Maintaining a healthy diet, exercising, and sometimes taking statins to control cholesterol can all work at protecting heart health. And these cholesterol-lowering recommendations from your doctor are backed by scientific evidence. Taking medication for high cholesterol lengthens life and delays death by an average of two years, even when the drug is started at an advanced age, according to researchers from the University of California, San Francisco, who reviewed more than 80 studies on cardiovascular disease.
So why is lowering cholesterol such a challenge?
It turns out people make a number of mistakes in their efforts to reduce high cholesterol. Take a few minutes to learn which obstacles could be standing between you and a successful cholesterol lowering plan.
Here are 10 ways you may be sabotaging your own efforts to reduce cholesterol:
- Ignoring dietary sugar. When people get a high-cholesterol diagnosis, they sometimes focus solely on limiting cholesterol and fat in the diet. But that means you may be overlooking sugars, which also contribute to high cholesterol, says cardiologist Erin D. Michos, MD, an assistant professor of medicine in the division of cardiology at the Ciccarone Center for the Prevention of Heart Disease and Johns Hopkins School of Medicine in Baltimore. The problem is that excess calories, which can come from sugar as well as fat, are turned into fats and triglycerides and can then contribute to unhealthy cholesterol levels. “People don’t realize that this is why their numbers are not getting any better, even though they are reducing fat and exercising,” says Dr. Michos. Also, don’t forget that alcohol heaps on more sugar (and cholesterol). Cut back on all sources of sugar, including sweetened drinks, and opt for whole grains over refined carbohydrates.
- Focusing only on LDL. Thanks to cholesterol education and even your doctor’s instructions, you might be too focused on your low-density lipoprotein (LDL) cholesterol, the so-called “bad” kind. You actually need to pay attention to your whole lipid profile, which includes total cholesterol and triglycerides.
- Not sticking to a medication plan. Even though statins have a proven impact on cholesterol levels and may have particular benefits for people with coronary heart disease, people do not always take statins as recommended. A summary of data published in the Journal of Vascular Health and Risk Management found that only about 25 percent of patients were taking their statins regularly five years after the drugs were first prescribed. There are many reasons why people have a hard time taking their medications as instructed, but the bottom line is this: If you don’t take your medication on schedule, you won’t get the heart-health benefits you need. Talk to your doctor about any barriers you’re facing, whether it’s a matter of timing, cost, or fear of side effects.
- Eating whatever you want. Taking statins does not mean you can ignore advice about a cholesterol-lowering diet, stresses Michos. Many people wrongly believe their medication will undo any cholesterol overload, regardless of what they eat. You still have to watch your calorie intake in addition to the fats and carbohydrates that could be contributing to your cholesterol problem.
- Cutting out all dietary fat. Another common mistake is thinking that all fats should be avoided. It’s true that you should cut out trans fats and saturated fats, says Michos, who adds, “the biggest source of trans fats is baked goods, like crackers, and cookies.” But you do need — in moderation — monounsaturated and polyunsaturated fats, such as olive oil, olives, nuts like walnuts and almonds, and the omega-3 fatty acids in fish, she explains. You’ll still have to watch the calorie count, which can add up fast even with “good” fat, but make sure to include small amounts in your diet.
- Not knowing your cholesterol numbers. High cholesterol has no symptoms, so many people don’t know they have it. National guidelines recommend cholesterol checks every five years after age 20.
- Banning the wrong foods. It’s true that if you have high cholesterol you should watch the amount of cholesterol you consume from food sources, keeping your daily total to less than 300 milligrams. This means you need to make thoughtful choices about what you eat. Consider eggs, which for years got a bad rap as a high-cholesterol food. “Eggs also are rich in protein and nutrients,” says Michos. So you can have one egg, if you want it — just don’t eat it with a fatty slab of steak and a glass of whole milk. In other instances, a healthy substitution, such as low-fat instead of full-fat cheese, can allow you to keep eating a favorite food while still aiming to reduce cholesterol intake.
- Not exercising. “Diet alone is often not enough — it should be combined with exercise,” says Michos. A review of health data from 4,469 British civil servants between 39 and 62 years of age showed that, over an 11-year period, increasing physical activity and eating more healthfully helped to lower LDL cholesterol, according to data published in the journal Heart. According to the research, which also looked at the impact of medication to lower cholesterol, successfully lowering high cholesterol takes a multi-pronged approach that includes diet, exercise, and, for people who need it, medication.
- Yo-yoing from fad diet to fad diet. How do you know which weight-loss, cholesterol-reducing diet to choose from the hundreds now being marketed? Michos says the diets that seem to work best for improving heart health and reducing cholesterol are among the oldest. She recommends a Mediterranean style diet, which emphasizes fruits, vegetables, whole grains, healthy fats, and fish. Stick with this diet, watch portions and count calories, and you can achieve weight loss, counter high cholesterol, and get off the roller coaster of sampling the latest trendy diet.
- Taking medications with grapefruit juice. Maybe you want to get a healthy start to your day and take your statins with breakfast. Makes sense, unless your breakfast includes grapefruit juice, which can interfere with your cholesterol control medication. Publishing in the Journal of Pharmaceutical Sciences, Japanese researchers showed that grapefruit juice can prevent your body from absorbing certain types of statins. Ask your doctor if your particular statin is likely to be affected by grapefruit juice. Even if it’s not, Michos notes, it’s still a good idea to separate the two by many hours. So go ahead and drink grapefruit juice in the morning, but plan on taking your statins in the evening, which is often recommended, anyway, because your liver makes more cholesterol at night.
These common mistakes are easy enough to avoid with some practice. And, because cholesterol-reducing recommendations really do work, if your numbers still aren’t going down, talk to your doctors about what might be keeping you from the level of success you need.