Features August 2008 Issue

Simple Changes in Diet Can Mean Big Cholesterol Reduction

Limiting your intake of saturated fats, processed meals and high-cholesterol foods such as eggs provides key health benefits.

Carole Iseli thought she was a fairly responsible and healthy eater. After all, the 60-year-old Cleveland resident wasn’t overweight and ate small portions. But her cholesterol levels, measured during regular check-ups, told a different story.

In February 2007, her total cholesterol was 247 and had been climbing steadily. When her nurse practitioner suggested she go on a low-dose statin to help bring down her cholesterol, Iseli instead chose to reach her targets through diet and exercise. This spring, her total cholesterol was 190, with a low-density lipoprotein (LDL or "bad" cholesterol) of 112.

"Carole is a great example of someone who saw a significant decrease in her cholesterol panel by following a heart-healthy style of eating," says Cleveland Clinic registered dietitian Andrea Dunn, who counseled Iseli.

Iseli says she shifted to a "high-fiber and low-fat" eating plan and did away with many of the supposedly "healthy" processed frozen meals she occasionally relied on for dinner. She also started studying labels for fiber and fat content and worked at least 30 minutes of brisk walking into her daily schedule.

"It was a fairly effortless process," Iseli says. "I’m far more aware of everything that I’m eating now."

Cholesterol and heart risk

Total cholesterol level is heavily influenced by genetics and your own physiology, but even if you have those factors working in your favor, diet still plays a crucial role. For example, a recent study of more than 21,000 men, ages 40 to 86, showed that too much dietary cholesterol—in this case, eating more than six eggs a week—can boost your risk of death by 23 percent.

The study, reported in the April issue of The American Journal of Clinical Nutrition, showed that patients with diabetes faced the most serious consequences from high cholesterol. Because diabetes is a common precursor to heart disease, patients with the condition should watch their blood sugar levels, blood pressure and cholesterol very carefully—even if they’ve been diagnosed as having only pre-diabetes, Dunn says.

"The question that isn’t addressed in this study is what’s alongside those eggs on your plate?" she adds. "For a lot of people, that’s going to be bacon or sausage, which will add cholesterol along with saturated fats. Cholesterol doesn’t usually come by itself."

When plaques, filled with bad cholesterol, form within your arteries, blood flow to and from the heart is restricted. If a plaque ruptures and a blood clot forms in a coronary artery, blood flow to the heart is reduced to the point where a heart attack can occur. A blood clot also can travel to the brain, causing a stroke.

Making the change

Dunn recommends keeping your daily cholesterol intake to 200 mg or less, and limiting animal protein to five ounces daily, whether it’s lean meat, fish or skinless poultry. Try plant-based proteins such as beans, lentils and legumes.

If you make a significant change in your eating habits, Dunn recommends getting a cholesterol screening about three months later to see how your body is responding.

She further warns that it’s not just the cholesterol in foods we need to be wary of, but also the saturated fats that can contribute to higher cholesterol levels and arterial plaque build-up.

As Iseli discovered, and Dunn notes, you can lower your total cholesterol 25 to 30 percent through lifestyle changes that include lowering saturated fat and cholesterol intake and adding more high-fiber, whole-grain products, as well as 30 minutes of exercise most days of the week.