Has your client been diagnosed with high cholesterol?
Is lowering your client’s cholesterol value an important goal? The first step is to coach the client to understand what cholesterol is.
Cholesterol is a steroid. It is also an essential structural component of our nervous system at the tissue level. Cholesterol is a waxy, fat-like substance made in the liver and found in certain foods, such as food from animals, like dairy products (whole milk), eggs and meat.
The body needs some cholesterol in order to function properly. Its cell walls, or membranes, need cholesterol in order to produce hormones, vitamin D and the bile acids that help to digest fat. But, the body needs only a small amount of cholesterol to meet its needs. When too much is present health problems, such as coronary heart disease may develop.
When too much cholesterol is present, plaque (described previously) may form in the body’s arteries narrowing the space for blood to flow to the heart. Over time, this buildup causes atherosclerosis (again, as described previously). When not enough oxygen-carrying blood reaches the heart, chest pain – called angina – can
result. If the blood supply to a portion of the heart is completely cut off by the total blockage of a coronary artery, the result is a heart attack. This is usually due to a sudden closure from a blood clot forming on top of a previous narrowing.
Types of Cholesterol
Cholesterol travels through the blood attached to a protein — this cholesterol-protein package is called a lipoprotein. Lipoproteins are classified as high density, low density, or very low density, depending on how much protein there is in relation to fat.
Low-density lipoproteins (LDL): LDL, also called “bad” cholesterol, can cause a buildup of plaque on the walls of arteries. The more LDL there is in the blood, the greater the risk of heart disease.
High-density lipoproteins (HDL): HDL, also called “good” cholesterol, helps the body get rid of bad cholesterol in the blood. The higher the level of HDL cholesterol, the better. If your levels of HDL are low, your risk of heart disease increases.
Very low-density lipoproteins (VLDL): VLDL is similar to LDL cholesterol in that it contains mostly fat and not much protein.
Triglycerides: Triglycerides are another type of fat that is carried in the blood by very-low-density lipoproteins. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.
What Factors Affect Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
Diet: Saturated fat and cholesterol in the food you eat increase cholesterol levels. The goal is to reduce the amount of saturated fat and cholesterol in your client’s diet.
Weight: In addition to being a risk factor for heart disease, being overweight can also increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as increase HDL cholesterol.
Exercise: Regular exercise can lower LDL cholesterol and raise HDL cholesterol. You should try to be physically active for 30 minutes on most days.
Age and Gender: As we get older, cholesterol levels rise. Before menopause, women tend
to have lower total cholesterol levels than men of the same age. After menopause, however, women’s LDL levels tend to rise.
Diabetes: Poorly controlled diabetes increases cholesterol levels. With improvements in control, cholesterol levels can fall.
Heredity: Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.
Other causes: Certain medications and medical conditions can cause high cholesterol.
How Much Cholesterol Is Too Much?
Everyone over the age of 20 should get their cholesterol levels measured at least once every 5 years. When being tested, your doctor may recommend a non-fasting cholesterol test or a fasting cholesterol test. A non-fasting cholesterol test will show your total cholesterol and HDL cholesterol. A fasting cholesterol test, called a lipid profile or a lipoprotein analysis, will measure VLDL, LDL, and HDL as part of the total cholesterol. It will also measure triglycerides. Your client’s doctor may start with a non-fasting cholesterol test and then recommend a lipid profile, based on results.
How Can I Help My Client to Lower Cholesterol Levels and Reduce Risks for Heart Disease?
A few simple changes can help your client to low- er their cholesterol. Recommendations include:
Eat low cholesterol foods. The American Heart Association recommends limiting your average daily cholesterol intake to less than 300 milligrams. If your client has heart disease, one report suggests limiting daily intake to be less than 200 milligrams. People can significantly lower their dietary cholesterol intake by keeping their dietary intake of saturated fats low and by avoiding foods that are high in saturated fat and substantial amounts of dietary cholesterol.
Quit smoking. Smoking lowers HDL (“good”) cholesterol levels. This trend can be reversed if your client is able to quit smoking.
Exercise. Exercise increases HDL cholesterol in some people. Even moderate-intensity activities, if done daily, can help control weight, diabetes, and high blood pressure – all risk factors for heart disease.
Encourage your clients to take medication as prescribed by their doctor. Sometimes making changes to food intake while increasing exercise is not enough to bring your client’s cholesterol level down. You may also need to have open discussions about the need for a cholesterol low- ering drug.
How is High Cholesterol Treated?
The main goal of lowering cholesterol is to lower LDL and raise HDL. There are two key ways to lower cholesterol:
- Eat a heart-healthy diet
- Take cholesterol-lowering medications
Doctors determine “goals” for lowering LDL based on the number of risk factors your client is seen to have for heart disease.
If you have 0-1 risk factor for heart disease, you are at low-to-moderate risk. Lifestyle changes are recommended to keep the cholesterol in check.
If you have 2 or more risk factors, you are at moderate risk or next-highest risk, depending on what heart disease risk factors you have. Some- times your doctor will try lifestyle changes, but most of these people require cholesterol-lowering drugs.
If you have known heart disease, diabetes or multiple risk factors, you are at high, or very high, risk. These people require a combination of cholesterol-lowering drugs and lifestyle changes to control their cholesterol levels.
Starting Your Health and Fitness Career
There is always something exciting about earning a new training or coaching certification and applying that new knowledge of how you train your clients. This also helps you hit the reset button.
NESTA and Spencer Institute coaching programs are open to anyone with a desire to learn and help others. There are no prerequisites.
That’s it for now.