Heart Health

Elevated blood lipids (blood fats), such as high cholesterol and elevated triglycerides can, lead to cardiovascular disease over time.  If you:

  • have high blood pressure (BP >140/90 mmHg),
  • are a male >45 or a female > 55 years,
  • are a smoker,
  • are overweight,
  • are physically inactive,
  • have a family history of cardiovascular disease,
  • and/or have diabetes,

then you are already at risk for heart disease. Maintaining healthy lipid levels is essential to reducing your risk of cardiovascular disease and stroke.

Cholesterol is a fat-like waxy substance that circulates in the bloodstream. Though it has important functions in the body and cells even make some cholesterol on their own, it also is supplied by foods that come from animal sources such as eggs, meats, and dairy foods.

Too much cholesterol circulating in the blood can build up in artery walls. Over time, artery walls can become narrowed and clogged, which can lead to heart attack and stroke. High cholesterol, known as hypercholesterolemia, can be caused by an excess intake of saturated fat and high cholesterol foods in the diet, heredity, or both.

There are many forms of cholesterol, but three main forms are: total cholesterol (TC), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). HDL and LDL cholesterol are two parts that contribute to the total cholesterol number.

HDL is mainly affected by physical activity level and is often called “good cholesterol” because it has a beneficial, protective effect against cardiovascular disease. HDL cholesterol should be > 40 mg/dL and is considered optimal when it is > 60 mg/dL. While an HDL level < 40 mg/dL, is linked to increased risk for cardiovascular 60 mg/dL, is considered a “negative risk factor” because it?disease, a level is associated with reduced disease risk. The average HDL for a man is 45 mg/dL and for a woman is 55 mg/dL. Exercise can be very beneficial when it comes to increasing HDL level.

LDL is called “bad cholesterol” because it contributes to plaque formation and clogging of blood vessels. It is affected by what you eat; high fat and high cholesterol foods raise LDL levels. Limiting fat and cholesterol in the diet, by choosing fruits and vegetables, lean meats and poultry, low-fat dairy foods, and whole grains, as well as exercising can help lower LDL.

Triglycerides are another form of fat found in the blood. Triglyceride levels can be elevated from eating a high fat diet, consuming large amounts of refined carbohydrate, and excessive alcohol intake. Triglycerides may be high even if total cholesterol is normal. To lower triglycerides, monitor fat and carbohydrate consumption by reading food labels. If you are overweight, moderate weight loss can also lower triglyceride levels. The National Cholesterol Education Program from the National Heart, Lung, and Blood Institute, recommends that triglycerides be less than 150 mg/dL.

National Cholesterol Education Program (NCEP) Classifications for Cholesterol and Triglyceride levels:

  Optimal Near Optimal Borderline High High
Total Cholesterol (mg/dL) 200 - 200-239 >240
LDL Cholesterol (mg/dL) <100 100-129 130-159 >160
Triglycerides (mg/dL) <150 - 150-199 >200

  Optimal Low
HDL (mg/dL) >60 <40

Source: The Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); NIH Publication No. 01-3305, National Cholesterol Education Program, May 2001.

Types of Fats in Foods

Saturated fat
Saturated fat is found mainly in animal products such as butter, regular or full-fat dairy products, beef, poultry, pork, fish, and eggs. It is also found in tropical oils such as coconut, palm, and palm kernel oils, even though they are plant oils. Saturated fat is solid at room temperature. Fried foods and many snack foods are high in saturated fat.

Trans fat
Trans fat is a type of fat formed by hydrogenation (adding hydrogen bonds to unsaturated fats). They are found in baked goods, fried foods, snack foods, and in some margarines. Foods containing partially hydrogenated oils have trans fat. Read food labels for trans fat content and look for foods containing 0 grams of trans fat. By 2006, the Food and Drug Administration (FDA) will require all food labels to list the amount of trans fat in foods.

Unsaturated fat
Unsaturated fat is a type of fat found in plant products and is liquid at room temperature. There are two main types of unsaturated fats: monounsaturated and polyunsaturated fats. Monounsaturated fats are found in olive, peanut, canola, and sesame oil. Polyunsaturated fats are found in margarines, vegetable oils like safflower, sunflower, corn, soybean and cottonseed, spreads, and salad dressings.

Omega-3 fatty acids
Omega-3 fatty acids are found in cold-water fatty fish like salmon, herring and mackerel, flaxseed, nuts like walnuts, soy, and fish oil supplements, canola and soybean oils. Omega-3 fatty acids have been shown to reduce total cholesterol and triglyceride levels. The American Heart Association (AHA) recommends at least two servings of fish per week. If you do not eat fish, fish oil capsules providing about 1 gram/day may be beneficial.

Plant sterols/stanols
Plant sterols/stanols are plant-derived compounds that have been added to food products such as margarines, salad dressings, mayonnaise, chocolate chews and even orange juices. Plant sterols/stanols have been shown to decrease total cholesterol and LDL levels. Read food labels for sterol/stanol content. The NCEP recommends 2 g/day to receive a cardiovascular benefit.

Fiber is found in many fruits, vegetables, breads, cereals, and other grain products. There are two types of fiber, soluble and insoluble. Soluble fiber is a viscous form of fiber that can help lower total cholesterol. Insoluble fiber helps regulate bowel function and may aid in reducing the risk of some types of cancer. Good sources of soluble fiber include oat bran, dry beans and peas, some vegetables, and most fruits. Good sources of insoluble fiber include wheat bran, whole grains, and vegetables. Aim to get about 25 grams of fiber per day by choosing at least three servings of vegetables, three servings of fruit, and four servings of whole-grain products each day. Increasing fiber consumption in the diet can cause gas and a feeling of fullness, so be sure to increase fiber intake slowly and drink plenty of fluids.

Recommendations for a healthy heart
A healthy lifestyle is important for preventing and managing high cholesterol. Some people may not be able to control cholesterol levels with diet alone and may have to take cholesterol lowering medications. Even if you are on a cholesterol lowering medication, a healthy lifestyle is important.

The AHA and the NCEP recommend the following therapeutic lifestyle changes if LDL levels are elevated:

  • Limit saturated fat to less than 7% of total calories
  • Limit total fat to 25-30% of total calories
  • Limit sodium to 2300 mg/day or less
  • Limit cholesterol to less than 200 mg/day
  • Consume 10-25 g of soluble fiber per day (and a total of 25-30 g. of fiber per day)
  • Eat 2 servings of fatty fish per week
  • Consume 2 grams of plant stanol/sterols each day
  • Achieve and maintain a healthy weight
  • Increase physical activity to at least 30 minutes of moderate activity, such as brisk walking, on most days of the week

For example, if you eat 2,000 calories per day, saturated fat and trans fat content should be less than 16 grams per day, while total fat should be less than 55 to 65 grams per day. Total daily cholesterol and sodium should remain less than 200 mg/day and 2,300 mg/day, respectively, regardless of calories consumed.

If your lipid profile is normal, it is recommended that you continue to follow a healthy lifestyle to maintain lipid levels. Healthy lifestyle recommendations include:

  • Limit saturated fat and Trans fat to 8-10% of your total calories
  • Limit total fat to less than 30% of total calories
  • Limit total cholesterol to less than 300 mg/day
  • Limit total daily sodium to less than 2,300 mg/day
  • Aim for a total fiber intake of 25-30 g/day
  • Eat 2 servings of fatty fish/week
  • Reach and maintain a healthy weight
  • Increase physical activity to at least 30 minutes of moderate activity, such as brisk walking, on most days of the week

For example, if you eat 2,000 calories per day, saturated fat and trans fat should total less than 18 to 22 grams, while total fat should be less than 65 grams per day. Daily cholesterol and sodium intakes should be less than 300 mg/day and 2,300 mg/day, respectively, regardless of calorie level.

For more information about heart-healthy eating ask your healthcare provider for a referral to visit a Registered Dietitian (RD) or go to http://www.eatright.org to locate an RD near you. An RD can determine a good calorie level for you and design a personalized meal plan to help you to achieve an optimal lipid profile.

A good way to make sure that you are following a healthy lifestyle is to read food labels. If you pay attention to the total fat, cholesterol, sodium and fiber information on the Nutrition Facts panel of food products, you can get useful information that will help you make informed decisions about whether or not a product fits into a heart-healthy eating plan. Remember to choose foods that are high in fiber and low in fat, saturated and trans fats, cholesterol and sodium.

Good Measure Meals fits perfectly into an overall plan for individuals seeking to manage healthy cholesterol levels. Our meal plan integrates healthy eating guidelines of the American Heart Association and incorporates foods encouraged in the Therapeutic Lifestyle Changes (TLC) eating plan. When combined with regular physical activity, Good Measure Meals may help you improve your lipid profile. A healthy, balanced diet is very important for anyone seeking to manage lipid levels.

For more information about heart-healthy eating, visit:
American Heart Association
Delicious Decisions
American Stroke Association
The National Heart, Lung, and Blood Institute