Month: April 2024

How to Improve Your Good Cholesterol & Lower Risk of Heart Disease

How to Improve Your Good Cholesterol & Lower Risk of Heart Disease

When focusing on the normal levels of LDL (the bad cholesterol) and disregarding the levels of HDL (the good cholesterol), we may falsely believe we are at low risk of heart disease. Low HDL puts you at risk for heart disease even if your LDL is normal. GET YOUR HDL UP. Keep reading to learn how!

Not all physicians walk through the blood tests after getting blood work done, one reason being that they are crunching for time. I don’t particularly like simply stating to my patients that their cholesterol is high and they need to improve their diet and then moving on with the conversation. I like explaining the numbers and discussing HOW they need improvement, including beneficial supplements. 

If you haven’t read my blog post “HOW TO REDUCE YOUR RISK OF HEART DISEASE BY GETTING TO KNOW YOUR CHOLESTEROL LAB TEST,” in which I break down the components of the lipid panel, I suggest reading that first.  

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Why is HDL important?

HDL, or high-density lipoprotein, is often referred to as “good” cholesterol because it helps remove LDL (low-density lipoprotein) cholesterol, the “bad” cholesterol, from the bloodstream. HDL carries cholesterol away from the arteries and back to the liver, where it’s processed and eliminated from the body. Because HDL helps remove excess cholesterol from the bloodstream, reducing plaque buildup in the arteries, higher HDL cholesterol levels are associated with a LOWER risk of heart disease.

What is considered low?

  1. For men: HDL cholesterol levels below 40 milligrams per deciliter (mg/dL) are considered low.
  2. For women: HDL cholesterol levels below 50 mg/dL are considered low.

What is a good HDL level to aim for?

Ideally, you want HDL above 60 – the higher, the better!!!

How do I improve my HDL levels?

1. Healthy Diet: 

Eating a heart-healthy diet can help improve HDL levels. Focus on consuming a high-fiber diet, such as vegetables, fruits, nuts, seeds, and whole grains; eating healthy fats regularly; and limiting saturated and eliminating trans fats, which can raise LDL cholesterol levels.

Examples of foods containing high levels of healthy fats such as omega-3: 

Fatty Fish: Fatty fish are one of the best sources of omega-3 fatty acids. Consume two servings a week of fatty fish. 
Examples include:
   – Salmon
   – Mackerel
   – Sardines
   – Trout
   – Herring
   – Anchovies
   – Tuna (especially albacore or yellowfin tuna)

Walnuts: Walnuts are unique among nuts because they contain a significant amount of ALA omega-3 fatty acids. They make a convenient and tasty snack or can be added to salads, oatmeal, or baked goods.

Flaxseeds: Flaxseeds and flaxseed oil are rich sources of alpha-linolenic acid (ALA), a type of omega-3 fatty acid. Ground flaxseeds can be sprinkled on yogurt, oatmeal, or smoothies, while flaxseed oil can be used in salad dressings or added to dishes after cooking.

Chia Seeds: Chia seeds are another excellent plant-based source of ALA omega-3 fatty acids. They can be added to smoothies, yogurt, or oatmeal or used to make chia seed pudding.

Hemp Seeds: Hemp seeds are rich in omega-3 fatty acids and a good source of protein and fiber. They can be sprinkled on salads, yogurt, or blended into smoothies.

Soybeans and Soy Products: Soybeans and soy products such as tofu and edamame contain ALA omega-3 fatty acids. Incorporating these into your diet can help boost your omega-3 intake, especially if you follow a plant-based diet.

Sea Vegetables: Certain types of sea vegetables, such as seaweed and algae, contain omega-3 fatty acids, particularly EPA and DHA. These are commonly consumed in Asian cuisines and are also available in supplement form for those who don’t consume fish or fish oil.

2. Regular Exercise: 

Regular physical activity, such as aerobic exercise (e.g., brisk walking, jogging, swimming, cycling), can raise HDL cholesterol levels. As recommended by health guidelines, aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.

3. Maintain a Healthy Weight: 

If overweight or obese, decreasing calorie intake and losing excess weight can help improve HDL levels. Even modest weight loss can have a positive impact on HDL cholesterol. Focusing on cutting down on simple carbohydrates and increasing protein will help lose weight while lowering cholesterol. 

4. Quit Smoking:

Smoking lowers HDL cholesterol levels and increases the risk of heart disease. Quitting smoking can lead to an increase in HDL cholesterol over time.

5. Taking Omega-3 supplements 

In addition to incorporating omega-3-rich foods into your diet, you may need to take supplements to improve your HDL. Fish oil supplements, in particular, are a popular choice for boosting omega-3 levels. They typically contain high concentrations of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), two types of omega-3 fatty acids that have been extensively studied for their cardiovascular benefits. Taking fish oil supplements can quickly obtain concentrated doses of EPA and DHA, which may help raise your HDL cholesterol levels and improve overall heart health. 

The major key to improving your cholesterol to lower your risk of heart disease and preventing chronic medical conditions such as high blood pressure, diabetes, impotence, and loss of mental acuity is to improve your nutritional intake. Focus on increasing your intake of vegetables, fruits, nuts, seeds, and whole grains. Avoid fried foods, refined carbohydrates, and trans-fats. By simply cutting down on simple carbohydrates (the big four – potato, bread, pasta, rice) and increasing protein, it can dramatically reduce your cholesterol levels.

I hope you found this blog post helpful. If you did, please share this on your social media and with friends and family!

Check out my other blog posts related to your well-being on my health page. Be sure to subscribe to my YouTube channel and follow me on my social media platforms (IG, TikTok)!

How to Reduce Your Risk of Heart Disease by Getting to Know Your Cholesterol Lab Test

How to Reduce Your Risk of Heart Disease by Getting to Know Your Cholesterol Lab Test

Your doctor will check your lipid panel at least once a year. A lipid panel is a blood test measuring various cholesterol and fats in your bloodstream. It generally includes total cholesterol, triglycerides, HDL, and LDL. It may also measure VLDL and non-HDL cholesterol. While this test is not the best predictive marker, it is what is commonly used to evaluate for risk of cardiovascular disease. Advanced lipid testing with better predictive risk factors include lioprotein subfractions and particle sizes in addition to the lipid markers and inflammatory markers. In this post we will be talking about the commonly used marker that evaluates for risk of cardiovascular disease, the lipid panel.

Not all physicians walk through the blood tests after getting blood work done, one reason being that they are crunching for time. I don’t particularly like simply stating to my patients that their cholesterol is high and they need to improve their diet and then moving on with the conversation. I like explaining the numbers and discussing HOW they need improvement, including beneficial supplements. 

Teaching what the values represent, the levels we need to aim for, and the changes we need to make really clarifies and motivates patients to improve their lifestyles. Repeating their lipid panel in 6-12 months tells us if their changes are making a difference. 

Here is what each value typically indicates: 

1. Total cholesterol: 

This measures the total amount of cholesterol in your blood, including both “good” (HDL) and “bad” (LDL) cholesterol, as well as very-low-density lipoprotein (VLDL) cholesterol. It should generally be less than 200. Since total cholesterol includes “good cholesterol,” I don’t focus on this when discussing the results with my patients; I go into the breakdown. 

2. Triglycerides:

Triglycerides are a type of fat found in your blood. Elevated levels of triglycerides are associated with an increased risk of heart disease, especially when combined with high levels of LDL cholesterol and low levels of HDL cholesterol. Although this is a type of fat in the vessels, high triglyceride correlates with excess calorie intake, a high-carb diet (refined carbohydrates), and lack of exercise. It should be less than 150, but ideally less than 100, and the lower the better.

3. High-density lipoprotein (HDL) cholesterol: 

Physicians often overlook high-density lipoprotein (HDL) levels. HDL is called the “good” cholesterol because it helps remove LDL cholesterol from the arteries. HDL is a protein that transports cholesterol from the cells and blood vessels back to the liver to be broken down or reprocessed. Therefore, we want more HDL to be around to get rid of the excess cholesterol and prevent it from causing damage.

Higher HDL cholesterol level is associated with a lower risk of heart disease. Low HDL levels correlate with low intake of healthy fats like omega-3 in our diet, lack of exercise, and high levels of bad cholesterol. Ideally, you want HDL above 60; the higher, the better. You can read my blog post on improving your good cholesterol and lowering your bad cholesterol

4. Low-density lipoprotein (LDL) cholesterol:

LDL is often referred to as “bad” cholesterol. LDL is the protein that carries cholesterol from the liver (where it is produced) to the blood vessels to transport the cholesterol to cells throughout the body. Cholesterol is an essential component of every cell in our body. However, when there is excess cholesterol production, LDL cholesterol builds up in the walls of your arteries, leading to atherosclerosis and increasing the risk of heart disease and stroke.

A diet consisting largely of cholesterol-rich foods like fried foods, sweet baked goods, and trans-fat-containing foods increases LDL. For low-risk, non-diabetic patients, LDL should be less than 100. For those at high risk, such as those with diabetes, LDL should be less than 70. 

5. Very-low-density lipoprotein (VLDL) cholesterol: 

VLDL is a type of lipoprotein that carries triglycerides in the blood. Elevated VLDL cholesterol levels can also increase the risk of heart disease, but this is not always calculated as part of your lipid (cholesterol) panel.

6. Non-HDL cholesterol: 

This is calculated by subtracting HDL cholesterol from the total cholesterol. It measures all the “bad” cholesterol in your blood, including LDL and VLDL cholesterol. Non-HDL cholesterol is considered a better predictor of cardiovascular risk than LDL cholesterol alone. For low-risk patients, this should be less than 130. For high-risk patients, such as those with diabetes, it should be <100 or even less than 70 based on their comorbidities.

MY DOCTOR SAID MY LIPID PANEL LOOKS GOOD, BUT AFTER READING THIS, I DO NOTICE THAT MY HDL IS LOW, AND I AM AT HIGH RISK OF HEART DISEASE! How do I improve my good cholesterol? Please read my blog post on how to improve your good cholesterol

I hope that this is helpful to you and that you feel empowered to improve your health. If you found this useful, please share it on social media and with friends and family.  

Go to my Health page to check out additional blog posts related to health topics. Be sure to subscribe to my YouTube channel and follow me on my social media platforms (IG, TikTok)!

Delivering Bad News As a Physician

During my hospice rotation in residency, Dr. B, the hospice director, asked me questions that really caught me off guard. The rhetorical questions went like this: “Are you uncomfortable delivering bad news to patients because you are projecting your feelings? Are you uncomfortable with death, and therefore, you have a hard time talking about it?”

During this time, my mom was still battling breast cancer. When Dr. B posed these questions to me, I was taken aback. I looked him straight in the eyes, and as I repeated his questions in my head, I began to feel a sense of confusion. Am I uncomfortable talking about death because I am uncomfortable with the idea of death? Am I afraid of my mom dying because I don’t want to feel the pain of her loss? Am I afraid of dying? Am I projecting my fear onto my mom?

When caring for someone kind and loving, you want to ensure they feel your love and joy in return. You want them to have everything they could ever want. How do you give them everything when you don’t have the most important thing to offer, time? When I posed this question to Dr. B, he reminded me that projecting my own emotions onto my mom was not helpful. Those are your emotions; you may be projecting pain onto her when she just needs your presence of joy and love. Your mother likely has her own fears and anxieties, and projecting your own onto her would only make things worse.

As physicians, we have many responsibilities, including delivering bad news. Instead of learning how to deliver news, we should learn how to manage our own emotions to deliver news more effectively.

Death is a complex topic that affects everyone. It is an inevitable part of life that we all have to face. From the moment we are born, we carry a proverbial ticking bomb inside us that will eventually go off, whether it is in two years or over a hundred. It doesn’t matter what our personal preferences are; death comes for us all and maybe there is beauty in that.