High Cholesterol: Myths, Facts, and How to Deal With It
You don’t have to be a health nut to have heard about high cholesterol. Television, magazines, the internet – all are full of stories about its hazards, advice about medicines to take or foods to avoid. But despite this bombardment of information, or maybe because of it, many things accepted as ‘common knowledge’ aren’t true.
Myth #1: All cholesterol is bad.
After years of hearing warnings about cholesterol, it’s not a surprise that most people think of cholesterol as an evil substance. On the contrary, cholesterol is actually needed in the body. It helps gives cell membranes stability, and is needed for the proper function of the brain’s seratonin receptors. Blood tests check for the ratio of high-density lipoprotein (HDL) to low-density lipoprotein (LDL) in the blood; it’s the LDL cholesterol that is associated with the increased risk of heart disease.
Myth #2: You shouldn’t eat eggs.
This is actually a semi-myth. It’s probably not healthy to eat three-egg omelets three meals a day, although for more reasons than just the cholesterol content. Eggs got a bad reputation early on because a single egg contains 200mg or more of dietary cholesterol, more than two-thirds of the recommended daily allowance. Research in recent years, though, suggests that dietary cholesterol is not as large a factor as originally thought. Roughly 75% of your cholesterol is actually made by your body.
Myth #3: Eating ‘low fat’ and ‘low cholesterol’ foods is the best way to be healthy.
‘Low fat’ and ‘low cholesterol’ labels don’t automatically translate into healthy food. A food may be low in cholesterol but still high in hydrogenated fats, saturated fats, or trans fats, which still contribute to high cholesterol levels. As an example, butter contains cholesterol, while margarine does not. But if the margarine contains the ‘bad fats’ listed, it may actually be less healthy than the butter. A heart-healthy diet should limit processed foods, and focus on fresh vegetables and fruits, whole grains, and lean meats and fish.
Myth #4: Only old people and fat people have to worry about cholesterol.
Being young and slender is certainly a plus, but even children can have high cholesterol. There is also a genetic form of high cholesterol called familial hyperlipidemia. Have your cholesterol tested in early adulthood, and at least every five years afterwards unless your doctor recommends differently. After age 40, a yearly cholesterol test is probably in order, especially if you have a family history of heart disease.
Myth #5: If your cholesterol levels are low, so is your risk of heart disease.
Most people are surprised to learn that doctors do not necessarily agree that cholesterol explains the risk of heart disease. Current research indicates that there may be an inflammatory process involved in the development of atherosclerosis, commonly called hardening of the arteries. Genetic predisposition may be the main culprit in developing coronary heart disease (CHD). High blood pressure, diabetes, smoking, and a family history of the disease should be taken into consideration by your doctor when determining your risk of CHD.
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I have high cholesterol. Now what?
High cholesterol doesn’t automatically mean a lifetime of pills and paranoia. Lifestyle changes can lead to a reduction in overall cholesterol levels. Weight loss, exercise, and especially diet can all help lower cholesterol, sometimes enough to avoid medication entirely. Of these, diet is especially important, since proper diet can reduce cholesterol as much as 10-20%.
Some people are more comfortable with formal diets that lay out strict rules. If this describes you, consider the Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), or the Ornish diet. While the details vary, these three approaches have many similarities, emphasizing fruits, vegetables, whole grains, lean protein and healthy fats.
The principles behind these heart-healthy diets can be adopted without choosing one particular plan. The key is to make permanent lifestyle and diet changes. It’s not necessary to search out foods labelled low fat or low cholesterol. In fact, a balanced, nutritious diet that depends on natural whole grains, fruit and vegetables works better to lower cholesterol than just replacing foods with low cholesterol versions.
Limit or eliminate butter, trans fat margarines, and polyunsaturated oils, and instead rely on canola, olive oil, or plant sterol spreads. Experiment with wine or wine vinegars when cooking to keep food from sticking, and reach for spices for flavoring instead of butter or sour cream. Seeds and nuts also contain healthy unsaturated fats, and can be eaten in moderation. Only 30% of daily calories should come from fats, even the healthy variety.
Reduce or eliminate whole eggs from the diet. Make an egg white omelet, or try a cholesterol-free egg substitute. Eat water packed tuna, salmon, trout, mackeral or herring once or twice a week for healthy lean proteins. Grill fish instead of frying to keep the fat content down. Dairy products can also be high in fat, so switch to skim milk, fat-free yogurt and low-fat cheese.
Adding soy protein may also help lower cholesterol, but read labels carefully. To be considered heart healthy, soy products should contain 6.25g or more of soy protein per serving, and have less than 3g of fat, less than 1g of saturated fat, and less than 20mg of cholesterol.
Eat seven to ten servings of whole fruits and vegetables each day. Not only are fruits and vegetables cholesterol free, but they contain antioxidants and fiber that help lower cholesterol. Dried plums, beets, pumpkin and eggplant are antioxidant rich but often overlooked. Beans also have big health benefits, with antioxidants, fiber, and protein.
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