The Cheap Girl’s Guide to Lowering Cholesterol Without Suffering

By Marla Walters on 30 December 2011 (Updated 2 January 2012) 16 comments
Photo: Roy Luck

Two months ago, I had a nasty little note in my mailbox at work. It was not a good way to start a Monday.

A laboratory near my hospital department needed volunteers to have their blood drawn so that their new employees could practice. I have easy-to-find veins, and their manager asked me to help, so I signed up. In return, I was told that I would receive a free printout of my cholesterol levels. So I submitted to a lab tech, let her practice on me, and promptly forgot all about it. When I arrived at work a couple of days later, I noticed a note in my mail basket, and opened it to find the cholesterol test results. Shocker! For the first time in my life, some of my cholesterol levels were “borderline.” (See also: 25 Healthy Changes You Can Make Today)

I am sure that those of you who read my posts about hot dogs or sauces are now thinking, “Well, duh, stupid!” Whoops, almost forgot about those corn flake cookies (which are truly exceptional). Anyway, I’m just shamelessly plugging my posts, and I digress.

I spent a little time bothering my co-workers with my results (oddly, they didn’t seem shocked or surprised). I also whined to my husband, who suggested I check to see what Paula Deen recommended. He’s a laugh a minute.

Finally, I sat down with our friend, the Internet, and did some reading. Sure enough, my diet needed some work. Yes, readers, I admit it — I have been in total denial. In retrospect, I think I was just wondering how long I could get away with my life of dietary debauchery.

The answer — 49 years. There you go.

I was not interested in using drugs to lower my cholesterol, nor was there an indication from my physician to do so. As you know from my previous posts, I always prefer the do-it-yourself approach.

What You Should Know About Cholesterol

If you are age 20 or older, you should get checked at least once every five years. This is especially true if you are overweight, have a family history of heart problems, are not physically active, are diabetic, or eat a high-fat diet.

Finding the lab results page a little confusing, I did some research about what the terms mean. From the Mayo Clinic:

Total cholesterol. This is a sum of your blood's cholesterol content.

High-density lipoprotein (HDL) cholesterol. This is sometimes called the "good" cholesterol because it helps carry away LDL cholesterol, thus keeping arteries open and your blood flowing more freely.

Low-density lipoprotein (LDL) cholesterol. This is sometimes called the "bad" cholesterol. Too much of it in your blood causes the buildup of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and can lead to a heart attack or stroke.

Triglycerides. Triglycerides are a type of fat in the blood. When you eat, your body converts any calories it doesn't need into triglycerides, which are stored in fat cells. High triglyceride levels usually mean you regularly eat more calories than you burn. High levels are also seen in overweight people, in those who eat too many sweets or drink too much alcohol, and in people with diabetes who have elevated blood sugar levels.

So, just how much cholesterol should a normal, healthy person be eating? The magic number is about 300 mg a day.

ARTICLE CONTINUES BELOW

What I Have Been Doing to Improve

I need to point out to you that I refused to suffer. I love to cook, and eat, and if I couldn’t make things that tasted good, it wasn’t going to work.

Diet Changes

My husband, always supportive, purchased several cookbooks for me. One of them has become a sort of bible — the American Heart Association’s Low-Fat, Low-Cholesterol Cookbook. I also purchased Mark Bittman’s Food Matters. Besides a lot of information about healthy eating, it contains great recipes. The internet also contains hundreds of low-cholesterol recipes. It's just a matter of educating yourself and picking up some new techniques. I have become a huge user of herbs. We eat a lot more fish and vegetables. I even snack differently — now I will have a handful of nuts instead of some slices of sharp cheddar. I have really re-vamped the way I shop and cook.

What foods should you look for? I started by following the Mayo Clinic's "Top Five" recommendations:

  1. Oatmeal, oat bran, and high-fiber foods
  2. Fish
  3. Walnuts, almonds, and other nuts
  4. Olive oil 
  5. Foods with added plant sterols or stanols (these help to block your absorption of cholesterol)

For breakfast, I love eggs. I made the switch to egg whites, and now I scramble them with leftover brown rice and whatever vegetables I have handy. Not only is it fast and easy, but I find it equally satisfying. Lunches are usually either a half of a sandwich on wheat bread, or leftovers. Dinners are my favorite meal to cook, and I am enjoying the challenge of using the "Top Fives." For example, fresh pesto made with walnuts, olive oil, just a little Parmesan, and fresh basil is great over oven-baked fish and whole-wheat pasta.  

My big nemesis is portion control. It isn't enough to change what you eat; you have to stop OVER-eating. The American Heart Association recommends, for the general public, these guidelines:

  • Eat at least five servings of fruits and vegetables daily.
  • Eat at least six servings of grain products daily.
  • Eat no more than 6 ounces (cooked weight) of lean meat, fish, or skinless poultry per day.  Have at least two servings of fish per week.
  • Limit yourself to less than 300 mg of cholesterol and less than 2,400 mg of sodium daily.
  • Include low-fat and fat-free dairy products, legumes, and poultry in your plan.
  • If you drink, limit yourself to one drink per day if you are a woman and two drinks per day if you are a man.

Exercising Regularly

Why exercise? It helps you to lose weight, and if you are overweight, you tend to have more LDL ("bad") cholesterol. A good basic start is to get at least 30 minutes a day. You do not have to join a gym — check out Andrea's great post about Fitness for People Who Hate Exercise, Janey's Exercising in a Winder Wonderland, or Camilla's Where to Find Free or Cheap Yoga Classes.

I am still not where I want to be with exercise, but I have found several types that I like (wait — make that “tolerate”). I walk, use a mini-trampoline, do a little morning yoga, and am occasionally dragged by friends to Zumba. When the weather improves, I’ll swim. I know it is a matter of commitment and increasing duration.

What Are My Results?

In roughly two months:

  • My total cholesterol dropped 27 points, from 209 to 182, and my HDL (“good cholesterol”) increased from 73 to 75. Unfortunately, my volunteer test did not provide my LDL (“bad cholesterol”), so I have no benchmark to compare, but my second test shows it at an acceptable 73. 
     
  • My triglycerides, which should ideally be under 150, actually went up from 158 to 169. There are several factors which may be influencing it, and I hope those are my underactive thyroid, since I have issues with that, or another medication I take. 
     
  • I have saved money. Over two months, I have saved $160 from my grocery budget. All you vegans and vegetarians can scream, "I TOLD YOU SO!" As it turns out, vegetables and grains are pretty cheap. Who knew?  
     
  • I have lost 3 pounds.

It’s a start. I am going to keep working on it, because I love a challenge and I know it’s high time I took better care of myself. My new goals include:

  • Monthly "try a new grain" recipes.
  • Increasing my exercise time from 30 minutes a day to 45.
  • Building my low-fat/low-cholesterol cookbook collection (the used bookstore has been a treasure trove).

And finally, here's a link to one of my new favorite recipes, from The American Heart Association's Low-Fat, Low-Cholesterol Cookbook — a turkey and vegetable calzone.

If any of you smarty-pants vegetarians or vegans have recipes that are really, truly, good, please share. I now have an open mind.

Before embarking on any diet or exercise programs, consult with your physician.

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Guest's picture
Rintin

I'm not vegetarian, but I did go a full year without eating meat some time back, and the recipe below is one that I devoured often. If you aren't a fan of tofu, cooked chicken would sub in nicely, I imagine.

TOFU CASSEROLE WITH MUSHROOMS

1 ½ tsp butter or margarine
1 lb. sliced mushrooms
1 chopped onion
2 ¼ cloves garlic
3 oz. uncooked brown rice
1 ½ cups blanched broccoli florets
¾ lb. extra firm tofu
¾ cups skim milk
1 ½ tbsp. Worcestershire sauce
3/8 tsp @ nutmeg, salt & pepper
¾ tsp red pepper flakes
3 oz. grated cheddar

Instructions:
1. sauté mushrooms in butter with garlic and onions, cook until tender
2. place rice in bottom of 2 quart baking dish
3. top with mushroom/onion mixture
4. add broccoli and tofu
5. mix milk with Worcestershire,salt, pepper, nutmeg and red pepper flakes; pour over casserole
6. top with cheddar
7. cover with foil and bake 350 for 1 hr or until rice is tender
8. uncover and bake 5 more minutes

(Taste great with purple glutinous rice if you can find it)

Bon appetit!!

Marla Walters's picture

Hey, Rintin! Thanks for writing and for including a recipe! I am a huge fan of casseroles so I will definitely be trying this. Just added the ingredients to my shopping list. Thank you!

Guest's picture
Thad P

Great job on getting your cholesterol down! Never easy to make lifestyle changes, but they pay huge rewards!

Marla Walters's picture

Thanks much, Thad P.! Appreciate the encouragement. Happy New Year to you!

Guest's picture
Lala

I'm am an anomaly - I'm a fat woman with excellent cholesterol and triglycerides. My doctor tests me every 6 months (I have bloodwork done for checking my thyroid, and he ALWAYS orders the cholesterol too), and I think my high was 180, after I forgot and ate a giant greasy burger and fries (not something I do all the time) the day before a blood draw.

I'm fat because I have a problem with portion control and gotten off my exercise regimen the last few years - not because I eat crappy all the time. I eat red meat maybe once a month, whole grain everything, brown rice, olive oil and LOTS of veggies. Sushi also happens to be one of my faves and salmon and tuna with low-sodium soy sauce is super for raising your HDL. I actually take out about half of the rice from the sushi pieces, since I just want enough to get a bit of soy sauce, and my doc said that is definitely a good idea (white rice being not so good anyway).

My husband, however has battled high triglycerides and borderline cholesterol for several years, (hereditary unfortunately) and we've discovered a few things that have dropped both of them into normal range and kept him from going on prescription meds: daily glasses of red grapefruit juice (regular is okay, but the red has way more benefits and there are several low sugar versions that are quite tasty), and fish oil pills in addition to the above dietary changes. He dropped around 35 points in cholesterol in 2 months and his triglycerides went from somewhere in the neighborhood 200, to the 150s. Apparently the red grapefruit juice is really good for triglycerides...

One of my fave easy recipes lately has been chicken wraps with cucumber:

take 2-3 chicken breasts and cook in non-stick skillet (no oil needed)
slice into strips

use whole wheat tortillas (we get the double fiber ones) and fill with a few strips of chicken, strips of cucumber (not slices - better crunch and coverage if you just make everything strips for this), a sprinkle of mozzarella cheese (or other low-fat shredded cheese), and drizzle with a bit of low-fat ranch dressing. I've also added strips of red/yellow peppers and fresh leaf spinach or whatever other veggie sounds good.

Andrea Karim's picture

When I was really overweight, my doctors were always looking to scold me about cholesterol and blood pressure, but mine were always excellent. It was always fun to see the look of shock on nurse's face when she ready my blood pressure... "Oh, 90/62. Huh." It's because I ate more veggies than you could shake a stick at!

I'm on a severely low carb diet now, and my cholesterol has gone up a bit, but it's mostly because of my weakness for cheddar cheese. I've since cut back on that, and will see how it goes.

Guest's picture
Ian Erickson

> Include low-fat and fat-free daisy products, legumes, and poultry in your plan.

Change that to "dairy" products and you're gold. Daisy products are mostly sour cream, which I don't think you meant. Delete this comment if you want. It's just a typo I noticed, and it's not meant to be vindictive.

Meg Favreau's picture

Thanks for catching the typo! It's been fixed.

Marla Walters's picture

Hi, Ian! Actually, I'd much rather eat "daisy" products, especially their sour cream. (See why I had this cholesterol issue in the first place?) Ha. Thanks, seriously, for catching the typo. (And thanks for fixing it, Meg.)

Guest's picture
Againstthegrain

Oh dear. Oh dear. Please, don't fall for the cholesterol nonsense. Cholesterol is a necessary and indeed, very important substance that you don't want to be too low (and the numbers used as lab cutoffs are artificially set very low - which, ahem, increases the market potential for cholesterol lowering drugs). Simply put, cholesterol is an important structural material. It's found in rich supply throughout the nervous system, particularly in the brain. Cholesterol is a raw material for making hormones and bile salts (to digest fats). Cholesterol is such an important substance for good health that the body will make it if it isn't consumed in the diet.

Despite the cholesterol hysteria of the past couple of decades, there is little evidence that lowering cholesterol will do anything to reduce the risk of cardiovascular disease, because cholesterol doesn't *cause* CVD. Half of all people who have heart attacks actually have so-called normal or even low cholesterol levels, so just having a low number means little in terms of prevention or prediction.

In fact, for women, higher cholesterol levels seem even to be protective for all-cause mortality. In elderly women, low cholesterol is strongly associated with dementia, cancer, and a number of other poor health outcomes, many of which are feared or considered far worse than CVD. The only thing that worries me about my cholesterol levels is not having enough.

Guest's picture
Againstthegrain

http://www.wired.com/magazine/2011/12/ff_causation/all/1

Long, but very good article worth reading for perspective.

Guest's picture
JD

All these are good ideas and a welcome reminder of the benefits of healthy eating. There is well founded, scientific evidence that shows causal links from high cholesterol levels and increased risk of heart attack. There will always be deniers of modern science. The earth is round, by the way, and our planet revolves AROUND the sun.

There is another class of people with naturally elevated levels of cholesterol that cannot be overcome through diet. In other words, they could exercise and eat nothing but oatmeal and soluble fiber (Metamucil is apparently wonderful at this) and still not bring down their LDL. So, for future posts, could we see finding cheap medicines tied in with the rest of the good advice? Many thanks again.

Guest's picture
Againstthegrain

JD,

Denier of science? That's actually pretty funny, because I would say it is cholesterol-phobes who are more akin to the flat-earthers. LOL.

Keep in mind not to long ago the "best scientists" of the day were the ones who insisted the earth was flat and that the sun revolved around the earth - public derision, loss of patronage (in modern times that would be grant funding) and worse being served to the current paradigm skeptics isn't anything new. We really aren't as advanced as we think we are, and the Emperor's New Clothes story still has value.

Scientific knowledge doesn't progress in smooth linear fashion, but rather lurches and shifts in paradigms, even today. What makes you so convinced that the earnest scientists of the mid and late 20th century weren't as wrong, biased, and misguided about the cause(s) of CVD disease as the astronomers of the past were about the earth's shape and the universe? Progress in science, no matter how advanced, simply doesn't move in a linear fashion - a body of knowledge shifts in fairly radically paradigms.

Have you actually *looked* at the data instead of the poor excuse for science that is fed to us (and to physicians, I might add, who are NOT scientists)? The science simply doesn't say what you apparently think it does.

be·lief/biˈlēf/
Noun:
An acceptance that a statement is true or that something exists.
Something one accepts as true or real; a firmly held opinion or conviction.

Scientific knowledge isn't based on belief. It's based a rational review of the best available data. The data is always incomplete, so acceptance of the data is always conditional (and hopefully not based on grant funding or profit, ahem).

If you go directly to the data that was purported to support the cholesterol hypothesis of CVD as well as the diet-heart hypothesis (these two hypotheses are not the quite same, btw), you'll see that the majority of data was woefully inadequate to support either hypothesis. Now that much of the data has been retested and extensively refined, and new data has shed light leading to alternative hypotheses (such as systemic inflammation, just to name one), few currently working in the CVD research field still accept the original hypotheses; most have moved on to other hypotheses, though progress was certainly hindered and misdirected when grant funding pushed most researchers down the cholesterol rabbit hole (my scientist husband relies on grant funding to run his NIH funded lab at a leading not-for-profit biomedical research institute, so I know a bit about how this funding process works, btw, and it isn't always pretty - though he isn't involved specifically in CVD research).

Unfortunately, we are in still the midst of a CVD paradigm shift, heavily defended by entrenched economic, social, and bureaucratic forces, so growing the critical mass needed to overturn the failed cholesterol and saturated fat phobia paradigm of the past will take significant time. But for those truly interested in seeking knowledge, once the blinders are truly off, sometimes it does turn out that the Emperor is quite shivering and naked. ;-)

Guest's picture
Guest

Read Gary Taubes' book "Good Calories, Bad Calories", especially the chapter on Triglycerides (or actually all of section 2. Skip section 1, just debunks old theories, gets into too much of a rant.)

Anyway, I have cut back my carbs to only vegetables and some fruit (I shoot for 10 servings a day, combined) and limit my grains altogether. When I do eat grains it's only high fiber, whole grains, never "white bread" stuff, or low glycemic carbs. Also STOP DRINKING ALL SWEET DRINKS! This includes fruit juices as well as soda. It's the sugar (or substitutes) and the high glycemic foods that raise your triglycerides. Following his advice (or the advice he has gathered from experts), I lowered my own triglycerides to 49. My LDL is 91 and my HDL is 79. My doctor's comment: Keep doing whatever you're doing. It works!

Guest's picture
Againstthegrain

Guest is definitely headed in the right direction. Way to go. The Taubes is a must-read.

Very good point about consuming sweetened beverages. Juices are sugar water - even so-called 100% fruit juices (many times the amount of sugar in a serving of fruit, and generally includes refined fruit juices are are essentially pure sugar - but it's legal to claim it's all fruit).

However the whole grain vs white flour & glycemic is a bit of a side-step & trap. So-called low glycemic whole grains (flour isn't "whole", even if the bran and germ aren't removed) can still significantly mess with blood sugar levels & triglycerides (esp if there is any degree of insulin resistance or glucose intolerance), and contribute NO nutrients that can't be found in some other more healthful foods. There are no essential grains; humans evolved without them and many populations existed just fine without grain consumption until fairly recently.

And that's not even getting into the gluten problem which is more widespread than realized, especially with the hybrid dwarf variant wheat strains that have overrun the food supply in the post-WWII era without testing for safety on humans or animals. These strains were developed to fit the high-crop yield demands for industrial agriculture and factory food processing, not the health of consumers. We aren't eating the same wheat our grandparents and great-grandparents ate, let alone the same wheat consumed in the Bible. The bran of seeds has its own toxic properties that can wreak gut havoc (phytotoxins meant to protect the plant's seeds from predators); fiber from vegetables and fruit is far preferable, especially soluble fiber, which keeps our gut biome happy.

I'd add it's also a good idea to reduce/avoid industrial seed/vegetable oils (oil from seeds that require industrial technology, solvents, & refinement to extract the oil and make it palatable - corn, soy, cottonseed, safflower, etc.). No, this doesn't generally include olive oil, which is botanically speaking a fruit, not a seed. Olive oil can be be produced without industrial technology, as can many nut oils.

Guest's picture
Brother Tony O

As I aged, I gave up red meat then chicken and finally, after watching Forks Over Knives, I am now a vegan. I used to love cheese, eggs, fish... but found that as my meal plan changed so did my tastes (I hadn't noticed how smelly cheese really is before I gave it up).

It was a sin how many pizzas I ate as a young man, having worked for most of the well-known pizza chains. I used to eat pizza for breakfast, lunch, and dinner. I also used to create my own baked derivatives using dough, sauce, and cheese.

My real weakness/addiction, I found, was sugar. FOK smacked me in the head with that realization. My routine used to include eating a half-gallon of ice cream every week - and this was after I began to call myself a vegetarian!

By committing to intelligent veganism, I returned to my high school weight in about a month, my knee pain (I couldn't do a squat without intense pain) is gone, and I have more energy. The kicker, for me, is that I actually exercise LESS than I did before changing my diet.

I didn't mean for my comment to turn into a testimonial but I'm so happy to be awake to and free from the processed foods we're marketed that I couldn't help myself.

What I really want to know is: it's been two years since you shared this post. How are you doing, Martha?