Cholesterol, The Good, The Bad And The Ugly

In the 90’s and 2000’s fats got a really bad rap and a lot of that carries over to today’s society. However, with diets like the ketogenic diet becoming more popular, people are slowly changing how they view fats and cholesterol. Fitness and nutrition isn’t just about looking good or feeling good, it is about actually BEING healthy inside and out. You can have the body of a greek god and still have horrible inflammatory markers or horrendous cholesterol profiles on the inside. You can be a vegan and still die of a massive heart attack or stroke because your “bad cholesterol” is too high. So I have dedicated this post to information about cholesterol and fats, how to interpret your lipid profile and how to fix it if you happen to be someone who has high cholesterol.

A little bit about cholesterol/fats/lipids

You have multiple different kinds of cholesterol/lipids in your body/bloodstream. LDL is a lipid that carries the “bad cholesterol” throughout your blood stream and is generally considered the be a big culprit in strokes, heart attacks and even dementia. HDL is another lipid that carries cholesterol and helps clear it from your blood stream, which is why they call HDL your “good cholesterol”. Our bodies produce both of these lipids naturally and through our dietary intake we can stimulate excess production of LDL/HDL. Some people have a genetic tendency to produce more bad cholesterol/LDL and others have very good cholesterol genetics and can get away with eating whatever they want. Don’t blame your cholesterol entirely on genetics however, because what you eat plays a large role as well. Those with a genetic tendency toward bad cholesterol just seem to be more sensitive to their diets than others (there are people out there with uncontrollable cholesterol related to genetic disorders, but this is fairly rare). However, more and more studies are showing that is not just the numbers that matter, it’s the ratio of LDL to HDL that matters. Therefore, if you have a very high HDL and a high LDL, this tends to offset the high LDL and doesn’t increase your risk of cardiovascular events!

How does my diet impact my cholesterol numbers?

Most would naturally assume that if you eat cholesterol, your cholesterol will go up right? WRONG. A multitude of studies have shown that dietary intake of cholesterol (eating foods high in cholesterol – such as shrimp, eggs, etc) doesn’t actually impact your cholesterol negatively at all! In fact, most of the foods noted to be high in cholesterol actually POSITIVELY impact your lipid profile by lowering LDL and raising HDL! As mentioned in the previous paragraph there are people that are “sensitive” to cholesterol change and they can indeed respond to dietary intake of cholesterol, but it is usually still a positive change (i.e. increasing your HDL) when eating high cholesterol foods. In fact, most of the foods that are notoriously high in cholesterol are practically superfoods and are a very healthy part of your diet. These are foods like whole eggs, full fat dairy, grass fed beef, shellfish/shrimp, fish and fish oil (more on these foods below, not all of them are super healthy). You’ve probably heard about the health benefits of adding fish oil supplements to your diet right? Well guess what, it’s full of cholesterol/lipids and it STILL helps lower your cholesterol/cardiovascular risk!

So what foods ARE bad for my cholesterol?

Now that we know that cholesterol itself is basically negligible toward our lipid profile when consumed (could actually improve it), what are we eating that DOES raise our bad cholesterol? Saturated fats and Trans Fats are the big culprits. We find saturated fats and trans fats in high processed foods, non-lean red meats, white meats with the skin on, some plant products and many dairy products. Non-lean red meat is a big player, but if you use a lean red meat, you are cutting down on the saturated fats. If you have skinless poultry, you should be completely fine as the skin of the bird has almost all the fat in it. Remember how I said even vegans can have high cholesterol? That’s because plants aren’t ALL health. Coconuts are loaded with saturated fat and you see everyone these days using coconut oil, coconut water, etc. Palm or palm kernal oil is also high in saturated fat. Many of your diary products are also high in saturated fat, such as your butters, cheeses, milk and creams.

Foods high in trans fats are usually your processed or fried foods as trans fat is actually a synthetic fat made to help keep foods more solid. You will sometimes see it listed as “hydrogenated or partially-hydrogenated oils”. Trans fats are especially bad because they don’t just raise your LDL, they lower your HDL and raise your triglycerides as well. You will find trans fats in your sweets (pie, cookies, donuts, etc) and in many fried foods. Since the USA decided that food providers/manufacturers needed to disclose the amount of trans fats in their foods many places have stopped using them (thankfully), but you will still see people try to sneak them in as “hydrogenated or partially-hydrogenated oils”. You can still find these oils in many breads and other places you wouldn’t expect them! Also, keep in mind that many studies have linked consumption of sugar to high triglycerides, indicated that it is actually high glycemic carbs/simple sugars that raise our triglyceride levels (another bad fat).

How do I fix my cholesterol levels?

There are multiple things you can do to help your cholesterol levels. All of which take time (including medications). This is why we generally check your cholesterol (lipid panel) every 6-12 months, unless you are high risk, in which case you may need more frequent monitoring.

• Decrease/limit your intake of saturated and trans fats
  • This will decrease your LDL
  • See above for a list of food examples, or run an internet search to build your own list of foods to avoid
• Increase the amount of exercise you are doing
  • This both lowers LDL and raises HDL
• If you eat fats, try to eat unsaturated fats
  • Unsaturated fats are healthy in moderation and will raise your HDL and lower your LDL
  • These fasts are found in things like whole eggs, fish/shellfish, avocado, beans/nuts, olive/olive oil and various vegetable oils like canola or sunflower.
  • In fact, go ahead and ADD some unsaturated fats (like fish oils, avocados and whole eggs) to your diet. Because we now know that increasing your HDL will lower your LDL since HDL is responsible for shuttling the cholesterol out of your system!
• Losing weight/fat
  • Simply losing fat has been shown to significantly improve almost all parameters of your lipid profile (lower LDL, increase HDL)
• Have a glass of wine
  • Occasional alcohol intake has been shown to raise your HDL
  • This doesn’t mean to go out on a bender just because you ate a steak, too much alcohol still negatively impacts your brain, blood vessels and many other things.
• Talk to your primary care provider
  • You might have a genetic tendency to high cholesterol and may benefit from added help from a statin medication. It is usually appropriate to try lifestyle modifications first (like I have mentioned above), but if you have had an adverse event related to cholesterol (like stroke, heart attack, etc) you may benefit from a statin.
    • Statins have been shown to help reduce your risk of stroke and heart attack OUTSIDE of their cholesterol lowering benefits as well, so even if you have great cholesterol, a Statin may still be recommended if you have high risk for, or have already had a stroke or heart attack.
  • I also don’t want you to simply blame your cholesterol on your genetics and think a pill will solve all your problems.
    • I have genetically bad cholesterol (I am very sensitive to saturated and trans fat intake – my cholesterol shoots up) and I do ALL of the above (except the pill) to keep my cholesterol in check (thus why I don’t need to take a pill).
  • Statins can only do so much, you will still need to work at trying to raise that good cholesterol with old fashioned exercise and proper diet.

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