Learning About Cholesterol

It’s been rather a long while since I wrote about the importance of finding reputable online resources for learning about cholesterol. You can permanently locate links to educational resources on my Resources/Info Links page, but I thought it might be helpful to discuss in a post.

Why?

Well, quite frankly it’s because when discussing high cholesterol and heart disease risk, many doctors – who speak daily, probably, about cholesterol – rush through the conversation and use unfamiliar terms. On the receiving end it can feel like a tornado rather than a give and take discussion of personal cholesterol results and the resulting medical goals.

Plus, you’re going to google cholesterol anyway, you know you are.

Which is good, actually, because the more you know about cholesterol and heart disease risk – and treatment alternatives — the more committed you are likely to be to your cholesterol management program. Well, maybe. (My commitment waxes and wanes.) At the very least, researching online will enable you to create a list of questions to ask your doctor at a follow up appointment.

And researching should help you question whether prescription medication is absolutely necessary for your personal cholesterol management plan. Which is a vital step many seem to skip.

Truth be told, cholesterol-lowering statin medication is absolutely justified for many, many people – and these meds have undoubtedly saved many lives. But if high cholesterol is your only risk factor, you should question the validity of statin meds for you individual case. Have a discussion about the pros and cons with your doctor. And to do that well, you need knowledge.

But you don’t want to search just anywhere on the web. Some sites – such as WedMD — are largely funded by big pharmaceutical companies so you’ll want to know their slant. To help ensure you are gleaning information from reputable, unbiased sites, here are a few to check out.

An excellent source is the National Cholesterol Education Program (NCEP) which I recently wrote about in my post, September is National Cholesterol Education Month. This site has a great deal of useful information, though it’s layout makes it difficult to navigate. See my post for specific links to the useful sections of this site – including an online calculator for heart disease risk.

For an excellent overview about cholesterol, a visit to the American Heart Association – Cholesterol Overview site is a great place to start. This site explains that cholesterol itself is not ‘bad’ and that it is created both by our bodies and from the foods we eat. Scrolling through this article you’ll find an explanation of ‘good’ and ‘bad’ cholesterol, and there’s even an animation if you really want to get a visual of what cholesterol is and how it works in your body.

The Mayo Clinic is one of my favorite sites for unbiased, well-explained information about cholesterol and heart disease risk. (Go ahead. Color me geeky.) It is vital to truly understand your personal heart disease risk; the Mayo Clinic’s High Cholesterol Risk Factors page explains that there are seven conditions which, when combined with high cholesterol, elevate heart disease risk.

Test results are a big factor in risk assessment, and it’s pretty likely that your doctor zoomed through your personal lipid panel test results and what they mean. To learn more about why the goal for ‘total cholesterol’ is at or under 200 mg/dL, what triglycerides are, and what those HDL and LDL numbers really mean, visit the Mayo Clinic’s incredibly useful High Cholesterol Tests and Diagnosis page. This page is an excellent reference that explains the targets for each key cholesterol measure – and relates them to heart disease risk level. In my humble opinion, this page is one of the most useful online resources available.

Finally, if you want to avoid statin medication by lowering cholesterol through diet and lifestyle, you’ll want a good nutritional resource. For that, the Cleveland Clinic’s Nutrition-Cholesterol Guidelines is a terrific resource that explains what’s good and bad about things like the different kinds of fats, dietary cholesterol, protein, carbohydrates, and plant sterols. Even better, it gives a daily target for each. Best of all (major geek alert), there’s a handy chart that summarizes the key info all in one place. Make sure you scroll to the bottom of the page to see this useful chart.

And OK, I lied a minute ago. In my humble opinion, the Cleveland Clinic’s nutrition-cholesterol guidelines page is one of the most useful online resources available.

Let’s make it a tie. I vote that the Mayo Clinic’s High Cholesterol Tests and Diagnosis page wins for explaining test results and targets, and the Cleveland Clinic’s Nutrition-Cholesterol Guidelines page wins for showing how to combat high cholesterol, nutrition-wise.

Beyond these there are, of course, many other great online sources for information about cholesterol and heart disease risk. And your doctor is potentially the best resource of all. That said, the more you know, the better questions you can ask your doctor — and that will go a long way to ensure the program you and your doctor devise is the best possible course for you.

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What is a low-fat recipe, really?

So there I was in the produce aisle searching for arugula to try that Pappardelle with Baby Spinach Arugula, Herbs and Ricotta recipe I posted about when my friend Michaela called.

“Why is this a good lo-co recipe?” she asked.  “Where is the nutritional info?  I didn’t see that in your post?  Can you add that?”  (Michaela writes historical fiction for teens – so she’s a stickler for details!  But we love her anyway.)

I stammered something to the effect of, “Well, um, it’s a Cooking Light recipe… so… um…”

And then I peered more carefully at the recipe.  Bucking usual Cooking Light norms, this recipe calls for whole-milk ricotta rather than a skim/reduced fat version.  And though I nearly always replace full-fat with lower fat, I didn’t in this recipe, as that felt risky – the ricotta mixed with hot pasta water is the entire sauce.  Plus, I felt sure that the folks at Cooking Light would have tried a reduced fat ricotta when they were testing it, and if it was good, it would have been in the recipe.

So why is a recipe with a full-fat ricotta okay as a low-fat / lo-co option?  (Or worse, maybe it’s not?)

Further inspection made me feel better – this recipe has 11.6 grams of fat and 329 calories – so only 4% of calories from fat.  And I didn’t need my calculator to see that 4% is far lower than the ‘no more than 30% calories from fat’ rule of thumb.  Woot.

But wait – it has 14 mg of cholesterol.  Is that OK?

ARGH.  It’s hard enough to plan lo-co dinners at all.  If I now need to analyze the nutritional content of every recipe I consider, you know I’ll abandon cooking altogether and end up dining at Wendy’s all the time.  With a Phish Food chaser.

So I jammed the recipe into my back pocket.  Questions be dammed: this recipe is from Cooking Light and I’m going with it.  Into the cart went the full fat ricotta this recipe calls for, as well as the arugula a few recipe reviewers suggested.

And I am happy to report that this recipe was fantastic the 2nd time around, with baby arugula instead of baby spinach and these other modifications:

  • The ‘pour the pasta water over the spinach/arugula’ suggestion was brilliant.  This cooked (blanched?) it just enough to take the edge off but still taste fresh.
  • I eliminated the dill as I just really don’t like it – and didn’t miss it at all.  Might try substituting other fresh herbs next time I make this
  • After adjusting to a finer grind on my pepper mill, it was fine, pun intended. (Of course I didn’t measure it, so have no idea if the ‘1/2 tsp’ is a good amount – I leave that to your personal taste & judgment.)

And here’s a bonus: my 16-year-old son actually ATE and LIKED this dish.  Not only that, the LIE ACTUALLY WORKED!  He bought that the arugula was an herb and actually ate some, though did leave a smattering at the bottom of his pasta bowl claiming it was too ‘leafy’ for him.  But overall, he actually liked it!

Another bonus – it is GREAT as a leftover for lunch.   So I highly recommend the Cooking Light Pappardelle with Baby Spinach (or Arugula), Herbs and Ricotta recipe.

For you data hounds out there (Michaela, that means you) here is the nutritional info per serving for this recipe – it’s also printed on the recipe itself but here goes: Calories: 329, Fat: 11.6g, Saturated fat: 3.6g, Monounsaturated fat: 6.1g, Polyunsaturated fat: 1.1g, Protein: 12.2g, Carbohydrate: 45.5g, Fiber: 2.9g, Cholesterol: 14mg, Iron: 2.9mg, Sodium: 373mg, Calcium: 118mg.

And if you really want to know more about nutritional info, check out the Cleveland Clinic’s Nutrition-Cholesterol Guidelines.  These guidelines lay out the % of total calories recommended for each type of nutritional element. Pasted below is a summary chart, but this web page has a lot of useful (albeit somewhat overwhelming) info.

And hey – look at that – turns out I can 100% confirm that this IS a great lo-co recipe:  it’s easy, fast, delicious AND has just 14 mg of cholesterol.  Which, looking at the chart below, is just 7% of the 200 mg total per day recommended in the chart below.  Totally lo-co.

And best of all, that leaves room for a Phish Food dessert, don’t you think?

NutrientFor a 1,800-calorie diet
Saturated fat, <7% of calories14 grams or less per day
Polyunsaturated fat, up to 10% of caloriesUp to 20 grams per day
Monounsaturated fat, up to 20% of caloriesUp to 40 grams per day
Total fat, 25% to 35% of caloriesBetween 50 and 70 grams per day
Carbohydrate, 50% to 60% of caloriesBetween 225 and 270 grams per day
Protein, about 15% of caloriesAround 67 grams per day
CholesterolLess than 200 milligrams per day
Fiber20-30 grams per day with a focus on viscous (soluble) fiber
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