OVER THE COUNTER: Making cholesterol your ally, and not your enemy
If you read the news these days, there seems to be so many things to worry about: terrorism, the spread of rare pathogens, ghastly crimes and the list goes on. But, in reality, in our modern world, our biggest threat is far less exciting: It's heart disease.
Responsible for a quarter of all deaths in America, heart disease is the nation's main killer. And one of the biggest risk factors for the disease is high cholesterol, especially the so-called bad kind, LDL, or low-density lipoprotein.
Fortunately, however, cholesterol levels can be controlled and lowered, through better eating, exercising, supplements and, if necessary, medication, allowing us to greatly improve our odds in the battle against heart disease. (Keeping blood pressure down is another important tool in the fight, too, but we will save that for another column.)
Unfortunately, cholesterol is complicated. First, despite its bad reputation, the waxy, fat-like substance is not necessarily an enemy. In fact, we need it to make vitamin D and hormones and it plays a role in digestion. We get it from foods and our bodies naturally produce it.
But when we have too much of the substance in our blood, cholesterol becomes a silent threat, increasing our risk of coronary artery disease, heart attack and stroke. We must keep track of the amount of it in our blood, and the kind, whether LDL or HDL. The only way to do that is to enlist the help of a doctor who will run a blood test. Your total numbers should be below 200 mg/dL, and your LDL number should be under 100 mg/dL. Your "good" cholesterol, known as HDL, or high-density lipoprotein, should be 60 mg/dL or higher. Yes, you read that correctly, higher is typically better here, as HDL is viewed as cholesterol's clean-up crew, picking up the trail of hazardous fatty substances from our bloodstream. When you get a cholesterol test, you'll see another number, and that's for total triglycerides; these should be below 150 mg/dL.
So, what weapons do we have to control cholesterol? The short answer is many.
First, eat differently. Consider the kinds of fats you're consuming, and ditch the ones from meat and dairy. Instead, choose healthier fats from nuts, flax seeds, olive oil, fish and avocados. Reject any foods with trans fats, including those hidden ones lurking in foods, such as pancake mixes, made with small amounts of partially hydrogenated oils. Cholesterol in foods such as eggs and shrimp should be watched, but saturated and trans fats actually are more likely to boost your cholesterol levels, especially the bad kind.
Fats, however, are only part of the equation here. We advise reaching for as many fiber-rich foods as possible. This doesn't mean you have to eat oatmeal and cereal that looks like twigs. If you can't stand the mealy mixture or breakfast flakes that resemble wood chips, don't worry, there are plenty of more colorful and tasty options, such as fruits, vegetables, lentils, legumes and beans – most of which are high in beneficial plant sterols.
Including more tofu and edamame in your diet is also helpful. And, surprisingly, eating more whey protein – even if you're not a weightlifter – has been linked to better cholesterol numbers. Choosing the right whey product is important: it should come from grass-fed, free-range cows, raised without hormones or antibiotics.
Second, exercise. Getting 30-minutes of exercise a day is ideal, but everything counts, such as walking more, playing more sports, and taking the stairs instead of the elevator to the office. Working out can increase your HDL levels, and help you lose weight, another risk factor for high cholesterol and heart disease.
Third, if you haven't already, quit smoking and cut down on alcohol. Of the many side effects of these two vices is poorer cholesterol numbers. Coffee is OK, as long as it's the filtered type, and free of too much cream. Even better, green tea may actually help slightly boost HDL levels.
Fourth, consider supplements to improve your levels. Taking a few grams daily of omega 3, 6 and 7 fatty acids – such as from fish oils – may improve your HDL levels and lower you LDL levels. Supplementing with niacin, chromium picolinate, panax ginseng, garlic, artichoke extract, bergamot (a type of Italian citrus fruit), barley, and fenugreek may also help.
Finally, if you've tried everything and can't get those numbers where they should be, medication is recommended. Statins are the most commonly used drug for getting cholesterol in a safe range, but keep in mind that these come with side effects, such as constipation or diarrhea, stomach pain and cramps, and muscle soreness, pain and weakness. Such side effects are far less of a concern, however, than the clogged arteries that these drugs treat.
As September is National Cholesterol Education Month, think of this as a good time to get your numbers checked, particularly if you haven't done so in a few years. You won't know if your levels are creeping up unless you get tested. And only when you know, can you do anything to improve your cholesterol levels.
Treat heart disease like the adversary it is, and work to make cholesterol your ally.