Dr. Chris Prakash, MD
by Chris Prakash, MD
Q I am a 50 year old female. My total cholesterol is 210mg/dl. I am otherwise healthy but have a strong family history of heart disease. Do I need medication? Can I change my lifestyle instead, and how?
To answer your question, I need more information. Just knowing your total cholesterol isn’t enough. Not only does the total cholesterol number need to be normal but HDL (good cholesterol) and LDL (bad cholesterol) numbers need to be in the appropriate range. Triglyceride levels also need to be controlled. Total cholesterol of less than 200mg/dl is desirable. LDL less than 100 is optimal, but may need to be less than 70 in some people at high risk of heart disease. HDL less than 40 (men) and less than 50 (women) is a risk factor, and level greater than 60 is considered protective.
Let’s say that your lipid profile is abnormal, the first step would be to modify lifestyle factors such as diet and exercise. If these fail, then medication may be necessary.
There are several changes you could make in your Daily Living, in order to bring down the cholesterol. The following are some simple tips:
Most of us eat super-sized meals, with portions that are twice the size recommended for good health. Eating smaller portions is the easiest way to control weight and cholesterol. One serving of meat or fish is about what fits in the palm of your hand, and one serving of fresh fruit is about the size of your fist. That’s how much we need.
Load your plate with fruits and vegetables (at least five servings a day) – to help lower LDL cholesterol. Foods enriched with plant sterols, such as some margarine spreads, yogurts, and other foods, can also help lower LDL cholesterol.
A heart-healthy diet has fish on the menu twice a week. Why? Fish is low in saturated fat and high in healthy omega-3 fatty acids. Go for fatty fish, such as salmon, tuna, trout, and sardines. Just don’t drop the filets in the deep fryer – you’ll negate the health benefits.
A bowl of oatmeal or whole-grain cereal has benefits that last all day. Besides helping reduce LDL cholesterol, the fiber and complex carbohydrates in whole grains help you feel fuller for longer, so you’ll be less tempted to overeat at lunch. Other examples of whole grains include wild rice, popcorn, brown rice, barley, and whole-wheat flour.
Nuts are high in monounsaturated fat, which lowers LDL cholesterol while leaving HDL “good” cholesterol intact. Several studies show that people who eat about an ounce of nuts a day have lower risk of heart disease. Nuts can be eaten as a snack, but don’t overdo it – they are high in calories.
Unsaturated fats (like those found in canola, olive, and safflower oils) help lower LDL cholesterol levels and may help raise HDL cholesterol. Saturated fats – like those found in butter and palm oil – (and Trans fats!) raise LDL cholesterol.
Whole grain carbs (as mentioned above) can actually help reduce LDL cholesterol. However, other carbs, like those found in white bread, white potatoes, white rice, and pastries, boost blood sugar levels, make you feel hungry sooner, and may increase risk for overeating.
The importance of regular physical activity cannot be stressed enough. Even 30 minutes of exercise five days a week (20 minutes three times a week for vigorous exercise, such as jogging) can help lower LDL cholesterol and raise HDL cholesterol. It also helps you maintain an ideal weight. If you’re not used to exercising, just go for a walk. It’s easy, healthy, and all you need is a good pair of shoes. Walking has been shown to lower risk of stroke and heart disease, help lose weight, and keep bones strong. If you’re just starting out, try a 10-minute walk and gradually build up from there.
You don’t need to be a rocket scientist to know that stress is bad for our health. Research shows that chronic stress raises blood pressure and for some people, might directly increase cholesterol levels. An easy way to reduce stress is to focus on breathing, and to take deep, refreshing breaths. It’s a simple stress-buster you can do anywhere. A better option, if you have time, would be yoga. Jenny Wilson, in a recent article in eParisExtra, enumerated the benefits of yoga. You could join her class “Everyday Yoga” right here in Paris.
Losing weight is one of the best things you can do to fight cardiovascular disease. Being obese increases the risk of high cholesterol, high blood pressure, and type 2 diabetes. Losing weight, especially belly fat (which is linked to hardening of the arteries), helps raise HDL “good” cholesterol and reduce LDL cholesterol.
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Dr Chris Prakash is a contributing columnist for eParisExtra!’s Live Healthy column and a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children. He can be reached at 9037850031 or Sucharu.prakash@usoncology.com
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