The Healthy Fats – Good vs Bad Cholesterol – High Cholesterol

First of all what are good and bad fats?

Dietary fat is one nutrient with a serious image problem: Fat in food is equated to fat on hips—but it’s not the same! Our bodies need certain fats. Getting the right amounts from the right sources will not only ensure your food doesn’t taste like cardboard, but also can help you lose stubborn pounds (yes, you read that correctly).

Fat’s (Ahem) Larger Purpose
The main reason fat gets a bad rap is that much of the type we eat comes in less-than-healthy packages like doughnuts and cheese chips. The fact that we’re wired to crave the flavour fat provides makes it even easier to overeat. Back when mammoth was still a menu item, calories were hard to come by. Humans evolved to seek out the most concentrated supply of them, and fat, with nine calories per gram versus four per gram in carbs and proteins), was our best food source for survival.

Though we no longer need that primitive urge to keep us alive, fat still plays a critical role: It delivers key nutrients to your body. Vitamins such as A, D, E, and K are called fat-soluble because they need to bind to fat to be absorbed. If fat isn’t available, the vitamins can’t be absorbed properly. Top your salad with low-fat dressing and you could miss out on a lot of the benefits in those leafy greens—which can also leave you jonesing for a snack later. Part of losing weight is being satisfied so you aren’t grazing all day on other foods. “And studies have found that foods with healthy fats, like avocado and nuts, take longer to digest and therefore help keep you fuller longer.”

The Low-Fat Lie
Approaching fat the way you do the limbo—how low can you go?—won’t send the scale plummeting. CDC data shows that while Americans consumed a lower percentage of calories from fat in 2000 than they did in 1971, the total number of calories consumed by women per day increased by more than 300! This is likely the result of manufacturers replacing the fat in foods with sugar. The ‘low fat’ message was interpreted as an invitation to indulge without keeping calories in mind. Cutting all fat from your diet means you’ll also miss out on good fats that can help you in your quest to shrink a size. A study in the journal Diabetes Care found that a diet rich in monounsaturated fats (such as almonds) may prevent the accumulation of abdominal fat. Fat is all about the source it comes from. Combining fats and carbs in the same meal will keep your blood sugar stable and help you avoid hunger-inducing spikes and dips.

This isn’t license to gorge on one ginormous cinnamon roll, though. Spread your fat-carb combos throughout the day: natural nut butter on whole-grain toast in the a.m., olive oil drizzled on your salad at lunch, guac with veggies for a snack.

One to Avoid
For all the friendly types of fat, there is one you should keep as an enemy: man-made trans fats, which have been shown to raise bad (LDL) cholesterol and lower good (HDL) cholesterol. Unlike other unsaturated fats, which tend to have health benefits, these have been chemically altered through a process called hydrogenation to make the product they are in easier to sell (for example, some packaged cookies contain hydrogenated or partially hydrogenated fats to make them last longer on store shelves).

Unfortunately, you may not even be aware they’re in a product, thanks to tricky labeling laws that allow manufacturers to list zero grams of trans fat as long as a serving contains less than 0.5 grams. To avoid them, stay away from food whose ingredients panel lists hydrogenated or partially hydrogenated oils.

Finally, always remember to watch your portions, even with good fats. Fat in any form packs more than twice the amount of calories as protein and carbs. Often, people eat the right foods but too much of them. Olive oil is the number one offender among her clients. A cup has close to 2,000 calories, and unless you’re a stickler for measuring, it’s easy to pour on more than the proper two-teaspoon serving.  Bottom line: In small doses, fat is one of your best food friends.

 

Size Matters: How Much Fat Is Healthy?

A guide to the amounts (and types) of fat you should eat each day

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1. Saturated Fats

So how much and what kinds of fat should you be eating? Expert guidelines suggest that 20 to 30 percent of your daily calories should come from fats, and no more than 10 percent from the saturated variety. Based on a diet of 1,800 calories a day, that’s between 40 and 60 grams of fat daily. Follow these suggestions to keep your portions in control.

Many of us know saturated fats as “bad” fats, but new research has led experts to question whether they are linked to heart disease, as previously thought. And one study even found that certain saturated fats can be metabolized by your body faster than others, which means they are rarely stored as flab.

Try:
1 tablespoon butter (salted) (12 g fat, 102 cal)
1 tablespoon coconut oil (14 g fat, 117 cal)
8 ounces reduced-fat milk (2 percent) (5 g fat, 122 cal)
3 ounces cooked ground beef, 85 percent lean (13 g fat, 212 cal)

If a fat is solid at room temp, it’s likely saturated.

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2. Polyunsaturated Fatty Acids (PUFAs)

These fats tend to be liquid at room temperature, like oils. PUFAs can help reduce the risk for type 2 diabetes and heart disease by helping improve cholesterol.

Try:
1 tablespoon safflower, corn, sunflower, soy, cottonseed, peanut, or other vegetable or nut oil (14 g fat, 120 cal)
1 ounce dry-roasted sunflower seeds (14 g fat, 165 cal)

PUFAs are often in plant-based foods.

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3. Monounsaturated Fatty Acids (MUFAs)

Eating this form of unsaturated fat can help improve cholesterol levels.

Try:
1/4 avocado (7 g fat, 80 cal) 
10 large green olives (4 g fat, 40 cal)
1 tablespoon peanut butter (8 g fat, 94 cal)

MUFAs may steady blood sugar.

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4. Omega-3 Fatty Acids

These may protect against cardiovascular disease. “Getting sufficient omega-3s is tough,” says Blaue. You’d have to eat salmon three times a week to get 500 milligrams per day of O-3s, the amount needed to reap the heart benefits.

Try:
3 ounces cooked salmon (4 g fat, 114 cal)
1 can sardines (3.75 ounces) in oil (11 g fat, 191 cal)
1 ounce walnuts (about 14 halves) (18 g fat, 185 cal)

Fish oil may fight body inflammation.

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5. Omega-6 Fatty Acids

To help decrease the risk of dying from coronary disease, “people should get a 1-to-1 ratio of omega-6 fats to O-3s,” says Blaue. Otherwise, our bodies can metabolize O-6s in a harmful way. “Most American diets,” she says, “have a 20-to-1 ratio of O-6s to O-3s.”

Try:
1 tablespoon margarine (11 g fat, 101 cal)
2 tablespoons Caesar salad dressing (17 g fat, 163 cal) 
1 tablespoon almond butter (9 g fat, 98 cal)

O-6s can help you absorb more vitamins from food.

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5 Ways to Boost Good Cholesterol

Higher levels of HDL, or “good” cholesterol, may help protect you from aneurysms

Bummer alert: Aortic aneurysms, a dangerous swelling of the aorta, affect 1 to 2 percent of women and kill around 13,000 Americans each year, according to the National Heart, Lung, and Blood Institute. They can only be repaired surgically and often go undiagnosed, but a new study shows hope for a treatment: The research, published in the journal Atherosclerosis Thrombosis and Vascular Biology, indicates thathigher levels of HDL, or “good” cholesterol, can help protect you from developing an aortic aneurysm.

Researchers from St. George’s University of London gave a peptide called Ang-II to mice to increase their blood pressure and try to induce an aneurysm. They then injected one group of mice with HDL and another with a placebo. Researchers discovered that they were unable to create new aneurysms in the mice that received the HDL injections, and these mice also showed a significant reduction in the size of their existing aneurysms. “It’s good news for mice, but we do need to translate this,” says lead study author Gillian Cockerill, PhD, group leader of the Vascular Biology Research Unit.

That said, existing research shows boosting your HDL is good for heart health and may help prevent coronary disease. “HDL is a type of cholesterol that actually cleans the blood vessels, as opposed to the LDL cholesterol (aka, bad cholesterol), which clogs them,” she says.

A few strategies on how get more of the good stuff.

Work it out: Since regular exercise helps boost HDL production, Zaric recommends logging at least 30 minutes of any aerobic exercise three to four times a week.

Quit the cancer sticks: Whether you’re a regular smoker or a “just one puff” kind of girl, it’s time to ditch the bad habit. “Smoking even in small amounts can actually suppress the HDL release from the liver,” says Zaric.

Drop some pounds: If your BMI is higher than 25, losing weight isn’t just all-around good for you—it can also up your HDL levels. That said, people who are at a normal body weight shouldn’t try to drop pounds just to increase HDL production.

Fill up on good fats: Consumption of monounsaturated fats has been linked to higher HDL levels. Get your fill by incorporating more avocado, salmon, sardines, olive oil, and olives into your diet.

Consider a cholesterol booster: If you’re generally healthy but have a low HDL count and a family history of heart disease, you might want to ask your doctor about OTC cholesterol-boosting medications, says Zaric. One thing to keep in mind: They can have the side effect of facial flushing or redness, which might last anywhere from 5 to 10 minutes.

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High Cholesterol (Hypercholesterolemia)

What Is It?

Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body’s cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You need only a small amount of fat in your diet to make enough cholesterol to stay healthy.

The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream. There are two main types of cholesterol: low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol) and high-density lipoprotein (HDL) cholesterol (the “good” cholesterol).

High levels of LDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol-rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, slowing or stopping the flow of blood to vital organs, especially the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack. Whenatherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke.

High levels of HDL cholesterol actually protect against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver.

Because high cholesterol levels can cause atherosclerosis, doctors recommend that people keep their cholesterol levels within a specific range. In general, adults older than 20 should try to keep their total cholesterol level below 200 milligrams per deciliter.

For a more precise assessment of the risk of atherosclerosis, your LDL cholesterol should be checked. According to guidelines established by the government-sponsored National Cholesterol Education Program, the desirable level for LDL cholesterol depends on whether or not a person already has a disease caused by atherosclerosis or diabetes or other risk factors for coronary artery disease. In addition to a high LDL cholesterol level and diabetes, risk factors for coronary artery disease include:

  • Being a male older than 45
  • Being a female older than 55
  • Being a female with premature menopause
  • Having a family history of premature coronary artery disease (a father or brother younger than 55 with coronary artery disease or a mother or sister younger than 65 with coronary artery disease)
  • Smoking cigarettes
  • Having high blood pressure
  • Not having enough good cholesterol (high density lipoprotein or HDL)

If you have coronary artery disease, peripheral arterial disease or have had a stroke from atherosclerosis, your LDL cholesterol should be 70 milligrams per deciliter or less.

The more risk factors you have, the lower your target LDL cholesterol should be. In general, an LDL cholesterol level of less than 100 is best, but less than 130 may be acceptable for people with few or no risk factors.

Your level of HDL cholesterol is also very important. People with levels below 40 milligrams per deciliter are more likely to develop atherosclerosis, heart disease and stroke. Levels of HDL cholesterol above 60 milligrams per deciliter are associated with less atherosclerosis and are thought to help protect against heart disease and stroke.

Symptoms

Most people with high cholesterol don’t have any symptoms until cholesterol-related atherosclerosis causes significant narrowing of the arteries leading to their hearts or brains. The result can be heart-related chest pain (angina) or other symptoms of coronary artery disease, as well as symptoms of decreased blood supply to the brain (transient ischemic attacks or stroke).

About 1 out of every 500 people has an inherited disorder called familial hypercholesterolemia, which can cause extremely high cholesterol levels (above 300 milligrams per deciliter). People with this disorder can develop nodules filled with cholesterol (xanthomas) over various tendons, especially the Achilles tendons of the lower leg. Cholesterol deposits also can occur on the eyelids, where they are called xanthelasmas.

Diagnosis

Your doctor will ask if anyone in your family has had coronary artery disease, high cholesterol or diabetes. The doctor will ask about your diet and if you have ever smoked. He or she will check your blood pressure and look for xanthomas and xanthelasmas. Your doctor can confirm a diagnosis of high cholesterol with a simple blood test.

Expected Duration

If your cholesterol level is high, you will need to make a long-term effort to bring it down. You can significantly lower your cholesterol levels by sticking with a diet that is low in saturated fats, high in fruits and vegetables, and by substituting “good” fats for “bad” fats. The dietary changes need to be permanent to maintain lower cholesterol levels. Daily exercise also is important. Exercise can raise HDL (good) cholesterol and lower total cholesterol.

Prevention

You may help to prevent high cholesterol by staying on a healthy diet and exercising daily. Avoid high-fat foods (eggs, fatty red meats, palm or coconut oil, dairy products made with whole milk). Instead eat more fresh fruits and vegetables, whole-grain breads and cereals, and low-fat dairy products.

Treatment

The initial treatment of high cholesterol should always be lifestyle changes. This means altering your diet and getting more exercise. Some people respond dramatically to dietary changes.

Diet

There is no consensus on the best diet. The most effective diet to lower total and LDL cholesterol is a vegetarian diet. However, this is not an easy diet to follow.

Many people prefer a “Mediterranean style” diet. There is no strict definition for what should be included in this type of diet. In general, this means

  • Getting the majority of daily food calories from plant sources, especially fruits and vegetables, grains, beans, nuts, and seeds
  • Using olive oil as the principal fat, replacing other fats and oils
  • Having some low fat cheese and/or yogurt daily
  • Eating fish a couple times per week
  • Limiting processed foods
  • Drinking alcohol in moderation unless medically not indicated. No more than two drinks per day for men and one per day for women.

The National Cholesterol Education Program recommends the following diet:

  • Saturated fat—less than 7% of calories
  • Monounsaturated fat—about 20% of calories
  • Polyunsaturated fat—about 10% of calories
  • Protein—about 15% of calories
  • Carbohydrates—about 50% of calories
  • Fiber— about 25 grams of soluble fiber per day
  • Cholesterol—less than 200 milligrams per day

Avoid all trans fats.

To maintain a desirable weight, you should take in only as many calories as you burn each day. If you need to lose weight, you need to take in fewer calories than you burn.

People who aren’t sure how to follow such a diet may find it useful to work with a health care professional such as a dietitian, nutritionist, doctor or nurse.

In addition to dietary changes, you should get at least 30 minutes of moderate-intensity exercise, such as brisk walking, daily.

Medications

Whether you need medication to lower your cholesterol level depends on how you respond to diet and your personal risk of heart attack and stroke.

There are five types of cholesterol-lowering medications:

  • Bile acid-binding resins, including cholestyramine (Questran) and colestipol (Colestid). They are used less often today because they lower HDL (good) cholesterol as well as LDL (bad) cholesterol.
  • Niacin (several brand names).
  • Fibrates, including gemfibrozil (Lopid), fenofibrate (Tricor) and clofibrate (Abitrate). Fibrates are especially helpful for people with high triglyceride levels.
  • Statins, also called HMG-CoA reductase inhibitors, including lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor), and rosuvastatin (Crestor). Statins block an enzyme called HMG-CoA reductase, which is necessary for the production of cholesterol. They are the most commonly prescribed cholesterol lowering medication.
  • Selective inhibitors of intestinal cholesterol absorption—There is only one available, ezetimibe (Zetia).

If your cholesterol is not controlled with diet and other lifestyle changes, your doctor may recommend that you take one or more of these medications. Each type of medication works differently and has different types of side effects.

In addition to dietary changes or medication, people with high cholesterol should try to control their other risk factors for coronary artery disease. This means keeping blood pressure at normal levels, not smoking, controlling your blood sugar, maintaining or losing weight and following a regular exercise schedule.

When To Call a Professional

Because it is possible to have high cholesterol for many years without symptoms, it is important to have your blood cholesterol level checked periodically. Current guidelines recommend that adults older than 20 undergo a full fasting lipid profile once every five years. This test measures LDL and HDL cholesterol and triglyceride levels. If the numbers are outside the desirable range, your doctor may suggest that you change your diet and monitor your cholesterol more frequently.

Prognosis

The effectiveness of following a healthy diet and using medications to lower cholesterol varies from person to person. On average, diet and exercise can lower LDL cholesterol by about 10%. Medications can lower LDL cholesterol by another 20% to more than 50%.

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