Many people use medications like Lipitor (Atorvastatin) to lower their cholesterol levels and reduce their risk of your heart attacks and strokes. For some patients doctors also recommend diet, exercise, and weight loss. But doctors and dieticians are discovering that popular cholesterol-lowering diets from the past four decades aren’t working. Patients have focused on lowering cholesterol and fat intake while increasing whole grain consumption. The new diet recommendations may surprise and even delight you. Former taboo foods like red meat, egg yolks, cheese, and real butter have joined the approved list.
The Truth About Cholesterol
Research has uncovered faulty myths about high cholesterol and heart disease causes. One prevalent delusion is that the cholesterol in foods you eat enters your bloodstream and clogs your arteries. According to Dr. Dariush Mozaffarian, a Harvard associate professor of medicine and epidemiology, most of the cholesterol in your body doesn’t come from food. Your liver produces three times more of this waxy fatlike substance than your body can absorb. So after years of study, researchers have determined that high-cholesterol foods have little impact on raising cholesterol levels.
“Some people make more cholesterol than others, and that has a greater effect on blood cholesterol than the things they eat,” said Terri Johnson, a dietitian at Baton Rouge General Medical Center. A combination of your natural cholesterol, calcium, and other debris creates the plaque that can clog your arteries and cause heart attacks and strokes. But while traveling through your bloodstream, cholesterol also is vital in making key hormones such as estrogen and testosterone, synthesizing vitamin D, and building and maintaining cell membranes, notes Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
To transport and store cholesterol, your liver packages it into lipoproteins. These particles are part fat and part protein. Low-density lipoproteins (LDL) carry cholesterol to your body’s cells. High-density lipoproteins (HDL) bring it back to your liver, which recycles or excretes it. Cholesterol tests are lipid panels that measure the levels of lipoproteins circulating in your blood along with triglycerides, which are fat and lipoprotein combinations.
In a healthy cardiovascular system, LDL, HDL, and triglycerides are in balance. Smoking, lack of exercise, obesity, poor diet, and other factors can throw your levels out of whack. This imbalance sets the stage for plaque buildup and heart disease. “The biggest takeaway is that heart disease risk is about much more than cholesterol,” said Mozaffarian. Researchers have linked quitting smoking, exercising, losing weight, and taking cholesterol medication to more optimal cholesterol levels and lower heart disease risk. Mozaffarian advocates focusing on your overall holistic health and not just your blood test results.
Rethinking Fat Consumption
Since the introduction of low-fat diets, cholesterol and obesity have risen. Heart disease, cancer, and hypertension have skyrocketed. A study of nearly 50,000 women showed that low-fat diets didn’t protect them from heart disease or stroke. Mozaffarian co-authored a key analysis of 76 studies involving more than 600,000 participants. It found little evidence to support recommendations of avoiding saturated fat from red meat, cheese, and butter that the medical community has vilified as bad for decades.
Instead of counting fats grams, Johnson encourages focusing on good fats. She pushes monounsaturated fats in nuts, avocados, and olive oil. Amazingly, animal fats from meat and butter prevent overeating. Consuming fat satisfies you. Because your digestive system breaks down fat more slowly, you feel full longer and eat less. Shockingly, eating more fat is the key to becoming lean. That’s why Johnson doesn’t encourage patients to avoid egg yolks and meat. Most of the egg’s nutrition comes from the yolk. Meats are good sources of protein and saturated fats that your body needs. Before cooking meat, Dr. Robert St. Amant, a cholesterol specialist at Baton Rouge General Medical Center in Louisiana, advises removing visible fat.
Foods are more than just the cholesterol or fat they contain, Mozaffarian noted, citing a recent study of more than 7000 participants. It tracked the health effects of a relatively high-fat Mediterranean-style diet that emphasizes olive oil, nuts, fruits, vegetables, fish, and other unprocessed foods versus a low-fat diet. The Mediterranean diet reduced the risks of heart attacks and strokes by about 30 percent. “We need to eat healthy, minimally processed foods overall — especially plants and olive oil and nuts — and not define those foods by the nutrients they have or lack,” said Johnson.
Modifying Whole-Grain Intake
While whole grains used to be important in cholesterol-fighting diets, doctors recommend lower quantities today. Processed carbohydrates like breads, rice, cereals, and chips are major players in raising cholesterol. They turn into sugar in your blood stream and affect your cholesterol negatively. Now St. Amant tells patients to avoid white vegetables such as potatoes and to eat others that are rich in color. Sugar in any form is bad, especially soft drinks sweetened with high-fructose corn syrup, which promotes diabetes.
Even though reducing whole grains is the new method, fiber still is an important cholesterol fighter. Johnson endorses fruit and vegetable sources. “With fiber, your blood sugars don’t go as high, so you’re not going to stimulate insulin in the same way,” she said. Johnson rarely asks patients to count calories or fat. Instead, she favors focusing on eating well. Manage your food quality and read ingredient lists so you know what’s in the foods you put in your body.