What Do Your Cholesterol Numbers Mean?

Transcript:

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LEAH: So often at the doctor's office, clients have a blood draw, they get a printout, they'll see a couple different numbers on your cholesterol numbers. This is called your lipid panel. But oftentimes you leave the doctor's office and you just don't even actually know what these numbers really truly mean or what's going on in your body. So that's what we want to break down today is help you understand what some of those numbers mean and again, how nutrition can play a role in those numbers going up or those numbers coming down.

So before we get too much further, I'm going to introduce myself. I am Leah Kleinschrodt. I am a Registered and Licensed Dietitian with Nutritional Weight and Wellness, and I see clients at our Woodbury office. So I see clients in person at the Woodbury office, and then also work with clients on Zoom. And we love the Zoom option because then we get to chat with people not only from the greater Minnesota area, but from all over the country and even all over the world.

BRITNI: Yeah, it is very cool.

LEAH: Yeah, very cool when you see some different addresses, some different zip codes and hear some different accents on the other line.

BRITNI: Yeah.

LEAH: So, yeah. So now let's think about why you would want to even talk to a dietitian or a licensed nutritionist to begin with. Most of, I think, what people think about, or maybe you'll see the advertising or, or what you'll read about in a book or a magazine or something, is many times people think weight loss is the only reason why you would go to a dietitian to talk about food, beverages, get some education and some counseling. Maybe you'd see a dietitian if you have an eating disorder also. But those are kind of like the two big ones.

But in reality, there are so many more reasons for nutrition counseling just to, than to just lose a few pounds. One of those very important reasons for nutrition education is to manage your cholesterol, which is exactly what we're going to talk about this morning. And it is interesting that, you know, there are some people that don't realize that actually food can impact your cholesterol numbers. I would actually, I'm going to back that up and even say actually, I do think most of our clients that come in and see us know that food matters, that it does make a difference, but there's a lot of nuance behind that story, or there's a lot of myths. There's a lot of misunderstandings about what foods are harmful or what foods are helpful to cholesterol levels.

So listeners, maybe think to yourself: have you heard that old myth of too many eggs is going to make your cholesterol levels go up? Or if you eat butter, or if you eat a hamburger patty, you know, made of beef two or three times a week, that's going to make your cholesterol numbers go up. This information, unfortunately, while well intended, it was based on faulty research to begin with. So we're going to again, dive into what are the true players that raise those cholesterol numbers, and again, like what are the foods we're looking at that will help stabilize those numbers or bring them back into a healthy range?

So I do have a cohost with me today. Her name is Britni Vincent, who is also a Registered and Licensed Dietitian. And just a little bit about us: we're both parents of young kids. I know, like my son, Landon, is actually probably the oldest out of all of our, out of our five kids if I'm doing the math correctly. Right? So, and he's four and a half. So like we've, we've got a lot of littles running around our houses these days. Yes. And we're both very fortunate to be able to work for Nutritional Weight and Wellness and work part-time so that we can dedicate a little extra time to the families, but still engage our brains and get out of the house and, and still kind of have that career aspect of things.

BRITNI: It's a wonderful balance.

LEAH: Absolutely.

Cholesterol numbers are not a good predictor of heart disease

BRITNI: So, good morning everybody. Well, let's jump right into what cholesterol numbers mean. So you might want to take a minute and look up your cholesterol numbers, or maybe you have it filed away so you can reference them while we're talking today. So before we get into the cholesterol numbers, here's an interesting piece of information. Cholesterol numbers are not a good predictor of heart disease. So let me say that again. Cholesterol numbers are not a good predictor of heart disease. Half the people hospitalized with a heart attack have normal cholesterol numbers, and half the people with high numbers have healthy hearts. So the big question is, why is there such a push on taking these medications to lower cholesterol?

LEAH: It's a really great question, and I think that, even that little piece that you said Britni, was hopefully eye opening or just counter to a lot of what we hear. We automatically think okay, high cholesterol numbers, especially that LDL cholesterol, which we'll get into. Like that automatically means like, oh my gosh, I could just like drop over walking down the street because I have a high LDL.

BRITNI: People get really scared about it.

What does cholesterol do in our body and where is it made?

LEAH: Yep. Absolutely. So, another question, let's, let's take a look at maybe a few more questions about why do we have cholesterol in our bodies to begin with, and where is that cholesterol made? You know, I like to think our bodies are pretty smart, and usually things are there for a reason. So I take that same approach with cholesterol. So thinking about where does cholesterol come from? Why do we need it?

A couple of really big players in terms of why we need cholesterol: one is to make our sex hormones. So think about, this is like estrogen, progesterone, testosterone. And both men and women have all three of these hormones just in different amounts. We also need cholesterol to make certain vitamins. Like vitamin D is one of the big ones that come into my brain. And here in Minnesota, that's a very popular conversation talking about vitamin D.

And then in addition, we need cholesterol to make bile for digestion. So bile is something that helps us digest fats in our intestinal tract. It's made by our liver, our gallbladder hangs on to it until we need it, and then it gets released when we eat a meal and we need to digest the fats in that meal. So one thing that happens is when people go on a cholesterol lowering medication, so like a statin medication, they might develop digestive issues and experience acid reflux. Or maybe on the other end they might experience more diarrhea or constipation or just indigestion or bloating or just changes in their digestion.

BRITNI: Yeah, that's a great point. And so in our body, the majority of our cholesterol is actually made in our liver. So many people still believe it comes from the cholesterol in food, like egg yolks. We still hear that all the time. But the reality is very little cholesterol comes from the food that contains cholesterol. And I believe it was 2015, the nutrition advisory board for the United States, they even came out saying, don't worry about eating eggs. Don't worry about eating foods high in cholesterol because they don't impact your cholesterol.

LEAH: Right.

BRITNI: Or have very little impact. So that was quite a while ago. But again, we're still hearing that message. So we are here to say, you can eat your eggs every day for breakfast.

LEAH: Mm-hmm.

Ideal ranges for LDL cholesterol numbers

BRITNI: And most of that cholesterol, again, comes from what is produced in your liver. And cholesterol is wrapped up in little packages called lipoproteins. And one is called high density lipoprotein or known as HDL. The other one is LDL, which is low density lipoprotein. So let's take a look at your cholesterol numbers specifically.

So if your LDL cholesterol is 160 or higher, you are considered at high risk. If it's 100-159, you're considered to be at some risk. And an LDL at 100 or lower is considered no risk. So questions to ask yourself to see if these numbers are accurate: Did you fast for 12 hours before the blood draw? You know, I just had a client recently and her numbers were high, but she wasn't fasting.

LEAH: Yeah.

BRITNI: So it's not, I mean, that's not very accurate at that, at that point.

LEAH: My husband was actually the same way. He just had a physical done last week and it was in the afternoon. So he didn't fast going into that. And yes. So his numbers came back a little higher, but it's, you know, we’re like, okay, let's look at this in context.

BRITNI: Yes.

LEAH: You were not fasting. You had breakfast. You had lunch; all that stuff.

Yeah. Yeah. So if that is the case, I think it's worth getting them redone.

LEAH: In a fasting state.

BRITNI: In a fasting state.

LEAH: Right. Yep.

BRITNI: Definitely. And I, I do want to mention that LDL is actually the carrier of our cholesterol. So it's carrying the cholesterol to the areas of need throughout our body.

LEAH: Mm-Hmm. Perfect. So on that note, we do need to take our first break. You are listening to Dishing Up Nutrition. A new trend this year that is the new weight loss goal is to live longer. Maybe you've heard this term before about having longevity, living longer, eating to live longer and healthier. And for some people they're prioritizing that more than they are weight loss. Eating to live longer and healthier is one of the goals at Nutritional Weight and Wellness. And it really has been ever since this company was founded over 30 years ago.

So if this is something, living longer, but also healthier, if this is something that interests you, join our wellness community of like-minded people. Take a look at our upcoming classes, visit our website, weightandwellness.com, or call our offices at (651) 699-3438. We'll be right back.

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Stress can increase cholesterol and how can we reduce stress?

BRITNI: Welcome back to Dishing Up Nutrition. In the show today, we will discuss how stress can actually increase your cholesterol. So how do you lower your stress level? I think that's a million dollar question.

LEAH: A billion dollar question, even.

BRITNI: So to reduce your stress level, we really recommend eating in balance at least four times a day to maintain normal blood sugar levels. Because skipping meals is really stressful for your body. I know people, when you hear stress, you think about emotional stress, work stress, all of that.

LEAH: Yep.

BRITNI: But the foods you're eating can be stressful and not sleeping enough is stressful for your body. And having your blood sugars go up and down, that's extremely stressful. So just eating that four times a day in balance makes a huge difference in the stress level in your body.

LEAH: Mm-Hmm. Yeah. I love that. Yeah. It's, it's that blood sugar roller coaster, right? When you're going up and down and all around again, your body interprets that as very stressful. So we try to keep you more stable rolling hills blood sugar instead of a roller coaster.

BRITNI: Yes.

LEAH: Yeah, that is a great point. Yes. And we will get to stress in just a little bit, but let's just rehash, we were talking a little bit about why might cholesterol, like say if you get your lipid panel done, if you went to your physical or if you got a lipid panel done, and if those numbers came back maybe higher than you expected, or, or if you were like, I know I've been kind of teetering on the high end for a while. Why might that be?

So we said, make sure ideally that you're fasting for these numbers or for the, for this blood draw. And sometimes that just doesn't always work out. But fasting is going to give you the best accuracy, the best indicators of what your true numbers are. So that's one reason. And if your cholesterol numbers are higher than you want, again, asking that question, remember before break, we actually said it's not the foods, at least foods with cholesterol that we're eating that make our LDL go up or make our total cholesterol numbers go up, because most of the cholesterol comes from our liver. So that question then becomes, all right, why is my liver kicking out so much cholesterol? Why is it kicking out so much of this LDL and HDL and just, and a lot of cholesterol in general?

Why might the liver be producing too much cholesterol?

It isn't the eggs I eat. So we just said that it's not the eggs. It's not the beef. What is it? So what is causing that liver to produce too much cholesterol? So there's a couple different reasons we're going to talk about, about why the liver may overproduce cholesterol, and we're going to go through a couple of these.

Sugar and processed carbs: one cause of high cholesterol

So listeners, just check in with yourselves and with your numbers and figure out, all right, what are the big players for you? It might be one in particular. It might be kind of a mismatch of a couple of these. The biggest and the worst culprit for high cholesterol numbers is sugar and processed carbs. You knew that was coming.

When people eat too much sugar, processed carbs… so think about things that have been pulverized into flour and then reconstituted into various things that get packaged in a factory and put into a box. Or alcohol: that's another one that sometimes we think about, but sometimes we don't.

So when people eat too much sugar, those processed carbs or drink too much alcohol, our liver gets damaged and it develops this condition called fatty liver. This can lead to cirrhosis of the liver. So this is the next step. So that's a, this is scarring of the liver and this is where the liver really starts to lose function. And one of the big functions in for our liver is detoxification and, and getting rid of toxins from the body.

So cirrhosis can be from too much sugar, the processed carbs or overdoing it on alcohol. And we're not talking just like one weekend of doing this. This is over time, day after day, month after month, year after year. For some people, decade after decade. So these are all very damaging items for the liver.

BRITNI: And not only do the, does the sugar and the processed carbs then damage your liver, but those create inflammation in our body. And one of the roles of cholesterol is to repair inflammation in your body.

LEAH: Yes.

BRITNI: So you're eating a lot of sugar. You're creating a lot of inflammation. Your liver's outputting more cholesterol to try to repair those areas of inflammation. And then your LDL carries it. So then we need to make more LDL to carry all this cholesterol out in your body. So if you can picture that in your head, that might be helpful.

Inflammation: a common cause of heart disease

And you know, so the next question we need to ask is what's the cause of heart disease? What role does cholesterol play in heart disease? And actually the cause of heart disease for many is inflammation, inflammation of the arteries. So what causes inflammation? You know, a lot of people think of inflammation as that acute inflammation. We get a little scratch, it becomes red, itchy as it heals. That's a normal healthy inflammatory response.

But the type of inflammation we're talking about today is often invisible. We, some people don't even know that it's happening. And it's that chronic inflammation which may or may not cause pain, but it can manifest in high blood pressure. It can lead to lead to Alzheimer's disease, diabetes, arthritis, cancer, lung disease. I mean the list really goes on and on.

LEAH: Yep.

BRITNI: And I know when we talk about inflammation, it's kind of a difficult concept to grasp because again, it's not always visible to your eye.

LEAH: Mm-Hmm. And like you said, you don't always feel it necessarily, like in until you start to see some of this lab work or until, oh, like something does start to twinge a little bit. It just kind of flies under the radar until we're really pretty far down that rabbit hole.

BRITNI: Yeah, that's a really great point. So when that chronic inflammation goes unchecked, your cardiovascular system, it's actually in big trouble at that point. Inflammation can occur in various places in the body as I described. You know, like rheumatoid arthritis is inflammation of the joints. And interestingly, people with rheumatoid arthritis are at double the risk of a heart attack compared to those that do not have rheumatoid arthritis.

LEAH: Mm-Hmm. Yeah. So that says, okay, again, maybe you feel it in your joints. You feel that inflammation in your joints, but it's not just in your joints at that point.

BRITNI: Exactly.

LEAH: It's, it's in the arteries and the circulatory system. It's in other places. It's probably also in the gut. Because when I think autoimmune conditions, like RA is one of those examples I think about what's going on in the gut also.

Oral health is important for heart health

BRITNI: Yeah, me too. Me too. And so research has found, of course, sugar is inflammatory. Gluten for some people can lead to a lot of inflammation. And then one thing we don't always think about is inflamed and weak gums can allow bacteria to leak into your bloodstream and weaken the walls of your arteries. So your oral health is really important for your heart health. And really we're finding out that our oral health is important for our entire body.

LEAH: Yeah. Again, it's just another area where that inflammation could show up. And that's one area that actually we can see. We can't see necessarily what's going on in our intestinal tract or inside our joints a lot of times. But we can look in our mouths. We have, most of us have mirrors. Most of us are brushing our teeth.

BRITNI: Hopefully.

LEAH: …most, most of the time. And so that is, we can see that area, which again, like then it's, oh yeah. This is something that we can monitor a little more closely.

BRITNI: Yeah.

LEAH: Yeah. Absolutely. So we need to do, we need to take our second break, but we will talk a little bit more cholesterol on the backside of break. You are listening to Dishing Up Nutrition. Here's another tip on how to change or reduce your stress level, which is another thing that can impact cholesterol. Pay attention to what you are thinking and focus on the positive. Don't believe every little thought that your brain is telling you because your thoughts really truly have the power over continuing your bad habits or not. We'll be right back.

BREAK

BRITNI: Welcome back to Dishing Up Nutrition. To change behavior we suggest actively engaging your brain. Have you noticed that when you are not paying attention to your eating plan, because you're either stressed or distracted, you suddenly sneak back into those old habits? Maybe eating cookies or a pint of ice cream at night, or chips, you know, whatever you are craving is.

So we invite you back to focus on your goals. Try to ignore those TV ads for pizza, wine, other processed food that I know can be so tempting. Just focus on that goal. And if you haven't written it down somewhere, put it somewhere visible that you actually see every single day. That can be really motivating for some people.

LEAH: Mm-Hmm. Right. I mean, if TV and your social media and stuff, they're going to put the ads out there to try to lure you away. I love that idea of, okay, here are, here's what I can control. Here are my goals and putting that front and center as well, just to try to crowd out some of the other messaging that we get.

BRITNI: Yeah.

LEAH: Yeah. Absolutely. So before break, we were talking, we had talked a lot about inflammation actually, and how inflammation increases cholesterol levels, but also just like where that inflammation comes from. How does that show up in the body? And, and then we also, we mentioned the dental health piece or the gum health, which is again, super interesting because that is one area, like we could probably see some of that inflammation. Then we know, well it's probably not just in my mouth. It's probably in other places and it could be affecting my heart, my cholesterol numbers, my lipid levels, things like that. Yep.

So when people ask about that relationship between cholesterol and heart disease, again, oftentimes we're coming from that conditioned place of that misleading information that the more fat we eat, the more cholesterol that we eat, the more red meat that we eat that contains cholesterol, the more heart disease we're going to have, the more our cholesterol is going to go up, the higher risk we have for having a heart attack or for having a stroke.

Healthy fats do NOT cause high cholesterol or heart disease

But when you actually, when you follow the research, it's not the good fats that we talk about here on Dishing Up Nutrition or that we counsel our clients on. Those are not the bad fats. These are not the harmful fats I should say. So we talk about using butter to cook up your eggs. Use, you can change things up and throw coconut oil. I love coconut oil in stir fries or like Asian type dishes.

BRITNI: Yeah.

LEAH: Cause it just, I think it accentuates some of those flavors really nicely. Use olive oil when you're doing some low heat cooking, or make sure that the salad dressings that you're buying in the grocery store, make sure those are using either maybe avocado oil or olive oil. Avocado oil: there's another one of those good fats. Avocados, nuts and seeds. I mean, all of these are the good fats, the helpful, the beneficial fats that we talk about.

But even beef, even beef and coconut oil, even though they have saturated fat in them and beef has some cholesterol, these are more natural fats. Our bodies know what to do with these. So it really comes down to, at least in terms of some of the biggest food components we look at for cholesterol, it is the sugars, especially those added sugars, the refined sugars in processed foods, processed carbohydrates, alcohol, which acts a lot like sugar and like kind of more like even a toxic sugar in the body and really does a lot of damage to the liver. These are the kinds of things that are much more harmful to our cholesterol numbers and to our circulatory system or like our arteries to begin with.

High blood sugar and heart disease connection

And then one more connection that I've done some reading about is actually the connection between high blood sugar and heart disease. So think about, I mean we could talk about, this could be type two diabetes, but this could even be prediabetes. This could be, you know, maybe you're noticing that fasting glucose number when you get those labs done. It's been creeping up over the years. Now maybe you're running in the nineties, high nineties, low 100s. High blood sugar kind of acts like I think about it like sand almost kind of scratching up against the inside of a tube. A little bit: it's not going to do a whole lot. But when that sand is present for a long, long time and there's a lot of sand in there, over time, it's just going to whittle away. It's going to scratch up the inside of that tube.

BRITNI: It's a great visual.

LEAH: Yeah. So you think about that high blood sugar, that that sugar floating around in the bloodstream, it damages that inside lining of our arteries and our veins. And that's where they get damaged. They get that inflammation in there and then that LDL tries to come to the rescue to repair that damage, like you were saying, Britni. Right?

But then what can happen is actually as that LDL is making its way towards, towards that area of inflammation, that extra sugar can actually attach onto that LDL and change it in a way that then that becomes actually a more damaged type of LDL. So it's trying its best. It's trying to get to that right area. But now that sugar attacks those little lipoproteins, those little carriers that you were talking about, and it damages their natural function.

Different types of LDL cholesterol

BRITNI: I'm glad you brought that up. You know, there's actually different types of LDL cholesterols.

LEAH: Yes.

BRITNI: So there is like a fluffy, more buoyant, less harmful kind, and then a more harmful, smaller dense LDL. And just getting your regular LDL tested doesn't tell us what kind it is.

LEAH: Yeah. Kind of just gives you that an umbrella number.

BRITNI: Exactly. And then you can also find out how many, specifically how many LDL particles you have, which can be helpful too. So there is some advanced testing that you can get done. Sometimes practitioners are willing to do it; sometimes not. They're usually called like a lipoprotein particle profile or an NMR. So just know that that is an option too.

LEAH: Right. And it doesn't hurt to ask. You can always ask and just see what your provider is willing, willing to order. And the thing is, like our game plan is still the same one way or the other is eat real food. Eat good fats.

BRITNI: Yep.

LEAH: Keep the sugars under control, the processed carbs. So you know, we're kind of working in the same direction either way.

Triglycerides: play a role in heart disease risk

BRITNI: Mm-Hmm. And so if we're looking at the cause of heart disease, we definitely want to look at the role of triglycerides. So on your lipid panel, you're going to find a triglyceride number, and triglycerides are the fats. While cholesterol is not a fat, it is a waxy substance made in the liver. I explain to clients that triglycerides are fats made from sugar.

LEAH: Mm-Hmm.

BRITNI: So generally there are direct correlation to the amount of carbs or sugar that you're consuming. So if your triglyceride number is 150 or more, that's a high risk, dangerous place to be. We recommend under 75 if possible, but we've met with clients at the beginning of their journey with triglycerides at 600 or even higher at times.

LEAH: Mm-Hmm.

BRITNI: So that is an independent risk factor, a strong independent risk factor for heart disease or heart attack. And sugar, processed carbs, and alcohol: those are really the main culprits. So again, what are triglycerides? When you eat too many processed carbohydrates or sugar, your body turns the triglycerides into a sticky fat. The higher the number, the higher the risk factor for a heart attack.

And at Nutritional Weight and Wellness, we encourage clients to keep their triglyceride number below 75. So many of our clients, you know, eating real food, meat, fish, eggs, veggies, healthy fats, have a normal LDL and a low triglyceride number often, you know, 50 to 60.

LEAH: Yeah. Absolutely. I, you probably do the same thing, Britni, but if a client brings in their lipid profile for us to kind of look at, or if they send it to you via email, my first thought, I always go to the triglycerides first.

BRITNI: Yes.

LEAH: I look at that one. Not only can we have a big impact on those triglycerides pretty quickly, but like you said, that is one of the strongest, if not the strongest indicator, like that's the biggest risk factor right there even more so than that LDL.

BRITNI: Yeah. And HDL and things like that. So I always look at those triglycerides first, see where we're at, then we can piece through the rest of that, that lipid panel. And I remember one of my, when I first started counseling with Nutritional Weight and Wellness, I had a client. She was an out-of-state client, and so we were talking on the phone at the time.

And we had two appointments. They were about a month apart. She had just had a lipid panel done before we met the first time. And I don't know how she did it and got a second lipid panel like four weeks later, five weeks later, whatever it was. So we had this four week time period or so between when we talked and started implementing a real food plan and getting some of the sugars out and just kind of bumping her carbs down, getting good fats in. In that amount of time in one month, she dropped her triglycerides by 200 points.

BRITNI: Wow.

LEAH: By 200 milligrams per deciliter, I think is what they, what it's measured by.

BRITNI: Wow.

LEAH: So, yeah. Which is great because some of those other numbers, it takes a little while for them to shift. But the triglycerides, we can make a big impact with them very quickly just by changing the way that we eat. And, and specifically just again, getting some of those sugars out, getting some of those extra processed carbs out and, and upping the healthy fats. Like you can really make a big difference.

BRITNI: And what do you usually tell your clients for a length of time to see more of an impact in like your LDL number?

LEAH: Right. Yeah, that's a great question. I get that a lot. So yeah, the triglycerides, those are the, you can impact those ones very quickly. The LDL and the HDL can take a little longer to kind of try to turn that Titanic a little bit more. I usually tell people try to give it at least six months and we really, we got to be dialed in pretty well with eating during that time. I give it at least six months. If we can give it a year even better.

And so it, that those ones take a little bit more time. And so if we can build in a little extra cushion there, it lowers people's stress a little bit. It kind of takes that edge off and, and just know we're in it for the long game.

BRITNI: Yes.

LEAH: Mm-hmm. So we have to take our third and final break. You are listening to Dishing Up Nutrition. And here are just a few other quick little tips from our Ongoing Support and Education classes on how we talk about or how we approach behavior change and how we can have success in reaching our nutrition goals.

So one aspect is sleeping to actually change your behavior, change your thoughts, and change your metabolism. Enlist your brain and think “I can. I know I will. I know I can.” Again, that positive self-talk is so important. Visualizing that success, practicing that positive self-talk. Say affirmations to yourself. All of these simple habits really truly do help change your behavior and change your mindset. We'll be right back.

BREAK

BRITNI: Welcome back to Dishing Up Nutrition. If you want to take a deeper dive to understand cholesterol, I suggest you read a blog by our registered dietitian, Brandy Buro called Saturated Fat, Cholesterol and Heart Health. This article is from February 15th, 2022, and you can find it on our website, weightandwellness.com. And we've got lots of other articles and podcasts on this topic too that you can listen to or, or read.

LEAH: Yep. Yeah. Absolutely. And Britni, or Britni; you're Britni. Brandy did a great little mini Dishing Up Nutrition episode a couple of weeks ago on the cholesterol stuff, which I thought she did a really great job flushing some of that stuff out. Yeah. So again, listeners, if, if that is something interesting to you, you can find that on our website or on your podcast platform. You just go back, it was maybe two or three weeks ago, something along those lines. And I thought Brandy did a really great job.

BRITNI: Yeah. Me too. So before break Leah, you had talked about a client story and how drastically your client saw her triglycerides drop. And I have a similar story. A gal, a woman in my Nutrition for Weight Loss class; this was years ago. But it sticks with me. Her triglycerides, I think were over 400 when she started class. And she got retested either two months afterwards or maybe at the end of class, and her triglycerides went down to something like 150 in that chunk of time.

LEAH: That's awesome.

BRITNI: Yeah. It was really, really cool to see.

LEAH: Yep. Yeah. Again, those triglycerides are just the ones we can make the biggest impact on the quickest just by changing what you're eating.

BRITNI: Yeah.

LEAH: We give the LDL and the HDL a little extra time, but the triglycerides are hugely impacted in that sense. Yeah.

More on how stress can increase LDL cholesterol

BRITNI: So in addition to too much sugar, processed carbohydrates and alcohol, other lifestyle habits can definitely impact your cholesterol number. And after the pandemic, maybe you saw that your LDL cholesterol number is higher, and that could also be because of the ongoing stress. So stress can actually increase your LDL cholesterol number. So maybe think about what is a good way for you to reduce your stress, even if it's something you could do five minutes a day. For some, that's meditation, yoga, meeting with friends or reading a book, walking by yourself, whatever resonates with you. You know, try to incorporate that into your day to reduce that stress.

LEAH: Mm-Hmm. Yeah. And I, I want to draw that connection for the listeners that stress makes our cholesterol numbers go up or it can, and that's because remember cholesterol we said in the beginning is, is a big building block for some of our hormones. But another hormone that that is really important for is cortisol, our, our stress hormone. So cortisol, when we're under stress, our bodies call for more of that cortisol, more more of that stress hormone. So we need more cholesterol to make that cortisol. Makes sense.

BRITNI: Mm-Hmm.

Cholesterol numbers can increase during perimenopause/menopause

BRITNI: Yeah. Yeah. Thank you for explaining that. I think that's really helpful. You know, in addition to the stress piece and food, we've also seen that as women move into perimenopause and menopause their cholesterol numbers, specifically your LDL, goes up.

Because, again, like Leah mentioned again cholesterol helps to make hormones. So it's your, your body's way of saying, ugh, I'm not, don't have as many hormones anymore. Let me try to make extra. And when our sex hormone levels drop, you know, we're just trying to compensate. So sometimes after a few years, you'll see your LDL go back down and sometimes it might remain higher than it used to when, when you were menstruating.

HDL’s role in the body: lowers risk of heart disease and stroke

LEAH: Yep. So that, thinking about heart health, inflammation, cholesterol, it's, it's a complicated topic, but hopefully we've did some digging into in terms of helping flush out some of that LDL and flushing out some of the triglycerides part of the story. But we haven't yet touched on the HDL, which is a really important player that we don't want to forget about.

BRITNI: Yeah.

LEAH: Right? So that's another, that's again, like, that's one of those four numbers you'll see on a lipid panel. You'll see HDL and really that's the number we want higher rather than lower. And HDL is the, again, you'll hear it as the good cholesterol and it's got a couple different functions in the body, but it kind of absorbs, if you think about it, tooting around in the in the arteries, it comes around collects extra cholesterol or free fatty acids and things like that. It kind of collects things and brings it back to the liver so that the liver can do with it what it's going to, you know, flush it out, put it into the bile, recycle it, reuse it, do whatever it's going to do.

So high levels of HDL cholesterol can actually lower your risk for heart disease and stroke. What we want to see optimally is that HDL at least at 60. I think the actual guidelines are like for men, it's for sure we wanted over 40. For women, we want it over 50. Again, if we can even just even that out and say like 50 to 60, that would be a really great range for most people to stay in.

BRITNI: Yeah.

LEAH: Yeah.

How to increase HDL cholesterol

BRITNI: And to increase your HDL, I think the two biggest players are exercise and omega-3 fatty acids.

LEAH: Yes. And where do we get omega-3s from Britni?

BRITNI: Yeah. Our best source of omega-3s are fatty fish. So salmon, mackerel, sardines, and you know, unfortunately those are not my favorite foods. Yeah. But even if it, even if you do like those foods, realistically, you're probably not eating them on a regular basis. So you can supplement with omega-3s. I mean, I definitely do, and generally I recommend all my clients to do that.

LEAH: Sure. Mm-hmm.

BRITNI: Because they are essential, meaning if you're not getting it from an outside source, our body isn't making it on its own.

LEAH: Right. Yep. Exactly. So, and I, a hundred percent, I do have a couple clients who really are very good about, say, eating salmon twice a week. And that's wonderful. But I think you're right. I think most of us, especially here in landlocked Minnesota, we just aren't always really regular about that. And before we wrap up our show, I did want to just throw in a couple extra little numbers.

Breaking down cholesterol ratios to determine risk

Again, as you're looking at your lipid panel and trying to assess where you are on the risk side of things, two things you can look for. One and most lipid panels actually will put this on, on your sheet, is you can look at your total cholesterol number and compare that to that HDL number. So you're doing a ratio between your total cholesterol and your HDL. What we want to see is we want that number to be at 3.5 or lower. So that can be a strong independent risk factor again, of do you have high risk for heart disease or lower risk?

And the other number that we like to look at or that will compare is actually taking your triglyceride number, compare that to your HDL number. So just two different ways to look at that. When we're looking at triglycerides to HDL, this is where we want to see as close to a one-to-one ratio as we possibly can. You know, even two to one, not too bad, but one to one. So really like your, in other words, your triglycerides and your HDL should be pretty much the same number, as close to the same number as possible. So that will again, indicate we've got less insulin resistance going on. We've got less, fewer triglycerides floating around; a good level of HDL so that, that risk factor for heart disease, inflammation, things like that, that, that number comes down a bit.

So hopefully that helps our listeners flush out, again, even looking at your own numbers and deciding where you're at in that risk factor and gave you some ideas on what we can do to impact those cholesterol numbers. So our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple, yet powerful message that eating real food is life changing. Thank you for joining us today.

BRITNI: Thank you.