LDL, HDL & Triglycerides
My medical practice focuses on children with high cholesterol, prediabetes, and/or weight issues. In some cases, this can run in the family. In rare cases, medication may be considered.
In all cases, simple and sustainable diet changes can vastly improve these conditions. My patients have great success in slowing weight gain, improving labs and feeling more empowered to make healthy food choices. Read on for more information about the conditions I treat and how to eat more of the delicious foods that support great health.
It is important to remember that cholesterol is a normal part of the body. It is made in the liver and used for many important functions; making vitamins, hormones and cells that line nerve tissue. Cholesterol is important! The trouble is when levels are too high in the bloodstream – particularly LDL particles.
LDL-Cholesterol, or LDL, is known as “bad” cholesterol and plays a role in heart disease and stroke by contributing to plaque formation in arteries.
In general, a high LDL can come from two places:
- Diet. Eating a diet high in saturated fats, trans fats and not enough vegetables, fruit, and whole grains can lead to a high LDL. Many children with a high LDL are eating a lot of cheese (pizza, macaroni and cheese, etc) or red meat (hamburgers and hot dogs). They also may be eating fast food – even once a week can bump LDL levels.
- Genetics. A genetic condition called Familial Hypercholesterolemia (FH) can impact the way your body processes cholesterol. The LDL cholesterol doesn’t get recycled properly, which makes it hard to get LDL levels into a healthy range by eating a healthy diet and exercising regularly.
The good news is that most people – even patients with FH – can create a big difference on their LDL level by making healthy changes to their diet.
- Eat more vegetables! More salad, roasted veggies, sliced carrots and cucumbers – whatever works! I have seen patients make phenomenal improvements in labs just by increasing their veggie intake.
- More whole grains. Look for protein and fiber in cereals, specifically the word “whole” in breads. Try steel-cut oats or thick, rolled oats for breakfast.
- Shifting from unhealthy fats to healthy fats. (Read more on Facts About Fats)
- Cook and eat at home! Anything you make at home (ok, with maybe a couple of exceptions) will be healthier – and less expensive – than what you can get in a restaurant.
- Eat treats once or twice a week. Enjoy cookies or ice cream here and there – just not every day.
If you know anyone who has had an angioplasty or a cardiac bypass surgery, this is likely from plaque buildup that has blocked arteries. Once an artery gets blocked, it is very difficult to treat. Preventing plaque buildup is a key strategy to reduce the risk of heart disease. This can be done by eating a healthy diet from a young age.
In every cholesterol panel, there are three main components measured: HDL, also known as “good” cholesterol; LDL, also known as “bad” cholesterol; and triglycerides.
HDL is the cholesterol that is beneficial to heart health and plays a very important role in keeping our arteries clean. It takes some of the LDL cholesterol – the “bad” cholesterol – away from the side of the arteries and brings it back to the liver for recycling. This is called, “reverse cholesterol transport.”
Having a high HDL is great for you; studies show that people with a high HDL (over 55 for women, over 45 for men and children) live longer and have a lower risk of heart disease.
You can raise your HDL by:
1. Getting regular, aerobic exercise. This can mean jogging, biking, cardio at the gym, swimming, spin class, dancing – whatever you like. Just be sure your heart rate goes up for at least 15 minutes so you get the full benefits.
2. Eating foods that are rich in healthy oils: olive oil, fish, nuts, nut butter and avocado are all great sources. (find HDL-raising recipes here)
3. Avoiding trans fats. These are found in fried foods and many processed foods – watch out for the ingredient “partially hydrogenated vegetable oil.” Trans fats not only raise your bad cholesterol, they lower your good cholesterol.
Be sure to talk to your doctor about the best ways for you to raise your HDL.
When you get a cholesterol panel, one of the levels included is called triglycerides. Triglycerides are a circulating form of fats made out of three sugars (tri + glyceride).
High triglycerides can put you at risk for:
- An acute illness called pancreatitis
- An increased risk of heart disease and stroke
You want your triglycerides to be low – under 100 for kids, under 150 for adults.
What are triglycerides?
Consider eating a piece of chocolate cake (or drinking a soda or eating a big plate of pasta). Some of the sugar and carbohydrates from that are used as energy. Everything remaining needs to be stored. The body packages the extra sugar and carbohydrate as triglycerides. They move through the bloodstream and are then stored in the liver. When your body needs extra energy — like during a vigorous workout — triglycerides can be broken down into sugar. But if your body never needs these extra storage units, they eventually turn into fat cells (adipocytes). So if you are eating a diet high in sugar or simple carbohydrates, this might show up on your bloodwork as high triglycerides.
Another cause of high triglycerides is being overweight or obese. Extra fat cells, called adipocytes, actually make their own triglycerides and secrete them into the bloodstream. So eating too much sugars, having high triglycerides, gaining weight – this can make even more triglycerides. It’s a vicious cycle!
How can I lower my triglycerides?
The good news is that triglyceride levels can be really well controlled by eating the right foods and cutting back on extra sugars and carbohydrates. Exercising is also a powerful way to reduce triglycerides.
The first steps are:
- Drink only milk or water. Soda, sports drinks, fruit smoothies, mocha cappuccinos, even soy chai lattes – have an extraordinary amount of added sugar. Plain coffee and tea are fine – and you can even add a bit of sugar if you need! Just keep it to a teaspoon or two. [link to sugar in beverages — or perhaps we can create a strong infographic]
- Watch your added sugar intake. You can get specifics from your doctor, your nutritionist or follow these general guidelines based on the AHA recommendations:
Suggest teaspoons of sugar limits per day:
- Child 2-5: 5 teaspoons (20g) per day
- Child 7–10: 6 teaspoons (24g) per day
- Child/Teen 11–18: 7 teaspoons (28g) per day
- Adult female: 7 1/2 teaspoons (30g) per day
- Adult male: 9 teaspoons (36g) per day
Infants do not need added sugars and they should be avoided. First foods should be breast milk, formula and pureed vegetables and fruits. Juice and sweet snacks should be avoided.
- Change to whole grains. This means whole wheat bread, brown rice instead of white rice and whole wheat bagels, English muffins, waffles and pancakes. When picking a grain product, make sure it has “whole” as the first ingredient.
- Make half your plate vegetables and/or fruits. This is such a powerful way to improve the quality of your diet, including breakfast and lunch, not just dinner!
- Cut down on sweets. Have dessert once or twice a week – not every day.
- Exercise: Aerobic exercise is best for lowering triglycerides. Great options are jogging, swimming, biking, or playing soccer or basketball.
- Weight loss can be a powerful way to reduce triglycerides. Even losing 5 percent of body weight can make a big difference.