Re-calibrating Our Views On Cholesterol
As a doctor of Internal Medicine, I find that one common misconception many of my young adults (ages 35 and below) have is that “bad” (LDL or non-HDL) cholesterol is a problem of older age. Too often the sentiment “Live while you are young!” is taken out of context by people in their teens, twenties and thirties to mean “Don’t worry about your health till you are older.” While it is true that after we reach the age of 20 our cholesterol levels begin naturally to increase, there are many factors besides age that determine the levels of bad cholesterol in our blood. While some of that is hereditary, many of these factors can be monitored and controlled from quite a young age. While I am a firm believer in living life to the fullest – I also am adamant that the choices we make about our health and wellness in our formative years provide a strong baseline for our bodies and minds of the future.
The Problems of Waiting Out Your Youth To Correct Cholesterol Levels
Patients of mine above the age of 50 are certainly at a higher risk of cardiovascular complications related to bad cholesterol than their younger counterparts. However, even children with poor dietary habits can have alarmingly high bad cholesterol levels and even the beginnings of blocked arteries before high school!
When one of my older patients at high risk has a very high LDL cholesterol (>190) and we have not been able to improve it with lifestyle changes such as exercise and diet, I may decide to use a prescription treatment for lowering those levels to minimize the risks of complications like strokes or heart attacks. The most widely prescribed are statins, which quickly reduce bad cholesterol levels in the blood . Statins, such as Lipitor, Crestor or Zocor, work by inhibiting HMG-CoA reductase, a liver enzyme which promotes cholesterol production in the human body.
(By the way, I have always advised my patients to CONTINUE their lifestyle efforts and to take Coenzyme Q10 whileon the statin, because statins deplete this substance which is a vital co-factor in your cells’ energy production.)
Despite the fact that I prescribe these medicines, as an advocate of a natural approach to health whenever possible, I’d much prefer that my patients never reach the point where taking a statin becomes their best option. While statins have proven to be extremely effective in reducing levels of bad cholesterol – their efficacy can be trumped by an array of side effects: muscle pain (not uncommon), liver problems (very rare) and increased risk of diabetes among them.
Today I’d like to talk specifically about one somewhat surprising side effect of statin use which has recently been highlighted by researchers in the peer-reviewed journal, Obesity.
In a new study, based on over 10 years of data collection, researchers found that patients prescribed statins “significantly increased their fat intake and calorie consumption, along with their BMI, in the last decade,”
Why, you ask? Patients taking these enzyme inhibitors are well aware of their positive benefits and therefore have a propensity for poor diet and lifestyle choices while prescribed them. Too often the mindset of “I take pills to lower my cholesterol – therefore I can eat whatever I want without getting sick” apparently becomes commonplace in those suffering from these kinds of health issues. Patients can become complacent with a poor, unhealthy lifestyle after viewing remarkably improved blood work results from a course of statins – and this is NOT a trend that doctors and patients should continue! When I read this I remembered that when the first statin, Mevacor, came out, one of my fellow doctors in my residency program told me he took it so he could “keep eating bacon and eggs”!
“Ok – I get it, Dr. Nolfo. You’d prefer I didn’t have to take statins if I had the choice. So what do I do instead? “
I am SO glad you asked! There are many ways to keep our cholesterol at a healthy level:
Yes, I know I say it a lot. But countless other physicians and researchers like myself agree: Lack of physical activity can increase bad cholesterol (LDL) – and even DECREASE the good cholesterol! (HDL)
2. DON’T SMOKE!
Smoking has been proven to lower your good cholesterol – BAD, BAD, BAD! And I seriously hope we don’t need to review the thousands of other health complications that can arise from such a terrible habit. Please don’t smoke! I like you just the way you are!
3. See Your Primary Care Doctor Regularly
General health plays a large role in our cholesterol levels. It is best that you make regular visits with your primary care doctor so you can be screened for other health complications such as diabetes or hypothyroidism, which can cause high cholesterol. Plus, it’s just the smart thing to do!
4. Eat Healthy, Real, Unprocessed Foods!
Clearly you saw this one coming! Diet is one of the most crucial factors in our cholesterol. Highly processed foods like chips, cookies, margarine, etc. can easily raise our levels of bad cholesterol. I have posted an array of healthy recipes of all kinds throughout this blog – please review for some great meal ideas to start changing your diet today! Vegan and Mediterranean diets have been shown to help cholesterol profiles. There is a little controversy about the effect of the Paleo diet on cholesterol, but my Paleo patients’ cholesterol profiles are usually quite good.\ because they don’t limit themselves to all meats and eggs and eat tons of fruits and veggies.
And just to give you a head start on the eating part – try this delicious and healthy black bean, corn and edamame salad! Not only is it perfect for the start of summer, but a new study shows that beans can help significantly reduce our bad cholesterol!
Go ahead, try this stuff!
Dr. Emily Nolfo