One in two adult Australians has a blood cholesterol level over 5.5[i] resulting in a huge cost to the community in terms of lives lost, and financial cost to the nation's Pharmaceutical Benefits Scheme (PBS) in order to control it.

The Australian Institute of Health & Welfare (AIHW) estimates high cholesterol is responsible for almost 12% of all deaths in Australia[ii]. Further analysis by the George Institute for International Health shows if all Australian adults maintained a 10% lower cholesterol level, thousands of lives could be saved each year[iii].

In the year ending June 2008, lipid modifying drugs were the most expensive class of drugs on the PBS - the program by which the government subsidises drug costs to the public[iv]. Over 20 million prescriptions were written, which cost the government more than 1 billion dollars, representing a 5 percent increase in one year. A further 232 million dollars came directly out of consumer's pockets as co-payments, amounting to an average total cost of $63 per prescription[v].

Dr Manny Noakes, senior research scientist and dietitian with the CSIRO and author of The CSIRO Healthy Heart Program says, The role of diet in managing cholesterol can be overlooked and we need to provide confidence to consumers and doctors that diet can work. For example, adding 2g plant sterols a day to the diet can lower cholesterol by an average of 10 percent. Doing this together with other changes, such as eating less saturated fat and increasing soluble fibre, can add up to significant cholesterol lowering benefit.

The Heart Foundation says people already taking cholesterol lowering medication should continue taking it as recommended by their doctor. However they support dietary change as well. Their recent Position Paper on Dietary fats and dietary sterols for cardiovascular health says, plant sterol-enriched foods have an additive effect in lowering LDL cholesterol when combined with statins[1] [vi].

Why is it that dietary strategies to manage cholesterol are so under-utilised? Perhaps because many people- including doctors - are confused about which foods work best. A survey of 200 doctors conducted on behalf of Unilever Australasia[vii] asked them to rate whether they thought plant sterol spreads, fish oil or oats were the most effective food in lowering blood cholesterol. Only 36% believed plant sterol spreads were the most effective food, and 32% believed fish oil was the most effective when in fact fish oil has no effect on cholesterol (although it has other heart health benefits).

The plant sterols in just 1 rounded tablespoon (25g) of Flora pro-activ a day - the amount typically spread on three slices of bread can lower cholesterol absorption by an average of 10 percent in 3 weeks, plus an additional 5 percent when also moving to a healthy diet. Other foods such as oats, almonds and olive oil, while having significant heart health benefits, do not lower cholesterol as much as foods enriched with plant sterols.

Accredited Nutritionist for Flora, Brooke Sprott, says following a cholesterol-lowering diet is a great first step for people concerned about their cholesterol. Using Flora pro-activ is an effective dietary strategy for lowering cholesterol absorption, and can be easily incorporated into a healthy diet.

Although many people perceive Flora pro-activ is expensive, it actually offers good value because it is scientifically proven to work and only costs 50c a day.

www.foodforcholesterol.com.au

[1] Statins are the name of the class of drug used to lower blood cholesterol levels.

[i] Australian Institute of Health and Welfare (AIHW). High blood cholesterol. Available at URL http://www.aihw.gov.au/riskfactors/cholesterol.cfm accessed 21 April 2009

[ii] Australian Institute of Health & Welfare (AIHW). The Burden of Cardiovascular Disease in Australia for the year 2003. Report by Vos T, Begg S, Barker B et al. Available from URL http://www.aihw.gov.au/publications/index.cfm/title/10317

[iii] Huxley RR, Clifton P, Perkovic V et al. How many Australian deaths from heart disease and stroke could be avoided by a small reduction in population cholesterol levels? Nutrition & Dietetics 2009; 66: 158-163

[iv] Pharmaceutical Benefits Scheme. Expenditure and prescriptions 12 months to June 2008. Table 8(a): Significant drug groups (incl Drs bag) by highest Government cost, year end: Jun 2007 to year end: Jun 2008 - Section 85 Only. Available at URL http://www.health.gov.au/internet/main/publishing.nsf/Content/053BB36E2A4173AACA2575910012F753/$File/BookPage8.pdf Accessed 27 July 2009.

[v] Pharmaceutical Benefits Scheme. Expenditure and prescriptions 12 months to June 2008. Table 8(a): Significant drug groups (incl Drs bag) by highest Government cost, year end: Jun 2007 to year end: Jun 2008 - Section 85 Only. Available at URL http://www.health.gov.au/internet/main/publishing.nsf/Content/053BB36E2A4173AACA2575910012F753/$File/BookPage8.pdf Accessed 27 July 2009.

[vi] Heart Foundation (Australia) Position statement Dietary fats and dietary sterols for cardiovascular health (2009). Available from URL http://www.heartfoundation.org.au/Professional_Information/Lifestyle_Risk/Nutrition/Pages/default.aspx accessed 2.7.09

[vii] Conducted by Galaxy Research on behalf of Unilever Australasia on a representative sample of 200 General Practitioners online between Friday 12 September and Wednesday 24 September, 2008.

Australia Medicine