Dietary Cholesterol VS Cholesterol measured by the Doc

Lyadeia

One my goals when I start my new regimen after the New Year is to reduce my total cholesterol count as measured by the doctor. I would like some good information concerning this, because you hear mixed info all the time and I want to sift through and find the truth...

As a side note, the doctor says that I have an extremely high level of "good" cholesterol and a normal level of "bad" cholesterol, so this high "good" stuff is what makes my total count look high. I would still like to get the total count down to a normal level, even if it is just for my mental well-being.

Here's where I am confused. So many times I see and hear people telling others that dietary cholesterol does not add to the total cholesterol count that the doctor measures when you have blood drawn. And if I were to take their advice, then I would not have to eat shrimp, egg yolks, and other such high cholesterol foods sparingly for cholesterol's sake. But on the other hand, when you ask people how to lower your cholesterol levels, the first thing out of their mouths is to eat less red meat, egg yolks, shrimp, and other foods known to have high dietary cholesterol. :ohwell:

But, if dietary cholesterol does not add to your total cholesterol count, then why can't I have the yolks in my omelet? I have a fantastic recipe for shrimp tacos that is low calorie and low fat that I don't want to say goodbye to, because it is a very healthy recipe and I even make the taco shells myself (the store bought shells are HORRIBLE cause they are fried with lots of ingredients I can't even pronounce...)

I'll admit that I know my cholesterol went up a little since I haven't been eating as healthy this year as I should have (I slacked off, even though I still lost weight...but I can do better!!!) and I haven't exercised as much as I used to.

So basically, what I want to know is what exactly is the connection between dietary cholesterol and the cholesterol the doctor measures? I have a plan for my food that I am fixing and finalizing right now to start on full force after the New Year (I will do my best until then, but I won't be going full force until then cause I am still gathering info, hence this thread :flowerforyou: ). I know that occasionally having shrimp, extra lean ground beef, or whole eggs won't make me gain weight as long as I am in my calorie limits, but I want to make sure that I am going to towards THIS goal as well since my goals are more than just lose pounds. I want to be all around healthy...

If I have shrimp once a week and lean burger for dinner once a week and maybe an omelet with yolks once a week...how exactly would that affect my cholesterol numbers? Or would it even matter since I will be working out 6 days a week doing P90X and Turbo Kick rounds?

Please share any empirical articles you have, if you have them, cause I would like to read what researchers and doctors have to say (without spending the dough at the doctor's office, haha!)

Thanks for reading my loooooong post, hehe. :flowerforyou:

roylawrence87

bump for knowledge! I have no idea!

NoAdditives

Ultimately, this is a question for your doctor. As with any issue there are numerous studies regarding cholesterol and specific foods that give conflicting results. Making sense of them can be difficult for those without advanced medical training.

My husband and I have been trying to research this specific issue since he found out he has high cholesterol. Neither one of us has been able to find anything conclusive online. He's stopped eating eggs and we've both been eating more vegetables and whole grains.

The only thing I know for sure is that gallstones are made of cholesterol. So regardless of whether or not the cholesterol in food has an affect on blood cholesterol, you need to be careful about what you eat. Women are especially at risk for gallstones, so high cholesterol mixed with too much cholesterol in food gives you higher odds of developing stones. I worked for a surgeon who told me, when we suspected I had gallstones, about the "4 F's" of gallstones/gallbladder disease (in order of importance): Female, Fertile, Fat, Forty.

TrainingWithTonya

I'm actually on my way to bed and saw this. I'm too wiped out now to answer, but I have a couple of books that are great reference on this from my exercise physiology program. So, I'm adding a quick post so that I see this in my list in the morning to pull out my books and give you are real reply. In a nutshell, though, limit your cholesterol intake to less then 300mg per day (200 if you are already borderline high on the bad stuff) and add activity and you will get the bad (LDL) down. The HDL, though, you don't want to lower, even if it throws you over on the total numbers, because it is actually protective for heart disease and such. I'll go into more detail tomorrow when I have the books and their referenced studies to give you.

mmtiernan

You definitely don't want to lower the good cholesterol and I don't know what your readings are but typically, if your overall total number is high, it's usually because your bad cholesterol (LDL and Triglycerides) are too high.

My Dad had a cholesterol scare a few summers back and researched it pretty obsessively. His takeback is to completely cut out trans fats which are anything with hydrogenated or partially hydrogenated oil. Also cut back on your intake saturated fat intake: full fat dairies, red meats, etc. I'm a chocoholic and unfortunately, most chocolate is also high in sat fat. Some folks will argue that sat fat is not bad for you, but everything I have read on cholesterol control also agrees that you need to cut down on the sat fat. I try to limit my take to less than 10 g per day although I've heard that the recommendation is to limit your sat fat to less than 10% of your total calorie intake.

Regular exercise works to keep cholesterol levels down and I've ready many times that reducing your body fat also reduces your cholesterol by similar percentage points.

Having said all of that (and again, what I've said is what I've read - I'm a computer geek not a cardiologist!) there's always the genetic wild card. My ex-husband died of a heart attack at the age of 38. He did not have a good diet (if it wasn't breaded and fried, he wouldn't eat it), drank alcohol excessively, smoked and did not exercise regularly. His heart attack was caused by clogged arteries. However, I had an uncle who had pretty much the same non-healthy lifestyle as my ex-husband who also died of a heart attack but made it to over 70. So, genetics clearly must play a huge part.

I don't know if any of this helps. I joined MFP primarily to begin to track my sat fat intake and my own cholesterol level has dropped considerably since - by about 75 points - so even tho there are folks who say sat fat isn't a contributor, it seems to have made a difference for me. When you add in the other factors, such as fat loss, I've always stayed within the normal range for weight and body fat. I have cleaned up my diet considerably, however and follow clean eating on about an 90%/10% most of the year. During holidays I tend to slack off to 80%/20%.

If it helps, my Dad's fave book on the subject is the Robert Kowalski book: The 8-week cholesterol cure.

TrainingWithTonya

Okay, the following are quotes from the textbook "Physical Activity Epidemiology" by Rod K. Dishman, Richard A. Washburn, and Gregory W. Heath. Chapter 7 is Physical Activity and Hyperlipidemia. I don't know if they will have it at your local library or not, but you might check the local college library or bookstore as it is the textbook from my Epidemiology class in my Exercise Physiology Bachelors program.

"Lipoprotein fractions, which transport cholesterol, are better predictors of CHD (coronary heart disease) risk. A low level of HDL-C (</= 40mg/dl) is a major risk factor for CHD; the incidence of CHD is about 18% among people having an HDL-C level below 25 mg/dl. Average levels of HDL-C are 40 to 50 mg/dl in men and 50 to 60 mg/dl in women. As a general rule, a 1% change from average in HDL-C is accompanied by about a 3% change in CHD risk, but a high ratio of total serum cholesterol to HDL-C is a better predictor of increased risk that is either component alone.

High levels of LCL-C (>160 mg/dl) and triglycerides (>200 mg/dl) also are associated with a high risk of CHD. Generally, an LCL-C level less than 130 mg/dl is predictive of a total cholesterol of less than 200 mg/dl and is normal, LCL-D levels of 130-159 mg/dl are considered borderline risk, and levels greater than 160 mg/dl are predictive of a total cholesterol greater than 240 mg/dl and are regarded as high risk. High blood levels of triglycerides elevate risk of CHD in men by 32% and women by 76% independently of HDL-C levels (Hokanson and Austin 1996). The incidence of CHD is about 12.5% among individuals with triglyceride levels above 145 mg/dl." Page 146

"Cholesterol and other fats (ie. lipids) are not soluble in water, sot hey are carried in the blood by binding with proteins. Such lipoproteins include triglycerides, chylomicrons, LDL, and HDL; they differ in their relative composition of cholesterol, lipids, phospholipids, and proteins." Page 147

"Only 1 in 500 people has the genetic form of hypercholesterolemia known as heterozygous familial type. Hence, almost everyone has some control over whether blood cholesterol or its components rise to the level that exaggerates risk for CHD. Though nearly 70% of the variation in blood cholesterol levels is explained by endogenous production by the liver, dietary intake of cholesterol from meats, poultry, fish, seafood, and diary products explains most of the fluctuation in each person's serum cholesterol level. Fruits, vegetables, grains, nuts, and seeds have no cholesterol. Though the national goal for dietary cholesterol is less than 300 mg per day, the average American daily intake is 450 mg among men and 320 mg among women.

Cigarette smoking, diabetes mellitus, obesity, alcohol, androgenic and anti-inflammatory steroids, and emotional stress also negatively influence blood lipid levels, especially increasing triglyceride and LDL-C levels. Obesity and cigarette smoking reduce HDL-C. Total cholesterol, LDL-C, and triglyceride levels are elevated in people with diabetes mellitus, but levels tend to normalize when blood glucose levels are controlled (Conti and Tonnessen 1992)." Page 150-151

"Dietary intake of cholesterol and fat has a strong influence on blood levels of cholesterol and lipids, even when a person's synthesis and metabolism of lipoproteins are normal. Cholesterol lowering drugs are designed to alter various aspects of synthesis and metabolism of lipoproteins. Likewise, it is believed that regular physical activity has metabolic effects, in addition to promoting weight loss, that can positively affect the regulatory physiology of lipid and cholesterol. The most consistent and fully studied effects of regular exercise on cholesterol fractions are a decrease in triglycerides and an increase in HDL-C, with a somewhat smaller lowering of LDL-C." Page 152

"The risk of heart attack in both men and women overall is highest at lower HDL-C levels and higher total cholesterol levels. However, people with lower levels of HDL-C (37 mg/dl or lower in men and 47 mg/dl or lower in women) are at a high risk, regardless of their total blood cholesterol levels. Conversely, those with high levels of total blood cholesterol have a lower risk of heart attack when they also have higher levels of HDL-C (53 mg/dl or greater in men and 67 mg/dl or greater in women)." Page 152.

Pages 153 through 158 list study after study of the effects of exercise on cholesterol levels and heart disease risk. They sum it up on page 159 with the Dose Response paragraph which includes the following:
"Though a few observational studies of recreational runners have reported a linear increase in HDL-C and linear reductions in LDL-C and triglycerides with increasing weekly running distance and with faster running pace, there have not been enough randomized controlled trials comparing different intensities to determine experimentally whether a dose response exists. Based on the collective evidence, it appears that aerobic or endurance exercise expending between 500 and 5000 kcal each week for at least 12 weeks and conducted at moderate or vigorous intensities yields similar changes in lipoproteins. Changes do not appear to depend on changes in fitness."

Another book I've used in my classes, specifically Cardiopulmonary Physiology, is "Pathophysiology of Heart Disease" which was edited by Leonard S. Lilly. Chapter 5 is all about Atherosclerosis, which can be caused by LDL accumulation in the arteries. These quotes are from that book.

"Observational studies have shown that in the United States and other societies in which consumption of saturated fat and cholesterol levels are high, mortality rates from coronary disease are greater compared with those in countries with traditionally low saturated fat intake and low serum cholesterol levels (e.g. Japan and certain Mediterranean nations). Similarly, data from the Framingham Heart Study and other trials have shown that the risk of ischemic heart disease increases with higher total serum cholesterol levels. The coronary risk is approximately twice as high for a person with a total cholesterol level of 240 mg/dl compared with a person whose cholesterol level is 200 mg/dl." Page 133

"Elevated levels of LDL particles correlate with an increased incidence of atherosclerosis and coronary artery disease. When present in excess, LDL can accumulate in the subendothelial space and undergo the chemical modifications that further damage the intima, as described earlier, initiating and perpetuating the development of atherosclerotic lesions. Thus, LDL is commonly known as "bad cholesterol." conversely, elevated high-density lipoprotein (HDL) particles appear to protect against atherosclerosis, likely because of HDL's ability to transport cholesterol away from the peripheral tissues back to the liver for disposal (termed reverse cholesterol transport) and because of its antioxidative properties. Thus, HDL has earned the moniker "good cholesterol."" Page 133

Finally, the book used for two of my nutrition classes this semester is "Nutrition for Health, Fitness, and Sport" by Melvin H. Williams. Chapter 5 is all about Fat and goes into great detail on the National Cholesterol Education Programs recommendations for a Cholesterol Lowering Diet. The section on cholesterol lowering through diet and exercise starts on page 195 and ends on page 205. Here is the list of recommendations, but know that there are more specifics about each of these that make up those 11 pages. I'm just quoting the main topic.

"1. Adjust caloric intake to achieve and maintain ideal body weight. One of the most common causes of high triglyceride levels is too much body fat, particularly in the abdominal region."

"2. Reduce t total amount of fats in the diet." "Reducing total fat into to 20 percent of lower of total daily Calories, as recommended in some healthy diet plans, will reduce total and LDL-cholesterol even more."

"3. Reduce the amount of saturated fat to less than 7 percent of dietary Calories. The American Heart Association recently decreased the upper limit of saturated fat intake from 10 percent to 7 percent. As a matter of fact, scientists recommend reducing intake of saturated fats as low as possible while consuming a nutritionally adequate diet."

"4. Reduce the consumption of trans fats and, comparable to saturated fat, keep dietary intake as low as possible. The combined total of dietary saturated and trans fats should not exceed 10 percent of daily caloric intake."

"5. Substitute monunsaturated fats for saturated fats and simple or refined carbohydrates. Consume about 10 to 15 percent of Calories from monounsaturated fats."

"6. Consume adequate amounts of polyunsaturated fatty acids." "Polyunsaturated fatty acids should constitute about 10 percent of t daily caloric intake, and if foods are selected wisely this should provide adequate amounts of both omega-6 and omega-3 fatty acids."

"7. Limit the amount of dietary cholesterol. In recent years some have contended that dietary cholesterol does not influence serum cholesterol and the development of CHD. For example, Hasler noted it is now known that there is little if any connection between dietary cholesterol and blood cholesterol levels, and consuming up to one or more eggs per day does not adversely affect blood cholesterol levels. On the other hand, in a meta-analysis covering 17 studies that evaluated cholesterol intake for at least 14 days, Weggemans and others noted that the addition of 100 milligrams of dietary cholesterol per day would increase slightly the ratio of total cholesterol to HDL-cholesterol, an adverse effect on the serum cholesterol profile. They concluded that the advice to limit cholesterol intake by reducing consumption of eggs and other cholesterol rich foods may still be valid.

Limiting cholesterol intake is particularly important for cholesterol responders, those individuals with a genetic predisposition whose body production of cholesterol does not automatically decrease when the dietary intake increases. The average US daily intake is approximately 400-500 milligrams or more.

Although some countries, such as Canada and the United Kingdom, do not provide specific recommendations regarding dietary cholesterol, the United States government does, as do some health professional organizations. The amount specified in the Daily Value for food labels is 300 milligrams. The American Heart Association recommends a total cholesterol intake of 300 milligrams per day or less, or 100 milligrams per 1000 Calories consumed."

"8. If you consume foods with artificial fats, do so in moderation."

"9. Reduce intake of refined carbohydrates and increase consumption of plant foods high in complex carbohydrates and dietary fiber, particularly water-soluble fiber. Refined sugar and starches provoke higher triglyceride concentrations more than complex carbohydrates with fiber do. Again, the value of complex carbohydrates in the diet is stressed, particularly high-fiber foods, as a means to help reduce serum cholesterol. Research has shown that without adequate amounts of fiber, a diet low in saturated fats and cholesterol has only modest effects on lowering CHD risk. Thus, replace high-fat foods with high-fiber foods."

"10. Nibble food throughout the day. Interestingly, David Jenkins shows a significant reduction in serum LDL cholesterol if subjects consumed their daily Calories, actually the same food, throughout the day rather than in three concentrated meals at breakfast, lunch, and dinner."

Also, the chart (Figure 5.15) on page 196 shows the following breakdown for percentages of total Calories per day as the recommendations to lower blood serum cholesterol.

"Less then 10% saturated and trans fats. 10-15% monounsaturated fats. Up to 10% polyunsaturated fats. 50-60% carbohydrates. Up to 20% protein. Less than 300 mg cholesterol a day."

Lyadeia

Thanks for the good info! :flowerforyou:

I am going to paraphrase and write it down in my personal little notebook for myself as I keep constructing my new improved meal plans. :drinker: