Cholesterol, found in our blood and in the food we eat, is a misunderstood compound that we have been instructed and cautioned for decades to fear.
We have been told that if we eat cholesterol, then our blood cholesterol levels will significantly rise. Science, however, now shows us that for most people, the cholesterol we eat in healthy food does not in actuality increase our blood cholesterol. Research suggests that it’s the excessive sugars in a person’s eating style that negatively impact our cholesterol levels, also causing weight gain and raising the risk of Type 2 diabetes (high blood sugar). This is largely because sugary foods have a damaging impact on our liver, the organ responsible for making cholesterol.
Another common misunderstanding is the notion that cholesterol levels will drop as does our weight. We think that if we lose weight, it will show immediately with an improved blood lipid panel. But this isn’t the case for about 20% of the population; here’s why: When we lose fat-weight, our fat stores shrink. The fat and cholesterol normally stored in the fat tissue and liver cells have nowhere to go when these fat cells shrink but into the bloodstream, causing a temporary rise in cholesterol to be noticeable in a fasting cholesterol blood test in some people. This rise in cholesterol being processed out of the body is usually not permanent, and these cholesterol levels will likely drop when this process stabilizes.
It’s also important to realize that a reduction in blood test cholesterol levels is a slower metabolic process that takes time. Cholesterol levels do not drop relative to a drop in fat-weight pound by pound.
Dr. Nieca Goldberg, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center, says it can take between three to six months (while some doctors say up to a year or more) to see lower LDL numbers after a successful diet and exercise weight loss experience, noting that it takes a longer period of time to see positive changes in a cholesterol blood test in women than in men.
So, if we see these unexpected shifts in our cholesterol levels, what should we look for?
1: Your triglyceride/HDL ratio is important. Many doctors and researchers are finding the triglyceride/HDL ratio to be one of the better predictors of heart disease. Research has shown that people with the highest number of triglyceride (bad-fat in blood)/HDL (good cholesterol) ratio, have a 16x risk of heart attack than those with the lowest ratio of triglyceride to HDL. A ratio of <2 is good, 3-4 is intermediate (risky), and >4 is high. This ratio also predicts risk for Type 2 diabetes and pre-diabetes. If your ratio is above 3.75, you are at increased risk for pre-diabetes or diabetes.
Example: If your triglyceride level is 150 and your HDL level is 25, then your ratio is 150/25 = 6. (high)
2. Your total cholesterol/HDL ratio is important. Another valuable ratio is your total cholesterol/HDL levels for predicting risk of heart disease.
Example: If your total cholesterol is 228 and your HDL is 69, then your ratio is 228/69 = 3.5 (good)
Low Risk Average Risk Higher Risk
Women <4.1 4.2-5.7 >5.7
Men <4.4 4.5-7.2 >7.2
*The higher the TC/HDL ratio = higher risk of heart disease
In general, high cholesterol can affect anyone, however, science shows that obesity is the most common risk factor. In addition, obesity and high cholesterol are both risk factors for cardiovascular health issues. Stress is also known to increase cholesterol levels especially the bad LDL cholesterol. Processed foods, fried foods, excess sugar in all its varied forms and trans fats must be eliminated from our diet if we aim to achieve good heart health. Smoking lowers good cholesterol, so stop smoking! Exercise is important for heart health, therefore moving somehow every day is key. Menopause for some women can raise cholesterol levels. Genetics can be a factor; familial hypercholesterolemia is an inherited form of high cholesterol that puts these people at risk of early heart disease. Science, however, shows that obesity is the most common risk factor. No matter your numbers or ratios, it’s always important to check with your doctor on the best course of action to support your cardiovascular health. And remember that how you fuel your body – your nutrition – is key to protecting and maintaining a healthy heart!
Ashley Lucas has a doctorate in sports nutrition and chronic disease. She is also a registered dietitian nutritionist. She is the founder and owner of PHD Weight Loss and Nutrition, offering weight management and wellness services in the Four Corners. She can be reached at 764-4133.