7 Ways to Lower Your Cholesterol

Author, Danielle Rosenfeld, MS, RD, LDN, is a member of the Penn Metabolic and Bariatric Surgery team.

Having high cholesterol levels can nearly double your risk for developing heart disease. The good news is that high cholesterol is a modifiable risk factor and every 1% reduction in your total cholesterol can lower your risk of heart disease 2% to 5%. February is Heart Month and there is no better time than now to get your numbers in check.

Know Your Cholesterol Numbers

Most of the time there are no symptoms associated with elevated cholesterol. Serum cholesterol tends to increase with age, especially among women, who have reduced estrogen levels as they reach menopause. This is why it is important to have your blood levels checked regularly by your health care provider.

Here are the cholesterol numbers you should know.

Total Cholesterol

Less than 200 mg/dl is a desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dl or higher raises your risk

HDL (Good) Cholesterol

60 mg/dl and above is considered protective against heart disease. Less than 40mg/dl (for men) and less than 50mg/dl (for women) are considered to be a major risk factor for heart disease

LDL (Bad) Cholesterol

Less than 100mg/dl is optimal, 200 to 99 mg/dL and 160 to 189 mg/dl is considered to be high

Triglycerides

Less than 100 mg/dl is optimal. High triglyceride levels combined with low HDL or high LDL can increase risk for heart disease

*Information is adapted from the American Heart Association

How You Can Lower your Cholesterol

Limit your saturated fat and trans fat intake

• Dietary saturated fats are actually much more dangerous than dietary cholesterol in terms of raising LDL. Saturated fats are found in: red meats, whole-milk dairy products such as butter, cream and cheese, coconut oil, palm oil, hydrogenated vegetable oils, and pastries.
• Trans fats are chemically engineered fats that help to increase the shelf life of foods. These fats increase your LDL and decrease HDL. Always make sure to read the food label and if possible, avoid all Trans fats.

Choose THIS

• White-meat chicken, lean turkey meat without the skin
• 92-99% lean ground beef
• Egg whites or substitutes
• Baked, grilled, steamed or roasted cooking methods
• Fat-free or low-fat dairy products
• Fresh fruit and vegetables

Instead of THIS

• Red meat, dark meat chicken
• Regular ground beef
• Whole eggs with yolks
• Fried foods
• Whole milk dairy products
• Pastries, potato chips and other snack foods

Opt for healthy MUFAs (monounsaturated fats)

MUFAs can actually lower total cholesterol and increase good, HDL cholesterol. Try to include a few servings of these foods into your diet: Nuts, peanuts, walnuts, pistachios, cashew nuts, hazelnuts (remember, keep nut servings to ¼ cup), avocado oil, canola oil, olive oil.

Remember, just 1 tablespoon of oil contains approximately 120 calories and 14 grams of fat- although it is a healthier fat you still need to use it in small amounts.

Include Omega-3 fatty acids

Omega-3s are polyunsaturated fats that aid in lowering total and LDL cholesterol. Food sources include: Fatty fish (salmon, tuna, mackerel, sardines, and herring), flax seed oil, canola and soybean oil, flax seeds, walnuts.

Aim for 25-30 grams of fiber/day

Increasing dietary fiber intake can result in lower cholesterol levels,
Eat beans (kidney, lentils, black beans, chickpeas), whole-grain cereals, oatmeal, quinoa, fruits (pears, raspberries, blackberries, apple) and vegetables.
Aim for 5 servings of fruits and vegetables/day.

Exercise regularly

Regular exercise can help reduce cholesterol. Aim for at 200 to 300 minutes each week.

Weight Management

• If you are overweight, simply shedding 5 to 10% of your weight can significantly reduce your blood cholesterol.
• Cutting 500 calories/day can promote a 1 lb weight loss/week.

Make healthier lifestyle choices

• Avoid smoking and drinking excess alcohol.
• Always compare food labels when shopping—pick foods low in saturated and trans fats.

Don’t wait until it’s too late. Follow these healthy lifestyle guidelines to help keep your numbers under control, regardless of what your family history is.

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

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Ready To Go Nuts? 6 Tips for Adding Nuts to a Healthy Diet

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the health benefits of nuts and provides tips for incorporating them in a healthy diet. 

They say good things come in small packages and nuts are no exception. Filled with protein, fiber, phytonutrients and antioxidants, nuts pack lots of good things into a small, convenient and healthy package. They keep you satisfied, help curb unintended grazing and have powerful cancer-fighting properties.

Previously shunned by healthy dieters because of their high fat content, it turns out that nuts actually contain heart-healthy mono- and poly-unsaturated fat, which has been shown to lower LDL or “bad” cholesterol levels.

In addition to being healthy, nuts are inexpensive and have a long shelf-life, which makes them perfect for throwing in your purse or briefcase when you’re on the go.

Before going nuts with nuts, check out the following tips to incorporating them into a healthy diet:

Control portions
Nuts are high in calories, so moderation is key. Limit serving size to one to two ounces per day. 

Use nuts as a substitute
Instead of simply adding nuts to your diet, use them to replace foods that are high in saturated fats like meat, or contain empty calories.

Always read the nutrition label
Look for items with nutrition labels that say “dry-roasted” or “raw” and avoid those that just say “roasted.” Roasted nuts often contain added oils. Also, choose unsalted nut varieties.

Love the nutty flavor? Try nut butters
There are a variety of nut butter options available today including peanut, almond and cashew. Before making your purchase, make sure the nut butter does not include added ingredients like sugar or hydrogenated fat.

Store properly 
If you’re buying a large bag of nuts, store them in the freezer for maximum freshness and to aid in portion control.

Chop or grind nuts as an add-in or topping
Add nuts to yogurt, oatmeal, salad or stir-fry to infuse them with the nutty flavor while keeping portions in check. You can also mix nuts with herbs to use as a crunchy coating for fish or chicken. Sound good? Check out this healthy recipe for almond encrusted tilapia.


- Cara Stewart, RD, LDN

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Bariatric Surgery Better Than Medication for Diabetes

A new study says people with type-2 diabetes may have more success in managing their diabetes with bariatric surgery rather than traditional medical therapies.

The study, published this week in the New England Journal of Medicine compared the standard treatment of medication, diet and exercise to weight-loss surgery, also known as bariatric surgery, for the treatment of type-2 diabetes.

“Research has already shown that gastric bypass surgery improves or resolves type-2 diabetes in days or weeks following surgery,” says Noel Williams, MD, director of the Penn Metabolic and Bariatric Surgery Program. “This new study shows that in addition to gastric bypass, sleeve gastrectomy has the same positive impact on type-2 diabetes and is more effective than medical management alone.”

During a sleeve gastrectomy, a sleeve-shaped tube is created from a small portion of the stomach and the majority of the stomach is removed. Food passes through the new stomach tube directly into the intestines. Nutrients and calories are absorbed from food normally, but patients feel full sooner and longer.

“It is important that patients choose an experienced physician to perform their weight-loss surgery,” says Dr. Williams. “The Penn Metabolic and Bariatric Surgery program performs more than 500 procedures every year and more sleeve gastrectomies than any program in the Philadelphia region.”

Type-2 diabetes is a chronic disease in which the body cannot or does not produce enough insulin to manage blood sugar levels. Type-2 diabetes is often associated with obesity, though people of average weight may also develop the disease.

“Research is proving that weight-loss surgery reduces the co-morbidities associated with obesity,” says Dr. Williams. “Following surgery some patients quickly see their blood sugar level return to normal and they are able to stop taking insulin and other medications.”

The study also found bariatric surgery helped people lower their blood pressure and cholesterol.

Read more about the study here.

Learn more about weight-loss surgery at Penn, and how it may help you control your diabetes by attending a free informational session about weight-loss surgery. 

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Get the Facts about Healthy Fats: Omega-3 and Omega-6 Fatty Acids

Rachel Griehs, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the nutritional importance of essential fatty acids.


For years experts have been saying that all fats are bad, but it turns out that is not the case. Among the healthy fats are omega-3 and omega-6, which are considered essential fatty acids. Although the body needs them, it cannot produce them itself, which is why they must be incorporated into your diet.

There are three types of omega-3 fatty acids:
1.    Alpha-linoleic (ALA)
2.    Docosahexaenoic (DHA)
3.    Eicosapentaenoic (EPA)

ALA is found in plant foods and flaxseed is the richest source. EPA and DHA are found in similar foods, including seafood, algae and higher fat cold water fish, such as mackerel, albacore tuna, salmon, sardines, Atlantic herring, swordfish and lake trout. Enriched eggs are also a good source of omega-3 fatty acids because the egg-producing hens are fed a diet that includes flaxseed and algae. As a result, these eggs contain all three types of omega-3 fatty acids. 

Omega-6 fatty acids are made up of linoleic acid. They are found in nuts, seeds and vegetable oils, specifically soybean, safflower and corn oil. Experts recommend that 5 to 10 percent of your total caloric intake should come from omega-6 fatty acids.

How do these fatty acids benefit health?

Omega-3 fatty acids thin the blood, reducing the risk for blocked blood vessels, heart attacks and strokes. They also prevent hardening of the arteries, lower triglycerides and help reduce blood pressure.

Omega-6 fatty acids lower cardiovascular disease risk by decreasing total cholesterol, including “bad” cholesterol (LDL—low density lipoprotein). However, by reducing the total cholesterol, omega-6’s also lower “good” cholesterol (HDL—high density lipoprotein), which functions like a sponge and carries “bad” cholesterol and other lipids to the liver for excretion.

The American Heart Association recommends that people who do not have coronary heart disease (CHD) eat a variety of fish, specifically oily fish, at least twice a week. For those with CHD, they recommend one gram of EPA and DHA from oily fish a day. It can be hard to obtain sufficient omega-3 from your diet alone. If so, talk to your physician about adding a fish-oil supplement.

- Rachel Griehs, RD, LDN

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