A Cardiologist’s Guide to Eating for Healthy Cholesterol

In the United States, the battle against high cholesterol is a formidable one. With nearly 94 million Americans aged 20 and older grappling with cholesterol levels exceeding the recommended range of 200 milligrams per deciliter (mg/dL), and 28 million crossing the threshold of 240 mg/dL, the importance of addressing this issue cannot be overstated. High cholesterol increases the risk of cardiovascular disease, making it a pressing public health concern. While genetics and hormonal factors contribute to cholesterol levels, dietary choices are often the primary influence.

Dr. Norman E. Lepor, a distinguished cardiologist at the Cedars-Sinai Heart Institute and a professor at the David Geffen School of Medicine at the University of California, Los Angeles, believes in the power of lifestyle modification, particularly dietary changes, as a pivotal step in managing cholesterol and reducing the risk of heart disease.

The Mediterranean Diet: A Heart-Healthy Choice

For many patients, Dr. Lepor recommends a dietary approach that is both straightforward and backed by scientific research—the Mediterranean-style diet. He emphasizes the allure of this diet, which is rich in fruits, vegetables, whole grains, nuts, legumes, and heart-healthy fats such as olive oil. Fish and seafood make regular appearances, while other protein sources like eggs, poultry, and dairy are enjoyed in moderation. Red meat, notorious for its association with increased cardiovascular disease risk, is limited. The American Heart Association supports this perspective, stating that consistent consumption of red meat elevates cardiovascular disease risk by an average of 22 percent.

Dr. Lepor encourages the incorporation of monounsaturated fats (found in avocados, olive oil, and seeds) and polyunsaturated fats (abundant in walnuts, flaxseeds, and fatty fish) into the diet. He suggests opting for oils like canola or high-quality olive oil rather than tropical oils. Nuts, especially, are favored for their heart-boosting properties. Berries like blueberries and blackberries, celebrated for their rich antioxidant content, are also recommended. These dietary changes, coupled with regular exercise, are key components of Dr. Lepor’s prescription for healthier cholesterol levels and overall well-being.

The Pitfalls of the Keto Diet

Dr. Lepor raises a red flag when it comes to the popular ketogenic (keto) diet. While some individuals experience rapid weight loss on the keto diet due to appetite-suppressing effects, it is not his preferred choice for coronary vascular health. The keto diet’s reliance on saturated fats can raise cardiovascular disease risk. Dr. Lepor emphasizes that the source of protein intake while on the keto diet plays a crucial role. A healthier source of protein can mitigate some of the concerns associated with this diet.

The American Diet: A Recipe for Health Risks

Beyond the keto diet, Dr. Lepor acknowledges that the typical American diet is often laden with saturated fats, trans fats, added sugars, sodium, and excessive calories. These dietary habits contribute not only to cardiovascular disease but also to the prevalence of type 2 diabetes, obesity, and certain cancers. The 2020-2025 Dietary Guidelines for Americans, published by the US Department of Agriculture in collaboration with the US Department of Health & Human Services, affirm the association between these dietary patterns and adverse health outcomes.

Dr. Lepor underscores the high intake of saturated fats, meat, pork, and starchy foods as primary concerns. A holistic approach to dietary improvement is imperative, and Dr. Lepor’s recommendations extend beyond just losing weight.

Weight Loss and Cholesterol

While weight loss can be an essential aspect of improving cardiovascular health, it is not the sole solution for reducing cholesterol levels. Dr. Lepor highlights that weight loss alone may not lead to significant reductions in cholesterol. It is not merely about shedding pounds but about the quality of the weight loss achieved. Dr. Lepor emphasizes that the relationship between weight loss and cholesterol reduction is not linear. Even individuals with slender physiques can face a substantial risk of developing coronary vascular disease.

A Focus on Quality Fats and Proteins

For individuals looking to manage their cholesterol effectively, Dr. Lepor advocates for dietary choices that prioritize healthier sources of fats and proteins. While weight loss may occur as a byproduct of these dietary changes, the emphasis is on achieving and maintaining overall heart health. Dr. Lepor advises incorporating monounsaturated and polyunsaturated fats, along with lean proteins from sources such as chicken, seafood, and plant-based options like legumes.

In conclusion, Dr. Norman E. Lepor’s insights offer a compelling perspective on the relationship between diet and cholesterol management. The Mediterranean diet emerges as a clear winner, supported by scientific evidence and endorsed by experts in the field. Avoiding diets high in saturated fats, such as the keto diet, and addressing the prevailing dietary patterns in the United States are essential steps toward a heart-healthy future. Dr. Lepor’s holistic approach underlines the significance of making sustainable dietary choices that promote cardiovascular well-being, regardless of body weight.

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