Nutrition With an Attitude
by Mary S. Choate, M.S., R.D.

Working the Numbers:
Eating to Improve Your Cholesterol Level

You’ve just had your yearly checkup with your doctor, and you have discovered that your cholesterol results will need improvement. High total cholesterol levels and other lipid (blood fat) levels can mean that you are at a higher risk for a heart attack or stroke. For many people, making healthful eating and activity changes will result in a lower cholesterol level.

Total Cholesterol
A total cholesterol of less than 200 mg/dL (milligrams per deciliter of blood) puts you at lower risk for heart disease. A person with high blood cholesterol (240 mg/dL and above) has more than twice the risk of heart disease of someone whose cholesterol is below 200 mg/dL.

The Good Guys: High-Density Lipoprotein (HDL)-Cholesterol
This kind of cholesterol has a good reputation for a reason. Its job is to move cholesterol from other parts of the body to the liver for excretion, keeping fatty cholesterol buildup in the arteries from forming.

An HDL-cholesterol level of 60 or more mg/dL is considered to be protective against heart disease. A low HDL-cholesterol level (less than 40 mg/dL) is a major risk factor for heart disease.

The Bad Guys: Low-Density Lipoprotein (LDL)-Cholesterol
LDL-cholesterol transports cholesterol from the liver to the rest of the body. As it circulates, it deposits cholesterol onto artery walls, where it forms sticky plaques that may eventually block the artery. An LDL-cholesterol level of less than 100 mg/dL is optimal.

Triglycerides
An elevated triglycerides level is significantly linked to a higher risk of heart disease. A healthy goal for this blood fat is below 150 mg/dL.

Your Eating Plan to Reduce Your Cholesterol Level
Foods high in saturated fat can raise your cholesterol level, especially LDL-cholesterol. The cholesterol you eat will raise your blood cholesterol to a lesser extent than saturated fat will, but should still be limited, especially if you have heart disease or diabetes.

Use the "Nutrition Facts" labels on food packages to help keep the amount of cholesterol you eat to 300 milligrams or less each day. People with diabetes, heart disease, or high LDL-cholesterol should limit it to 200 mg per day. Label reading can also help you limit your saturated fat intake to not more than 20 grams per day.

Cholesterol is found only in foods from animals, such as eggs, meat, poultry, fish, and dairy products. Limiting whole eggs to three or four per week and the portion size of animal protein foods to three ounces cooked (about the size of a deck of cards) is an easy strategy to decrease the cholesterol you eat. Choosing foods low in cholesterol means including fruits, vegetables, nuts, and whole grain foods in meals and as snacks.

Foods that are naturally low in saturated fat are fruits and vegetables; whole grains and foods made from grains like most cereals, rice, and pasta; lean red meats and poultry without skin; low-fat or fat- free dairy products; lean fish and shellfish; nuts, beans, and peas; and vegetable oils such as olive, canola, safflower, sunflower, peanut, and soy.

Foods to avoid or limit because they are high in saturated fat and/or cholesterol are whole milk; cream; ice cream; butter; egg yolks; cheese; bakery goods; saturated oils like coconut oil, palm oil, and palm kernel oil; organ meats like liver, sweetbreads, kidney, and brain; high-fat processed meats like sausage, bologna, salami, and hot dogs; fatty red meats that aren’t trimmed; duck and goose meat; and solid fats like shortening, regular stick margarine, and lard.

A type of saturated fat not listed on the Nutrition Facts label is called "hydrogenated" or "partially hydrogenated" oil. This kind of fat starts out as a heart-healthy unsaturated vegetable oil, but is processed to make it more solid and more saturated. Hydrogenated fats can raise cholesterol levels, particularly LDL-cholesterol. Read ingredient labels on cookies, snack foods, stick margarine, and baked goods to limit this kind of fat.

Soluble fiber, like that found in oat bran, oatmeal, beans, peas, rice bran, barley, psyllium seed, flaxseed, citrus fruits, strawberries, and apples has been shown to help lower blood cholesterol, and LDL-cholesterol in particular. Eating these foods several times a week may help to lower LDL-cholesterol.

Special margarines and dressings containing a concentrated form of plant sterols and stanols have also been shown to be effective. At the Co-op, we carry Take Control and Benecol brands. These must be used in the amount recommended on the package each day. Using less is not as effective.

Twenty–five grams of soy protein per day has been shown to reduce LDL-cholesterol levels. Try mixing a soy protein powder in juice or eating soy foods such as soy nuts, soymilk, soy burgers, tofu, tempeh, or the numerous other soy products available.

Choose monounsaturated fats, such as olive and canola oil, for home use in cooking and baking. These fats tend to lower LDL-cholesterol without affecting HDL-cholesterol levels.

Maintaining a healthy weight and participating in regular physical activity are additional ways to reduce LDL-Cholesterol.

Raising HDL-Cholesterol
In some people, eating too many simple carbohydrates can decrease HDL–cholesterol levels. Sources of simple carbohydrates are ingredients like sucrose, table sugar, brown sugar, confectioner’s sugar, fructose, raw sugar, turbinado sugar, glucose, dextrose, maple syrup, corn syrup, honey, maltose, and dextrose.

Food choices that are rich in the heart-healthy complex carbohydrates and fiber are whole grain breads and cereals, rice, corn, oats, barley, potatoes, legumes, fruits, and vegetables.

Moderate drinking (one to two alcoholic drinks per day) increases protective HDL-Cholesterol. This effect happens equally with different kinds of alcohol-containing beverages. The American Heart Association has stated that this benefit isn’t great enough to recommend drinking alcohol if you don’t do so already.

Both weight control and regular physical activity, even plain old walking, raise HDL-cholesterol. Smoking has been shown to lower HDL-cholesterol levels.

Lowering Your Triglyceride Level
For some people, bringing down a high triglyceride level is first in their heart health plan.

Increasing the amount of unsaturated fat in the diet, while also decreasing the simple carbohydrates and saturated fat (to keep your total calorie intake at a healthy level), can help with lowering triglyceride levels in some people.

Even small amounts of alcohol can lead to large increases in blood triglycerides. So limiting or even avoiding alcohol altogether may be appropriate.

Weight control and physical activity are also effective triglyceride-lowering tools.

How Quickly Will Your Numbers Change for the Better?
Within just a few weeks, the healthy changes you make will show up in a lower cholesterol level. For some people, even with a healthy eating and activity plan, their cholesterol levels remain high. In this case, they should discuss other approaches to cholesterol lowering with their personal healthcare professional.

The information in this article is of a general nature. You may wish to speak to your health professional or a registered dietitian working closely with your own healthcare practitioner to develop a plan based on your personal and family history and current health status.

More Ways to Whip Cholesterol into Shape!
There are many resources for more information about how to make these positive heart-healthy changes. Some of them are listed below:

At the Co-op, you can sign up for a grocery store tour with me to go over personalized meal and snack planning strategies focused on cholesterol lowering.

The research-based Healthnotes health information kiosks in both Co-op Food Stores are a good source of additional information regarding herbs and supplements which may be useful for maintaining or improving heart health.

On the web, visit:
The American Heart Association site for more information about heart-healthy eating, including recipes: www.americanheart.org

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