fruits instead of biscuits, oatmeal w cinnamon for breakfast (plain and not the sugary kind), have beans instead of meat some days.

Thanks for the replies.
I'll work on trying to get oats into him. I doubt I'll have any joy with porridge as he doesn't drink milk but maybe I can find some recipes that use them. I know you can make porridge with water but I don't think it's very appetising that way so he'd probably fill it with sugar or jam which won't help the weight loss!
We do eat quite a lot of fruit and veg but to be honest no, we probably dont hit the 5 a day every day so there's room for improvement there.
He literally only drinks water apart from if we go out he might have a glass of wine, but he doesn't drink any hot drinks or fizzy drinks etc so I think he gets enough water.
We don't have puddings or cakes except on special occasions and as DS is allergic to dairy and eggs they are usually fairly low fat desserts anyway. But cheese could be a problem. DH will help himself to cheese and biscuits as a snack or dessert fairly often.
We are both at home more or less full time now so I don't think he eats much that I don't know about, though as I'm currently unable to drive for medical reasons he does the majority of the shopping and I have noticed chocolate wrappers in the car door pockets after he's been to the shops. I can't control that of course - he needs to want to change himself. He's had a bit of a scare recently though so hopefully he'll take notice.

I’m also another who thinks genetics play a part. Whilst diet helps, I doubt it stops it in its tracks so to speak

A whole food planet based diet will reverse that as plants do not contain cholesterol. It's meat, eggs, fats that are the cause. If you cut out these foods, cholesterol drops. Most illness is lifestyle rather than genetics, despite what we are told we do have the power to control our health without medication.

Seems like a big deal to change diets but it's surprisingly how good you feel and how easy it is to get used to. I had changed my diet after a serious illness and was amazed at how great I felt.

Have you watched 'how not to die'? It's on YouTube & Netflix think.

It's saturated fat that causes the problem, not cholesterol in food. Eggs are not a big problem.

Diet makes no difference to my cholesterol. It's genetics.

That said the healthier the diet, the better for long term health. Porridge is fine with water.

Ask for the breakdown.
HDL - good cholesterol.
TRiglycerides - bad cholesterol, linked to diet and lifestyle.
LDL - bad cholesterol made by the body in the liver. Can be hereditary if high and lifestyle really has little impact on this.
The ratio of bad to good cholesterol is what's key, the overall 'total cholesterol' number tells you very little. 6.8 May sound high for example, but not if you've got a really good HDL. It will push the total number up. It's the balance of good to bad that's key.
DH fit and healthy, non smoker etc is on statins in his 40's due to a really raised LDL.
Ask for the numbers.

Try it for 3 months and see. Whole foods plant based diet. No processed foods, dairy, eggs, meat. Most high cholesterol is not genetic just like most cancers aren't.

Also if he's overweight make sure he has his hba1c (sugar) checked to exclude pre-diabetes. Diabetics are far more likely to have cardiovascular disease than non diabetics, severalfold, so addressing lipids on its own in health promotion may not be enough. Check BP too.

Adding cinnamon or vanilla to porridge makes it much nicer if that would sway him, as does piling the fruit on. You can get 3 portions just in one go right there.

I always though I ate pretty healthily until I got unwell, I cooked from scratch, tried to eat my 5 a day. Research showed me I was wrong, the British diet is not great but we are used to it so see it as fine.

The British Heart Foundation has really good information for weight loss and lowering cholesterol, worth taking a look

Thanks all.
Yes we have all the figures @cptartapp
The HDL is low, triglycerides are just at the upper limit of normal and total cholesterol high. I was surprised that the HDL was low as I was under the (perhaps erroneous) impression that that's where the Mediterranean diet was helpful as stuff like olive oil and oily fish contain good cholesterol? We eat plenty of that kind of thing so it was a bit of a shock.

What was the LDL? The ratio?

I've not got them to hand right now but i remember the HDL was 0.7 and the ratio was 9 point something.

How large are the portion sizes of meat and cheese in your husband's diet? Are the biscuits made with butter fat? What does he eat for breakfast or lunch?

If his cholesterol levels are sensitive to saturated fat in his diet, you need to look for sources of saturated fat in his diet.

A dietician once told me only about 10% of your cholesterol is down to diet, the rest genetics. They reckoned benecol etc was a waste of money…..that you couldn’t physically consume enough to make a difference.

That was about 15 years ago though so not sure of current thinking is the same.

Dh cut out cheese and that seemed to make a difference, he’d only been just over the line and then a few months later was just under. He’s never bothered getting tested again which worries me.

The ratio 9.something!!! Wow that seems extremely high. Preferred is less than 4.5. Is that right? Would be interesting to know his LDL.
DH went on statins with a ratio of around 5.

It's not your responsibility, OP. He should be delighted that you are prepared to support him in changing his diet by buying different foods and cooking different dishes.
Has he been given advice by the GP?
Has he googled to see what changes HE needs to make to what he eats?

Just for context, I have to watch my weight and blood pressure. I manage food buying and cooking. I eat small portions, go easy on the salt, eat porridge for breakfast, etc. DH does none of these. I'm responsible for what goes into my mouth. Your DH needs to engage, and not expect you to manage his health.

Family history of stroke or heart attack? Did they check his glucose and BP?

Good question lljk I don't often weigh things, I just tend to use one packet of everything between us. So a 500g packet of mince between the 4 of us if I was making spag bol for instance, and I probably give myself roughly half of what I give DH and the boys so I guess they get maybe 140g? If I'm doing a casserole, curry, or stir fry then I'll use one packet of chicken or beef- I think they're either 400g or 600g - again, they have more than me, so probably he gets 120- 170g or so of meat. I give everyone one chicken breast if I'm roasting them and last night we had lamb steaks, one each.
Cheese, he helps himself really so I dont know. I rarely use it in cooking as DS can't have it and I don't do separate meals. DH doesn't like any other dairy produce apart from cheese and butter so I don't want to stop him eating it completely if possible. Lunches we usually have soup, eggs, beans on toast, salad with some fish or cold meats etc, nothing particularly unusual. For breakfast he has toast or cereal (no milk....bleurgh) and some fruit. I think it's the eating between meals that's the issue to be honest.

He is going back for a fasting test next week cptartapp as the blood was taken in hospital when he was quite ill due to covid and not starved so the GP did query the reliability, though said it probably wouldn't be that much different. They're doing HbA1c then too. No family history of cardiovascular disease as far as we know - not in the last 2 generations anyway and his BP is normsl 120/70 at the last check.

How much cheese do you buy weekly or monthly? Sounds like all eaten by your husband. So you can know that way how much he eats.

When you say "beans on toast" : most people put butter on the toast
Soup: do you make this with saturated fat or animal flesh?

"probably give myself roughly half of what I give DH and the boys"

Does that mean that out of 500g mince, you get 100g, the boys together get 200g, & your DH gets 200g to himself?

The diet-link idea is that saturated fats matter -- so biscuits don't make direct difference to cholesterol unless made with butter or lard. Maybe diet won't make a difference, but you won't know if you don't try.