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For A Healthy Heart, Just Lowering LDL Cholesterol Is Not Enough

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For a healthy heart, improving blood lipids ratios is important. Total and LDL cholesterol should be within acceptable range, with high HDL and low triglyceride levels. Healthy body weight, increased intake of omega 3 and saturated fats, fiber rich food, lower intake of sugar and wheat products help lower triglyceride levels. Supplements help reduce inflammation.

Many are led to believe, that the only way to manage blood lipids (fats such as cholesterol and triglycerides) and reduce cardiovascular disease risk, is to take medication (like statins). While it is true that there is a time and place for the responsible use of medications, diet and supplements can also help improve the blood lipid profile and reduce inflammation – known risk factors for cardiovascular diseases such as heart disease and stroke.

Lipid Ratios Are More Important Than Lipid Levels

Conventional wisdom has always focused on lowering LDL-C (Low Density Lipoprotein Cholesterol), but there is more to the puzzle than that. Healthy blood lipids are about improving the ratios of the various lipids. These can be tested for with blood work such as total cholesterol, LDL-C and HDL-C (High Density Lipoprotein Cholesterol), and triglycerides.

The goal of diet therapy should be to improve these ratios while reducing inflammation as well. In a nutshell, both total cholesterol and LDL-C should be within an acceptable range, HDL-C should increase and triglycerides should decrease.

Also, diet therapy should ensure that the right type of LDL-C is produced by the liver; this is essentially an issue of size. Large LDL-C molecules are less atherogenic i.e. they do not contribute to atherosclerosis (plaque formation) in the same way as small LDL-C molecules do. Target levels for all lipids are tailored, based on a person’s individual risk for cardiovascular disease which your doctor can help determine.

Eating To Improve Lipid Ratios

1. Increase Intake Of Omega-3 Fats

To reduce triglycerides, it is important to achieve and maintain a healthy body weight and increase your intake of the omega-3 fats EPA and DHA. The best triglyceride-lowering omega-3 fats are found in fatty fish like salmon, herring, sardines, mackerel or trout, and omega-3 fortified eggs.

2. Eat Fiber-Rich Foods

If digested carbohydrate enters the blood too quickly, insulin levels spike and consequently, triglyceride levels increase as well. Limit (or avoid, if you can) consumption of refined grains and grain products (the white stuff like white bread, pasta, crackers, bungs, bagels). Try to eat more fiber-rich foods at each meal and snack, to slow down digestion and absorption of carbohydrates.

3. Reduce Intake Of Grain Products

Eat smaller amounts of whole grains and grain products (they can still lead to rapid rises in blood sugar if eaten in large amounts), and try to include loads of non-starchy vegetables like broccoli, cauliflower, snap peas, green beans, kale, asparagus, peppers, Swiss chard, kale, zucchini and Bok choy in your diet instead.

4. Cut Down On Sugar In Your Diet

Reduce added/concentrated or ‘free’ sugars (as they are referred to) found in sweetened beverages, candies, pies, fruit juices, pastries, dried fruit, or foods with lots of added sugars in the ingredient list.

5. Add Some Saturated Fat To Your Diet

The low fat mantra is out. Contrary to what has historically been recommended (since the 1950s), getting more saturated fat in your diet is good; it will boost HDL-C with little to no meaningful increase in LDL-C levels.

Get some HDL-boosting saturated fat from foods like 2% milk, yogurt and Greek yogurt, 2% cottage cheese and other cheeses, butter, coconut milk and oil, nuts and seeds, and nut and seed butters.

Increasing HDL-C levels will improve all the important ratios of total cholesterol:HDL-C, triglycerides:HDL-C, and LDL-C:HDL-C; these ratios are better predictors of heart disease risk than LDL-C alone.

6. Eliminate Trans Fats From Your Diet

Eliminate HDL-C lowering industrial trans fats i.e avoid foods that contain ‘shortening’, ‘hydrogenated’ or ‘partially hydrogenated’ vegetable oils. Make reading ingredient lists a habit.

Reducing Inflammation

The best way to reduce inflammation, and the associated oxidation (including oxidation of LDL-C and the lining of blood vessels), is to include foods that do just that. Plant foods stand out in this regard.

Antioxidant-rich and anti-inflammatory foods include, but are not limited to dark green and orange fruits and vegetables, tomatoes and tomato products, mushrooms, dark chocolate, berries, green, white and black tea, and pretty much any fresh or dried herb and spice. Also, try oils like avocado and olive oil (rich in phenolic compounds) which lower inflammation and help to prevent LDL-C oxidation/damage.

Supplements

When it comes to lipid management, reducing inflammation, LDL-C oxidation and heart health in general, supplements are a great way to support a healthy diet. My go-to list includes:

  • Omega-3 fats and CoQ10 (co-enzyme Q10)
  • Vitamin C and Vitamin D, with supporting nutrients like magnesium, boron, zinc and vitamin K2
  • Vitamin E (but must be a good quality brand with all 8 forms/isomers, a.k.a. ‘full spectrum’)
  • Curcumin, which is a standardized product to ensure maximum absorption

Takeaway

Lipid ratios are more important than individual lipid levels; they can be managed with a little attention to detail, where diet is concerned. The good news is that you don’t need fancy or exotic foods – help is as close as your grocery store. With some minor tweaks to your diet and targeted use of supplements, improved heart health is easily within reach.

Doug Cook
Expert

I am a Registered Dietitian & Integrative & Functional Nutritionist and former Certified Diabetes Educator with over 15 years of clinical nutrition experience. I practice a holistic and integrative approach providing science-based guidance on food and diet along with nutritional supplements where appropriate. My strength lies in my ability to explain complicated nutrition and scientific concepts in plain language which I then put into everyday practical dietary advice. I have a unique approach to nutrition counselling. I have the solid education & training of a dietitian but know that there are many points of views outside this model, and I incorporate them into my practice.

Doug Cook
Expert

I am a Registered Dietitian & Integrative & Functional Nutritionist and former Certified Diabetes Educator with over 15 years of clinical nutrition experience. I practice a holistic and integrative approach providing science-based guidance on food and diet along with nutritional supplements where appropriate. My strength lies in my ability to explain complicated nutrition and scientific concepts in plain language which I then put into everyday practical dietary advice. I have a unique approach to nutrition counselling. I have the solid education & training of a dietitian but know that there are many points of views outside this model, and I incorporate them into my practice.

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