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  • Writer's pictureMaria C Colon-Gonzalez

Let's talk about cholesterol and cardiovascular disease

Updated: May 6

Cholesterol is what forms the outer shell of our cells. It is also essential to make hormones like testosterone and cortisol. Also, it manufactures vitamins in your body, like vitamin D, and aids in the digestion of food. Your body makes cholesterol in the liver. Thus, we really do not need to consume cholesterol in our diets.

Because cholesterol does not dissolve in the blood, proteins must carry it. When cholesterol binds to proteins, that are known as lipoproteins. Lipoproteins are what are measured in the typical cholesterol or lipid panel.

HDL (high-density lipoprotein) - Helps bring cholesterol back to the liver, the home of it. It reduces the build-up of plaques in the arteries, which is the type of cholesterol you want "high,", especially for women as they lose their estrogen.

LDL (low-density lipoprotein) - The most predominant type, builds plaque in the arteries.

When you want to interpret your cholesterol results, doctors look at the following:

  1. LDL total number

  2. Total cholesterol-to-HDL ratio - these numbers provide more information about your coronary heart disease risk.

  • The higher the ratio, the higher the risk for cardiovascular events

  • Ideally, the ratio should be below 5:1.

Other lab tests/blood work tests that can enhance the interpretation of cholesterol levels are

  1. Apo B levels in patients with an intermediate risk for cardiovascular events - since it is a better measurement of atherogenic plaques. You should get this test once a year.

  2. hs-CRP in patients with an intermediate risk for cardiovascular events

  3. Lpa allows your doctor to know your genetic risk of developing heart disease due to cholesterol plaques. You should have this test once in your lifetime.

Intermediate risk for cardiovascular events is defined as a 10%-20% risk of heart attack in the next 10 years. Sometimes, it might be challenging to have your medical insurance pay for the test mentioned above, but these can be as cheap as $6.00

Sometimes, patients ask me how much is impacted by my diet versus genetics?

Both play a role.

Genetic conditions: Familial hypercholesterolemia (FH) can be caused by inherited changes (mutations) in the LDLR, APOB, and PCSK9 genes, which affect how your body regulates and removes cholesterol from your blood. Familial hypercholesterolemia affects 1 in 250 persons.

Lifestyle Behaviors will significantly impact both cholesterol numbers and reduce your risk of cardiovascular diseases. These include how you choose to nourish your food and move your body. But we also know that when stress levels are high, hormones like cortisol and adrenaline increase levels of triglycerides in the blood. Triglycerides, a form of super energy in the body, can increase your LDL cholesterol levels.

Specifically, I tell my patients to limit their sources of animal foods as much as possible (meats, eggs, cow milk, and its products, poultry, and fish). Be aware of baked goods and coconut oil used in these. Physical activity, especially cardio, increases HDL, helping lower the cholesterol.

So, how does a holistic physician help patients lower their cholesterol?

  1. Lifestyle interventions in the areas of food, movement, and smoking cessation.

  2. Morning oats breakfast with added wheat germ, try doing an oat porridge with either cauliflower or lentils; natural plant sterols (nuts and seeds) added to your salads, smoothies, breakfast and snacks. Add garlic to your food, cooked well to avoid abdominal bloating.

  3. Supplements: Red yeast for some patients

Finally, if none of these have helped, your total cholesterol is above 150, and LDL is above 70, a statin can be an option. For people with heart disease or diabetes, statin is worth discussing with your doctor.

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