How much do you know about cholesterol?
True or false...
- The lower my cholesterol, the lower my risk for heart disease.
- If a product's package reads "low cholesterol," the product is low in fat.
- Women don't get heart disease, so they don't need to worry about cholesterol.
- Cholesterol is the only risk factor for heart disease I should worry about.
- There's no cholesterol in peanut butter.
- I can lower my cholesterol level by eating more fish.
- The best age to have your cholesterol level checked is age 50, because that's the peak age for heart attacks in men.
- Because both of my parents died from coronary disease when they were young, I suppose it makes no sense for me to try to prevent the development of heart disease.
1. The lower my cholesterol, the lower my risk for heart disease.
True and false. The statement above is true -- according to the statistics, your risk for heart disease is lower when you have low total cholesterol and low LDL (low density lipoprotein) cholesterol. LDL cholesterol is the fatty substance that is most related to arterial blockage.
The statement above is also false –total cholesterol and LDL alone do not determine all of your risk. HDL plays a role too. Your risk for heart disease is actually higher if you have a low HDL (high density lipoprotein) cholesterol level. HDL is the "good" cholesterol -- it carries fat out of the coronary arteries.
2. If a product's package reads "low cholesterol," the product is low in fat.
False. Fat and cholesterol are two different things. A lot of foods marked "low cholesterol" contain oils that may be high in saturated fats -- substances that research suggests may be as bad for you as cholesterol. Unsaturated fats, such as vegetable oil, are also high in calories.
Remember, fat is high in calories -- 1 gram of fat has 9 calories. Proteins and carbohydrates each have 4 calories per gram. It's true that we all need some fat in our diets. But when you add fat, select monounsaturated fats such as olive oil, canola oil, peanut oil, nuts and seeds. Monounsaturated fats do not increase blood cholesterol when included in a low-fat meal plan. The total amount of fat in your diet should be kept to about 20 to 30 percent of your daily intake (or 1 tbsp. of the fats listed above, per meal).
3. Women don't get heart disease, so they don't need to worry about cholesterol.
False. Heart disease is the leading cause of death in men and women. More than 250,000 women die each year from heart disease. However, women often have higher levels of HDL (high density lipoprotein) cholesterol. HDL carries LDL ("bad" cholesterol) out of the blood. Higher levels of HDL protect against heart disease. Once a woman reaches the age of 50 (about the age of natural menopause), the risk of heart disease increases dramatically because of the reduced levels of estrogen, a hormone that helps protect a woman's body against heart disease. In young women who have undergone early or surgical menopause, the risk of heart disease is also higher.
4. Cholesterol is the only risk factor for heart disease I should worry about.
False. There are several other important risk factors that predispose you to heart disease. The good news is that most of these can be changed through small modifications in your lifestyle. Cigarette smoking is by far one of the strongest risk factors for heart disease. However, your risk for heart disease is drastically reduced within a year of quitting smoking. Within four years of quitting, your risk for heart disease is equivalent to that of a non-smoker.
Other risk factors that should be addressed include physical inactivity, diabetes, uncontrolled high blood pressure, and obesity, each of which makes the heart work harder. Adding 30 minutes of moderate exercise 3 to 5 times a week; lowering the amount of fat in your diet to under 30 percent of your intake; and treating your high blood pressure, diabetes and other medical conditions will help prevent the development and/or progression of heart disease.
5. There's no cholesterol in peanut butter.
True. Cholesterol is found only in animal products. Foods from plants do not contain cholesterol. However, peanut butter is high in fat (about 50% fat!). Excess fat can raise blood cholesterol levels. So, eat peanut butter in moderation. It is a good source of protein, and most fats are polyunsaturated or monounsaturated.
6. I can lower my cholesterol level by eating more fish.
True. Most fish has less fat than lean red meat. Shrimp and crayfish are higher in cholesterol, but still low in fat. Stay within five to seven ounces of meat, fish, or poultry per day.
7. The best age to have your cholesterol checked is age 50, because that's the peak age for heart attacks in men.
False. It is important to have your cholesterol level checked when you are young, since the process of arterial clogging (called atherosclerosis) is a gradual one and takes many years. Heart attacks in people who are age 50 may be the result of plaque that began to form on the inside of their coronary arteries when they were teenagers.
Total cholesterol should be measured at least every 5 years starting at age 20. If your values are within the normal range and you do not have other risk factors for heart disease, you can continue getting tested every 5 years. If your values are not at the appropriate levels, you should discuss lifestyle changes you can make or medication that may be needed with your doctor. You and your doctor should also discuss a re-testing schedule.
Note: If you have high cholesterol and your doctor has told you there may be an underlying genetic cause, you may want to have your children, under age 20, get their cholesterol levels tested. Talk to your children's health care providers about cholesterol testing.
8. Because both of my parents died from coronary disease when they were young, I suppose it makes no sense for me to try to prevent the development of heart disease.
False. While your family history is an important risk factor (and not changeable), you can control your risk of developing heart disease by controlling high cholesterol (through diet and sometimes medication), stopping smoking, controlling high blood pressure, managing diabetes and exercising regularly. In fact, recent research shows that you can stop or reverse the progress of atherosclerosis by following a very strict risk factor modification program.
Because coronary heart disease is a slow, gradual process that probably starts in childhood, it is important that cholesterol levels be tested at an early age (20 years). Those who have a strong family history of heart disease should be even more vigilant in testing their cholesterol values. A strong family history is:
- Having a first-degree male relative who has had a heart attack, angioplasty, or bypass under age 55.
- Having a first-degree female relative who has had an angioplasty, heart attack, or bypass under age 65.
- Lowering your cholesterol level by 1 percent lowers your risk for heart disease by 2 percent.
- For some people, losing excess weight will lower total blood cholesterol levels.
- Egg yolks and organ meats, such as liver, are the foods highest in cholesterol. (One egg yolk has 213 milligrams of cholesterol.)
- The American Heart Association recommends limiting cholesterol to 300 milligrams a day.