High cholesterol? Small diet shifts might help

Cholesterol is a waxy substance in your blood. Your body needs some, but when cholesterol levels become too high – often due to diet and lifestyle – plaque can form in your arteries. Cholesterol buildup can limit blood flow to your heart or brain, increasing your chances of a heart attack or stroke.

About 1 in 5 adolescent children in the United States had an unhealthy cholesterol measurement between 2009 and 2016. About 10% of adults have high total cholesterol above 240 mg/dL. Because you can’t feel your cholesterol levels, healthy adults should have levels checked with a blood test every four to six years.

A cholesterol check is also called a lipid panel. Testing is recommended beginning between ages 9 and 11. Here’s what the numbers mean:

“By screening for cholesterol in childhood, we can intervene with lifestyle or medication at an earlier age,” said Kari Murdy, RD, an M Health Fairview Pediatrics Lipid Clinic coordinator and dietitian. “We can dramatically reduce the risk for heart attack or stroke in adulthood if we start treating people when they're in their teens versus in their thirties, forties, or fifties.”

Some people have genetically high cholesterol that can’t be completely controlled with diet or lifestyle. But Murdy says controlling other risk factors, such as overweight, diabetes or high blood pressure (hypertension) can help reduce risk of heart attack and stroke. Diet plays a big part, but Murdy says don’t worry. She’s not going to ask anyone to be perfect with their diet. Just try to make it a bit healthier with gradual changes.

“Anytime is a good time to make improvements in how you eat,” said Jeremy Van’t Hof, MD, a preventive cardiologist with M Health Fairview and an assistant professor with the University of Minnesota Medical School. “The longer you're exposed to the unhealthy diet, the worse effects it can have on your body. So even small changes early can have benefit down the road. Making big changes later in life can also be beneficial, but when disease has already developed, then you shift from preventing the disease to stopping the progression.”

Van’t Hof and Murdy offer some suggestions for how everyone can show their heart some love through food.

Keep it simple.

“People tend to overcomplicate what healthy eating looks like,” Murdy said. “There’s no need to weigh servings or count grams of sodium if you don’t want to. Just think of it as having a protein, a grain, some fruit, and a vegetable at each meal.”

At each meal,

• Half of the plate should be fruits or vegetables.
• A quarter of the plate should be grains.
• A quarter should be protein.

Guidelines also recommend two or three servings of low-fat or fat-free dairy each day. Murdy recommends looking at MyPlate for more on serving sizes and meal recommendations.

Pick the healthiest proteins.

Your serving of protein should be about the size of the palm of your hand. The most heart-healthy choices are plant-based proteins like beans or lentils or lean meats like fish or chicken. Red and processed meats like bacon and beef are higher in saturated fat that is associated with higher rates of low-density lipoprotein (LDL), commonly called “bad cholesterol.”

Another source of saturated fat is dairy products. Choosing low-fat or non-fat milk, yogurt, and cheese gives you protein with less saturated fat.

Fill your plate with fruits and veggies.

Fiber is linked to healthier cholesterol levels and lower levels of inflammation, both of which are good for your heart. A fast way to increase your fiber intake is by eating fruits and vegetables. Try increasing the size of your vegetable serving or going back for seconds of the vegetables instead of the protein or grain. Murdy also encourages fruits and veggies for snacks. Consider veggies with hummus or fruit with peanut butter.

Rethink snack time.

We often think of packaged foods like crackers, chips, and cookies for snack time, but snacks are an opportunity to get more nutrients. In addition to snacking on fruits and vegetables, consider increasing protein with string cheese, Greek yogurt, eggs, or nuts, Murdy said. Popcorn is also a fiber-rich food that will fill you up until your next meal.

Limit fast food.

“If people are regularly eating fast food or food from places like gas stations or having a lot of soda or pop in their diet, that’s where I usually start because those foods are closely related to heart disease,” Van’t Hof said.

Fast food and sugar-sweetened beverages are high in simple carbohydrates and salt. The combination can lead to high blood pressure, higher cholesterol, and weight gain. All of which can affect heart health.

It does take longer, but making time to prepare meals at home allows you to control what goes into them and can help your heart. One way to maintain healthy blood pressure is to limit salt in your diet to 2,000 milligrams per day.

“Sodium can raise blood pressure, which is one of the most impactful risk factors for heart disease,” Van’t Hof said. “Most people don't feel when they have high blood pressure, so they might be living with it for many years.”

Sweeten sparingly.

Sugar is an energy source for your body, but if you don’t use that energy, it gets packaged into triglycerides. Triglycerides are cholesterol particles that float around in your bloodstream. High levels of triglycerides increase the risk of heart attack and stroke. Sodas and desserts contribute the most added sugar in America diets. Look for ways to cut back, such as smaller serving sizes or low-sugar alternatives.

Overall health is important.

Food choices give you several opportunities throughout the day to make a difference in your heart health. But you can also improve heart health when you prioritize sleep, get exercise, and manage your stress.