Cholesterol and Heart Disease

1. Cholesterol and Heart Disease Beth Kalicki Heli J. Roy, PhD, RD Pennington Biomedical Research Center

2. Blood cholesterol levels correlate with weight. However, lean individuals can have high cholesterol levels. • Blood cholesterol levels also correlate with the diet. A diet high in saturated fat and cholesterol increases blood cholesterol level. • Some individuals have high blood cholesterol level due to genetics. Cholesterol Trends PBRC 2010

3. Cholesterol travels in the bloodstream. • It is vital to the functioning of the human body. • It serves three main functions: • to make steroid hormones • to produce bile acids • it is a main component of cell membranes and structures. Cholesterol in the Body PBRC 2010

4. High level of blood cholesterol can cause accumulation of cholesterol in the arteries. • There are no signs of accumulation at early stages. • Build up of cholesterol leads to hardening of arteries. • Hardening of arteries can lead to heart attack and stroke. • Atherosclerosis can begin in childhood. • After age 20, it is recommended that blood cholesterol levels be checked every five years. Development of Heart Disease PBRC 2010

5. Cholesterol is made by the liver and is also consumed in the diet. • The intestinal track absorbs the cholesterol from foods. • Excess cholesterol that is not used for hormone production accumulates in the bloodstream and cells and can result in cholesterol plaques. Where Does Cholesterol Come From? PBRC 2010

6. There are 3 main types of cholesterol: • High Density Lipoproteins (HDL) • Low Density Lipoproteins (LDL) • Very Low Density Lipoproteins (VLDL) Cholesterol Types: PBRC 2010

7. The Good Cholesterol = HDL Levels should be greater than or equal to 60 mg/dL The Bad Cholesterol = LDL Levels should be less than 100 mg/dL PBRC 2010

8. LDL cholesterol level is controlled by the liver and the intestines. • Consuming foods that are high in cholesterol can increase cholesterol absorption and blood cholesterol level. Low Density Lipoprotein (LDL) PBRC 2010

9. HDL helps to remove cholesterol from the body, which lowers the risk for heart disease. • HDL Cholesterol level that is <40 is a risk factor for heart disease. • HDL Cholesterol level that is > 60 is cardio-protective. High Density Lipoprotein (HDL) PBRC 2010

10. To increase HDL Cholesterol: • exercise regularly, • maintain a healthy weight and BMI, • avoid smoking, • eliminate trans fats, • increase the amount of monounsaturated fats, • add soluble fiber to your diet (Ex: oats, fruits, nuts), and • have alcoholic drinks occasionally. Ho to Improve High Density Lipoprotein (HDL) PBRC 2010

11. Cholesterol level guidelines for children and adolescents (age 2 to 19): Total Cholesterol: • Acceptable range = less than 170 mg/dL • Borderline range = 170 to 199 mg/dL • High range = 200 or greater mg/dL LDL Cholesterol: • Acceptable range = less than 110 mg/dL • Borderline range = 110 to 129 mg/dL • High range = 130 or greater mg/dL Cholesterol Guidelines for children PBRC 2010

12. Cholesterol level guidelines for adults (age 20 and older): Total Cholesterol: • Acceptable range = less than 200 mg/dL • Borderline range = 200 to 239 mg/dL • High Range = greater than or equal to 240 mg/dL LDL Cholesterol: • Acceptable range = less than 100 mg/dL • Borderline range = 130 to 159 mg/dL • High range = 160 to 189 mg/dL • Extremely High Range = greater than or equal to 190 mg/dL Cholesterol Guidelines for Adults PBRC 2010

13. Limit foods that are high in saturated and trans fats. • Limit cholesterol intake to less than 300 mg daily. • Substitute soy protein for animal protein occasionally. • Eat a diet that is rich in fiber and whole grains. (The recommendation is to consume 25 to 30 grams of fiber daily). Reducing Blood Cholesterol Levels PBRC 2010

14. Eat a diet that is low in cholesterol, saturated fats, and free of trans fats • Participate in moderate intensity exercise at least 30 minutes a day • Maintain healthy weight and BMI • Get a periodic physical exam Reducing Blood Cholesterol Levels PBRC 2010

15. Choose Margarine Over Butter • Choose Whole Grain Bread • Rules to Remember When Selecting Foods: • The first ingredient listed on the Nutrition Facts and Ingredients label is the one that is used the most. • Always try to choose foods that have fats and oils listed later on in the ingredients label. Dietary Recommendations PBRC 2010

16. Encourage children to consume a variety of fruits and vegetables. • Offer whole grain breads and cereals. • Help them choose low fat foods. • Help them maintain their weight within normal range. • Make sure they get 60 minutes of physical activity most days of the week. Dietary Recommendations for Children to Prevent High Cholesterol PBRC 2010

17. Authors: Beth Kalicki Heli Roy, PhD, RD Division of EducationPhillip Brantley, PhD, DirectorPennington Biomedical Research CenterSteven Heymsfield, MD, Executive Director • The Pennington Biomedical Research Center is a world-renowned nutrition research center. Mission: • To promote healthier lives through research and education in nutrition and preventive medicine. • The Pennington Center has several research areas, including: • Clinical Obesity Research • Experimental Obesity • Functional Foods • Health and Performance Enhancement • Nutrition and Chronic Diseases • Nutrition and the Brain • Dementia, Alzheimer’s and healthy aging • Diet, exercise, weight loss and weight loss maintenance • The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis. • The Division of Education provides education and information to the scientific community and the public about research findings, training programs and research areas, and coordinates educational events for the public on various health issues. • We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the Pennington Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call (225) 763-3000.  PBRC 2010

18. American Diabetes Association. (2009). Diabetes, Cholesterol, and Heart Disease. Fact Sheet. Retrieved August 13,2009, from http://www.diabetes.org/utils/printthispage.jsp?PageID= ALLABOUTDIABETES_253269 • American Heart Association. (2009). About Cholesterol. Cholesterol. Retrieved August 11, 2009, from http://www.americanheart.org/print_presenter.Jhtml?identifier=512 • American Heart Association. (2009). Cholesterol: Welcome to the first step for a healthy heart. Cholesterol. Retrieved August 13, 2009, from http://www.americanheart.org/print_presenter.jhtml?identifier=1516 • American Heart Association. (2009). High Cholesterol Increases Your Risk. Cholesterol. Retrieved August 13, 2009, from http://www.americanheart.org/presenter.jhtml?identifier=1502 • American Heart Association. (2009). It’s Not Just a Man’s Problem. Women and Cholesterol. Retrieved August 13, 2009, from http://www.americanheart.org/print_presenter.jhtml?identifier=185 References PBRC 2010

19. American Heart Association. (2009). Learn The Facts. Cholesterol. Retrieved August 13, 2009, from http://www.americanheart.org/presenter.jhtml?identifier=3006030 • American Heart Association. (2009). Start Healthy Habits Early. Children and Cholesterol. Retrieved August 13, 2009, from http://americanheart.org/presenter.jhtml?identifier=211 • Center For Disease Control. (2006). Cholesterol Fact Sheet. Fact Sheets and At-A-Glance Reports. Retrieved August 18,2009, from http://www.cdc.gov/print.do?url=http://www.cdc.gov/DHDSP/library/fs_cholesterol.htm • Federal Citizen Information Center. (2009). What You Need to Know About Cholesterol. Health. Retrieved August 18, 2009, from http://www.pueblo.gsa.gov/cfocus/cfcholesterol08/focus.htm • Nazano, Brenda. (2009). High Cholesterol: Heart-Healthy Diet. Cholesterol Management Guide. Retrieved August 13, 2009, from http://webmd.com/cholesterol-management/guide/heart-healthy- diet?print=true References PBRC 2010