Cholesterol…Take Control

During my initial consultation with clients I go through a Nutrition and Health Assessment so that I have a firm understanding of all factors impacting overall health and nutrition. It is becoming increasingly more common to discover that they are on statins (prescription drugs used to lower Cholesterol levels). Statins are a class of cholesterol lowering drugs that inhibit the enzyme HMG-CoA reductase which plays a central role in the production of cholesterol. An unsettling thing I’ve observed is that the majority of my clients, after years of being on Cholesterol-lowering medications, have no idea what their actual cholesterol levels were. They only remember the doctor telling them that they were elevated. The American Heart Association recommends all adults age 20 or older have their cholesterol levels checked every four to six years.

Your total cholesterol and HDL (good) cholesterol are among numerous factors your doctor can use to predict your lifetime or 10-year risk for a heart attack or stroke.

I’m by no means telling you to stop taking medication that your doctor has prescribed, but I do encourage you to be an active participate in your journey to health! Ask questions, do research, and take precautionary measures to decrease those chances of ending up on such medications.

Cholesterol in and of itself isn’t bad. In fact it is necessary for cell function, helps our bodies make Vitamin D, is essential for hormone function and aids in the production of bile that helps us emulsify fat. It is made by our liver but is also found in some foods.

Cholesterol

There are two forms of cholesterol produced by the body : Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). A low LDL cholesterol level is considered good for your heart health. However, according to the American Heart  Association, LDL number should no longer be the main factor in guiding treatment to prevent heart attack and stroke. A diet high in saturated and trans fats raises LDL cholesterol.  LDL is the “bad” cholesterol. HDL is the “good” cholesterol .In this case, higher levels are better.  Having low HDL cholesterol actually increase risk for heart disease. Some factors that are associated with low HDL levels are having high blood triglyceride levels as well as genetic factors, type 2 diabetes, smoking, being overweight and having a  sedentary lifestyle.

There are multiple factors can cause unhealthy cholesterol levels. Some are within your ability to change while others are not.

Let’s start with factors that are not modifiable:

Heredity. Our genes help determine, in part, the amount of LDL cholesterol your body makes and how fast it is removed from your body. High blood cholesterol can run in families. The good news is that even if it runs in your family, you can still take action to lower their cholesterol. Conversely, even if high cholesterol does not run in your family, you can still develop it. High cholesterol is a common condition among Americans, even young persons, and even those with no family history of it.

Age and sex. According to the National Heart Lung and Blood Institute, Blood cholesterol begins to rise around age 20 and continues to go up until about age 60 or 65. Before age 50, men’s total cholesterol levels tend to be higher than those of women of the same age—after age 50, the opposite happens. That’s because with menopause, women’s LDL levels often rise.

Here’s the empowering part– The elements that you CAN control to impact healthy cholesterol levels:

Being Overweight/ Lack of Exercise. Excess weight tends to increase your LDL level. Also, it typically raises triglycerides, a fatty substance in the blood and in food and lowers HDL. Being overweight has a negative impact on fats circulating in the bloodstream and inactivity depresses protective HDL. The simple acts of increasing your activity level and losing weight can impact your cholesterol levels for the better. Check with your doctor before taking on any exercise.

Diet. (You knew this part was coming). Saturated fats increase your LDL cholesterol level more than anything else in your diet. Trans fat, found mostly in foods made with hydrogenated oils and fats such as stick margarine, crackers, and Ffench fries also lead  to elevated LDL Levels. Diets with too much saturated fat, trans fat, and cholesterol are the main cause for high levels of blood cholesterol—a leading contributor to the high rate of heart attacks among Americans.

Don’t think sugar gets a free pass…a study published in the American Journal of Clinical Nutrition found that HDL levels decreased as carbohydrate intake (white breads, rolls, white rice, etc which convert to glucose in your body) increased. Additionally, it is important to note that a high-sugar diet raises your risk for heart disease by promoting metabolic syndrome. Metabolic syndrome is a cluster of health conditions including high blood pressure, insulin and leptin resistance, high triglycerides, liver dysfunction, and visceral fat accumulation.

Additionally, a meta-analysis of 17 low-carb diet trials covering 1,140 obese patients published in the journal Obesity Reviews found that low-carb diets neither increased nor decreased LDL cholesterol. However, they did find that low-carb diets were associated with significant decreases is body weight as well as improvements in several CV risk factors, including decreases in triglycerides, fasting glucose, blood pressure, body mass index, abdominal circumference, plasma insulin and c-reactive protein, as well as an increase in HDL cholesterol.

Let’s talk about what you SHOULD be eating:

1. High-fiber foods

Oatmeal and Oatbran are great options. The reason is because they contain soluble fiber. Soluble fiber reduces the “bad” LDL cholesterol by which binding cholesterol and its precursors in the digestive system and dragging them out of the body before they get into circulation. Soluble fiber is also found in such foods as beans/legumes, barley and other whole grains, fruits high in pectin (apples, grapes, strawberries and citrus).

According to the Mayo Clinic, five to 10 grams or more of soluble fiber a day decreases your total and LDL cholesterol. Eating 1 1/2 cups of cooked oatmeal provides 6 grams of fiber. If you add fruit, such as bananas, you’ll add about 4 more grams of fiber.

2. Fish and omega-3 fatty acids

Omega -3 fatty acids can reduce your blood pressure and risk of developing blood clots. In people who have already had heart attacks, fish oil — or omega-3 fatty acids — reduces the risk of sudden death.

The American Heart Association recommends eating at least two servings of fish a week. The highest levels of omega-3 fatty acids are in:

• Mackerel
• Lake trout
• Herring
• Sardines
• Albacore tuna
• Salmon
• Halibut

If you don’t like fish, you can also get small amounts of omega-3 fatty acids from foods like ground flaxseed.

I do suggest taking an omega-3 or fish oil supplement with a high amount of EPA and DHA.

3. Nuts!

Nuts are high in polyunsaturated fatty acids and help keep blood vessels healthy as well as reducing LDL levels.

Eating about a handful (1.5 ounces, or 42.5 grams) a day of most nuts, such as almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts, may reduce your risk of heart disease. Just make sure the nuts you eat aren’t salted or coated with sugar, chocolate, yogurt…etc.

Do be mindful of portions and stick to the 1.5oz serving, as nuts are high in calories and it’s easy to lose track of how many you’ve had. To avoid eating too many nuts and gaining weight, replace foods high in saturated fat with nuts. For example, instead of bacon or croutons in your salad, add a handful of walnuts or almonds or crunch and flavor.

4. Healthy fats

• “Good” unsaturated fats — Monounsaturated and polyunsaturated fats — lower disease risk. Foods high in good fats include vegetable oils (such as olive, sunflower, avocado), nuts, seeds, and fish.

• “Bad” fats — trans fats — increase disease risk, even when eaten in small quantities. Foods containing trans fats are primarily in processed foods made with trans fat from partially hydrogenated oil. Fortunately, trans fats have been eliminated from many of these foods.

• Saturated fats, while not as harmful as trans fats, by comparison with unsaturated fats negatively impact health and are best consumed in moderation. Foods containing large amounts of saturated fat include red meat, butter, cheese, and ice cream.

• Be sure that when you cut back on foods like red meat and butter, replace them with fish, beans, nuts, and healthy oils instead of refined carbohydrates.

What about eggs?

According to Francisco Lopez-Jimenez, MD at the Mayo Clinic, “Chicken eggs are high in cholesterol, but the effect of egg consumption on blood cholesterol is minimal when compared with the effect of trans fats and saturated fats.

The risk of heart disease may be more closely tied to the foods that accompany the eggs in a traditional American breakfast — such as the sodium in the bacon, sausages and ham, and the saturated fat or oils with trans fats used to fry the eggs and the hash browns.

Most healthy people can eat up to seven eggs a week with no increase in their risk of heart disease. Some studies have shown that this level of egg consumption may actually prevent some types of strokes.”

Great, you gave me all of this information…simplify it for me!

• Start by checking your levels! Most doctors will do a lipid panel for you (Total Cholesterol, HDL, LDL, Triglycerides). Use this as a baseline so that you can see how you’re body is trending over time. If you have elevated levels, evaluate your diet, make changes, and re-test in 3 months!

• Limit intake of unhealthy fats (bacon, fried foods, hydrogenated oils, convetionaly fatty meats, sausage, etc.)

• Replace processed meats with fatty fish (salmon, mackerel, tuna, halibut, etc) and lean protein (chicken, turkey, pork, lean ground beef).

• Replace simple carbohydrates (white breads, pastas, pastries, rolls, etc) with more complex carbohydrates (oats/oatbran, beans/legumes)

• Instead of sugary fruit and veggie juices, eat WHOLE fruits and vegetables, which have far less sugar and contain significant amounts of fiber!

• Instead of unhealthy salad dressings laden with saturated fat, try olive oil and vinegar or walnut oil for a nice twist.

• Keep processed foods (anything packed) to a minimum! Instead eat foods in their natural form.

Try this cholesterol-improving day of meals:

Here’s a power breakfast to start your day with.

• ½ cup rolled oats, dry
• 1 tbsp ground flaxseed
• 2 tbsp walnuts
• 1/4^th tsp cinnamon
• 1/4^th tsp vanilla extract
• 1 cup milk (if using non-dairy milk choose unsweetened)
• ½ cup berries

Heat milk in a small pot on the stove. Add in oats and ground flaxseed and cook as directed on oats container. Feel free to add more milk to reach desired consistency. Stir in cinnamon, vanilla, and walnuts. When oats are done top with blueberries and stevia to taste or 1-2 tsp of honey or brown sugar.

For staying power (protein) have with 1 hardboiled egg or 3oz of Nitrate Free Turkey .

As a heart healthy snack have:

1 sliced apple with 1-2 tbsp peanut or almond butter

For lunch have:

3 cups of mixed greens (spinach, kale, baby lettuce, arugula), 4-6oz chicken breast, ½ cup black beans, 1/2 sliced avocado, 1 tbsp cojita cheese, 1/4^th cup salsa, squeeze of fresh lime, 1/4^th cup tomatoes, 1/4^th cup sliced bell peppers (add any other veggie)

In need of another snack? Try one of these options:

• 1/4^th cup mixed nuts with 1 cup berries
• 1 harboiled egg mashed with 1/4^th avocado, salt, pepper on 1 slice of whole grain toast
• 4oz canned tuna in olive oil with a little sea salt and have with 1 cup cherry tomatoes

End your day with this:

5oz grilled salmon, ½ cup cooked quinoa, 1 cup roasted asparagus, 1 cup roasted butternut squash tossed lightly with olive oil, sea salt and pepper

Make sure to drink at least half of your body weight in ounces of water throughout the day! J

References:

http://ajcn.nutrition.org/content/85/1/225.full.pdf

http://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp#

http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192?pg=2

https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf