Diet or Medication?
Dear Personal Dietitian,
I just got my blood test results from my yearly exam and my cholesterol has gone way up.
My LDL went up and my HDL has only increased a
little, so my . overall ratio is quite above normal. Now I have about 2 months to see if I can adjust my diet to lower
my levels or I've got to take medication. I really don't want to do that if I
can help it. I'm concerned about not
getting enough protein while I'm trying to adjust my diet, so I have some
specific questions about my current diet.
Currently I eat for breakfast a 7 egg omelet (with only 1 yolk and 6 whites) a day. Can cutting out this yolk make a difference ? My diet is so basic I don't know what else I can do. I eat 1 can of tuna mid-morning and another one in the afternoon with broccoli and cauliflower. (Each can contains 20mg of cholesterol so that is an additional 40mg of cholesterol each day). My other two meals are 6 oz chicken breast with no skin and broccoli and cauliflower and lettuce for supper and lunch. I hope your dietitian doesn't mind me asking about this but I feel very anxious about the results and am not sure who to talk to. I'm only 42 and I weigh 170lbs down from 189lbs, but even after losing weight, my cholesterol ratio is too high. Thanks for any help!
Hi Chris,On our diet plan at say around 2000 Calories, (this depends upon your current weight, height, activity level, sex, etc) you would get around 100 grams of protein, which is more than adequate for your current body weight, even considering that it is a weight loss and cholesterol lowering diet too. Your diet plan would be lower in total protein than what you are eating now for two reasons. One is that you would be on a lower cholesterol plan which requires that animal foods be reduced. This is because each ounce of any meat, even if it is low in fat like poultry or fish, contains about the same amount of cholesterol in its muscle cells as high fat animal meats, roughly about 30 mg of cholesterol per ounce. You can't follow a low cholesterol diet and eat a lot of meat, poultry, etc, even if it is lean. Second, when on a weight loss diet, your calories have to be reduced below your current maintenance calories, so your total fat, protein, and carbohydrate goes down as well. This is a much different situation from the needs of someone who is exercising intensely and trying to gain weight or maintain their weight. Their protein intake is correspondingly higher and coincides with the fact that they are eating more calories per day than someone in your situation. Remember, there are many other foods that contribute protein, not just animal foods and the Personal Diet gives recommendations in relation to your current diet habits. Cutting out the egg yolk will make a difference, but you'll need a better balance of all your foods to get the best results.
Carolyn Classick-Kohn,MS,RD
Heart healthy diet OR medication?
The answer to this question will depend upon a lot of things: your lipid profile (total cholesterol, cholesterol ratios, triglyceride levels), your body weight and physical conditioning, the reason your cholesterol and/or triglyceride levels are high (heriditary, lifestyle factors, etc.) and your response to diet changes. But here's a few things everyone should consider:
1. Optimizing your diet to improve your heart health and body weight is a good move whether you have high cholesterol or not. Even if the diet changes have a minimal effect upon your cholesterol levels, there are other reasons to stay on a solid nutrition plan. Eating right improves other disease risk factors as well and improves overall health. Maintaining a healthy body weight can help prevent the onset of other health problems such as back and joint problems, diabetes, certain cancers, high blood pressure, and improves energy level. A heart healthy diet is appropriate for all of these health issues.
2. Many people think they are following a heart healthy diet when in fact they are not. There are many things involved in developing a diet plan - eating less of some foods and adding certain foods into the diet can make a huge difference in the effectiveness of the diet. Balance of nutrients is important as well. So many people "give up" on diet and go to medications without having ever followed a real heart healthy diet plan.
3. Even if you need to take medications to lower your cholesterol or triglycerides, following a good nutrition plan will make your medication more effective. You may need to take less of the drug if you optimize your diet and your body weight. So, even after adding medications, the diet plan is a very important part of treating high blood lipid levels.
There are some people who don't respond well to dietary treatment, just as there are those who have to change medications before they find the one that works best for them. But eating well has many other health benefits and doesn't have the side effects of medications, so in most cases, diet and medication work very well together to help you achieve your health goals.