More than half of the adults in Singapore have high cholesterol, according to the 2010 National Health Survey.
Dr Lim Su Lin, chief dietitian at the National University Hospital, said having high cholesterol levels raises the risk of getting coronary artery disease, heart attack or stroke.
Each 1mmol/L of total cholesterol above the normal limit of 5.2 mmol/L is associated with a 35 per cent increased risk of death from a heart condition and a 25 per cent increased risk of ischaemic stroke, or a stroke due to blockage of blood vessels, said Dr Lim.
In Singapore, nearly one out of three deaths is due to heart disease or stroke, she added.
While high cholesterol could be inherited, said Dr Lim, it is a fact that unhealthy diets and habits are passed on from generation to generation.
"Some people grow up thinking that it is normal to eat you tiao, nasi lemak, roti prata and cakes for breakfast every day. Many people like to blame their high cholesterol levels on genetics because it absolves them from having to take responsibility for it," she said.
But it is never too late to start doing something about it. She gives some tips on how to bring down cholesterol levels:
1 Minimise the intake of foods with trans fat. Among all the types of fat, trans fat is the worst culprit in causing heart disease and stroke.
A study of 80,000 female nurses showed that trans fat doubled the risk of heart disease in women, compared with those who rarely ate trans fat.
The main source of trans fat is processed foods containing partially hydrogenated fats or shortening such as pastries, cookies, tarts, pies, doughnuts, creamy bread, french fries and confectionery.
2 Avoid deep-fried foods when eating out. The oil used for deep- frying is usually reused many times. Reheating oil repeatedly at high temperature produces harmful compounds which may increase one's risk of heart disease, high blood pressure, stroke and Alzheimer's disease.
It is costly for restaurants and food vendors to throw away the oil after every round of deep-frying. It is very hard for the authorities to control the practice of reusing oil.
Hence, it is better for consumers to minimise choosing deep-fried foods when eating out.
If you want to eat deep-fried food, cook it at home with a healthy oil no more than once a week and discard the leftover oil.
Opt more often for food cooked with healthier cooking methods, such as grilling, air-frying, baking, steaming, stewing, boiling and roasting.
3 Limit your saturated-fat intake. A diet high in saturated fat increases the risk of heart disease and stroke. It is estimated to cause 31 per cent of coronary heart disease and 11 per cent of stroke worldwide.
Saturated fats are present in animal products such as meat fat and poultry skin, full-cream dairy products, butter and lard.
Plant sources such as coconut milk and palm oil also contain high amounts of saturated fats.
Saturated fats can increase total cholesterol and low-density lipoprotein (LDL), which is considered bad cholesterol.
4 Choose unsaturated oil for cooking at home, such as canola, olive, rice bran, peanut, soya bean, corn and sunflower oils.
5 Remove visible fat and skin from meat and poultry before cooking and eating.
Choose leaner cuts of meat, such as loin or breast meat but avoid sausages, Chinese sausages and luncheon meat.
Include fish in your diet on most days, especially oily fish such as salmon, sea bass, threadfin, cod fish and mackerel as they contain omega-3 fatty acids, which can help lower the risk of cardiovascular disease. Replace meat with beans or legumes in your dishes and soups on some days.
6 Choose low-fat dairy products such as skimmed milk and low-fat cheese instead of full-cream dairy products.
Use low-fat milk or yogurt to replace coconut milk in cooking.
7 Limit your cholesterol intake. Although there is recent data to show that we do not need to completely avoid high-cholesterol foods such as eggs and shellfish, it is important to consume these in moderation.
You should limit the consumption of shellfish to no more than once a week and have no more than four egg yolks per week.
For other high-cholesterol foods which have not been fully studied, such as organ meats, which can be very high in cholesterol, it is best to avoid them or eat them only once in a long while.
8 Include more soluble fibre in your diet. Soluble fibre, such as those present in oatmeal, oat bran, barley, fruit, vegetables, legumes, beans and nuts, is able to reduce cholesterol by binding it to bile acid in the small intestines.
9 Have fruit and plain nuts as snacks instead of potato chips, cakes and kuehs.
10 Exercise often. Physical inactivity increases the risk of heart disease and stroke by 50 per cent.
It is recommended to have 30 to 60 minutes of physical activity, such as brisk walking, sports, swimming or dancing, at least three times a week. Choose an exercise which you like to do.
Ng Wan Ching