From A1c%, to cholesterol, triglyceride labs, to CRP - there are numerous tests we draw to understand how our diet is affecting our overall health. While research shows that 90% of heart disease is caused by modifiable diet and lifestyle factors, there is still a lot of confusion of what foods to eat and which to avoid. (1) Zooming in closer, I am going to layout some thought starters on cholesterol/cardiovascular labs, and propose some advice on how to hit optimal targets.
Yet, first let's get the elephant out of the room: high cholesterol is a symptom of some sort of inflammation in the body. It is not necessarily caused from eating egg yolks, and or other high quality cholesterol containing foods. Conclusions from research based in the 1960s suggested that cholesterol was caused from high cholesterol (animal) foods and saturated fat. However, more recent data, and stronger research puts this myth to bed. While 25% of the population may respond to a higher cholesterol intake, the increase does not impact heart health or the LDL to HDL ratio. In other words, I have no problem starting my every day with eggs and or bacon/sausage, and some sort of vegetable of course, even as a type 1 diabetic with an increased risk of heart disease. I digress.
Long-term studies on saturated fat and heart health are just as comforting, if not more. Low carbohydrate diets tend to be high in fat, including saturated fat, and have shown health benefits beyond lowering cholesterol including weight loss, decrease in triglycerides, fasting blood glucose, blood pressure, waist circumference, c- reactive protein/CRP (indicator of inflammation), to name a few. (2) So once again, understand you are doing no harm to yourself when you consume saturated fat and high quality cholesterol foods.
Ben Franklin said, “An ounce of prevention is worth a pound of cure.” Diet and overall health marry this quote perfectly.
To improve heart health first know your numbers, and what they mean, and how to interpret them. The total cholesterol is not the be all. Nearly half of the heart attacks, take place with people with low cholesterol. With all my clients, I hear their story, understand their lifestyle and interpret labs with this angle:
What is total cholesterol? HDL? LDL? Total triglycerides? The I take it a step further and measure: Total cholesterol/HDL? Triglycerides/HDL ratio?
With these results, I also want to know if my client has lost weight recently, and how long the weight has been stable, and/or if the client is postpartum. All the above can affect the lab results. Further more, let's use some hypothetical lab results and play with the interpretations:
|Optimal (not to be construed as a target for drug therapy): <170 mg/dL|
|Optimal (not to be construed as a target for drug therapy): <100 mg/dL
Highly Abnormal (please review with your medical team further): >499 mg/dL
|HDL CHOLESTEROL||70 mg/dL|
|Optimal (not to be construed as a target for drug therapy): >50 mg/dL|
|LDL CHOL (CALC)||78 mg/dL|
|Optimal (not to be construed as a target for drug therapy): < 100 mg/dL
Highly Abnormal (please review with your medical team further): >189 mg/dL
As you can see beneath each result are optimal ranges. However, going off what I want to know, I will calculate a few ratios.
Trig/HDL = 0.87
- Ratio is ideal 1:1 or less. If it's 2.5-3.0 there are some said lifestyle changes to made. If it's >3 may indicated insulin resistance and increased heart disease.
Total cholesterol/HDL = 2.285
- Goal is to be below 5. Closer to 5 or above, can be an indication of cardiovascular diet/lifestyle modifications.
Ideally want HDL to be above 70 mg/dL for immunity and overall health outcomes.
- HDL increases with exercise, grassfed butter, cream, and coconut oil. HDL is made from fat, so we need to eat clean and quality fat for the raw materials. A little alcohol can also increase HDL.
A high LDL can be a sign of maybe some low thyroid, as well as, miss managed stress, sleep deprivation, high blood sugars, or too many carbohydrates in the diet.
If Triglycerides are high, review the amount of carbohydrate in the diet. Research has shown by limiting carbohydrates to 120-150g per day, can improve triglyceride levels, unrelated to weight loss. (3)
Understand what foods to eat and avoid:
- Avoid man-made foods, including vegetable oils. Indeed, vegetable oils/margarine were once recommended for heart health.
- Avoid eating large portions of foods that are high in omega 6 fatty acids. For example: nuts and seeds should be treated like a condiment. Please note the emphasis on "large." Nuts are healthy and have many wellness benefits, but any good thing, can be overdone.
Feed your heart the nutrients it needs:
- Eat whole real food, more often than not,
- Have wild seafood twice a week (omega 3 fatty acids),
- Eat antioxidant-rich foods at every meal (think produce, coffee, chocolate). An awesome goal to strive for, is 2 cups of vegetables at meals and 1 cup at snacks. Enjoy fruit, but keep quantity less than vegetables.
- Enjoy polyphenol- rich foods such as cocoa, coffee, spices, tea, wine, vegetables, fruit.
Treat yourself with the care it deserves:
- Sleep like you are getting paid for it. In a way you are!
- Get spiritual - religious or not. But make the goal of getting in touch with yourself, being present, and finding calm in our busy lives.
- Be kind with your thoughts and actions. Our feeling shape who we become.
Above all, remember that it is hard to manipulate nature. I always tell my clients, "Mother Nature cries everytime we throw out a yolk." Keep things simple. Eat real food, and try to not over think it.
PS - the picture is a Strawberry Scrambler - 2 eggs, 3 strawberries, fresh parsley, ginger, coco nibs, salt/pepper #antioxidants #sweet