It’s never too early to start thinking about our heart health. It’s the engine that keeps our body running so we need to take care of it. According to the Centers for Disease Control (CDC) the United States has over 600,000 deaths every year from cardiovascular disease (CVD). At 70 deaths per hour that makes CVD the number one killer of Americans. The numbers don’t improve internationally. According to the World Health Organization nearly 18 million people die from CVD every year.

There are a variety of things we can do to improve our heart health. Today we’re going to talk about cholesterol.

First, science.

Cholesterol gets its name from the Greek words chole (bile) and stereos (solid). It is made by all animals and is an essential part of our cell membranes. To transport the cholesterol that our bodies produce (where most of our cholesterol comes from) the body uses lipoproteins (the body’s transport mechanism for lipids). When we talk about cholesterol there are two types of lipoproteins we need to concern ourselves with: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL is the molocule that takes cholesterol where it needs to go throughout the body. HDL is what carries the cholesterol back to the liver for recycling. LDL are generally categorized as “bad” because they are the primary component of arterial plaque (the build up of which can lead to heart attacks), and because having high LDL levels is associated with a greater risk of CVD. HDL is generally categorized as “good” because it carries excess cholesterol to the liver, and because high HDL levels are associated with a lower risk of CVD.

Atherosclerosis
Atherosclerosis is the scientific name for the accumulation of plaque in the blood vessels. This plaque is primarily composed of fat, cholesterol, and calcium. Although the precise cause is unknown, recognized risk factors include high levels of LDL, low levels of HDL, smoking, obesity, physical inactivity, age, and family history. Athersclerosis is dangerous because it begins early in our lives and its symptoms don’t manifest until middle age when it becomes a major health risk.

What can we do about it?

Aside from pharmaceutical options, the only ways we can moderate our levels of cholesterol are through diet and lifestyle changes.

Diet

Our bodies can only be as strong as what we feed it, therefore it’s important to think about what we’re eating. If we eat lots of junk food, we can expect to have junk health. To control our cholesterol, we’re going to have to make some changes to what we eat, and the two most important things to change in our diet are the fats we eat and how much soluble fiber we’re consuming.

Trans fats

The fat to avoid is trans fat, often known as hydrogenated vegetable oil. Its development was spurred by the need to improve the shelf life of foods, but they have no health benefits and are regulated throughout much of the world. However, due to political considerations, few countries have outright banned them. Trans fats are often found in industrial sweet breads, junk food, and deep-fried foods. Trans fats have been shown to raise LDL levels (which increases the risk of CVD) and some studies have shown that it lowers HDL levels as well.

Saturated fats

Saturated fats are found in animal products like milk, butter, and fatty cuts of steak. There is a correlation between high levels of saturated fat consumption and high levels of LDL. The American Heart Association (AHA) found that reducing saturated fat intake and replacing it with healthier sources of fat (particularly polyunsaturated fats) had the same cardiovascular benefit as taking pharmaceuticals to reduce cholesterol.

Monounsaturated fats

Monounsaturated fats are found in avocados, peanut butter, many types of nuts, and oils such as olive oil and peanut oil. A study in the American Journal of Clinical Nutrition found that a diet high in monounsaturated fats, when compared to a diet high in saturated fats, led to increased levels of activity, and surprisingly, a better mood. Another study found a diet high in monounsaturated fats led to a reduction in LDLs without affecting the levels of HDLs.

Polyunsaturated fats

Polyunsaturated fats are known as essential fats because our bodies need them, but can’t make them. These fats help regulate muscle movement, blood clotting, and inflammation. Common sources of polyunsaturated fats are walnuts, sunflower seeds, canola oil, tuna, and salmon. In a longitudinal study the journal Experimental & Clinical Cardiology found that eating fish just once a week significantly decreased the risk of coronary artery disease.

The Skinny on Fat [click to expand]

Fats and oils are a type of hydrocarbon (molocule primarily made of hydrogen and carbon) broadly known as lipids. Generally speaking, fats are solid at room temperature and oils are liquid at room temperature. To understand how these fats are categorized, we need to delve into a bit of chemistry.

Most fats are triglycerides, that is three (usually different) fatty acids bound to a glycerol molecule. These triglycerides are broken down by the body into their constituent fatty acids. It is the chemical structure of these fatty acids that determine its type.

Fatty acids are chains of carbon and hydrogen atoms capped at one end by the remains of the glycerol molecule it was bound to. The carbon of these chains can either be connected by single bonds to two other carbon atoms and two hydrogen atoms, or they can be connected to two carbon atoms (one by single bond, one by double bond) and one hydrogen atom. If the hydrocarbon chain of the fatty acid has no double bond, thus maximizing its hydrogen, it is said to be saturated (with hydrogen).

If the hydrocarbon chain has one or more double bonds between its carbon molecules, it is said to be unsaturated. If the chain has only one double bond it is called monounsaturated. If it has more than one it is called polyunsaturated. Trans fats are unsaturated fats with a different arrangement of atoms. Oleic acid (unsaturated) and elaidic acid (trans) are chemically identical, but arrange themselves differently.

Soluble fiber

Soluble fiber is found in nuts, seeds, oatmeal, and some fruits and vegetables. Plant fibers are non-digestible but they still aid with digestion. Soluble fibers absorb cholesterol when it passes through the small intestine and prevent it from being reabsorbed by the body.

Body weight and exercise

We all know that losing weight is associated with being healthier. When it comes to cholesterol levels, it’s definitely true. According to the Archives of Internal Medicine losing weight leads to reduced levels of LDLs and greater numbers of HDLs. Other studies come at it from the other direction showing a correlation between obesity and overall levels of cholesterol.

Aside from diet, the best way to lose weight is with exercise, and it just so happens that exercise is another great way to lower our cholesterol levels. According to Sports Medicine, regular physical activity increases HDL levels. Even something as simple as walking faster has been found to increase HDL levels. To reap these benefits, it’s recommended that we spend at least 120 minutes per week doing moderate physical activity, but that more activity reaps better results.