Cholesterol-Lowering Gene May Increase Risk of Cataracts – Managed Healthcare Executive

In a study, both common and rare HMGCR variants were associated with an increased risk for cataract.

People who have genetic variations associated with lowering LDL-cholesterol similar to statin medications appear to have an increased risk of developing cataracts and having cataract surgery, according to new research published in the Journal of the American Heart Association (JAHA).

Previous research has found some evidence that statin medications may increase the risk of cataracts. Statin medications reduce levels of LDL-cholesterol by inhibiting an enzyme called HMG-CoA-reductase (HMGCR).

“We were able to establish a link between genetic variants that mimic inhibition of HMGCR and the development of cataracts,” lead study author Jonas Ghouse, M.D., Ph.D., said in a press release. He is a fellow in the cardiac genetics group, Laboratory for Molecular Cardiology in the department of biomedical sciences at the University of Copenhagen in Denmark.

He said this research wasn’t able to find any association between newer non-statin, lipid-lowering medications and cataract risk, so this effect is likely specific to statins. “However, it’s important to stress that the benefits of statins for lowering levels of low-density lipoproteins in people who have high blood cholesterol levels completely outweighs the small risk of cataracts, and cataract surgery is effective and safe,” Ghouse said.

Investigators in the JAHA study used large-scale genotyping and exome sequencing from the UK Biobank, which tracks serious health and medical conditions of nearly half a million adults. The researchers focused on five common previously identified genetic variants that lower the level of LDL cholesterol. They then calculated genetic scores based on each variant’s previously identified impact on LDL cholesterol.

The analysis found that common genetic variants in more than 402,000 people, who were not taking statins, that mimic the effects of LDL-cholesterol lowering statins are associated with a higher risk of cataracts and cataract surgery. Compared with non-carriers, carriers of these rare mutations were more than four-and-a-half times as likely to develop cataracts and over five times as likely to have cataract surgery.

In addition, researchers found a found stronger association between the gene and cataract surgery compared with a cataract diagnosis, which they said could reflect a more severe type of cataract.

Investigators conducted analyses of other LDL-lowering pathways, but found no association between the genes NPC1L1 and PCSK9 and cataract risk.

One of limitation of the study is that while carrying these genetic variants constitutes a lifelong risk for the development of cataracts, that risk should not be evaluated the same for people who begin taking statins later in life given the positive impact statins may have by lowering blood cholesterol levels.

Side Effects of “Way Too High Cholesterol” — Eat This Not That – Eat This, Not That

We need cholesterol for our overall health, but too much is a bad thing. High cholesterol can cause major health problems and is called a silent killer because there’s often no warning signs. While high cholesterol can be inherited, lifestyle choices like poor diet, lack of exercise and smoking can increase the risk. Dr. Bayo Curry-Winchell, Urgent Care Medical Director and Physician, Carbon Health and Saint Mary’s Hospital explains the difference between good and bad cholesterol and how it can affect your health. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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Dr. Curry-Winchell says, “The ‘good’ cholesterol helps protect vital organs such as your heart from a stroke or heart attack by carrying the unhealthy “bad” cholesterol to the liver. This process ultimately helps decrease the amount of cholesterol (also referred to as plaque) from settling within the walls of your blood vessels. The “good” cholesterol is vital in helping to reduce your risk for a cardiac event.”

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Dr. Curry-Winchell shares, “It’s important to remember your liver naturally makes enough cholesterol for your body. Extra cholesterol comes from the food you eat. The excess amount is referred to as ‘bad’ cholesterol. The “extra” can build up in the walls of your arteries. It’s referred to as atherosclerosis, a reduction or blockage that causes narrowing of the blood vessels impacting blood flow to the heart.”

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According to Dr. Curry-Winchell, “You are considered to have high cholesterol if your total cholesterol (which includes your LDL ‘bad’ and HDL ‘good’) is over 200. The goal is to have less than 100 mg/dL of ‘bad’ LDL cholesterol and more than 40 mg/dL of the ‘good’ HDL cholesterol.”

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Dr. Curry-Winchell explains, “A heart attack or stroke also referred to as a myocardial infarction or cerebrovascular accident can be a result from excess cholesterol within the arteries that have decreased or blocked arteries from transporting blood to the heart. A cardiac event from high cholesterol can be life altering.”

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“As cholesterol builds up within your vessels it decreases the amount of blood allowed to flow to your heart,” Dr. Curry-Winchell says. “This leads to less blood flow and oxygen delivered to the heart which ultimately causes more stress on the heart and pain in the chest often referred to as angina.”

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Dr. Curry-Winchell states, “Too much cholesterol can cause gallstones to form. A pain that is linked to intermittent stomach pain, nausea, and vomiting.”

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“It is important to know that high cholesterol can be a silent disease,” Dr. Curry-Winchell emphasizes. “You may not have any symptoms. The only way to know if you have high cholesterol is to get screened. A blood test and talking to your health care provider will allow you to know your risks of a cardiac event.”

Heather Newgen

Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more

Bison vs. beef: Differences in cholesterol and more – Medical News Today

Bison is game meat that may be a healthier alternative to beef. With less saturated fat, it may be a better red meat option for managing cholesterol levels and as part of a balanced diet.

This article looks at the nutritional profile of bison meat and how it differs from beef. It discusses differences in farming methods, flavor, and preparation. In addition, we share tips for meal ideas using bison meat.

Bison are large bovine animals similar to cattle. The Department of Agriculture (USDA) notes that the bison bull is the largest animal indigenous to North America, standing taller than 6 feet at the hump and weighing more than a ton.

Some people refer to bison as American buffalo or buffalo. Farmers rear bison as livestock, and people prepare and eat the meat in a similar way to beef.

Although bison and beef taste similar, they have differences in their nutritional profile.

Bison is lower in cholesterol than beef. The following table compares the two.

The American Heart Association (AHA) recommends that people limit their consumption of saturated fat to avoid raising low-density lipoprotein (LDL). High LDL cholesterol is a risk factor for heart disease and stroke.

For individuals wanting to lower their cholesterol, the AHA advises they should reduce saturated fat to less than 6% of their daily calories. For someone eating 2,000 calories per day, that’s around 11–13 g of saturated fat.

Because bison contains less calories, cholesterol, and saturated fat, 2013 research suggests it may be a healthier alternative to beef.

Bison is a good source of protein and some vitamins and minerals. The nutritional profile of both bison and beef is as follows:

Experts advise that people limit their red and processed meat consumption to avoid high cholesterol, heart disease, and other health conditions.

The World Cancer Research Fund (WCRF) advises people to eat no more than three portions of red meat per week — equivalent to 350–500 g (about 12–18 oz) cooked weight.

Additionally, the American Heart Association (AHA) notes that eating more plant protein instead of red meat may improve heart health.

Foods that are low in cholesterol and saturated fat include:

  • vegetables
  • fruits
  • whole grains, such as oats, barley, brown rice, and buckwheat
  • beans and legumes, such as chickpeas, cannellini beans, kidney beans, and lentils
  • soy, tofu, and tempeh
  • oily fish, such as sardines, tuna, salmon, and mackerel
  • white fish, such as cod, haddock, and bass
  • poultry, such as turkey and chicken without skin
  • seitan
  • nuts and seeds
  • avocados
  • low fat dairy products, such as skim milk and cottage cheese

Including these foods as part of a balanced diet and limiting saturated fats from red and processed meats can help individuals lower their cholesterol and reduce their risk of stroke and heart disease. In addition, it may reduce someone’s risk of cancer, obesity, and other chronic health conditions.

In addition to their cholesterol profile, bison and beef have several other differences.

Rearing and farming methods

Bison is game meat and producers raise the animals on ranches or farms. The animals may be allowed to roam freely or kept in more confined conditions.

Wild game is usually lower in saturated fat because the animal gets more exercise. In comparison, most beef is mass-produced on farms, where animals may not be active.

The USDA notes that farmers slaughter 20,000 bison each year compared to approximately 125,000 cattle per day. In addition, producers do not give antibiotics or hormones to bison.

Beefalo

The USDA explains that beefalo are 3/8 bison and 5/8 domestic cattle. Farmers feed beefalo inexpensive, high-roughage feed to gain weight easily. Therefore, the nutrition profile of beefalo may be more similar to beef than bison.

Omega-3 fatty acid profile

Game meats, particularly meat from grass-fed animals, may contain more omega-3 fatty acids than beef. Most commercially produced beef is grain-fed, resulting in a higher omega-6 to omega-3 ratio. Omega-3 fatty acids are anti-inflammatory and may improve cardiovascular and brain health.

Flavor and appearance

In its raw state, bison is a deeper shade of red than beef. Unlike beef, there is no marbling of the fat in the meat.

Some people say that bison has a sweeter, richer flavor than beef.

Preparation and cooking

People should handle bison like any other meat by storing it at the correct temperature and avoiding cross-contamination.

Due to its lower fat content, it may be easy to overcook bison.

The USDA advises that individuals can cook bison for longer at a lower heat of 325°F. People must ensure they cook raw ground bison to an internal temperature of 160°F by measuring with a food thermometer. Raw bison steaks and roasts must reach a minimum internal temperature of 145°F.

People can braise less tender cuts of bison by simmering with a small amount of liquid in a tightly covered pan. Alternatively, they can stew them with other ingredients.

People can use bison as they would beef. For example, individuals could grill or pan-fry a bison steak or roast it and serve it with vegetables.

Ground bison is adaptable in many recipes and meal ideas. Here are a few examples:

  • bison meatballs
  • bison burger
  • bison in a tomato sauce to serve with pasta
  • bison black bean chili
  • bison filling for enchiladas or tacos
  • bison Cajun rice
  • bison and bean stew

Bison contains less cholesterol, calories, and saturated fat than beef. Farmers rear bison differently from cows, giving the meat a more beneficial nutritional profile. People can include it in many everyday meals but take care not to overcook it.

People should be mindful of how much red meat they consume and opt for other low cholesterol protein sources such as fish, legumes, or soy.

High cholesterol: The sign of ‘build-up’ on your face that can have ‘severe’ consequences – Express

Glaucoma is a common eye condition where the optic nerve, which connects the eye to the brain, becomes damaged.

The study looked at 866 cases of primary open-angle glaucoma, the most common type of glaucoma, among more than 136,000 study participants who were followed for 15 or more years.

Participants provided researchers with updates on statin use and cholesterol levels every other year throughout the study period.

After analysing the information, study authors found that for every 20-point increase in total cholesterol there was a seven percent increase in glaucoma risk.

Silent Symptoms of High Cholesterol You Need to Know — Eat This Not That – Eat This, Not That

High cholesterol is called a silent killer because there’s often no symptoms that indicate there’s a problem. Dr. Eric Tam, Physician at Mighty Health tells us, “The dangerous news is that high cholesterol alone does not directly show signs or symptoms. Rather, when symptoms present, it is actually due to having high cholesterol over too long of a period of time.” That said, there are a few warning signs to be aware of and Eat This, Not That! Health spoke with experts who reveal what they are. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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Dr. Tam explains, “High cholesterol is commonly defined by having total cholesterol levels above 200 mg/dL; but this is not actually the full picture. It’s important to then break this value down to your low density lipoprotein (also known as “bad cholesterol”) and your high density lipoproteins (“good cholesterol”). High levels of low-density lipoprotein (LDL), or “bad cholesterol,” have been associated with an increased risk of atherosclerosis, potentially leading to several other conditions such as coronary artery disease, stroke, and peripheral arterial disease. It does so by accumulating in your blood vessel walls, subsequently forming plaque that can put you at higher risk for strokes and heart attacks by causing blockages in these blood vessels. High-density lipoproteins (HDL), or “good cholesterol,” helps clear cholesterol by bringing it to the liver to get processed.”

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Nancy Mitchell, a Registered Nurse with Assisted Living Center shares, “The symptoms of high cholesterol are often silent or easy to miss, and although cholesterol production does slow down as we age, high levels are often problematic for older adults. High levels of LDL increase the chances of heart disease and other complications from poor blood flow to the heart, so regular checks for those over 65 are often recommended.”

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Mitchell says, “High cholesterol is dangerous because it indicates the likelihood that blood flow is reduced, which in turn makes the chances of heart attack and heart disease more likely.” 

Dr. Edward Salko, Board-Certified Physician, Medical Director of PersonaLabs adds, “It is quite clear that increased LDLs have a direct effect on the risk of acquiring cardiovascular diseases, atherosclerosis, stroke, etc., as it indicates a higher build-up of cholesterol in the arteries.” 

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Dr. Salko states, “While there may be no clear symptoms, there are pre-indicators of high cholesterol. Poor diet and a sedentary lifestyle may limit fat metabolism, and increase blood cholesterol. Age also plays a role, because the older we get, the less functional our liver becomes leading to lesser cholesterol being excreted from the body.”

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Trista Best, MPH, RD, LD says, “It is generally agreed upon by professionals that there are no signs or symptoms of high cholesterol. Blood tests should start early in life, as early as 10 years old, to check cholesterol levels. These tests should be repeated regularly throughout life and high cholesterol should be addressed to prevent heart disease.”

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Dr. Tam shares, “Over time, a poor diet can lead to high cholesterol, which can cause the development of plaque in our coronary arteries—the arteries that supply oxygen and nutrients to the heart. This can then eventually lead to what we call a heart attack. So, if you’re noticing chest pressure at rest or with exercise, visit your cardiologist for further testing to evaluate if you have plaque buildup in these arteries.”

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According to Dr. Tam, “High cholesterol can create a temporary blockage of blood vessels in the brain, causing stroke symptoms that thankfully resolve with time. However, if you’re experiencing sudden weakness or having difficulty finding the right words, go to the emergency room to get evaluated so specialists can do further imaging studies and testing to confirm the cause.”

female neurologist is showing a male patient something on a synthetic brain
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Dr. Tam reveals, “As physicians, our biggest fear is when a patient suffers a full-on stroke. This requires emergency hospitalization as this is due to complete blockage of certain blood vessels in the brain, causing damage to that local area that controls certain functions of your body.”

Heather Newgen

Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more

What you need to know about maintaining healthy cholesterol levels – Charlotte Post

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Exercise is one of the ways to manage cholesterol levels through healthy habits along with proper diet.

Understanding and improving cholesterol is important for people of all ages, including children and teens.

Maintaining healthy cholesterol levels can help keep your heart healthy and lower your chances of getting heart disease or having a stroke.

High cholesterol usually has no symptoms. In fact, about 38% of adults in the United States are diagnosed with high cholesterol, according to the American Heart Association. Understanding what cholesterol is, the role it plays, when to get screened and how to manage it are important aspects of protecting your overall health and prevent a heart attack or stroke.

Understand cholesterol
A waxy, fat-like substance created by the liver and consumed from meat, poultry and dairy products, cholesterol isn’t inherently bad for you.

In fact, your body needs it to build cells and make vitamins and other hormones. However, too much cholesterol circulating in the blood can pose a problem.
The two types of cholesterol are low-density lipoprotein (LDL), which is considered “bad,” and high-density lipoprotein (HDL), which can be thought of as “good” cholesterol.

Too much of the “bad” kind, or not enough of the “good,” increases the risk of cholesterol slowly building up in the inner walls of the arteries that feed the heart and brain.
Cholesterol can join with other substances to form a thick, hard deposit on the inside of the arteries called plaque. This can narrow the arteries and make them less flexible – a condition known as atherosclerosis. If a blood clot forms, it may be more likely to get stuck in one of these narrowed arteries, resulting in a heart attack or stroke.

Understand risk
Your body naturally produces all the LDL it needs. An unhealthy lifestyle can make your body produce more LDL than required. Behaviors that may negatively affect your cholesterol levels include lack of physical activity, obesity, eating an unhealthy diet and smoking or exposure to tobacco smoke.

In addition to unhealthy habits, which are the cause of high LDL cholesterol for most people, some people inherit genes from their parents or grandparents – called familial hypercholesterolemia (FH) – that cause them to have too much cholesterol and can lead to premature atherosclerotic heart disease.
If you have a family history of FH or problems related to high cholesterol, it’s important to get your levels checked.

Get cholesterol checked
Adults age 20 and older should have their cholesterol and other traditional risk factors checked every 4-6 years as long as their risk remains low.

After age 40, your health care professional will use an equation to calculate your 10-year risk of heart attack or stroke. People with cardiovascular disease, and those at elevated risk, may need their cholesterol and other risk factors assessed more often.

Managing cholesterol
If you have high cholesterol, understanding your risk for heart disease and stroke is one of the most important things you can do, along with taking steps to lower your cholesterol.

Often, simply changing certain behaviors can help bring your numbers into line.

Eating a heart-healthy diet that emphasizes fruits, vegetables, whole grains, lean or plant-based protein, fish and nuts while limiting red and processed meats, sodium and sugar-sweetened foods and beverages is one of the best ways to lower your cholesterol.

While grocery shopping, look for the American Heart Association’s Heart-Check mark to help identify foods that can be part of an overall healthy eating pattern.

Other lifestyle changes include losing weight, quitting smoking and becoming more physically active, as a sedentary lifestyle can lower HDL. To help lower both cholesterol and high blood pressure, experts recommend at least 150 minutes of moderate-intensity aerobic exercise a week, such as walking, biking or swimming.

For some people, lifestyle changes may prevent or manage unhealthy cholesterol levels. For others, medication may also be needed. Work with your doctor to develop a treatment plan that’s right for you. If medication is required, be sure to take it as prescribed.

Controlling your cholesterol may be easier than you think. Learn more about managing your cholesterol at heart.org/cholesterol.

Top 5 Googled Questions About Cholesterol Answered — Eat This Not That – Eat This, Not That

Cholesterol is a serious health concern that’s called a silent killer because there’s usually no warning signs or symptoms that indicate there’s a problem, and it seems to be on people’s mind. According to Google Trends, there are five top questions regarding cholesterol that people have been searching consistently the last year and Dr. Norman Lepor, a Los Angeles-based cardiologist with Cedars-Sinai addresses them. Read on to find out more—and to ensure your health and the health of others, don’t miss Already Had COVID? These Symptoms May “Never Go Away”.

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Using Google Trends, the top rising Google queries related to cholesterol from 5/18/21 – 5/18/22 are these, the top questions that have been researched the most over the last year:

  • What is cholesterol? – top overall query about cholesterol
  • How do I know if I have high cholesterol? top overall query about cholesterol
  • What causes high cholesterol in women? — a question that has risen 300% in the last year
  • What reduces cholesterol quickly? — a question that has risen 70% in the last year
  • What is a normal range for LDL and HDL cholesterol? — a question that has risen 70-90% in the last year (questions about LDL have risen between 80-90% and HDL have risen 70%).

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Dr. Lepor explains, “Cholesterol is a fat-like, waxy substance that helps your body make cell membranes, many hormones, and vitamin D. The cholesterol in your blood comes from two sources: the food you eat and your liver. Cholesterol is carried into your bloodstream on spherical particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) known as the ‘bad cholesterol’ and high-density lipoproteins (HDL) known as the ‘good cholesterol.’

LDL cholesterol plays a major role in the development of plaque in arteries called atherosclerosis that is a risk factor for heart attack and/or stroke. What’s important to know is that most of the cholesterol in our bodies is made by our liver – not the food we eat – so when someone has high cholesterol, a low fat, low cholesterol diet may not be enough to slow down the development of plaque in their arteries that is made by LDL. Lipid-lowering cholesterol medication is often needed over and above a low fat, low cholesterol diet to get to levels that slow down the development of plaque in our arteries.”

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Dr. Lepor says, “High cholesterol typically has no symptoms until it has progressed, and you have developed atherosclerosis (plaque) in your arteries that puts you at risk for heart attack and/or stroke. A blood test called a lipid panel is the only way to check your cholesterol levels. Because high cholesterol is a precursor to heart disease, heart attack and/or stroke, it is important to see your doctor regularly for annual visits so they can assess your risk for heart disease and conduct the necessary tests.

To optimize cholesterol levels, health care professionals will often recommend lifestyle modifications such as reducing dietary intake of saturated fats, and increasing intake of ‘good’ fats called monounsaturated and polyunsaturated fats. Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish.

However, in the vast majority of people with high cholesterol, the addition of medication is necessary to achieve good cholesterol levels. There is an inherited genetic condition known as familial hypercholesterolemia where very high LDL levels are seen at a young age. These patients are at very high risk of heart attack and/or stroke and can take multiple cholesterol lowering medications – on top of diet and exercise – to reduce LDL to desirable levels.”

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Dr. Lepor shares, “It is quite common for young healthy women to have higher total cholesterol levels that is unrelated to heart disease since it is the HDL or “good” cholesterol that is elevated. This elevation of HDL-cholesterol is related to the female sex hormone, estrogen. But, particularly during menopause when hormone levels fluctuate, we may see changes in the balance of HDL and LDL cholesterols, which can put women at risk. One way for post-menopausal women to know if their HDL cholesterol levels are protective against heart disease or not is to undergo a test called a coronary calcium score, where plaque in your arteries can be detected.”

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According to Dr. Lepor, “It can take months to lower cholesterol with diet and exercise changes alone, and for some diets won’t be enough to slow down the development of plaque in their arteries. However, the use of cholesterol medications enables us to start lowering cholesterol much faster. Statins are the most commonly used medication to lower cholesterol. Statins have been around for decades, but some people are not able to tolerate statins or are not able to get their LDL cholesterol low enough through lifestyle modifications and a statin. Fortunately, now there are newer cholesterol medications that can be added on top of statins that are particularly useful for people with known heart disease who may need more help lowering their LDL. The latest of these medications, called Leqvio (inclisiran), is given by a healthcare professional twice a year, after two initial injections, and can lower cholesterol by more than 50%. Medications can have certain side effects, so it’s important to speak with a doctor to determine the best treatment option if you need extra help with lowering your LDL cholesterol beyond lifestyle modifications.”

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Dr. Lepor states, “There is no one size fits all in terms of cholesterol levels, and because high cholesterol has few warning signs, it is important to see a physician for your annual physical to maintain good health. Physicians will assess your risk of heart attack and/or stroke by taking into account your cholesterol levels, family history of heart attack and/or stroke, and other risk factors such as diabetes, smoking and hypertension. The higher your risk of having a heart attack and/or stroke, the lower we want the LDL cholesterol to be.

For most people, we like LDL levels to be lower than 100 mg/dl to prevent heart attack and/or stroke, but in patients who have known heart disease, we now recommend LDL-cholesterol levels to be lower than 70 mg/dl. HDL levels less than 40 mg/dl in men and less than 50 mg/dl in women are risk factors for heart attack and/or stroke. An HDL level greater than 50 mg/dl in women and greater than 40 mg/dl in men is considered a healthy level.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

Heather Newgen

Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more

4 Worst Breakfast Habits To Avoid if You Have High Cholesterol — Eat This Not That – Eat This, Not That

High cholesterol may seem harmless, as there are no signs or symptoms, but left unchecked this condition can be dangerous.

According to the Centers for Disease Control, up to 38% of Americans have high cholesterol, putting them at risk for heart disease and stroke. While some people inherit high cholesterol, it’s often a result of lifestyle choices.

Smoking, drinking alcohol, eating an unhealthy diet, and having a sedentary lifestyle can all increase your risk for high cholesterol. Taking action and changing your habits is often the first line of defense to lowering cholesterol naturally. If lifestyle changes alone don’t lower your cholesterol enough, your doctor may recommend medication to keep it in a safe zone.

Not smoking, cutting down on alcohol, and getting up and moving is easy enough to understand (although actually doing it may prove difficult). One of the most confusing lifestyle shifts is changing how you eat. With all of the diet myths and changing research, you may not know where to even start when it comes to lowering your cholesterol with diet.

Fortunately, you can help lower your cholesterol with your first meal of the day. Dietitians recommend that you avoid these four worst breakfast habits if you have high cholesterol. Read on to learn more, and to continue to eat healthily, don’t miss these Eating Habits You Must Follow If High Cholesterol Runs In Your Family.

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You roll out of bed, throw on some clothes, and run out the door. Who has time to make anything in the morning, let alone eat it? Skipping breakfast does more than lead to ravenous mid-morning food cravings—it could also raise your cholesterol levels.

“Eating breakfast has been shown to lower total and LDL cholesterol (our bad cholesterol),” says Kathryn Piper RDN, LD, NBC-HWC of The Age-Defying Dietitian. In a 2020 meta-analysis, researchers found that the LDL cholesterol of people who skipped breakfast was an average of 9.24 mg/dL higher than those who started their day with a meal.

And, no– coffee doesn’t count as breakfast. Patricia Kolesa, MS, RDN, recommends having a small snack like a yogurt parfait or overnight oats with your coffee if the idea of a big meal first thing in the morning doesn’t appeal to you.

RELATED: The #1 Best Breakfast to Eat to Lower Cholesterol, Says Dietitian

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If carbohydrates are stealing the show at breakfast, you could be missing out on an essential nutrient: protein.

“Stabilizing your blood sugar keeps you fuller for longer, prevents random and late-night snacking, and supports healthy cholesterol levels by nourishing your adrenals and thyroid hormones,” says Lacey Dunn, MS, RD, LD, CPT, author of The Women’s Guide to Hormonal Harmony and owner of Nourish Well Nutrition.

Traditional breakfast foods tend to be carb-heavy: toast, oatmeal, pancakes, fruit, yogurt, waffles… but there are plenty of opportunities to fit in a serving or two of protein.

Add eggs or egg whites to toast, stir collagen powder in your coffee, sprinkle protein powder over your oatmeal, or whip up a turkey breast scramble to support healthy cholesterol levels, encourages Dunn.

RELATED: 19 High Protein Breakfasts That Keep You Full

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“Choosing breakfast foods high in refined carbohydrates is one of the worst things you can do for your cholesterol, and one of the easiest traps to fall into, as so many popular breakfast items fit this bill,” says Sharon Puello, MA, RD, CDN, CDCES.

A diet high in refined carbohydrates can increase your triglycerides and the number of small LDL particles in your blood, which both increase your risk for heart disease, explains Puello.

Starting your morning with sugary cereal, donuts, pastries, pancakes, bagels, or any other refined carbohydrate can significantly affect your risk for heart disease. Researchers found that just one to two extra servings of refined carbohydrates per day can increase the risk of coronary heart disease by 10 to 20 percent. But, adding one to two servings of whole grains can decrease the risk by the same amount.

Choose whole grains and fruit over refined carbohydrates and add a healthy serving of protein and fat to your breakfast to keep you full and satisfied.

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While breakfast meats like bacon and sausage are okay on occasion, they shouldn’t be gracing your breakfast plate on a routine basis.

Processed meats are full of sodium and saturated fat that may raise your blood pressure and cholesterol and increase your risk for certain cancers, explains Lisa Andrews, MEd, RD, LD Owner of Sound Bites Nutrition.

Choosing a processed plant-based meat alternative isn’t the solution. Many plant-based meat alternatives are high in saturated fat and sodium, just like their meaty counterparts.

To enjoy these foods without raising your cholesterol, watch the portion size and try to enjoy them only a couple of times a month instead of weekly.

RELATED: Side Effects of Too High Cholesterol

What Is Cholesterol? How It Works, Foods to Avoid & the Truth About HDL – Forks Over Knives

Cholesterol is a little molecule with huge implications for human health. Read on for a breakdown of how cholesterol works—including why HDL (“good”) cholesterol might not be as good as you think—and learn the most important steps you can take right now if you’re among the 38% of Americans who have high cholesterol.

Topics covered in this article:

What Is Cholesterol?

Cholesterol is a waxy type of lipid found in almost every cell of the body. A building block of animal life, cholesterol helps form cell membranes and plays a key role in the production of hormones, vitamin D, skin oils, and digestive acids.

The liver makes all the cholesterol that the body needs. Some factors can cause excessive levels of cholesterol to enter the bloodstream; over time, this can seriously impair our cardiovascular systems.

‘Good’ Cholesterol vs. ‘Bad’ Cholesterol

Cholesterol is not water-soluble, meaning it can’t travel through the bloodstream on its own. For transport, it gets bundled with particles called lipoproteins. The main types of lipoproteins that carry cholesterol are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL (‘Bad’) Cholesterol

Low-density lipoproteins carry cholesterol produced by the liver to the rest of the body, allowing cells to extract the fat and protein content for various uses. LDL cholesterol constitutes most of the cholesterol in your body.

Some factors (discussed below) can lead to excess LDL cholesterol in the blood, a condition called hypercholesterolemia. Over time, excess LDL adheres to artery walls, building up fatty deposits that harden into plaques. Atherosclerosis, as this process is known, restricts the amount of blood that can flow through the arteries.

Coronary artery disease develops when atherosclerosis restricts blood flow through arteries that supply blood to the heart. CAD is the leading cause of death worldwide.

Fatty streaks, the first stage of atherosclerosis, can begin to form in childhood.

HDL Cholesterol: Is More Always Better?

If LDL are cholesterol delivery trucks, high-density lipoproteins are the garbage trucks. HDL absorbs excess cholesterol and carries it to the liver to be flushed out of the body. When functioning properly, HDL helps keep LDL levels in check, which is why it’s commonly referred to as “good” cholesterol.

But a growing body of research suggests that more HDL cholesterol isn’t always better, and that the quality of our HDL particles may matter more than the quantity. “Once your HDL cholesterol gets … to around 60 or 70 milligrams per deciliter, it looks like there’s a plateau effect,” says Nicole Harkin, MD, FACC. After that point, additional HDL is not associated with cardiovascular benefits and in fact may increase the risk of cardiovascular disease. “Research has started to uncover that it really is much more about the HDL functionality, how well those particles are extracting that [excess] cholesterol that’s been deposited,” Harkin says.

Certain stressors prevent HDL from carrying out its task of purging excess cholesterol from the body. “HDL can become dysfunctional and pro-inflammatory in situations of oxidative (cellular) stress,” says Michelle McMacken, MD, FACP, DipABLM, executive director of Nutrition and Lifestyle Medicine at NYC Health + Hospitals. McMacken notes that saturated fats raise HDL levels but have also been shown to render HDL more inflammatory and likely to promote plaque buildup.

The takeaway: “Just because your HDL cholesterol is high, that does not protect you from cardiovascular disease,” says Harkin. “It’s not as meaningful of a number as we once thought.”

What About Triglycerides?

Like cholesterol, triglycerides are a type of fatty acid that come from our liver and from the foods we eat. They, too, get bundled with lipoproteins and carried through the body so cells can extract the fat and protein for use. When we consume more calories than we need, we take in excess triglycerides, which our body stores as fat. Because elevated triglycerides can contribute to atherosclerosis, triglyceride levels are typically measured alongside LDL and HDL cholesterol. Lifestyle measures aimed at reducing LDL cholesterol can also bring down triglycerides.

What Causes High Cholesterol?

For most people, high cholesterol is primarily lifestyle-related, the American Heart Association notes. Lifestyle factors that drive up LDL cholesterol (or decrease HDL cholesterol) include:

  • Unhealthy diet
  • Being overweight or obese
  • Sedentary lifestyle
  • Cigarette smoking

Genes play a role in the amount of cholesterol that your liver produces. Familial hypercholesterolemia, an inherited genetic condition, impacts an estimated .05% of the population. Genetics can also influence cholesterol levels in indirect ways, such as by predisposing someone to be overweight.

Having Type 2 diabetes is a risk factor for high cholesterol, though more research is needed to understand the connection.

Diet

Among the lifestyle factors that can influence LDL cholesterol levels, diet plays a major role.

“Studies have shown that one of the strongest contributors to our blood levels of cholesterol, from a dietary standpoint, is our intake of saturated fat, which is found predominantly in animal products, particularly red meat (processed and unprocessed) and dairy.” Harkin adds that palm oil and coconut oil, which are found in many highly processed foods, are also high in saturated fat.

Trans fats also drive up cholesterol levels. Historically, these fats could be found in the form of partially hydrogenated oils in margarine, shortening, butter, cakes, cookies, and salty snack foods. In 2018, the Food and Drug Administration banned manufacturers from using trans fats, but these fats may still occur in deep-fried foods due to the extreme temperature at which oils are heated.

Does Eating Cholesterol Raise Cholesterol Levels?

There’s been some debate about the degree to which dietary cholesterol raises blood cholesterol levels. Because foods high in cholesterol are also typically high in saturated fat, it’s difficult to tease apart the effects of each.

However, a large 2019 study looked for associations between the consumption of cholesterol and rates of cardiovascular disease in 29,615 participants over a median of 17.5 years. They found that, independent of fat and overall diet quality, higher cholesterol intake was in fact associated with a higher risk of CVD. They identified a dose-response relationship: For every additional 300 milligrams of cholesterol consumed daily, there was a 17% increase in the risk of CVD and 18% increase in the risk of death from all causes. (For reference, a single egg contains around 180 milligrams of cholesterol.)

The easiest way to keep cholesterol out of your diet is to steer clear of animal products. All animals produce cholesterol in their livers, so when we eat other animals or animal-based products, we consume their cholesterol. (This is why, when checking nutrition labels, the presence of any cholesterol is a telltale sign that an item isn’t vegan—though the absence of it doesn’t guarantee that a product is vegan.)

What Are Normal Cholesterol Levels?

Ranges for “normal” cholesterol levels vary based on age, sex, and medical history, but according to the Mayo Clinic, adults age 20 and older should aim for the following numbers.

Interpreting Total Cholesterol Numbers

Total Cholesterol (mg/dL) Results
Below 200 Desirable
200–239 Borderline high
240 and above High

Source: Mayo Clinic

Interpreting LDL Cholesterol Numbers

LDL Cholesterol (mg/dL) Results
Below 70 Optimal for people who have coronary artery disease (CAD)
Below 100 Optimal for people who have diabetes or other risk factors for CAD
100–129 Near optimal if there is no CAD; high if there is CAD
130–159 Borderline high if there is no CAD; high if there is CAD
160–189 High if there is no CAD; very high if there is CAD
190 and above Very high, likely representing a genetic condition

Source: Mayo Clinic

Interpreting HDL Cholesterol Numbers

HDL Cholesterol (mg/dL) Poor Better Optimal
Men Below 40 40–59 60 and above*
Women Below 50 50–59 60 and above*

Source: Mayo Clinic

*Note: There is some debate about whether HDL cholesterol in excess of 60 mg/dL is truly beneficial. LDL cholesterol levels may be a more reliable indicator of cardiovascular health. Learn more here.

For more detailed information about normal cholesterol levels, see the American Heart Association and American College of Cardiology guidelines for clinicians.

Testing

If diagnosed early, high cholesterol can be resolved before doing any damage to the cardiovascular system.

Cholesterol screening should start early in life. Children should be screened at least once between ages 9 and 11, according to the Centers for Disease Control.

For adults at low risk of cardiovascular disease, the CDC recommends cholesterol testing every five years, starting at age 20. Those who have a family history of heart disease or other risk factors (such as a previous cardiac event, high blood pressure, diabetes, and prediabetes) should be tested more frequently.

Symptoms of High Cholesterol

High cholesterol doesn’t typically present any noticeable symptoms until it’s developed into atherosclerosis, and even then, it often goes unnoticed.

Some people with advanced atherosclerosis may experience chest pain, shortness of breath, and feelings of fatigue, especially during exercise, when the heart demands more oxygen but is unable to get it because the artery is so diseased it can’t dilate to provide adequate blood flow. Erectile dysfunction can also be a sign of cardiovascular disease. In rare cases, elevated blood cholesterol can cause fatty, yellowish bumps on or around the eyelids, a condition known as xanthelasma palpebrarum.

But for many, a heart attack or stroke is the first noticeable symptom of high cholesterol and cardiovascular disease, which is why regular screening is so important.

Complications of High Cholesterol

The primary complication arising from high cholesterol is cardiovascular disease, including coronary artery disease, stroke, and myocardial infarction (heart attack). Strokes and heart attacks follow a similar chain of events: An arterial plaque ruptures. A blood clot forms on the ruptured plaque. The blood clot completely blocks blood from flowing through the artery, preventing blood from getting to the brain (in the case of stroke) or the heart (in the case of heart attack).

High cholesterol and resulting atherosclerosis may contribute to high blood pressure, as the heart has to work harder to pump blood through constricted, plaque-laden blood vessels.

In addition to cardiovascular complications, a number of studies suggest that high cholesterol may impair insulin sensitivity, leading to insulin resistance. Insulin resistance significantly increases the risk of several chronic diseases including Type 2 diabetes, fatty liver disease, chronic kidney disease, and Alzheimer’s disease.

How to Lower Cholesterol

For patients with extremely high cholesterol and/or established cardiovascular disease, lipid-lowering medications, such as statins, may be necessary. For many people, lifestyle modifications alone may be enough to bring cholesterol down into the healthy range.

“For the vast majority of patients who have elevated cholesterol and who do not yet have heart disease, the first-line therapy is lifestyle modifications,” says Harkin. “That involves changes in diet, exercise, and all the other lifestyle factors, but diet [is] one of the biggest levers that we can pull.”

Foods to Avoid

To lower your cholesterol, steer clear of the following foods, which are high in trans fats, saturated fats, and/or cholesterol.

  • Red meat (processed and unprocessed)
  • Dairy products (milk, cheese, butter)
  • Palm oil
  • Coconut oil
  • Lard
  • Highly processed foods

Excessive alcohol use and consumption of refined sugars has been strongly tied to elevated triglycerides.

Best Foods to Eat to Lower Your Cholesterol

The AHA recommends eating a diet rich in whole plant foods to improve cardiovascular health. These include:

  • Whole grains
  • Legumes
  • Fruits
  • Starchy vegetables
  • Non-starchy vegetables
  • Nuts
  • Seeds

Plant foods can lower cholesterol in two key ways: by crowding out unhealthy foods, and by providing the body with ample soluble fiber, which binds to excess cholesterol so that it’s excreted as waste. Most plant foods contain soluble fiber, but especially good sources include beans, lentils, chia seeds, oats, barley, and berries.

Harkin recommends a whole-food, plant-based diet for its ability to promote heart health and metabolic health overall. “A [WFPB diet] is by definition very low in saturated fat, and it’s very high in that soluble fiber,” says Harkin. “It’s also obviously great for regulating blood sugar levels, blood pressure—all these things that help us lower our overall risk of cardiovascular disease.”

Success Stories

Bill McGrail Before and After Adopting a Plant-Based Diet for His Arthritis and Cholesterol - On the left, a photo of him heavier set, standing in the kitchen next to a turkey; on the right, a photo of him crossing the finish line of a race

Forks Over Knives has heard from many readers over the years who have reduced their cholesterol after adopting a whole-food, plant-based lifestyle.

To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer. For meal-planning support, check out Forks Meal Planner, FOK’s easy weekly meal-planning tool to keep you on a healthy plant-based path.

Depiction of atherosclerosis plaque

Surprising Habits That Are Raising Your Cholesterol — Eat This Not That – Eat This, Not That

“High cholesterol” is rarely spoken of in a positive context but not all cholesterol is created equal. “Overall, cholesterol is important for our bodies. We use cholesterol to do a variety of things,” says Kate Kirley, MD. “Our body creates cholesterol whether we eat it or not and it’s good to have for certain functions within our bodies. But there are some types of cholesterol that are potentially helpful and protective. We usually think of HDL, or high-density lipoprotein, cholesterol as somewhat protective for our hearts and blood vessels because it absorbs cholesterol and carries it back to the liver. We tend to think of LDL cholesterol, or low-density lipoprotein, as the main type of cholesterol that we focus on as a potentially harmful cholesterol for our hearts because it collects in the walls of your blood vessels.” Here are five unexpected habits that might be raising your bad cholesterol levels. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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Did you know birth control pills could impact LDL cholesterol levels and possibly lead to blood clots? “The main concern is if you have higher plaque levels that you might develop a clot on one of these plaques and have a stroke or a myocardial infarction (heart attack) or sudden cardiac death,” says Dr. Ernst Rietzschel of Ghent University in Belgium. “That’s the main risk with having plaque, with having atherosclerosis.” If in doubt, speak to your doctor about which birth control is right for you.

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Research shows coffee is linked to higher LDL cholesterol levels—but it’s a complex situation. “There are certain types of coffee where the low-density lipoprotein (LDL) cholesterol levels may be a little higher, like French press coffee, Turkish coffee and espresso,” says cardiologist Dennis Bruemmer, MD, PhD. “Most of the LDL we have in our body is genetically predetermined. We can make it much worse by consuming the wrong foods. But your LDL wouldn’t lower much if you stopped drinking coffee.” The real problem, he says,  is the ingredients people are adding to their brew. “Now we’re not talking coffee anymore,” says Dr. Bruemmer. “We’re talking about cream and caramel, things high in sugar. They’re consumed as a full meal and have 50 grams or more of sugar. Once you consider the cream and even the size you’re talking about 600 calories, over a quarter of your daily calories right there. It’s completely out of proportion to what moderation would be considered.”

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Cholesterol levels tend to go up as we age (sometimes referred to as the “baby boomer heart”), which is why regular blood panel screenings are so important. “As we get older, cholesterol levels rise,” says Cleveland Clinic. “Before menopause, women tend to have lower total cholesterol levels than men of the same age. After menopause, however, women’s LDL levels tend to rise and HDL can drop.”

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Are you sitting at your desk above and beyond what is required for your job? You might want to rethink that. “A large review of studies published in 2015 in the Annals of Internal Medicine found that even after adjusting for physical activity, sitting for long periods was associated with worse health outcomes including heart disease, Type 2 diabetes and cancer,” says Erin Donnelly Michos, M.D., M.H.S. “Sedentary behavior can also increase your risk of dying, either from heart disease or other medical problems. Even if you’re doing 30 minutes per day of physical activity, it matters what you do the other 23 hours of the day.”

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Not that you need a reason for quitting smoking outside of “it has zero benefits and is destroying your health,” but smoking has been shown to raise LDL cholesterol levels. “Smoking is so bad for your heart, and smoking really truly is one of the worst things we could do, not just for your heart, but for your brain and your lungs and all sorts of things,” says Dr. Cho. “It’s really bad for your lungs. But these risk factors are additive. So you smoke and you have high cholesterol, you have now doubled your risk. You smoke, you have high blood pressure, and you have cholesterol, it’s additive. It’s really additive. So it’s really important for your children, for yourself, for your longevity, but for your quality of life that you don’t smoke.”

Ferozan Mast

Ferozan Mast is a science, health and wellness writer with a passion for making science and research-backed information accessible to a general audience. Read more