February 6, 2020

Cholesterol – What Impacts Our Levels?

Show Notes

On this episode, Chuck Gaidica is joined by Kristian Hurley, Senior Director of Community Impact for the American Heart Association of Southeastern Michigan as well as Grace Derocha, a registered dietitian, certified health coach, diabetes care and education specialist at Blue Cross Blue Shield of Michigan. Together, they discuss cholesterol levels and how they can affect heart health.

“We’ve said it a million times, eat smart. Eat those things that we all know are healthy. Everyone knows this. Eat your fruits and vegetables. Eat those whole grains. Eat those lean meats and proteins. Fish is fantastic. Those are all things that are going to help you.” – Kristian Hurley

In this episode of A Healthier Michigan Podcast, we explore:

  • What is cholesterol and where does it come from?
  • The difference between good and bad cholesterol
  • Controllable and uncontrollable risk factors
  • The importance of a healthy diet
  • Tips on how to monitor cholesterol levels
  • What are triglycerides?
  • How tobacco smoke impacts cholesterol

 

Transcript

Chuck Gaidica: This is A Healthier Michigan Podcast, episode 47. Coming up, we discuss cholesterol and its relation to heart health.

Chuck Gaidica: Welcome to A Healthier Michigan Podcast. It’s a podcast dedicated to navigating how we improve our health and well-being through small healthy habits we can start implementing right now. I’m your host, Chuck Gaidica and every other week if you’ve been joining us, you know that we sit down with a certified health expert from Blue Cross Blue Shield of Michigan and we dive into topics that cover nutrition and fitness and today heart health, but also this idea of cholesterol. This episode we’re going to spotlight cholesterol and we’re going to do it with a few experts to help us understand the importance of paying attention to it. Registered Dietitian and Certified Health Coach Grace Derocha is back. Hello.

Grace Derocha: Hi.

Chuck Gaidica: Nice to see you.

Grace Derocha: Always nice to see you.

Chuck Gaidica: Registered Dietitian, Certified Diabetes Educator, Certified Health Coach at Blue Cross Blue Shield of Michigan. She’s got a blog. She’s on the radio, TV, movies, dancing. I don’t know. Justin Timberlake is her … What is he your crush?

Grace Derocha: My boyfriend. Tom knows. My kids call him Uncle Justin.

Chuck Gaidica: Come on.

Grace Derocha: Yeah, it’s true. I have a cardboard cutout of him in our house.

Chuck Gaidica: Do you really? This is a whole separate podcast that we’re going to have to get into. Kristian Hurley is here. She’s the Senior Director of Community Impact for the American Heart Association of Southeastern Michigan. She’s been in nonprofit executive leadership for a long time, but now she comes to us with a treasure trove of information about heart health and cholesterol this morning. It’s good to see you.

Kristian Hurley: Good to see you too.

Chuck Gaidica: I should say today, right? It could be any of time of the day-

Grace Derocha: And she can sing.

Chuck Gaidica: She can sing and we just learned that too. That’s really what should be fun is we’ll do a podcast about the stuff you don’t know about the people we’re talking to.

Kristian Hurley: Right. Oh, scary.

Chuck Gaidica: You’re into karaoke are you?

Kristian Hurley: I do enjoy it.

Chuck Gaidica: Yeah, no I karaoke too and I’ve got a theory. If you drink enough, I sound just like Sinatra. If you have a beer and not if I have it, if you do, I sound much better.

Kristian Hurley: That’s generally true.

Grace Derocha: I think that’s a good theory.

Chuck Gaidica: It is.

Grace Derocha: It’s a good thing.

Chuck Gaidica: It is. It’s probably good for your heart. I’m not sure. Well, let’s talk about this idea because we hear this word, it’s a bit of a scary idea when you hear cholesterol, especially if a doctor says yours is too high. But, what is cholesterol? Can we start there?

Grace Derocha: Yeah, so cholesterol is interesting. It’s a waxy substance.

Chuck Gaidica: Mm-hmm (affirmative). See, I’m scared already.

Grace Derocha: I know. It’s not a candle. It’s a waxy substance that we create in the body through the liver naturally, but we also intake some with some of our food choices in the food that we eat.

Chuck Gaidica: And to be fair, some people, DNA maybe makes them overproduce or producing that nothing to do with what they’re eating too, right?

Grace Derocha: Yeah that’s-

Chuck Gaidica: This may not be that you’re just eating junk food all the time.

Grace Derocha: Right. If I was talking about uncontrollable risk factors genetically, you may just have naturally higher cholesterol. I’ve had patients like that. They did everything right. They were fit, they ate healthy and nutritious food, but their cholesterol just tended to be higher because of how their body made and produced cholesterol.

Chuck Gaidica: It’s not inherently bad, right? If we’re all producing it, that means we’ve all got it floating around in our bloodstream, so it’s not really bad at the start.

Kristian Hurley: No, not necessarily. I mean even things like your triglycerides, which we haven’t talked about yet will give you additional energy per se, right? There are some good qualities to it, but in general Americans are getting way too much cholesterol. 94 million Americans have high cholesterol. 40% of our population are dealing with high cholesterol, so yes and no. There’s a lot that we need to do to generally get that down.

Chuck Gaidica: If we look at and we break down how it’s being produced, Grace has already mentioned it comes from the liver. Most of it comes from the liver cholesterol production?

Grace Derocha: Yeah. It’s in ourselves, but then our liver is the main producer of it.

Chuck Gaidica: Yeah. And then what about the foods we eat? There is a direct correlation to what we eat. If I am having too much oil and butter and stuff and I go give blood, it comes out looking like oil in my car. I mean there, there really is a direct connection for many, many people.

Grace Derocha: Yes, absolutely. What is interesting is that it is based on the food we eat when it comes to … oftentimes people think if they have food with cholesterol, which is always animal products, then their cholesterol will be high. That is one part of it and then the other part is overweightedness or processed fried foods that aren’t the best for you either.

Chuck Gaidica: What if you’re not moving? What if you’re sedentary, right? Does that allow it to build up or is that just my idea that it’s sitting all in one place and it’s not moving around?

Grace Derocha: Exercise definitely important component of helping your cholesterol come down and improve some of the numbers. Well, I should say total cholesterol and LDL, but then exercise can help bring the HDL number up, which we’re going to talk about a little bit, which would be a good thing.

Chuck Gaidica: So risk of heart disease goes up? I mean there is an equation that you can really have a correlation here, right? To-

Kristian Hurley: Well, absolutely. Any heart or blood vessel disease is generally caused by a buildup of cholesterol in those artery walls, right? The way to really think about it is if you have a buildup of fat in your arteries and it blocks your blood flow to your heart, you’re going to have a heart attack. That’s a heart attack. If you have a blockage and it cuts off the blood flow to your brain, then you’re going to have a stroke, right? There is a direct correlation as to why it’s important to manage your blood pressure.

Kristian Hurley: The good cholesterol and the bad cholesterol, I think one great thing is that the good cholesterol actually helps to clear out the bad cholesterol out of your artery, so you really want to make sure we’re talking about food and exercise that you are eating foods that are going to give you higher levels of good cholesterol and getting that physical activity so that you can be helping your body to fight that bad cholesterol. As we said, it’s not all bad. There’s good cholesterol that you can get also from food and from honestly exercising.

Chuck Gaidica: Well, let’s talk about food. Let’s deal with that for just a minute.

Grace Derocha: I love food.

Chuck Gaidica: Oh, and everybody. We all love all kinds of food and we’ve just come out of a holiday season and my New Year’s resolution is less birthday cake. Good luck. But the kinds of foods that you’re going to eat could be high in fat maybe there’s more sugar. What are the things that we really should be paying attention to that are in foods that directly are proven to affect our cholesterol?

Grace Derocha: Your overall calories, you want to make sure you’re having the right amount of calories for your body. But then specifically the types of fat that you’re choosing to help your happy or healthy HDL cholesterol go up and then your LDL cholesterol and total cholesterol be in the right range.

Chuck Gaidica: We are going to dig into this because it does get a bit confusing. Happy. What did you say? Happy cholesterol.

Grace Derocha: Yeah, so HDL.

Chuck Gaidica: H for happy?

Grace Derocha: Yeah, happy or healthy. That is the one that we want to have. I always say over 60 milligrams per deciliter. That is the specific number when you get your blood drawn for your cholesterol numbers. The way to help do that, well there’s a couple of ways, but the one of the number one ways is by incorporating heart healthy foods.

Chuck Gaidica: Yeah. And what would those be? Heart healthy foods?

Kristian Hurley: Fruits and vegetables always are going to be a key. Whole grains are going to be very, very helpful. Fat-free or like we said, lower fat milks are always going to be good for you. Poultry can be good. I cut off the fat.

Grace Derocha: Yeah, lean protein.

Kristian Hurley: Lean protein. Lean meats in general. Salmon is a fabulous thing to eat to help your good cholesterol.

Grace Derocha: Yes.

Kristian Hurley: Those kinds of things are all going to be working toward-

Grace Derocha: Some of those heart healthy fishes. Your salmon, halibut, mackerel, all those.

Chuck Gaidica: If you’ve ever heard of the book Blue Zones, if you scan the world and you see Sardinia lights up and you see Japan lights up, you can see places where fish and natural foods are important and low-fat foods and good heart-healthy oils, like an olive oil maybe.

Grace Derocha: Yeah, some nuts, some seeds.

Chuck Gaidica: These guys are living to a hundred plus.

Kristian Hurley: Absolutely.

Chuck Gaidica: Yeah. When we see it, we should be encouraged that whatever they’re doing is making some sense.

Kristian Hurley: Oh, absolutely. Absolutely. Yeah.

Chuck Gaidica: When we have high cholesterol, short of some emergency, something like a heart attack, can you really ever tell that you have it? Would you feel sluggish or you really could be walking around not knowing unless you go get your blood drawn.

Grace Derocha: I think it’s not symptomatic. You know what I mean? If your cholesterol is high, it’s not like when you break your arm you because it hurts.

Chuck Gaidica: Sure.

Grace Derocha: But a chronic condition like having high cholesterol or even arthrosclerosis, which is basically the buildup in the artery walls of plaque, which is high cholesterol. Then the next step would be, in a bad way, would be a heart attack or stroke because of a blockage. You don’t feel that until something happens.

Kristian Hurley: Which is why it’s so critically important to get it checked and to go to those annual wellness physicals and make sure that it’s being checked and know what your numbers are and know what they mean so that you can stay on topic. Because you really wouldn’t know otherwise. And then also really importantly, knowing your family history. We talked about how it can be familial and that, that’s going to be key because you could have high cholesterol and be perfectly fit. You can look fantastic and feel fantastic and you just have a family history and you’re just genetically inclined to having it. I think it’s also good to know that if you do have a family history of high cholesterol and you’ve got kids, even your kid should be getting checked for high levels of cholesterol as early as age two.

Chuck Gaidica: Oh, really?

Kristian Hurley: Oh yeah, if there’s a family history for it. It’s very important to know that. It’s one of those things just being knowledgeable about and having it checked often and knowing what it means and making those lifestyle changes that are going to…

Chuck Gaidica: The genetic part is interesting to me and it brings a few questions to my mind because I think we have an adopted person in our family, right? I think one of the struggles that this younger child who’s now maturing is going to have, and they’ve already thought of this, they don’t really know the genetic history, so they sort of have to start from a baseline, which is still good. Get some blood work, so you kind of know. But I don’t know that grandma had troubles, so that’s a dilemma. And then talk to me for a minute about demographics. When we hear about heart issues, heart attacks in general, can you speak to the idea of men versus women, people of color or not, are there any things that jump up? I was talking about parts of the world light up. Are there demographics that light up that those persons should be a little more concerned than not?

Kristian Hurley: Yeah, I mean women have typically have higher rates of high cholesterol than men actually, so that’s one key demographic.

Chuck Gaidica: Just because. Not just because not because they’re eating differently. It’s just-

Kristian Hurley: Yeah, I mean-

Chuck Gaidica: … because they’re women.

Kristian Hurley: Do you have anything to add on that?

Grace Derocha: Yeah. I was going to say, so women naturally carry more fat on their body because we have to make babies. There is a little bit of research that shows just because naturally that’s the way we’re built and men technically carry more lean muscle versus fat per se.

Chuck Gaidica: Interesting. Yeah.

Grace Derocha: There’s a little bit of research about that, which makes sense-

Kristian Hurley: It does.

Grace Derocha: … obviously. But we’ve talked about this when we talked about sodium. Heart disease is the number one killer of men and women across the board, so never to forget that is really important.

Chuck Gaidica: Yeah. All right, so we’ll keep talking about this idea. I want to in now to this healthy HDL cholesterol and the LDL, the lousy cholesterol because I think a lot of people would get confused about this. Let’s deal with lousy cholesterol. LDL, what is it?

Grace Derocha: The lousy cholesterol, the LDL and I like to call it lousy too because it’s not the best. That is a cholesterol … It stands for low density lipoprotein, which is what I … just LDL.

Chuck Gaidica: LDL is a lot easier. Yeah. Yeah.

Grace Derocha: LDLs the bad one. What we want, we want to keep that number to less than a hundred. I like to say less than a hundred for both, some people say less than 130 for men, but just less than a hundred in a perfect world. What that does, it actually takes cholesterol to your arteries. It makes the plaque buildup and that’s why it’s lousy. If you’re picturing your artery wall, the LDL is like, I’m just going to drop some of that all around that wall.

Chuck Gaidica: Well it happens in our homes in the pipes that run in and out of our house. I mean you’ll see buildups if you’ve ever had a broken pipe or seen one there’s gunk inside there that builds up over time, even in fresh water pipes and that’s been a similar way I’ve always kind of thought of them.

Kristian Hurley: That’s a perfect example. Yeah, think about those cloggy pipes. You don’t want that happening in your body and everybody knows what that causes.

Grace Derocha: Yeah, exactly.

Chuck Gaidica: It’s not just this narrowing of the pipe per se with the buildup because sometimes that buildup can clog, right? But sometimes that stuff can break off and that’s a clot so that can travel and cause grief by itself.

Kristian Hurley: Absolutely.

Grace Derocha: Heart attack or stroke and the buildup itself. If you think about, that impacts your blood pressure because now your heart has to work harder to pump blood through because now an artery that was whatever this big, you guys can’t see me, but-

Chuck Gaidica: Oh we can.

Grace Derocha: You can. Now because of the buildup it’s this big, so then your heart has to work harder to push the blood through the body.

Chuck Gaidica: I forgot this question. See what happens when you get to be my age. There really could be a correlation if you’re exhibiting symptoms of high blood pressure, that may be one thing to have checked out, right? The cholesterol to make sure.

Kristian Hurley: Both of those factors are going to go into your risk overall for heart disease and stroke. One of the tools that the AHA has right now on our website is our Check Change Control calculator and you can go in there and once you’ve gotten your checkup you can put in your HDL numbers and your LDL numbers, your lousy and your healthy cholesterol and your triglycerides as well and you can put in your blood pressure and it will tell you your risk for heart disease or stroke and then that’s something that you are then armed to have an additional conversation with your healthcare provider.

Kristian Hurley: There is additional tests that you can request of your doctor that maybe isn’t something that they would normally do. Maybe for example, a calcium scoring test where they can go in and really look at that builds up in your arteries. They wouldn’t necessarily need to do that unless you were-

Grace Derocha: You knew that there was buildup to a certain degree.

Kristian Hurley: Right. If you’re a very high risk, you’ve been experiencing some high levels of bad cholesterol, then maybe that would be something you would consider, but you wouldn’t know to ask for that unless you know you had a good sense of what your risks were.

Chuck Gaidica: And tell us again, because I’ve looked at the website for the American Heart Association, it’s Check-

Kristian Hurley: Check Change and Control Cholesterol specifically. Fantastic resources available through that program all just as it says. Making sure that people are aware and they’re checking that cholesterol. Because again, you’re not going to know necessarily that you have it unless something bad happens and you don’t want that.

Grace Derocha: You know what, I always say know better, do better. Check is so important to that.

Kristian Hurley: Check it and change it. We have so much control over this. I mean it really is one of those things where lifestyle factors in what we’re eating and how much physical activity we’re getting it really makes a big difference in your cholesterol. It’s a reversible. Even if you get a bad score you can reverse that.

Chuck Gaidica: Yeah. I think we’ll talk about that a little bit more because it is important to understand that some little changes in lifestyle can have high impact. We’ll come back to this idea because it’s really important and I’m so glad American Heart Association has that because it does give us a baseline. Really at any moment you’ve gotten blood work where you can plug in those numbers tomorrow, a year from now whenever it is, you can start to follow how you’re impacting your health.

Grace Derocha: Yeah and I don’t want … Because I think it’s important because we mentioned a few times that there is a genetic predisposition. 75% of our body makes cholesterol, but that 25% that we own and have control over can greatly impact how your heart health lives in remains for the rest of your life. I don’t ever want that to be … because some of my patients, you know who you are, they’ll say to me, “Oh, it’s all genetic.” And I’m like, “Listen, Sally and Joey”-

Chuck Gaidica: Most of it’s not.

Grace Derocha: You have so much power here. You know what I mean?

Chuck Gaidica: Yeah.

Grace Derocha: To feel empowered and knowing these things and not chalking it up to it’s my grandparents’ fault, or whatever. It’s not, you can own it.

Chuck Gaidica: Let’s talk about the good cholesterol, the healthy, the HDL. What is it and what does it do in our bodies?

Grace Derocha: Yeah. The healthy and happy HDL. Just like LDL brought that plaque buildup, the HDL does the opposite and takes it away. I always tell people it makes your blood more slippery. That’s just kind of my description.

Kristian Hurley: Yeah. It keeps it from sticking-

Chuck Gaidica: Oh, interesting. Okay.

Kristian Hurley: … to your artery walls.

Grace Derocha: Yeah, it’s a little bit sly about that.

Chuck Gaidica: Where does it go? If it helps get rid of the bad cholesterol and it comes off the artery walls and it’s going, where does it go?

Grace Derocha: There’s a lot of different places it can go. One, hopefully there’s not that much that it has to go anywhere. Two, if you’re eating healthy and you have some fiber in your diet that can help street sweep some of it out of the system.

Chuck Gaidica: Well, wait a minute. Okay, I’m not a doctor, I don’t even play one on a podcast, but it’s in my blood and then it goes where? Back to the liver before it’s secreted to catch up with my oatmeal? Literally, what’s going on?

Grace Derocha: It can be processed more efficiently so you can get rid of it as a toxin.

Chuck Gaidica: Fascinating. The human body is fascinating. A healthy.

Grace Derocha: That’s why a healthy diet with fruits and vegetables and antioxidants that help fight free radicals then help the organs work efficiently to then get rid of some of that waste. But here’s the key, it’s not quite like the pipe that we’re picturing in this example. You know what I mean?

Chuck Gaidica: Mm-hmm (affirmative).

Grace Derocha: Because you think if there’s buildup and it has to go somewhere, but what happens? It helps break it down so that it’s more-

Chuck Gaidica: I see, so it’s soluble?

Grace Derocha: Does that make sense?

Chuck Gaidica: It just dissolves.

Grace Derocha: That’s slipperiness of it-

Chuck Gaidica: Interesting.

Grace Derocha: … can help get rid of it.

Chuck Gaidica: If we’re looking at those numbers and we’re trying to change and control and track what’s going on, the idea, what number are we looking for with good HDL?

Kristian Hurley: For your HDL, you want to make sure it’s over 60.

Chuck Gaidica: Okay. Yeah. That would be a good number for having some balance?

Kristian Hurley: Yes.

Grace Derocha: Yes.

Chuck Gaidica: And you’ve mentioned this Kristian, a couple of times, triglycerides. What are those?

Kristian Hurley: Triglycerides are fat in the blood that your body uses for energy. High triglyceride levels are associated with liver, pancreas problems and heart disease as well. They’re part of that calculation for your overall cholesterol rate. I happen to know my husband has issues with this and so I know that it is very affected again by the foods that you’re eating. And so increasing the foods where you’re going to be getting better, healthy cholesterol from is going to really help you to take down those triglycerides. Triglycerides are also one, I think, that is a highly effected by having that familial high cholesterol. If you have a family history of it, sometimes you can get checked and your triglycerides can be over 700.

Chuck Gaidica: Really? Wow.

Kristian Hurley: Oh yeah. And you want it to be somewhere around a little over 150 or something like that. You don’t want it to be 700. If you just have that family history and it’s genetic, it could be something where they’re just completely out of control. In that case, even if it is genetic, again, what you eat and how you move can still help you to get your cholesterol under control.

Grace Derocha: When we’re talking about controllable risk factors for triglycerides, inactivity really raises triglycerides, a very high carbohydrate diet. A lot of my patients that might be type two diabetic or diabetic and don’t have good control of their blood sugar, usually also have high triglycerides.

Chuck Gaidica: Oh, interesting.

Grace Derocha: Inactivity and a high carb diet when we’re talking about the controllable risk factors can greatly impact your tracking.

Chuck Gaidica: But see that’s a slippery slope there because you would think that a lot of things that fall under heart healthy meals, oatmeal, bananas, greens, I mean, some of the stuff isn’t necessarily going to be high carb. A lot of that stuff is good carbs, but still carbs.

Grace Derocha: Yeah, and I’m talking the people that might be pop drinkers-

Chuck Gaidica: Oh, gotcha.

Grace Derocha: … and have dessert at every meal-

Chuck Gaidica: Or lots of bread or something-

Grace Derocha: … A lot of processed things.

Chuck Gaidica: … processed bread.

Kristian Hurley: Heavily processed carbohydrates.

Grace Derocha: A lot of added sugars. It would have to be significantly high. Not our healthier carbohydrate choices.

Chuck Gaidica: If I get a blood panel and I got the results, I’m looking at it, I may also see something called VLDL. What is that one?

Grace Derocha: It’s actually very low density lipoprotein and that can just contribute to the impact of LDL, which is the lousy because it also is a carrier of plaque. I know. LDL has like … it’s like its evil sidekick.

Chuck Gaidica: It is complicated-

Grace Derocha: It is.

Chuck Gaidica: I think there’s a lot of chemistry going on there and we haven’t even talked about meds. I know some people that have had to turn to medications. They’ve tried the lifestyle change and walking and oatmeal and all this stuff and it’s just in their genetic makeup where they’ve got cholesterol levels at 200 and it doesn’t budge.

Grace Derocha: Yeah. I’ve had quite a few patients, I mentioned that earlier, who that genetic part of what they … they were doing everything and then they felt so defeated because they were doing so many good things with their lifestyle and with their controllable risk factors that they really wanted to see an impact there and sometimes it doesn’t. But I never want that to be an excuse for someone that’s listening to not try their best to really do what you can to control the controllable risk factors.

Kristian Hurley: Because sometimes you can also delay. Even if you have that genetic tendency to it, if you are following a heart healthy diet and you’re getting that physical activity, you might not need to start medication until you’re over 40 as opposed to doing it when you’re in your 20s and 30s which is better. There is things that people can do to maybe delay it. It might be coming, but you can maybe delay it a bit.

Chuck Gaidica: And so that also means being self aware because if you never get a blood test or if you do and you never look at it … because there are some people that want to get tested and then they’re like, “La, la, la, la, I don’t want to look, I don’t want to know doc, you just tell me if there’s a problem.” But we need to be engaged. We need to understand it.

Kristian Hurley: You have to be in partnership with your physician. They are a wonderful service to you, but you have to … again, you have to go in with questions and there are so many resources for you. Like we talked about, AHA has some … Check out the AHA heart.org website, fantastic resources for people. You can do that risk calculator. There’s also a whole guide on there for people to walk through. All of these things that we’re talking about today, you can see it and walk through it. There’s myths that you can get busted in that guide, questions that you can ask your doctor, things that you can note down based on what your lifestyle is currently. Utilize the tools that are free and available to you-

Grace Derocha: Absolutely.

Kristian Hurley: And be in partnership with your physician. Be empowered.

Grace Derocha: And own it.

Kristian Hurley: Mm-hmm (affirmative). Absolutely.

Chuck Gaidica: If you will indulge me a minute, I want to tell you a quick little story. About two years ago, I go on this journey where I’m trying to get healthy in general and I have a friend who’s a doctor and he said, “I’ve got a lifestyle change.” Never called it a diet, right? I’ve changed the vernacular there. He said, “But the first thing I want to do is do a blood panel, blood workup on you so we have a baseline of before and then we’ll look at some of these control factors and what’s changing.” I do it and I get this entire printout and I see it. None of the categories are awful. None of them are crazy off the charts. None of them are in the red zone. Six months later, I’ve already started losing some weight.

Chuck Gaidica: I’ve changed to more heart healthy oatmeal. I’m walking, I’m exercising, I’m eating black beans at lunch. I’m making changes. To be fair, it’s more veggie, but I’m not a vegetarian. Six months later, we do the same blood workup. He calls me and he says to me these exact words, “You should be the poster child for what I’m trying to teach people to do.” And I said, “Well, that’s great. What happened?” He said, “Pull up your charts.” I go online. I pull it up. My numbers went down incrementally, but his association was things well, those numbers dropped in your bad cholesterol and that’s a 25% reduction in stroke and heart attack and this went down and that’s a 10% reduction in this. He’s going through it and he said, “Let me just tell you again, you should be the poster child.” Now I don’t say this to brag, I’m just saying I’m just a regular guy who wasn’t starting off so bad. I wanted to lose some weight. In six months of a lifestyle change, I had proof on paper that change makes a difference.

Kristian Hurley: It sure does.

Grace Derocha: That’s why people should listen to me.

Chuck Gaidica: No really. Because when you tell me this stuff, when you both are saying this, I’m living walking proof that I was able to make an impactful change in my life based on small little changes that are so common sense. Intellectually, we know it, but they kind of fly by us because we just don’t want to think about them. Let’s talk about this idea of change. Knowing your numbers and being self aware, important right?

Grace Derocha: Yeah. Total cholesterol, just to reiterate, should be less than 200, your LDL less than 100, your HDL greater than 60 and then your triglycerides less than 130 okay. It’s a lot of numbers.

Chuck Gaidica: Well you can, you can hit reverse and you can go back and replay this.

Grace Derocha: Yeah. You can write that down or you can go to AHA or a Healthier Michigan to find those numbers. You can compare where you are and then when you look at that, now we can talk about what you need to do.

Chuck Gaidica: Yeah. I know what I did and some of it is kind of subjective to me, but what are the main things that we can do to impact lifestyle change? Won’t call it a diet.

Kristian Hurley: Sure, in general, again, we’ve said it a million times, eat smart. Eat those things that we all know are healthy. Everyone knows this. Eat your fruits and vegetables. Eat those whole grains. Eat those lean meats and proteins. Fish is fantastic. Those are all things that are going to help you. Move more. For adults, we want to get about 150 minutes of physical activity a week. That can be incremental. It doesn’t mean in one day that you need to go walk 150 minutes on a treadmill, but just making sure that you are active, that you’re moving, that you’re walking. Think of sitting as a bit of a chronic disease. If you’re finding that you’re sitting a whole lot, get up and move. That’s going to be critically important for you. And then knowing your fats. We talked about saturated fats, replacing saturated fats with unsaturated fats, really reading your labels. Can’t say that enough. And knowing what you’re putting into your body if you’re-

Chuck Gaidica: Does salt play a part in it? Is sodium an issue?

Kristian Hurley: You definitely want to lower your sodium intake. Absolutely.

Grace Derocha: Obviously we visited that. I would say salt, per se, alone doesn’t actually change your cholesterol numbers per se. But kind of what I was talking about earlier, if you have any kind of plaque buildup, arthrosclerosis and your artery is now narrowed, that will increase your blood pressure, so they have impact on each other.

Chuck Gaidica: And fats? Bad fats versus good fats. We hear all these highfalutin phrases, mono-saturated, poly, whatever.

Grace Derocha: Yeah, MUFAs, PUFAs. When we’re talking about food and we’re talking-

Chuck Gaidica: Did you just say something in a foreign language?

Grace Derocha: Yes.

Chuck Gaidica: Call me a name?

Grace Derocha: Yeah.

Chuck Gaidica: What did you say?

Grace Derocha: MUFAs and PUFAs. Mamas and the papas. You’re distracting me.

Chuck Gaidica: Sorry. I’m sorry.

Grace Derocha: No. Yes, when we’re talking about fat, your unsaturated fats are the ones that you want to incorporate. I’m thinking about how detailed I want to get here. The saturated fats are the ones that at room temperature are hard, so those-

Chuck Gaidica: Think of Crisco.

Grace Derocha: Right. Those sitting in your arteries would then be some of that plaque buildup.

Chuck Gaidica: Yeah. But even coconut oil sitting at room temperature is hard.

Grace Derocha: He’s going to get me on this topic.

Chuck Gaidica: But no, I mean it’s been an analogy that you’ve used many, many podcasts ago that I have always thought and I’ve tried to pass that knowledge onto even my family. If it’s at room temperature and it’s a solid fat, probably not the best if not a really bad one versus its liquid form, like sesame oil or olive oil-

Grace Derocha: Olive oil, avocado oil-

Chuck Gaidica: … or something.

Grace Derocha: Yeah, for sure. The unsaturated fats, which there’s MUFAs, which I call monounsaturated fatty acids is what it is. And then PUFAs, which are polyunsaturated fatty acids, those are the ones that we want to start incorporating. Those include things like your Omega-3s, your Omega-6s, is your Omega-9s-

Chuck Gaidica: Fish. Nuts. Right?

Grace Derocha: Yeah. Fish, nuts, seeds, beans have some of them. Yes, making sure that we’re getting some of those in, but also making sure you’re keeping your ratio good. I want to bring this up because I think it’s important and I think a lot of people know a lot of things because they’ve looked it up. Maybe they might not be practicing it yet, but knowing is half the battle. I always tell people, make sure you’re getting your Omega-3 fatty acids in because those are the ones that decrease inflammation and can really help. Your Omega-6s are not bad for you and they are still heart-healthy, but especially in America, our ratio is extreme when it comes to the Omega-6s versus Omega-3s.

Chuck Gaidica: Omega-3 is coming from?

Grace Derocha: Omega-3s are like avocados and some of our heart healthy fish, I’m trying to think, where grape seed oil-

Chuck Gaidica: Oh, interesting.

Grace Derocha: Is Omega-6. Where avocado oil or olive oil is more Omega-3. Does that make sense?

Kristian Hurley: I was recently reading a study there around Omega-3s and that particularly when we talk about demographics and African American men, they were finding that supplementing the diet with Omega-3 was having significant impact on lowering our cholesterol levels, particularly in that population. Just something to mention. That was a fantastic study.

Chuck Gaidica: Supplementing in African American men, supplementing with a supplement or supplementing with food sources?

Kristian Hurley: I think they were specifically talking about a supplement, but I think adding just these healthy fats naturally you could certainly still do that naturally. But adding that supplement is also helpful if you are already having experiencing high cholesterol, go ahead and add that supplement.

Grace Derocha: Yeah, I know exactly what … I read that too. I always say whenever it can be from real food, that’s the ideal situation. The recommendation from AHA and from any dietitian would be to have fish two to three times a week to help get that. Because in a perfect world for women we should be getting about 1.1 gram of Omega-3 per day and for men 1.6 grams per day. What that means is two to three servings of fish per week.

Chuck Gaidica: It’s that simple.

Grace Derocha: That’s the easy way to explain that. What has happened is most Americans don’t have enough, so that’s why in that study, them using a supplement allowed us to see that in that population they saw great improvement because of what I said, having your fish two to three times a week.

Chuck Gaidica: I think everybody gets fish. Not everybody likes fish, but I think avocados are this kind of thing where … I know they’ve caught on in recent time with avocado toast and things. But I still think there are people who walk into … I’ll name one a Qdoba and they will completely look away from getting guac because they think, “Oh my gosh, is that fattening?” And they lathered everything else up, but they’re not getting-

Grace Derocha: Right. With the queso dip on there.

Chuck Gaidica: Exactly. I think there’s a way to look at avocados in a whole different light now.

Grace Derocha: Yeah. I think looking at trying to gain some of the good nutrition from it, and then maybe you don’t have pie later. That was not a good example. Do you know what I mean? Make some of those choices to incorporate some of the good nutrition without overthinking calories because of weight loss.

Kristian Hurley: Yeah. Sometimes you might not know what to do with one. You know what I mean? If it’s something where, you’re hearing it today and you’re thinking, oh, I’d love to try an avocado, but I’ve never made anything with avocado in it we have just thousands of recipes on heart.org where you can go and literally search for avocado and you’ll come up with guac recipes and things that you can do with that because that’s important. Not everybody knows how to prepare some of these dishes and it doesn’t have to be complicated. There are resources out there to support you and help you. Please check out heart.org for recipes.

Grace Derocha: And Tommy, you’re going to hear this, Kahlea already knows this, but I make a chocolate mousse that is an avocado base. Sorry bud.

Chuck Gaidica: He doesn’t know?

Grace Derocha: No, I mean he doesn’t mind avocado.

Chuck Gaidica: I’ve tried this. It’s actually really good.

Grace Derocha: It’s really good.

Grace Derocha: I mean, because avocados are creamy.

Chuck Gaidica: Plus it’s got cocoa.

Grace Derocha: Yeah. There’s ways that you could definitely incorporate it that you might not realize. Usually you don’t think avocado and think dessert.

Kristian Hurley: I put it in smoothies and my boys have no idea that there’s an avocado in there.

Grace Derocha: Yeah, because it’s creamy.

Chuck Gaidica: And it does make it creamy.

Grace Derocha: Delish.

Chuck Gaidica: Next episode, we’re talking with Dan Muncey who is a fitness guy. I think he just like bikes here when he’s coming. But exercise is so important.

Kristian Hurley: It is.

Chuck Gaidica: Tell us about the ground rules for what we should be thinking about for this heart healthy idea of keeping the cholesterol down. What kind of exercise? How much per week, again, per day?

Kristian Hurley: 150 minutes a week of moderate intensity aerobic exercise or 75 minutes per week of vigorous aerobic exercise. That’s the recommendation again, that can be accumulated over time. If you’ve got time in the morning for a 15 minute run, take it and then, do some additional things throughout the day.

Kristian Hurley: You might do some vigorous and some moderate physical activity. And then just, again, making sure that you’re moving and not sitting. Making sure that you’re increasing the intensity of the physical activity that you’re getting over time and doing some muscle work as well, lifting some weights. Sometimes when I go to the gym I’ll do those little circuits. They have a little 30 minute circuits in the middle. I mean do the circuit and get some light weights added and you’ll feel better and it will improve your cholesterol.

Grace Derocha: Yep. I tell people, and this is quick and easy, and I think you guys have heard me say this before, 30 minutes a day is 2% of your day. So that means if you can give yourself that 2% a day, you have 98% of your day to do whatever you want and why not say thank you to your body.

Chuck Gaidica: Thank you body.

Grace Derocha: Thank you body, 2%.

Chuck Gaidica: Alcohol, stress, breathing, mindfulness. We’ve had other episodes on all of those things. To be fair, my watch told me while I was sitting here this morning, you were both coming into the studio. It’s time to breathe.

Grace Derocha: Time to stand up.

Chuck Gaidica: Right, time to stand up. We can use high tech and apps and other things to help us. But talk about specifically, let’s start with alcohol. Moderate alcohol is still okay for heart health?

Grace Derocha: Mm-hmm (affirmative).

Chuck Gaidica: I hear things all the time. It kind of changes about red wine, et cetera, but if it’s low-to-moderate use, no big deal.

Grace Derocha: Yeah, moderation. Moderation is one for women per day and two for men.

Kristian Hurley: If you’re smoking-

Grace Derocha: Please don’t.

Kristian Hurley: Please don’t. Stop smoking. Smoking-

Grace Derocha: Smoking cessation for sure.

Kristian Hurley: And vaping is basically the same thing-

Grace Derocha: Also, so please don’t.

Kristian Hurley: … so please don’t do that. One vape cartridge has as much as a whole-

Chuck Gaidica: Nicotine?

Kristian Hurley: Nicotine a whole-

Chuck Gaidica: Does it really?

Kristian Hurley: … pack of cigarettes. Please know that it’s the same thing.

Chuck Gaidica: And that’s affecting cholesterol or just your vein and artery health in general.

Kristian Hurley: Smoking will lower your HDL, your happy, your good cholesterol in your body.

Grace Derocha: And it will increase your triglycerides too. Any kind of tobacco use-

Chuck Gaidica: Come on, yeah.

Grace Derocha: … will make your happy, not so happy. And then your triglycerides will go up.

Kristian Hurley: Yeah, so that’s key. Just at the very basic level, if you have been diagnosed with high cholesterol and you have meds for it or you’re on a statin, take your meds as directed because as we said, it could be a million reasons why the doctor has you on it. Maybe it’s genetic, maybe you don’t agree that you should be on these, but if you have been prescribed, take your meds and do these lifestyle changes as well.

Grace Derocha: Well, I would say smoking too, like you were mentioning, it affects the constriction of your arteries. If your artery is going to be smaller from smoking and there’s plaque buildup we know it just happened.

Chuck Gaidica: And what about de-stressing? Actually having a more healthy lifestyle, including exercise can lead to less stress. We know that.

Kristian Hurley: Absolutely.

Grace Derocha: Absolutely. Exercise is a great de-stressor. Making sure you get enough sleep is a key in helping your cholesterol and your blood pressure for that better overall heart health. I did want to say I went to a … as a dietitian you have to get your education credits. I went to a super interesting symposium the other week and a cardiologist was speaking about being fit versus unfit and what that meant and the impact on someone’s heart health. In their studies they were showing that even someone who was carrying a little bit excess weight, if they were unfit, meaning they did not do any kind of exercise, their risk for heart disease or stroke or heart attack increased because of that factor and not the overweightedness. Not that we want anyone to be overweight. I want everyone to feel comfortable.

Chuck Gaidica: Interesting.

Grace Derocha: … but that their fitness level and doing something versus doing nothing impacted their heart health greatly. He went through a million different studies going way back into today showing this consistent theme. He said to us, “When I see patients, when I watched them,” he’s like “I go and get them on purpose because I want to see how quickly they stand up and walk to me.”

Chuck Gaidica: Wow.

Grace Derocha: And if you’re walking at a 3.0 pace on a treadmill to me to come into me, I know that we’re going to have better results. He’s like, “I note in the chart to see if are they walking faster to me.”

Chuck Gaidica: Wow.

Grace Derocha: Are they walking slower to me? Because I will know from that. And if I asked them, “Have you been exercising?” He’s like, everyone says, “Yes,” but I’ll know. And I thought that was so interesting even to note for yourself. How quickly do I get off the ground when I’m playing with my kids? Not as quickly as I used to, but at least I’m still trying. You know what I mean?

Chuck Gaidica: Well, and how many studies are we now seeing that again, we’ve talked about this, we’ll continue to talk about it. Good heart health, equal sign, brain health from Alzheimer’s Association, equal sign mental health. I mean it makes sense to us, but we ignore that these basic things affect us holistically and can do some good. As we wrap up this podcast, if we want to be engaged with our doctor and not be afraid to actually be the lead. Let the tail wag the dog and let somebody else tell me what to do. What do we request our doctor to do when it comes to one of these blood panels? What are we actually asking them to take as a sample of our blood so we know? A lipid profile, what is it called? What do we actually ask?

Grace Derocha: I would like for them to do a complete blood … like a CBC, so complete blood count. You have your cholesterol panel then, but you also have taking a look at your electrolytes and also your blood sugars and how those are running.

Chuck Gaidica: Good idea. All right, so give us the website again so we can all get all this good stuff.

Kristian Hurley: So visit heart.org, where you can access your Check. Change. Control. Cholesterol Risk Calculator. You can also access our cholesterol guide book for individuals so that you can get all the information that we talked about today.

Grace Derocha: MUFAs and PUFAs and puffers are on there listed?

Kristian Hurley: Yes. They are, just like that.

Grace Derocha: I was going to-

Chuck Gaidica: They were a great band back in the 60s too, I think. Kristian Hurley from the American Heart Association, always good to see you.

Kristian Hurley: Good to see you too.

Chuck Gaidica: Thanks for coming in. Grace Derocha.

Grace Derocha: Thank you.

Chuck Gaidica: Thanks for giving us a little bit of your day today, what 2% we got from you today.

Grace Derocha: Right.

Chuck Gaidica: You didn’t even exercise yet or did you? Not quite? Okay, well you’ve got time.

Grace Derocha: Did I?

Chuck Gaidica: Yeah. Well thanks for listening to A Healthier Michigan Podcast brought to you by Blue Cross Blue Shield of Michigan. If you want to know more about the show, catch previous episodes, lock in on what’s coming next, you can go online for our website as well, ahealthiermichigan.org/podcast. You can leave us reviews, ratings on iTunes or Stitcher, and you can get new episodes on your smartphone or tablet, so when you’re out there working through our February winter in Michigan, you will be able to say, “I’m doing it. I’m actually making some kind of progress.” You can also subscribe to us on Apple Podcast, Spotify, or your favorite podcast app. I’m Chuck Gaidica, have a great day.