Four Key Practices to Improve Your Cholesterol

Cholesterol is essential to your health. It is used to make hormones and is a structural component of every cell in your body. We need cholesterol but imbalance of cholesterol can put us at risk for cardiovascular disease.
Balancing cholesterol is not a simple task. Often we must combine medications, supplements and ALWAYS lifestyle practices – what we call the Four Pillars of Health.

The First Pillar: Movement

Intentional movement or exercise is an essential cardiovascular disease prevention strategy. Besides lowering the high risk types of lipoproteins and triglycerides and increasing your protective HDL cholesterol, movement also improves arterial wall stiffness, and insulin sensitivity which reduces blood pressure. All of these help to lower risk of heart attack and stroke.

Even if you are currently sedentary (meaning sitting for at least 6 hours per day with no form of formal movement), it is not too late to start moving your body. And, it does not matter what type of activity you do – just pick something that causes your heart to pump and your pores to sweat. You can do hula hoop, Zumba, fast walking, dancing, etc. Start moving at least 3 times per week for at least 15 minutes with an initial goal of 30 minutes 3 times per week and then 5 times per week working on getting your heart rate to about 50-75% of your maximum. An easy way to figure out you age-related maximum heart rate is to take 220 minus your age. So, for a 50-year-old that would be 170 beats per minute (bpm). So, for a sedentary 50-year-old, the initial heart rate goal would be 50-75% of that maximum or 85-127 bpm.

For those who have been exercising regularly, the goal is at least 30 minutes 5 times per week of exercise at 70-80% of heart rate. Most forms of aerobic exercise combined with strength training are excellent for cardiovascular health. High Intensity Interval Training or HIIT (a 20-minute workout is sufficient due to the intensity) combined with resistance training (weight lifting or bands or body weight) will have the greatest impact on your cardiovascular health.

The Second Pillar: Diet

While there is no one agreed upon diet to reduce cholesterol and improve cardiovascular health, the general consensus is that The Mediterranean Diet is one of the most beneficial diets for improved cardiovascular outcomes and health outcomes in general. There are many different forms of this diet but, in general, this diet focuses on increasing your intake of a variety of vegetables, leans proteins such as chicken, fish and vegetarian proteins, olive oil, nuts and avocados. The Mediterranean diet reduces beef, pork, and processed carbohydrates and consuming whole grains in moderation and fruit for desserts instead of baked or prepared desserts. If you are following this diet and have not seen a drop in your cholesterol, be patient, this lifestyle change can take up to 12 months to be reflected in your lab tests.

Regardless of which diet you follow, make sure to include soluble fiber daily. Consuming at least 5-10 grams of soluble fiber per day can lower your LDL. Start low and go slow with fiber because it can rev up your digestive system. I suggest starting with 1-2 tablespoons of ground organic flax per day in your smoothie, in yogurt, in water or on top of your vegetables and working up to 4-5 tablespoons per day. Flax should be kept cold at all times in the refrigerator or freezer. Other forms of soluble fiber include oat bran, beans (especially lentils), tofu, avocado, green vegetables like broccoli and Brussels sprouts, chia seeds, apples, blueberries, sweet potato and many others.

The Third Pillar: Stress Management

We have a delicate balance in our bodies between the sympathetic (fight-or-flight) and parasympathetic (rest and relax) nervous systems. Under stress our bodies increase the tone of the sympathetic nervous system which will create an increase in cortisol (stress hormone) levels. During stressful times, cortisol triggers increase in LDL cholesterol and lowers HDL cholesterol. In addition to negative changes in cholesterol balance, stress hormones also increase glucose production and blood pressure. All of these changes are risk factors for heart disease.

There are multiple ways to increase the parasympathetic tone of the body and just 15-20 minutes of practice a few times a week can make a great impact on your overall health. There are many forms of stress management. If you are interested in exploring meditation, check out the Insight Timer App. There are forms of movement like yoga, tai chi and chi gong which also can help lower our stress response. Most forms of exercise as well can be a stress busters. And there are loads of other techniques like biofeedback, massage, acupuncture and more. Being with friends and family members who are supportive, singing, dancing and laughter will also lower stress.

The Fourth Pillar: Sleep

Lack of sleep can have a profound effect on our overall health including raising cholesterol and cortisol levels. Less than 6 hours of sleep per night increases LDL and lowers HDL in men especially. Sleep apnea is an independent risk factor for high LDL and triglycerides as well as low HDL cholesterol. Managing sleep apnea with weight loss and CPAP usage can decrease cholesterol. If you are sleeping less than 6-8 hours per night or more than 9 hours per night, prioritize your sleep management. If you are not sleeping well, start with sleep hygiene: avoid screens at least 30 minutes before sleep, use the bed only for intimacy and sleep, make sure the bed is comfortable and that the room is dark, quiet and not too warm. Also, consider working with a trained sleep counselor like a Cognitive Behavioral Therapy for Insomnia (CBT-i) specialist.

Remember, for many of us, having elevated cholesterol is genetic. Working on your lifestyle and using the appropriate medications and supplements will improve your cardiovascular outcomes but you may still need additional medication and/or herbal therapies.

Personalizing your lifestyle program to help balance cholesterol is a priority at Robinson MD. We perform extensive cholesterol lab testing in our office so we can analyze your personal lipid profile and make a personalized plan for you.

Sources:

National Library of Medicine – Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study
National Library of Medicine – Metabolic and anti-inflammatory effects of a home-based programme of aerobic physical exercise
National Library of Medicine – Differential Effects of Aerobic Exercise, Resistance Training and Combined Exercise Modalities on Cholesterol and the Lipid Profile: Review, Synthesis and Recommendations
JACC Journals – The Effect of Mediterranean Diet on Metabolic Syndrome and its Components: A Meta-Analysis of 50 Studies and 534,906 Individuals
National Library of Medicine – What are the effects of psychological stress and physical work on blood lipid profiles?
MDPI – Effect of Continuous Positive Airway Pressure on Lipid Profiles in Obstructive Sleep Apnea: A Meta-Analysis

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Four Key Practices to Improve Your Cholesterol

The First Pillar: Movement

The Second Pillar: Diet

The Third Pillar: Stress Management

The Fourth Pillar: Sleep

Sources:

10 Rules for Reading Food Labels

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