Aggregate statistics continue to tell us that heart disease is the number one killer of men and women. Therefore, it’s no surprise that cholesterol and heart disease are popular topics in the media; specifically, there is the attention that these health concerns receive in a slew of advertisements endorsing various pharmaceuticals and food products promoting a healthier heart. This article is dedicated to reviewing the role of cholesterol in our bodies and its impact on our health.

What exactly is cholesterol?
Cholesterol is a “waxy” fat found naturally in your body. Cholesterol is produced from two sources:

1. Our bodies, primarily by the liver (approximately 75%)
2. The food we eat, including meats, dairy products, eggs, and animal fats (approximately 25%).

Our bodies manufacture all the cholesterol we need; too much cholesterol in the blood can lead to coronary heart disease, stroke, and heart attacks. Desirable levels of total cholesterol are below 200mg/dL. It is recommended to limit dietary cholesterol to 300mg or less per day, and I instruct my clients to carefully review their cholesterol intake. I place an emphasis on the levels of saturated and trans fat in foods, the two ‘evils’ that raise your blood cholesterol levels. Food labels can be confusing to read; certain foods may be high in cholesterol yet low in saturated fat. Two good examples are shrimp and packaged products. Shrimp, though high in cholesterol, contains very little if any saturated fat and is a great food choice. In contrast, a package of cookies can be “cholesterol free” and still be loaded with saturated fat.

Cholesterol travels to and from cells by special carriers called lipoproteins.

There are two main types, Low-Density Lipoproteins (LDL) and High Density Lipoproteins (HDL). LDL is deposited on artery walls, causing a buildup called plaque. It is also referred to as the “bad” cholesterol. Desirable levels of LDL are below 130mg/dL. HDL, on the other hand, is helpful in carrying excess cholesterol out of the body and is considered the “good” cholesterol. Desirable levels of steady HDL are above 60mg/dL. Some of the best ways to increase your HDL levels is through aerobic exercise, maintaining a healthy body weight, and not smoking. A key to lowering LDL is by focusing on healthy food choices. A diet high in soluble fiber and low in saturated fat, trans fat, and cholesterol are key. Remember, the lower your LDL levels (and the higher your HDL levels), the less risk you have for heart disease.

Triglycerides travel with cholesterol as well. Triglycerides are fatty molecules formed in the liver and fat tissue. Triglycerides make up most of the fat we eat and can indirectly contribute to a higher blood cholesterol level. If you have a high blood triglycerides level, you should avoid excessive amounts of sweets and alcohol. Desirable levels are below 150mg/dL.

Current research has shown how the amount and type of fat you eat can directly affect your cholesterol level. Let’s focus on learning about the different types of fat.

Cholesterol-Raising Fats:
Saturated fats are one of the worst offenders. The American Heart Association (AHA) recommends that we limit our consumption of these fats to less than 10% of total calories. Saturated fats are found in animal fats such as lard, butter, meat fat, dairy products made with whole milk (cheese, ice cream), and in vegetable fats such as palm oil, palm kernel oil, coconut oil, and cocoa butter.

Trans Fats occur as a result of the hydrogenation process, which turns oil into a more solid fat. Trans fatty acids are formed when liquid oil is partially hydrogenated to form more stable oil that can withstand higher cooking temperatures. A good example is changing vegetable oil to vegetable shortening. Most people don’t realize that just one gram of trans fat can be more hazardous to your health than one gram of saturated fat. Eating just one gram of trans fat per day can increase your risk of heart disease by 20%. Trans fats can be found in some margarine, snack foods (chips), baked goods like cookies and cakes, and fried foods. Many food companies and some states are taking a stand on trans fats by omitting or forbidding their use.

Heart Healthy Fats:
Mono-unsaturated fats decrease cholesterol but keep HDL the same. Good examples are olive, canola and peanut oils, avocados, olives, pistachios, almonds, macadamia nuts, pecans, hazel nuts, and peanuts.

Poly-unsaturated fats decrease total cholesterol LDL and HDL. Good examples are safflower, sunflower, corn, sesame, and soybean oils, sesame, poppy and pumpkin seeds, walnuts, and wheat germ.

Omega-3 fats, which are polyunsaturated fats, may reduce the risk of heart disease by lowering triglycerides and decreasing blood clotting. Sources include flaxseed oil, fish such as tuna, salmon, mackerel, sardines and herring, soybean and canola oils, and walnuts.

What other factors can be beneficial in lowering my cholesterol?

Keep in mind the following when making heart healthy food choices.

Plant Sterols, also referred to as phytosterols, are naturally found in some vegetable oils, nuts, grain products, fruits, and vegetables. Plant sterols have the ability to help lower LDL cholesterol. You can find plant sterols in common foods like vegetable oil spreads (margarines), mayonnaise, smoothies, orange juice, and some snack bars. The National Cholesterol Education Program’s guidelines for adults with elevated cholesterol levels include two grams of plant sterols a day for effective cholesterol lowering.

Dietary Fiber comes in two types, soluble and insoluble. Recommended daily allowance is 30-35 grams per day for men and 21-25 grams per day for women. Most Americans consume only about half the recommended amount. Though both types are great for you, soluble fiber has the beneficial quality of assisting with lowering blood cholesterol. Soluble fiber can be found in fruits and vegetables, oat bran, barley, dried beans and peas, psyllium and flax seed.

Insoluble fiber promotes bowel regularity and aids in the prevention and treatment of uncomplicated forms of constipation, diverticulosis, and hemorrhoids. Sources include wheat bran, corn bran, rice bran, whole grain cereals and breads, dried beans and peas, nuts, seeds, and the skin of fruits, and vegetables.

Preparing “meatless meals” and replacing animal products with Soy bean products such as soy drinks, tofu, tempeh, soy flour, and soy vegetarian foods can significantly decrease high blood cholesterol levels (including LDL and blood triglycerides). Some recommendations are to consume at least 25g of soy protein per day.

Can my cooking techniques affect my cholesterol levels?

Definitely. If you are in the habit of frying foods at home, adjust your cooking techniques. Try to bake, steam, roast, broil, stew, or boil your meats and vegetables.

When preparing meats, trim the visible fat from meat before cooking, and remove the skin from poultry. Here are a few shopping tips that promote a heart-healthy diet:

• Choose white meat instead of dark meat whenever possible.
• Select skim or 1% milk instead of 2% or whole milk to reduce fat intake.
• When shopping for meat, select lean cuts such as round, sirloin, and loin.
• Buy plenty of fresh fruits, vegetables, and whole grains for optimum health.
• Read nutrition labels on food packages. Avoid saturated and trans fats.

Some final nutritional thoughts:
Keep in mind that calories still count, even when eating a low fat diet. Just because something is low fat doesn’t necessarily mean it is low in calories. Following a low fat, low cholesterol diet can usually reduce your blood cholesterol by about 10-15%, thus lowering your risk of heart disease by 20-30%. Individual results can vary, depending on a person’s genetic makeup. Always consult your doctor and registered dietitian concerning any dietary changes. Strive for a low fat, low cholesterol, and high fiber diet for long term, optimal health!