Ask The Doctor: Elevated Cholesterol

The short answer: Probably, but it depends on your HDL (good cholesterol) and triglyceride (the fat in your bloodstream) readings. Some doctors believe a high HDL (60 or more) cancels out the bad effects of a high LDL. However, researchers know an elevated LDL makes it harder for HDL to do its job. Think of LDL as a dump truck that drops trash on the street (blocking your arteries) and HDL as the street sweeper that cleans it up. If there are more dump trucks than street sweepers, the street will be congested. So I never like a patient’s LDL to be elevated, even when he or she has a high HDL or low triglycerides.

The good news: Simple changes can reduce your bad cholesterol and increase the good. For example, exercising for 30 minutes or more, four to five days a week, can lower LDL. In addition, recent research from the New England Journal of Medicine suggests the Mediterranean diet—low in saturated and trans fat, higher in healthy unsaturated fats, and lower in calories—reduces LDL cholesterol significantly better than other diets. This diet is rich in vegetables, lean fish, and chicken and low in red meat. A really low- or no-fat diet does a good job of lowering LDL at times, but may also unfortunately reduce HDL. Choose foods high in soluble fiber—whole grains, legumes, fruits, vegetables, nuts, and seeds—to reduce your LDL level. I recommend cereals that contain 10 to 15 grams of total fiber with several tablespoons of regular or golden flaxseed powder sprinkled on top. (Golden flax contains nearly twice the fiber as regular flax.) This will give you almost 20 grams of fiber in one bowl. Bonus: A low-fat, high-fiber breakfast provides lasting energy and lowers blood pressure—two big heart-healthy changes.

Eating foods and drinks with added phytosterols (plant stanols and sterols) is another way to drop your LDL. The American Heart Association recommends 2 to 3 grams a day of plant sterols to block the absorption of cholesterol and lower LDL by 5 to 10 percent.

But here’s the most important piece of advice: Heart disease can kill in an instant, so reduce your elevated LDL now because the potential health consequences of waiting simply aren’t worth it.

Mark A. Moyad, MD, MPH, is the author of Dr. Moyad’s No Bogus Science Health Advice (Ann Arbor Media Group, October 2008).

4 Ways to Lower Cholesterol
* Niacin (a minimum of 100 to 200 mg a day) raises HDL and lowers LDL and triglycerides.
* Vitamin C (500 to 1,000 mg per day) can reduce inflammation in the arteries.
* Fish oil (500 to 1,000 mg daily) is another inflammation fighter.
* Red yeast rice extract (600 to 1,200 mg a day) can lower the production of cholesterol in the liver within a few weeks.