One of the most important things you can do is manage risk factors that can lead to heart disease. There are some risk factors that you can’t control include a family history of early heart disease and your age. A high cholesterol level can contribute to plaques in the arterys that can lead to heart disease.
But there are some that you can control. Diet, exercise and not smoking are a few that can make a big difference.
Ryan Whitney, MD, is here to discuss some of the actions you can take to try to avoid medications, on the way to a healthier you.
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Helpful Ways to Manage Your Cholesterol
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Learn more about Dr. Ryan Whitney
Ryan Whitney, MD
Dr. Ryan Whitney is a cardiologist.Learn more about Dr. Ryan Whitney
Transcription:
Melanie (Host): High cholesterol increases your risk of heart disease and heart attacks. If your cholesterol is creeping upward, you can improve it with medications. However, there are lifestyle changes that you can make to avoid going on medications that might have side effects. My guest today is Dr. Ryan Whitney. He’s a Cardiologist with Bryan Heart. Welcome to the show, Dr. Whitney. So let’s talk about cholesterol. What role does cholesterol play in our body?
Dr. Ryan Whitney (Guest): Cholesterol is an important part of normal bodily function. All of our cell walls are actually made up of cholesterol and other types of what we call “lipids”. Cholesterol is a necessary component to just being alive and having our bodies do what they are supposed to do. On the other hand, it can also play a big role in the development of plaque and clogging up arteries if we build up too much cholesterol.
Melanie: People hear good cholesterol, bad cholesterol tell us the difference.
Dr. Whitney: Good cholesterol/bad cholesterol. The easiest way that I like to explain that to folks is think of your good cholesterol as the garbage men. The good cholesterol is your HDL. Your LDL is your bad cholesterol and think of that as the garbage. The LDL builds up along the side of the street and the garbage men, the HDL, they come by pick it up and bring it back to the liver to be processed. The easiest way to remember what’s good and what’s bad is the LDL is your lousy cholesterol and you want that to be low. Your HDL is your happy cholesterol and you want that to be high.
Melanie: What a great explanation that was. We hear so much about statins and side effects and people seem very hesitant to want to go on certain medications when they hear that their cholesterol is rising. What do you recommend to people as a first line of defense if you start to notice that their cholesterol is creeping up a bit?
Dr. Whitney: The first thing that we all need to do is all the stuff that none of us really seem to want to do which is to eat right and exercise. People really underestimate how much mileage they can get out of just making some minor lifestyle changes. When we say exercise, we’re not talking about going out and running a marathon. Just going and doing 30 minutes of aerobic exercise five times a week is all you really need. A good brisk walk will count just fine and some basic dietary changes also can help. Looking at what you’re eating and cutting back on the simple carbohydrates and moving towards some of the more complex carbohydrates; cutting back on the saturated fats and trading those fats for mono and poly unsaturated fats. In other words, cutting out the animal fats and trying to switch over more toward the fats that you get with nuts and legumes and other things.
Melanie: People hear some foods actually can reduce your cholesterol level. Do you talk to people about these? What about supplements like fish oil and things?
Dr. Whitney: There are foods that can lower your cholesterol. We’ve all heard about oatmeal and essentially anything that is more of a fiber type food will help lower your cholesterol.The way that will work is by binding some of the cholesterol that’s in the gut and just moving it on through so it doesn’t get absorbed into the body as well as some of the cholesterol that naturally gets circulated into the gut as part of digestion.They combine that and help move it out. Anything that’s got a lot of fiber in it can help lower your cholesterol a bit. Oatmeal seems to be the classic one. Cheerios have their little heart shaped bowl on the box a while back but you really have to eat about 5 bowls of Cheerios a day to make that worthwhile. The fiber is one thing. In terms of supplements, there are a handful of supplements out there. Fish oil – the jury is a little bit on the fence in terms of fish oil and whether or not it actually convincingly reduces risk of heart disease and stroke. What it can do is help lower your triglycerides and we use that quite often. We use fish oil quite often in people who have high triglycerides. Other things that are out there that can and have been shown to reduce cholesterol are things called “plant phytosterols”. These are supplements that you can pick up and they have actually made it into the cholesterol treatment recommendations to help lower your cholesterol.
Melanie: What’s the relationship, Dr. Whitney, between blood sugar levels and cholesterol? People hear they should know their numbers. Is there are relationship there?
Dr. Whitney: Yes, there actually is. Primarily, blood sugar is going to go after the triglycerides. As your blood sugars get a little more out of control, your triglycerides--which are the fats that float around in your blood--those will start to go up. Sometimes, we’ll see that especially in diabetics where if they don’t tighten up their blood sugar control, their triglycerides continue to creep up. We also see people who are overweight and inactive have higher triglycerides. Those folks we worry about quite a bit because that usually means they are creeping into what’s called “insulin resistance” otherwise called “pre-diabetes”. If your triglycerides are high, you’re overweight and you’re inactive, that means that you’re traveling on the road to developing diabetes and it’s really important to make some lifestyle changes to head that off.
Melanie: What about sleep? We’re hearing more and more in the media about the importance of a good night’s sleep. How does that relate to our cholesterol numbers?
Dr. Whitney: Sleep doesn’t necessarily directly affect your cholesterol but sleep will affect a lot of other things. People who have poor sleep tend to have higher blood pressures, they may be less active, and they’re more tired during the day. So, indirectly, it’s going to affect your numbers that way. Good sleep hygiene or getting enough rest and enough quality rest at night is very important. If you are having trouble sleeping, you may need to talk to your doctor about that because you may have something called “sleep apnea” which is a serious condition that definitely needs to be treated.
Melanie: Dr. Whitney, what do you tell your patients--and I’m sure you get this question all the time – about statins and the medications out there? You’ve given us such great information on lifestyle modifications people can do to keep their cholesterol in check but if they do have to go on a medication, what do you tell them about these medications?
Dr. Whitney: That’s a great questions and generally the statins are very safe. They are some of the most widely prescribed drugs on the planet and they have not been shown to cause cancer or cause other big time problems like that. A lot of patients do get very worried about the side effects. The most common side effects are muscle aches and those will go away with discontinuing the drug or sometimes even switching from one statin to a different one. In my clinic, sometimes we have to hop through several different statins before we find one that the patient can take. The vast majority of patients will take a statin and have absolutely no problems with it. One of the things I get asked a lot in clinic is my patients will say, “What about all the side effects?” and they’ll read about side effects on the internet. I’ll say, “What do you mean about the side effects? Such as they have been shown to make you live longer? They’ve shown to reduce heart attacks and reduce strokes. Those don’t sound like bad side effects to me.” There are some populations that really need to be on a statin. For instance, if you have coronary disease, if you have diabetes, if you have blockages in the arteries going up to your brain. There are other conditions where those folks really need to be on a statin. If you don’t need to be on a statin, then at that point, it’s really up to you to take care of yourself, to exercise, to eat right, to lose weight, to help control your cholesterol so you don’t need therapy in the future.
Melanie: I was going to ask you for your best advice but you just pretty much gave it. Just tell the listeners what you really want them to know about cholesterol and managing their numbers.
Dr. Whitney: Cholesterol is silent. You will never know what your cholesterol is if you don’t look until you come in having a heart attack or a stroke. That’s the wrong time to find out what it is. It’s a simple blood test. Most workplaces now will have health screenings. If not, just make sure you get in to see your physician and get a blood check at least once a year, depending on your age or every couple of years if you’re younger, and know what your cholesterol numbers are. Finding out what your cholesterol is in the emergency room is not the right time.
Melanie: Thank you so much, Dr. Whitney. What great information. If you’re concerned about your cholesterol levels schedule an appointment with the Bryan Heart, Lipid and Prevention Clinic by calling 402-483-3333. That’s 402-483-3333. You’re listening to Bryan Health Radio. For more information you can go to bryanheart.com. That’s bryanheart.com. This is Melanie Cole. Thanks so much for listening.
Melanie (Host): High cholesterol increases your risk of heart disease and heart attacks. If your cholesterol is creeping upward, you can improve it with medications. However, there are lifestyle changes that you can make to avoid going on medications that might have side effects. My guest today is Dr. Ryan Whitney. He’s a Cardiologist with Bryan Heart. Welcome to the show, Dr. Whitney. So let’s talk about cholesterol. What role does cholesterol play in our body?
Dr. Ryan Whitney (Guest): Cholesterol is an important part of normal bodily function. All of our cell walls are actually made up of cholesterol and other types of what we call “lipids”. Cholesterol is a necessary component to just being alive and having our bodies do what they are supposed to do. On the other hand, it can also play a big role in the development of plaque and clogging up arteries if we build up too much cholesterol.
Melanie: People hear good cholesterol, bad cholesterol tell us the difference.
Dr. Whitney: Good cholesterol/bad cholesterol. The easiest way that I like to explain that to folks is think of your good cholesterol as the garbage men. The good cholesterol is your HDL. Your LDL is your bad cholesterol and think of that as the garbage. The LDL builds up along the side of the street and the garbage men, the HDL, they come by pick it up and bring it back to the liver to be processed. The easiest way to remember what’s good and what’s bad is the LDL is your lousy cholesterol and you want that to be low. Your HDL is your happy cholesterol and you want that to be high.
Melanie: What a great explanation that was. We hear so much about statins and side effects and people seem very hesitant to want to go on certain medications when they hear that their cholesterol is rising. What do you recommend to people as a first line of defense if you start to notice that their cholesterol is creeping up a bit?
Dr. Whitney: The first thing that we all need to do is all the stuff that none of us really seem to want to do which is to eat right and exercise. People really underestimate how much mileage they can get out of just making some minor lifestyle changes. When we say exercise, we’re not talking about going out and running a marathon. Just going and doing 30 minutes of aerobic exercise five times a week is all you really need. A good brisk walk will count just fine and some basic dietary changes also can help. Looking at what you’re eating and cutting back on the simple carbohydrates and moving towards some of the more complex carbohydrates; cutting back on the saturated fats and trading those fats for mono and poly unsaturated fats. In other words, cutting out the animal fats and trying to switch over more toward the fats that you get with nuts and legumes and other things.
Melanie: People hear some foods actually can reduce your cholesterol level. Do you talk to people about these? What about supplements like fish oil and things?
Dr. Whitney: There are foods that can lower your cholesterol. We’ve all heard about oatmeal and essentially anything that is more of a fiber type food will help lower your cholesterol.The way that will work is by binding some of the cholesterol that’s in the gut and just moving it on through so it doesn’t get absorbed into the body as well as some of the cholesterol that naturally gets circulated into the gut as part of digestion.They combine that and help move it out. Anything that’s got a lot of fiber in it can help lower your cholesterol a bit. Oatmeal seems to be the classic one. Cheerios have their little heart shaped bowl on the box a while back but you really have to eat about 5 bowls of Cheerios a day to make that worthwhile. The fiber is one thing. In terms of supplements, there are a handful of supplements out there. Fish oil – the jury is a little bit on the fence in terms of fish oil and whether or not it actually convincingly reduces risk of heart disease and stroke. What it can do is help lower your triglycerides and we use that quite often. We use fish oil quite often in people who have high triglycerides. Other things that are out there that can and have been shown to reduce cholesterol are things called “plant phytosterols”. These are supplements that you can pick up and they have actually made it into the cholesterol treatment recommendations to help lower your cholesterol.
Melanie: What’s the relationship, Dr. Whitney, between blood sugar levels and cholesterol? People hear they should know their numbers. Is there are relationship there?
Dr. Whitney: Yes, there actually is. Primarily, blood sugar is going to go after the triglycerides. As your blood sugars get a little more out of control, your triglycerides--which are the fats that float around in your blood--those will start to go up. Sometimes, we’ll see that especially in diabetics where if they don’t tighten up their blood sugar control, their triglycerides continue to creep up. We also see people who are overweight and inactive have higher triglycerides. Those folks we worry about quite a bit because that usually means they are creeping into what’s called “insulin resistance” otherwise called “pre-diabetes”. If your triglycerides are high, you’re overweight and you’re inactive, that means that you’re traveling on the road to developing diabetes and it’s really important to make some lifestyle changes to head that off.
Melanie: What about sleep? We’re hearing more and more in the media about the importance of a good night’s sleep. How does that relate to our cholesterol numbers?
Dr. Whitney: Sleep doesn’t necessarily directly affect your cholesterol but sleep will affect a lot of other things. People who have poor sleep tend to have higher blood pressures, they may be less active, and they’re more tired during the day. So, indirectly, it’s going to affect your numbers that way. Good sleep hygiene or getting enough rest and enough quality rest at night is very important. If you are having trouble sleeping, you may need to talk to your doctor about that because you may have something called “sleep apnea” which is a serious condition that definitely needs to be treated.
Melanie: Dr. Whitney, what do you tell your patients--and I’m sure you get this question all the time – about statins and the medications out there? You’ve given us such great information on lifestyle modifications people can do to keep their cholesterol in check but if they do have to go on a medication, what do you tell them about these medications?
Dr. Whitney: That’s a great questions and generally the statins are very safe. They are some of the most widely prescribed drugs on the planet and they have not been shown to cause cancer or cause other big time problems like that. A lot of patients do get very worried about the side effects. The most common side effects are muscle aches and those will go away with discontinuing the drug or sometimes even switching from one statin to a different one. In my clinic, sometimes we have to hop through several different statins before we find one that the patient can take. The vast majority of patients will take a statin and have absolutely no problems with it. One of the things I get asked a lot in clinic is my patients will say, “What about all the side effects?” and they’ll read about side effects on the internet. I’ll say, “What do you mean about the side effects? Such as they have been shown to make you live longer? They’ve shown to reduce heart attacks and reduce strokes. Those don’t sound like bad side effects to me.” There are some populations that really need to be on a statin. For instance, if you have coronary disease, if you have diabetes, if you have blockages in the arteries going up to your brain. There are other conditions where those folks really need to be on a statin. If you don’t need to be on a statin, then at that point, it’s really up to you to take care of yourself, to exercise, to eat right, to lose weight, to help control your cholesterol so you don’t need therapy in the future.
Melanie: I was going to ask you for your best advice but you just pretty much gave it. Just tell the listeners what you really want them to know about cholesterol and managing their numbers.
Dr. Whitney: Cholesterol is silent. You will never know what your cholesterol is if you don’t look until you come in having a heart attack or a stroke. That’s the wrong time to find out what it is. It’s a simple blood test. Most workplaces now will have health screenings. If not, just make sure you get in to see your physician and get a blood check at least once a year, depending on your age or every couple of years if you’re younger, and know what your cholesterol numbers are. Finding out what your cholesterol is in the emergency room is not the right time.
Melanie: Thank you so much, Dr. Whitney. What great information. If you’re concerned about your cholesterol levels schedule an appointment with the Bryan Heart, Lipid and Prevention Clinic by calling 402-483-3333. That’s 402-483-3333. You’re listening to Bryan Health Radio. For more information you can go to bryanheart.com. That’s bryanheart.com. This is Melanie Cole. Thanks so much for listening.