What the Mediterranean Easter Bunny Taught Me About Cholesterol
In my G.O.A.L.S. Society group, we had a lot of discussion on cholesterol this week. In fact, the story goes like this.
A very fit, young woman with a family history of high cholesterol had her labs checked. Her LDL cholesterol was reported high. She was quite concerned given her family history. She understands while there is a genetic component, she also wants to do her best to address the level.
So what to do??
Before we can discuss solutions, let’s talk about mindset.
Let’s be honest, any time we get a report on our health that doesn’t fit into the “normal” category, we often think about the worst case scenario. From there, we start to blame ourselves and even think that we are flawed, damaged, not right.
So… here is the thing. There is a much bigger picture… the number doesn’t necessarily define us. Adopting a thought such as, “I will do my absolute best to take care of myself, and I will rely on others to help me along the way. I am not alone. I do not have to do this alone,” will allow you to begin working on this...
Ok - let’s get back to cholesterol.
And, I am going to put the focus today on nutrition. I won’t be talking about alternative solutions and medication. Medication may ultimately be necessary because even after the best efforts at making these lifestyle changes, many people still struggle to lower their LDL enough. Again… genetics. And remember, the reason we are concerned about high cholesterol levels is because elevated levels can increase our risk of cardiovascular disease. Other cardiovascular disease risk factors include: family history, smoking, obesity, high-fat foods, inactivity.
The experts agree that there are nutrition plans that are known to decrease the risk of cardiovascular disease. Today I want to focus on The Mediterranean Diet. The Mediterranean diet, abundant in minimally processed plant-based foods, rich in monounsaturated fat from olive oil, but lower in saturated fat, meats, and dairy products, is an ideal nutritional model for cardiovascular health.
The main components of Mediterranean diet include:
Daily consumption of vegetables, fruits, whole grains, and healthy fats
Weekly intake of fish, poultry, beans, and eggs
Moderate portions of dairy products
Limited intake of red meat
Other important elements of the Mediterranean diet are sharing meals with family and friends, enjoying a glass of red wine, and being physically active.
The main sources of fat and alcohol among persons in the traditional Mediterranean are primarily extra-virgin olive oil (EVOO) and red wine, respectively. The abundant use of olive oil, through salads, traditionally cooked vegetables, and legumes, together with the moderate consumption of red wine during meals makes this diet highly nutritious and palatable.
Red wine and EVOO contain several bioactive polyphenols (hydroxytyrosol and tyrosol, oleocanthal, and resveratrol) with postulated anti-inflammatory properties. Postulated antiatherogenic properties of olive oil were supposedly attributed to its high content of monounsaturated fat (MUFA; oleic acid), and some more recent investigations also suggest that bioactive polyphenols, only present in the EVOO, but not in the refined-common variety of olive oil, may contribute to these cardioprotective actions.
Research has consistently shown that the Mediterranean diet is effective in reducing the risk of cardiovascular diseases and overall mortality.
A study of nearly 26,000 women found that those who followed this type of diet had 25% less risk of developing cardiovascular disease over the course of 12 years. The study examined a range of underlying mechanisms that might account for this reduction, and found that changes in inflammation, blood sugar, and body mass index were the biggest drivers.
One interesting finding of this eating plan is that it dispels the myth that people with or at risk for heart disease must eat a low fat diet. Although it does matter which types of fats are chosen, the percentage of calories from fat is less of an issue.
The PREDIMED study, a primary prevention trial including thousands of people with diabetes or other risk factors for heart disease, found that a Mediterranean diet supplemented with extra virgin olive oil or nuts and without any fat and calorie restrictions reduced the rates of death from stroke by roughly 30%. Most dietary fats were healthy fats, such as those from fatty fish, olive oil, and nuts, but total fat intake was generous at 39-42% of total daily calories, much higher than the 20-35% fat guideline as stated by the Institute of Medicine. Risk of type 2 diabetes was also reduced in the PREDIMED trial.
I think the main takeaways are: genetics play a huge role in everything, you are not broken, help is on the way, you didn’t do anything wrong, all fats are not created equal, let’s all move to Italy.