Clearing Up Cholesterol Confusion

CLEARING UP CHOLESTEROL CONFUSION

Over the past few years more of my friends are being told to watch their cholesterol intake. Some are actually losing weight and exercising more, others are popping the statin Lipitor. I was told I needed to cut back on my “bad” cholesterol. I’ve been advised to eat less processed foods, less meat, more fruits and vegetables—in other words the standard advice for eating healthier. In any case, I’ve decided to find out a bit more about cholesterol and I’m sharing my findings with you in this post.

Cholesterol is a soft, waxy fat that your body needs to function properly. However, too much cholesterol can lead to heart disease, stroke or atherosclerosis—a clogging or hardening of your arteries. Cholesterol comes from two sources. Your liver makes all the cholesterol you need. The remainder of the cholesterol in your body comes from foods derived from animals. For example, meat, poultry and full-fat dairy products all contain cholesterol, called dietary cholesterol.

As a senior, you should probably get your cholesterol tested every couple of years, more often if you have a heart condition. Here are excerpts from a Harvard Medical School article updated in April 2018, Making sense of cholesterol tests:

Time to get your cholesterol checked?  Okay, but which test should you get? It’s not so simple anymore. Here is a rundown of some of the choices and their pros and cons:

Total cholesterol. This is the simplest and least expensive test. The test doesn’t require any sophisticated lab work, either. The simple, do-it-yourself home tests measure total cholesterol.

But total cholesterol includes both “good” high-density lipoprotein (HDL) cholesterol, and the “bad” varieties, chiefly low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL). So if your total cholesterol is in the desirable category, it’s possible that you may have unhealthy levels of HDL (too low) and LDL and VLDL (too high). Think of total cholesterol as a first glimpse, a peek. Doctors are not supposed to make any treatment decisions based on this number alone.

Thus, you probably need a complete cholesterol test — also called a lipid panel or lipid profile — which is a blood test that can more closely measure the amount of cholesterol and triglycerides in your blood.

HDL cholesterol. HDL wins its laurels as the “good” cholesterol because it sponges up cholesterol from blood vessel walls and ferries it to the liver for disposal. In contrast, LDL deposits the harmful fat in vessel walls

An HDL level of 60 or above is associated with a lower risk of heart disease, and below 40 is associated with a higher risk.

Cholesterol: The good and the bad of it HDL High-density lipoprotein Makes up 20%–30% of total cholesterol The “good” cholesterol Moves cholesterol from arteries to the liver. LDL Low-density lipoprotein Makes up 60%–70% of total cholesterol Main form of “bad” cholesterol Causes build-up of plaque inside arteries. VLDL Very-low-density lipoprotein Makes up 10%–15% of total cholesterol With LDL, the main form of “bad” cholesterol A precursor of LDL.

 LDL cholesterol. The LDL measurement is usually considered the most important for assessing risk and deciding on treatment. The definition of a healthy level keeps on getting lower. For people at low risk of heart disease, an LDL of less than 100 is desirable, However, people at higher risk of heart disease, an LDL of less than 70 or perhaps even lower is considered “optimal.” Some experts say that an LDL of less than 70 would be a healthy LDL goal for all of us.

Your LDL is computed by plugging the measurements for total cholesterol, HDL, and triglycerides into a: LDL = Total cholesterol – HDL – (Triglycerides ÷ 5). LDL can also be measured directly in a non-fasting blood sample.

You have to fast for about 10 hours before the test because triglyceride levels can shoot up 20%–30% after a meal, which would throw off the equation. Alcohol also causes a triglyceride surge, so you shouldn’t drink alcohol for 24 hours before a fasting cholesterol test.

The numbers to know
Test	Generally desirable level
Total cholesterol	under 200 mg/dL
LDL (bad) cholesterol	under 100 mg/dL
HDL (good) cholesterol	over 60 mg/dL
Triglycerides	under 150 mg/dL

You, like me, might need to make changes in your diet. Here are excerpts from another Harvard Medical School article that was updated in July 2018, 11 foods that lower cholesterol:

It’s easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what foods you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream.

Doing this requires a two-pronged strategy: Add foods that lower LDL, the harmful cholesterol-carrying particle that contributes to artery-clogging atherosclerosis. At the same time, cut back on foods that boost LDL. Without that step, you are engaging in a holding action instead of a steady — and tasty — victory.

Add these foods to lower LDL cholesterol

Different foods lower cholesterol in various ways. Some deliver soluble fiber, which binds cholesterol and its precursors in the digestive system and drags them out of the body before they get into circulation. Some give you polyunsaturated fats, which directly lower LDL. And some contain plant sterols and stanols, which block the body from absorbing cholesterol.

1. Oats.
2. Barley and other whole grains..
3. Beans. Beans are especially rich in soluble fiber. They also take awhile for the body to digest, meaning you feel full for longer after a meal. That’s one reason beans are a useful food for folks trying to lose weight.
4. Eggplant and okra.
5. Nuts
6. Vegetable oils. Using liquid vegetable oils such as canola, sunflower, safflower, and others in place of butter, lard, or shortening when cooking or at the table
7. Apples, grapes, strawberries, citrus fruits..
8. Foods fortified with sterols and stanols. Sterols and stanols extracted from plants gum up the body’s ability to absorb cholesterol from food. Companies are adding them to foods ranging from margarine and granola bars to orange juice and chocolate.
9. Soy.
10. Fatty fish..
11. Fiber supplements. Supplements offer the least appealing way to get soluble fiber. Two teaspoons a day of psyllium, which is found in Metamucil and other bulk-forming laxatives, provide about 4 grams of soluble fiber.

 

Reduce cholesterol levels by avoiding these foods:

Saturated fats. Typical sources of saturated fat include animal products, such as red meat, whole-fat dairy products and a few vegetable oils, such as palm oil, coconut oil and cocoa butter.

Trans fats. The right amount of trans fats is zero! That’s why the FDA banned trans fats from the U.S. food supply.  Trans fats are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. These fats have no nutritional value — and we know for certain they are bad for heart health. Trans fats increase LDL cholesterol and triglyceride levels while reducing levels of HDL cholesterol.

Weight and exercise. Being overweight and not exercising affect fats circulating in the bloodstream. Excess weight boosts harmful LDL, while inactivity depresses protective HDL. Losing weight if needed and exercising more reverse these trends.

Putting together a low cholesterol diet

A largely vegetarian “dietary portfolio of cholesterol-lowering foods” substantially lowers LDL, triglycerides, and blood pressure. The key dietary components are plenty of fruits and vegetables, whole grains instead of highly refined ones, and protein mostly from plants.

Of course, shifting to a cholesterol-lowering diet takes more attention than popping a daily statin with its possible side affects. It means expanding the variety of foods you eat and getting used to new textures and flavors. It’s probably worth it!