High cholesterol does not usually cause symptoms and can only be detected through a blood test. However, it is a crucial risk factor to consider when managing heart health. In this article, I will discuss some essential information about cholesterol that many people may not know but cannot afford to overlook, as it may have an adverse impact on their health.
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Point 1: Women Present Differently For A Heart Attack
This may seem a little bit grim, but it's my first point because it's really important and it has nothing to do with diet! It's that women present differently for a heart attack than men. Many of us are not aware of this.
We’ve all seen the movie scenes where a man gasps, clutches his chest and falls to the ground. In reality, a heart attack victim could easily be a woman, and the scene may not be that dramatic.
As with men, women’s most common heart attack symptom is chest pain or discomfort. However, women may experience other symptoms that are typically less associated with heart attack, such as shortness of breath, sweating, nausea/vomiting, reflux and back or jaw and throat pain.
Women also tend to be less likely to get medical help and treatment quickly despite the warning signs. Early treatment is essential to limit the amount of damage to the heart.
Point 2: Cholesterol Is Only One Risk Factor For Heart Disease
Cholesterol is only one risk factor for cardiovascular disease (CVD), and looking at cholesterol alone won’t give us a very good overall picture of heart health or the risk of having a heart attack in the future.
So, your doctor or another health care professional will likely use a tool like the QRISK3 calculator to calculate the likelihood of you having a stroke or heart attack in the next ten years.
The tool considers several factors, including your smoking and alcohol consumption habits, blood pressure, weight, any other coexisting medical conditions you may have, such as diabetes, and your family history of heart disease. The score increases with an increase in the number of risk factors, indicating a higher risk of heart disease.
Point 3: Some People Have A Higher Risk Of Heart Disease
Diabetics
My next point is also grim, but if you have diabetes, you’re 2-4 times more likely to die from heart disease compared with adults who don’t have diabetes.
What I find with my diabetic patients is they are very focused on improving their blood sugar levels, and often, heart health and cholesterol are pushed as a lower priority or more of an afterthought. Still, it's really important to make changes to look after your heart health, too.
Women Post Menopause
Also, women going through or after menopause should pay higher attention to cholesterol levels. It may not have been an issue earlier in life, but after menopause, our oestrogen levels drop, and oestrogen has a protective effect on the heart because it can reduce the levels of ‘bad’ cholesterol in your blood. So after menopause, the cholesterol in your blood often rises, and this continues into old age, with 65% of women aged 65 and over having raised cholesterol compared to 48% of men.
Strong Family History
If you have a family history of high cholesterol, this puts you at a higher risk of also having high cholesterol. It doesn’t mean that your destiny is sealed, but you may have to pay more attention than the average person to your diet and lifestyle choices, and you should have your blood cholesterol levels checked more frequently. If you don’t have a family or personal history of high cholesterol heart disease or diabetes, you should still be getting your cholesterol checked every four to six years, according to the CDC and American Heart Association. But I recommend that if you don't know your cholesterol results right now and don't remember when you last had them checked, then you should probably get them checked. Knowledge and information is power!
Point 4: What Are You Replacing Saturated Fat With?
My next point is that, yes, with cholesterol-lowering advice, we are often focusing on reducing saturated fat in the diet, which is all good. Still, when you reduce something, we need to consider what you're replacing it with. It’s the combination of fats and carbohydrates a person regularly eats that has the largest impact on blood cholesterol levels. If you go low fat but have a lot of refined sugar, it’s not going to help your heart health.
So, instead of focusing solely on cutting out saturated fats, thinking about eating more of the right foods is often a better approach. Then, naturally, it will displace some of the saturated fat. So eat more fruits, vegetables, and whole grains, as well as more plant fats like avocadoes, olive oil, nuts, and seeds. This is key to a Cholesterol-Controlling Diet. The fibre in these foods can contribute to bringing down your cholesterol levels, and the healthy fats will help lower inflammation in the body. all helping improve your heart health.
Point 5: Don't Fret About Dairy
Another point I want to highlight is that dairy foods like milk and yoghurt shouldn’t be classified alongside the saturated fat in butter, cream, fatty cuts of meat, and coconut, as they’ve been shown to provide protection from heart disease. You can still choose low-fat versions if you prefer or if you find it helpful in managing your weight. The lower-fat varieties will still provide the same amount of calcium and other nutrients. However, it is thought that the combination of other nutrients in dairy, like calcium, potassium, and phosphate, seems to have a protective effect on the heart, almost counteracting the saturated fat.
Point 6: Not All Cholesterol Is Bad
My next point is that not all blood cholesterol is bad. Being diagnosed with high cholesterol can be alarming, and the three numbers you’re given for your cholesterol levels can also be confusing. The three numbers that you usually see are so-called “good” HDL (high-density lipoprotein) cholesterol, “bad” LDL (low-density lipoprotein) cholesterol, and total cholesterol. A higher HDL cholesterol number is good for heart health since it flushes bad cholesterol from the bloodstream. However, a high level of LDL cholesterol increases your risk for heart disease and stroke since LDL cholesterol’s structure allows it to stick to the walls of arteries, where the deposits are known as plaque buildup.
So, make sure you look at the breakdown of your cholesterol results. A lot of the focus is placed on lowering our bad cholesterol, but there are a lot of things we can do to help us raise our HDL, too. These include:
- Physical Activity, high-intensity exercise in particular. This is when you're getting a bit more sweaty and breathless. This has been shown to increase HDL cholesterol, but really, any exercise is going to be good for the heart.
- Losing extra weight if you're overweight can help raise your HDL levels.
- Finally, getting enough omega-3 fatty acids in your diet can help increase HDL cholesterol. The best way to do this is to consume oily fish once a week. Oily fish are coloured fish, such as salmon, mackerel, trout, sardines, and herring. If you don't like oily fish, there are plant sources, but they are really not as good as the oily fish. Plant-based sources include chia seeds, walnuts, flax seeds, hemp seeds, rapeseed oil, soy, and pecans.
Point 7: You Need To Take Statins Correctly
Statins have made a tremendous impact on saving lives. But in order to be effective, they have to be taken exactly as prescribed. If you’ve been prescribed statins, make sure you know when to take them and at what dose. Your pharmacist can answer any questions you have. Certain statins work better when taken with a meal. Others work best when they're taken at night.
Grapefruit juice contains a chemical that can interfere with your body’s ability to break down certain statins, so it should be avoided in most cases, but again, always consult with your healthcare team.
Point 8: Other Things May Be Raising Your Cholesterol
Medications That Raise Cholesterol
Some medications that you may be taking to treat other conditions — including steroids and birth control — can raise cholesterol levels. So, make sure all of your healthcare professionals know about all of the medications you’re taking. There may be alternative treatments that won’t affect your cholesterol if it's something that needs to be prioritised.
Cholesterol Levels During Pregnancy
Higher-than-usual cholesterol levels are normal during pregnancy and necessary to support hormones like estrogen and progesterone. So, this is not a time to be concerned about your cholesterol. Have your cholesterol levels checked when you're not pregnant for a more accurate result.
Point 9: Dietary Supplements To Lower Cholesterol
Be careful of dietary supplements marketed toward lowering your cholesterol, as the supplement industry is not well regulated. For more details, check out my article on the best and worst cholesterol-lowering supplements.
Some supplements, like fibre supplements and turmeric, can interfere with medications.
Turmeric supplements are safe for most people, but they may interact with blood thinners such as warfarin. So always check with your doctor before taking turmeric supplements. High doses of these could have a blood-thinning effect; if taken on top of prescribed anticoagulants, this could increase the risk of dangerous bleeding.
POINT 10: Patience
My last point is, please don't expect results too soon. If you just recently made lifestyle changes or started taking medication, it may be too early to see results. Remember, you didn’t develop high cholesterol overnight, so it may take some time to get it back down to healthy levels. Keep working with your doctor or dietitian, stay consistent with your diet and follow your treatment plan to see results.
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More about the author:
Hi there! My name is Maria, and I am a Registered Dietitian practising in Ireland and Bermuda. I have extensive experience in helping clients improve their health through the power of good nutrition. I hope you enjoyed this recipe. If you have any questions or concerns, please do not hesitate to contact me. Additionally, if there are nutrition topics or recipes you would like me to make in future posts, please let me know. I would be more than happy to help.
Stay happy and healthy 💚
Your Registered Dietitian
Maria xox
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