Greens over grease is bottom line toward curbing extra cholesterol, experts say

Published on Sunday, September 1, 2024

By: Danny Barrett Jr., dlbarrett@umc.edu

When heart disease runs in the family, it can feel like a losing battle with all the health-related numbers you have to track after 40, with cholesterol levels among those dreaded stats.

Winning that battle over the long haul, whether there’s a family history of heart attacks and strokes or not, can be as simple as taking a daily pill and making key changes in your diet, cardiologists say.

“Familial hypercholesterolemia is common, occurring in 1 in 250 people,” said Dr. Bradley Deere, cardiologist and assistant professor in the Division of Cardiovascular Diseases. “If you have a personal or family history of early heart disease, stroke or high cholesterol, then you should consider talking with your doctor, having your levels checked. FH should be treated early to prevent or delay the onset of heart disease. Fortunately, we have many tools to help lower your overall risk.”

In reality, the human body makes all the blood cholesterol it needs. It’s a waxy, fat-like substance made in the liver and is indeed essential for good health. The body uses it to make hormones and digest fatty foods.

For most Americans, the trouble comes in when we eat too much dietary cholesterol, which is found in animal products such as meat, seafood, poultry, eggs and dairy. Levels are measured in milligrams per deciliter, or mg/dL, and involve low-density lipoprotein and high-density lipoprotein, or LDL and HDL. In short, normal levels of HDL, or “good” cholesterol, may lower the risk of heart disease and stroke. LDL, or “bad” cholesterol, earns the name because it’s a sign there’s too much dietary cholesterol in the blood, often from foods fried in various processed vegetable oils at high heat. 

During a cholesterol check, or lipid panel, doctors will also measure for triglycerides, a type of fat in the blood used for energy. Too high a level along with not enough of the “good” cholesterol or too much of the “bad” one means a higher risk of cardiovascular disease. A total cholesterol reading is based on the HDL, LDL and triglycerides numbers.

Those without heart disease are recommended to keep LDL levels below 100 mg/dL. For people with a prior heart attack or stroke, or deemed at high risk for either, the ceiling for LDL is lower, at 70 mg/dL. People are considered at high risk based on test results if they show levels of more than 130 mg/dL.

The first steps toward staying in the safe zone on cholesterol involve avoiding fried foods and eating a more heart-healthy diet, regular exercise and quitting smoking. “We also know that maintaining healthy blood pressure levels, blood sugar levels, and body weight lowers overall risk,” Deere said. “Talk with your doctor about your overall risk and make a treatment plan that works for you.”

Statin drugs such as atorvastatin and ezetimibe remain a go-to option to help lower LDL in the blood, often recommended alongside the diet adjustments. They work by reducing LDL levels when combined with heart-healthy changes in diet.

“In combination with lifestyle changes, LDL levels can typically be lowered to a safe zone for most individuals,” Deere said. “We also have newer classes of medications that are safe and effective such as PCSK9 inhibitors, which involve injections under the skin every 2-4 weeks, and inclisiran, which is an injection under the skin every six months.”

Healthier cuisine pairs nicely with any cholesterol medication, dietitians say, stressing an overall switch from fried food to more vegetables, fruit, legumes such as chickpeas and lentils, whole grain and healthy fats such as those found in fish and nuts. The idea is to avoid the kind of inflammatory response produced in the body with fried foods, particularly in the arteries.

“The best way to keep LDL in check at the lunch counter or dinner table is to include plenty of anti-inflammatory foods in your body to help quickly repair artery damage, as well as minimize those foods that contribute to that damage,” said Dacia Breeden, a registered dietitian based at the UMMC Cancer Center and Research Institute.  “Good examples of anti-inflammatory foods are primarily going to be your plant-based foods, such as fruit, vegetables, beans, peas and healthy starches.”

An ideal lunch plate for anyone looking to maintain good numbers for cholesterol would be a salad with plenty of fresh greens, avocado, chopped carrots, tomatoes, cucumbers, chickpeas, black beans and/or any vegetable, Breeden said. A homemade dressing is best for reducing inflammatory ingredients and preservatives in general, she said, using fresh citrus, vinegars, any number of dry seasonings and herbs with a less-processed oil such as flaxseed or olive oil.

Dinner time for those with lower cholesterol numbers in mind would involve baked fish instead of fried, greens sautéed in a low-sodium vegetable broth instead of butter, blackeye peas and sweet potatoes, Breeden said. For dessert, try pureeing frozen fruit into a homemade sorbet, she said.

“We can certainly enjoy amazing flavors with food without the oils,” Breeden said. “For example, you can use fresh or bottled citrus with fish and vegetables. And air fryers instead of deep-frying have been very helpful. Your body will thank you with a much lower cholesterol level for your next doctor visit!”

Appointments with the cardiac care team at UMMC to test cholesterol levels and learn other information on heart care may be made online or by calling 601-978-5678. Online resources to learn more about cholesterol and heart health include the American Heart Association, the Mississippi Department of Health’s Heart Disease and Stroke Prevention Program and the National Lipid Association.

The above article appears in CONSULT, UMMC’s monthly e-newsletter sharing news about cutting-edge clinical and health science education advances and innovative biomedical research at the Medical Center and giving you tips and suggestions on how you and the people you love can live a healthier life. Click here and enter your email address to receive CONSULT free of charge. You may cancel at any time.