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need the help of all chowhounds

  • r

Yesterday I received the disturbing new that I have
high cholesterol! especially disturbing because I am
only 23, and have always thought of "high cholesterol"
as something that happened to older folks. I am slim
and fairly active, and was unprepared to learn that my
cholesterol level now puts me into the "moderate" risk
category for heart attacks. Okay, here's my question:
I've always scoffed at those scared of butter and
cheese, and happily wolfed down red meats and barbeque,
now I am looking into diets which could lower my
cholesterol and I am confronted with a bewildering
array of contradictory information. The party line, of
course, is that diets high in saturated fats are bad,
bad, bad -- no more sour cream, potato chips,
cheeseburgers, french fries or ice cream for me. But
other reports question this orthodoxy. Some limit the
bad foods to butter and red meat. I'm so confused, and
dread the idea of leaving behind my chowhounding days,
food is one of my greatest pleasures (possibly the
greatest) and I don't want to be Puritanical just to
punish myself. On the other hand I don't want to start
weakening my heart at such a young age, am rather
hoping to live to a ripe 90 years old. Chowhounds,
please help, what do you know of this question? what
have been your experiences? what foods really need to
be renounced? what diet is most effective? how do I
lower my cholesterol without giving up good eating?

Thanks,
Rachelhope

p.s. more regular exercise will accompany any diet
change.

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  1. How high is it?? Don't go on the Ornish diet just yet.
    You are correct that there are differing medical
    opinions out there. I'd want a second opinion
    myself, before I drastically changed my lifestyle.
    pat

    4 Replies
    1. re: pat hammond

      To clarify, the panic which inspired my first post
      (after a torrid night of dreaming I had accidentally
      eaten potato chips) prompted me to leave out several
      details. First, I did get the HDL/LDL breakdown and I
      have too high an LDL count, also I hadn't eaten in 11
      or so hours immediately preceeding the test, and
      lastly, I was sent in for the test because of
      cholesterol deposits the optometrist saw in my eyes; so
      the verdict seems fairly unquestionable that my
      cholesterol rates are high (although not sky-rocket
      high).

      To complicate matters, as many of you astutely picked
      up on, my doctor gave me absolutely no explanation.
      Rather in fairly poor grammar (she's Chinese --
      actually hardly "my" doctor, just someone who I made an
      appointment with through Berkeley health services) she
      gave me the news, admonished me to eat less butter and
      hung up. So, with fairly little reference, no big rock
      to cling to, I had a prolonged panic attack culminating
      in my message to you all.

      Now that my blood pressure is lowering, (I think I was
      at risk from a heart attack during the 24 hours after I
      lay down the receiver), I am trying to put things in
      better perspective. I have been surfing the web, also
      happen to be reading Jeffrey Steingarten's book "The
      Man Who Ate Everything" and his iconoclastic
      perspective has been much welcome, and am coming to see
      that the main casualties to my diet will be red meat,
      chicken skin, and butter. This is too bad, because I
      would gladly roast a chicken just to eat the whole
      epidermis and leave the flesh behind. I like
      salmon-skin rolls (although the omega-3 fatty acids may
      make those a positive good), the crackled fat on the
      edge of a barbequed steak, and avocado everywhere (the
      only vegetable no-no).

      The additions to my diet will be fiber, fiber, and more
      fiber, hopefully not to the point of extreme
      flatulence. I guess the only really hopeful news is
      that I haven't been drinking quite enough wine. Because
      of the burden of school work I've been drinking only
      about 4-5 glasses a week, I think I'll have to raise
      that to 7-9.

      And of course, exercise. I went for a jog today.

      Thanks for the responses, I'll let you know in 6 months
      how it goes. Of course, as my diet isn't really as bad
      as I suggested and I am young, it could just be that I
      have naturally high cholesterol rates and changing what
      I eat won't make a figs worth of difference.

      Rachelhope

      1. re: Rachelhope

        I've been told before that there's an "eye sign" for cholesterol, but have ever managed to find out exactly how one tells...

        Again, I'd recommend you make your changes gradually, with frequent testing. If you go extreme and your level descends, it'll be a pain to later work backward to see how much you can get away with without having the numbers rise to a danger level.

        1. re: Jim Leff
          f
          Frank Language

          Jim writes: >

          My [late] dad had a little fatty lump in the corner of
          his eye for years, and finally had it surgically
          removed; I forget if this was before or after he had
          his heart attack...(he was 49 and lived to be 56, with
          a triple bypass in his early 50s).

          I have a history of both cardiovascular disease and
          diabetes (yum) on my dad's side, so I'm foolish but
          cautious. For instance, I eat ice cream and butter (in
          moderation, but everyone will tell you they do it in
          moderation), but I use yogurt instead of sour cream and
          eat tofu raw. (contains phytoestrogens, which is
          important for all us premenopausal women.) As a matter
          of fact, I often eat tofu as a main course. And it's
          good that I like plain popcorn.

          The funny thing is, I get a full reading twice a year
          from the same doctor; when I was about 25, my
          cholesterol was 200 and an alarm sounded: I was to
          strictly limit my this and that, and eat fiber and
          fresh vegetables until sawdust came out of my ears. I
          OD'd on oat-bran muffins (this was the mid-80s) and my
          next reading was "in the normal range". They especially
          say this not because my total cholesterol has gone down
          (it's still about 200) but because the breakdown shows
          a very strong HDL count.

          Stress can raise your cholesterol count, you know. And
          red wine - well, if it works for you, that's what's
          important. I find nutritionists often can't see the
          forest for the trees, and are very preoccupied with
          numbers; do you notice they'll say one thing one week
          and then refute it the next? I even read an article
          once saying stearic acid (found in beef) was
          beneficial. Eventually the prophecies in the movie
          Sleeper, in which Woody Allen wakes up in the 21st
          century and the doctors are holding a cigarette to his
          lips and telling him to "draw the smoke deep into your
          lungs" will come true. Eat hearty.

        2. re: Rachelhope

          Well, I'm certainly glad you've thought it through
          more clearly, but you are certainly entitled to proper
          medical/nutritional counselling. I hope you get
          some. There are many routes to go. One thing that I
          haven't seen anybody mention yet is pectin (you know -
          pears, blueberries, strawberries, I think tomatoes),
          which works with fiber to whisk the food through your
          body (hopefully before it can absorb ALL the bad
          things we throw into it). If you're planning heavy on
          the fiber, at least you can vary your diet more if you
          link it to pectin-containing foods, too. Works for
          me, though I'm not sure how much genetics has to do
          with it. Good luck to you. Hope you can find a
          lifestyle you can live with.

          Then, of course, there's always the routine of Fats
          Goldberg (former owner of Goldberg's Pizzera on 2nd
          Ave), who, according to Calvin Trillin, eats
          incredibly spartanly, except during his carefully
          planned all-out eating binges in St Louis a few times
          a year.

      2. Rachel,


        I’m in the same boat. A recent test
        put my total cholesterol up near
        300, and while I’m waiting for the
        results of a full lipid panel to give
        me the HDL/LDL/triglyceride
        breakdown, that’s still too high
        for chowhound comfort. However,
        total serum cholesterol isn’t the
        end-all, be-all indicator of
        cardiovascular health.

        Get a full panel that shows the
        breakdown between HDL, the so-
        called “good” cholesterol ad LDL
        (aka the “bad”). The ratio of HDL
        to LDL is more important than
        total cholesterol. Have your doctor
        explain the difference, and if he
        doesn’t seem to know what he (or
        she) is talking about, find another
        one. There are many good books
        available about heart stuff to give
        you some background.

        For even more details, check out
        Berkeley Heartlab
        (www.berkeleyheartlab.com).
        They have a whole new set of
        diagnostic indicators, including
        levels for homocysteine and
        lipoprotein (a) and something
        called LDL pattern. These go
        beyond the serum volumes as
        predictors for heart disease.

        Exercise is a given, but you don’t
        have to be fanatic for
        cardiovascular benefit. I ride my
        bike to work, hit the gym about 2-
        3 days each week, and walk a lot. I
        recently had a treadmill test for
        something unrelated and my doctor
        says my heart is in great shape
        (except, of course, for that high
        cholesterol). I’m 45, by the way.

        When it comes to eating, the
        easiest way to cut saturated fat
        from your diet is reduce your
        consumption of red meat. It’s not
        that hard to use meat as a flavor
        agent instead of the bulk of your
        meal, and you can still get lots of
        big flavors without any meat at
        all. I’m not a vegetarian by any
        stretch, but we eat real good food
        almost every night, and there’s
        usually no meat involved. If you
        cut back on meat, you can still
        indulge in the other flavorful fats
        (cheese, ice cream, and butter
        being my favorites). I also use
        olive oil or canola oil exclusively
        for cooking. Avoid margarine and
        other hydrogenated fats because
        research suggests that the trans
        fats they contain are worse that
        animal fat.

        Food is a major focus of my life. I
        write restaurant reviews for the
        weekly paper here in Portland
        (Oregon) and have a web site
        (www.realgoodfood.com) devoted
        to, well, real good food. I’m
        confident that I’ll be able to keep
        eating the things I like, although
        maybe not as often, and still live
        to a ripe old age. I’m sure you can,
        too.

        Jim Dixon

        4 Replies
        1. re: Jim Dixon

          "If you cut back on meat, you can still indulge in the other flavorful fats (cheese, ice cream, and butter being my favorites"

          Jim, unless you're on to some very very new health info I haven't been privvy to, cheese, ice cream, and butter are not at ALL suitable under the circumstances, in lieu of meat or otherwise.

          1. re: Jim Leff

            Jim

            You’re right...people with elevated
            cholesterol probably shouldn’t be
            eating cheese, butter, and ice
            cream, at least not in large
            quantities. What I was trying to
            say is that by limiting one form of
            saturated fat (meat), you could
            still have a little in what I
            consider a more desirable form.

            I had been tested a few months
            back and got that “near 300”
            reading. Since there’s some family
            history of high serum levels, I
            was a little worried. But the lipid
            panel I did last week came back at
            202, with good hdl/ldl/
            triglyceride numbers, so I feel
            better about my eating habits.

            I don’t try to avoid any particular
            food group, but I’m aware of what
            I’ve been eating, so if I have
            curried tofu from the vietnamese
            cart in front of my building for
            lunch (the coconut milk probably
            cancels any benefits from the tofu,
            but it tastes great), then I’ll eat
            something with less saturated fat
            for dinner.

            As for cheese, butter, and ice
            cream....I do eat a little cheese
            every day, especially since I
            brought back some fabulous
            pecorino from Italy. But a pound of
            butter lasts about a month in our
            house, and I eat ice cream only if
            there’s no chocolate (now that
            would be a good discussion...dark
            chocolate is actually rather
            benign, health-wise).

            Jim Dixon

            1. re: Jim Dixon
              f
              Frank Language

              Jim Dixon writes: "now that would be a good
              discussion...dark chocolate is actually rather
              benign, health-wise"

              In what way is it benign? I'd really like to know,
              since I prefer dark chocolate.

              1. re: Frank Language

                First a disclaimer a la Stuart
                Smalley (aka Al Franken): I am
                not a trained dietician....

                But I have read several articles
                about the health consequences of
                eating chocolate, and while I'll
                have to go back to them for
                specifics, the basic gist is this: the
                type of fat found in chocolate is
                metabolized in much the same
                manner as monosaturated fat (as
                is found in olive oil), and there's
                something else that mediates
                chocolate that I can't
                remember....dark chocolate is
                better because it has fewer
                additives (milk, cream, or in the
                case of cheaper chocolate,
                hydrogenated oils).

                There was an interesting article
                about fine chocolate in last week's
                Wednesday NY Times.

                I'll try to dig up some more info.

                Jim Dixon

        2. Without a doubt you must have a retest and possibly
          an additional retest after that. I was tested once
          and the results showed that my cholesterol was at
          a lethal level. They forgot to tell me to fast before
          the test and I went in after a breakfast of poached
          eggs and buttered toast! This is an exaggerated
          example of how your level can vary from day to day
          and hour to hour. However, it does vary even without
          the eggs, etc. You must be tested several times to
          be sure of the results.

          1. Hi Rachel

            First, needless to say, I'm not a doctor...but I have read up on cholesterol (mine is high, naturally).

            Because of your age, and the fact (at least I presume it's a fact) that this is your first high reading, you don't need to go on the maximum austerity diet right away. If I were you, I'd just start working on the obvious stuff. No more knee-jerk butter consumption (that means butter as a daily habit...put jam on your english muffin at breakfast, and eat bread plain in restaurants) or eggs (no more over-easies every breakfast...once in a while's ok). Whenever viable, opt for chicken or fish rather than beef or pork (a burger once in a while won't kill you...not even a cheeseburger if you're otherwise being careful). Notch down to the next lower fat milk (they make a kind of skim/low fat milk that's creamier without the fat...I like it ok, though sometimes I need whole Ronnybrook).

            These kinds of gentle changes--plus exercise--MAY make a big dent in your next test result (in fact, this result may well have been faulty!). You're fortunate enough to be young enough that you can ratchet down gradually. If the gentle changes don't do it, you've got to start checking up on the latest findings re: shrimp and alcohol and olive oil, avoiding cheese and meat like poison, etc. But until you hit a dead end, don't neurose and don't do anything drastic (unless your doctor tells you to!). And, come to think of it, you maybe should consider a different doctor, seeing as how you've been left so confused and upset by what he/she told you.

            Oh, and you're not "weakening your heart", don't worry. All that's happening is: smooshy stuff in your blood is building up, and that shmooshy stuff may at some point affix itself to your arterial walls, and that may at some point start restricting blood flow and that may at some point affect your heart and general health. Meanwhile, even though it's a pretty high number, you're not doing anything irreversible to yourself, at least not according to current thinking as I understand it. But keep your eye on it; test every 6 months (or as instructed by your doctor)
            --------ciao

            1. j
              jonathan gold

              Some people are just born with tendencies
              toward high cholesterol, and while diet and
              exercise can help a little, they can't do it
              all. The new breed of anti-cholesterol drugs--
              Zocor and Lipotor--are quite safe, have few
              if any side effects, and usually lower
              triglycerides etc. fairly dramatically.

              Doctors will sometimes imply that high LDL
              counts are caused by poor self-discipline,
              but it is perfectly reasonable to supplement
              dietary changes with the drugs--they will
              give you peace of mind if nothing else.

              And they'llsave you from the eternal foodie
              breakfast of plain, water-cooked oatmeal--one guy
              I know actually douses the stuff with steak sauce
              to hide the taste.

              1. Sorry to Hear about that Rachel, I'm in there with you.
                I was twenty Three when I Blew a 380, wow!. I cut back,
                did the exercise thing etc...
                I went back and blew a 410, yeow! Some Times it's just
                in the blood. At the time the drugs that were available
                just riddled your liver with serosis, nice choice huh.
                Now I just watch what I eat, but decided that Quality
                not Quantity was what I wanted. It's not for every one,
                but I can't live like my brother and eat boiled chicken
                every night just to shoot for the low three's.

                1. see:

                  www.rahul.net/cgi-bin/fatfree/USDA/US...
                  (Enter a food name and see what elements it contains
                  )=======================================================
                  also for weight cholesterol stuff...

                  listserv@maelstrom.stjohns.edu