It’s a brand new year and, if you’re like many of my patients, you’re taking steps to create a new, healthier, you! As I tell my patients, one of the most beneficial things you can do to improve your health is to have both your “good” and “bad” cholesterol levels checked to ensure they are within optimal range. If you don’t know what good or bad cholesterol is, or why they’re so important, allow me to share some cholesterol facts with you.
Good vs. Bad Cholesterol
When I do cholesterol levels on my patients, I like to explain to them why there are two major types of cholesterol we need to be concerned about: HDL, or high density lipoprotein “good” cholesterol, and LDL, or low density lipoprotein “bad” cholesterol.
Lipoproteins are what carry cholesterol through your blood. LDL are very small carriers and HDL are big, buoyant carriers. Let’s look at the trouble-maker first, LDL cholesterol. Because LDL are very small carriers, they cannot clear as much cholesterol out of the blood. This can cause the build up of plaque on arterial walls of the heart and the brain. This plaque then narrows the artery and makes the passageway much thinner so less blood gets through to the heart or the brain. It can then form a clot, which may block any further passage of blood resulting in a heart attack or a stroke.
A variant of LDL cholesterol is Lp(a), in which your LDL levels are broken down into on your lab tests. High Lp (a) levels carry a high risk factor for the development of fat deposits in arteries.
Another variant of LDL, VLDL, or very low-density lipoprotein, may also need to be tested, if you have particularly high triglycerides (see below). It is not directly tested for; rather, it is calculated as a percentage of your triglycerides. Therefore, if your triglycerides are high, then your VLDL levels will also be high and place you at higher risk for heart disease.
Now, HDL, or good, cholesterol does just the opposite. Because of its larger lipoproteins, the more HDL you have, the more cholesterol it can transport to your liver where it’s disposed of. HDL protects the arteries from developing plaque by keeping them cleaner.
The next thing I explain to my patients is about triglycerides, a type of fat that your body makes, generally from too high sugar consumption in the form of carbohydrates. When triglyceride levels are too high it can be very detrimental to your heart and the health of your arteries. High triglycerides usually accompany low good HDL and high bad LDL levels, placing the patient with this combination at very high risk for heart disease and/or stroke.
Am I At Risk For Heart Disease/Stroke?
If you’re wondering if you might be high risk for heart attack and/or stroke, two or more of the following factors are the general guidelines:
• Do you smoke?
• Do you have high blood pressure?
• Are you diabetic?
• Do you have high LDL bad cholesterol levels?
• Do you have a history of heart attack or stroke in your family?
• Are you older than 45 if a man, or 55 if you’re a woman?
• Do you have elevated Lp (a) levels (see above)?
What Can I Do To Improve My Cholesterol?
The overall goal of cholesterol improvement is to reduce the LDL cholesterol. Before I tell you what to do to improve your cholesterol numbers, first, let’s see what beneficial levels to aim for:
Total cholesterol: Less than 200 are ideal.
Triglycerides: Less than 150 are ideal.
HDL: Over 50 nanograms/dL. The higher the number you can raise your HDL to, confers the most heart and brain health.
LDL: Levels should ideally be below 130 nanograms/dL for most healthy persons and below 70 ng/dL if you’re at high risk for developing heart disease.
As I mentioned, there are several recommendations I give to my patients that all work together to lower your cholesterol and decrease your chance of a heart attack and/or stroke. Most of them are lifestyle changes such as:
➢ Quit smoking
➢ Add a little alcohol! A moderate amount of dark red wine (contains antioxidants) and dark beers (contain hops, an herb) have been proven beneficial to heart and vascular health.
➢ Lose weight. Most high cholesterol levels accompany obesity, but not always.
➢ Exercise. At least 30 minutes a day, at least 5 times a week doing aerobic (heart strengthening, fat reducing) activities like bicycling, treadmill, stair climber, elliptical trainer, aerobic routines like Zumba, that incorporate intervals – shorter, high intensity bursts of exercise which strengthens the heart are better than longer, less intense exercise.
➢ Weight training. 3 times a week. Builds muscle, burns fat.
➢ Change your diet. Include more high fiber, low sugar foods like oatmeal, legumes, green/yellow vegetables. Limit fruits to low sugar, low glycemic varieties like Granny Smith apples and dark red plums. Limit saturated fats (animal fats like beef, pork, poultry) and add more monounsaturated fats (from nuts, flax seed oil, fish).
➢ Supplements/vitamins/minerals: Make sure you include cholesterol/heart healthy folic acid (vitamin B9), natural niacin (B3) into your diet, as well as Omega-3 fats, CoQ10, resveratrol, magnesium, garlic, red yeast rice, to help decrease bad cholesterol levels and keep arterial walls clean. You may even want to look into EDTA chelation therapy as a means to remove toxic wastes in your body and improve calcium and cholesterol metabolism. Guggulsterones, more commonly known as guggul, or guggulipid extract, has been used in Indian Ayurveda medicine for centuries to control obesity and lower cholesterol. In fact, studies show that it can lower cholesterol by 14-27% and lower triglycerides by 22-30%.
If you’ve started a health improvement regimen this New Year, good for you! I’m proud of you! Do yourself a favor, though, and check-in with your doctor to get some baseline cholesterol, and other blood tests, so both of you will know where you’re starting and where you need to be.
If you make the effort and follow at least most of my recommendations listed above, by the time spring rolls around I predict your weight will be lower, your cholesterol improved and a whole new, healthier you will be ready to emerge from last year’s you!
Mark Rosenberg, M.D.