Sorting Out the Cholesterol Confusion
29
August

By Adem Lewis / in , , , , , , , , , , , , /


Hey, everyone. I’m Dr. Keller Wortham. Today, we are talking about cholesterol. Yeah, I know. Cholesterol, it’s a term that gets thrown around, all the time. There’s high cholesterol, low cholesterol, good cholesterol, bad cholesterol and so many terms. It could kinda make your head spin. Well, today, I’m gonna break it down for you. We’ll be talking about this very important molecule that can cause some problems and also has some benefits. I will make sure you understand the good, the bad and the greasy about cholesterol. [Clears throat] Cholesterol is, essentially, a molecule that is very important for life, but if you get too much of it, it can lead to things like heart disease, heart attack and stroke. How do we find the sweet spot for cholesterol? Well, today, I’m gonna walk you through the different terms we use, when we talk about cholesterol. I’m gonna help you find out if you know if you’re in your sweet spot, and if you’re not, some things that you can do to try to get there. [Clears throat] So, you ready? Alright, let’s do it. Alright. First of all, cholesterol is, basically, a molecule that’s this waxy molecule that exists in your blood, and it is responsible for the health of your cell membranes. It’s basically very important in a lot of cellular functions, and it’s also a building block for certain hormones that you have, like estrogen, testosterone, to name a few. It’s a very crucial molecule. However, if we get too much cholesterol, then it can start to have an inflammatory effect on the body. It can start to kind of inflame the inside of the blood vessels, something we call the endothelium. It can start to deposit there and create these plaques, and that whole process can be bad for your heart and your blood vessels. [Clears throat] How do you know if your cholesterol’s good, bad, somewhere in the middle? Well, luckily, there’s a very easy way to determine it, by doing a blood test or a lipid panel. Now, if you’re one of my patients and you come in, we certainly check your lipid panel, at least once every two years. If you’ve got some other risk factors that might be associated with high cholesterol, we’ll check it even more frequently. Before we get into what a lipid panel is, let’s talk a little bit about the things that happen, that you find on a lipid panel, so you can kind of understand a little bit more. Cholesterol exists in the blood, but it’s transported by a certain little protein carrier molecule. These lipoproteins are, basically, the way that cholesterol moves about the body, and there are different ones. They come in different shapes and sizes, and some of those are better for your body than other ones. [Clears throat] There’s one particular lipid or lipid protein called LDL, and that stands for low-density lipoprotein. It’s, basically, a larger one, and that is what we know as bad cholesterol. Okay? LDL, bad. Then there’s one called HDL. That’s high-density lipoprotein, and that’s what we often refer to as the good cholesterol. LDL is bad because it, basically, is more inflammatory to your blood vessels and can start to deposit more plaque on the walls and the inside of your arteries. HDL is considered good because it can kind of pick up the cholesterol from the walls of your arteries and get it out of there, get it back to the liver and even get it excreted from your body by way of your stool. When we draw a lipid panel, at your doctor’s, just a simple blood test. What you’re gonna see, often, are the values for your total cholesterol — basically, how much cholesterol you have in your body — and then the portion of that that’s LDL or bad cholesterol, and the portion of it that’s good cholesterol or HDL. Another component that you’ll see there, something called triglycerides, which is another fat that circulates through the body. It can also be quite inflammatory to the body. It’s often related to how much blood sugar you have or the way your body’s metabolizing sugars. Those are all components that you can see in your lipid panel. That’s a little bit about how you find out, how you get diagnosed with either normal, good, bad, high, low cholesterol. If you get diagnosed with high cholesterol, the question might be, “Well, how did it get there?” Well, in some people, it could just be bad genetics. In fact, you don’t have to be consuming fats and cholesterol to even get high cholesterol. Your liver, the organ right here, makes its own cholesterol. If you’ve got a genetic make-up that just is really hyperactive, you can make a lot of cholesterol that can be very inflammatory to your blood vessels. For most of us, our cholesterol gets high because of our lifestyle. I’m gonna go over some things that you could be doing or some things that could be part of your lifestyle, that could be increasing your cholesterol levels. In general, a sedentary lifestyle, so if you sit a lot. Maybe you are at a desk job, all day long. Maybe you work in transportation, so you’re driving all day. You’re a trucker. You’re an Uber driver, something like that, so you’re not getting a lot of physical activity. That, alone, can start to raise cholesterol levels. Also, number two, a diet high in saturated fats. Saturated fats are typically animal fats, for the most part. If you’re eating a lot of red meat, if you’re eating a lot of other things, like chicken, if you’re having a lot of eggs, if you’re having saturated fats which are fats from animal products like cheese, like butter, these are things that are just high in saturated fats. There are some other vegetable oils, like Crisco and Wesson oil, that are high in saturated fats. You could be… If you find yourself eating a lot of red meat, if you’re frying a lot of food, you’re putting a lot of saturated fats into your body. That includes cholesterol, and that also tends to pump up your LDL or your bad cholesterol. Also, trans fats. Trans fats are another part of… They’re another fat that exists, out in the world, that are really, really bad for you. Trans fats are, basically, a synthesized fat that they tried to make in a laboratory, to preserve food better Really, they made a fat that preserves food quite well. It won’t spoil, but it’s really bad for our arteries. It causes that inflammation I was talking about, and it causes a hardening of the arteries much faster. Trans fats are something else that you could be putting in your diet that’s not great for your cholesterol. Obesity, in general. A lot of these things lead up to obesity — a sedentary lifestyle, eating a lot of fats — but, in general, just being overweight can start to shift the levels of your cholesterol to fractions that are not as good. Additionally, smoking. Smoking is really bad for your cholesterol levels. We know that just the use of nicotine and the burning of tobacco can cause shifts in your cholesterol. It shifts your good cholesterol down and your bad cholesterol up, and can raise your total cholesterol. Smoking’s another lifestyle habit that can worsen cholesterol. Then, diabetes. Diabetes, as well, can increase your triglycerides, which is, like I said, a fatty portion of your blood, and something called the VLDL. That’s a very-low-density lipoprotein, and that’s even more corrosive and inflammatory to the arteries. Why are we talking about all this? Why is it so bad? Well, it has to do with the cardiovascular system, and that’s basically meaning… It’s our fancy, scientific word for the heart and the blood vessels. Your heart is arguably your most vital organ. In fact, I’m wearing pink today, just to honor the heart and pay tribute to it because the heart has a really important job. It starts beating from before we’re even born, when we’re a fetus in the womb. It must continue beating, every second, roughly, for the rest of our lives, until the day we die. It’s a very, very important organ. It doesn’t get to take a break, and it just has to keep going. The heart needs, like any muscle… The heart is a muscle. It needs a constant supply of blood and oxygen, to keep going. It’s not like other muscles. If you get a cramp in your bicep or you get a charley horse, you can rest that muscle and let more oxygen get in there. You don’t get to rest your heart, so you don’t want it to get a cramp. The heart gets its oxygen from these little arteries called the coronaries. Those coronaries supply the heart with the blood and the oxygen it needs, but because they’re so small, they’re very susceptible to something called atherosclerosis. [Cough] That’s what we’re talking about, today. Atherosclerosis basically means the hardening of the arteries. It happens when you get high cholesterol or you have a lot of inflammation in your diet. It starts to make the arteries kind of inflamed. They get more rigid. They get harder. Cholesterol starts to deposit on the insides of them, and you can think of that kind of like the rusting of a pipe. As the pipe rusts, it gets more narrow. I don’t know if you’ve ever heard the piece of advice, “Don’t pour turkey grease down the drain, or you’re gonna clog your drain” because it’ll start to coat that pipe. That’s basically what’s happening here. Believe me, when it comes to your body, you don’t want clogged pipes, especially in your heart. What happens is, if you get a bunch of this atherosclerosis and it clogs off the coronary arteries that are bringing blood to your heart, the heart doesn’t get the oxygen it needs. It can’t take a break. It keeps beating. It starts to get, in effect, a cramp, and that is, basically, a heart attack. Then that muscle starts to die. This happens, every day, to thousands of people. Okay? Heart attacks and cardiovascular disease are the number one killer, in our country, of men and women One out of every four people in the country are gonna die from a heart attack or from some form of cardiovascular disease. It’s critical that we protect our hearts, and to do that, one of the most important things we can do is keep our cholesterol in check. A lot of information. You following me? Okay, good. I think I’m following myself. Let’s see what we’re gonna talk about now. Ah. Okay. So, we’ve talked about cholesterol, the levels that are high, why it’s probably very important to keep it in check. If you go to the doctor and you’ve been diagnosed with high cholesterol, what can you do? What can you do to bring that cholesterol down? Well, in some cases, if your cholesterol is really high, a doctor might prescribe you a medication. Maybe you’ve heard of the statins or other lipid-lowering drugs. That could be a route that you could go. Fortunately, there are a lot of things you can do, right at home, right in your diet, right with your lifestyle, that will start to change your cholesterol. I’m gonna go over those things. Maybe, if you have high cholesterol or if you’re just someone who really wants to work on improving your cardiovascular system, you can implement these changes. Alright. You ready? Okay. Number one, stop smoking. If you’re a smoker, please quit. I know it’s really hard. I know it’s very, very hard. It’s a strong addiction. I see people who are smokers, every day, who are trying to quit, who know it’s bad for them. Seek out the help of your physician, if you need to. There are lots of medications and replacements that can help, but the bottom line is, [cough] smoking is very hard on the heart and the blood vessels. A lot of people think about the lungs. It’s true, smoking is bad for your lungs, but it really inflames the arteries. It changes the cholesterol from, basically, good to bad. It lowers your HDL or your good cholesterol, and it raises your LDL or your bad cholesterol. Quit smoking. You will do your heart a world of good. Okay? Number two, exercise. The heart loves exercise. It basically helps pump more blood through your body, but it also helps pump more blood to the heart, itself. It gets more efficient. Those coronary arteries get more flexible. Exercise, also, inherently, is good for your cholesterol level. Just exercising, 30 minutes a day or even four times per week, will lower your total cholesterol levels and, again, start to raise your HDL, or your good cholesterol, and lower your bad cholesterol. Okay? Number three, reduce your saturated fats. Again, we’re talking about animal products, your red meat. We’re talking about your butters. We’re talking about your cheeses. We’re talking about some of those other things that are just higher in saturated fats. You wanna reduce your saturated fats, and that will lower your cholesterol. I’m not saying that you can never have a piece of meat. When you do, if you wanna opt for leaner meat options, not so much the red meat, but maybe go more for chicken, for fish, which is high in healthy fats, which brings me to another thing you can do to lower your cholesterol. That is eat more healthy fats, and I’m gonna show you some examples, right now. We just talked about seafood. Salmon, some coldwater trout, those being great healthy fats that can actually lower your cholesterol, but there are some plant-based ones, as well. We’ve got olive oil. We’ve got avocado oil. These are great for salad dressings. We’ve got avocados, themselves, very good and healthy fats. Chia seeds, chia seeds are great. You can sprinkle them on so many things. You can add them to so many foods. These are all very rich, all very rich in omegas, These omega oils are great for lowering your bad cholesterol and, also, lowering your triglycerides. They help reduce the inflammation that’s going on in your body, that’s basically causing an irritation to the arteries. Okay? You following me, so far? Okay, good. We got a couple more. Increase fiber. Fiber is that molecule that’s found in, basically, fruits and vegetables. I’ve got some very fibrous vegetables, here. We’re talking about kale. We’ve got some broccoli. We’ve got a nice red bell pepper. A lot of people, when they think about fiber, they think about grains, so I got some farro, right here, as a nice healthy grain. Yes, there’s a lot of fiber in grains, a lot of fiber, especially if they’re whole grains. You get the most bang for your buck in vegetables. When you eat fiber, it basically goes into your digestive system, and it helps to pull cholesterol out of your blood and then help you excrete it in your stool. You can lower, lower your cholesterol by eating a lot of fiber. It also helps keep you full for longer, so you tend to kind of eat less bad foods for you. Okay? That’s another thing you could do. Lower alcohol, that’s another one. Some people will say, “Well, a little bit of alcohol can be good for my cholesterol.” It’s true. In moderation, alcohol can have a positive effect on the cardiovascular system. If you’re having too much of it… And that means more than a drink a day, for women, or, certainly, more than two drinks a day for men. Then, any benefits you might get from alcohol are going to go out the window. Okay? Then, lastly, manage stress. Stress is very hard on the body. When you’re stressed, your cortisol levels go up. Cortisol is very inflammatory for the body. It can also have effects on the cholesterol. If you’re trying to protect your heart and your blood vessels, then you need to manage your stress. A lot of things that we talked about, already, can help that. Exercise can help that. Getting proper sleep can help that, just taking breaks. Those can all help manage your stress. Those are a lot of things that you have, within your power, to manage your cholesterol, to lower it, to get it to that sweet spot we were talking about. If you want some extra help… Since we talked a lot about the inflammation aspect of high cholesterol, if you wanna reduce inflammation, a lot of the foods that we just talked about naturally reduce things. You can also add some supplements. There are natural anti-inflammatory supplements that you can add. Omega-3 oils are one. You can get it in fish tablets or from vegetable-based oils. Curcumin is another one. It’s a natural anti-inflammatory. It’s the bioactive ingredient in turmeric. You can find supplements that have those and add them to your diet. You will help reduce your inflammation, and you’ll help reduce the bad effect that cholesterol is having on your heart and your blood vessels. All things equal, that’s going to protect your heart. It’s going to keep you going. Chances are, you will live much longer than someone who’s not addressing these issues. Alright? There you go. I hope you’ve enjoyed today’s topic on cholesterol, on finding the sweet spot. I hope you understand, a little bit more, what you can do to help prevent heart disease. I would be happy to answer any questions that you might have. I’m here to talk about lots of topics for you. If there’s other things that you want us to address, please bring them up. Again, thanks for tuning in. I’m Dr. Keller Wortham, and I hope you have a great day. I know your heart does, too. Bye.


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