by Bill Rodgers, RN, MSN, Christian Hospital Diabetes Institute education program coordinator
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The American Heart Association reports cardiovascular disease kills nearly 1 million Americans every year, which amounts to about one death every 33 seconds. And one out of two people will be diagnosed with heart disease in their lifetime. Many risk factors are associated with the development of cardiovascular disease, such as family history, smoking, high blood pressure, age, diabetes and gender, to name a few, but there's one risk that can be readily modified . . . your cholesterol or blood lipid levels.
Lipids are essential for healthy cell function, as long as they're found in healthy amounts in the body. Lipid is another word for fat or fat-like substance. The liver produces about 1,000 milligrams of lipids -- cholesterol -- each day, while another 200-500 milligrams can come from foods. The cholesterol produced in your liver is all the cholesterol your body needs to survive.
Many factors can raise your lipid levels -- heredity or genes, eating foods high in saturated fats and cholesterol, excess weight, smoking, age, stress and lack of exercise.
Your doctor can measure the amount of lipids in your blood through a simple blood test that can break down your lipids into these categories:
- Low-Density Lipoproteins (LDL) -- "Bad" cholesterol -- can lead to a buildup of cholesterol or plaque in the arteries; the lower your LDL, the lower your risk for developing heart disease; reaching your target LDL is the most effective way to protect your heart and blood vessels; the American Heart Association suggests LDL below 100 is optimal
- High-Density Lipoproteins (HDL) -- "Good" cholesterol -- helps carry excess cholesterol out of the arteries and back to the liver; high levels of HDL (above 40) promote a protective mechanism, helping prevent the buildup of plaque in your arteries and decreasing the risk for developing heart disease; the American Heart Association suggests HDL above 60 gives some protection against heart disease
- Triglycerides -- Fat-like substances carried throughout the bloodstream and stored in the body's tissues as fat; it's unclear the exact role triglycerides play in the development of cardiovascular disease, but high levels (above 150) increase the risk for heart attack and stroke; the American Heart Association suggests high triglyceride levels are due to being overweight or obese, physical inactivity, cigarette smoking, excess alcohol consumption, or a diet very high in carbohydrates (60 percent of more of calories)
High cholesterol tends to have a genetic component, which is why it's important to know your family's health history. Other factors that can increase cholesterol include eating food with high levels of saturated fat and cholesterol, obesity, genetic disorders, a malfunctioning thyroid gland, and stress.
Getting on Track
The National Cholesterol Education Program suggests a three-part Therapeutic Lifestyle Changes plan to achieve healthy lipid levels:
- Part One -- Lose weight, if you're overweight
- Part Two -- Follow a heart-healthy meal plan
- Part Three -- Ramp up your physical activity
Several drug options are effective as well, but healthy lifestyle changes are essential to lower your lipids and lower your risk for cardiovascular disease.
Each day, follow some basic nutritional guidelines:
- Eat Foods Rich in Soluble Fiber -- Oatmeal or oat bran, apples, pears, kidney beans and prunes; soluble fiber has been shown to reduce LDL cholesterol beyond levels achieved by a diet low in saturated and trans fatty acids and cholesterol alone
- Eat Foods Rich in Polyunsaturated Fat -- Walnuts, sunflower seeds and almonds; vegetable oils, including soybean oil, corn oil and safflower oil; foods rich in polyunsaturated fat have been shown to reduce cholesterol and even help keep blood vessels healthy and elastic; polyunsaturated fats also include essential fats that your body needs but can’t produce itself – such as omega-6 and omega-3, which play a crucial role in brain function and in the normal growth and development of your body
- Eat Foods Containing Omega-3 Fatty Acids (Two Servings a Week) -- Fatty fish (salmon, mackerel, herring, trout and sardines) and Omega-3 fatty acids have been proven to offer cholesterol-lowering benefits and can also reduce the risk of sudden death associated with cardiovascular disease
- Eat a Variety of Vegetables -- Always a healthy component of overall nutrition
- Use Olive Oil -- Especially the Extra Virgin Variety -- It has excellent cholesterol-lowering ability and contains a potent concoction of antioxidants that can lower your LDL without decreasing your HDL, or "good" cholesterol
Moderation is key. You can enjoy "less than healthful" options on occasion, but staying on track most of the time will best help you achieve your target cholesterol goals.
Having overall success lowering lipid levels must include some level of physical activity, especially when it comes to weight loss and raising your HDL, or "good" cholesterol. Here are some ideas to help boost your activity level:
- Park your car farther away from where you're going and walk from there
- Take the stairs instead of the elevator
- Walk or bike to work
- Take a brisk walk during your lunch break
- Hide the remote and "commercial-cise" walk around the room or do chair exercises
- Work in the yard
The benefits of physical activity go well beyond just lowering cholesterol; physical activity also can reduce your risk for many other types of disease. Generally speaking, exercising for 30 minutes a day, three to four times per week, can lower your LDL and elevate your HDL. Remember, it's always important to get your doctor's approval before beginning any type of physical activity.
When Medication Is Required
Sometimes lifestyle changes aren't enough to create healthy blood lipid numbers, and medication may provide the extra help needed to achieve your goal. The most commonly prescribed cholesterol drugs, called statins, slow down the rate at which LDL is made in the body and help speed up the rate in which the liver can destroy it. The side effects are usually well-tolerated and include upset stomach, constipation and cramping. Rarely, a liver test may reveal some minor abnormalities that are corrected when the medicine is discontinued. Some cholesterol medicines work by interfering with the absorption of cholesterol in the intestines; these drugs are known as resins. They are usually tolerated well, but can cause constipation or bloating. Always report symptoms to your doctor and follow your health care provider's directions.
A Commitment Worth Making
High cholesterol levels can lead to dangerous narrowing of blood vessels and can eventually lead to a heart attack or stroke. Regular health exams that include monitoring cholesterol levels will keep you on a path to a healthier lifestyle. If your lipid levels are high, you can treat them successfully with diet, exercise, weight loss and medications. It takes a commitment, but it's a commitment worth making.
What Your Cholesterol Levels Mean -- American Heart Association
Bringing Down Your Cholesterol with a Healthy Meal Plan -- American Diabetes Association
Cholesterol and Triglycerides: The Good, the Bad and What It Means to You -- MerckSource
Cholesterol: About.com, J. Moll
The Top Four Foods (in Addition to Brown Rice) to Help Manage or Prevent Type 2 Diabetes -- U.S. News Health
Drug Therapy for High Cholesterol -- American Diabetes Association
High Blood Cholesterol: What You Need to Know -- National Institutes of Health
Heart Health Center: Cholesterol -- Discovery Health
The Christian Hospital Diabetes Institute can help with your diabetes diagnosis, treatment and management. Specially trained clinicians and dietitians teach you about eating healthy, exercising and taking your medicines correctly. They work with you and your doctor to create a plan just for you.