Inaugural bells & peppers Q&A: What to do about high cholesterol

​Hello, friends, and welcome to the inaugural bells & peppers Q&A post – you asked, and I deliver! But first, the recovering attorney in me feels compelled to include the following disclaimer: I am not a doctor, a nurse or a health professional. As a certified nutritionist, I am not licensed to TREAT illness through nutrition or other lifestyle changes, and it is important that you seek the advice and recommendations of your medical professional, particularly when dealing with a medical diagnosis such as high cholesterol.
 
OK. Attorney hat is now removed. 

So what the heck is cholesterol anyway?

​Several of you asked me this week to address the issue of high-cholesterol, and this is not a surprise, since 1 in 3 Northern Americans suffer from this problem. Cholesterol is a sterol (fancy that – chole“sterol”…), which is a molecule found in animals that is essential to the production of certain hormones, including the all important vitamin D (Did you know vitamin D is a hormone and not a vitamin? Now store that in your memory bank for your next game of Trivial Pursuit.). Cholesterol is also a component of all of our cell membranes. Our bodies produce cholesterol – our livers to be more exact – to the tune of 1-2 grams per day. You also get cholesterol from foods, more specifically, from animal-derived foods like meat and dairy (plants do not have cholesterol). Strangely, your body produces more cholesterol when you eat certain foods with more cholesterol, such as saturated and trans fats, providing a double whammy. 

​There are 2 types of cholesterol – HDL (high-density lipoprotein) and LDL (low-density lipoprotein), although technically, HDL and LDL are not really forms of cholesterol but rather lipoproteins (as their names suggest) that carry cholesterol throughout your body (another Trivial Pursuit factoid). HDL is often referred to as “good” cholesterol and LDL as “bad” (or “lousy”) cholesterol, basically because HDL transports extra cholesterol to your liver for disposal, and LDL transports cholesterol and fat from your liver to the rest of your body. LDL is also the main ingredient in blood vessel plaque, which can build up and cause blockages that lead to cardiovascular disease (CVD). So when assessing your cholesterol levels, you want your LDL levels to be a good bit lower than your HDL – having a high HDL level is actually a good thing. 

And why is cholesterol such a bad thing?

Historically, individuals with total cholesterol levels over 200 mg/dL were considered to have “high” cholesterol, although new research suggests that 150 mg/dl might be a better cut-off. There has been a significant amount of controversy recently over the impact of cholesterol on health and whether it really is as problematic as we were once led to believe, since there are some cultures in the world where cholesterol levels are generally “high” but whose populations do not suffer the same cardiovascular issues we have in this country (and nearly half of all heart attacks occur in people with “normal” cholesterol levels). In fact, researchers are now even questioning whether the egg, which has been maligned for years as a major culprit in the high cholesterol epidemic, actually is a problem at all when it comes to your cholesterol levels. 

​I have done a good bit of research on the issue of high cholesterol and its relationship to heart disease because my family history includes individuals who have suffered from both, including my dad, who passed away of Alzheimer’s Disease in 2013. What the most updated studies suggest is that our emphasis on cholesterol numbers does not provide a holistic picture of our health or propensity for cardiovascular disease. The research suggests instead that the combination of your cholesterol levels and the level of internal inflammation in your body, measured by the level of C-Reactive Protein (CRP) in your blood, a substance released by cells during the inflammation process, is more telling in terms of your risks of heart disease. 

​Basically, atherosclerosis, or the hardening and narrowing of arteries that is responsible for heart disease, is an inflammatory disease, and as the walls of your arteries become more damaged due to inflammation, it becomes easier for LDL particles to “stick” to the walls, build-up and cause blockages (my apologies to the heart doctors out there for this simplistic explanation). Ultimately, if you have high cholesterol or are concerned about heart disease, ask your doctor to test your CRP level. A level under 1 mg/L is considered “low” and over 3.0 mg/L is “high,” while levels between 1.0 and 3.0 mg/L are considered “average.” 

You do not want your arteries to look like this.

​One interesting side note is that they are finding that plaque build-up in the brain might be responsible for Alzheimer’s Disease (and my dad suffered from a blocked artery, a heart attack and later Alzheimer’s – a coincidence?), which may explain why renowned American neurosurgeon Dr. Sanjay Gupta has declared that when it comes to lifestyle habits “what is good for your heart is good for your brain.” 

So all of that is interesting, but what can I do if I have high cholesterol?

​Now, what you really want to know is what to do about high cholesterol. Again, your first step should be to visit your doctor, get your cholesterol and CRP levels tested and discuss a comprehensive treatment protocol with him/her. Depending on the results of the tests and your risk factors, that protocol might include taking statins, cholesterol-lowering drugs that are among the most widely used medications in this country. With about 28% of Americans over 40 taking a cholesterol-lowering drug and more than 90% of these individuals on statins, it is clear that statins are big business.

​While statins play an important role in treating some patients with high cholesterol, like all medications, they can cause undesirable side effects, such as memory loss, type 2 diabetes, diarrhea, headaches, nausea or vomiting, dizziness, etc., and the reality is that most cases of high cholesterol (not all, but most) can be managed through nutrition and lifestyle changes alone with only positive side effects. In fact, the research shows that by making certain dietary changes, in particular eating a more plant-based diet, you can lower cholesterol as much – if not more – as you can by taking statins.

Now let’s get to the “meat” (pun intended) of this post – what dietary and lifestyle changes do I recommend for someone suffering from high cholesterol (and remember, this is not a “treatment” for high cholesterol, it is merely my suggestions for leading a healthier lifestyle). It turns out, the same habits that have been shown to lead to overall good health, vitality and longevity are those that seem to play an important role in naturally reducing high cholesterol levels.

As I discussed in a previous post, one of my absolute favorite books on health is The Blue Zones, by New York Times best-selling author Dan Buettner. This book discusses the research conducted by National Geographic on five of the healthiest and longest-living populations in the world, analyzing the commonalities in their diets and lifestyles, as well as other scientific findings, to create a “prescription” for lasting change that may add years (healthy years) to your life. As I re-studied the list of recommendations from The Blue Zones, I was struck by the fact that they are almost identical to the recommendations provided in recent studies on how to lower your cholesterol and your risk of heart disease. These recommendations include:

1. Eat more plants (remember, plant foods do not contain cholesterol), limit your intake of meat and dairy, and eliminate your intake of trans fats. Try to work your way up to 10 servings of fruit and vegetables a day (start with just adding 1 serving more each day than you currently eat and gradually work your way up to a total of 10).
2. Fill up on whole grains and legumes/beans and reduce your intake of highly processed and refined grains and sugar (the soluble fiber in these foods binds to cholesterol and helps transport it out of the body). Add at least 1 cup of whole grains to your diet each day, for example oatmeal at breakfast, and at least 1/2 to 1 cup of legumes/beans per day.
3. Eat a handful of nuts/seeds daily (studies show that eating 2 oz. of nuts every day can lower your LDL by 5%). An easy way to add nuts to your diet is to eat a handful as an energizing mid-morning and/or late afternoon snack.
4. If you choose to drink alcohol, drink it in moderation – 1-2 servings at most per day. Also, limit (or reduce or eliminate) your intake of caffeine, which has been shown to increase cholesterol levels as much as 10%.
5. Take an Omega-3 supplement daily (or, if you eat fish, incorporate fatty fish such as salmon 3 times per week). If you struggle to take supplements every day, start by taking an Omega-3 just one day this week and build up day-by-day until it is a daily habit.
6. Make purposeful movement a part of your everyday life. If exercise is not currently part of your daily routine, start by just adding a 10-minute walk to your schedule each day, or reach out to me for easy ways to add more movement into your everyday life to get leaner, stronger and healthier.

To learn more about foods that can help lower cholesterol, check out this article from a little university called Harvard.

​For more tips on simple steps you can take each day to live a healthier and happier life, please contact me at kathleen(at)bellsandpeppers.com. Or post questions on this topic or others in the Comment section below. As always, I look forward to your questions, ideas, recommendations and requests for future Q&A topics. And stay tuned for next week, when I will give you some of my favorite, healthy and super tasty recipes that fit today’s recommendations!

When mama talks about reducing dairy, she doesn't expect me to give up milk, does she?

​Until next time, be happy and healthy,
Kathleen