3012: How Genetics Impact HDL and LDL Cholesterol and Targeted Lifestyle Strategies to Improve Wellbeing

[00:00:01] Wenn jemand Charles und Melanie gesagt hätte, dass sie nach ihrem Tinder-Match gemeinsam einen Channel mit crazy Aufgaben starten, also wirklich crazy, fünf Tage auf einer einsamen Insel verbringen, eine Zipline an einem Gurt runterrasen, eine Million Views knacken, eine Wand mit Saugnöpfen hochklettern und Falschirm springen in Ägypten? Das hätten die beiden niemals geglaubt. Aber das ist das Ding mit Tinder. Es führt dich an Orte, die du nie erwartet hättest. Wohin es dich auch führt. It starts with a swipe. Tinder.

[00:00:29] Kennt ihr auch diesen einen Freund, der morgens einfach so ruckzuck aus dem Bett und danach aus dem Grinsen gar nicht mehr rauskommt? Der sogar noch vor dem ersten Kaffee unverschämt gut gelaunt ist und mit der Morgensonne um die Wette strahlt? Furchtbar. Ekelhaft. Wie kann man nur so... Ausgeruht sein? Ganz einfach. Trainiere deinen Schlaf und werde auch du zum Morgenmenschen. Mit der Galaxy Watch 7 oder dem Galaxy Ring und der Samsung Health App.

[00:00:55] It's another Q&A edition of Optimal Health Daily and I'm Dr. Neil Malik. Hey there, welcome back to another Friday show where I answer your questions. On all the other days, I read health and fitness blogs to you kind of like an ongoing audiobook. With permission from the authors, of course. Now, I'll let you know how you can send in your own question at the end of the show and get rewarded for doing it. But for now, let's hear today's audio question and start optimizing your life.

[00:01:23] Hi there, this is Kim. I have already left a message before, which you did read on a Friday podcast. What is your thoughts on people saying cholesterol is hereditary? And so if you do all the things you're supposed to do and you still have high cholesterol, they say that's hereditary and, you know, most doctors still want to get you on meds, which we don't want.

[00:01:53] Thank you. Have a great day. Bye. Thank you so much for taking the time to send in your audio question, Kim. The bottom line is this. Yes, high blood cholesterol levels can be hereditary. All right, that'll do it for another episode of... Hmm? What's that? This episode's not over? All right, I'll keep talking. Well, let me first review what cholesterol is and what normal blood cholesterol levels should look like.

[00:02:20] According to the National Heart, Blood, and Lung Institute, for those 20 years of age or older, we want our total cholesterol numbers to be less than 200. So when we go in for those blood tests, we're looking for a total cholesterol value less than 200. We want our LDL, or bad cholesterol levels, to be less than 100. And we want our HDL, or good cholesterol, to be above 40 if we're male and above 50 for females.

[00:02:50] Now, I remember when I was first learning these terms in school, it was hard for me to remember which type of cholesterol was good and which one was bad. So my instructor said to imagine that the L in LDL meant lousy or lethal cholesterol, and the H in HDL meant happy or healthy cholesterol. The LDL cholesterol, or lousy or lethal cholesterol, that's the one that clogs up our arteries. So that's why we want that number to be less than 100.

[00:03:21] HDL actually helps the body clear lousy cholesterol from the arteries, which is why it's considered good. So by clearing LDL from the arteries, HDL lowers our risk for heart attack and stroke. That's why we want that number for females to be above 50 and for males above 40. Now we hear about those success stories of those that were able to manage their high cholesterol with just lifestyle changes.

[00:03:48] They talk about how happy they are now that they don't have to take medications anymore. Why can't that be us? I mean, they're not lying, right? It is possible, isn't it? Yes, it's absolutely possible. But it may not be possible for everyone. So as you asked, Kim, some have a genetic predisposition to having high cholesterol. One of the reasons for this, and this is likely not the only reason, is that some people have high levels of something called lipoprotein A.

[00:04:17] And it's estimated that about 1 in 5 Americans have high levels of lipoprotein A, which is about 63 million Americans. Lipoprotein A is really similar to LDL, that lousy or lethal cholesterol. So like LDL, lipoprotein A can clog the arteries. Now there is a lab test that a doctor can order that checks for the amount of lipoprotein A floating around in the bloodstream.

[00:04:45] The doctor will usually order this test if someone has a family history of early heart disease or if the patient is unaware of their family medical history. If blood levels of lipoprotein A are high, even if blood cholesterol levels look normal for now, the doctor may still recommend medications like a statin as a preventive measure. Because we're learning again that lipoprotein A may contribute pretty significantly

[00:05:12] to an increased risk of heart disease or stroke. So let's just say we do have a genetic predisposition to high cholesterol. Should we just give up and just accept the fact that we're going to have to be on medication? Yes and no. We might still need to be on medication, but dosing matters. We may need less medication if we make lifestyle changes that we know are helpful for reducing blood cholesterol. Less medication means less side effects.

[00:05:41] And let's be honest, less expensive too. So what are some of the lifestyle changes we can make to try and lower our cholesterol levels naturally? Well the first one would be weight loss. Now this may not be an issue for you Kim, but I'm mentioning this just in case. One of the most effective ways to lower blood cholesterol is weight loss. And this weight loss doesn't have to be dramatic.

[00:06:05] Just 5 to 10 pounds of weight loss can actually lead to a 5 to 8% drop in LDL levels specifically. The second is to eat less trans fat and less saturated fat and more omega-3 and monounsaturated fats. Trans fats have been banned from most foods, but you can still find small amounts in some store-bought and restaurant foods.

[00:06:28] So when reading a food label, if you see the words partially hydrogenated oil listed as one of the ingredients anywhere on the ingredients list, the food has trans fat in it. These fats have been shown to increase LDL cholesterol while at the same time decreasing HDL cholesterol. Now there are some trans fats found naturally in foods like red meat, but those aren't what I'm talking about here.

[00:06:55] Instead, red meat is usually high in saturated fat and saturated fat may also increase LDL cholesterol levels. Most health organizations recommend we get 0 grams of trans fat every day. So that means complete avoidance. And less than 10% of our total calories for the day should come from saturated fat. Now when it comes to omega-3 fats and monounsaturated fats, these tend to actually reduce LDL cholesterol.

[00:07:24] The best sources of omega-3 fats are those fatty cold water fish like salmon, mackerel, anchovies, sardines, halibut, and trout. You can also get omega-3s from plant-based sources. More on that in a moment. Now the goal is to try and get 1.5 to 2 grams of omega-3 fats each day. Now if you don't like any of the fish that I mentioned, talk to your doctor about using an omega-3 supplement.

[00:07:52] Now as far as monounsaturated fats, which are also helpful, olive oil is one of the best sources. My third tip, which is another diet recommendation, eat more fiber. So you remember how I was just saying that you can find plant-based sources of omega-3s? Well one of these just happens to be high in omega-3 fats and dietary fiber. This magical food would be walnuts.

[00:08:17] So one way to add more fiber and omega-3s to your diet would be, let's say, a quarter cup of walnuts each day. Fruits, vegetables, and whole grains are of course good sources of fiber too. Now the reason fiber is so helpful is because it binds to cholesterol and helps the body get rid of it. So in a way, it acts like HDL cholesterol, that happy or healthy cholesterol. Now the daily fiber target for females is 25 grams each day.

[00:08:45] And for males, 38 grams each day. Oh, and when increasing fiber intake, increase it slowly. That'll help avoid any gastrointestinal distress. And if you're increasing your fiber intake, it does help to drink more water too. My fourth suggestion is also a diet recommendation. Eat less added sugar. Added sugar get converted to fat very easily. So eating less added sugars can help lower fat levels in the blood,

[00:09:13] which in turn will lower cholesterol levels in the blood. And lastly, exercise and stress management. One of the most effective ways to increase that HDL or good cholesterol or happy or healthy cholesterol is through high intensity exercise. But high intensity exercise is not for everyone. So having a discussion about high intensity exercise with your doctor is important first. And for those that maybe haven't been active in a while,

[00:09:42] I don't recommend starting with high intensity exercise, even if it's safe to do so. So it's better to start slowly with more moderate intensity activities first. But if your doctor says you're ready and your body says you're ready, high intensity activity done two to three times a week seems to help. And when it comes to stress management, we see that high levels of stress for months and years at a time does raise bad cholesterol levels too.

[00:10:08] So one of the best ways to manage stress is to guess what? Get in that workout. So to sum up, Kim, yes, high cholesterol levels can be hereditary. But that doesn't mean we're necessarily going to have to be on medication. We can try and lower our cholesterol levels naturally with some of the tips I mentioned through lifestyle. And even if you follow all of these steps perfectly, your doctor may still believe that taking a cholesterol-lowering medication

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[00:12:00] Perfect for that protein pick-me-up or a tasty late-night treat. Plus, Wonderful Pistachios comes in a variety of flavors and sizes. Perfect for enjoying with family and friends or taking them with you on the go. So, get snackin' and get crackin' with the snack that packs a protein punch. Visit WonderfulPistachios.com to learn more. I wish you all the best, Kim, and I thank you so much for taking the time to send in your audio question.

[00:12:28] Now, if you want to send your questions in and get a copy of our Optimal Living Daily Workbook for doing so, you can email your questions to health at oldpodcast.com. That's health at oldpodcast.com. Or, if you want your voice played on the show, just like Kim, come by oldpodcast.com slash ask. Or, you can do it the old-fashioned way and call in your question.

[00:12:55] The number is 1-61-ILOVE-OHD. That's 1-614-568-3643. I so appreciate you sending in your questions. Answering them is my favorite part of the show. All right, that'll do it for another Q&A edition of Optimal Health Daily. Thank you so much for listening every day and all the way through. I hope you have a great start to your weekend. And, of course, I'll see you back here tomorrow where your optimal life awaits.