Cholesterol Counts!

Heart disease could be considered an epidemic in America. Since 1910, heart disease has been the leading cause of death in America (except 1918 the year of the great flu pandemic). Today, it is estimated that cardiovascular disease, including heart disease and stroke, account for over 35% of all US deaths.

Heart disease is caused by narrowing or complete blockage of the coronary arteries. The coronary arteries provide blood and oxygen to the heart. When these arteries get plaque buildup they narrow - this is also known as atherosclerosis. Narrowing of the arteries leads to reduced blood flow to the heart, which leads to chest pain. If blood flow is completely blocked it can lead to a heart attack. This is obviously an oversimplified explanation, yet helpful in understanding how diet and cholesterol play a role in heart disease.

The good news is that heart disease can be prevented, and for those already diagnosed many may be able to reverse the disease and shrink plaque. There are numerous studies that show that stabilizing and reversing coronary heart disease through diet and drugs is possible.

One of the critical risk factors for heart disease is high cholesterol levels. When LDL cholesterol is too high it leads to the cholesterol plaque that builds up on the artery walls. According to the American Heart Association (AHA) the current goals for cholesterol levels are:

- Total Cholesterol: Less than 200

- HDL Cholesterol: 60 or higher is protective against heart disease

- LDL Cholesterol: 100 or lower if you have heart disease or diabetes, 130 or lower if you don't have heart disease or diabetes but have 2 or more risk factors, and 160 or lower for everyone else

To increase your HDL levels: - Lose excess weight and maintain a healthy weight.

- Get physically active following the guidelines of 3-5 days per week for 30-90 minutes per day.

- Follow a low-fat diet of no more than 30% of total Calories from fat (a maximum of 50 grams of fat for a 1,500 Calorie diet, and 65 grams of fat for a 2,000 Calorie diet).

- Replace saturated fat such as butter, cheese, whole milk and beef fat with monounsaturated fats such as olive oil, canola oil, avocado and many nuts and seeds.

To decrease your LDL levels:

- Replace saturated fats with monounsaturated fats or polyunsaturated fats such as vegetable oils, nuts and seeds, and fatty fish. Total saturated fat for the day should be less than 7% of total Calories (about 11-15 grams or less per day). A one-ounce cube of cheddar cheese has 6 grams of saturated fat, and one tablespoon of butter has 7 grams of saturated fat. Saturated fat intake is thought to be the strongest dietary factor in high cholesterol levels - make it a priority to cut back!

- Eliminate trans-fat from your diet. Less than 1% of total Calories should come from trans-fats - that's 1.5-2 grams per day. A word of caution related to trans-fats: if a label says "0 grams trans-fat" - read the ingredients list. If any ingredient says "partially hydrogenated" that food contains trans-fat. The labeling laws allow companies to put "0 grams of trans-fat", if the amount in a serving size is 0.5 grams or less. It's very easy to go over the 1% limit if you aren't reading the ingredients.

- Increase fiber especially soluble fiber. Total daily fiber intake should be about 25 grams for women and 38 grams for men. For cholesterol-lowering benefits include soluble fiber which is found in oats, buckwheat, barley, legumes, and most fruits and vegetables.

- 2-3 grams per day of plant sterols and stanols are found to be helpful in reducing cholesterol levels. These are generally recognized as safe and can be found in specially formulated margarines, low-fat yogurts, juice, bread, and cereal, along with supplements such as Nature Made's "CholestOff".

- Limit added sugars. The AHA is recommending no more than 100 Calories of added sugar for women and 150 Calories of added sugar for men. That is about 25 grams for women and 38 grams for men.

So what should we eat?

- An abundance of fresh or frozen fruits and vegetables.

- Whole grains and unprocessed grains.

- Fish especially those high in omega-3's such as salmon and mackerel at least 2 times per week.

- Fat free or low-fat (1%) dairy products.

- Lean cuts of meat or vegetable alternatives such as tofu.

- Healthy fats such as olive oil, avocados, nuts, seeds, canola oil and other vegetable oils.

The American Heart Association has a great resource for fats called "Meet The Fats". For a copy of the file in.pdf form go to the "Articles" section of my website.

If you need help reducing your cholesterol, ask your doctor about a referral to a registered dietitian. Many insurance companies will cover the cost, at least in part. You might also consider a health and wellness coach to help you make the lifestyle changes necessary to reduce your risk of heart disease and plan for your long-term health and wellness.

Laura is a registered dietitian and certified wellness coach. She is the owner of Balanced Body Nutrition, providing wellness coaching and nutrition counseling. For more information on coaching and nutrition services visit: balancedbodynutrition.com balancedbodynutrition.com or contact her at