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Cholesterol & Your Heart: Know Your Numbers

November 01, 2019

We may know that cholesterol is related to heart disease and that it can build up in our arteries.  But where does it come from, how can we lower it, and when should we consider medication?

Where does cholesterol come from?

Our bodies make cholesterol in a tightly-controlled process that is influenced by genetics.  Cholesterol is made in the liver before entering the bloodstream.  We also consume cholesterol when we eat certain animal products.

It’s important to have the right balance of LDL and HDL cholesterol.

Too much LDL may lead to a buildup of cholesterol in the walls of our arteries, but HDL can remove cholesterol from both the artery walls and the bloodstream.

Eating too much saturated fat may raise the “bad” cholesterol in our blood.  Saturated fats are found in animal products like meat and dairy and plants like palm and coconut.  We don’t usually eat saturated fat by itself; it’s often in desserts and dishes that are also high in salt or sugar.  Think about a typical fast food meal of a cheeseburger, fries, and a soda or milkshake.  It’s high in saturated fat, salt, and sugar and low in many beneficial nutrients such as fiber and vitamins.

How can we lower our cholesterol?

Eating healthy isn’t about what to avoid.

If you eat enough vegetables, fruits, whole grains, beans, legumes, nuts, and seeds, then you leave less room for foods higher in salt, sugar, and saturated fat.

Unsaturated fats may improve cholesterol when used instead of saturated or trans fats.  They are found in fatty fish, nuts, seeds, avocados, and plant oils like olive and canola.  Omega-3 fatty acids are a type of unsaturated fat that may reduce inflammation and improve heart health.  Choose non-fried seafood each week and include plant sources of omega-3 fatty acids such as flaxseeds, chia seeds, hemp seeds, walnuts, and canola oil.

2019 Food Guide

Canada’s government updated its food guide in January of this year to reflect the most current research.  The guide focuses on cooking more often, enjoying your food, and eating with others.  Even if we aren’t ready to change the food we eat, the guide encourages us to eat more mindfully.

Most of the foods depicted in this visual are a good source of fiber, which is a nutrient that can help lower cholesterol.

  • Women 18-49 years old should eat 25 grams of fiber a day and 21 grams if 50 or older.
  • Men 18-49 years old should aim for 38 grams a day and 30 grams if 50 or older.

If these numbers seem unattainable, start small.  Try to increase your intake by choosing whole grains like oatmeal over refined grains like white flour, then up your fruit and vegetable intake.  Once that becomes a habit, have beans and legumes instead of meat a few times a week and experiment with plant-based meals.

The Mediterranean way of eating centers on foods naturally rich in fiber and has been shown to improve health and reduce the risk of many diseases, including heart disease.

If you think eating healthy is bland, try using sofrito to flavor some dishes.  It is a Mediterranean sauce made from onions, tomatoes, garlic, and pepper.  If you would like to incorporate more plant-based meals, try something hearty like chili.  If you want to eat more vegetables, try roasting them; this recipe uses frozen broccoli for minimal prep.

When should we consider medication?

You may have heard that new cholesterol guidelines were released at the end of 2018.  Much like the new blood pressure guidelines that were released at the end of 2017, these aren’t necessarily meant to put more patients on medication.  Instead, they are useful to start conversations between health care providers and patients about risk factors and possible treatment options.

The American Heart Association says that optimal LDL cholesterol for the average person is likely below 100 mg/dL, but if you have diabetes or heart disease, your cholesterol target may be different.

The new guidelines begin by emphasizing the importance of a heart-healthy lifestyle, which is something we can all work towards.  This article focused on how our eating influences cholesterol, but don’t forget that stopping tobacco use, achieving a healthy weight, and being physically active can all play a role in improving cholesterol and heart health.


Know Your Numbers – Smart Patient Series

Join Jordan Allem, MD and Meredith Ebersohl, RD, LDN to learn how to manage your numbers to improve your heart health Thursday, November 14 at the WakeMed Raleigh Campus Heart Center.

Register to Attend