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Cholesterol Education

Cholesterol Education

Early dietary counseling may benefit your health later in life

Written by Emily Creasy, MS, RD, LD, (Nutrition Remarks writer), Reviewed by Nalin Siriwardhana, Ph.D.

Health News Highlights (June 24, 2012) <<Print PDF>>

According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 6 adult’s has high cholesterol. Having high cholesterol doubles your risk for developing cardiovascular diseases (CVD). The average cholesterol level for adults in the United States is 200 mg/dL, which is considered borderline high. Studies now show that providing nutrition education at an early age can help to lower saturated fat intake overtime and subsequently result in lower cholesterol levels during adulthood.

Cholesterol should not always be viewed as a bad thing. In fact, your body needs a certain amount of cholesterol to work properly and can even make the amount it needs naturally. In the body, cholesterol is needed to help build cell membranes, make hormones and bile acids, and to effectively use vitamin D. According to the American Heart Association, your body manufactures about 75 percent of the cholesterol in the blood. Genetics and family history can play a role in how much cholesterol your body makes. The remaining cholesterol comes from food.

Cholesterol is only found in animal products or foods that are made using animal products. Examples of high cholesterol foods include, beef, eggs, full-fat dairy products, and foods high in saturated and/or trans fats.

Your total cholesterol level is made up of two main parts: low-density lipoproteins (LDL), and high-density lipoproteins (HDL). In the body, high levels of LDL cholesterol build up in your blood and overtime can result in blockages or clogged arteries that transport blood. High levels of LDL cholesterol, also known as bad cholesterol, are linked with an increased risk for developing CVD, including heart disease. On the other hand, high levels of HDL cholesterol, also known as the good cholesterol, are linked with improved health and a decreased risk for developing heart disease. It is believed that HDL cholesterol works in the body to help breakdown and remove LDL cholesterol from the blood.

There are many lifestyle factors that can affect your cholesterol levels. The United States Department of Agriculture (USDA) recommends consuming at least one to two cups of fruits, and one to three cups of vegetables each day as well as whole grains. These foods are rich sources of fiber, which works in the body to help remove cholesterol from the blood. It is also important to limit your intake of saturated fats and/or trans fats. Saturated fat intake has been linked to high blood cholesterol levels and an increased risk for heart disease. Physical activity is also important and, when paired with a healthy diet, can help to lower LDL cholesterol and raise HDL cholesterol levels. In addition, diet and exercise can promote weight loss. Being overweight or obese is often associated with higher total cholesterol levels. The National Institutes of Health (NIH) states that for those who are overweight or obese, losing just 5 to 10 percent of your current weight over a six-month period can help to lower the risk for heart disease.

While following a fiber-rich, low-fat diet is an important factor for maintaining a healthy cholesterol level, it can be difficult to know how to follow a healthy diet without adequate teaching and nutrition education. Efforts to educate school age children on the importance of nutrition are improving, however no standards are in place with regard to nutrition education in schools, making it difficult to determine the quality and impact of the education. A study by Dr. Niinikoski and colleagues at the University of Turku and Turku University Hospital, Turku, Finland, found that, when started at a young age, nutrition education focusing on a healthy, low-saturated fat diet could benefit adults later in life.

The researchers followed a total of 1062 children from 7 months through 19 years of age. The intervention group was provided with dietary counseling every three to six months. Dietary counseling was individualized for each child and focused on a low-saturated fat diet. Initially education was directed towards the children’s parents and emphasized the importance of fats and the introduction of healthy foods into the diet. After age 7 the counseling was aimed more directly at the children and topics ranged from healthy fats in the diet to portion control and sodium intake. Additionally, parents were encouraged to discuss the topics when at home. The remaining children were considered the control group and received no nutrition counseling. The group was seen twice a year until age 7 and then once each year thereafter until age 19. Basic health education and checkups were provided. Food logs were recorded by all children and families and analyzed every 6 to 12 months.

At visits, study participants had blood drawn to monitor and follow blood lipid and cholesterol trends. Following the study it was noted that the intervention group had lower total cholesterol and LDL cholesterol levels and significantly lower total fat and saturated fat intake. Education also showed to improve the HDL cholesterol levels among males. Based on this, nutrition education at an early age was able to significantly influence the dietary habits of participants later in life. Emphasis on a healthy, low-saturated fat diet aided in creating a more favorable blood lipid profile and a decreased risk for heart disease among intervention participants.

Adolescents are beginning to consume increasingly more amounts of food outside the home. Because of this, it is important that healthy nutrition education and practices be integrated into schools as well as the home. This can help to encourage children and adolescents to make better food choices both inside and outside the home.

Unfortunately, there are no easily noticeable symptoms associated with high cholesterol. This means that you can have high cholesterol and be completely unaware until it starts to cause damage to your body. Because of this, the CDC recommends having your cholesterol levels checked at least once every five years. Aim to keep your total cholesterol level below 200 mg/dL. Levels between 200 and 239 mg/dL are considered borderline high and levels over 240 mg/dL are considered high. In addition, LDL cholesterol levels should remain below 100 mg/dL, with levels over 130 mg/dL being borderline high and over 160 mg/dL being high. Unlike total and LDL cholesterol, HDL cholesterol should be high. Levels below 40mg/dL for men and below 50 mg/dL for women are considered low. Aim to keep your HDL cholesterol above 60 mg/dL for improved heart health. For more recommendations or medication intervention, meet with your doctor to determine a plan that works best for you and your family’s specific needs.


Niinikoski H, Pahkala K, Ala-Korpela M, Viikari J, Rönnemaa T, Lagström H, Jokinen E, Jula A, Savolainen MJ, Simell O, Raitakari OT. Effect of repeated dietary counseling on serum lipoproteins from infancy to adulthood. Pediatrics. March 2012.

Centers for Disease Control and Prevention. Cholesterol. http://www.cdc.gov/cholesterol/.

American Heart Association. Cholesterol. http://www.heart.org/HEARTORG/Conditions/Cholesterol/Cholesterol_UCM_001089_SubHomePage.jsp.

National Institutes of Health. Cholesterol. http://www.nlm.nih.gov/medlineplus/cholesterol.html.

United States Department of Agriculture. MyPlate: Food Groups. http://www.choosemyplate.gov/food-groups/.

National Center for Education Statistics. Nutrition Education in Public Elementary and Secondary Schools. http://nces.ed.gov/pubs/web/96852.asp.

Copyright © 2012 Nutrition Remarks. All rights reserved

Lower Your Cholesterol With Strawberries

Lower Your Cholesterol With Strawberries

Written by Emily Creasy, MS, RD, LD, (Nutrition Remarks writer), Reviewed by Nalin Siriwardhana, Ph.D.

Health News Highlights (March 15, 2012) Print PDF

Adding strawberries to your diet may help to lower the unhealthy cholesterol levels. The bioactive compounds of strawberries can also help to reduce inflammation and risk for developing heart disease.

Cholesterol is a wax-like substance that is not always bad and is actually needed by our body to function properly. We normally produce enough cholesterol in our body. Well-known dietary sources of cholesterol include meat and dairy products. Our total cholesterol level is made up of two main types of cholesterol including low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL cholesterol is most often referred to as bad cholesterol, while HDL cholesterol is considered to be good cholesterol. Consuming a diet high in cholesterol can lead to the accumulation of LDL cholesterol in the blood. Family history can also contribute to high cholesterol levels. If high cholesterol runs in your family, you may inherit certain genes, which cause your body to produce too much cholesterol. Over time, LDL cholesterol can slowly build up and possibly even clog the arteries supplying blood to the brain and heart resulting in heart attack or stroke. HDL cholesterol has been shown to help remove LDL cholesterol from the blood and protect your cardiovascular system. To boost your HDL levels, the American Heart Association recommends engaging in regular physical activity, and following a heart healthy diet rich in whole grains, vegetables, and fruits, such as strawberries.

A study by Dr. Basu and colleagues found that strawberries may be a simple, yet effective way to lower both total and LDL cholesterol levels. Twenty-seven participants were randomly assigned to consume either a prepared strawberry beverage, or a non-strawberry beverage, twice a day for eight weeks. The strawberry beverage contained the equivalent of three cups of fresh sliced strawberries. No other special diet or lifestyle changes were made. Following the study, those who consumed the strawberry beverage showed a significant reduction in both total cholesterol and LDL cholesterol levels. The addition of strawberry to the diet helped to decreased total cholesterol levels by 10% and decrease LDL cholesterol levels by 11%. The non-strawberry group showed a decrease in total cholesterol of 2% and no changes in LDL cholesterol levels.

Dr. Zunino and colleagues at the United States Department of Agriculture, Agricultural Research Service, noted that the addition of strawberries to the diet also helped to decrease the concentration of small HDL cholesterol particles in the blood. High levels of small HDL particles in the body are associated with increased coronary risk, as reported in a study by Dr. Benoit J. Arsenault and colleagues at the Hospital Laval Research Centre, Quebec, Canada.

The 2010 Dietary Guidelines for Americans recommends that adults consume at least 2 cups, or servings, of fruits each day. When prepared without added fats or sugars, fruit can be a heart healthy addition to your diet. Per cup, strawberries contain 53 calories, making up only 2.5 percent of a 2,000-calorie diet. Strawberries are also a rich source of vitamin C, fiber, and folate, all of which are needed for your body to stay healthy. The American Heart Association recommends keeping your total cholesterol level below 200 mg/dL. In addition, aim to keep your HDL cholesterol above 60 mg/dL and your LDL cholesterol less than 100 mg/dL.


Basu A, Fu DX, Wilkinson M, Simmons B, Wu M, Betts NM, Du M, Lyons TJ.Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutrition Research. July 2010.

Zunino SJ, Parelman MA, Freytag TL, Stephensen CB, Kelley DS, Mackey BE, Woodhouse LR, Bonnel EL.Effects of dietary strawberry powder on blood lipids and inflammatory markers in obese human subjects. The British Journal of Nutrition. November 2011.

Cheung MC, Brown BG, Wolf AC, Albers JJ.Altered particle size distribution of apolipoprotein A-I-containing lipoproteins in subjects with coronary artery disease. Journal of Lipid Research. March 1991.

Arsenault BJ, Lemieux I, Després JP, Gagnon P, WarehamNJ, Stroes ES, Kastelein JJ, Khaw KT, Boekholdt SM.HDL particle size and the risk of coronary heart disease in apparently healthy men and women: the EPIC-Norfolk prospective population study. Atherosclerosis. September 2009.

American Heart Association. You’re your Cholesterol Levels Mean. http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-Your-Cholesterol-Levels-Mean_UCM_305562_Article.jsp

American Heart Association. About Cholesterol. http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/About-Cholesterol_UCM_001220_Article.jsp

American Heart Association. Lifestyle Changes and Cholesterol. http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Lifestyle-Changes-and-Cholesterol_UCM_305627_Article.jsp

United States Department of Agriculture. Dietary Guidelines for Americans, 2010. http://www.cnpp.usda.gov/dietaryguidelines.htm

United States Department of Agriculture. National Nutrient Database for Standard Reference. Strawberry.

Copyright © 2012 Nutrition Remarks. All rights reserved