The fight against cholesterol: Diet and exercise play a major role | VailDaily.com

The fight against cholesterol: Diet and exercise play a major role

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While some factors such as genetics and age can increase a person's risk for cardiovascular disease, healthy lifestyle choices can lower risks

By Lauren Glendenning
Brought to you by Kaiser Permanente

A high total cholesterol number used to be cause for worry, but these days doctors are focusing on cholesterol numbers in combination with other factors when determining a person's overall cardiovascular risk.

Cholesterol is a waxy substance in the body that helps build cells, but too much of it can be a bad thing. The liver makes cholesterol, but the remainder comes from animal foods such as meat, poultry and full-fat dairy products, according to the American Heart Association.

"High cholesterol is often caused from a combination of genetics — including inherited high cholesterol levels — and diet," said Dr. Carol Venable, Internal Medicine Physician at Kaiser Permanente's Frisco Medical Offices. "There are also secondary causes, such as medications, hypothyroidism, certain kidney diseases, etc., that can lead to higher cholesterol levels."

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What is cholesterol?

Cholesterol is a type of fat, or lipid, in the blood. LDL (low-density lipoprotein) cholesterol is considered the "bad" cholesterol, while HDL (high-density lipoprotein) is the "good" cholesterol. LDL cholesterol contributes to fatty buildups in the arteries, known as atherosclerosis, which narrows the arteries and increases the risk for heart attack, stroke and peripheral artery disease, says The American Heart Association.

HDL cholesterol acts as a scavenger and carries the bad cholesterol away from the arteries and back to the liver, but it doesn't completely eliminate bad cholesterol. The American Heart Association reports that only one-third to one-fourth of blood cholesterol is carried by HDL.

Finally, triglycerides store excess energy from the diet and are the most common type of fat in the body.

"A high triglyceride level combined with high LDL (bad) cholesterol or low HDL (good) cholesterol is linked with fatty buildups within the artery walls, which increases the risk of heart attack and stroke," reports the American Heart Association.

A cholesterol test is called a lipid panel and measures all of the fats in your blood.

Cholesterol levels

The primary danger of having cholesterol that is too high is cardiovascular disease, such as heart attack and stroke, Venable said.

Certain foods can help you lower your cholesterol (see factbox), and exercise can help raise your HDL cholesterol number (this is good). A person can't control family history and age, but we can make better lifestyle choices.

Eating a healthful diet, maintaining a normal body weight and engaging in exercise are all ways to reduce risks for cardiovascular disease, Venable said. Statin medications — which are medications that lower cholesterol — also lower cardiovascular risk, even in high-risk patients with normal cholesterol levels, Venable said. Several other medications can lower cholesterol, too, but Venable said they are typically second or third line and used only if patients cannot tolerate statin medications.

"We use cholesterol numbers, along with other risk factors, such as age and blood pressure, to calculate a 10-year risk of atherosclerotic cardiovascular disease," Venable said. "A 10-year risk matters because we know that even in patient with what would historically have been termed 'normal' cholesterol levels, taking a statin medication will lower cardiovascular risk in high-risk patients."

Fight cholesterol with better food choices

  • Have berries and almonds on top of oatmeal instead of a blueberry muffin
  • Have egg whites with vegetables instead of fried or scrambled eggs
  • Eat fish instead of red meat or processed deli meats
  • Grill or roast chicken instead of frying it
  • Try pretzels and cocoa-dusted almonds instead of potato chips and chocolate bars

*Source: Kaiser Permanente

Heart-healthy

For a heart-healthy diet, choose foods that are low in saturated and trans fats, and limit sodium and added sugars.

Foods that help lower cholesterol include:

  • Oats
  • Whole grains
  • Fruits and vegetables
  • Beans
  • Eggplant and okra
  • Nuts
  • Vegetable oils
  • Apples, grapes, strawberries, citrus fruits
  • Foods fortified with sterols and stanols
  • Soy
  • Fatty fish
  • Fiber supplements

*Source: Kaiser Permanente; Harvard Medical School