Managing Hyperlipidemia (High Blood Cholesterol)

When your annual blood work is done, a lipid panel is included to measure cholesterol and triglyceride levels. This panel includes your
total cholesterol, HDL (the “good” cholesterol), LDL (the “bad” cholesterol), and your triglycerides. High cholesterol and triglycerides are
associated with heart disease, diabetes, and fatty liver disease.

What is Cholesterol?
Cholesterol is a waxy substance found in our blood stream and cells, and comes from two major sources – food and cholesterol
produced by the liver. Cholesterol has many functions in the body: it helps to build and repair cells, aids digestion of fat, and serves as
the structural component of Vitamin D, sex hormones and stress hormones, such as testosterone and cortisol.

When we eat, the fat and cholesterol absorbed from our food cannot mix freely with our blood – think of oil and water don’t mix.
Therefore, our liver makes fat and cholesterol carriers called lipoproteins which can move freely through our bloodstream, distributing
fat and cholesterol to various places in the body. There are a few types of lipoproteins: VLDL, LDL, and HDL. These are the substances
measured on the lipid panel when your blood is drawn.

What do my Lab Values Mean?

• Total Cholesterol. Total cholesterol is the combination of VLDL,
LDL, and HDL. A value above 200 mg/dL increases your risk of
getting heart disease or having a stroke.
• LDL. LDL (low density lipoprotein) is known as the “bad
cholesterol” because these particles adhere to blood vessels
and arteries, causing a buildup of plaque that can lead to
heart attack or stroke. Elevated LDL, levels above 100 mg/dL,
along with other risk factors significantly increase the risk of
developing heart disease.
• HDL. HDL (high density lipoprotein) is known as the “good
cholesterol” because it travels through the blood, removing
LDL and other unwanted particles. Think of HDL acting like a
garbage truck. A value less than 40 mg/dL for men and less
than 50 mg/dL for women is undesirable and heightens your
risk of heart disease.
• Triglycerides. Triglycerides are a type of fat that circulates in the
blood. Elevated levels, greater than 150 mg/dL, combined with
low HDL or high LDL cholesterol is associated with the buildup
of plaque in the arteries that increases risk of heart attack and
stroke.
How Does Elevated Cholesterol
Contribute to Heart Disease?
Atherosclerosis, or Ischemic Heart Disease, is the
leading cause of death for both men and women,
affecting 1 in 4 individuals. It is a multiple stage
process in which plaque (a fatty substance) builds
up inside the arteries, eventually hardening and
narrowing them. The progression of atherosclerosis,
along with other risk factors, can cause a heart attack
or stroke.
The cells that line our blood vessels and arteries are
called endothelial cells. It is important that they are
healthy. Aging, smoking, and a poor diet can damage
these cells. Once damaged, LDL cholesterol can enter
the lining of the arteries. LDL is not welcome in the
lining of the arteries, so our body reacts by initiating a
series of inflammatory processes. This process is what
leads to the development of plaque. If precautions
are not taken to reverse or stop plaque formation
a blood clot can form, leading to a heart attack or
stroke.

Lab Order Normal Value My Values When LDL and triglyceride levels are elevated more
particles enter through the endothelial cells, thus
Total Cholesterol <200mg/dL
accelerating and worsening heart disease risk. When
>40mg/dL for men HDL levels are low, less LDL is removed from the
HDL Cholesterol
>50mg/dL for women blood stream. Other risk factors also affect heart
disease risk.
LDL Cholesterol <100mg/dL
Triglycerides <150mg/dL
What Can I Do to Lower My Cholesterol
and Reduce My Risk of Heart Disease?
Sleep
“Almost everything will work again if you unplug it for a few
minutes... including you.”
Enough sleep is just as important for health as nutrition and
exercise. Poor sleep has been linked to high blood pressure, heart
disease, diabetes, obesity, and an increase in stress hormones.
Researchers have found that seven to nine hours of sleep
per night is linked to better health outcomes. Sleep impacts
metabolism, appetite, cravings, moods, depression and anxiety,
and attention span. To sleep better, aim for at least 30 minutes
of exercise per day, avoid excess caffeine, talk to your doctor
about medications that interfere with sleep, and establish an
evening routine that doesn’t involved screen time (TV, iPad or
tablet, phone). Instead, try reading, bathing, listening to music,
meditating, or stretching and deep breathing.

Exercise Diet
“The food you eat can be either the safest and most powerful form
“Those who do not find time for exercise will have to find time
of medicine or the slowest form of poison.”
for illness.”
A heart healthy diet focuses on consuming a variety of fiber-
Those that maintain an active lifestyle have a 45% lower risk
rich whole grains, legumes, fruits and vegetables, low-fat dairy
of developing heart disease than do sedentary people. More
products, skinless poultry and fish, nuts and seeds, and non-
vigorous forms of exercise have been shown to lower LDL and
tropical vegetables oils. Saturated fats, trans fats, sodium, red
raise HDL levels (ex: jogging about 20 miles per week). With
meat, refined carbohydrates, sweets and sugar sweetened
all forms of activity, it is the total weekly amount of energy
beverages are limited.
expended that matters, not the duration of a single exercise
session. If you’re just beginning an exercise routine, short and
frequent bouts might be better tolerated. Experts recommend at
least 30 minutes of exercise on most – if not all – days. What Foods Lower LDL, RAISE HDL,
and Protect My Arteries?
Stop Smoking
A Mediterranean dietary pattern - including
“Don’t think of it as quitting, think of it as gaining.”
monounsaturated fats, omega-3 fatty acids, colorful
Smoking damages the endothelial cells of your blood vessels,
fruits and vegetables, beans, and whole grains - has been
decreases HDL levels, and raises blood pressure. Within 1 year
associated with lower cholesterol levels and decreased
after quitting, your risk of coronary artery disease decreases by
risk for heart disease. The foods included in this eating
50%! If you quit between the ages of 30-60 you can increase life
pattern provide fiber, an essential nutrient for lowering
expectancy by 6-10 years. Ask your doctor if you need help with
LDL cholesterol levels and weight management. They also
smoking cessation.
provide antioxidants and vasodilators which protect cells
and keep blood vessels healthy.
Stress Management
“Worrying doesn’t take away tomorrow’s troubles, it takes away
today’s peace.” Monounsaturated Fat: olive oil, canola oil, nuts and
When stress is excessive, it contributes to high blood pressure nut butters, seeds, avocados
and a variety of behavioral responses that increase heart disease
risk such as overeating, smoking, increased alcohol consumption, • Use olive and canola oil for cooking and salad dressings
poor sleep, and physical inactivity. Positive self-talk (I can’t do • Sprinkle small amounts of nuts and seeds onto salads and into
this vs. I’ll do the best I can), daily relaxation (yoga, medication, yogurt, oatmeal, and smoothies
prayer), or simply doing something you enjoy (taking a walk, • Spread nut butter on toast, fruit or whole grain crackers
knitting, coffee with friends) can help to relieve stress. • Use avocados on sandwiches instead of mayonnaise, spread
on toast, mix with lime juice for a quick guacamole, or on top
of salads
Omega-3 Fatty Acids: fatty fish such as salmon and
tuna (wild bluefin, white albacore, and chunk light are
highest), flaxseeds, walnuts, flaxseed oil, canola oil
• Aim to consume a variety of fatty fish 2-3x per week (3.5 oz.
per serving)
• Try mixing flax seeds or walnuts into oatmeal, yogurt,
smoothies, or mixing into baked goods like homemade bran
muffins
Vegetables: dark green, red/purple, yellow/orange,
and white vegetables and herbs and spices
• Aim to get at least five to six servings of vegetables per
day (1/2 cup cooked, 1 cup raw, or 2-3 cup salad greens is
considered 1 serving)
• Fill half your plate with vegetables
• Mix veggies into eggs, smoothies, rice, pastas, quesadillas, and
casseroles
• Enjoy large salads for meals, use beans as a source of protein
• Snack on chopped veggies with hummus or yogurt dips
Colorful Fruits: figs, red grapes, pomegranates,
oranges, apricots, melon, grapefruit, kiwi, peaches,
pineapples, berries, apples, bananas, cherries, dates,
plums, pears, raisins, lemons
What Foods Raise LDL, LOWER HDL, and
Harm the Arteries
• Saturated fats and oils: butter, bacon drippings, lard,
palm oil, coconut oil, and fatty red meat, pork and
poultry with the skin
• Trans fats: “partially-hydrogenated oils” are found in hard
margarine, snack crackers, cookies, chips, shortening,
and non-dairy creamers. Look at the ingredient list for
“partially hydrogenated oils”
• Fatty and processed meats: sausage, hot dogs, bacon,
salami, salted and cured meat, bologna, corned beef,
smoked meats, dried meats (jerky), and canned meat,
ribs, T-bone or rib-eye steak, barbeque pork, skin-on
chicken, 70-30% or 80-20% ground meats, and organ
meat
• Egg yolks: limit egg yolks to one per day, at most
• High fat dairy: choose dairy that contains no more that
1% milk fat – including cream, cheese, milk, yogurts,
and coffee creamers or whipped toppings
• Refined carbohydrates: white bread, white rice, white
pasta, sweets, cakes, cookies, pie, candy, crackers,
cookies, chips, and sugary cereals
• Fast food: hamburgers, fries, fried chicken, barbeque,
pizza, and tacos

• Aim for 3 servings of fruit per day (1 small fruit, 1 cup melon, 1
cup berries, or 1 oz. dried fruit)
• Add fruit to breakfast by mixing dried fruit into oatmeal,
topping yogurt or whole grain cereals with berries, adding it to
smoothies, or smearing with 1-2 tbsp. peanut butter
• Have fruit for dessert. Melt a square of dark chocolate and
drizzle over berries or ½ a banana
• Make fruit easily accessible. Place a fruit bowl in high-traffic
areas of the house or in the front of the fridge
• Buy seasonal berries and melon in the summer months and
take advantage of citrus fruit, pomegranate, pears, apples,
bananas, and frozen berries in the winter months
• Pair fruit with nuts, nut butters, a cheese stick, yogurt, or just
eat alone for a snack

Legumes: lentils, split peas, navy beans, great

northern beans, pinto, kidney, red, butter, black
beans, chickpeas, and soybeans

• Aim to eat legumes daily (1/2 cup serving) as part of our daily
protein intake
• Substitute legumes for meat protein sources on one day per
week (ex: Meatless Mondays)
• Add drained and rinsed canned beans to salads, soups, tacos,
quesadillas and casseroles
• Snack on hummus (a chickpea spread) with veggies and
whole grain crackers
• Snack on edamame (baby soybeans) – found in the frozen
food section