Elevated blood lipids (blood fats), such as high cholesterol and elevated triglycerides
can, lead to cardiovascular disease over time. If you:
- have high blood pressure (BP >140/90 mmHg),
- are a male >45 or a female > 55 years,
- are a smoker,
- are overweight,
- are physically inactive,
- have a family history of cardiovascular disease,
- and/or have diabetes,
then you are already at risk for heart disease. Maintaining healthy lipid levels
is essential to reducing your risk of cardiovascular disease and stroke.
Cholesterol
Cholesterol is a fat-like waxy substance that circulates in the bloodstream. Though
it has important functions in the body and cells even make some cholesterol on their
own, it also is supplied by foods that come from animal sources such as eggs, meats,
and dairy foods.
Too much cholesterol circulating in the blood can build up in artery walls. Over
time, artery walls can become narrowed and clogged, which can lead to heart attack
and stroke. High cholesterol, known as hypercholesterolemia, can be caused by an
excess intake of saturated fat and high cholesterol foods in the diet, heredity,
or both.
There are many forms of cholesterol, but three main forms are: total cholesterol
(TC), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). HDL and
LDL cholesterol are two parts that contribute to the total cholesterol number .
HDL is mainly affected by physical activity level and is often called “good cholesterol”
because it has a beneficial, protective effect against cardiovascular disease. HDL
cholesterol should be > 40 mg/dL and is considered optimal when it is > 60 mg/dL.
While an HDL level < 40 mg/dL, is linked to increased risk for cardiovascular disease,
a level 60 mg/dL, is considered a “negative risk factor” because it is associated
with reduced disease risk. The average HDL for a man is 45 mg/dL and for a woman
is 55 mg/dL. Exercise can be very beneficial when it comes to increasing HDL level.
LDL is called “bad cholesterol” because it contributes to plaque formation and clogging
of blood vessels. It is affected by what you eat; high fat and high cholesterol
foods raise LDL levels. Limiting fat and cholesterol in the diet, by choosing fruits
and vegetables, lean meats and poultry, low-fat dairy foods, and whole grains, as
well as exercising can help lower LDL.
Triglycerides
Triglycerides are another form of fat found in the blood. Triglyceride levels can
be elevated from eating a high fat diet, consuming large amounts of refined carbohydrate,
and excessive alcohol intake. Triglycerides may be high even if total cholesterol
is normal. To lower triglycerides, monitor fat and carbohydrate consumption by reading
food labels. If you are overweight, moderate weight loss can also lower triglyceride
levels. The National Cholesterol Education Program from the National Heart, Lung,
and Blood Institute, recommends that triglycerides be less than 150 mg/dL.
National Cholesterol Education Program (NCEP) Classifications for Cholesterol and
Triglyceride levels:
|
|
Optimal
|
Near Optimal
|
Borderline High
|
High
|
|
Total Cholesterol (mg/dL)
|
200 |
- |
200-239 |
>240 |
|
LDL Cholesterol (mg/dL)
|
<100 |
100-129 |
130-159 |
>160 |
|
Triglycerides mg/dL |
<150 |
- |
150-199 |
>200 |
|
|
Optimal
|
Low
|
| HDL (mg/dL)
|
>60
|
<40
|
Source: The Third Report of the Expert
Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
(Adult Treatment Panel III); NIH Publication No. 01-3305, National Cholesterol Education
Program, May 2001.
Types of Fats in Foods
Saturated fat
Saturated fat is found mainly in animal products such as butter, regular or full-fat
dairy products, beef, poultry, pork, fish, and eggs. It is also found in tropical
oils such as coconut, palm, and palm kernel oils, even though they are plant oils.
Saturated fat is solid at room temperature. Fried foods and many snack foods are
high in saturated fat.
Trans fat
Trans fat is a type of fat formed by hydrogenation (adding hydrogen bonds to unsaturated
fats). They are found in baked goods, fried foods, snack foods, and in some margarines.
Foods containing partially hydrogenated oils have trans fat. Read food labels for
trans fat content and look for foods containing 0 grams of trans fat. By 2006, the
Food and Drug Administration (FDA) will require all food labels to list the amount
of trans fat in foods.
Unsaturated fat
Unsaturated fat is a type of fat found in plant products and is liquid at room temperature.
There are two main types of unsaturated fats: monounsaturated and polyunsaturated
fats. Monounsaturated fats are found in olive, peanut, canola, and sesame oil. Polyunsaturated
fats are found in margarines, vegetable oils like safflower, sunflower, corn, soybean
and cottonseed, spreads, and salad dressings.
Omega-3 fatty acids
Omega-3 fatty acids are found in cold-water fatty fish like salmon, herring and
mackerel, flaxseed, nuts like walnuts, soy, and fish oil supplements, canola and
soybean oils. Omega-3 fatty acids have been shown to reduce total cholesterol and
triglyceride levels. The American Heart Association (AHA) recommends at least two
servings of fish per week. If you do not eat fish, fish oil capsules providing about
1 gram/day may be beneficial.
Plant sterols/stanols
Plant sterols/stanols are plant-derived compounds that have been added to food products
such as margarines, salad dressings, mayonnaise, chocolate chews and even orange
juices. Plant sterols/stanols have been shown to decrease total cholesterol and
LDL levels. Read food labels for sterol/stanol content. The NCEP recommends 2 g/day
to receive a cardiovascular benefit.
Fiber
Fiber is found in many fruits, vegetables, breads, cereals, and other grain products.
There are two types of fiber, soluble and insoluble. Soluble fiber is a viscous
form of fiber that can help lower total cholesterol. Insoluble fiber helps regulate
bowel function and may aid in reducing the risk of some types of cancer. Good sources
of soluble fiber include oat bran, dry beans and peas, some vegetables, and most
fruits. Good sources of insoluble fiber include wheat bran, whole grains, and vegetables.
Aim to get about 25 grams of fiber per day by choosing at least three servings of
vegetables, three servings of fruit, and four servings of whole-grain products each
day. Increasing fiber consumption in the diet can cause gas and a feeling of fullness,
so be sure to increase fiber intake slowly and drink plenty of fluids.
Recommendations for a healthy heart
A healthy lifestyle is important for preventing and managing high cholesterol. Some
people may not be able to control cholesterol levels with diet alone and may have
to take cholesterol lowering medications. Even if you are on a cholesterol lowering
medication, a healthy lifestyle is important.
The AHA and the NCEP recommend the following therapeutic lifestyle changes if LDL
levels are elevated:
- Limit saturated fat to less than 7% of total calories
- Limit total fat to 25-30% of total calories
- Limit sodium to 2300 mg/day or less
- Limit cholesterol to less than 200 mg/day
- Consume 10-25 g of soluble fiber per day (and a total of 25-30 g. of fiber per day)
- Eat 2 servings of fatty fish per week
- Consume 2 grams of plant stanol/sterols each day
- Achieve and maintain a healthy weight
- Increase physical activity to at least 30 minutes of moderate activity, such as
brisk walking, on most days of the week
For example, if you eat 2,000 calories per day, saturated fat and trans fat content
should be less than 16 grams per day, while total fat should be less than 55 to
65 grams per day. Total daily cholesterol and sodium should remain less than 200
mg/day and 2,300 mg/day, respectively, regardless of calories consumed.
If your lipid profile is normal, it is recommended that you continue to follow a
healthy lifestyle to maintain lipid levels.
Healthy lifestyle recommendations include:
- Limit saturated fat and Trans fat to 8-10% of your total calories
- Limit total fat to less than 30% of total calories
- Limit total cholesterol to less than 300 mg/day
- Limit total daily sodium to less than 2,300 mg/day
- Aim for a total fiber intake of 25-30 g/day
- Eat 2 servings of fatty fish/week
- Reach and maintain a healthy weight
- Increase physical activity to at least 30 minutes of moderate activity, such as
brisk walking, on most days of the week
For example, if you eat 2,000 calories per day, saturated fat and trans fat should
total less than 18 to 22 grams, while total fat should be less than 65 grams per
day. Daily cholesterol and sodium intakes should be less than 300 mg/day and 2,300
mg/day, respectively, regardless of calorie level.
For more information about heart-healthy eating ask your healthcare provider for
a referral to visit a Registered Dietitian (RD) or go to
http://www.eatright.org to locate an RD near you. An RD can determine a
good calorie level for you and design a personalized meal plan to help you to achieve
an optimal lipid profile.
A good way to make sure that you are following a healthy lifestyle is to read food
labels. If you pay attention to the total fat, cholesterol, sodium and fiber information
on the Nutrition Facts panel of food products, you can get useful information that
will help you make informed decisions about whether or not a product fits into a
heart-healthy eating plan. Remember to choose foods that are high in fiber and low
in fat, saturated and trans fats, cholesterol and sodium.
Good Measure Meals fits perfectly into an overall plan for individuals seeking to
manage healthy cholesterol levels. Our meal plan integrates healthy eating guidelines
of the American Heart Association and incorporates foods encouraged in the Therapeutic
Lifestyle Changes (TLC) eating plan. When combined with regular physical activity,
Good Measure Meals may help you improve your lipid profile. A healthy, balanced
diet is very important for anyone seeking to manage lipid levels.
For more information about heart-healthy eating, visit:
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