Misconceptions about how high cholesterol levels affect people with diabetes can make dining a dilemma. Our experts separate fact from fiction to clear up cholesterol confusion for good...
Nearly 80% of women 18-44 years old can’t name their cholesterol numbers, according to a 2007 survey by the Society of Women’s Health Research.
This information is as important as your husband's cell phone number, especially for women with diabetes, who have an increased risk of heart disease.
That's why it's critical to understand cholesterol in a larger context beyond just numbers, says Isaac Eliaz, M.D., director of the Amitabha Medical Clinic and Healing Center in Sebastopol, Calif.
You need to learn how life choices can impact future well being, he says.
So how do you learn about how high cholesterol levels?
And do the guidelines change if you have diabetes?
Test yourself about cholesterol and how it impacts your body.
Cholesterol myth or not? All cholesterol is bad for you.
“Scary statistics about cholesterol and heart disease cause people to assume that it’s all bad, but that’s not true,” Eliaz says.
Cholesterol is a waxy, fat-like substance produced by the liver and is found in certain foods like eggs, dairy and meat.
“It’s actually crucial to building healthy cells that keep your body and all its systems running smoothly.”
HDL (high-density lipoprotein), or "good," cholesterol has been shown to protect your heart.
"But too high levels of LDL cholesterol and triglycerides can leave fatty deposits in your blood that build up in the arteries, increasing your risk for stroke, heart attack and other forms of cardiovascular disease," says Ping Wang, M.D., professor of medicine and director at the Center for Diabetes Treatment and Research at University of California, Irvine.
“Learning to manage your cholesterol levels through your diet and exercise make a significant impact on health," he says.
Cholesterol myth or not? Blood glucose levels impact cholesterol levels.
People with diabetes have good reason to worry.
"High glucose levels, which most people with diabetes have, can cause the body to produce more triglycerides,” says Om Ganda, M.D., head of the Lipid Clinic at the Joslin Diabetes Center in Boston.
“Glucose attaches to LDL cholesterol in the blood, making them sticky – which means they last longer and are more likely to build up inside your arterial wall,” he explains.
That means the higher your glucose levels, the stickier your blood and the greater your risk for cardiovascular disease.
Cholesterol myth or not? All diabetics have high cholesterol levels.
“Having diabetes can make you prone to elevated levels of cholesterol, but it’s certainly not a given,” Wang says.
“Many people with diabetes have the same cholesterol levels as the general population, and managing your diabetes well – with help from your doctor – can keep your levels in check,” he says.
Cholesterol myth or not? Diabetics have the same target numbers as people without the disease.
Your cholesterol levels may be the same as those for healthy people, but those numbers don’t mean the same thing if you have diabetes.
“Because [diabetics’] risk for heart disease is so high, levels that may not be unhealthy for the general population can be problematic for [them],” Ganda says. “As a result, your target numbers have to be even more conservative if you have diabetes.”
The average person should aim for LDL levels below 130 mg/dl and HDL levels above 60 mg/dl. But people with diabetes need to keep LDL levels under 100 mg/dl – and possibly under 70 mg/dl if they have other risk factors such as a family history of heart disease – and HDL levels over 40 mg/dl.
“It may be difficult to meet these strict standards with diet and exercise alone, so [ask] your doctor if you’re a good candidate for statins, lipid-lowering drugs that can help you keep cholesterol under control," he says.
Cholesterol myth or not? High levels of LDL cholesterol are a predictor of diabetes.
Despite the scary talk about LDL cholesterol, triglycerides actually are the best predictor for diabetes.
“High levels of triglycerides indicate you may be developing insulin resistance, a predictor of diabetes, and people who are overweight and obese are most likely to have these high numbers” Ganda says.
“Fortunately, moderate exercise, such as taking a brisk walk, can activate enzymes that break down triglycerides and regenerate good cholesterol, bringing you back to healthy levels,” he says.
Cholesterol myth or not? Cholesterol-lowering medications are bad for you.
“Recent studies indicate that high doses of cholesterol drugs may increase your risk for diabetes,” Wang says. “That said, using the medication can drastically reduce your risk for heart disease, so for most people the benefit is worth the potential risk.”
Work with your prescribing doctor to develop a treatment plan that that works best for you to minimize any potential downsides, he advises.
Cholesterol myth or not? Eating oatmeal can lower your cholesterol.
Your morning bowl of oats really can help bring your cholesterol down to healthy levels.
“Complex carbs like oatmeal contain high amounts of soluble fiber, which can reduce the absorption of cholesterol into your bloodstream and lower levels of LDL cholesterol,” Ganda says.
Not a fan of the hot cereal? Legumes, citrus fruits and whole grains are also rich in these healthy fibers, he says.
Cholesterol myth or not? You can’t eat red meat if you have high cholesterol levels.
Relax, you don’t have to swear off burgers and steaks.
“Red meat is often packed with saturated fats, which are known to raise cholesterol levels, but you can opt for leaner cuts of meat to curb your fat intake,” Ganda says.
A 3.5-ounce serving of lean cut beef should contain less than 10 grams of fat and 4.5 grams of saturated fat, according to the U.S. Department of Agriculture.
The leanest cuts: sirloin, loin and round.
“Choose meats with the least amount of visible fat [or marbling], and cut off any extra fat,” Ganda says.
But watch your portions. Regardless of the type of meat, you should eat no more than 6 ounces (about the size of two decks of cards) per day.
Cholesterol myth or not? You can’t have high cholesterol levels if you’re not overweight.
Sorry, being thin doesn’t give you a free pass.
“While exercise, diet and weight can have a significant impact on cholesterol levels, heredity plays a role as well,” Eliaz says. “If high cholesterol runs in your family, you may still be at risk – regardless of your weight. So share your health history with your doc and get cholesterol levels checked to make sure you’re in the clear.”
Cholesterol myth or not? Eggs are off limits if you have high cholesterol levels.
Not anymore. Eggs are high in cholesterol, but doctors no longer tell people with high cholesterol levels to give them up.
“When consumed as part of a balanced diet rich in greens and fiber, eggs will not increase your cholesterol,” Eliaz says.
“Stick to no more than five a week or use egg whites only, which contain zero cholesterol,” he says.
Cholesterol myth or not? If food is labeled cholesterol-free, it’s heart-healthy.
Not so fast.
Added sugars found in processed foods are associated with lower levels of HDL cholesterol and higher levels of triglycerides, increasing your risk for heart disease, according to research published in the Journal of the American Medical Association in 2010.
“Just because something is free of cholesterol doesn’t mean it’s good for you,” Ganda says. “Added sugars can spike insulin levels and high levels of saturated fat can also raise cholesterol and triglyceride levels – all of which are bad, especially if you have diabetes."
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