Yes, it’s true. My Cholesterol is up, despite my trim waistline and healthy BMI. I eat a heart healthy plant-based diet (minimal meat and dairy, but include eggs and seafood). I also exercise regularly — 4 to 5 days per week. So when I got my latest results, I was more disappointed than surprised.
While cholesterol is important for our body’s functions, only a little is necessary to keep us healthy. Too much cholesterol in your blood can lead hardening of the arteries and advancing heart disease. A healthy cholesterol profile includes a Total blood cholesterol below 200 mg/dL with LDL (bad) cholesterol below 100 mg/dL and HDL (good) cholesterol >50.
Changes in diet, activity level and abdominal girth can influence your Cholesterol levels (lipid metabolism). But there are other factors, too.
“With increasing age often genetic ‘switches’ can go off that also increase cholesterol, much like hair loss or hair turning grey. Some women increase cholesterol absorption after menopause with increases in cholesterol levels,” says Dr. James Underberg, Clinical Assistant Professor of Medicine NYU Center for CV Prevention, Director Bellevue Hosptial Lipid Clinic and President-Elect National Lipid Association.
I did some research on fine-tuning a healthy lifestyle to improve cholesterol values. Here’s my take-home advice:
2015 Dietary Guidelines recommend reducing intake of cholesterol-raising fats. The saturated fats and trans fats we consume influence our Cholesterol more than the cholesterol in foods we eat. So enjoy that egg, yolk and all! Be mindful of amount and type of fat you are consuming in your daily diet. The DASH diet has approximately 27% total calories from fat. Like USDA Food Pattern and AHA diet, it is low in trans fats and limits saturated fats to just 5-6% caloric intake.
Excess sugar increases blood sugar levels, ultimately raising triglycerides. Refined grains easily break down to sugars and can cause blood sugar to spike as well.
Research suggests that certain bacterial strains may reduce blood cholesterol levels by altering cholesterol metabolism and facilitating its excretion via the feces. According to the National Lipid Association, although data is limiting, results are promising.
Plant sterols and stanols are naturally contained in nuts, seeds, grains, legumes, (and in small amounts in fruits and vegetables). There is much evidence to support that these compounds have lipid-lowering effects. Some studies have shown that consuming 2 grams of phytoesterols per day may help reduce LDL by 10%.
Viscous fiber has been associated with reductions in total cholesterol, LDL and non-HDL-C. These include pectins (found in apples), oats, barley, legumes, broccoli, Brussels sprouts and carrots. 7g of viscous fiber per day is recommended for LDL reduction.
In the OmniHeart study comparing variations in a DASH diet (percentages of carbohydrates/protein/fats), the Protein diet (48/25/27) had the greatest reductions in Cholesterol overall vs the Carbohydrate (58/15/27) and Unsaturated Fat (48/15/37) diet. The other diets, both comprising 15% protein did help decrease levels as well. Thus, 15% – 25% protein is a good rule of thumb.
You may be surprised to see how much fat, sat fat, sugars and sodium you are eating. And perhaps you aren’t getting as much fiber and lean protein as you thought. LoseIt Premium is one app that can track your nutrient intake.
200-300 minutes of moderate to high intensity aerobic exercise/week can lower triglycerides and may show a slight increase in HDL (good) cholesterol. Resistance training may yield even greater results – as much as 4 – 9% HDL increases in men and women after 6-9 weeks, according to some reports. My HDL went up 70mg/dL from 55mg/dL after adding in higher cardio/resistance. And that’s a good thing!
Cholesterol doesn’t change overnight. “I usually ask patients to return to see me after diet and lifestyle adjustments in about 3 months. Any longer and they don’t start, but too soon and they do not see results, and can get discouraged,” advises Dr. Underberg.
Jacobson et al (2015). National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2 Journal of Clinical Lipidology (2015) 9, S1–S122 Retrieved from: http://www.lipidjournal.com/article/S1933-2874(15)00380-3/pdf
Jennifer Moll, PharmD (2016). Which Foods Contain the Highest Amount of Phytosterols? Retrieved from: https://www.verywell.com/which-foods-contain-the-highest-amount-of-phytosterols-697742
Melanie Thomassian (2011). Low Cholesterol Diet: How Much Cholesterol Can I Have Per Day? Retrieved from: http://www.healthcentral.com/cholesterol/c/7291/131385/cholesterol
Lauren O’Connor, MS, RDN, RYT is a Los Angeles based registered dietitian, yoga teacher and founder of Nutri Savvy Health. Her motto: “Discover the Joy of Whole Body Nutrition”. Besides authoring her own blog, she is a health writer, menu developer and nutritional consultant with articles and recipes in numerous publications including Food & Nutrition magazine, Shape, Redbook, Livestrong, AZCentral and DietsinReview.