High Cholesterol Can Lead to Heart Attacks and Strokes
Why does cholesterol matter?
Cholesterol is a waxy substance found in your blood. Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease.
With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.
High cholesterol can be inherited, but it's often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol.
Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. There are different types of cholesterol, based on what the lipoprotein carries. They are:
- Low-density lipoprotein (LDL). LDL, or "bad" cholesterol, transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
- High-density lipoprotein (HDL). HDL, or "good" cholesterol, picks up excess cholesterol and takes it back to your liver.
A lipid profile also typically measures triglycerides, a type of fat in the blood. Having a high triglyceride level can also increase your risk of heart disease.
Factors you can control — such as inactivity, obesity and an unhealthy diet — contribute to high cholesterol and low HDL cholesterol. Factors beyond your control might play a role, too. For example, your genetic makeup might keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol.
Factors that can increase your risk of bad cholesterol include:
- Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers and microwave popcorn, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your cholesterol.
- Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
- Lack of exercise. Exercise helps boost your body's HDL, or "good," cholesterol while increasing the size of the particles that make up your LDL, or "bad," cholesterol, which makes it less harmful.
- Smoking. Cigarette smoking damages the walls of your blood vessels, making them more prone to accumulate fatty deposits. Smoking might also lower your level of HDL, or "good," cholesterol.
- Age. Because your body's chemistry changes as you age, your risk of high cholesterol climbs. For instance, as you age, your liver becomes less able to remove LDL cholesterol.
- Diabetes. High blood sugar contributes to higher levels of a dangerous cholesterol called very-low-density lipoprotein (VLDL) and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.
High cholesterol can cause a dangerous accumulation of cholesterol and other deposits on the walls of your arteries (atherosclerosis). These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:
- Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you might have chest pain (angina) and other symptoms of coronary artery disease.
- Heart attack. If plaques tear or rupture, a blood clot can form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you'll have a heart attack.
- Stroke. Similar to a heart attack, a stroke occurs when a blood clot blocks blood flow to part of your brain.
The same heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place. To help prevent high cholesterol, you can:
- Eat a low-salt diet that emphasizes fruits, vegetables and whole grains
- Limit the amount of animal fats and use good fats in moderation
- Lose extra pounds and maintain a healthy weight
- Quit smoking
- Exercise on most days of the week for at least 30 minutes
- Drink alcohol in moderation, if at all
- Manage stress
Lower Your Cholesterol
A diet rich in fruits, vegetables, whole grains, beans, and good fats can help lower what’s sometimes called “bad cholesterol.” You may hear your doctor call it “LDL cholesterol.” You have a greater chance of getting heart disease when your LDL level gets too high.
You get other benefits from these foods. They also:
- Lower your blood pressure
- Boost immunity
- Protect against heart attack, stroke and some cancers
To help you make the best choices, here are lists of what to add to your shopping cart and what to avoid.
Focus on these when you’re at the grocery store -- and remember a farmer’s market might have some great picks, too:
Produce: Look for colorful fruits and vegetables, such as berries, oranges, apples, yams, broccoli, spinach, and bell peppers. Naturally cholesterol-free and low-fat, fruits and vegetables are the foundation of a good diet.
Whole grains: Oats, quinoa, barley, and whole wheat offer up fiber, complex carbohydrates, and protein. Look for breads, pastas, and cereals made with a variety of whole grains.
You will need to avoid certain grains, though, if your doctor says you can’t eat gluten or you have celiac disease, which affects your small intestine.
Be sure to read the labels to make sure the products you buy are also low in fat, sugar, and sodium.
Meat and beans: Choose skinless cuts of chicken or turkey breasts, and lean cuts of meat such as pork tenderloin and beef round, sirloin, or tenderloin. Read labels to be sure the meat is at least 92% fat-free.
Buy protein-rich beans such as black, soy/edamame, kidney, or garbanzo beans. Nuts and seeds: Snack on them or use as garnishes in salads and pastas. Stock up on the plain varieties.
When you buy natural-style peanut butter or almond butter, look for products that contain just the nuts, or just nuts and salt.
Dairy/calcium: Look for low- or reduced-fat products (yogurt, milk, and cheese), as well as canned fish such as tuna, sardines, and salmon.
If you’re lactose-intolerant or vegan, try calcium-enriched or fortified cereals and juices, and green, leafy vegetables, to fill the calcium gap.
Vitamin D, which helps you take in more calcium, is often added to dairy products, some cereal products, and margarine. It’s also found naturally in fish and egg yolks.
Omega-3-rich foods: Most of us aren’t getting enough of this good fatty acid in our diets.
You find these fats in fish. Cold-water fish such as salmon, tuna, halibut, herring, and mackerel have higher amounts. You can also find plant omega-3 fatty acids in walnuts and ground flaxseed.
Also look for foods enriched with it. These may include eggs, dairy, soy products, breads, cereals, and pasta.
“Good” oils: Some oils can be good for you. Olive oil can help raise the level of your “good” cholesterol (HDL). Look for other vegetable-based oils: canola, soy, and sunflower.
Plant sterol-enriched foods: Plant sterols and stanols are substances that help block cholesterol from being absorbed in your small intestine.
They are found naturally in foods in only tiny amounts. You can get some plant sterols from produce, nuts, seeds, and legumes, but not nearly the 2 grams a day recommended for people with high cholesterol.
If you need more, look for sterol-enriched foods such as margarine spreads, some yogurt or low-fat milk, some fruit juices, and some cereal. Be sure to read the labels to make sure the food is not also high in fat and sugar.
Some nutritionists recommend avoiding certain aisles in the supermarket. Bypass rows with bakery items, crackers, cookies, and other foods high in saturated fat.
In general, avoid items if any of these things appear high on the food label’s ingredient list:
Trans fats: These are bad for you and can be found in packaged snacks such as pastries, cookies, crackers, and some types of margarine. Read the nutrition facts to see all the fats in the product.
Other foods that are often filled with trans fats: biscuits, breakfast sandwiches, microwave popcorn, cream-filled candy, doughnuts, fried fast foods, and frozen pizza.
Salt: Too much sodium can help raise your blood pressure. You probably already know not to have too much canned soup and salty snack foods. Did you know it can also lurk in breads and rolls, cold cuts and cured meats, pizza, some chicken, and some fast-food sandwiches?
You might be surprised how often it’s found in frozen foods, too. When in doubt, read labels. Try not to get more than 2,300 to 2,400 milligrams per day.
Sugar: Yes, it tastes so good. But too much might cause problems with weight gain, heart disease, and diabetes as well as cholesterol. Easier said than done, but try to limit how much of this you eat and drink.
You probably know many of the “usual suspects”: soda, sweet tea, candy, cakes, cookies, and ice cream, among others.
But did you know sugar is added to things you might not even think about -- from spaghetti sauce to fast food? That also includes many tomato ketchups, breakfast bars, and even tonic water.
The lesson: Read labels. And here are common added sugars to check for:
- Brown sugar
- Corn sweeteners and syrup
- Dextrose and fructose
- Fruit juice concentrates
- High fructose corn syrup
Foods that have one or more of those things listed high on the ingredient list may have a lot of sugar.
Cruise the perimeter of the store: This is where you’ll usually find produce, nuts and seeds in bulk, lean meats, and low-fat dairy.
Shop when you’re full: You’ll be less tempted by sweets and salty snacks if you’re not hungry.
Read food labels: Ingredients are listed by weight, from most to least, so it’s helpful to focus on the first three to five ingredients. Beware of prepared foods promoting one particular ingredient -- look at the whole package instead.
Talk to your doctor or dietician about more ways to improve your diet.
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