Cholesterol is a substance found in food and in your body. A high level of cholesterol in the blood, referred to as hypercholesterolemia, is a serious risk factor for developing heart disease. Fortunately, your diet can positively influence cholesterol levels; therefore it's beneficial to make healthy eating choices as consistently as possible.

According to the Heart and Stroke Foundation South Africa, "80% of westernised South Africans have raised blood cholesterol, of which 20% have levels that place them at high risk of developing heart disease." Familial hypercholesterolemia is a hereditary condition, but for the majority of people with high cholesterol levels, it's due to following an unhealthy lifestyle. Ideally, one's cholesterol levels should be as follows:

• Total cholesterol < 5.0 mmol/l
• LDL "bad" cholesterol (increases the risk of heart attack) < 3.0 mml/l
• HDL "good" cholesterol (helps remove excess cholesterol from the blood) > 1.2 mmol/l

In general, when choosing and preparing food, look for:

• High fibre options
• Low saturated and trans fat content
• Foods that are not cholesterol-rich
• A variety of fruit, vegetables, nuts and legumes

These basic guidelines about your food choices will help to lower your risk:

Carbohydrates are a source of energy, as well as fibre. Fibre helps to lower blood cholesterol, so go for whole-wheat or wholegrain options whenever you can. Oats and bran cereals are great options for breakfast, and whole-wheat pastas and breads are readily available. Keeping the skin on potatoes and sweet potatoes also increases the fibre content of your meal. Lower your intake of pies, pastries and biscuits - these are high in fat. Instead of your usual cereal, try something different for breakfast, like Quinoa. (or cinnamon oats)

Protein is a very necessary part of a healthy balanced diet. Animal sources of protein contain saturated fat, and some even contain cholesterol, and so it's important to learn how to make healthier protein choices. Foods like liver, eggs and shellfish contain cholesterol, so keep them to a minimum. Also aim to reduce your intake of saturated fat because these have a huge impact of total cholesterol levels.

When choosing your meat, choose the leanest cuts you can get, or cut any visible fat off the meat before cooking it. Removing the skin from poultry drastically reduces the fat content of the meal. When choosing frozen fish fillets opt for the un-crumbed versions and grill them in the oven instead of frying them. Try replacing saturated fat with unsaturated fats which may help lower cholesterol levels. You can find omega-3 fatty acids in oily fish, such as tuna, salmon, pilchards and mackerel. If you buy tinned tuna, go for the one in brine and rinse the tuna before use. Take a look at this Ginger chicken recipe that requires no oil.

Lentils and beans are an excellent source of plant protein and are high in fibre. They can be added to stews, soups, rice, curries, or salads. Besides being a protein source, some nuts and seeds are excellent sources of mono-unsaturated fats. They can be added to salads, breakfasts or eaten as part of a snack.

Fruit and vegetables are fibre-rich and contain antioxidants. Keep the skin on your fruit as it keeps the fibre content high, helping to lower your cholesterol levels. Whenever possible, steam your vegetables - it doesn't require oil, and also keeps your veggies crunchy. Try to eat at least 5 portions of various fruit and vegetables a day. The greater the variety, the greater your intake of various vitamins and minerals. Make sure you have some Vitamin C-rich options too, such as citrus fruits, guavas, tomatoes and dark green vegetables. Frozen vegetables are a great option if you're short of time or cannot get fresh produce. Try this delicious vegetable and bean salad.

Keep an eye open for dairy products that are labelled reduced fat, fat free or low fat. Start to gradually replace your full-fat milk with 2% milk, and then eventually with fat free or skimmed milk. Cream and cream cheeses are rich in saturated fat, so try to use cottage cheese or plain yoghurt instead.

• Other sources of mono-unsaturated fats: avocado, canola, olive and peanut oils, olives, some nuts like almonds, cashews, pecans, and peanuts.
• Other sources of poly-unsaturated fats: sunflower, soybean and corn oils, walnuts, pumpkin and sunflower seeds, soft or tub margaries which state that they have a high polyunsaturated fat content.
• Foods like butter, lard, ghee, coconut and palm oil are high in saturated fat.
• Have your cholesterol and blood pressure checked and try to keep them within the acceptable healthy range.
• Be physically active every day as this may help to lower your cholesterol levels.

While it's important to remember that all foods can be a part of healthy nutritious eating, try to make healthier choices every day and ensure that you are eating a variety of foods.

For more information about heart disease and stroke, go to the Heart and Stroke Foundation South Africa website: www.heartfoundation.co.za