I was at nutrition talk at a gym recently where I heard an RD (registered dietician) tell a younger, in shape-looking guy who was on a statin (cholesterol lowering medication) that he did not have to worry about what he ate at all. I was surprised because this is not the truth (plus I don’t think you should give health advice to people without knowing all their info), but perhaps I should not be because we have been given so much conflicting information on cholesterol, what causes it, what is good to eat, what isn’t, what to do, that it is hard to know what the truth is (eggs are the first thing that come to mind—they were vilified for a while and a lot of people are still confused about eating them).
So, lets start at the beginning! What IS cholesterol?? According to the NIH, it is a waxy, fat like substance that is found in all cells of your body and is used to build cells, make hormones, make Vit D, as well as help digest food. It travels through your bloodstream in small packages called lipoproteins (so called b/c they are made of lipids (fat) and proteins!) There are three levels that your doctor will commonly look at: LDL, HDL, and total cholesterol. LDL (low-density lipoproteins) is called the “bad” cholesterol since it is the one that builds up in your blood vessels as plaque and leads to increased risk of heart disease. HDL (high-density lipoproteins) is called “good” cholesterol since it carries other cholesterol back to your liver where it is then eliminated from your body. I like to think of it as “h” equals “happy” to remember that it is the good cholesterol. (As a side note- triglycerides are also tested in your lipid panel but they are not cholesterol since they are a fatty acid and not a lipoprotein. They are the main ingredient in body fat, as well as in the fatty foods we eat; triglycerides are how our body stores excess calories. High levels can also contribute to heart disease)
Ok, so now we know what cholesterol is. How does it affect our bodies? Although we need cholesterol in our bodies, having too much cholesterol puts a person at health risk since it accumulates along the walls of our blood vessels as plaques and can cause heart attacks, strokes, and a myriad of other health issues. A common myth is that we can eat to much cholesterol and have it affect our serum levels—or the amount of lipoproteins in our blood stream. In fact, for 70% or more of the population the amount of cholesterol we eat does NOT affect our levels. However, there is a small percentage where it can affect levels (such as the young man in the beginning). Considering this, a recent committee ruled that “overconsumption of cholesterol is not a concern” and the RDA in America has changed to no longer cap cholesterol at 300mg.
So, this means I can eat anything?! Not so quick- although eating cholesterol does not affect levels WHAT you eat does! Recent studies have shown that a low-carb diet is more beneficial for losing weight than a low fat diet—and losing weight will automatically reduce your cholesterol. This means not just exercise (which in and of itself helps lower levels) but also eating better. While the Mayo Clinic needs to update their list to reflect the new dietary recommendations, they did get the other points right: avoid trans fats (these exist in processed foods— anything that says “hydrogenated” on the label—as well as in fried foods; truly trans fats should be avoided at all costs), eat more Omega-3’s (occurring in herring, mackerel, and salmon as well as flaxseed, walnuts, and almonds), increase your fiber intake (this means veggies!), and increase intake of whey protein.
Another ingredient to avoid: sugar. Not just in the form of processed foods and simple carbs but sugar itself. A recent study showed that just drinking sugar sweetened beverages affects HDL regardless of weight or diet. So, even if you are eating well and exercising but having sugar in your diet you might be shooting yourself in the foot. Remember we skimmed over how triglycerides are how your body stores extra calories and sugar is nothing but empty calories. Plus, processed sugar is the devil** AND it is in EVERYTHING!! Exactly what is the reason for putting sugar in my canned tomato sauce?? Or my salsa?? I don’t need that shit. And no, I don’t always make everything from scratch and so do buy pre-made foods, although I prefer to make my own life does not always allow me the time.
So, to get back on track. You don’t have to worry about the amount of cholesterol in foods. Buy the full fat versions (also because fat is what causes satiety or the “feeling full” so without it you will want to eat more anyway and too many calories causes more issues than too much fat), eat eggs for breakfast every morning, add more veggies in (salads are your friends!), choose grilled instead of fried, eat more fish*, and lose some weight if needed. Get moving!
*Please check the Monterey Bay Aquarium Seafood Watch list of recommend fish before buying- they list fish to avoid and it might surprise you. Farmed fish done correctly is better than overfished wild- caught fish and they will guide you to the best choice. Download the app for quick reference in the store!
** I am referring to processed sugar and not the naturally occurring sugar in foods. Yes, I am aware that eating fresh fruit is eating fructose.