Diet and Cholesterol

Dietary factors have been known to contribute to cardiovascular health for decades. This area continues to be a major area of research into human health. Components of diet can also affect cholesterol levels, so it is natural to discuss both topics...


The first step to reducing LDL levels is lifestyle changes. These include consuming a low-fat diet, exercising and quitting smoking. Despite the attempts at controlling cholesterol levels with lifestyle changes, new research suggests that there is a genetic component to cholesterol. Current thinking is that cholesterol metabolism is hereditary, so if you have elevated LDL levels, there is a good chance you will need medical therapy. If after a month or so after dietary measures have been implemented LDL levels are not at acceptable levels, your health care provider should start medical therapy.

Diets can contribute to cholesterol levels in the body. Diet modification is a primary therapy at lowering cholesterol levels. Research in this area has changed current thinking regarding cholesterol and diets. Diets high in cholesterol were once thought to increase cholesterol levels in the body. However, recent studies suggest that it is not the cholesterol content in diets that contribute to cholesterol levels in the body, but the content of saturated fats. Current recommendations reflect this in recommending a diet low in saturated fat rather than low in total cholesterol. In 2006, the American Heart Association (AHA) released dietary guidelines for a heart-healthy diet. The AHA recommends a diet high in fruits and vegetables, whole grains, lean meats, poultry and fish and low in saturated fat. Table 4 offers examples of foods consistent with the AHA recommendations.

It is very easy to become confused on what are good dietary habits and what are not just due to the huge volume of information available. Many good resources are available at no or minimal cost. Good resources to start are any cookbooks developed by The Mayo Clinic, The American Heart Association and Weight Watchers. Online resources are available at the National Volunteer Firefighter Council (NVFC) website accessible at http://www.healthy-firefighter.org/; the Mayo Clinic has free recipes accessible at http://www.mayoclinic.com/health/heart-healthy-recipes/RE00098.

These resources offer recipes that do not sacrifice flavor while maintaining a healthy diet. It also nearly impossible to adhere to a strict diet. For example, if you have the urge to eat a donut, go ahead; just don't make a habit of eating a donut every day. Try to adhere to a healthier diet 90% to 95% of the time and you will improve your overall health and reduce your risk of cardiovascular disease.


 

 

Table 1: CLASSIFICATION OF CHOLESTEROL
LDL CHOLESTEROL CLASSIFICATION
From "Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)" by The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001, Journal of the American Medical Association, 285, p. 2487. Copyright © 2001, American Medical Association. All rights reserved. Adapted with permission.
&llt; 100 Optimal
100–129 Near or below optimal
130–159 Borderline high
160–189 High
> 189 Very high
HDL CHOLESTEROL
<40 Low
>60 High

 

Table 2: CARDIAC RISK FACTORS FOR TREATMENT OF CHOLESTEROL

* Cigarette smoking
* High blood pressure or currently being treated for high blood pressure
* Low HDL cholesterol (&llt;40 mg/dL)
* Family history of CVD (cardiovascular disease)
* (CVD in male first-degree relative &llt; 55; CVD in female first-degree relative &llt; 65)
* Age (men &ges;45; women &ges;55)
* Cardiovascular disease
* Diabetes mellitus*

*Considered to be equivalent to CVD

Note: HDL levels greater than 60 are considered a negative risk factor for cardiovascular disease and reduce the total number of cardiovascular risk factors by one.

From "Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)" by The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001, Journal of the American Medical Association, 285, p. 2487. Copyright © 2001, American Medical Association. All rights reserved. Adapted with permission.

 

 

Table 3: DETERMINING LDL GOALS
PATIENT CLASSIFICATION LDL GOAL

From "Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)" by The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001, Journal of the American Medical Association, 285, p. 2487.

Copyright © 2001, American Medical Association. All rights reserved. Adapted with permission.

CVD and CVD equivalents (diabetes mellitus) <100
Multiple risk factors <130
0–1 risk factors <160