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What Your Doctor Doesn't Tell You About Cholesterol

Last Christmas, we once again had the pleasure of seeing friends and family and enjoying a different kind of holiday celebration by visiting a Chinese buffet.  This is our second year of doing something a little different from the usual holiday feast, and everyone agrees, it is a great way to get together without all the fuss.

Our small group consists of six friends and family and throughout our conversations that day two of the six people told me they were taking cholesterol lowering drugs, and a third was in the queue to start taking them as well.  Now I’m no mathematician, but that is three out of the six taking the same prescription drug.  Wow, fifty percent just in our small group is relying on a drug that diet alone could make a significant impact on whether they need that drug or not.  And what I found most unusual, was they said their cholesterol level wasn’t that high.  It was actually just a tad over what the experts advise it should be. 

That really struck me as odd.  Are doctors really writing prescriptions that liberally without taking the time to offer advice on how to lower cholesterol through diet and exercise?    

I asked both of them if their doctor asked them what they typically eat in a day.  They both replied no, although one was referred to a nutritionist (which is a good thing).  So I asked them if they knew where cholesterol comes from.  Once again, the answer was no. 

Did you know your liver naturally produces cholesterol?  As a matter of fact, our liver produces about two-thirds of the cholesterol available to our body and the rest comes from our diet. 

Now, cholesterol isn’t a bad thing.  It’s found in every cell in our body, and serves as the building block for estrogen, testosterone, and the vitamin D that is produced in our skin by exposure to sunlight.  Cholesterol is a major component of nerves and the brain, and because it cannot be used for energy, it provides no calories.

Our body makes about 800 to 1,000 milligrams of cholesterol each day, so we don’t need any additional cholesterol from the food we eat.  But, that’s the problem.  As a society, we eat far too many fatty foods that contain cholesterol. 

What exactly is cholesterol?  Cholesterol is a lipid (lipids include fats, oils, and cholesterol) found only in animal products.  It is contained in both the lean and fat parts of animal products and is tasteless and odorless.  Plants do not contain cholesterol and are therefore cholesterol-free.

Too much cholesterol can cause blood cholesterol levels to rise, which can increase the risk of blood clots, heart attack, and stroke.  In general, the higher the blood cholesterol level, the more likely it is that plaque will build up in the arteries causing heart disease. 

Diets high in saturated fat are known to elevate cholesterol levels in most people, while trans fat raises blood cholesterol levels even more than saturated fat does.  Known as the “bad fats”, saturated and trans fat can raise blood cholesterol levels and increase the risk of heart disease.  Saturated fat is found in high fat dairy products such as butter, cream and cheese, and in meat and poultry skin.  Trans fat is found in foods prepared with partially hydrogenated oils and include donuts, fries and many packaged foods. 

The two basic types of cholesterol we hear about most often are HDL (high-density lipoprotein cholesterol), and LDL (low-density lipoprotein cholesterol).  If you need a quick way to remember them think of HDL as ‘heart disease lowering’ cholesterol, and LDL as ‘lousy and destructive’ cholesterol.

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HDL is the good type of cholesterol, and the one we want high levels of in our blood.  HDL helps remove cholesterol by racing around our bloodstream grabbing the LDL cholesterol and transporting it to the liver for its eventual excretion from our body.  High HDL cholesterol levels are protective against heart disease. 

LDL (or ‘lousy’) cholesterol is the bad cholesterol, and the one we want to stay away from.  It is designed to navigate throughout our bloodstream, like little courier vans packed with fat droplets, and feed liquefied cholesterol directly to our cells.  Over time this process can result in a build up of plaque and narrow our coronary arteries so less blood is flowing to our heart muscle and brain.    

In many cases, by keeping our LDL low and our HDL high we can keep our cholesterol levels in check and avoid having to take any medication.  There may be people who were born with genetic traits that either reduce or increase cholesterol absorption, but for the majority of people in today’s society, it’s diet and lifestyle that play the key role in cholesterol accumulation.  To paraphrase some of the best health educators:   “Genetics may have loaded the gun, but it’s your lifestyle that pulls the trigger.”   Fortunately, we can make a choice to eat foods that will help lower cholesterol naturally, and reduce the risk of heart disease.

Here are a few dietary tips to help keep your cholesterol within a healthy range:

  • Eat foods loaded with fibre.  Switch from refined white grains to whole-grains.  Look for the words “whole grain whole wheat flour including the germ” on your bread products, and many pastas and baked goods are now made with whole grains.  Look for some of the other less known grains also such as spelt, rye, and kamut.  Oatmeal, oat bran and other high-fiber foods such as kidney beans, apples, pears, barley and prunes can reduce the absorption of cholesterol into our bloodstream.
  • Fatty cold-water fish such as salmon or tuna can be heart-healthy because of the high levels of omega -3 fatty acids they contain, which can reduce blood pressure and risk of developing blood clots.
  • Walnuts, almonds, and other nuts are loaded with beneficial omega -3 fatty acids, which can reduce blood cholesterol.  Nuts are high in calories, so limit them to a small handful.  
  • Add garlic to as many recipes and dishes as you can for its cholesterol-lowering effects.
  • Sprinkle nuts and seeds on your salads instead of cheese.
  • Olive oil contains a potent mix of antioxidants that can lower ‘lousy’ (LDL) cholesterol but leave ‘healthy’ (HDL) cholesterol untouched.
  • Many foods are now available that have been fortified with sterols or stanols — substances found in plants that help block the absorption of cholesterol.  Margarines, orange juice and yogurt drinks with added plant sterols can help reduce LDL cholesterol.

 To receive optimal benefits from these foods, we may also have to make diet and lifestyles changes such as:  cut back on the amount of cholesterol and total fat we consume (especially saturated and trans fats), keep active, and not smoke. 

 By educating ourselves about cholesterol, consuming foods for a heart healthy diet, and having a healthy and active lifestyle, we can keep our cholesterol levels in check and not have to take medication and risk the side effects they produce.  And the best part…you won’t have to worry about what your doctor doesn’t tell you about cholesterol.  You’ll already know!

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