Focus On…The Cholesterol Riddle with Helene Rosenhouse-Romeo, RDN, CDN, CLC, MPH, Director Of Maternal And Child Services

Let’s begin with a little riddle. Guess what “it” is. You’ve heard about it from your doctor and from TV commercials. You read about it in advertisements. It is even listed on your favorite cereal box. Your doctor tells you to “watch it!” Have you guessed the “it” yet?

Correct, it is cholesterol! But if you are like most people, how to manage it remains a mystery.

What is Cholesterol?

Cholesterol is a type of fat that has some important jobs within the body. It is a part of every cell membrane, and from it, our bodies make needed hormones, vitamin D, and other agents that help aid in the digestion of fats.

Where Does it Come From?

Our bodies make all the cholesterol we need in the liver. How much cholesterol our bodies make is not something we can control, and for most people, how much the body makes is not a problem. The other way we get cholesterol is through the food we eat -- and that is something we can and should control if we want to stay healthy.

Good Cholesterol vs Bad Cholesterol

Not all cholesterol works the same way in the body. The two most common types of cholesterol are HDL, known as the good cholesterol, and LDL, known as the bad cholesterol.

• To help remember which is the good cholesterol, think “h” for healthy!
• You want high HDL (above 60 mg/dL is great) and low LDL (ask your doctor if below 70 mg/dL or 100 mg/dL is best for you).

Note: mg/dl stands for milligrams per deciliter, a unit of measure in medicine that indicates the concentration of a substance, such as glucose or cholesterol, in a specific volume of blood.

What makes HDL good is that it moves the extra cholesterol from the tissues and bloodstream back to the liver where it is removed or reused. HDL cholesterol also protects artery walls from damage and improves blood flow inside the arteries. Keeping arteries healthy and open reduces the risk of heart disease.

On the other hand, LDL cholesterol, when too high, raises the risk of heart disease and stroke because it builds up in the arteries and causes blockages. So, the goal is to increase the healthy “HDL” cholesterol. But how do we do that?

What Foods Raise Bad Cholesterol?

Eating a lot of high-fat animal products and breads, cakes, and muffins that have lots of added sugar, fats, and white flour are not good because they raise LDL. They also raise another type of fat in the blood called triglycerides. Triglycerides in the blood should be less than 150 mg/dl, because when they build up, they also cause harm in our bodies.

So, what should you eat to have less inflammation and help avoid heart disease, stroke, high blood pressure, cancer, and dementia?

• All vegetables, beans, lentils, and fruits. These have lots of healthy nutrients and fiber, zero cholesterol, and no unhealthy fats.
• No more than six ounces total per week of red meats like steak, hamburger, or pork.
• Avoid foods with added sugar.

What About Eggs?

A few decades ago, people thought that they had to avoid eating eggs if they wanted to lower their cholesterol. We know today, however, that eggs can be part of a balanced diet. The same is true for shellfish like shrimp and lobster, because while they are high in cholesterol, they are low in saturated fats. Saturated fats are solid fat at room temperature.

Studies show that eating high-fat foods and low-fiber foods is more harmful than just avoiding foods that contain high cholesterol alone. Your breakfast might be two eggs with two slices of cheese and three slices of bacon on a white roll with butter. But changing it to two eggs, one slice of cheese, a slice of avocado, and tomato with a whole corn or wheat tortilla or a side of pinto beans is a much better way to control your cholesterol and improve your health than avoiding eggs altogether.

What Else Should I do?

If you want to raise your HDL, here are a few things you need to do.

1. Exercise, which can be as simple as walking/moving more than you are presently. Start slowly and work up to at least 20 minutes each day. If you sit a lot, once per hour stand up and march in place for five minutes or do five squats where you raise your arms overhead and bend your seat back as if you are going to sit in a chair keeping knees over ankles (Squats: Benefits, Proper Form and Tips).
2. If you smoke, get help quitting (Guide to Smoking and Vaping Cessation Programs in NYC).
3. Keep your medical appointments and take your medicine, if prescribed.
4. Schedule an appointment with one of our Ryan Health registered dietitians.

These four steps can help you raise your HDL and lower your LDL, so you can solve the cholesterol riddle once and for all.

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To make an appointment with a Ryan Health provider to check your cholesterol or other health issues, use our Online Scheduler or call 212-749-1820.