Better Health & Living
Lowering Cholesterol: A Dietitian Is As Good As Drugs
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About one in three Americans has unhealthy levels of heart-threatening LDL cholesterol, according to the American Heart Association (AHA). Now, a new University of Michigan Medical Center study shows that getting serious about food and exercise--and finding a little help so that healthy habits "stick"--can lower LDL significantly, in some cases as much as medication.
Researchers tracked 175 people with high cholesterol who received diet and exercise counseling from registered dietitians in 11 states. After eight months and a handful of sessions, 44 percent of the study participants had lowered their LDL to healthy levels. The average drop was 6.4 percent, "but some people did even better," says lead researcher Kathy Rhodes, RD, PhD, manager of nutrition services for the university's cardiovascular center. "About 23 percent of people saw a 20 percent reduction, and 12 percent of the people in the study had a 30 percent reduction in LDL with diet and exercise--the same kind of improvement you'd get with a low dose of a cholesterol-lowering statin drug."
The AHA recommends keeping LDL levels under 160 mg/dl if your risk of heart disease is low, under 130 mg/dl if you have up to two risk factors (such as high blood pressure or being overweight), and under 100 mg/dl if you have heart disease or diabetes. Here's Dr. Rhodes's best, research-tested advice for getting your LDL in line.
My cholesterol's just a little high. Can I use diet and exercise instead of drugs?
Often, yes. Even if you and your doctor later determine that you need a cholesterol-lowering drug, diet and exercise are still really important as a foundation.
The diet we recommended for this study included:
- Lots of fruits and vegetables.
- 10 grams of cholesterol-lowering soluble fiber daily from foods such as oats, barley, beans, apples, pears, and oranges--an amount you can get if you have oatmeal for breakfast, some beans with lunch, lots of vegetables, fruit as a snack, and a grain like barley at dinner.
- More "good" fats such as olive and canola oil and small portions of nuts, as well as less trans fat (found in fried foods and commercial baked goods) and less saturated fat (found in fatty meats and full-fat dairy products like milk, cheese, and ice cream). An example of a good swap is a little peanut butter on whole-wheat bread instead of a bagel with butter or cream cheese.
- Fish twice a week and lean meats like chicken, turkey, and lean red meat at other times.
- 30 to 60 minutes of exercise at least five days a week. People in the study walked, swam, rode a stationary bike, or used a treadmill at home, and some went to classes at a gym or used exercise tapes.
If I already take cholesterol-lowering drugs, why should I bother with healthy eating or exercise?
There are several good reasons! First, a healthy lifestyle can help control cholesterol so you'll need the lowest possible dose of medication. Second, high cholesterol isn't the only factor that raises your risk of a heart attack. If your cholesterol is under control but you have high blood sugar or high blood pressure, are overweight, or eat a diet that provides very few protective antioxidants (found in fruits and vegetables), you're still at risk. This program improves all of those risk factors--and it makes you feel good! People in our study had more energy, their clothes fit better, and they were less bothered by everyday health complaints like heartburn.
Can I do these things on my own, or do I have to see a registered dietitian?
A dietitian can really help you find ways to fit the changes into your life and can help you stay on track while you're developing new habits. We found that people who went to the most appointments tended to get the best results.
The good news is that many health insurance plans now cover nutritional counseling, especially for people with diabetes and those who have heart disease or are at risk for it. To find out if your plan does, call the customer service number on the back of your insurance card. Even if it isn't covered, consider paying for a few visits out of your own pocket. You may need three or four visits, and you can expect to pay $100 to $150 an hour. It sounds like a lot of money, but it could help you lower the cost of taking medicine for your lifetime or even avoid that expense altogether.
How will I know that my healthy eating and exercise habits are paying off?
Ask your doctor for a fasting cholesterol test. Most insurance plans cover cholesterol checks every 6 to 12 months, but when you're making changes, you may want to check every 3 months.
By Susan Flagg Godbey and the Editors of Better Health & Living®
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