High Cholesterol

High Cholesterol

While lowering cholesterol is the gospel of healthy hearts for people under age 65, there’s been some controversy over whether reducing cholesterol means anything in older people. In fact, a few years ago, a major physicians committee didn’t recommend cholesterol testing for people over age 65. They didn’t think lowering cholesterol in that age group had any benefits.

But before you decide to smother your food in butter and forgo your next cholesterol screening, know that a study by the National Institute on Aging in Bethesda, Maryland, found that high cholesterol was a risk factor for death from coronary heart disease in older men and women. And doctors like Lee Lipsenthal, M.D., medical director of the Preventive Medicine Research Institute in Sausalito, California, still believe that you can increase both the length and the quality of your life by keeping your cholesterol in check, no matter what your age. “There are still health benefits from treating high cholesterol in older people, absolutely,” he says.

Lowering cholesterol does improve the quality of life in older people. “We are just now beginning to see that you can reduce angina and the risk of heart attack within a short period of time by lowering a person’s cholesterol,” says John C. LaRosa, M.D., chancellor of Tulane University Medical Center in New Orleans.

To find out if cholesterol is a problem for you, you have to get tested. When you do, you’ll get three sets of numbers: total cholesterol, high-density lipoproteins (HDL), and low-density lipoproteins (LDL). HDLs are the “good” cholesterol and they take cholesterol away from your arteries. LDLs are the “bad” cholesterol and they carry cholesterol to the artery walls.

For total cholesterol, a score under 150 is ideal, less than 200 is desirable, 200 to 239 is borderline high risk, and 240 or more is high risk. An HDL level less than 45 is high risk, according to Dr. Lipsenthal.

When it comes to LDL, a score of less than 100 is desirable if you have heart disease. Less than 130 is acceptable if you don’t have heart disease, but when it’s 130 to 159, you’re at borderline high risk, says Dr. Lipsenthal. Get to 160 or more, and you’re in a high- risk category.

Despite its reputation, cholesterol is not evil. Your body actually needs it to build healthy cell membranes and manufacture hormones. But your body makes enough on its own. It doesn’t need all the extra cholesterol that results from getting too much fat in your daily diet.

When your body has more cholesterol than it needs, cholesterol starts to stick to your artery walls. That’s the beginning of heart disease.

The best way to naturally lower your cholesterol is to cut the fat out of your diet. But besides cutting high-fat foods, you can also reduce your cholesterol numbers by adding certain other foods, Dr. Lipsenthal says. Then combine a healthy diet with exercise, and you’ll do your heart a world of good by getting your cholesterol counts in the ranges where they should be. Here’s how to get started.

Try This First

Switch to low-fat dairy. Choosing fat-free milk and low-fat cheese over their full-fat counterparts is an easy and relatively painless way to cut fat grams out of your diet, says May M. Harter, R.D., coordinator of nutrition and weight management programs at New Britain General Hospital in Connecticut. “Don’t omit dairy to cut out the fat. There are plenty of choices,” she says. Pick fat-free yogurt and frozen yogurt, for instance.

Other Wise Ways

Mix up your meats. You don’t have to cut meat out of your diet to lower your fat and your cholesterol. You just have to make different meat choices, Harter says. Use extra-lean ground meat or ground turkey breast the next time you make burgers. Look for lean roast beef, or buy cuts such as select-grade eye of round, tip round, bottom round, and top sirloin. And when you cook chicken or turkey, remove the skin, she suggests.

Cut down the size. It’s not always what you eat that increases your cholesterol—it’s how much you eat, explains Harter. “Portion size is important. If you are used to eating two hamburgers for dinner, scale it back to one.”

If you get a huge deli sandwich, take off some of the meat or ask the server to trim it a bit and add more vegetables on top. An ideal portion of meat is about two to three ounces, about the size of a deck of cards. You should eat no more than two portions a day, suggests Harter. When you are counting your meat portions, remember to include poultry, pork, and fish in addition to red meat.

Add flavor, not fat. Many people add butter and oils to their cooking to enhance the taste of food. But you can have great taste without the fat, Harter says. Here are just a handful of simple ways to add flavor without adding fat grams and cholesterol points.

• Use no-stick spray such as Pam instead of oils to fry or sauté food.

• Use low-fat, reduced-sodium chicken broth to coat pans and cookware instead of oil or butter.

• Cook food with flavored vinegars.

• Cook or marinate foods in low-fat or nonfat salad dressing.

Spread your oats. Eat two ounces of oat bran a day, says Stephen T. Sinatra, M.D., director of the New England Heart Center in Manchester, Connecticut, and author of Optimum Health. Oat bran, found in oatmeal and some cereals such as Cheerios and Life, contains soluble fiber, which is thought to soak up cholesterol and take it out of your system. In various studies, oat bran has shown to lower high cholesterol anywhere from 3 to 20 percent.

Keep the skin on. When you eat a grapefruit, don’t cut it in half and scoop out the fruit. Peel it like an orange and eat it in pieces, Dr. Sinatra recommends. Eating it that way, you eat the white stringy stuff on the outside called pectin. Since pectin is another form of soluble fiber, eating more of it may help lower your cholesterol.

Try a Mediterranean taste. The next time you want oil or butter to cook with, reach for olive oil instead. Olive oil is an oil made mostly of monounsaturated fat, which is fat that may actually help raise your HDL, or “good,” cholesterol. But fat is fat, and too much will ultimately raise your cholesterol levels, so don’t slather it on everything. Dr. Lipsenthal suggests cooking with olive oil instead of other vegetable oils and using a little bit of olive oil on your bread instead of butter. If you have heart disease, however, you should avoid all oils.

Garnish with garlic. Use garlic when you make your meals. Dr. Lipsenthal says garlic can help neutralize the damage caused by high cholesterol.

To get an effect from garlic, you’d have to eat about a half a clove to a clove a day, notes Dr. Sinatra. If you aren’t up to that malodorous challenge, a couple of enteric-coated garlic capsules will provide you with about 1,000 milligrams of garlic a day.

Protect arteries with flax seeds. Take 1 1/2 tablespoons of ground flaxseeds or 1 teaspoon of flaxseed oil a day, suggests Dr. Lipsenthal. To incorporate them into your menu, use either the ground seeds or oil when you make salad dressing. Flaxseeds and flaxseed oil, found at most health food stores, contain omega-3 fatty acids, which are thought to protect the heart from the damaging effects of high cholesterol. “Omega-3’s have a role in strengthening the artery walls,” explains Dr. Lipsenthal.

Select some soy products. Eating soy products has been shown to lower cholesterol. In a study of 4,838 people in Japan, researchers found that an increase in soy products corresponded to a decrease in cholesterol levels.

In another study, at the University of Kentucky in Lexington, researchers found that eating about 47 grams of soy protein a day could lower total cholesterol 9.3 percent and could lower LDL, or “bad” cholesterol, by 12.9 percent compared to a diet in which the protein is derived from animal sources.

“Soy has a lot of great stuff in it. It is also a wonderful meat substitute as far as protein and nutrition goes. You are substituting a higher-fiber, lower-fat food that is a filling replacement, and it has a lot of benefits,” Dr. Lipsenthal says. Here are some of his recommendations for serving soy products.

• Steam a cup of soybeans. “They are real tasty that way. They look like lima beans but taste a lot better,” he says. Look for them at your health food store.

• Toss tofu into salads, stir-fries, and pasta dishes. Marinate it in a low-fat sauce or gravy to give it taste, he says.

• Use soy milk instead of cow’s milk.

• Look for nutritional supplement shakes with soy in them at your grocery or health food store.

• Try low-fat soy burgers or veggie burgers made with soy.

Shake it up. To get the daily benefits of soy and flaxseeds, try a shake. Dr. Sinatra has one every day. He mixes eight ounces of soy milk with two tablespoons of ground flaxseeds. (You can buy ground flaxseeds in health food stores or grind them yourself in a coffee mill.) He tosses a few strawberries or blueberries into the blender and mixes it all up. The result is a great, nutty, fruit shake that contains a variety of cholesterol-lowering and protective elements: soy, omega-3 fatty acids from flaxseeds, and fiber from the seeds and berries.

Eradicate oxidation. Try to include antioxidants in your diet or take antioxidant supplements, suggests Dr. Lipsenthal. Antioxidants are chemicals that prevent cholesterol from oxidizing. It’s the oxidation that causes cholesterol to harden and clog arteries. “Antioxidants don’t lower cholesterol but they diminish the damaging effects of cholesterol,” he says. He suggests a daily dose of the following.

• Vitamin C. Take between 1,000 and 3,000 milligrams a day. Food sources include broccoli, brussels sprouts, red cabbage, citrus fruits, guavas, parsley, and mustard greens. Over 1,200 milligrams of vitamin C daily may cause diarrhea in some people.

• Vitamin E. Take between 100 and 400 international units per day. Food sources include salad and cooking oils (except coconut oil), seeds, nuts, wheat germ, asparagus, avocado, seafood, apples, carrots, and celery. Watch the fat content of these foods. If you have heart disease, you should be ultra-careful and possibly consider a supplement instead. (Although vitamin E is generally sold in doses of 400 international units, one small study showed a possible risk of stroke in dosages higher than 200 international units. Consult with your doctor if you are at high risk for stroke.)

• Vitamin A. Take 2,500 international units in the form of beta-carotene. Food sources include carrots; dark green, leafy vegetables, such as spinach and collard and mustard greens; yellow vegetables, such as squash, pumpkins, and sweet potatoes; and yellow fruits, such as peaches and apricots.

Stop smoking. Smoking raises your cholesterol and does even more untold damage to your heart, Dr. Lipsenthal says.