the basics of cholesterol

February was National Heart Month making this time a perfect time to talk about heart disease.  Well, not really just about heart disease but more importantly what can be done to reduce the risk of heart disease.  


But first, a scary primer.


Heart disease is the leading cause of death for men and women in the US. One person dies every 37 seconds in the United States from heart disease, which translates to about 647,000 Americans each year—that's 1 in every 4 deaths.  

While there certainly may be a genetic link, there are also many things to do to help reduce the general risk. One of those “things” is to first get a checkup with your doctor – whether in person or using one of the many online concierge services currently available – to have your lipid profile evaluated.

When we hear “lipids” often the first we think of is cholesterol and that’s certainly one of the many to examine. But total cholesterol is just a start when looking at lipid levels overall.


Let’s first break down the basics.


Total Cholesterol. Cholesterol is a waxy substance our body needs to help with cell structure, hormones, and bile. It’s not inherently bad; in fact, it’s really important and needed to build cells. Your liver makes all you need and then the rest comes from foods that are rich in saturated fat (animal meats, full fat dairy, butter, etc).  This doesn’t mean giving up all these foods. Stick with me. 

That’s just a small snapshot, though.  Then we have LDL (think L for lousy, should be low) and HDL (think H for happy, should be high) levels of cholesterol and non HDL cholesterol which is your total cholesterol minus the HDL cholesterol.  More on all those in a bit.

First, all together those numbers tell you about your risk of atherosclerosis and then are a part of the puzzle, with other modifiable risk factors like exercise, smoking habits, sleep, diet and body fat, influencing their total impact.

Let’s stick with cholesterol for a bit.

First, total cholesterol levels ideally should be less than 200 mg/dL.

Now, remember cholesterol is a waxy substance meaning it’s not water-soluble and needs to travel around your blood riding on lipoproteins (remember those terms used above – LDL and HDL?). 

LDL stands for low-density lipoprotein and HDL stands for high-density lipoprotein

Research suggests these components are more important than just total cholesterol alone.

HDL is considered “normal” if it’s between 40-59 mg/dL but most experts suggest >60 is ideal. 

LDL should be less than 100 mg/dL because the higher this number, the higher your heart disease risk.

Total:HDL Ratio is another number often mentioned or listed in blood panels and is simply the total cholesterol divided by HDL cholesterol.  As an example, if total cholesterol is 200 and HDL 50, that would be a ratio of 4. Ideally, the ratio should be less than 3.5.

Alright, so that’s about as heavy as I’ll get with the science.  Now let’s talk about what to do if your numbers aren’t quite where they need to be.

Since you can’t quite change your parents, here’s what you can do.

First, if bodyweight is a concern then working towards getting body weight (and more specifically body fat) under control is recommended.  How? By following the information here on Pursuit Online Journal along with a few very specific nutrition strategies.

Think Fiber.  Fiber is like a sponge and that sponge essentially “absorbs” cholesterol much like a sponge absorbs water and helps excrete excess. Fiber comes from foods like fruit, veggies, oats, beans, hemp seeds and the like.  Unfortunately, the recommendation is about 30 or so grams of fiber per day but most guys eat just about half of that. 

Try oats in the AM.
Add a couple of TBS of hemp seeds in your smoothie.
Add some beans to a salad.
And choose veggies and fruit for snacks.

 

Replace saturated fat with unsaturated fat.  For a while, saturated fat was all the rage with people essentially suggesting gnawing on bacon by the pound.  Well, hold up. Too much saturated fat can increase cholesterol, so replacing some with unsaturated options isn’t a bad idea.  

What does that look like?

Try olive oil instead of butter & coconut oil

Trim visible fats off meat (yes, even grass-fed beef is still primarily saturated) and the skin on chicken too
Limit fried foods
And, yes, limit bacon, sausage and the like to occasional indulgences.


Add in aerobic exercise. Yes, yes – resistance training is amazing. For all the reasons. And so is aerobic exercise for a number of reasons, including – it’s potential to boost HDL – which is a tough one to increase. So get that heart rate up, consistently. 


Lose Body Fat (if you need to). The number on the scale isn’t the be-all and end-all, but if you carry excess body weight, particularly around your midsection, that can move your lipids in the wrong direction.


Add in omega 3’s.   Omega-3’s come from fish, like salmon, sardines, anchovies and tuna. Remember above when I talked about replacing saturated fat with unsaturated fat – well, this is a great example.  Swapping out your usual animal protein a couple days a week with fish can be hugely helpful for your health and lipids in general.   

There you have it.  Start by going to your doc, getting your lipids measured and taking necessary steps to reduce the risk of you becoming a statistic.  Now go celebrate National Heart Health Month with a giant salad, add in some beans and a high-fat fish, like sardines, and take pride in knowing you’re doing something good for the ‘ole ticker.

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