Hippocrates was on to something when he urged, “Let food be thy medicine and medicine thy food” (image: Elizabeth Tessier / Burstology).
Can you feel it? Probably not, unless you have the surreal gift of body manipulation.
Those of us who aren’t superheroes should know that cholesterol is forever cruising undetected throughout our bodies, as if sharing an Uber with our blood cells.
If that sounds ominous, it’s because we’ve all heard the health warnings about cholestrol. But it’s time to get acquainted with both sides of the slippery C.
Talk about cholesterol, and you’re talking about the waxy material that is an important building block of new cells. That’s pretty important.
People have been throwing shade at cholesterol for years. It’ important to know that some cholestrol can cause heart disease if you have your too much. But the health warnings obscure the reality that, like UV rays, your body needs the right amount of cholestrol to thrive.
Many of the body’s internal processes need the two kinds of cholesterol, LDL (“bad”) and HDL (“good”) to carry out key tasks, such as helping to synthesize hormones like estrogen and testosterone.
This yin-yang tension between the healthful and harmful effects of cholesterol makes it important to stay on top of your LDL and HDL levels.
HDL, or high-density lipoprotein, does good deeds. It sweeps up up undesirable substances like bad cholestrol, triglycerides and harmful fats, and passes them along to the liver for processing, You might call the cleanup crew.
But look out for LDL, or low-density lipoprotein. It can cause heart disease or stroke. An overabundance of LDL cholesterol in your body can encourage lipoprotein to combine with other substances and create a thick, tough deposit called plaque that builds up inside your arteries. Attractive image, huh? Yeah. And it’s dangerous.
What Is Your Cholesterol Ratio?
So, what use is cholesterol? You want your body to make cells, right? Then you need both LDL and HDL. You just need the right ratio.
The magic ratio may be found by dividing your total cholesterol number (LDL + HDL) by your HDL number.
For example, a total cholesterol of 200 mg/dL, with an HDL of 50 mg/dL, would mean a ratio of 4:1. That’s within the recommended range of less than 5.) The higher the ratio, the higher the risk of heart disease.
Do you know your cholesterol ratio? I sure don’t. No brag. I’ve foolishly taken my eye off that ball. But like any health-conscious consumer, I know I need to pay better attention. I plan to ask for my cholesterol numbers next time I get a blood test. Girl Scout’s honor.
Knowing the figures is important (I keep reminding myself). They can alert you to your risk of heart disease, the world’s No. 1 cause of death.
If you’re avoiding foods high in cholesterol, you’ll probably want to go easy on the ones pictured (image: FotoshopTofs / Pixabay).
The plaque deposits caused by too much LDL can create bottlenecks inside the artery.
Think of your blood as the water in a river. Kayakers and canoers encounter similar bottlenecks, except they are called rapids or cataracts.
A kayaker or canoist can go around the blockage by portaging, or carrying their boat and belongings overland along the river, relaunching where the water is calmer.
If only portaging were an option in our arteries. Once deposits start to form, unfortunately, you’re on your way to atherosclerosis also called hardening of the arteries. If a blood clot forms and cannot pass through a narrowed artery, blocking it instead, the result could be a heart attack or stroke.
Does that sound scary? It does to me. That’s why I’m glad we have strategies to kick LDL levels into the cellar and raise HDL levels to the rooftops.
LDL Cholesterol, the Black Sheep
I like the way the American Heart Association distinguishes between the good and bad cholesterols:
“Think of LDL cholesterol as being a (bad) family member who carries stuff all through the house and drops it along the way,” the AHA suggests on its website, heart.org. “HDL cholesterol is another family member who picks up the dropped stuff and puts it away. This (good) person helps keep the house from becoming impassable.”
Your level of cholesterol is one of the main controllable risk factors for heart disease. Other factors that can further increase your risk are high blood pressure, smoking and diabetes. The number of risk factors and their severity determine your chances of getting heart disease.
Cholesterol Disorder in Youth Going Untreated
Youthful folks who think they’re immune to heart disease may have another think coming, according to a recent study. A cholesterol disorder that raises the risk of heart disease in young people is going untreated in half of the Americans who have it.
Lifesaving statin drugs can treat the genetic disease, which causes dangerously high cholesterol levels starting at birth.
A study of affected patients found that, while statin drugs are proven to lower cholesterol levels, only one out of two Americans with the disorder is getting treated.
The good news is that eight out of 10 people who have what is called familial hypercholesterolemia said a medical professional has told them their blood cholesterol level is high.
The bad news is that so few of those diagnosed are getting the right treatment or any at all, according to the National Health and Nutrition Examination Survey. Of the half of patients who are taking statins, only 38 percent are on a dose that’s high enough.
The correct treatment is of vital importance. People who don’t treat the inherited cholesterol disorder are 13 times more likely to get heart disease at a young age, according to the research report in Circulation, the journal of the AHA.
The disorder affects about one in every 250 adults in the United States. The study urges clinicians to step up efforts to diagnose patients with very high cholesterol from any disorder and relay the importance of taking the right dose of statins to reduce levels.
Death rates from heart disease vary from one region to another. But the greatest concentration is in the Bible Belt. The information helps public health officials decide where to concentrate their efforts (infographic: U.S. Centers for Disease Control).
Some red flags that could indicate you’ve inherited super-high cholesterol are, visible fatty deposits on the hands, elbows, need, ankle or around the eyes. People of any age with the condition might have chest pains or other symptoms of heart disease.
The disorder is diagnosed using a blood test measuring cholesterol levels, a physical exam and a review of the patient’s family medical history.
Liver Contributes Cholesterol
When I lived in Boston, a friend of mine was as thin as a vegan on a cattle ranch. He ran regularly and ate a healthy diet that included such delicacies as dry toast (seriously).
He should have been healthy, right? He was, except the level of cholesterol in his blood was more than twice what it should have been.
How was this possible? Cholesterol in your body can come from animal-based foods. But a lot of it is made by your liver. In fact, a healthy liver makes all the cholesterol your body needs, as well as helping to clear any excess.
Some people, including my friend in Boston, have the bad luck to be born with a liver that naturally churns out way too much cholesterol.
If your liver produces a normal amount of cholesterol, you’re lucky. But if you also consume lots of full-fat dairy foods, beef, pork and chicken, you may be eating a dangerous amount of saturated and trans fats.
The caution list includes tropical oils found in commercial baked goods, like palm oil, palm kernel oil and coconut oil. Once consumed, they can give your liver the incorrect advice to generate more cholesterol.
For people whose bodies naturally produce a healthy level of cholesterol, a steady diet of animal-based foods and saturated and trans fats can also push that level into the danger zone.
That includes not only chickens but also the eggs they produce. Conflicting research has been published over the years about whether concentration of cholesterol in egg yolks should make them a no-no for people with high cholesterol.
A study published in 2019 found that adults who ate an additional three or four eggs a week beyond their daily intake of 300 mg of dietary cholesterol per day from all sources, including eggs, had a higher risk of both heart disease and early death.
Yikes, right?
The study in the Journal of the American Medical Association found that the additional eggs pushed the disease risk up 6 percent and the risk of death up 8 percent.
The numbers are important but not exactly overwhelming. Only you can decide how much importance to place on them. As additional food (sorry) for thought, previous studies found that dietary cholesterol intake doesn’t necessarily translate to higher blood cholesterol.
Regardless of whether you come by your high cholesterol through your diet or an inherited condition you will have an elevated risk for heart disease.
Be an Active Partner in Treatment
Your level of cholesterol is one of the main controllable risk factors for heart disease. Other factors that can further increase your risk are high blood pressure, smoking and diabetes. The number of risk factors and their severity determine your chances of getting heart disease.
Medical studies show consistently that one of the strongest predictors of whether a patient will have a good or bad outcome from fighting a disease is how actively they participate in their treatment.
So, if you have high cholesterol, it will pay to educate yourself about what it is, learn the various approaches to treating it, and follow through on your chosen treatment.
Among the less obvious high-cholesterol treatments to consider are:
- New approaches wending their way through the government approval process,
- Nutritional advice,
- Natural remedies that have stood the test of time, and
- Other cultures’ healing systems, such as Traditional Chinese Medicine.
As with any illness, you will benefit from forming good working relationships with your medical team and making it clear that you intend to be be a full partner in any decisions about treatment.
Adopt a Healthier Lifestyle
One way to take charge of your treatment plan for high cholesterol is to consider making lifestyle changes that are likely to lower LDL levels. The Mayo Clinic, in an article in its online newsletters, identifies the “Top 5 Lifestyle Changes to Improve Your Cholesterol.”
There are so many variables involved, it’s tough to predict the outcome, but studies have zeroed in on these lifestyle strategies as the most important:
1. Eat heart-healthy foods. Limiting your daily fat calories to 7 percent of your diet is recommended. So is eating healthier fats, like olive oil and canola oil, lean cuts of meat, and low-fat to no-fat dairy products.
Cut out trans fat, which increases bad cholesterol and decreases good cholesterol, a one-two punch that boosts the likelihood of a heart attack.
To avoid that, eliminate fried foods and many commercial baked products. Give a wide berth to foods with partially hydrogenated oils.
Foods high in omega-3 fatty acids, such as salmon, help boost levels of the good cholesterol, HDL, in your bloodstream (image: Dana Tentis / Pexels).
Develop the habit of reading the ingredient analysis label on food packages, usually called, “Nutririon Facts.” It’s likely to be more accurate than any marketing claims about the product’s health-giving properties.
If the nutrition summary lists even small amounts of trans fat, beware. Remember that the amount can add up if you’re not careful.
The good foods to eat if you’re keen on controlling your cholestrol are actually very good, if you prepare them well. They include some types of fish, like salmon, mackerel and herring.
All are rich in omega-3 fatty acids, which help increase the good HDL cholesterol, reduce a type of fat in your blood called triglycerides, and lower blood pressure.
Other foods rich in omega-3 fatty acids are walnuts, almonds and ground flaxseeds (add it to your baking). They also provide soluble fiber.
The other type of fiber, insoluble, also offers heart-health benefits, but the soluble kind helps lower levels of the bad, LDL kind of cholesterol, There are two types of fiber — soluble and insoluble. Both have heart-health benefits, but soluble fiber also helps lower your LDL levels.
Some other wonderful foods containing soluble fiber are oats and oat bran, fruits, beans (like kidney beans, navy beans, etc.), lentils, and vegetables.
If you make good smoothies, or can learn how, then put them on the list of foods friendly to a low-cholesterol eating plan. That is, if you make them with an ingredient called whey protein, which lowers both LDL and total cholesterol.
Sold as a powder in health-food stores, whey protein is one of two proteins in dairy products and is believed to account for many of the health benefits attributed to dairy.
2. Increase physical activity, with your physician’s approval, to the point where you are exercising most days of the week. Depending on the activity you choose, you may find yourself enjoying not only the way it makes you feel but also any social aspects involved.
Exercise is a biggie, because it raises the good, HDL, cholesterol.
If you haven’t been exercising regularly, ease into it. Start with three days a week and slowly increase the number of days — one at a time — until you are moving six or seven days a week. It’s unimportant how fast you ramp up. The more important goal is that you stick with the activity, whatever it is.
On the weeks when you don’t increase the number of days you work out, slowly increase how long you workout to a total of 30 minutes or more. Keep in mind that you’ll get the same benefits from, say, three 10-minute sessions of exercise as you would from one 30-minute session. So pick the time format that suits you best.
If you haven’t been exercising, you may be surprised at the way it gradually helps you lose weight. You needn’t join a gym or buy expensive equipment. Some simple ideas for adding physical activity are:
- Playing a sport,
- Walking briskly or running at lunch hour,
- Biking to work, or
- Swimming laps
Any concerns you might have about getting started on the exercise habit and maintaining motivation can be tackled by recruiting a buddy or joining an exercise group, like a running or walking club. If you look around, you should be able to find one that is inexpensive or free.
For folks who, for some reason, cannot do much exercise, thy can do a little. The cumulative benefits of gradual action are inevitable. Even counting down a few sit-ups during television commercials, taking the stairs instead of the elevator, or parking at the far end of the parking lot can make a difference when you do it consistently, over time.
3. If you smoke, quit. You probably saw this one coming, especially if you indulge. So as not to disappoint you, I’ll say it: “If you smoke, stop.”
As with any addiction, It’s easier said than done. I liken it to someone telling me, “If you eat chocolate, stop.” Except, with cigarettes, the stakes are higher and the nicotine addiction stronger.
Maybe you’ve tried to quit before and weren’t able to stick with it. In a way, that’s a good thing. Most smokers attempting to quit have to try multiple approaches, multiple times, before succeeding. You’ve just been getting the unsuccessful methods out of the way. Smart.
Giving up the ciggies might boost your good, HDL cholesterol levels. Immediate benefits will include lowering your blood pressure and your pulse. Another benefit from day one is that you’ll no longer have to go out half-dressed in freezing weather to smoke in order to keep your non-smoking partner happy.
Further good news is that, due to the amazing regenerative powers of the human body, your risk of heart disease will decline, within a year, to the level of someone who has never smoked.
4. Maintain a healthy weight. You may have in mind a certain number of pounds you would like to lose or a size you would like to fit into. Many of us do. Meeting your weight-loss goals is another matter. It may help boost your motivation to know that losing as little as 5 percent to 10 percent of your body weight can have a positive effect on your levels of cholesterol.
We all respond to different ways of losing weight. If you haven’t found strategies that work for you, consider examining your eating habits and the routine you follow each day. Armed with this knowledge, list your challenges to losing weight and ways to overcome each one.
Small changes add up. If you eat when you’re bored or frustrated, take a walk or indulge in a favorite hobby instead. If you’ve gotten into the habit of picking up fast food for lunch, try packing something healthy from home. In time, you may wonder how you ever stomached the fat-laden fast food.
Try keeping carrot sticks or baby carrots around for snacks. Kee on hand whatever you need to make air-popped popcorn. Every day, pack something healthier from home. For snacks, grab a sliced apple or air-popped popcorn instead of potato chips. Avoid mindless eating.
5. If you drink alcohol, do it in moderation. There is evidence that higher levels of HDL cholesterol may result when you drink a moderate amount of alcohol. But the benefits are considered too modest to suggest that anyone who doesn’t already drink take up the habit.
On the other hand, moderate use of alcohol has been linked with higher levels of HDL cholesterol. For healthy adult women, and men over 65, that’s up to one drink a day, For healthy men age 65 and younger, moderation means up to two drinks a day.
Is It Enough?
Healthy lifestyle changes will do you good, no matter what. For some people, however, they may not reduce cholesterol levels enough.
Do your best to make your lifestyle changes incremental and reasonable enough for you to continue them and find the best way to incorporate them into your life. If you can enlist others in your household to make healthy changes, that should help,
Be patient if results aren’t immediate. Think of this as a long game. If your physician still suggests medication to help lower your cholesterol, then take it as prescribed.
Continue your positive lifestyle changes, because they can help you keep the dosage low or, if you’re lucky, eliminate the need for pharmaceuticals. Now, there’s a worthwhile goal.
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