Cholesterol Concerns and Management Through Diet

[bshapiro]

Just got bloodwork back from Dr. - - cholesterol is way high, and if in 4 mos it doesnt get better, we are going to talk about meds.

No more cheese? Meat?

Any similar experiences? Advice?

I'm willing to give up the ice cream at night and milk in my coffee - -but beef and lamb and cheese will be very hard-

B

[prasantrin]

Eat more foods high in Omega-3 fatty acids--salmon, sardines, herring, etc. Also tofu, walnuts, and ground flaxseeds. I add ground psyllium husks to my morning smoothies, and it is also supposed to be helpful.

Supplements like garlic tablets and Omega-3 may also help reduce blood cholesterol levels.

(If you scroll down to the bottom of each of the links I posted, you can see how each herb and supplement rates in terms of effectiveness for helping with certain conditions, based on scientific studies--psyllium husks get an "A", for example, for helping lower cholesterol, but only a "C" in helping with hyperglycemia.)

Start exercising more, too, if you don't already, and lose weight if you need to.

My good cholesterol had good numbers. but my bad cholesterol was somewhat high. I still ate all the bad foods I ate before (fatty foods are good), but in smaller quantities. I also lost 15 pounds, exercised more, and I started taking garlic tablets and Omega-3 supplements. My bad cholesterol is more reasonable now, but it's difficult to say which helped more--exercise and weight-loss, or the supplements. I would guess the former rather than the latter, at least in my case.

Edited October 28, 2007 by prasantrin (log)

[Pyewacket]

Eat oats for breakfast every morning.

If you don't like regular cooked rolled oats, try making muesli-equal parts grated fresh apples, rolled oats and skim, almond or rice milk.

Granola is good too, but usually is high in fat and sugar.

[markk]

Omega-3 fatty acids tend to do more for lowering triglyceride levels (related to sugar intake) when taken at a dosage of 2 grams/day. Also, twice daily doses of timed-release Niacin have been shown to have great affects on lowering cholesterol and increasing artery health, but as with the Statin medicines, some monitoring of liver function is necessary.

But don't rule out diet, much as we all want to. You need to examine and lower your intake of saturated fats, and you should watch out for foods gratuitously high in cholesterol - you know what they are. Fatty meats, butter, egg yolks...

Aerobic Exercise is a must, and can turn quite pleasurable too - when you reach a level with a form of exercise that gets your heart rate up and keeps it there for a minimum of 20 minutes, the endorphins that cause "runner's high" start to kick in, and it feels euphoric. If you're allergic to exercise, try 'power walking' - walking as fast as you can (build to it slowly) and then stay at maximum speed for 20-30 minutes.

But while all these things help, you'll (sadly) want to cut those fatty pieces off the steak and forgo their eating pleasure, and you'll want to lower your intake of cholesterol (and the saturated fats that also raise them).

[Sony]

The first thing I would say is to find a good registered dietitian (good = one that doesn't suck the joy out of eating by setting unrealistic expectations). *I will admit that I am probably biased* because this is my professional field, but a good one can take into account your lifestyle, what you are willing to change, compromise on, or absolutely CAN'T give up. S/he should serve as a coach to help you reach your goals in a managable way and take into account any other medications/supplements you are on and conditions you may have.

Although it may seem expensive to start (especially if insurance does not cover it or you don't have insurance), meds aren't exactly cheap either (though they usually are covered by insurance). It's a personal decision...

OK, so this is my 2 cents:

1. Exercise (aerobic) will generally raise good cholesterol (HDL) and lower bad cholesterol (LDL). Even just being more active in general helps. If you're already really active, consider how you can bump it up in duration or intensity.

(The extra activity, plus loss of some "excess" weight, is what I had to to do personally to lower my cholesterol into normal range after 6 years. I genetically have high cholesterol and found out at the age of 20. I have never been overweight, but losing 10 pounds that I didn't need by moving more most likely helped.)

2. Avoid trans fat (which is thought to lower HDL and raise LDL) and saturated fat (which raises LDL). Trans fat is now on nutrition labels, but it's also really common in fried foods, baked goods (especially packaged ones)...anything made with partially hydrogenated vegetables oils. Research is pointing to trans fat as just as harmful,if not more so, than saturated. As far as saturated fat, this is where those red meats, cheeses, butter, high-fat dairy, etc. need to be carefully chosen/eaten in modest portions or avoided.

3. Eat omega-3 fatty acids (which lower triglycerides and total cholesterol). Fish oils contain DHA and EPA (2 types of omega-3's), which lower triglycerides. Certain plant sources (flaxseeds, walnuts) contain a different type of omega-3 (ALA) that lowers total cholesterol and triglycerides.

It's really individual how to get enough of these. Eating a lot of these may be a "healthier" way to gain weight, but typically people with high cholesterol are looking to maintain or lose weight. If you're a woman of child-bearing age, there may be limits on how much of certain fatty fish you want to eat to avoid mercury. Some people may want to take in fish oil supplements instead of eating the actual fish, but again, it's an individual situation. Some people have side effects from supplements (e.g. fishy burps)- but I suppose that can happen from eating the fish itself, right?

4. Eat more soluble fiber, which can lower total cholesterol. Sources of these include oats, beans/legumes, and fruits/vegetables (certain ones higher than others, like apples). How much you should aim for is, again, individual.

So figuring out what to eat (and how much to eat) and what to avoid...there's general advice that's good, and certain things that work better for some people than others. But in order how to make any eating changes work for your personal life, I still strongly recommend seeing a registered dietitian. If you PM me and would like to share where you are, I might be able to recommend a colleague. If you prefer to make your decisions without a dietitian, I genuinely wish you the best of luck!

Edited because I misspelled "dietitian"

Edited October 28, 2007 by Sony (log)

[tsquare]

All great advice, but also know that not everyone can change their levels through diet and exercise. Just as some people with bad dietary habits and no exercise can have great numbers, you may or may not be able to change those numbers.

Some medications may also impact the numbers - if you are taking other prescriptions, you might want to see if they could be a factor.

Worth trying the diet and exercise routines (especially if you are male) but don't get down on yourself if they don't work. Niacin was my best non-prescription - and the only time I have called 911 - after months of use, I had a flush that scared me that badly.

Some studies are suggesting statin drugs may have additional beneficial results anyway - so if you can tolerate them (and their cost) taking them may be a good decision.

Oh, and by the way, if you do the research, the conclusion is that there is no set number that is bad. What they have determined is a number that can be effectively lowered by the drugs. It is an interesting insight in how the prescription is used.

[markk]

Niacin was my best non-prescription - and the only time I have called 911 - after months of use, I had a flush that scared me that badly.

They (doctors) are specifically using the timed-release version on Niacin, which avoids the flush - but Niacin still has to be monitored by a physician for various reasons related to the liver. Still, it's great for artery health and lowering cholesterol, as is Omega-3 which is proven effective in daily doses of 2 grams (best to buy the "no repeat" capsules at that strentgh.

But taking these doesn't let you eat a fatty rib steak with a pat of butter on it - and boy, I wish it did, because that's how I ate for 30 years!

[docsconz]

Frankly, unless you have trouble tolerating the meds, have specific contraindications or cost is a major issue, I would not worry about avoiding them as they are very good and even reverse some disease that is already there.

[bshapiro]

Thank you all for advice and sharing!

After talking to many people here's what i think i'm going to do:

1. Trade in the sheep milk's yogurt for oatmeal in the morning.

2. Fish Oil Pills, also possibly Polyphenols (plant sterols - the stuff found in red wine), Red Yeast Rice (natual form of Statin)

3. Soy milk instead of Creamline milk in my coffee.

4. Excersise (this one is the hardest - - i have no idea how i'll get it in- - but i'm not giving up beef and cheese - - if i've got to do it i will).

5. 30% reduction in beef and cheese.

I'll keep you posted! Also keep sending feedback an ideas!

B

[prasantrin]

One thing about oatmeal for breakfast--whenever I have oatmeal, I get hungry after a couple of hours, compared to 3-4 hours after having a scrambled egg and rye crackers. It's also still important to have protein in the mornings. So add some low-fat yoghurt to your oatmeal, or some lean protein to your breakfasts (or as a mid-morning snack). Something like tuna with Ryvita rye crackers (or the like) are good. The tuna is lean, and rye crackers add fiber (and help keep you full longer).

Also, be careful with what soy milk you buy. Stay away from ones like Silk which are chockfull of additives. The ones at Chinese grocery stores are usually better. Or go with low-fat milk (1% isn't bad--skim is gross!).

Adding exercise can be easier than it seems. One of my mother's friends started walking during her lunch break, which was only 30 minutes long. She didn't change much else in her life, but just from adding that 30-minute walk, she lost 10 pounds. If you can still manage to eat lunch at your desk while you're working, you can use your lunch (or breaks) to go for a walk, or run up and down the stairs.

[BeeZee]

My cholesterol is slowly creeping up despite a healthy lifestyle (it's genetic, my size 2 Mother who goes to the gym 3x a week has to take meds)...I'm at 210 now (and LDL isn't great either) and I want to see if I can stop it from going up any more and maybe get it down 10 points or so.

I already eat a low fat diet, take 1000 mg fish oil capsule every day, very little animal protein, exercise 3-4 times a week. I indulge once a week if we go out for dinner.

Has anyone had luck reducing their cholesterol naturally, by adding a lot of oatmeal, flaxseed, etc to their diet?

[egale]

I did. About four years ago my cholesterol hit 220. Within three months I got it down to 175, purely through diet. My doctor shook my hand. However, I had been eating a lot of meat. Now I eat a big bowl of oatmeal every morning, a lot of fruits and vegetables, and (mainly) fish and chicken.

I want to add, however, that I have never met any one else who reduced their cholesterol through diet. Whenever I met someone who said they had high cholesterol, I would tell them about my experience reducing it through diet. The response always was that their high cholesterol was not amenable to dietary changes.

My husband and I would laugh about it and joke that I am apparently a completely unique human being!

[egale]

Oh -- there's one thing I want to add. A low-fat diet is not necessarily the answer, especially if your LDL is not great. You should eat a lot of healthy fats like olive oil and avocados and cut out the "bad" animal fats.

I cut out all dairy products -- butter, milk, cheese -- in addition to the other changes I made. Now my LDL is very low and my HDL is very high.

Dietary changes DO work. But they go against the grain of an American diet.

[BeeZee]

Yeah, I think I'm cursed with Mom's genes...I don't eat butter or cheese except as ocassional treats, either. Lowfat yogurt, lowfat cottage cheese...when I cook I use olive oil, I do eat avocado (but no way I could eat it more than once a week)...

I have appt with Doc next week for my physical, I'll see what his perspective is. I ordered a natural supplement which is supposed to reduce cholesterol, I am going to bring it to show him.

[Porthos]

FWIW I was able to reduce my cholesterol following the South Beach Diet.

[Katie Meadow]

From my own experience and from reading, I'm convinced that having a genetic propensity toward high cholesterol does not mean that you can't bring the numbers down with diet. In so many ways--both lucky and unlucky--I am my father's daughter, and that includes high blood pressure and high cholesterol. About two or three years ago my cholesterol was borderline high. My doctor thought I should give serious thought to reducing it. Since I was already on blood pressure med I decided to see if I could avoid another script, so I started paying better attention to my diet and made sacrifices that I could live with.

In the two or three years since then, I managed to reduce my total cholesterol by 50 pts, which put me in a much healthier range. I didn't go cold turkey on all cholesterol; I'll give up butter on toast and in my oatmeal when hell freezes over, but I looked at everything I was eating and made adjustments. I pretty much stopped eating eggs except in baked goods once in a while. I cut down on red meat to maybe twice a month. I use small amounts of bacon for flavoring in soups, and once in a great while I will indulge in a BLT. I cook primarily with olive oil. Most of my animal protein comes from chicken, and usually I poach it and use it in soups or grill it and shred it in burritos, but I rarely roast a chicken or eat chicken with the skin. I make my own stocks with chicken parts and even ham shanks, but I de-grease the stock before using it.

I cut way back on dairy. I stopped eating ice cream. We started making fruit sorbets and ices instead. My downfall was nibbling on cheese, or eating cheese for a meal. I stopped spreading cheese on crackers or bread. We make our own pizza, and my half usually has minimal amounts of mozz. Lasagne and mac 'n' cheese I consider treats, not staples. I stopped eating breakfast pastry altogether. I cut way back on all sweet baked goods, and don't bother eating them unless they are really fabulous. If they seem ho-hum I would just as soon pass and wait for something better to come along.

I'm not sure I buy into the idea that eating certain "good" foods can lower cholesterol. I eat a lot of whole grains and beans and take my fish oil and flax seed caps, but I'm pretty convinced that I lowered my cholesterol by eliminating many of the usual suspects. Not everyone has success with diet, but it's worth finding out if it works for you before assuming you need meds.

[agray]

I've not suffered from your problem, so I'm a little reluctant to dispense medical advice. However, I think it's worth looking into the possibility that a low-fat diet may not actually help everyone reduce their 'bad cholesterol' levels as egale mentions above. This has been the received wisdom for some time in North America, but people have been getting less healthy the last couple of decades, while continually reducing consumption of animal fat in particular.

Gary Taubes has been writing about this for a little while - this article in the NYT Magazine is one of his most well-known: http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html

"If you work out the numbers, you come to the surreal conclusion that you can eat lard straight from the can and conceivably reduce your risk of heart disease."

"...the major trends in American diets since the late 70's, according to the U.S.D.A. agricultural economist Judith Putnam, have been a decrease in the percentage of fat calories and a ''greatly increased consumption of carbohydrates.'' To be precise, annual grain consumption has increased almost 60 pounds per person, and caloric sweeteners (primarily high-fructose corn syrup) by 30 pounds. At the same time, we suddenly began consuming more total calories: now up to 400 more each day since the government started recommending low-fat diets."

This book is also very interesting: "Fat An Appreciation of a Misunderstood Ingredient, with Recipes" by Jennifer McLagan - http://www.amazon.com/Fat-Appreciation-Misunderstood-Ingredient-Recipes/dp/1580089356/ref=sr_1_1?ie=UTF8&s=books&qid=1267132131&sr=8-1

In my own household, we're phasing out margarine and increasing our use of butter, and I've just gone out and procured some pork fat from a local organic farmer, which I'm planning to render into lard for cooking. Fat from a well-raised animal has a very good composition - lots of Omega 3s and the like. I'm planning on doing more experimentation in this area, as it really looks like many fats have been given a bad, and potentially harmful, reputation.

Edited February 25, 2010 by agray (log)

[Lisa Shock]

You may wish to check out info on Dr Dean Ornish, he did a series of clinical trials demonstrating reversal of heart disease (and cholesterol) through diet.

[haresfur]

Like my brother told me, "We chose the wrong parents."

I think maybe 15 % reduction typically can be achieved with diet. You can alter the HDL:LDL ratio with diet and exercise bringing up the HDL.

Time release niacin can help and has pros/cons vs statin drugs. I'm also a big believer in additional folate although that's an independent risk factor factor from cholesterol.

[BeeZee]

Thanks for all of the good info, everyone. Plenty of stuff to discuss with my Doc when I go in next week. I don't think he's a fan of "holistic" medicine but he's got to have some perspective regarding the recent studies. I can certainly keep a food diary and try to see where I can improve. It would be a heck of a lot easier if I were someone who didn't already exercise and eat well and could easily remove the excess items (I won't call them "bad" items, since everything is OK in moderation).

[LizD518]

FWIW I was able to reduce my cholesterol following the South Beach Diet.

I had my cholestorol checked for the first time just about 2 weeks after starting South Beach. Overall I was at 217, with good cholestorol at 68, and bad at 149 - one point away from being over the recommended range.

I was wondering how this diet was affecting my numbers, and how long it takes for dietary changes to take effect. Butter and olive oil are my two favorite fats to use, with olive oil far and away what I use the most. However, I had done a lot of baking and eating of baked goods around Thanksgiving and Christmas. Prior to South Beach I hardly ate cheese at all, but with SB I was eating a lot of low-fat cheeses like mozzarella sticks. And for the first two weeks, stuff like oatmeal is forbidden.

I also drink a decent amount of lowfat (1% or skim) milk - around a half cup a day, plus yogurt. Protien is almost always chicken, turkey, lean pork and occasionally shrimp and fish.

I guess what I tend to wonder is if this is a really horrible diet that I need to focus on, or if I am naturally pre-disposed to higher cholestorol. I keep meaning to check with my Mom and find out more about my family history.

[andiesenji]

After many years of having my cholesterol tested and outliving several doctors who kept advising me to change my diet, even though my cholesterol was normal, I am still convinced that genetics has more to do with cholesterol than diet.

I'm now 70 and my doctor (age 38) shakes his head as he studies notes on what and how I eat (lots of supposedly "bad" foods, i.e., butter, cheese, bacon and etc.) and then looks at my blood tests that reveal my total cholesterol is 148 with LDL at 19% of the total and HDL 81%.

I'm descended from a long line of ancestors who also ate all the "wrong" foods, lived much longer than others in their generations with little incidence of heart disease.

I've often written about my great-grandmother who was born in 1844 and died in 1949 when I was ten. She ate loads of butter, bacon, ham and cheese. There were no tests for cholesterol back in those days but I would wager that hers was much like mine is now.

My dad passed away last month at age 89 from complications following cancer surgery but he still had normal cholesterol a few weeks before he died.

I also think it IS possible to mitigate the levels of triglycerides and lipids somewhat with diet but far too often the results are not all that satisfactory, considering the hoops through one has to jump to achieve it.

I also don't trust most, if not all, of the cholesterol-lowering drugs. Some of the early ones were taken off the market because of undesirable side effects and others were rushed (in my opinion) into production after patient trials that in some cases were not as thorough as advertised.

There is a lot of money to be made in the industry and as recent news has shown, not every drug company thinks of patient welfare before profits.

Frankly, I would rather enjoy a somewhat shorter life than spend years denying myself the things I truly love.

[Darienne]

This topic is very close to my heart. Gosh, I didn't even intend a pun.

I have had high cholesterol and triglycerides my whole testing life. I've been put on Lopid and I can't remember two of the others and Lipitor with no good effect. I had the strange abdominal pains on Lipitor which are very 'dangerous' and went off it. Then when I got well again, the heart specialist said...well, let's try it again. No thank you.

I live with high numbers (Canadian numbers don't match US). However, I had, when last tested, normal homo-cysteine (whatever it is). Some think it's a more useful test for heart disease. And my carotid doppler was satisfactory last time too. My Father was the first in his family to live past 60. I am just pushing 69.

Ten years ago one day, I was talking to my favorite ever prof in the world, planning to meet for lunch. His cholesterol was perfect and he was making fun of me. He was also dead the very next day. Half of all the people who die from heart attacks have perfectly normal cholesterol levels.

I don't make anything of any of it. I sleep with aspirin beside the bed. My diet is mostly vegetarian. So far, so good.

[emilyr]

According to this BBC news article a recent study said diet can help reduce plaque build up, but not completely eliminate it.

[angevin]

Contrary to what doctors and the American Heart Association would lead you to believe, this is a very controversial topic. High cholesterol is correlated with heart disease, but it has not been proven to cause it (or plaque build up for that matter.) In fact, some communities have been discovered where both very high serum cholesterol and unusual longevity are both prevalent. The one that comes to mind is in Italy.

But even more shakey is the correlation between dietary intake of cholesterol and serum levels.

If you're a part of the high-LDL-cholesterol-is-a-killer camp, there are some ways that show promise is raising the HDL levels to improve the ratio. Drink lots of red wine, lay off the processed carbs, exercise, reduce stress and most of all ENJOY LIFE!