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Cholesterol
By Naomi Graves, Pharm. D.
August 31, 2004 |
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September is National Cholesterol Education Month!
Do you know your cholesterol numbers? If not, find out! Lewis Drug regularly conducts cholesterol screenings. About half of American adults have borderline-high or high cholesterol. So what? Well, for women, you have a 1 in 3 chance of developing heart disease sometime in your life. Men, your chances of developing heart disease are 1 in 2! Heart disease is the number one killer of both men and women in the United States. Every 33 seconds, an American dies from heart disease. High cholesterol is related to heart attacks, stroke, and maybe even dementia.
What is Cholesterol and Why is it Bad?
Cholesterol is a fat-like substance that occurs naturally in cells everywhere in your body, including the brain, nerves, muscle, skin, liver, intestines, and heart. Cholesterol is necessary for your body to produce some hormones, vitamin D, and the bile acids that help to digest fat. However, our bodies can make the cholesterol they need to do these things. When there is too much cholesterol in your bloodstream, the extra builds up in the blood and narrows the arteries; this forms “plaque.” Plaque can break away from the walls of blood vessels and get lodged somewhere. When this happens in the heart, it may cause a heart attack. When blood vessels are blocked in the brain, a stroke may occur.
There are two kinds of cholesterol, HDL (“healthy”) and LDL (“lousy”). LDL causes problems. HDL helps carry away LDL to the liver, where the body can get rid of it. Remember this: you want your HDL to be HIGH and your LDL to be LOW.
When you get your cholesterol checked, you can learn your HDL and LDL numbers. Before we discuss the cholesterol goals, we need to learn about the heart disease risk factors.
What Are Heart Disease Risk Factors?
- Diabetes
- History of heart disease or stroke
- Cigarette smoking
- High blood pressure (untreated or treated)
- Low HDL (less than 40)
- Heart disease in father or brother before he was 55 or heart disease in mother or sister before she was 65
- Age (men 45 years or older; women 55 years or older)
(Note: if your HDL cholesterol is over 60, you get to subtract one risk factor.)
What Are Cholesterol Goals?
If you have very high risk, your LDL goal is less than 100 (even better when less than 70). You are at very high risk if you already have heart disease or disease of the blood vessels to the brain, you have diabetes, or your have two or more risk factors together with a 20% chance of having a heart attack within 10 years. Calculate your 10-year risk here. (external link)
If you have moderately high risk, your LDL cholesterol goal is less than 130 (even better less than 100). You are at moderately high risk if you have two or more risk factors.
If you have low risk, your LDL cholesterol goal is less than 160. You are at low risk if you have one or no risk factors.
How is High Cholesterol Treated?
Depending on the number of risk factors and cholesterol goals, you may need to begin a low cholesterol diet or begin drug therapy. Look here (external link) to see charts that help health care professionals decide whether you need drug therapy or whether you should try a low-cholesterol diet. Note that treatment goals just changed in July 2004 for people with very high or moderately high risk. People with very high risk can be treated until the LDL is less than 70, and people with moderately high risk can be treated until the LDL is less than 100. Confused? Ask your pharmacist or doctor for more information.
If your LDL cholesterol is higher than your goals, your doctor may ask you to try a low-fat, low-cholesterol diet or may begin a medication. I will focus on diet in this article; you can learn more about medications here (external link) or by talking with your pharmacist.
Your doctor may recommend exercise as part of your cholesterol-lowering plan, too. 30-60 minutes of exercise each day will not only help lower your cholesterol and shed pounds, it will also help you feel great about yourself!
Stop smoking. I know that’s easier to say than to do, but talk to your pharmacist or doctor for help. You can quit, and your heart will thank you!
Healthy Food Choices
Saturated fat and trans fats cause problems, so try to keep them out of your meals! In fact, try to get less than 10% of your total daily calories from a combination of saturated fats and trans fats. Foods that contain these fats include eggs, fatty meats, whole milk, butter, margarine, shortening, french fries, doughnuts, cookies, and cakes.
Polyunsaturated fats are liquid at room temperature and when refrigerated. They may help get rid of cholesterol deposits in the blood. Guidelines suggest using them for 10% or less of your daily calories. Examples are vegetable, safflower, corn, sunflower, soy, and cottonseed oils.
Monounsaturated fats are also good. These will help your stomach empty slowly after a meal, helping you feel full longer. Examples of monounsaturated fats are avocados, most nuts, and olive, peanut, and canola oils.
In general, limit your intake of fats to 30% of your daily calories. Fats contain twice as many calories as protein and carbohydrates. However, you’ll want to keep 20-35 grams of fat in your diet each day. Your body needs the fat to insulate itself, to carry fat-soluble vitamins, and to keep your skin and hair healthy.
Try adding more omega-3 fatty acids to your diet. These can actually decrease your risk of heart disease! Healthy choices include salmon, herring, lake trout, sardines, flaxseed, and soybean and canola oils.
Use Take Control or Benecol instead of standard margarines. These products are made from plants and can block the absorption of cholesterol.
Add fiber to your diet. Fiber-rich foods such as oatmeal and vegetables will help your body get rid of up to 5% of the fats eaten in a meal.
Learn more about the TLC (Therapeutic Lifestyle Changes) diet here. (external link)
Would You Like to Learn More?
For more information about cholesterol, go to http://www.nhlbi.nih.gov/chd. This is a great interactive website, and the source of most of my information.
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