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September is National Cholesterol Education Month!

“My cholesterol’s a little on the high side.”

38% of Americans (CDC.gov)



Cholesterol 101

I’m sure you’ve received some education about cholesterol levels (even if it’s unsolicited) either from your doctor, spouse, grandparents, neighbor...the list can go on for a while. I remember in the 90’s, just hearing the very word “cholesterol” sent shivers down the spines of middle-aged adults. There can be a lot of conflicting information out there...remember the whole “You should NOT eat the egg yolk...no wait, YES you should” debate?

I’m sure I’m not too far off by assuming that each facet of advice you receive may differ depending on whom you speak with. Like most medical and nutritional plans, they are tailored for a specific individual. Nothing within these fields can be approached as a “one size fits all”. So many factors including age, weight, lifestyle and family history (genetics) play a role in the mystery that surrounds cholesterol. But let’s start to unpack that mystery a bit here. I’ll start from the beginning…..

What Is Cholesterol?

Cholesterol is a type of fat that is produced naturally in the liver, and appears as a waxy substance. It is present in every cell in the body and is necessary to make hormones such as estrogen and testosterone as well Vitamin D (yep, it’s also a hormone) in addition to bile acids which help dissolve fat.


Since your body produces about 800 milligrams of cholesterol daily from fat, sugar, and protein sources in the body you don't really need to add it into your diet. Most people (myself included) do and that's fine but consuming too much or just not processing it well may eventually leave you in the danger zone. Foods that have a higher saturated fat content mostly come from animal sources including: beef, poultry and dairy products. A good rule of thumb if you are unsure is to ask yourself “Did any part of what I’m eating come from a source that has or once had a liver?...If the answer is yes...then it DOES contain cholesterol.

Because cholesterol is a fat (and would otherwise just float), it has to hitch a ride with a lipoprotein in order for it to properly circulate in the bloodstream. Lipoproteins play an important role in cholesterol and triglycerides (fat in the blood) and there are two different kinds in your body. Perhaps you've heard your doctor or dietitian mention HLD and LDL levels? It all breaks down like this:

LDL Levels

This stands for low-density lipoprotein. It can also be referred to as “bad” cholesterol, and accounts for the majority of your body’s cholesterol. Higher LDL cholesterol levels can build up in your arteries (remember it’s a waxy substance) causing a plaque which can block the flow of blood to and from your heart along with other organs. This blockage can increase your risk for developing heart disease and stroke.

HDL Levels

This stands for high-density lipoprotein. It can also be referred to as “good” cholesterol, which absorbs cholesterol and carries it back to the liver where it is broken down and removed from the body. Higher HDL levels can decrease your risk for heart disease and stroke.

What are optimal levels of HDL cholesterol?

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood or millimoles (mmol) per liter (L). When it comes to HDL cholesterol, higher numbers are better.


At risk Desirable

Men: Less than 40 mg/dL (1.0 mmol/L) 60 mg/dL (1.6 mmol/L) or above


Women: Less than 50 mg/dL (1.3 mmol/L) 60 mg/dL (1.6 mmol/L) or above

(Mayo Foundation for Medical Education and Research. 2020, November 10).

How Do I Lower My LDL and Raise My HDL Cholesterol Levels?

I’m sure you already know what I’m going to say but I’ll start with……

Exercise:

You don’t have to start training at 5am every morning for a marathon...but 30 minutes of moderate intensity exercise 5 days a week is the minimum starting point according to the Academy of Nutrition and Dietetics as well as the American Heart Association. With all our busy lives we can sometimes build up 30 minutes to be an extensive amount of time but it really does go by fast. Pick something you love (or even just like to start) to do that will get you moving. Some suggestions are below:

  • Ride a bike

  • Take a brisk walk

  • Running/jogging

  • Yoga/Pilates (YouTube has lots of videos on each form)

  • Play a sport (join a team with a friend)

  • Take the stairs at work (if that is an option)

  • Park your car at the far end of the parking lot to get more steps everywhere you go. I also find this option to be less stressful in busy lots.

Weight Loss Plan:

Committing to losing just 5% of your weight is a great start and will reflect in your cholesterol numbers. Usually introducing one healthy habit into your daily routine such as 30 minutes of exercise like I mentioned above will open you up to other healthy habits. After you finish a nice medium paced walk, you probably won’t want your next meal to be loaded with saturated fats. You might notice a shift in your dietary choices and start preparing oven roasted lean proteins and veggies for example.

If you prefer to start with adjusting your diet before incorporating exercise, start off slowly by making half your plate vegetables or salad. Your digestion and mood will thank you for the change. Notice how you feel at the end of the week from where you started. Feel free to keep a food journal about what new foods you tried (if any) and what you enjoyed most.

Eating healthier does not mean sacrificing flavor. Instead of adding in extra salt, try fresh or dried herbs and spices. If you have a small herb garden, this is another opportunity to use what you grow. If you have a few favorites from the grocery store, add in a teaspoon of olive oil and some rosemary and thyme to your oven roasted veggies. Not a fan of rosemary...there are several suggestions below for you to try on any meal you’d like. It’s a never ending mix n’ match of flavors at your fingertips. You won’t even miss the salt.

Fun Fact: Did you know it only takes ten days to re-acclimate your taste buds! This means you can retrain your buds to crave new foods...even as an adult. This can also help curb salty and sugary food cravings!

  • Oregano

  • Basil

  • Parsley

  • Tarragon

  • Coriander

  • Turmeric

  • Ginger

  • Garlic

  • Lemongrass

  • Curry

Alcohol...Moderation is Key

What is the link between alcohol and cholesterol? I’m glad you asked! In a nutshell, alcohol is processed and broken down into triglycerides and cholesterol in the liver. This can raise LDL (or “bad” cholesterol) levels in the blood.

According to the 2020-2025 Dietary Guidelines for Americans, it is recommended that both men and women with good overall health consume no more than 1 drink a day. The portion sizes per spirit are listed below. You can also check out more recommendations by clicking on this link 2020-2025 Dietary Guidelines for Americans. It’s also just a fascinating read, if you have the time and the curiosity.

Beer: 12 oz and 5% abv

Wine: 5 oz and 12% abv

Liquor: 1.5 oz and 40% abv


Smoking

Cigarettes put a lot of pressure on your heart and other organs. It also increases LDL cholesterol levels by making the waxy substance that is cholesterol even stickier so it’s more prone to clogging arteries. The good news is that your body begins to recover almost immediately after quitting smoking. This does NOT mean I recommend delaying such an important step to not only lowering LDL levels in the blood but improving your overall health. According the the American heart Association a few of the benefits are listed below:

  • After the first 20 minutes: your blood pressure and heart rate recover from the nicotine-induced spikes.

  • After 12 hours: the carbon monoxide levels in your blood return to normal.

  • After two weeks: your circulation and lung function begin to improve.

  • After one to nine months: clear and deeper breathing gradually returns; you have less coughing and shortness of breath; you regain the ability to cough productively instead of hacking, which cleans your lungs and reduce your risk of infection.

  • After one year: your risk of coronary heart disease is reduced by 50 percent.

(What is cholesterol? www.heart.org. n.d.).



What Do You Recommend To Eat?

There are so many delicious and nutritious dietary options when trying to lower LDL cholesterol levels and raise HDL levels. I hope this doesn't seem like a punishment, it shouldn’t. This does not mean you can never have a burger and fries again if that is one of your favorite meals. It just means that it should be eaten in moderation due to the high saturated fat content. I love a good burger myself, but no more than once a month. I also learn to appreciate and savor it more this way. It makes the meal more special for me. You may not see it this way at first, and I understand that. Hopefully in time, once you have gradually made a few small changes, you might come around to feeling that way too.

Fiber…(A Recap From The June Post)

Fiber is an important part of maintaining healthy cholesterol levels. Fiber also reduces blood sugar, helps to keep your bowel movements regular and aids in weight control by helping you to feel fuller. If you wish to increase your fiber intake, also increase your fluid intake. There are two types of fiber: Soluble and Insoluble.


Soluble Fiber: Dissolves and forms a gel-like substance in the gut.

Insoluble Fiber: Adds bulk to the stool and helps alleviate constipation.


Soluble fiber is the one to keep your eye one regarding cholesterol levels. The gel-like substance that it forms moves its way through the intestines and attaches to fat, bile salts, cholesterol ingested from your diet, as well as sugars, and excretes them out of the body. The soluble fiber helps to keep the cholesterol from absorbing and travelling to other parts of your body.


Below are a few foods that are naturally high in fiber according to the Academy of Nutrition and Dietetics:

  • 1 large pear with skin (7 grams)

  • 1 cup fresh raspberries (8 grams)

  • ½ medium avocado (5 grams)

  • 1 ounce almonds (3.5 grams)

  • ½ cup cooked black beans (7.5 grams)

  • 3 cups air-popped popcorn (3.6 grams)

  • 1 cup cooked pearled barley (6 grams)

When increasing fiber, be sure to do it gradually and with plenty of fluids. As dietary fiber travels through the digestive tract, it is similar to a new sponge; it needs water to plump up and pass smoothly. If you consume more than your usual intake of fiber but not enough fluid, you may experience nausea or constipation. Gradual steps are always best.


Omega 3’s

This type of “healthy” fat has been all over the media for decades now. Fish, nuts and olive oils are great sources. I’m not saying that you can load up on healthy fats without any consequences. Yes, this fat is good for you but there is such a thing as “too much” which then can tip the scale back to extra calories and fat. I know it can be confusing and frustrating.


I would also recommend seeking out fresh caught fish instead of farm raised. Farm raised can add antibiotics to their feed and it’s better to avoid it if possible. If not, do some research on where it came from. Each fish farm has its own standards and there may be a few reputable ones out there worth looking into. Fresh caught fish is a great option and usually available at most supermarkets. It should state it clearly in the label if it’s fresh or farm raised. Try to incorporate 4-6 ounces of fish once a week into your diet. Twice a week is better but if you’re not used to eating fish, once a week is a great start. Grilling or baking is best. You don’t want to add a bunch of other fats to the fish. Try a little olive oil (1 tsp) and fresh lemon juice. If you’re feeling adventurous, try some herbs. Rosemary and salmon are one of my favorite combos. Play around with the flavors, your palate might really surprise you.


A few fish with a high Omega 3 count to add to your dinner plates are:

  • Salmon (sockeye or coho are great options)

  • Trout

  • Mackerel

  • Herring

  • Tuna

Walnuts, Almonds and Avocados!

These are also good sources of Omega 3’s. Again, a little goes a long way. Keep the nut portion sizes to 1 ounce.


Avocados are great meat substitutes and are delicious in smoothies as well due to their creamy texture. If you can eat the guacamole without the corn chips...then great! Try swapping out the chips for carrot and/or celery sticks. You can also spread the guac on a sandwich or slice the avocado itself directly onto your whole grain bread. If the chips are too much of a temptation then skip the guac all together. The idea is to get some “heart healthy fats” into your diet, not add more fried snacks. Aim for adding in 2 avocados a week to start. If you already love them and eat them anyway...great! Keep in mind they do have a lot of calories but the health benefits are undeniable.


DASH and Mediterranean Diets

The DASH (Dietary Approach to Stop Hypertension) Diet is one of the best and healthiest diets for managing heart disease and diabetes. It has proven time and time again to lower blood pressure and cholesterol and reduce the risk of heart attacks and kidney disease.


This DASH Diet Link contains helpful advice and additional resources for you to review. There are also some great links about the Mediterranean Diet and how they compare and contrast each other. I highly recommend you take full advantage of this helpful information and see what works best for you and your day-to-day life. Make sure to check out some sample menus...it’s inspiring.


Talk To Your Doctor

Even though diet, exercise, and lifestyle choices play a big role in cholesterol levels, sometimes these are not enough. Genetics can also have a big say in how cholesterol works in your body, and although it’s important to live a healthy life, medication may also have to be a part of that...and that’s ok. Always talk with your doctor first about what the best approach is for you. And Remember….Health starts from the inside out….but also from the ground up!


To discuss more detailed information regarding the topics within this blog, or to inquire about customized nutrition plans, please reach out to Cathleen Winter at cathleen@wellnesswithincw.com


A Little About Me

My name is Mary DeBlasio, and I live in Silver Spring, MD. I recently graduated Magna Cum Laude with a Bachelor of Science in Nutrition and Dietetics in May of 2021. I am very interested in mindful eating, and foods that correlate with the seasons. My goal after graduation is to pursue a dietetic internship with a focus on clinical dietetics. I would like to concentrate on patients suffering from gastrointestinal issues. All my information is backed by credible sources cited within the blog.


Sources

Centers for Disease Control and Prevention. (2020, January 31). LDL & HDL: Good & bad cholesterol. Centers for Disease Control and Prevention. https://www.cdc.gov/cholesterol/ldl_hdl.htm.

Cholesterol in the blood. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/cholesterol-in-the-blood.

Feingold, K. R. (2021, January 19). Introduction to lipids and lipoproteins. Endotext [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK305896/.


Gordon, C. B. (n.d.). What is cholesterol? EatRight. https://www.eatright.org/health/wellness/heart-and-cardiovascular-health/what-is-cholesterol.

How it's made: Cholesterol production in your body. Harvard Health. (2019, July 31). https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body.

Mayo Foundation for Medical Education and Research. (2018, July 17). Can eating certain foods help improve your cholesterol levels? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192.


What is cholesterol? www.heart.org. (n.d.). https://www.heart.org/en/health-topics/cholesterol/about-cholesterol.



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