Friday, May. 23, 2008
Food Matters
By Chuck Newcomb
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ReprintDear Chuck: I found out that I have high cholesterol. I never had to watch my diet before. What should I eat to bring my cholesterol down? J. K.
It would be easy to say that avoiding cholesterol should help lower cholesterol in the blood, but the answer is a little more complicated than that. Even if you totally avoid cholesterol in foods you can have high serum (blood) cholesterol since the body actually makes it - sometimes too well. Cholesterol is a waxy-type lipid (fat) substance found in all parts of your body. There is something good about cholesterol: it aids in the formation of cell membranes, some hormones, and the sun actually uses cholesterol to make vitamin D. This does not mean, however, that getting a great tan lowers cholesterol.
High blood cholesterol is a significant risk factor for heart disease. Cholesterol and other fats are carried in your blood stream in the form of special particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is the type of cholesterol is commonly called the "bad" cholesterol, and is a type of fat in the blood that contains the most cholesterol. It contributes to the formation of plaque buildup in the arteries, known as atherosclerosis.
Blood cholesterol is rather specific to each individual so a full lipid profile is an important part of your medical history and important information for your physician to have. In general, healthy levels are as follows: LDL - less than 100 milligrams/per deciliter (mg/dl); HDL - less than 40 mg/dl puts you at higher risk for heart disease; and a total cholesterol level below 200 mg/dl is considered desirable.
Before taking cholesterol lowering medications you should do what you can to decrease cholesterol using increased physical activity, weight loss, smoking cessation and proper diet. Avoid foods high in fat, saturated fat, dietary cholesterol, and excess calories. Some studies show a reduction in cholesterol when adding foods like olive or canola oil, soy beans, high water-soluble fiber foods, and fish to your diet.
Don't be confused by labels reading "no cholesterol." Cholesterol is found only in animal products since the liver of animals makes cholesterol. It is usually a better idea to look for foods that are low fat overall. Most oils are not so great either since they frequently contain lots of polyunsaturated fats that are not very stable in the body and can cause damage to blood vessels and tissues. Hard vegetable fats, such as shortening, are a poor choice due to the unnatural form of fats called trans fatty acids that can also lead to damage. Whole plant foods are generally best.
Dr. Dean Ornish has published studies showing an actual reversal of heart disease with very strict diets, regular exercise and good, clean living. Most other moderate approaches to diet and lifestyle change only hope to slow down the progression of the disease. So the idea of becoming a strict vegetarian, lean, mean running machine may not be appealing to many but the alternative is not too exciting either.
Chuck Newcomb, MS, RD, CDE is a consulting Registered Dietitian currently providing medical nutrition therapy services for Memorial Hospital Los Banos. He has a Masters of Science in Clinical Nutrition from New York University. E-mail questions to the Attention of ChuckRD at: MHALosBanos@SutterHealth.org.