Wednesday, September 27, 2006
Question:
I just found out my cholesterol is high and I should watch what I eat. I'm so confused!! I don't eat fried foods. I use olive oil. I take the skin off of chicken. I eat a red meat maybe once a week. I eat alot of fish/salmon. I try to walk alot. I'm not a couch potato. I'm not overweight. (I do have a little extra around my stomach) My cholesterol was high one year ago too. I've made an appt with my doctor, but she is probably going to tell me to watch what I eat again!!!! Suggestions??
Reply:
Dear reader,
I’m sorry to hear that you are having some trouble with maintaining good cholesterol levels despite eating what sounds like a good heart healthy diet. But I am glad that you are taking your cholesterol level seriously and have been following it over the past year.
The first thing I would suggest is to more closely examine your cholesterol profile including the LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. Remember that total cholesterol is a summation of good + bad cholesterol. It is possible to have a high total cholesterol value and still not be at increased risk for heart disease. This is most often seen in pre-menopausal women or young athletic adults who have elevated levels of HDL cholesterol and normal range LDL levels. Also, the LDL component of your cholesterol profile is of particular importance since LDL can greatly affect your risk of heart disease. High values are >160mg/dl and borderline high values between 130-159mg/dl. (see table below regarding cholesterol levels)
If you do indeed have elevated bad cholesterol and assuming no secondary cause is at play such as low thyroid levels, then action is warranted. A good heart healthy diet is generally what you described…low in saturated fats, trans fatty acid, and cholesterol. A very regimented and consistent healthy diet can lower cholesterol levels on the order of 10-30%. Unfortunately, these types of diets are often difficult to maintain and require constant vigilance as bad fats seem to be ubiquitous in everyday food. It’s always a good idea to double check what’s in the food you eat and drink especially if you didn’t have to make it from scratch. There are some foods you can eat that can actively lower your cholesterol. Red yeast rice, cholesterol lowering margarines such as Benecol or Take Control, nuts such as walnuts and almonds, green tea, and soluble fiber such as psyllium and oat nuts have all been shown to have mild to modest effects in lowering your cholesterol.
Exercise is beneficial to improving cholesterol but it depends on how much, how often, and how hard. You mentioned that you try to walk a lot. The general recommendation is not to try but to do at least 30minutes of moderate-intensity (brisk walking) activity on most, if not all, days of the week. There is a clear association between more frequent, higher intensity exercise and improved cholesterol levels. Often times your HDL and triglycerides will improve more dramatically than your LDL. Perhaps this is an area you can improve upon.
I just found out my cholesterol is high and I should watch what I eat. I'm so confused!! I don't eat fried foods. I use olive oil. I take the skin off of chicken. I eat a red meat maybe once a week. I eat alot of fish/salmon. I try to walk alot. I'm not a couch potato. I'm not overweight. (I do have a little extra around my stomach) My cholesterol was high one year ago too. I've made an appt with my doctor, but she is probably going to tell me to watch what I eat again!!!! Suggestions??
Reply:
Dear reader,
I’m sorry to hear that you are having some trouble with maintaining good cholesterol levels despite eating what sounds like a good heart healthy diet. But I am glad that you are taking your cholesterol level seriously and have been following it over the past year.
The first thing I would suggest is to more closely examine your cholesterol profile including the LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. Remember that total cholesterol is a summation of good + bad cholesterol. It is possible to have a high total cholesterol value and still not be at increased risk for heart disease. This is most often seen in pre-menopausal women or young athletic adults who have elevated levels of HDL cholesterol and normal range LDL levels. Also, the LDL component of your cholesterol profile is of particular importance since LDL can greatly affect your risk of heart disease. High values are >160mg/dl and borderline high values between 130-159mg/dl. (see table below regarding cholesterol levels)
If you do indeed have elevated bad cholesterol and assuming no secondary cause is at play such as low thyroid levels, then action is warranted. A good heart healthy diet is generally what you described…low in saturated fats, trans fatty acid, and cholesterol. A very regimented and consistent healthy diet can lower cholesterol levels on the order of 10-30%. Unfortunately, these types of diets are often difficult to maintain and require constant vigilance as bad fats seem to be ubiquitous in everyday food. It’s always a good idea to double check what’s in the food you eat and drink especially if you didn’t have to make it from scratch. There are some foods you can eat that can actively lower your cholesterol. Red yeast rice, cholesterol lowering margarines such as Benecol or Take Control, nuts such as walnuts and almonds, green tea, and soluble fiber such as psyllium and oat nuts have all been shown to have mild to modest effects in lowering your cholesterol.
Exercise is beneficial to improving cholesterol but it depends on how much, how often, and how hard. You mentioned that you try to walk a lot. The general recommendation is not to try but to do at least 30minutes of moderate-intensity (brisk walking) activity on most, if not all, days of the week. There is a clear association between more frequent, higher intensity exercise and improved cholesterol levels. Often times your HDL and triglycerides will improve more dramatically than your LDL. Perhaps this is an area you can improve upon.
