Cholesterol: The Good, the Bad, & the Balance

I’ve always had high cholesterol. But I’ve never worried about it. Why?

• My mother told me it was genetic – “Grandma had high cholesterol, and she lived to age 93!”
• My good cholesterol has always been the really high part – so doctors have never had a problem with my final number.
• I’m an active, healthy person: I’ve always exercised regularly and eaten my vegetables.
• Also, I was a vegetarian for several years. Surely that means something?

So everything was fine…

…until a couple months ago, when my new doctor at UVA, Allison Lyons, MD, reviewed my numbers and put up a red flag.

The Red Flag of Bad Cholesterol

She emailed me (how cool is it that my doctor and I email back and forth when I have questions?) saying:

“Your HDL (good cholesterol) is great but your bad cholesterol (LDL) is a little higher than I would like. My goal would be <130 for you. How much do you eat in terms of cheese, red meat, dairy, sweets, etc.? I would like to control it with some changes in diet first, and we can then recheck in one year.”

I balked. Me? Have a health issue? But considering our family had followed the Paleo diet for a while, so that we still tend to avoid carbs and rely heavily on meat, and also I’d fallen off my running routine, maybe this was a sign that I did need to make some changes. I asked Lyons what she recommended I do. Her reply:

“I would try to cut back on red meat (only having once per week). I would also try to walk for 30-40 minutes per day. Both of those things together should help.”

Oh dear. This prescription sounds fairly simple, but for me, this seemed impossible. A rush of resistance flooded my brain, as I thought of all the reasons I absolutely would flunk my doctor’s charge.

The Barriers to Balance

• I’m not that big a fan of chicken. My kids would not want it every night.
• I only like fresh fish. Which is hard to get and expensive.
• Pork is red meat, and it’s my favorite.
• I don’t have time to walk for 40 minutes EVERY DAY!
  • Mornings are out, because I can’t wake up early enough in the winter (not to mention it’s cold!).
  • My lunchtime is when I meet with friends I can’t see otherwise.
  • After work is when I’m spending time with my kids, helping with homework and getting them fed and bathed and put to bed.
  • And after that, I’m exhausted, it’s dark, and it’s time to spend with my partner.

Cholesterol, Not All Bad 

What is cholesterol, exactly?

Believe it or not, cholesterol is not the evil trespasser in your blood whom you should vow to destroy at all costs. In fact:

• You need it. As Lyons told me, “Cholesterol is a fatty substance that is present in everyone’s blood and is necessary for your body to function.”
• You make it. Also, you don’t just get cholesterol from meat, dairy and eggs. Your own liver produces cholesterol, all on its own.

The kicker? The liver is an overachiever. Lyons says, “When you eat a diet that is high in cholesterol, your liver tends to make more cholesterol as well.”

Good thing the U.S. government decided to stop warning us about cholesterol recently.

Cholesterol, Not All Good

So, why worry about cholesterol, if your own body makes it? As with most things in life, the issue boils down to balance.

There’s two types of cholesterol:

• LDL, the “bad” cholesterol, is the culprit responsible for blockages and deposits.
• HDL, the “good” cholesterol, actually tries to eat up and remove LDL cholesterol.

“When you have too much cholesterol in your body, it starts to deposit in your blood vessels, like dirt in a pipe. When it sits on the surface of the blood vessels for a long time, it becomes calcified and hardens.” The result?

• Blockages that clog the pipe, slowing blood flow, causing heart disease and peripheral artery disease
• Deposits or plaques that weaken, flake off and get lodge in arteries, causing heart attacks and strokes

Your cholesterol numbers help doctors determine if you’re in the right balance of good and bad.

The best-case scenario: Bad cholesterol under 100, good over 50, and the total number less than 200.

My numbers:

Total Cholesterol: 250
LDL: 159
HDL: 74

I felt doomed.

Making Hard Heart Changes

But I couldn’t stop thinking about my dad. His was a number even worse than my cholesterol. He was only 52 when he suddenly, with no warning, dropped dead of a heart attack. It was the worst thing that ever happened to me. And I just can’t imagine doing that to my kids.

So, after the winter holidays, I did what a lot of people do and made some New Year’s Resolutions, including lowering my cholesterol. I made this goal a priority – to myself, to my partner, to my kids, to my friends.

And the impossible became possible.

Finding Time to Exercise

I started walking 30-40 at lunch every day at work. This actually happens to be a refreshing break, even when it’s cold. My mind is cleared for the rest of the day, I get some fresh air and light and some personal time. I look forward to this. I eat at my desk. I limit friend-lunches to once a week, even if that means pushing people out a while.

And if I miss a day walking, I have found other ways to exercise at home that aren’t too disruptive to my kid time: either having a half-hour dance party with the kids or doing a free, half-hour workout video on grokker.com. On the weekends, I walk the dog (who needs to lose weight).

Food Fix

This actually wasn’t as hard as I had anticipated.

• I found out pork (red meat? White meat?) was allowed.
• I now stop for fish on my way home one night a week. I get the fast-cooking kind that doesn’t take a lot of time and effort.
• We use ground turkey instead of ground beef.
• I keep my vegetable portions larger than everything else on my plate.
• I drink almond or coconut milk and mostly avoid cheese and other dairy, though I do eat a yogurt at lunch every day.

Of course, I have to wait until October to see if these changes have had the desired effect. But I will check in then and let you know!