IF you are confused about cholesterol, you are not alone.
New cholesterol guidelines from heart health experts have recently changed the way health care providers manage cholesterol. Now is a great time to catch up — and separate Truth from myths.
LDL cholesterol levels are a major factor in risk for cardiovascular disease
Myth #1: Your cholesterol level determines whether you should take cholesterol medication.
*Fact : Your overall heart health risk determines whether you should take cholesterol medication.
If this myth sounds familiar, it is because that was the old-school way of managing cholesterol.
Before, if your cholesterol was high, your provider would prescribe a medication to lower it and then check your blood regularly to make sure that your LDL (“bad”) cholesterol stayed under a certain target level.
What’s wrong with that? This approach led patients and health care providers alike to over-focus on cholesterol target numbers that were actually pretty arbitrary. We don’t really know how much different LDL-cholesterol levels change your risk of heart attack and stroke (i.e. your cardiovascular risk) — and after all, that’s what we really care about, not blood test results.
Your cholesterol is just one indicator of your risk among many. Smoking cigarettes or just getting older, for example, are even bigger risk factors
Overall heart risk determines level of cholesterol medication.
Myth #2 : Statin cholesterol medications lower the likelihood of heart attack, stroke and death for anyone who takes them.
Fact: The higher your cardiovascular risk, the more you will benefit from taking a statin. For people with good heart health, the side effects of statins usually outweigh the benefits.
Statin medications lower the likelihood of heart attack, stroke and death for people with high cardiovascular risk, regardless of their cholesterol levels
Given the side effects of statins, such as muscle pain (more common) and a higher risk of diabetes and liver damage (less common), it’s important that providers recommend cholesterol-lowering medication only for people who benefit from it the most, for whom the benefits outweigh the harms.
If you are someone who has low cardiovascular risk, statins won’t do you much good; they won’t significantly reduce your already-low risk of heart attack and stroke — even if they bring your “high” cholesterol level down to normal range.
On the other hand, you might have “good numbers” when you get your cholesterol checked, but if you’re high risk for other reasons, taking a statin could literally be a lifesaver. If you are moderate risk, you should weigh the pros and cons of statin medications with your primary care provider and make a decision together about what is right for you.
EATING LESS REDUCES CHOLESTEROL.
Myth #3: A heart-healthy diet means eating less fat.
Fact: Eating healthy fat is better for your heart than eating less fat.
A heart-healthy diet means eating real food and less processed, packaged, and fast food.
What does “ real ” mean? It means eating food that is close to its original form, whether that’s spinach sautéed in olive oil or a green apple with natural peanut butter.
A good rule is to shop the perimeter of the grocery stores, where you will find fresh fruits, veggies, dairy and meats.
The inner aisles are more likely to have packaged, processed foods with fewer nutrients your body needs (like fiber), and what you don’t need (like added sugar).