Life is never so simple as just reducing a single number with a guarantee that you will live longer and better – unfortunately. Whether the number is your blood pressure or as we will discuss this month, your “bad” cholesterol called low-density lipoprotein (LDL). Reducing these numbers does not absolutely mean you won’t have a stroke or heart attack; however, it does mean you are reducing your risk.
What is LDL & Why Is It Important?
LDL is one of the three “lipids” that are commonly measured in the blood and is the one that carries cholesterol around the body. The other lipids routinely measured are total cholesterol and high-density lipoprotein (HDL). LDL transports cholesterol, think of it as a dump truck that takes and deposits cholesterol at places needed and sometimes not needed. HDL, on the other hand, transports cholesterol away from the places that LDL has deposited it. It is better to have relatively more HDL than LDL.
Cholesterol is the fatty substance, which comes from diet or is made internally, that the body needs in moderate levels to keep cells and organs healthy. However, high amounts of cholesterol that build-up in arteries and form deposits called plaques can and do lead to rupture and occlusion of the vessel. If this occurs in the heart or brain the result can be a heart attack or stroke, respectively. Since large deposits of cholesterol can cause severe disease, it follows that anything that causes the build-up is bad. Hence, LDL is called the “bad” lipid because it is responsible for transporting and accumulating cholesterol.
Role of Diet in Cholesterol Build-up
There is ample scientific data that shows if one eats a lot of saturated fat then cholesterol rises and is available to be taken by LDL to cause risk of heart disease and stroke. Saturated fats are abundant in our Western diets and found in red meat, cheese, dairy products, and many other common items on our diet. Add to the saturated fat the trans fats that we find in processed foods like cookies, fried food, and cakes to name just a few and it is easy to understand why those of us in the “developed” nations have much higher risk of heart and stroke than people who live in the developing countries who eat fresh fruits, vegetables, and fish that are low in saturated and trans fats.
Another important fact is that our bodies cannot make some of the essential fatty acids needed to combat cholesterol like omega-3 and omega-6 found in oily fish, nuts, and seeds. Thus, one can choose to eat less saturated and trans fats while consuming the essential fatty acids: This becomes the foundation for a healthy cardiovascular diet.
If one is at risk for heart disease or stroke (and all of us are as we age), one must be strategic in lowering LDL. There are three ways to lower LDL. One is to take medicine, another is to exercise regularly, and diet is the all important third one. Exercise and diet are the two things that you can do without a doctor’s prescription and should be part of everyone’s healthy aging plan.
With regard to diet, the goal is to eliminate as many saturated and trans fats as possible from one’s diet while eating more fruits, vegetables, fiber, oats, nuts, and fish. Read all food labels and avoid those foods high in saturated and trans fats. Avoid fast food restaurants that still use trans fats by the gallons in their preparation. Wherever you eat, ask what kind of oil is used for frying their food. Eat more polyunsaturated and monounsaturated fats (read the labels of the foods you buy) as these fats help lower LDL. This includes plant-derived oils like sunflower, peanut, olive, and canola. Seeds, nuts, avocados, and soybeans are all sources of good fatty acids. Fatty fish are recommended like tuna, trout, herring, mackerel, and salmon.
Fruits and vegetables are rich in ingredients that lower cholesterol because they contain fiber and sterols and stanols that help inhibit cholesterol absorption from the intestines. Bran, oats (remember Cheerios – the heart healthy food!), whole wheat, apples, bananas, berries, citrus fruit, beans, eggplant, and okra contain soluble fiber that reduces LDL. And, all are good for you and a far better choice than many of the things we might eat.
What Is the Target LDL Number?
One of the things that has changed over the past few years is that scientists, physicians, nutritionists, and health associations, including the government, are backing away from absolute number targets and categories like those shown in the table below. Although the table is still a useful guideline, the informed opinion now is that for healthy aging one should measure your lipids at least once a year and then try and lower total cholesterol and LDL. There is no single magic number above which or below which is certain to cause or prevent heart attack and stroke. What is recommended is that each of us know where we are and then eat and exercise to reduce LDL. If this is not successful, you and your physician may consider starting a statin drug therapy to assist in this healthful struggle with LDL levels.
The Bottom Line
There is an enormous amount of scientific information that relates high cholesterol and high LDL with heart attack and stroke. It is vital that you eat those foods that are known to reduce LDL. You and your doctor should monitor your lipids and lower your LDL.
Serum Lipids Commonly Measured & Classification
Less than 200 mg/dL Desirable
200 to 239 mg/dL Borderline high
240 mg/dL and above High
Less than 100 mg/dL Optimal (ideal)
100 to 129 mg/dL Near optimal
130 to 159 mg/dL Borderline high
160 to 189 mg/dL High
190 mg/dL and above Very high
Less than 40 mg/dL Major heart disease risk factor
60 mg/dL and above Gives some protection against heart disease