Any discussion of heart disease and its risk factors is often joined by a discussion of cholesterol. Last week we talked about the basics of what cholesterol is and how it is measured. This week let’s talk about what we can do to improve our cholesterol numbers and lower the risk of developing cardiovascular disease. Just because we have MS doesn’t mean that we are immune to developing other serious diseases.
In heart disease, there are two types of risk factors "” those you can’t change (age, sex, and family history of early onset heart disease) and those you can (smoking, high blood pressure, high blood cholesterol, being overweight/obesity, physical inactivity, and diabetes- type II). High cholesterol can lead to atherosclerosis (hardening of the arteries) which can then lead to heart attack or stroke when plaque in the artery breaks loose.
Factors that increase LDL
The three main contributors to high LDL (low density lipoprotein), the "bad" cholesterol, levels are diet high in saturated fat, excess weight, and physical inactivity. Diets with too much saturated fat, trans fat, and cholesterol are the main cause for high levels of blood cholesterol. Excess weight and physical inactivity tend to increase your LDL level, while raising triglycerides and lowering HDL (high density lipoprotein), the "good" cholesterol. Conversely, regular physical activity can raise HDL, lower triglycerides, lower LDL, and help you lose weight.
Saturated fats are found primarily in foods that come from animals (ie. meat, egg yolks, shrimp, dairy products, and lard) are usually solid at room temperature. Cholesterol in the diet also comes from animal products. Trans fat, also called trans fatty acids, is found in foods made with hydrogenated vegetable oils, such as stick margarine, crackers, and french fries. According to the National Heart, Lung, and Blood Institute (NHLBI), saturated fat raises your LDL cholesterol level more than anything else in your diet.
Unsaturated fats are usually liquid at room and refrigerator temperatures. Unsaturated fat is found in vegetable oils, nuts, olives, avocados, and fatty fish, such as salmon, tuna, and mackerel. While eating foods rich in omega-3 fatty acids - a type of polyunsaturated fat found in fatty fish and in some plant sources (such as walnuts, canola and soybean oils, and flaxseed) - doesn’t lower LDL levels, it does protect the heart by limiting inflammation in the artery walls and by preventing blood clots from forming.
Therapeutic Lifestyle Changes (the TLC Program)
Decreasing LDL cholesterol is not just about changing your diet, it is about altering your lifestyle. Making lifestyle changes is never easy so keep your goals in mind. Lowering cholesterol, reducing risk factors for heart disease, and living healthier and longer. I’d like to point out that many of the suggestions found in healthy-heart literature complement the various dietary approaches used in treating multiple sclerosis.
Read these posts for more information:
The Therapeutic Lifestyle Change Program as outlined by NHLBI (pdf) has three parts:
* Diet: Decrease saturated fat, trans fat, and cholesterol. Increase intake plant stanols and sterols. Increase intake of soluble fiber (ex. oatmeal, barley, apples, peaches, bananas, hard beans, lentils, broccoli, carrots).
* Physical Activity: Try to get at least 30 minutes of moderate-intensity activity on most days of the week.
* Weight management: If you are overweight, losing even 10 percent of your current weight lowers your risk of heart disease.
With the TLC Diet Guidelines, you should eat:
* Less than seven percent of the day’s total calories from saturated fat.
* 25 to 35 percent of the day’s total calorie from fat.
* Less than 200 milligrams of dietary cholesterol a day.
* Limit sodium intake to 2400 milligrams a day.
* Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level. (Ask your doctor or registered dietitian what is a reasonable calorie level for you.)
Links to collections of heart-healthy recipes and meals were provided in the previous post. But I found another page full of recipes which you might enjoy - Stay Young at Heart: Cooking the Heart-Healthy Way.
When making lifestyle changes, I like the idea of taking a "SMART" approach. Set goals which are Specific, Measured, Appropriate, Realistic, and Time-bound. Don’t be vague or generic in setting goals. Be specific. More importantly, be realistic in setting your goals. Keep them small and achievable. Set yourself up for success!
Work closely with your doctors, dietitian, or other health care providers. They can help you learn how to eat healthy, satisfying meals, find a weight loss program, or learn to engage in physical activities safely and effectively. Keep a diary of what you eat (including amount and nutritional values), what physical activities you engage in (including length and intensity), and your weight (if you need to drop pounds).
Cholesterol-Lowering Medications and their Use in MS
In the next post, we’ll discuss the various types of cholesterol-lowering medications and the research exploring their use (specifically statins) in the treatment of multiple sclerosis. To date, the results have been contradictory and inconclusive. Please come back next week to learn more.
SOURCES: High Blood Cholesterol: What You Need To Know (pdf) by NHLBI