This month, we feature a four-part series on cholesterol to commemorate National Cholesterol Education Month. This second article focuses on the dietary and lifestyle modifications you can make to promote healthy cholesterol levels.
For most people, changes in diet and lifestyle are simple yet challenging. But, whatever positive adjustments you make can be beneficial. By not just addressing the symptoms (high cholesterol and high triglycerides) but the causes (e.g., eating saturated foods) of dyslipidemia (altered blood cholesterol levels), the problem is more likely to be resolved.
The good news? By modifying your habits, not only will your cholesterol and trigylceride levels will improve, but other measures of health like body mass index (BMI), blood pressure and fasting glucose levels will move in the right direction.
A diet that maintains healthy cholesterol levels is high in fruits and vegetables, low in saturated, partially-hydrogenated and trans-fats, and high in Omega-3 fats, as indicated below:
Eat More Fruits & Vegetables
By substituting simple carbs with “slow” carbs from fruits and vegetables, you will increase the amount of fiber, vitamins, minerals, antioxidants and phytochemicals in your diet. The number one source of added sugars in the American diet is soft drinks and sugary beverages. Taking in excess added sugars not only adds extra calories that lead to weight gain but also promotes the development of triglycerides.
Increase Soluble Fiber Intake
Fiber comes from plant sources and is typically classified as either soluble or insoluble. Insoluble fiber, which does not dissolve in water, passes through the intestines largely intact. Insoluble fiber moves bulk through the intestines and is responsible for keeping us “regular”. Soluble fiber is not digested but when mixed with water, forms a gel-like substance and swells.
When it comes to heart health, only soluble fiber is beneficial in lowering cholesterol. In fact, studies have shown that consuming 10 to 25 grams of soluble fiber a day can lower cholesterol by 18 percent. Soluble fiber only lowers LDL or “bad” cholesterol; it minimally, if at all, affects HDL or “good” cholesterol and triglycerides.
Foods that are high in soluble fiber include cereal grains (barley, oatmeal, oatbran), certain fruits (oranges, grapefruits, pears, prunes), beans (lima, kidney, pinto, navy and black), peas (chick peas, black eyed peas) and vegetables (Brussels sprouts, carrots, broccoli). Adding these foods to your diet naturally helps to lower cholesterol levels.
Functional foods and supplements also offer a convenient way to increase your soluble fiber intake. A variety of product forms are available such as drink mixes, capsules, wafers and soft chews. Popular brands include Metamucil, Benefiber, FiberCon and Citrucel.
An excellent and inexpensive source of soluble (and insoluble fiber) is flax seeds. A recent study published in the American Journal of Clinical Nutrition linked whole, ground flax seed with reduction in total cholesterol and LDL cholesterol levels.
Flax seeds can be purchased either whole or as ground meal (note, whole seeds must be ground to derive their nutritional benefit). Flax products can be purchased at a natural product store like Whole Foods and even mainstream supermarkets. Flax seed growing, processing and storing methods are important so look for industry leaders like Omega Nutrition, Arrowhead Mills and Flora. A number of websites including The Flax Seed Shop and Flax Matters also offer a wide range of flax seed products for online purchase.
If you decide that a fiber supplement is right for you, remember that the recommended intake by the National Cholesterol Education Program is between 10 and 25 grams of soluble fiber content. Be sure to drink plenty of water so that you avoid constipation.
Eat More Heart Healthy Fats
If you’re watching your cholesterol intake through diet, then the first foods to limit are those high in this substance. Foods that are high in cholesterol include eggs, organ meats and full-fat dairy.
Eating foods that are high in saturated fats promotes the development of cholesterol in the body. Substitute red meat which lean chicken, turkey or fish and full-fat dairy with low-fat or non-fat dairy, to reduce your saturated fat intake.
The Omega-3 fats eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in deep cold water fish promote heart health. The American Heart Association (AHA) recommends that healthy individuals consume at least two servings of fish a week that contain these two beneficial fats. Good sources include salmon, sardines, trout, herring and oysters. Choose wild fish versus farm raised as the Omega-3 content tends to be higher.
Foods that contain partially-hydrogenated oils or trans-fats pack a double whammy because they not only raise LDL or “bad” cholesterol levels, but they decrease HDL or “good” cholesterol levels. These unhealthy fats are pervasive in the food supply especially in packaged, processed foods. Start reading labels and avoid foods with ingredients that state, “made from partially-hydrogenated (soy-bean or corn) oil”.
Salad dressings are often made with partially-hydrogenated oils. A good substitute is olive oil. This monounsaturated oil is featured heavily in Mediterranean cooking and is associated with heart health.
Instead of reaching for cookies, candies or other highly processed foods for snacks, grab a handful of nuts. While nuts are high in fat, the type of fat is unsaturated. Plus, they offer fiber and protein and are more satiating than the empty calories found in most conventional snacks.
In particular, walnuts are very health promoting. A recent study published in the American Journal of Clinical Nutrition found that diets supplemented with walnuts resulted in significantly greater decrease in total cholesterol and in LDL cholesterol than diets without walnuts.
Cooking Heart Healthy Meals at Home
More than ever, Americans are cooking dinner at home to eat healthier. Recognizing this trend, the National Heart, Lung and Blood Institute (NHLBI) developed several cookbooks to help Americans cook heart healthy meals.
Heart Healthy Recipes is a colorful booklet with a wide variety of recipes that promote heart health. Given that rates of heart disease and obesity are higher among certain ethnic groups, the NHLBI also created recipes that appeal specifically to African American and Latino culinary preferences.
In addition to modifying your diet, you can make changes in your lifestyle that improve your cholesterol and risk profile:
Lose Extra Weight. Carrying extra weight, contributes to high cholesterol. If the extra weight is carried around your abdomen (as opposed to hips), your risk of cardiovascular disease is even higher. You can help lower LDL levels by losing weight.
Increase your Physical Activity. Moderate physical exercise can help raise HDL levels.
Quit Smoking. By kicking the habit, you can decrease blood pressure and raise HDL levels. Within one year of quitting, you can cut your risk of a heart attack in half.
Drink Alcohol in Moderation. Although drinking in moderation (one drink a day for a woman; two drinks a day for a man) confers some health benefits, at risk drinking leads to all sorts of health problems including high blood pressure, heart failure and stroke.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.