There are really bad levels and there are really good levels of cholesterol, but the definition of “normal” and “healthy” is changing. On top of that, while traditional cholesterol testing — total, direct LDL, HDL, triglycerides, and ratios — is a great initial indicator of health, it doesn’t show the full picture.
For instance, I received a test that showed my total cholesterol was over 200, which technically is elevated and not ideal. Yet, for me, this wasn’t necessarily bad. My LDL (the “bad” cholesterol) was well within the “normal” or “healthy” range, so were my triglycerides, and so were my ratios (total cholesterol versus HDL and triglycerides versus HDL). In fact, my HDL (the “good” cholesterol) was on the highest end of good. Therefore, due to the fact that my good cholesterol was on the higher end, my total cholesterol was elevated. So, elevated total cholesterol in my case was actually a good health indicator.
Luckily, there seems to be a new form of cholesterol testing that may show a more accurate picture of your overall cholesterol health, as well as a more efficient way of identifying possible cardiac events. What is it you ask? Measuring the size of your LDL — low-density lipoproteins — instead of the level. Cardiovascular scientists are beginning to take into consideration the size of the particle itself, how big or small it is, in conjunction with your health.
What is Cholesterol?
The thing that usually surprises people the most is that your body actually produces its own cholesterol, which is an essential part of building cells in your body. Yet, while this waxy substance is great in healthy doses, it can be lethal in the wrong doses. Cholesterol is delivered to the body from two sources: first from your liver and the “remainder of the cholesterol in your body comes from foods derived from animals,” including “meat, poultry, and full-fat dairy products.”
This is called dietary cholesterol and it’s generally where problems arise due to the standard American diet.
There are a variety of staples in the standard American diet that are high in saturated and trans fats, which “cause your liver to make more cholesterol than it otherwise would,” causing cholesterol production to increase from normal to unhealthy. When your body hits that unhealthy range of cholesterol — low-density lipoproteins (LDL) and triglycerides, in particular — it will “slowly build up in the inner walls of the arteries that feed the heart and brain.” On top of that, cholesterol “can join with other substances to form a thick, hard deposit on the inside of the arteries,” which leads to atherosclerosis, heart attack, and stroke.
With that said, while you want to focus on low LDL levels, this isn’t the only cholesterol to be concerned with. It’s also important to have higher HDL (high-density lipoproteins or “good” cholesterol) and low triglycerides.
Types of Cholesterol
Before talking about measurements, let’s take a moment to get reacquainted with the different types of cholesterol. They are all important to know about, understand, and be aware of.
What are Lipoproteins?
Lipoproteins are the water-soluble carrier molecules that transport cholesterol through the blood. A lipoprotein particle is “composed of an outer shell of phospholipid, which renders the particle soluble in water; a core of fats called lipid, including cholesterol and a surface apoprotein molecule that allows tissues to recognize and take up the particle.” There are three types of lipoproteins delineated by their density that are navigating their way around your body: “high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL).”
By now, you’ve probably taken note that LDL is also referred to as “bad” cholesterol. This is due to the fact that it “contributes to fatty buildups in arteries (atherosclerosis).” Atherosclerosis “narrows the arteries and increases the risk for heart attack, stroke, and peripheral artery disease, or PAD.”
Along with noticing LDL is bad, you’ve probably noticed that HDL is good. This means that higher levels of HDL are actually an indicator of better health. Research has shown that “HDL acts as a scavenger, carrying LDL (bad) cholesterol away from the arteries and back to the liver, where the LDL is broken down and passed from the body.”
Yet, don’t get too excited.
Just because you have high HDL, doesn’t negate an elevated LDL. In fact, it’s estimated that “only one-third to one-fourth of blood cholesterol is carried by HDL.” With that said, by boosting HDL levels, you are adding an additional layer of protection against heart attack and stroke.
Last, but definitely not least in the cholesterol puzzle, is your triglyceride level. You’ve most likely heard this term from your doctor, but not a whole lot of people talk about triglycerides. These fats are actually the “most common type of fat in the body.” These fatty molecules are great at storing “excess energy from your diet,” but, too much can be detrimental to your health. It’s important to note that “normal” triglyceride values are different depending on age, sex, and diet.
What’s the indicator that things aren’t looking so great?
If you have a “high triglyceride level combined with high LDL (bad) cholesterol or low HDL (good) cholesterol” this means you have a greater risk of “fatty buildups within the artery walls, which increases the risk of heart attack and stroke.” It’s best to keep your triglycerides on the low end in the healthy range.
Understanding Healthy Cholesterol Numbers
Now you know about the different types of cholesterol, but how do you know if your recent lab results are good or bad? Hopefully, you’ve got a doctor, dietitian, or nutritionist to walk you through your numbers. As you can see from my example, they can be somewhat confusing and a “high” value doesn’t necessarily lead to “unhealthy” all the time.
The government has issued guideline ranges to help you assess whether action needs to be taken. Your cholesterol is measured in milligrams per deciliter of blood (mg/dl). A lipoprotein or lipid profile — basically, a complete cholesterol test — “will give you results for your HDL (good) cholesterol, LDL (bad) cholesterol, triglycerides, and your total blood (or serum) cholesterol.” The following gives you an idea of healthy cholesterol ranges for adults:
A total cholesterol score “that is less than 200 milligrams per deciliter is considered desirable for adults.” A test score “between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.” While LDL, HDL, and triglycerides are measurements from your blood, your total cholesterol is actually a mathematical equation using your preexisting cholesterol levels: HDL + LDL + 20% Triglycerides = Total Cholesterol Score.
Low-Density Lipoproteins (LDL)
This is the one that should really be kept in check! It’s recommended that your LDL level stays below 100 milligrams per deciliter. With that said, levels between “100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors.” A test score that is between “130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high,” and then “a reading of 190 mg/dL or higher is considered very high.”
High-Density Lipoproteins (HDL)
On the other hand, you want your HDL levels to be higher. For instance, “a reading of less than 40 mg/dL is considered a major risk factor for heart disease,” while “a reading from 41 mg/dL to 59 mg/dL is considered borderline low,” and a reading of 60 mg/dL or higher is optimal.
Triglycerides are found in many processed foods including starchy foods, sugary drinks, and baked beans. Too much of a good thing could lead to elevated levels of triglycerides. A normal or healthy triglycerides reading should be less than 150 mg/dL. From there it jumps directly to borderline high, between 150 to 199 mg/dL, high, between 200 to 499 mg/dL, and very high, above 500 mg/dL.
A New Type of Measuring Cholesterol
With this new measurement that seems to be taking the world by storm, instead of measuring the level of LDL in your blood, lipidologists are saying that the size — referring to the amount of lipids crammed into that lipoprotein particle — may be a better indicator of cardiovascular health.
A report from the Center for Genomics and Human Health at Saint Joseph’s Translational Research Institute in Atlanta, Georgia, explains the controversial topic:
“The role of low-density lipoprotein cholesterol (LDL-C) in the pathogenesis of cardiovascular disease (CVD) and the clinical benefit of lowering LDL-C in high-risk patients is well established. What remains controversial is whether we are using the best measure(s) of LDL characteristics to identify all individuals who are at CVD risk or if they would benefit from specific therapies … The size of LDL particles and assessment of the number of LDL particles (LDL-Num) have been suggested as a more reliable method of atherogenicity.”
Basically, this report by Superko HR and Gadesam RR, explained that “individuals with the same level of LDL-C may have higher or lower numbers of LDL particles,” which means these two individuals will have different risks for cardiovascular risk even though their LDL levels are similar. In short, an LDL particular size test may show a different risk range for atherogenicity — factors that relate to or cause atherogenesis or cardiovascular disease.
Many studies have concluded that, while LDL levels are an important piece of the puzzle, measuring the size LDL particles may be a better indicator of your cardiovascular health.
Whether you’ve got questionable cholesterol levels or great lab results, maintaining healthy cholesterol is a lifelong chore. While diet is incredibly important, especially consuming a good amount of cholesterol-free plant-based foods, lifestyle is also equally important. Exercise is one of the best ways to increase your HDL levels and get your blood moving in your body! Reducing stress is another great technique to help reduce LDL numbers.
Yet, it’s always a good idea to include at least a handful of cholesterol-friendly foods into your daily regimen. Here are a couple to get you started!
Avocado is not only delicious, but it’s also incredibly nutrient dense. What does this mean? One avocado provides a slew of vitamins, minerals, healthy fats, protein, healthy carbs, and dietary fiber. Basically, avocado is the whole package! The key to avocados lowering cholesterol lies in the “rich source of monounsaturated fats and fiber — two nutrients that help lower ‘bad’ LDL and raise ‘good’ HDL cholesterol.”
Here are a few creative avocado recipes to get you started: Mexican-Spiced Chocolate Avocado Pudding, Spiced Black Bean Guacamole, Chickpea Salad Stuffed Avocados, or this Deconstructed Sushi Bowl with Spicy Sriracha Dressing.
Along with avocados, nuts are also an especially nutrient-dense plant-based food that can help lower cholesterol. They are not only a great source of monounsaturated fat, but walnuts in particular offer omega-3 fatty acids, a form of polyunsaturated fat that has been linked to better heart health. On top of that nuts — almonds specifically — are “rich in L-arginine, an amino acid that helps your body make nitric oxide,” which in turn “helps regulate blood pressure.”
Almonds and walnuts are both incredibly diverse ingredients to have in your kitchen. Besides enjoying these healthy delights as an easy and simple raw snack, they can be chopped, pulverized, or processed to create all sorts of delicious foods. You can make delicious and dairy-free Almond Milk or Almond Butter or try out making walnut-based bread, such as this Black Bean, Quinoa, and Walnut Loaf or this Carrot Walnut Bread.
It’s difficult to not mention oats in almost any article dealing with heart health. This is due to the fact that whole grains — grains that “keep all parts of the grain intact, which provides them with more vitamins, minerals, plant compounds and fiber than refined grains” — have been linked to a drastically lower risk of heart disease and stroke. When it comes to oats, you want to take a closer look at beta-glucan. This soluble fiber “helps lower cholesterol” and it has been found that eating oats may “lower total cholesterol by 5% and ‘bad’ LDL cholesterol by 7%.”
Staring your day with oats is one of the best ways to wake up your gut, ensure a smooth digestive tract, and retain energy. Here are a couple of morning oat recipes to get you started: Protein-Packed Breakfast Quinoa Bowl, Apple Parsnip Oatmeal With Cranberry Sauce, Irish Soda Bread Baked Oatmeal, or this Banana Split Oatmeal with Roasted Almonds.
While apples may have natural sugar, they also have a very special type of fiber called pectin. Pectin is a “starch called a heteropolysaccharide, that occurs naturally in the cell walls of fruits and vegetables,” but occurs in high levels in apples. This soluble fiber has been linked to lower LDL cholesterol levels.
Apples are filled with water and natural sugar, making them a great option for beverages and smoothies. While you may want to turn towards that traditional apple pie first, keep in mind that baked recipes generally add sugar on top of already naturally sugar-rich apples. A diet high in sugar can have adverse effects on your cholesterol. Here are a couple of apple recipes to keep sugar low and pectin high: Apple Pear Smoothie, Celery Sunshine, or this Liver-Protecting Fennel Juice.
Tea has also been linked to healthier cholesterol levels. This is due in particular to two compounds: catechins and quercetin. Catechins “help activate nitric oxide, which is important for healthy blood pressure,” and “they also inhibit cholesterol synthesis and absorption and help prevent blood clots.” Quercetin has been shown to “improve blood vessel function and lower inflammation.” On top of that, tea may also be a great agent to help increase HDL, yet more research is necessary to establish this as a health benefit.
You don’t have to enjoy tea all on its own. You can infuse your food and create unique beverages with your favorite tea. Here are a few creative tea recipes to inspire you: Pumpkin Earl Grey Oatmeal, Sage and Black Tea Latte, Goji Detox Tea, or this Earl Grey Rose Nectar.
We also highly recommend downloading our Food Monster App, which is available for iPhone, and can also be found on Instagram and Facebook. The app has more than 15,000 plant-based, allergy-friendly recipes, and subscribers gain access to new recipes every day. Check it out!
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