Kelly Anne Spratt, D.O., Director of Women's Cardiovascular Health at the University of Pennsylvania Presbyterian Medical Center, answers your questions.
Q. I am 43 years old. My recent physical gave me the news that my cholesterol level was 231! Of course I have been reading labels to determine the cholesterol in the foods I'm eating. Now what I would like to know is where is all this coming from? Everything I read has 5 mg or 0 mg of cholesterol. Based on a daily allotment of about 300 mg, this seems like nothing!
What does percentage of fat in a food have to do with cholesterol? If something has no cholesterol, yet is 40 percent or higher in fat, what is the relationship? As an example, I looked at turkey bacon and low sodium, lower-fat bacon. The actual bacon had less cholesterol in it -- 10 mg as compared with the turkey at 20 mg! Yet the fat content of actual bacon must be higher than turkey bacon. What's the deal here? And what else can I do to lower my cholesterol?
A. High cholesterol (over 200) is a major risk factor for heart disease, so you are correct in beginning to limit your intake of this type of fat. However, the best approach is limiting fats in general to no more than 25 percent of your total dietary calorie intake. As you rightly point out, many so-called "cholesterol free" foods have plenty of fat and so can contribute to high amounts of cholesterol in your bloodstream. The total amount of fat in a food may still be quite high but because a single type of fat (cholesterol) is low, the manufacturer is allowed to advertise as "cholesterol free," with the obvious implication that this would be a food that is good for you.
One question that comes to my mind is what is the breakdown of your cholesterol of 231; that is, what part is "bad" or LDL cholesterol and what part is "good" or HDL cholesterol? Many premenopausal women may have a total cholesterol that is higher than 200mg/dl, but they have a very high HDL, perhaps even greater than 100mg/dl. There is a major clinical difference if you have an HDL of 90mg/dl versus 30mg/dl with a total cholesterol of 231mg/dl. Have your doctor give you this breakdown.
As far as the best approach for overall healthy eating, simply keep your total fat intake to 25 percent of your daily calorie intake. Try to eat foods that have less than 6 total fat grams per serving, and maintain an ideal body weight. Exercise is important; if you have other health problems, consider lower impact exercise such as swimming.
By the way, I make turkey bacon for my family since it has only 2.5 grams of fat per serving, far less than regular bacon!