I received lots of phone calls and text messages about my post last week.  Apparently, many of you enjoyed the “Q&A” format I used and also liked reading about what others are interested in, when it comes to nutrition.  So, I decided to devote the next two posts to cholesterol, a topic I find myself discussing frequently with clients. To keep this entry from being too long, I’ll address cholesterol, nuts and omega-3 fatty acids today and flavinoids, olive oil and fiber tomorrow.

Q1. What’s the difference between good (HDL) and bad (LDL) cholesterol?

Bad cholesterol, or “LDL cholesterol,” is a type of plaque which builds up in the walls of the arteries, making them narrow and rigid.  Good cholesterol, or “HDL cholesterol” is helpful because it carries cholesterol away from the arteries and to the liver where it’s broken down and subsequently passed from the body.

Q2. What are the dangers and causes of high cholesterol?

High cholesterol is interesting; you can’t see it or feel it, yet when it goes above a certain benchmark, it can put you at risk for heart disease, a stroke, heart attack or other cardiovascular diseases.  Elevated cholesterol levels can be caused by genetics, being overweight and inactive or eating foods high in saturated fat such as whole milk, butter and meat.

Q3. Studies have shown that some nuts, including walnuts and almonds, can reduce cholesterol as well as help keep blood vessels healthy and elastic. How do nuts affect our cholesterol?  What are the best types to eat and how much?

Clinical studies have shown that foods with significant amounts of mono-unsaturated fatty acids and poly-unsaturated fatty acids (MUFAs and PUFAs) can help reduce cholesterol.  Nuts including peanuts and almonds are two such foods.  Eating one and one-half ounces of peanuts (about 20 whole nuts) or 1 ounce of almonds (about 24 whole nuts) four to five times a week is all you need for good health.  Keep in mind, though, their cholesterol-lowering abilities are most effective when you eat the nuts in place of other high-fat snacks.

 Q4.  Because nuts are high in fat, is there a particular concern about eating too much?

Too much of anything isn’t good, so just follow the suggested consumption guidelines, and you’ll reap the benefits.

Q5. What are the benefits of Omega-3s in regard to cholesterol? What types of fish contain the highest levels and how much (and how often) should they be eaten?

Omega-3 fatty acids are polyunsaturated fats that are found in most cold water fish.  These fish would include mackerel, tuna, herring, trout, salmon and sardines.  Fish should be consumed twice a week — that would be about 12 ounces per week.

While omega-3 fatty acids have heart heath benefits, when it comes to cholesterol, they’ve been shown to reduce triglycerides, which, when elevated, are a risk factor for heart disease.  They don’t necessarily lower cholesterol levels.

 Q6. Is there a particular way the fish should be prepared to reap the most benefits?

Obviously, fish should not be fried, if you’re trying to keep your cholesterol in check.  Depending upon the fish, it could be grilled, poached, roasted, pan seared, broiled, baked or steamed.

Q7.  What are the benefits of taking a fish oil supplement, rather than eating fish? Are there other sources of Omega-3s, besides fish and supplements?

A fish oil supplement can augment a diet low in omega-3 fatty acids, though I wouldn’t recommend substituting the pill for the actual fish.  Other sources of omega-3 fatty acids include flax seed, walnuts, grass-fed beef and fortified foods such as pasta; however, these foods are a source of ALA, or alpha linolenic acid, a type of omega-3 that’s converted to the more potent DHA and EPA which are found in fish.