Dr. Christina Cherian explains the different types of cholesterol, how they affect your health and foods that may help lower cholesterol.
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What is Cholesterol and How do I Eat to Lower It
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Learn more about Christina Cherian, MD
Christina Cherian, MD
Dr. Christina Cherian is a board-certified family medicine physician that supports the St. Petersburg, Florida area. She completed her undergraduate degree in biomedical sciences from the University of South Florida in Tampa, Florida and then earned her Doctor of Medicine from the University of South Florida’s Morsani College of Medicine. Dr. Cherian is passionate about and educated in disease prevention and reversal through evidence-based nutrition. As a family medicine physician with BayCare Medical Group, she delivers a range of acute, chronic, and preventive medical care services. In addition to diagnosing and treating illness, she provides preventive care, including routine check-ups, health-risk assessments, immunization, screening tests, and personalized counselling on maintaining a healthy lifestyle. She is a member of the American Academy of Family Physicians, the Florida Academy of Family Physicians and the American College of Lifestyle Medicine. Dr. Cherian speaks intermediate Spanish and Malayalam.Learn more about Christina Cherian, MD
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What is Cholesterol and How do I Eat to Lower It
Deborah Howell (Host): Welcome to BayCare Health Chat. I'm Deborah Howell and I invite you to listen as we discuss diet and cholesterol. Today, we'll find out what cholesterol really is and how we can modify our diet to lower it. I'm joined today by Dr. Christina Cherian, a Family Medicine Physician at BayCare. Dr. Cherian, it's a true pleasure to have you with us today. And we're going to jump right in. What are the different types of cholesterol?
Christina Cherian, MD (Guest): So, cholesterol is a wax like substance produced by our liver and it's necessary for various processes in the body, but it doesn't dissolve in blood. So, to be transported in our blood, it's actually packed into two types of carriers. And so, you may be familiar with these LDL and HDL. And the LDL sometimes known as bad cholesterol is necessary in small quantities, because it delivers cholesterol to various parts of the body, but high LDL can dramatically increase your risk of heart disease.
But HDL sometimes called the good cholesterol can help get rid of the LDL bad cholesterol. So, they work like garbage trucks. And then we also have the triglycerides. They're also a type of fat that's found in the blood and they actually store unused calories. So, those are the types of cholesterol.
Host: Thank you. And I like the garbage truck analogy. I can just see them doing their work right now. So, what is the role of cholesterol in the body?
Dr. Cherian: So, like I said, it's actually produced by the liver and it aids in building cell membranes, the walls of our cells and in producing hormones for our body. And our bodies actually produce plenty of cholesterol to meet our needs. And so, we actually don't need to consume any extra cholesterol through our diets. And then the triglycerides, like I mentioned, when you eat your body converts any calories it doesn't need to use right away into triglycerides. So, they get stored for energy to be used later on.
Host: Got it, now the heart of the matter, no pun intended, why do cholesterol levels matter and how are they related to cardiovascular risk?
Dr. Cherian: Well so, our number one killer here in the US is heart disease. And the cause of heart disease is something called atherosclerosis or the thickening of artery walls and the narrowing of these vessels with plaque. That leads to decreased blood flow and, and ruptured plaques, and eventually leading to heart attacks and strokes.
This process actually begins in childhood and fatty streaks, the early sign of heart disease has actually been seen in children as young as eight. So, diets high in various of these unhealthy fats that we'll talk about a bit more, raised cholesterol levels causing this process. And high triglycerides can also contribute to this process of heart disease. And so, as a family physician, we actually check cholesterol levels on a regular basis. And we use a calculator that actually takes into account the cholesterol levels that we just discussed, the LDL, HDL and the blood pressure, age, presence of diabetes and tobacco use. And we calculate a risk of having a heart attack or stroke in the next 10 years.
And so depending on that value, we kind of designate whether a person has a high, low, or moderate risk. And the biggest factor for heart disease, which is our number one killer, is elevated cholesterol.
Host: Wow. Well, thank God not all fats are bad for us. So, what's the difference between the good fats and the bad fats.
Dr. Cherian: So, our good fats, are the unsaturated fats. So, these can be found in olive oil, avocados, most nuts, like walnuts, pistachios, almonds, pecans, seeds, like Sesame seeds, pumpkin seeds, flax seeds, and chia seeds. And, in fish as well, high-fat fish like salmon. Now the bad fats are the saturated fats and trans fats, which you may have heard of. So, saturated fats are found in meat, including chicken and seafood, processed meats, margarine, milk, dairy, including butter, ice cream, milk, and most oils, including coconut oil, which actually has the highest amount of saturated fat. And then also certain snack foods like cookies and cupcakes and things like that.
So, trans fats, now these are very processed fats and they can be found in many foods, including fried foods like donuts, baked goods, including cakes, pie crust, biscuits, frozen pizza, cookies, crackers. And the biggest dietary source of these trans fats is partially hydrogenated oils. So, you can actually see that in the ingredients list and then small amounts of these unhealthy trans fats can also occur naturally in some meat and dairy products, including beef and lamb. So, that's the good fats and bad fats.
Host: Wow. Okay. I have some adjustments to make even chicken. You kind of surprised me with that one. All right, let's talk about some dietary sources of cholesterol and fats. Can you give us some suggestions?
Dr. Cherian: Yes, definitely. So, the dietary sources of cholesterol and fats that we discussed, is mostly found in meat and dairy and eggs as well. So, for instance, cholesterol is found in the fatty part of these animal products. So, butter, egg, meat, whole milk and poultry. All of these have cholesterol and the biggest sources actually of saturated fat in the American diet are chicken and cheese. So, that's where we get most of our saturated fat from. And did you know that one egg actually has more than two times as much cholesterol is a big Mac? 60% of the calories in eggs are actually from fat, much of it, which is the unhealthy fat or saturated fat.
Host: You just broke my heart equal parts because just love eggs so much. And I thought, you know, I was doing the protein thing, which was really good for me in the mornings, but I guess you can do the egg whites instead, right?
Dr. Cherian: That would be better for you. Absolutely. So, in addition to that, you can actually get if you regularly eat more calories than you burn, particularly from refined carbohydrate foods, so that means your white breads, white pastas, refined grains, rather than whole grains; you can have the high triglycerides as well. Remember, those are the ones that store energy for later.
Host: So, I have a question. You said something interesting there. If you eat more than you exercise off. So, what if I kind of just ate some of the bad stuff, but I exercised a whole lot that day, does it cancel each other out or no?
Dr. Cherian: Not quite. So, the triglycerides, that's just one part of the equation. So, the most important thing would be checking your LDL cholesterol or your whole cholesterol panel to see what the big picture is, and then determining your risks from that.
Host: Okay. Now I understand that there are some evidence-based diet recommendations from the American Heart Association to lower cholesterol. Can you tell us about these recommendations?
Dr. Cherian: Absolutely. So, all of our major guidelines actually, promote whole plant foods like fruits, vegetables, whole grains, legumes, and nuts and seeds, for a heart healthy diet. And, many of them actually discourage or eliminate animal products. So, chicken, beef, dairy, and seafood, and the dairy part includes the butter, ice cream and cheese.
So, the gist of it is to maximize the fruits, veggies, whole grains, legumes, and nuts, and seeds and minimize pretty much everything else. And as it turns out, low fat plant-based diets actually reduce LDL levels by about 15 to 30%. So, by removing cholesterol and limiting unhealthy fats, like the trans fats and the saturated fats, we address the cause of high cholesterol and thereby lower that heart disease risk.
Host: Do you know, anyone who eats 100% clean and healthy every single day?
Dr. Cherian: Absolutely not, including me.
Host: So what should we aim for?
Dr. Cherian: Right. So, a good goal to aim for would be to incorporate two to three fruits, two to three veggies in the day, in rough handfuls one to two whole grains and legumes. So, one to two handfuls of legumes, and then making sure we have one handful or two of a variety of nuts and seeds in the diet, including some source of those healthier, there's some healthier nuts and seeds like chia seeds, flax seeds, and walnuts. So, including those in the diet as well. And then you can incorporate seafood or poultry more sparingly once or twice a week or so.
Host: Okay. Are there any additional foods to include that may lower cholesterol?
Dr. Cherian: Absolutely. So, certain foods actually slow the absorption of cholesterol. And can actually reduce the amount of cholesterol that the liver produces. So, those would be oats, beans, barley, soy protein, nuts, like we mentioned, almonds, Brussels sprouts, wheat germ. There are quite a few foods that can do this for us.
Host: Wonderful. Well, Dr. Cherian, this has been very enlightening. I'm going to go clean out my fridge, throw out a bunch of stuff. Thank you for all the good information you've given us today. A great gift.
Dr. Cherian: Absolutely. No problem.
Host: To learn more about diet and cholesterol and all the services at BayCare, please visit our website@baycare.org. And that wraps up this episode of BayCare Health Chat. Always remember to subscribe, rate, and review this podcast and all the other BayCare podcasts so we can share the wealth of information from our experts together. This is Deborah Howell. Thanks for listening and have yourself a terrific day.
What is Cholesterol and How do I Eat to Lower It
Deborah Howell (Host): Welcome to BayCare Health Chat. I'm Deborah Howell and I invite you to listen as we discuss diet and cholesterol. Today, we'll find out what cholesterol really is and how we can modify our diet to lower it. I'm joined today by Dr. Christina Cherian, a Family Medicine Physician at BayCare. Dr. Cherian, it's a true pleasure to have you with us today. And we're going to jump right in. What are the different types of cholesterol?
Christina Cherian, MD (Guest): So, cholesterol is a wax like substance produced by our liver and it's necessary for various processes in the body, but it doesn't dissolve in blood. So, to be transported in our blood, it's actually packed into two types of carriers. And so, you may be familiar with these LDL and HDL. And the LDL sometimes known as bad cholesterol is necessary in small quantities, because it delivers cholesterol to various parts of the body, but high LDL can dramatically increase your risk of heart disease.
But HDL sometimes called the good cholesterol can help get rid of the LDL bad cholesterol. So, they work like garbage trucks. And then we also have the triglycerides. They're also a type of fat that's found in the blood and they actually store unused calories. So, those are the types of cholesterol.
Host: Thank you. And I like the garbage truck analogy. I can just see them doing their work right now. So, what is the role of cholesterol in the body?
Dr. Cherian: So, like I said, it's actually produced by the liver and it aids in building cell membranes, the walls of our cells and in producing hormones for our body. And our bodies actually produce plenty of cholesterol to meet our needs. And so, we actually don't need to consume any extra cholesterol through our diets. And then the triglycerides, like I mentioned, when you eat your body converts any calories it doesn't need to use right away into triglycerides. So, they get stored for energy to be used later on.
Host: Got it, now the heart of the matter, no pun intended, why do cholesterol levels matter and how are they related to cardiovascular risk?
Dr. Cherian: Well so, our number one killer here in the US is heart disease. And the cause of heart disease is something called atherosclerosis or the thickening of artery walls and the narrowing of these vessels with plaque. That leads to decreased blood flow and, and ruptured plaques, and eventually leading to heart attacks and strokes.
This process actually begins in childhood and fatty streaks, the early sign of heart disease has actually been seen in children as young as eight. So, diets high in various of these unhealthy fats that we'll talk about a bit more, raised cholesterol levels causing this process. And high triglycerides can also contribute to this process of heart disease. And so, as a family physician, we actually check cholesterol levels on a regular basis. And we use a calculator that actually takes into account the cholesterol levels that we just discussed, the LDL, HDL and the blood pressure, age, presence of diabetes and tobacco use. And we calculate a risk of having a heart attack or stroke in the next 10 years.
And so depending on that value, we kind of designate whether a person has a high, low, or moderate risk. And the biggest factor for heart disease, which is our number one killer, is elevated cholesterol.
Host: Wow. Well, thank God not all fats are bad for us. So, what's the difference between the good fats and the bad fats.
Dr. Cherian: So, our good fats, are the unsaturated fats. So, these can be found in olive oil, avocados, most nuts, like walnuts, pistachios, almonds, pecans, seeds, like Sesame seeds, pumpkin seeds, flax seeds, and chia seeds. And, in fish as well, high-fat fish like salmon. Now the bad fats are the saturated fats and trans fats, which you may have heard of. So, saturated fats are found in meat, including chicken and seafood, processed meats, margarine, milk, dairy, including butter, ice cream, milk, and most oils, including coconut oil, which actually has the highest amount of saturated fat. And then also certain snack foods like cookies and cupcakes and things like that.
So, trans fats, now these are very processed fats and they can be found in many foods, including fried foods like donuts, baked goods, including cakes, pie crust, biscuits, frozen pizza, cookies, crackers. And the biggest dietary source of these trans fats is partially hydrogenated oils. So, you can actually see that in the ingredients list and then small amounts of these unhealthy trans fats can also occur naturally in some meat and dairy products, including beef and lamb. So, that's the good fats and bad fats.
Host: Wow. Okay. I have some adjustments to make even chicken. You kind of surprised me with that one. All right, let's talk about some dietary sources of cholesterol and fats. Can you give us some suggestions?
Dr. Cherian: Yes, definitely. So, the dietary sources of cholesterol and fats that we discussed, is mostly found in meat and dairy and eggs as well. So, for instance, cholesterol is found in the fatty part of these animal products. So, butter, egg, meat, whole milk and poultry. All of these have cholesterol and the biggest sources actually of saturated fat in the American diet are chicken and cheese. So, that's where we get most of our saturated fat from. And did you know that one egg actually has more than two times as much cholesterol is a big Mac? 60% of the calories in eggs are actually from fat, much of it, which is the unhealthy fat or saturated fat.
Host: You just broke my heart equal parts because just love eggs so much. And I thought, you know, I was doing the protein thing, which was really good for me in the mornings, but I guess you can do the egg whites instead, right?
Dr. Cherian: That would be better for you. Absolutely. So, in addition to that, you can actually get if you regularly eat more calories than you burn, particularly from refined carbohydrate foods, so that means your white breads, white pastas, refined grains, rather than whole grains; you can have the high triglycerides as well. Remember, those are the ones that store energy for later.
Host: So, I have a question. You said something interesting there. If you eat more than you exercise off. So, what if I kind of just ate some of the bad stuff, but I exercised a whole lot that day, does it cancel each other out or no?
Dr. Cherian: Not quite. So, the triglycerides, that's just one part of the equation. So, the most important thing would be checking your LDL cholesterol or your whole cholesterol panel to see what the big picture is, and then determining your risks from that.
Host: Okay. Now I understand that there are some evidence-based diet recommendations from the American Heart Association to lower cholesterol. Can you tell us about these recommendations?
Dr. Cherian: Absolutely. So, all of our major guidelines actually, promote whole plant foods like fruits, vegetables, whole grains, legumes, and nuts and seeds, for a heart healthy diet. And, many of them actually discourage or eliminate animal products. So, chicken, beef, dairy, and seafood, and the dairy part includes the butter, ice cream and cheese.
So, the gist of it is to maximize the fruits, veggies, whole grains, legumes, and nuts, and seeds and minimize pretty much everything else. And as it turns out, low fat plant-based diets actually reduce LDL levels by about 15 to 30%. So, by removing cholesterol and limiting unhealthy fats, like the trans fats and the saturated fats, we address the cause of high cholesterol and thereby lower that heart disease risk.
Host: Do you know, anyone who eats 100% clean and healthy every single day?
Dr. Cherian: Absolutely not, including me.
Host: So what should we aim for?
Dr. Cherian: Right. So, a good goal to aim for would be to incorporate two to three fruits, two to three veggies in the day, in rough handfuls one to two whole grains and legumes. So, one to two handfuls of legumes, and then making sure we have one handful or two of a variety of nuts and seeds in the diet, including some source of those healthier, there's some healthier nuts and seeds like chia seeds, flax seeds, and walnuts. So, including those in the diet as well. And then you can incorporate seafood or poultry more sparingly once or twice a week or so.
Host: Okay. Are there any additional foods to include that may lower cholesterol?
Dr. Cherian: Absolutely. So, certain foods actually slow the absorption of cholesterol. And can actually reduce the amount of cholesterol that the liver produces. So, those would be oats, beans, barley, soy protein, nuts, like we mentioned, almonds, Brussels sprouts, wheat germ. There are quite a few foods that can do this for us.
Host: Wonderful. Well, Dr. Cherian, this has been very enlightening. I'm going to go clean out my fridge, throw out a bunch of stuff. Thank you for all the good information you've given us today. A great gift.
Dr. Cherian: Absolutely. No problem.
Host: To learn more about diet and cholesterol and all the services at BayCare, please visit our website@baycare.org. And that wraps up this episode of BayCare Health Chat. Always remember to subscribe, rate, and review this podcast and all the other BayCare podcasts so we can share the wealth of information from our experts together. This is Deborah Howell. Thanks for listening and have yourself a terrific day.