Cholesterol: What’s the Deal?

I knew not to completely freak out when I got the news: your cholesterol is high (see test results above and/or left). From things I’ve read, I realized that there is a lot of controversy about the impact of cholesterol on heart disease risk and overall health. But that knowledge is very rough so I did some digging.

First, I emailed my doctor:

I just got my lipid test results and I'd like to talk with you about what it all means. My overall cholesterol is high, but the HDL is really high (which is a good thing, I gather). My triglycerides are over the standard range as well. Basically, do I have cause for concern and if so, what should I do?

Starting about 4 months ago, I started working out with a trainer functional/strength training) 3 times per wk and I do yoga 2 times per week. I began monitoring my food intake (1600-1800 calories per day) with the new year. I have finally started to lose a little weight (about 7 lbs). I do eat a fair amount of olive oil and other MUFAs, which is probably not bad. I do eat about 1 oz of cheese a day (it's one of my favorite snacks) and love eggs. Could this be a problem? Otherwise, I don't know what else I can really do -- it might just take more time for the diet/exercise changes to show.

Please let me know if there is anything else I should be doing or if there is a cause for concern.

This is what she recommended:

I reviewed your labs; total chol was 255, goal around 200, LDL was 140, goal is 130 or less. You need to follow a low chol diet; eliminate cheese, eggs( sp. Yolk); you can have egg whites and Egg substitutes. I believe the main focus has to be weight loss and continued exercise, your BMI is 39 and the goal would be 25, but, if you go at least down to 30 that will be OK. If possible you can restrict further your calories to between 1200-1500 cal a day*. Recheck chol in 6 months.

This response was pretty much what I expected, but still left me wanting to know/understand more. I went out in search of another perspective. I found it through LifeSpotlight.com. I followed a link to a truly enlightening article in Men’s Health that offers a more complex explanation:

It could be that it's not bad foods that cause heart disease, it's bad habits. After all, in Volek's study, participants who followed the low-fat diet -- which was high in carbs -- also decreased their triglycerides. "The key factor is that they weren't overeating," says Volek. "This allowed the carbohydrates to be used for energy rather than converted to fat." Perhaps this is the most important point of all. If you consistently consume more calories than you burn, and you gain weight, your risk of heart disease will increase -- whether you favor eating saturated fats, carbs, or both.

But if you're living a healthy lifestyle -- you aren't overweight, you don't smoke, you exercise regularly -- then the composition of your diet may matter much less. And, based on the research of Volek and Dr. Krauss, a weight-loss or maintenance diet in which some carbohydrates are replaced with fat -- even if it's saturated -- will reduce markers of heart-disease risk more than if you followed a low-fat, high-carb diet.

"The message isn't that you should gorge on butter, bacon, and cheese," says Volek. "It's that there's no scientific reason that natural foods containing saturated fat can't, or shouldn't, be part of a healthy diet."

This information is a good start. Lifestyle change/weight loss is the key, really. Any which way I can get there will probably result in lower lipid levels. I’m not going to stress too much about the cheese and eggs. I have to remember that I’m not even two months past a period in which I was actively gaining weight. I was overindulging mostly on extra carbs and sugars, which could not have been good for my health. I’ve started to change my diet and exercise habits but the effects of those changes take time to show themselves. I will check my levels again in 6 months – it will be interesting to see if weight loss alone results in lowered levels. If not, I will cut way back on the eggs/cheese/meat and see if THAT works.

*And about those calorie recommendations: Yes, I would lose weight much faster eating only 1200-1500 calories per day. However, since I burn about 2,200-2,600 per day depending on what type of exercise I do, I would be pretty miserable trying. I’d rather stick with my goal of losing about 1.25lbs per week as opposed to 2-3lbs. The key is being able to stick with it over the long haul. I don’t care how long it takes. As my weight goes down, I realize that my calorie level will have to do so as well. FitDay does a good job of helping me see how much of a calorie deficit I need to have in order to meet my weight loss goal.