LDL Lowering Diet

gwd

gwd

Cathlete
Hi gals (and guys)!

I'm looking for opinions from all of you as I have come to respect your knowledge and insight that this board has to offer. My BF just got some not-so-great blood work back...HDL 63 (good), LDL 132 (not so good), making his total cholesterol borderline. Well, I just read through the "diet" that he should follow and I find a bit of it to be, from what I've learned here, not so healthy (and a bit ridiculous to say the least). It is basically a NO fat, low sodium, but sugar doesn't matter, diet. Huh???? Here are the items I found questionable.

Foods not allowed...
Low-fat yogurt (can only have fat free)
Low-fat sour cream (can only have FF sour cream substitute)
Low-fat cottage cheese (only FF)
Avocado (I thought that was healthy fat?)
Low-fat frozen yogurt (again, only FF)

Foods allowed (and here's where I have some problems)...
Prepared or baked desserts, pies, cakes, quickbreads, etc.
White sugar, brown sugar,high fructose corn syrup, honey, maple and corn syrup, jelly, jam, marmalade
Candy:sour balls, gum drops, lifesavers, jelly beans, marshmallows

While some of the diet is quite sensible and healthy (ie, lean protein, lots of veggies) in many cases the allowed foods are highly refined and processed. To me, some of this seems a bit extreme and not all that healthy, certainly nowhere near being "clean". Yes, they do include healthy(er) oils such as canola and soybean in the allowed, but seem to gloss over healthy fats. Also, there is NO mention of integrating foods high in soluble fiber and omega 3s.

Now, my BF certainly doesn't have saintly eating habits :p so any change would be good. We've talked about him giving up the peanut butter (Jif) and butter sandwiches, pepperoni and cheddar, ice cream (he's addicted to it :+ ), clam dip and Doritos and trying to eliminate most of the egg yolks.

So, I guess my questions are as follows...

1. Have you any recommendations for LDL lowering foods other than oatmeal?

2. Opinions on consumption of healthy fats?

I'm sorry this kind of rambled on. I told my BF that I knew some very knowledgable people that may have some ideas or suggestions as this kind of hit him like a ton of bricks. I was hoping you guys could help me out a little.

TIA for any advice you may be able to send our way.

Wendi
 
Honestly, with an HDL of 63, he is fine. We like HDL to be over 50 and LDL to be below 100. But...HDL actually has a protecting effect. So, his higher HDL is protecting him from his borderline LDL.

Keep up with your healthy eating. Cholesterol is only 1 risk factor for heart disease (and that diet looks like it is promoting another risk factor...type 2 diabetes!)

Moderation is key in everything. Whole grains, fruits and vegetables, 4oz servings of lean protein, lots of water. Sugary desserts shouldn't even be included!

I don't know about your significant other, but if this is his only risk factor, he should be fine. Does he not exercise? Does he have high blood pressure? Has his mother died before age 65 of heart disease? Has his father died before age 50 of heart disease? Does he have diabetes? Does he smoke? Is he overweight?

If your answer to all of those (other heart disease risk factors) is no, and this is his only one (although it looks fine to me) I think you're good. I wouldn't put him on a statin at this point. I do recommend that he keep his HDL high...take Niacin supplememnts.

-Becky McGilligan
2nd year medical student
Florida State University College of Medicine
 
Thanks so much for the quick responses.

jordysyd...Interesting reading, to say the least.

Becky...I didn't mind the numbers so much, especially knowing that his HDL was good. It was more of his doctor making him a bit nervous. As far as other risk factors, that's where it gets a bit hairy. He does exercise fairly regularly (treadmill, a little weight training) and is quite athletically inclined. He does have slightly elevated blood pressure (currently on medication). His mother just recently passed due to a massive stroke (among other issues) but did have a heart attack in her 70s. His alcoholic father died of heart disease sometime in his fifties. He does not have diabetes (all of that blood work is very good). He is 55, doesn't smoke, doesn't drink, is a bit overweight now. He's put on about 15lbs since recovering from prostate cancer (LPR surgery in Feb.) making him about 30lbs overweight.

Soooo...should I still toss that wretched "diet" out the window and push the healthy fats or have him try to go with a very strict total fat intake? Niacin, huh??? I will definitely pass that along! Thank you so, so much!

Take care,

Wendi
 
I think you should try a well-balanced diet. Go ahead and throw bad fats out the window, but don't let him eat all that sugar! For 55, his cholesterol numbers are admirable, especially after having put on 15 lbs recently. I think the best thing to do is get rid of that 30 lbs. Increase exercise length...if he is running for 30 minutes, slowly increase it up to an hour. Or do intervals on the treadmill...jog, run, sprint, jog, etc.

Here's how the docs I work with do diet (and this is for losing weight, maintaining weight, just plain healthy eating):

(Picture an inverted pyramid)
Mostly veggies and fruits (fill up on a salad w/ light dressing first for lunch and dinner)
Then whole grains (throw out any white grains...only WG pasta, WG bread, WG rice)
Then 4oz meat servings. I really recommend for weight loss to only do 4 oz a day.
Sparingly, use healthier oils (olive oil), promise butter is good. Also, sparingly sweets. If you have a sweet tooth, satisfy it with fruit.

I recommend eating every 3 hours or so. Eat a healthy breakfast (I don't recommend eggs for him...too high in cholesterol)...try cereal and skim milk w/ a glass of Tropicana Light and Healthy OJ. Then have a mid-morning snack (bananas are easy to take to work and eat). Then a healthy lunch (green salad w/ light dressing and maybe a sandwich or something light). Mid afternoon snack (I like yogurt for this...another dose of calcium). Then dinner (once again a big green salad w/ light dressing...a good standby at our house is to eat 4oz seasoned (gotta love those McCormick's low-sodium seasonings) chicken with rice and broccoli. Usually have a slice of WG toasted bread too. If you get hungry before bedtime, have an apple. It's hard to get hungry with this much fiber.

Kashi makes some great WG products. Their cereals are great and some have higher protein levels (in case you are concerned w/ not getting enough protein w/ only 4 oz of meat/day).

One of the more prescribed meds given to raise HDL cholesterol is Niaspan. It is simply a formulation of high doses of niacin. The doses are so high that it causes hot flashes and flushing at night sometimes. I don't think your BF needs that much. He really doesn't need it at all since his HDL is over 65...but to keep it up like that, it can't hurt to give a little (just not enough to cause the flushing).

I wouldn't stress too much on those risk factors. A mother having a heart attack in her 70s is not an indicator of heart disease in your BF. She had to have been under 65. Same goes for the dad...had to have been under 50 (and the drinking could have precipitated it anyway).

I am so proud of you for being so pro-active in your health care. You are the kind of patient I hope to treat someday. (Well, maybe not so much since I am going to be a surgeon...I don't wish surgery on you! :))

-Becky
 
Becky - Thanks so much for putting my mind at ease (and hopefully his)! I honestly think he needs to find a different GP *rolls eyes*. I know that after being diagnosed with prostate cancer last winter he gets a bit spooked when he gets questionable test results. I had figured that if he just changed some of those not so great eating habits and promoted his healthy habits more (snacking on fruit, salads for lunch, lots of veggies...all of which he does do) he should be fine. Thank you so, so much for your advice. Good luck...surgery, tough field!

Take care,

Wendi
 
As you just discovered, many doctors don't know much about nutrition. When my father had cancer surgery, the diet suggestioins they sent home with him (which my stepmother took just for a laugh) were full of things like ice cream,, butter, whatever had fat in to gain weight. We had a good laugh over them,, then threw them out.

The list of "allowed foods" is just appalling! (And I frankly don't consider many of them "foods" at all!). (It sounds like a friend of one of my students, who goes on an 'all Twizzlers" diet anytime she wants to lose weight!)

There are some MD's who are very knowledgeable about nutrition and more of a holistic approach to health, like Joel Fuhrman, Neal Barnard and Dean Ornish. Their diets are cholesterol lowering and are whole-foods based.
 
Thanks for the resources Kathryn. You know, now that I've seen firsthand how little doctors seem to know about proper nutrition, I'm considering looking into studying to be a *real* nutritionist. Between this episode, my own personal journey towards becoming fit and healthy this past year and the threads on going back to school, career changes, etc., I'm starting to think that could be an option. But I digress...

I will definitely check out those references!


Thank you,

Wendi
 
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