Hello and thanks for joining us for today’s chat on heart health. We’ll be starting in just a few minutes, but if you have a question, you can go ahead and get it in queue.
We'll jump right into questions from our readers.
The best way to lower your cholesterol is through dietary adjustments. Favor vegetarian sources of fats (like fish, nuts and seeds) and limit fats that come from animal sources. Get plenty of fresh vegetables and fruit and whole, unprocessed grains. Exercise can be helpful too, but what you eat makes the most difference.
Yes. Sugar does affect your heart health. High blood sugars damage the blood vessels in your body and increase your risk of heart disease and stroke. And there’s plenty of proof that controlling diabetes lowers the risk of heart and blood vessel disease.
It can sometimes be difficult to determine if chest pain (even if it comes on at night) is due to heart or other issues. Although chest pain at night is less likely to be from your heart, it may be a good idea to discuss this with your doctor. A stress test may be required to really determine if the heart is causing your symptoms.
It is challenging to add up all the sodium you eat during the day. Most people should stay under 2500mg per day that’s about 1 teaspoon of salt. Read the nutrition labels of foods you prepare or check the restaurant menus – try to stay below 20% of sodium per meal.
Hi YV! great question. Some baseline measurements would include your blood pressure, your fasting blood sugar and your cholesterol profile. If there are many individuals in your family with heart disease, checking your lipoprotein A and your serum homocysteine levels may also be helpful.
We’re not sure how stress directly affects the heart but we do know stress affects how we handle everything in our life. This maybe related to increased stress hormornes. Also, we do know people under stress may eat more, exercise less, sleep poorly, and smoke more.
Quitting smoking can raise good cholesterol levels – which is a big benefit. Although e-cigarettes may be an improvement over regular cigarettes, you will probably not see the whole benefit on cholesterol levels without quitting altogether.
For most people eggs are ok. The yolk of a chicken egg has about 190 mg of cholesterol. For someone with heart disease, diabetes or high cholesterol that’s about their daily limit. So if they eat an egg they need to limit the rest of their cholesterol intake that day. The cholesterol limit for otherwise healthy people is 300mg per day so 1 egg a few days of the week is fine. Eggs provide protein and and are about 75 calories each so a good food for most people.
The new cholesterol guidelines really focus on a more holistic approach to assessing risk. But from a cholesterol perspective, both the good (HDL) and bad (LDL) cholesterol levels remain important. In general, the ratios are less helpful in assessing risk.
The best fats to use in cooking are polyunsaturated fats – so that means olive oil, canola oil, and other vegetable oils. You should avoid saturated fats, trans fats, and cholesterol so that means avoid butter and shortening.
The cholesterol guidelines changed to focus prevention efforts on people who are at high risk of developing heart disease or having heart-related events (like heart attack or stroke), rather than just focusing our efforts on those with high cholesterol. This is overall an improvement (because cholesterol levels are not the only thing that identifies high risk individuals).
I love that you are asking about ways to get exercise indoors! This is important at any age. You want to get aerobic exercise to pump your heart, resistance exercise to build muscle, and flexibility. So keep walking up and down the stairs. Use the internet and TV to get more ideas for items to do floor exercises and lift items around the house. Be careful to watch for hazards in the house to keep from falling, slipping and hurting yourself.
Hi Paul! Memory problems can be a side effect of statin medications. This is an unusual side effect and tends to be quickly reversible with stopping the medication. If your memory issues are related to statin medications, you should see an improvement quickly.
As you might imagine, it is difficult to provide specific medical advice in this setting. I would discuss your concerns with your doctor and ask whether it makes sense for you to have a stress test.
All fiber, as well as the fiber found in psyllium, can help lower cholesterol. It’s important that the fiber be consumed with a meal for maximum impact (as opposed to on its own).
Diabetes does increase your risk of heart disease and stroke. The high blood sugar damages the blood vessels in your body – so it’s very important to keep your blood sugars under control with diet and medications if needed. Luckily there’s a lot of research and treatment options to help diabetics live a long healthy life.
The latest guidelines say that an LDL (bad) cholesterol level at or above 190 mg/dL is an indication for statin therapy. People with lower LDL levels may be candidates for treatment as well depending upon whether other factors come into play. If you already have heart disease or if you have diabetes, you are a candidate for statins regardless of your LDL level. Otherwise, using the new risk calculator, if you have a 10 year risk of heart events exceeding 7.5%, you would also be considered a candidate for statin medications.
Chickens raised different ways may have varying levels of cholesterol (but not by much). Old fashioned raised chickens probably are healthier. But the basics don’t change. If you have high cholesterol or are watching your cholesterol – one egg a few times a week is fine as long as you’re limiting your cholesterol from other sources.
Risk factors for heart disease include: older age, family history of heart disease, high blood pressure, smoking, diabetes, cholesterol abnormalities, excess weight, inactivity and poor diet. Interestingly, the new risk calculator does not take family history or any of the lifestyle measures into account – which is why it is somewhat controversial.
Statin intolerance is probably more common than has been recognized. Some studies suggest that 10-20% of people taking the medications cannot tolerate them. Your situation is difficult because you already have heart disease and we know patients can benefit a lot from statin treatment. You could try taking lower doses or taking the medication every other day. You can also help lower your cholesterol by supplementing your diet with fiber and phytosterols. Meeting with a dietician may be helpful to make sure you are doing everything from a diet perspective. Low vitamin D and low thyroid function can make statin intolerance more likely so if these have not been checked, you should have those evaluated.