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More On Cholesterol

In lasts week’s article we talked about dietary fats and explained why elevated blood fats (called “lipids”) are so detrimental to one’s health.  We discussed how there are many different types of fat, some of which are healthy, and some of which are very harmful.

I believe that every adult should know his or her own lipid levels, just like they know their blood pressure reading.  You should have your lipid levels checked about every three years, unless you currently have abnormally high levels and/or you have other cardiac risk factors, in which case you will want to check your levels much more frequently (your physician will tell you how often you need to do this).  A complete lipid panel will measure your total cholesterol level, a total triglyceride level, and an HDL and LDL level.

Remember:  you should be fasting at least 5 hours or more when you have your lipids checked for the most accurate results.

There are more esoteric lab tests available as well (e.g. homocysteine levels, C Reactive protein levels, etc) but these are indicated only when one is at significant risk for cardiac disease—your doctor can help you decide if you want these levels as well).

HDL cholesterol, or High Density Lipoprotein, is the healthy blood lipid.    It has been shown to promote arterial wall health.  It somehow causes the artery to rid itself of excess fat buildup and thus could be viewed as an arterial cleanser.  It scours the blood vessels, keeping them healthy and clear of obstruction.  The higher the reading of HDL, the better.  For every one point rise in HDL levels, we reduce our risk of heart attack by 2-3%.

HDL cholesterol should be greater than 50 in a healthy, well-conditioned female adults and greater than 45 in males.  If your level is in the lower 40’s you are considered “borderline” and you have some work to do.  If your HDL is below 40, you not only have some work to do but you may even need medication.  Your own personal physician will help you make this decision.

What increases HDL Cholesterol?

There are many things that can help raise your HDL.  Exercise is one of the most helpful things you can do.  I am not talking about having to go out and kill yourself exercising—simply walking at a brisk pace for 30 minutes every day will raise your HDL levels.  A few years ago after I had my back surgery, I started a walking program 30 minutes each morning.  When I started, my HDL was 38.  My other cholesterol levels were fine.  I checked my HDL last year and it had risen to 50!  I don’t with exercise, but I am consistent every day with my 30 minute walk.

Not smoking is very important in raising HDL.  This should not be a problem for the members of our Church who follow the word of wisdom, but I wanted to mention it to be complete.  If you or someone you know smokes (cigarettes, pipe, cigar, marijuana—anything) encourage them to quit.  It is arguably the best thing overall you can do for your health.

Weight loss helps raise HDL.  Isn’t that interesting?  You might think that because HDL is a type of cholesterol that gaining weight would make it rise.  But it doesn’t.  Weight loss raises HDL.

Eating less saturated fat (which comes mainly from animal-based food products) raises HDL.  You can still consume fats but make sure they are mono-unsaturated (Olive oil, Canola oil) or poly-unsaturated fats.  One note of caution:  some of the poly-unsaturated oils also contain trans-fatty acids (partially hydrogenated vegetable oils), which are very bad for the arterial wall.

LDL Cholesterol, or low-density lipoprotein, is very bad for the arteries.  This has been proven conclusively.  LDL cholesterol measurements are considered optimal if they are under 100.  One is considered “borderline” if one’s reading is 100-130; at these levels you need to do some work but there need not be a feeling of panic.  However, if your LDL is greater than 130, you have a problem that needs to be addressed through dietary changes and/ or cholesterol lowering medication (the latter is used if you have other cardiac risk factors—your doctor wall help you decide).  If your level is greater than 160 you should definitely consider cholesterol-lowering medications as well as diet modification.

Lowering the LDL Cholesterol:

We usually (but not always) see elevated LDL levels in patients who are overweight, who consume way too much saturated fat in their diets, or who have a genetic predisposition (it runs in the family).  Therefore, lowering this LDL monster requires weight loss, exercise, dietary modification, and changing your family tree!  Of course the latter is impossible so we better focus on the former.

I just mentioned above that weight loss and exercise both increase the good HDL cholesterol levels while reducing the bad LDL levels.  Isn’t it nice that we can accomplish these two goals (raising HDL and lowering LDL) just by starting a walking program 30 minutes each day and by trying to lose just 1-2 pounds per week?  I know it is “easier said than done” but you would be surprised at how much healthier a person would be if they followed this advice.

Animal-source foods are rich in saturated fats, which are then converted into LDL cholesterol in our own livers.  This is why the cardiologists have been begging us for years to reduce our intake of saturated fats (big juicy hamburgers, thick tasty steaks, deep fried foods, whole milk, high fat cheese, real butter...the list goes on and on).

The problem we have run into is that the cardiologists (and other medical authorities) were right in one sense but wrong in another:  they begged us to give up saturated fats (correctly) but in their place they suggested carbohydrates (starches and sugars).  We now know that because carbs are readily converted into triglyceride (good old “fat”) by our bodies, and then converted into LDL cholesterol by our own livers, that this advice didn’t help our LDL levels much at all.  At the end of the day we simply were trading dietary fat for sugar, which then got converted to fat in our bodies anyway.  We did not improve our LDL levels but we sure created a lot of new diabetics!

The answer, I believe, is a low saturated fat, high protein diet that is also low in refined starches and sugars.  I will be discussing these types of diets next week.