Lowering cholesterol with exersice and diet

Q. How does exercise lower cholesterol? What activities are the most effective?

A. For the record, cholesterol in the body is a good thing—it is needed for cell membranes and the production of hormones, among other functions. But too much can signal that there is too much fat in the blood. Back in the ’80s when people became aware of the need to control their cholesterol levels, many did so by shunning eggs since they contain a large amount of the substance. However, eggs are not a problem. The body makes what cholesterol it needs; the more that comes from food, the less the body makes. So cholesterol levels are controlled automatically. But a diet high in saturated and trans fats, typical of someone who eats lots of unhealthy food, may overload the body beyond its ability to regulate its levels.

Cholesterol levels reflect the amount of fat being carried through your blood by different “lipoproteins.” These numbers are used as a measure to predict your risk for heart disease. Your total cholesterol number is not as important as the figures for each of the components: your LDLs, HDLs and triglycerides.

High-density lipoproteins (HDLs) are considered to be beneficial since they sweep the blood of excess fat and cholesterol. On the other hand, low-density lipoproteins (LDLs) are worrisome because they can contribute to the build-up of plaque in your arteries. Recent research shows that the size of each of these particles is as important as the number. So with LDLs, if they are bigger and fluffier they are less likely to contribute to plaque than the smaller and denser variety. (The type of blood test to ascertain size is not often performed in a regular check-up, however.)

Experts agree that out-of-whack cholesterol, especially LDL at or above borderline levels, needs to be treated to lower the risks of heart disease. Doctors recommend an LDL level below 100 mg/dL (milligrams per deciliter of blood.), and below 70 mg/dL for those with other risk factors. Triglycerides should be below 150 mg/dL, and “good” cholesterol, HDLs, should be kept high, above 40 mg/dL and more than 60 mg/dL optimally. To find out more check out: http://www.nhlbi.nih.gov/health/public/heart/index.htm#chol

People with Type 2 diabetes or existing heart disease may need to lower their cholesterol right away, so doctors usually prescribe a quick fix, statins such as Lipitor and Zocor. At their highest doses, these potent pharmaceuticals have the ability to lower “bad” cholesterol from 20 percent to as much as 60 percent in just a few months. But even when statins are prescribed, lifestyle changes—better diet and more exercise—are an integral part of long-term management.

Diet guidelines are to reduce the main culprits: saturated animal fats (like high-fat meat and dairy) and trans fats (hydrogenated oils) in foods. A recommended diet should have less than 35 percent total fat with less than 7 percent of that saturated fat and minimal trans fat. Eating plenty of fruits, vegetables, grains and “good” unsaturated fats, such as those found in nuts, can also help lower LDLs and boost HDLs. A high soluble-fiber diet, the kind of fiber found in oatmeal, psyllium supplements and dried beans, can lower LDLs, too.

One problem with fighting high cholesterol with diet only is that even if LDLs decrease, HDLs may drop, too. Keeping HDLs high is important because it is estimated that for every 1 mg/dl increase in HDL, the risk for coronary heart disease is reduced by up to 3 percent. But doing aerobic exercise along with diet changes can prevent or decrease a drop in HDLs.

Exercise alone works to a degree, too. The biggest effect of exercise on improving cholesterol levels is boosting HDLs and lowering triglycerides. But to give HDL levels a good boost above the baseline, exercise must be regular and expend enough energy to burn at least 800 to 1,200 calories per week. Any aerobic exercise—from walking and running to swimming and cycling—counts. Walking at three miles in an hour burns about 300 calories, on average. To meet the threshold then, a person needs to walk around eight to 12 miles a week, or do some other aerobic activity for at least 30 minutes on six or more days per week.

As far as triglycerides go, exercise can reduce them by around 15 percent to 25 percent. There appears to be a similar threshold of regular exercise required to trigger the effect—expending at least 1,200 calories a week, with up to 2,500 to 3,000 calories a week recommended.

How fitness affects LDLs is less clear. Reductions from 5 percent to 19 percent have been seen, but often with concurrent weight or fat loss. However, some studies have found that LDL is reduced even without weight change, usually from burning at least 1,200 calories per week. While exercise may not consistently decrease LDLs, it may improve their quality. Early research suggests that regular aerobic exercise can produce more of the bigger, fluffier variety.

It’s unclear whether weight training affects cholesterol levels. Since changes seem dependent on total calories burned and weight training tends to burn fewer calories than moderate or vigorous aerobic activity, the impact appears minimal. Also, the jury is still out on whether intensity—how hard a workout is—plays a role. To see most cholesterol changes, exercise must be at least moderate (a brisk walk or cycle ride where you move at an intensity that feels “somewhat hard” or “hard.”. An exact dose-to-response has not been yet been determined, but a session may need to last long enough to burn around 350 calories at a time, or result in an accumulation of 1,200 to 2,500 calories over a week.

Exercise as an anti-cholesterol treatment does not work for everyone. Some people seem more resistant to changes, especially in HDLs, probably due to genetics. Keep in mind that using exercise is a slow approach and you may not see changes for three to six months, if you do at all. But even if exercise does not improve the numbers, exercise is always a good thing since it helps reduce other heart disease risk factors, such as high-blood pressure.

Almonds: can lower your LDL by 4.4 percent.

Almonds: Studies have found that eating just a quarter cup of almonds a day can lower your LDL by 4.4 percent, according to dietitian Leslie Bonci, who is also the director of sports nutrition at University of Pittsburgh Medical Center. “Eating nuts, especially almonds, which are high in good-for-you monounsaturated fat, is better than simply eating a low-fat snack like pretzels,” says Bonci. Of course, they can also be high in calories, so stick with a small serving and choose almonds that are dry roasted without oil.

Oatmeal: You’ve seen the commercials with people proclaiming dramatic drops in their cholesterol numbers thanks to a daily serving of this hot cereal. Those great results are due to the high levels of soluble fiber found in oatmeal. “The soluble fiber binds to the bile acids that are the precursor to the development of cholesterol and help flush it out,” explains Bonci. It doesn’t matter how you get your oats—those instant, just-add-water packets are just as good for you as traditional, slow-cooked versions.

Fish: Omega-3 fatty acids are widely considered to be the best of the “good” fats, and the best place to find them is in fish—especially fatty fishes like salmon, halibut and tuna. According to Dorfman of the ADA, you want to get 1.5 to 3 grams per day of omega-3. A 4-ounce piece of salmon will give you close to 3 grams, and you can also get these fatty acids from walnuts and flaxseed (two tablespoons of flaxseed provides 3.5 grams) and in fish oil supplements.

Red wine: Not everything that’s good for you has to feel virtuous. A glass of red wine, which contains flavanols, has been shown to have anti-inflammatory properties that may help lower cholesterol and stave off heart disease. But in this case, more is definitely not better. “For women, the recommendation is one drink a day and for men it’s two,” says Bonci. More than that will, literally, dilute any potential benefits. These flavanols can also be found in red grape juice and dark cocoa.

Soy: Soybeans, soy nuts and edamame, plus any products made from soy (like tofu, soymilk, etc.) can help to reduce the production of new cholesterol. A little can go a long way—aim for about 25 grams of soy protein a day (the amount in a cup of edamame). And those who are at an increased risk of breast or prostate cancer may want to skip it since too much of soy’s phyto-estrogens can act similarly to the body’s own estrogen (which has been shown to feed some hormone-dependent tumors).

Now that you know the good stuff to add to your diet, try to reduce—or better yet, eliminate—these bad-for-you foods from your repertoire:

Whole-milk dairy products: Saturated fat, which clogs arteries and increases LDL levels, is the No. 1 cholesterol-boosting culprit. And foods like ice cream and cheese are where you’re likely to find them. Swap out the Ben & Jerry’s Chubby Hubby for a lower-fat frozen yogurt, and skip the brie in favor of something less rich, like a part-skim mozzarella.

Processed meats: Bacon, sausage, liverwurst and the like are also wonderful sources of artery-clogging saturated fat. Look for lower-fat options, like bacon and sausage made from turkey and other lean protein sources.

Fast-food fries: Even worse than saturated fats are the dreaded trans fats. “You might as well take a gun and shoot yourself!” says Dorfman. The main source of trans fats are partially hydrogenated oils, and that’s exactly what most fast-food restaurants are still using to cook their fries. Trans fats hit cholesterol with a double whammy—in addition to raising your LDL, they simultaneously lower your HDL.

Tropical oils: Palm kernel and coconut oils are two of the fattiest of oils—100 percent of the bad-for-you saturated variety. Don’t use them when you cook at home, and try to avoid them when you eat out (most fast-food restaurants have eliminated them, but you can check their Web sites for detailed nutritional information). Use heart-healthy mono- and polyunsaturated fats, like olive, canola and safflower oil, instead.

Baked goods: Many manufacturers of packaged cookies and cakes have eliminated trans fats from their recipes, but check the nutrition labels to be sure. But all baked goods—even those that are homemade—are high in saturated fats, thanks to the butter and shortening. Since no one wants to give up dessert completely, eat high-fat baked goods only occasionally, opting more often for low-fat sweets like sorbets.

Article by Martica.

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