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For Your Heart's Sake, Lower Your
Cholesterol
There's a lot of news about
cholesterol these days, and with good reason. High
cholesterol contributes to heart disease, which kills more
Americans than all cancers combined.
What is cholesterol?
Cholesterol is a waxy, fatlike
substance that your body, mainly the liver, produces in
sufficient quantities to make some hormones, vitamin D, bile
acids to help digest fat and to build healthy cell membranes
(walls) in the brain, nerves, muscles, skin, liver,
intestines and heart. It only takes a small amount of
cholesterol to meet all these needs.
Your body makes all the cholesterol it needs; you don't
have to get cholesterol in your diet.
Why is a high cholesterol level
unhealthy?
Cholesterol causes a problem only
when there is too much of it in the blood. When there is
excess cholesterol, it is deposited in the lining of the
arteries, including the arteries that feed your heart muscle.
This narrows the area inside the artery where blood flows.
High blood cholesterol itself does not cause symptoms, so
many people are unaware that their cholesterol level is too
high.
You should have your cholesterol checked every five years
beginning at age 20. The most accurate test is a lipoprotein
profile, a blood test given after fasting for nine to 12
hours. It will tell you your:
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Total cholesterol
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LDL (bad) cholesterol; this cholesterol is what's
deposited in your arteries
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HDL (good) cholesterol; this cholesterol helps keeps
deposits from building up in your arteries
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Triglycerides; these are another form of fat in your blood
Even without a lipoprotein profile, you
can get a rough idea of your cholesterol health if you know your
total cholesterol or HDL cholesterol. These levels can be
determined through a non-fasting cholesterol test often given at
shopping malls or health fairs. If your total cholesterol is 200
mg/dl or more, or if your HDL cholesterol is less than 40 mg/dl,
you should ask your doctor about getting a lipoprotein
profile.
A total cholesterol level of 200 mg/dl to 239 mg/dl is
considered borderline high; 240 mg/dl and above is high. The
higher your HDL cholesterol, the better, because it helps
protect against heart disease. A level of less than 40 mg/dl is
low; optimal is 60 mg/dl and above.
Having a high level of LDL, or bad, cholesterol can cause a
fatty lining to form along the insides of your artery walls. (An
LDL level of 100 mg/dl or less is desirable; 130 mg/dl to 150
mg/dl is borderline high; 160 mg/dl and above is high to very
high.) This buildup is called plaque, and it makes the arteries
narrower and harder. Then there is less room for blood to flow
through -- like a partially clogged pipe. This process, called
atherosclerosis, develops over a long time. It is especially
dangerous if it narrows the paths to the heart and brain,
creating a major risk for heart attack, stroke and
cardiovascular disease.
Triglycerides also play a role in heart disease. Borderline-high
level of triglycerides is considered 150 to 199 mg/dl; high is
200 mg/dl or more.
What causes high
cholesterol?
Saturated fat and cholesterol in the
food you eat make your blood cholesterol level go up, says the
National Heart, Lung and Blood Institute (NHLBI). Saturated fat
is the main culprit, but cholesterol in foods also has an
impact. Reducing the amount of saturated fat and cholesterol in
your diet will help lower your blood cholesterol level.
Many foods that come from animals (meat and poultry, whole and
reduced-fat milk and butter) are high in both saturated fat and
cholesterol. Some non-animal foods also are high in saturated
fat, such as foods made with coconut and palm oils and
hydrogenated vegetable oils like shortening and margarine.
Saturated fats are solid at room temperature.
Besides saturated fats, these fats are also found in
foods:
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Monounsaturated fats. These are founding vegetable oils,
such as canola, olive and peanut. These are liquid at room
temperature. Monounsaturated fats may help lower LDL
cholesterol and decrease your risk for heart disease.
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Polyunsaturated fats. These are found in other vegetable
oils: safflower, sunflower and corn oils, as well as in
seafood. These can be liquid or soft at room temperature.
Polyunsaturated fats help lower LDL cholesterol.
-
Trans-fats. These fats are produced when vegetable oils
are made into margarine or shortening, says the American
Dietetic Association (ADA). You can find trans-fats in
snack foods and commercial baked goods. The label will say
"partially hydrogenated vegetable oil" or
"vegetable shortening." Trans-fats act like
saturated fats, the ADA says, and raise LDL cholesterol,
as well as lower HDL cholesterol.
You should consume no more than 30
percent of your daily calories from fat. That means 7 to 10
percent saturated fats; 10 to 15 percent monounsaturated fats;
and about 10 percent polyunsaturated fats, the ADA says. For
cholesterol, you should aim for less than 300 mg a day.
Other factors that influence your cholesterol levels
include:
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Heredity. Your genes determine how fast LDL is made in
your body and removed from your blood. One type of
inherited high cholesterol is hypercholesterolemia; this
can lead to early heart disease.
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Weight. Being overweight usually raises your LDL
cholesterol. Losing weight may lower your LDL level, as
well as your triglycerides, and boost your HDL
cholesterol.
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Exercise. Getting regular exercise may lower your LDL
cholesterol and raise your HDL cholesterol.
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Age and gender. Until menopause, women usually have lower
total cholesterol levels than those of men. After
menopause, women's LDL levels tend to rise. For both
men and women, total cholesterol levels rise until about
age 65.
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Alcohol. Although moderate alcohol use (one drink a day
for women and two drinks a day for men) boosts HDL
cholesterol, and may slow age-related stiffening of the
arteries, it has no effect on LDL cholesterol, and
excessive alcohol consumption raises triglycerides. Too
much alcohol also damages the liver and heart.
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Stress. Long-term stress can raise cholesterol levels,
although this may be because some people try to ease their
stress by eating fatty foods. It is the fatty foods that
boost cholesterol levels.
The main goal of cholesterol-lowering
treatment is to lower your LDL level enough to reduce your risk
for developing heart disease or having a heart attack. The
higher your risk, the lower your LDL goal will be.
What should you eat?
To eat a heart-healthy diet, you need
to cut down on foods high in saturated fats, like fried foods,
red meat, processed meats (cold cuts and hot dogs), some kinds
of cheese and most commercially prepared baked goods (muffins,
cookies, doughnuts).
A low-saturated-fat, low-cholesterol eating plan has less than
7 percent of calories from saturated fat and less than 200 mg of
dietary cholesterol per day. This plan calls for only enough
calories to maintain a desirable weight and avoid weight gain.
If reducing your saturated fat and cholesterol intakes
doesn't lower your LDL enough, you should increase the
amount of soluble fiber in your diet.
Fish is a good choice for a healthy diet. Many types contain
high levels of omega-3 fatty acids, which may help lower blood
cholesterol and blood pressure and reduce your risk for
dangerous blood clotting. Cold-water and fatty fish, such as
salmon and herring, contain the most omega-3s.
Eat more vegetables, fruit and whole grains (like oatmeal). They
contain fiber, which fills you up, and also limit your fat
intake while still giving you the nutrients you need.
If you eat red meat, here are some ways to decrease fat without
giving up flavor:
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Decrease the amount of meat in a recipe.
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Serve smaller portions of meat and add more vegetables,
grains and fruit to a meal.
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Select a lean cut when you buy meat. The terms
"round" and "loin" indicate lower fat.
Other tips for reducing your
cholesterol
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Drink black or green tea, which has powerful antioxidants
that may help prevent cholesterol from damaging your
arteries.
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Exercise. Regular physical activity -- 30 minutes on most,
if not all days -- is recommended for everyone. It can
help raise HDL and lower LDL cholesterol.
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Maintain a healthy weight. Losing weight if you are
overweight can lower your LDL cholesterol.
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Control your blood pressure.
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Don't smoke.
If lifestyle changes do not bring down
your cholesterol level, talk to your doctor. Drug therapy is
available. Your doctor can tell you whether this therapy is
appropriate for you.
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