The good, the bad and the ugly cholesterol

Q&A with Cynthia L. Ritter, CCRN, MSN, ARNP-C

Central Florida Health News: Is there a “Good” and “Bad” cholesterol?

Cynthia L. Ritter: Yes. Cholesterol is made of two types of lipoproteins, triglycerides and something called Lp(a). The two lipoproteins, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) have been given the terms good and bad cholesterol. LDL is the bad; HDL is the good.

CFHN: What is considered normal cholesterol levels?

Ritter: Remember that your cholesterol is a measurement of several elements.

Total Cholesterol Category
Less than 200 mg/dL Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL Borderline high
240 mg/dL and above High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.

Too much cholesterol in the blood can lead to cardiovascular disease.  Cardiovascular disease is the No. 1 cause of death in the United States.  2,200 Americans die of cardiovascular disease each day, an average of one death every 39 seconds.

CFHN: What foods are best for lowering cholesterol?

Ritter: Five nutrition strategies to lower your cholesterol and reduce your risk of heart disease:

1. Eat more vegetables, fruits, whole grains, and legumes.

These wonders of nature may be one of the most powerful strategies in fighting heart disease. The increase in dietary fiber as part of a healthy diet helps lower bad LDL cholesterol.

2. Choose fat calories wisely.

Eat a bare minimum of saturated fats and trans-fatty acids (for example, fats found in butter, salad dressing, sweets and desserts). When you use added fat, use fats high in monounsaturated fats (for example, fats found in olive and peanut oil). Another strategy is to use plant stanols or sterols as a dietary option to help lower bad LDL cholesterol.

3. Eat a variety — and just the right amount — of protein foods.

Commonly eaten protein foods (meat, dairy products) are among the main culprits in increasing heart disease risk. Reduce this nutritional risk factor by balancing animal, fish and vegetable sources of protein. Substituting soy protein for animal protein has been reported to lower LDL cholesterol, which reduces your risk of heart disease. Higher intakes of omega-3 fatty acids has been shown to help reduce the risk of heart disease. The American Heart Association recommends that fish be included as part of a heart-healthy diet.

4. Limit cholesterol consumption.

Dietary cholesterol can raise blood cholesterol levels, especially in high-risk people. Limiting dietary cholesterol has an added bonus: You’ll also cut out saturated fat, as cholesterol and saturated fat are usually found in the same foods. Get energy by eating complex carbohydrates (whole wheat pasta, brown or wild rice, whole-grain breads) and limit simple carbohydrates (regular soft drinks, sugar, sweets). If you have high cholesterol, these simple carbohydrates exacerbate the condition and may increase your risk for heart disease.

5. Feed your body regularly.

Skipping meals often leads to overeating. For some, eating five to six mini-meals may help keep cravings in check, help control blood sugars and regulate metabolism. This approach may not be as effective for those who are tempted to overeat every time they are exposed to food. For these individuals, three balanced meals a day may be a better approach.

CFHN: At what point is medication necessary for high cholesterol beyond nutrition and exercise?

Ritter: It takes a team to develop and maintain a successful health program. You and your healthcare professionals each play an important role in maintaining and improving your heart health. Know how to talk with your doctor about your cholesterol levels and be sure you understand all instructions. Follow your plan carefully, especially when it comes to medication — it won’t work if you don’t take it as directed. And learn how to make diet and lifestyle changes easy and lasting.

BIO: Cindy L. Ritter is a certified, advanced registered nurse practitioner with Winter Haven Hospital’s Bostick Heart Center. She has a certification in critical care and a master’s of science degree in nursing.

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