"My cholesterol is too high," a patient explained. "But I can't help it. It's hereditary." She was right. Her type of high cholesterol is called familial hypercholesterolemia (FH). It's an inherited genetic defect that causes an abnormal amount of dangerous LDL cholesterol to accumulate in the bloodstream. This condition is fairly common, affecting an estimated 1 out of every 200 to 250 people around the world.
What's the big deal? According to the Familial Hypercholesterolemia Foundation, a person with this disorder is 20 times more likely to develop heart disease, heart attacks and strokes at an earlier age than the general population. It affects males and females alike and can even strike young children.
Medications such as statins that help lower cholesterol in the blood are the first line of treatment for this condition. That makes some patients wonder if nutrition interventions are necessary or effective. Yes, they are. Nutrition therapy along with exercise can often prevent or delay further complication of the disease. Here are some guidelines:
Eat foods that contain less saturated fat. While the role of saturated fat and heart disease remains controversial, researchers do know that saturated fat tends to produce more inflammation in the body. Saturated fat can also raise "bad" LDL cholesterol levels in the blood. Since the treatment for inherited high cholesterol is to reduce inflammation and prevent the accumulation of LDL cholesterol in the blood, it's probably smart for patients with FH to avoid excess amounts of saturated fat, says Amy Reisenberg, MS, RDN, who works with heart patients at Stanford University Hospital.
Eat more anti-inflammatory foods. Heart disease is caused by inflammation within our arteries and some foods contain substances that can calm things down. Known anti-inflammatory foods include whole fruit, vegetables, garlic and tea. Fatty, cold-water fish such as salmon, tuna and sardines are also high in anti-inflammatory omega-3 fats. Reisenberg advises her patients to eat 3 to 4 ounces of fish at least twice a week.
Have some nuts. They provide a good amount of healthful fats that do not promote the rise of LDL cholesterol. Yet they are also low in the more harmful saturated fats. Those that are lowest in saturated fat include sunflower seeds, almonds, hazelnuts, pine nuts, pistachios, walnuts, pecans and peanuts. Some nuts are higher in saturated fat, however. We are called to eat these less often or in smaller amounts: Brazil nuts, macadamias (darn it) and cashews.
It's true we can't change what we inherit. But as a wise person once told me, "Genetics loads the gun; lifestyle pulls the trigger."
(Barbara Quinn is a registered dietitian and certified diabetes educator affiliated with Community Hospital of the Monterey Peninsula. She is the author of "Quinn-Essential Nutrition" (Westbow Press, 2015). Email her at to firstname.lastname@example.org.)
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