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Understanding and improving your cholesterol

According to a recent survey conducted by the Society for Women's Health Research (SWHR), an advocacy organization based in Washington, D.C., 80 percent of women in the U.S. between 18 and 44 don't know their cholesterol level. These are alarming statistics when you consider that high cholesterol is a major risk factor for the biggest killer of American women, heart disease.Ladies (and men!), I ur
/ Source: TODAY contributor

According to a recent survey conducted by the Society for Women's Health Research (SWHR), an advocacy organization based in Washington, D.C., 80 percent of women in the U.S. between 18 and 44 don't know their cholesterol level. These are alarming statistics when you consider that high cholesterol is a major risk factor for the biggest killer of American women, heart disease.

Ladies (and men!), I urge you to get your cholesterol tested. Once you know your numbers, here’s how to understand what they mean:

Optimal Numbers:

Total Cholesterol: < 200

LDL-Cholesterol: < 100

HDL-Cholesterol: 40 or higher

Cholesterol Ratio: less than 5

LDL-Cholesterol (remember L for Lousy)

The higher your LDL cholesterol, the greater your risk of developing life-threatening plaque. So, you want your low-density low. According to the National Institutes of Health (NIH), the optimal level of LDL cholesterol is below 100 mg/dL. High LDL cholesterol is defined as 160 mg/dL and higher — but certainly anything above 130 is worth treating.

HDL-Cholesterol (remember H for Hero)

HDL cholesterol, on the other hand, is like nature’s plaque vacuum cleaner — it picks up the vessel-clogging cholesterol and carries it away to the liver, where it is disposed of in the form of bile. The higher your HDL levels, the cleaner your blood vessels will be. So, you want your high-density high. According to the NIH, people with HDL of 60 mg/dL or higher have a lower risk of heart disease — whereas HDL below 40 mg/dL is considered too low.

Cholesterol ratio

Because HDL is so important to the health of blood vessels, some physicians prefer to talk about the cholesterol ratio — your total cholesterol divided by your HDL cholesterol. For example, if your total cholesterol number is 250 and your HDL is 50, your ratio is 250/50 or 5. A ratio of 3.5 (or less) is considered optimal, and people are urged to aim for a ratio less than 5.

Improving your cholesterol numbers through diet:

If your LDL-cholesterol is elevated, right off the bat, I tell you this: If you are overweight, focus on losing weight. Research has shown that losing just 10 pounds can reduce LDL cholesterol by 5 to 8 percent. Become more physically active. Even moderate exercise can help improve your cholesterol, as well as triglycerides and blood pressure. Eliminate or at least drastically limit the foods you eat that contain saturated fats, trans fats, dietary cholesterol and refined carbohydrates.

Limit saturated fats

Saturated fats are found in animal-based foods, including meats, butter, whole-milk dairy products (including whole-milk yogurt, cheese and ice cream) and poultry skin. They are also found in some plant-based oils, including palm oil.  

Avoid trans fats

Most stick margarines contain trans fats, and trans fats are found in many packaged baked goods, potato chips, snack foods, fried foods and fast foods that use or create “hydrogenated” oils. (All food labels must now list the amount of trans fats, right after the amount of saturated fats — good news for consumers.) There is no safe amount of trans fats, so try to keep them as far from your plate as possible. 

Limit cholesterol-rich foods

Research into the effects of dietary cholesterol have been mixed, which is not surprising — different people have different susceptibilities. Still, if you want to take a firm hand to reduce your risk factors, you may want to consider cutting down on all high-cholesterol foods, including egg yolks, shellfish, liver, and other organ meats like sweetbreads and foie gras.

Soluble fiber can improve your cholesterol

Soluble fiber can help reduce LDL-cholesterol by grabbing onto cholesterol and escorting it through your digestive system and out of your body. Some of the best soluble-fiber-rich foods include oatmeal, barley, lentils, brussels sprouts, peas, beans (kidney, lima, black, navy, pinto), apples, blackberries, pears, raisins, oranges, grapefruit, dates, figs, prunes, apricots, broccoli and sweet potatoes.

Healthy fats: Omega-3 and Monounsaturated Fats

There was a time when heart researchers slapped the same label “bad” on every kind of fat. Now, we know that trans fats and saturated fats are amazingly dangerous for cardiovascular health, but omega-3 fats and monounsaturated fats are actually good for your heart. Because all fats (heart-healthy fats included) are dense in calories, be sure to moderate your intake so you don’t gain weight.

Omega-3 fatty acids

Heart-healthy fish oils are especially rich in omega-3 fatty acids. In multiple studies over the past 15 years, people who ate diets high in omega-3s had 30 to 40 percent reductions in heart disease, and fewer cases of sudden death from arrhythmia. Although we don’t yet know why fish oil works so well, there are several possibilities. Omega-3s seem to reduce inflammation, reduce high blood pressure, decrease triglycerides, help to make blood thinner and less sticky so it is less likely to clot … PLUS raise HDL cholesterol!

So omega-3s affect nearly every risk factor for heart disease.  I recommend eating at least three servings (4-ounce portions) of one of the omega-3-rich fish every week — fish like wild salmon, sardines, anchovies and mackerel (not king). If you cannot manage to eat that much fatty fish, incorporate omega-3-fortified eggs and additional plant-based sources like walnuts, soybeans and ground flaxseed. Also, consider taking fish-oil capsules.

Monounsaturated fats

Scientists discovered the benefits of monounsaturated fats, mainly found in olive oil, by observing Mediterranean populations. They use olive oil more than any other form of fat and typically have low rates of coronary artery disease. Research shows it doesn’t help to just add monounsaturated fats to your diet — you need to replace some of the unhealthy fats that are already in your diet with better choices. Best foods for monounsaturated fats include: olive oil and olives, canola oil,avocado, macadamia nuts, hazelnuts, pecans, almonds, peanuts, cashews, pistachio nuts and natural peanut butter.

Plant sterols or stanols

Sterols and stanols have a structure similar to cholesterol, and they compete with cholesterol for access to receptors in the small intestines. Research reports that 2 grams of sterols/stanols per day can reduce LDL-cholesterol levels by between 5 and 14 percent. Although it’s difficult to get a therapeutic dose from food alone, pistachio nuts, sunflower seeds, sesame seeds and wheat germ are all good sources. Sterols and stanols are also added as functional ingredients to certain heart-healthy foods (e.g., Take Control Light and Benecol Light spreads, Promise Activ Supershots and CocoaVia chocolate bars) … they’re also sold in over-the counter supplements like Cholest-Off by Nature Made. If you have high cholesterol and want to try a therapeutic dose, speak with a registered dietitian about the best course of action.

Joy Bauer is the author of “Food Cures.”  For more information on healthy eating, check out Joy’s Web site at