Saturday, January 5, 2013

High Cholesterol?

So what about all this business of high cholesterol, lipids, triglycerides, and statins?

As someone who has a background with a science education these terms aren't foreign to me. But I do realize sorting through what is all the HDL "good" cholesterol versus LDL "bad" cholesterol and what to do with your readings can be dizzying at the least.

First and foremost, this article is not meant to replace your doctor. If you have questions about any of these topics, promptly contact your physician or medical care taker for your personal health.

That out of the way, let's start with HDL, LDL, and Total Cholesterol:HDL ratio. What do all these terms mean?

When your HDL level is higher than your LDL I've found my doctor say "Well, your LDL is a little high, but your HDL is so much higher it's not something we'll worry about right now."

When your LDL is higher than your HDL but your LDL is still in the "acceptable range" then it still seems okay.

What are the ranges? Here in America it's proposed per WebMD:

LDL CholesterolLDL-Cholesterol Category
Less than 100Optimal
100 - 129Near optimal/above optimal
130 - 159Borderline high
160 - 189High
190 and aboveVery high

HDL CholesterolHDL-Cholesterol Category
60 and aboveHigh; Optimal; associated with lower risk
Less than 40 in men and less than 50 in womenLow; considered a risk factor for heart disease

Total CholesterolCategory
Less than 200Desirable
200 - 239Mildly High
240 and aboveHigh

And a note about triglycerides ...

Triglycerides are the chemical form in which most fat exists in food and the body. A high triglyceride level has been linked to higher risk of coronary artery disease. Triglycerides are a family of lipids.
TriglyceridesTriglyceride Category
Less than 150Normal
150 - 199Mildly High
200 - 499High
500 or higherVery high

And to make matters worse all this information in combination doesn't necessarily spell out what one should do to (a) raise HDL (b) lower LDL (c) lower total cholesterol (d) exercise (e) modify diet.

First analyze what each of your numbers are fit within each range. My last reading gave me very high HDL, borderline high LDL, very low Total Cholesterol and normal triglycerides. So to understand what I should do next, I need to look at the trend of my readings. Both my LDL and HDL have lowered, along with my total cholesterol. But my ratio of LDL to HDL has risen, that is to say my LDL by comparison of last time when compared to my HDL is higher, thus worse?

And to note, just to define statins ... those are the medications that are prescribed that act like, well, Drano that clears out the clogs in arteries and such. Many doctors swear by that treatment and I've even researched that many people have stated their doctor wants them to try all of the classes before abandoning hope. Um, that means you get a whole host of side effects and may not even find the right one! I think it's best to treat yourself before you ever get to a stage of your doctor prescribing a statin.

The overall problem with most people with high cholesterol is that they tend to be low in HDL and high in LDL. The best thing to do, period, is to always keep your HDL high and your LDL low.

It's actually easier (so some sources state) to lower your LDL than raise your HDL.

So let's analyze some thoughts between all of the things mentioned in new light.

"Foods high in saturated fat can increase cholesterol more than foods high in cholesterol, like eggs," says Columbia University nutrition researcher Wahida Karmally, DrPH, RD.

Put simply people think eggs are bad because they have high cholesterol, but in actuality they are fine for you since they have such low saturated fat.

But also worthy of mentioning, cholesterol and saturated fat, are not necessarily unhealthy. 

People who eliminate trans fat and carbohydrates from grains (soda, pasta, bread, desserts) see major drops in bad cholesterol and triglycerides despite continuing to eat cholesterol-rich foods like red meat, eggs, cream, and butter. 

So what does that mean?

The "lipid hypothesis" (dietary cholesterol clogs arteries that lead to heart disease) is not the whole story. LDL build up is not from how many eggs you eat, but is in response to inflammation. This is triggered by a diet high in trans fat and processed carbohydrates, not saturated fat.

To recap then, along with lowering bad (LDL) cholesterol you boost good (HDL) cholesterol and control inflammation.

There's some good articles from WebMD and Mark's Daily Apple that explain surprising foods that lower your LDL, raise your HDL, and decrease inflammation. When I read the list of what raises HDL and decrease inflammation I crave all those foods. But also, when I read the list of what raises LDL I crave all of those foods too! So maybe that's why my HDL and LDL are always somewhat balancing each other out. I mean, who doesn't love mashed potatoes and turkey! Those are both on the raising LDL list. I'm sure in moderation is fine, but I love, love, love my potatoes!

Of course the most sensible thing to do to raise your HDL includes that simple word we hear over and over again ... Exercise! Because really, your cholesterol isn't just associated with diet. You must always watch your weight for obesity and be careful of overeating. Putting your food in a separate area or room from that which you eat (like leaving your food in the kitchen and eating at the table) will reduce your chance of overeating. People are more likely to grab more food if it is in front of them.

And as always, speak with your doctor before you change your diet or exercise regime.

I once had a friend who swore by the Atkins diet for people with high blood pressure. Upon speaking with my doctor he said this was ridiculous and wondered aloud where people got these silly ideas. He actually told me the Atkins diet is the WORST diet out there with people who suffer with high blood pressure or with a risk of heart or coronary disease.

Oh and I recently started drinking aloe vera juice because I found some conclusive studies pointing toward anti-inflammatory properties (well and prevention of pancreatic cancer). When I consulted my doctor about this, he just shrugged and said it was fine to drink if I wanted but he didn't think the anti-inflammatory properties were that significant. Well, the brand I found that I like best now is Alo. I've tried some other brands but this one actually contains some significant amount of vitamin C and isn't as sweet as other brands.

He pointed to foods like garlic and onions that have anti-inflammatory properties. Ah, back to the whole fruit and veggie adage.