Total cholesterol has probably been overemphasized as a single risk factor for heart disease. On the other hand, the fats that circulate in our blood vessels do have an impact on our heart health. Which blood fats are important?
The diet-heart hypothesis suggesting that high cholesterol of any kind pushes a person towards heart disease got its start in the first half of the 20th century. It held sway through the middle and into the end of the century. During that time, however, technological advances made more subtle measurements of blood fats possible. Doctors and patients aren’t just worrying about total cholesterol any more.
What Are Healthy Blood Fats?
Q. I have a good HDL of 69 and my triglycerides are 126. My total cholesterol is 252 but an NMR lipid test found I have super-high dense lipoproteins in my blood, which is not good.
The doctor gave me a prescription for atorvastatin but I would rather do this naturally. Is there any way to use diet and exercise to make my lipoproteins big and fluffy?
Making LDL Particles More Buoyant:
A. As technology for measuring cholesterol, lipoproteins and triglycerides improved, people began to realize that the type of LDL particles in the blood stream makes a difference. When a person has many small, dense LDL particles the risk is higher than if the particles are large and buoyant, or, in your term, “fluffy.”
Oddly enough, the conventional medical advice to reduce saturated fat and use vegetable oil (corn, safflower, sunflower, etc) instead may lead to small, dense LDL particles (OpenHeart, online, March 5, 2014). Saturated fat in the diet promotes larger, fluffier lipoproteins, even though we’ve all been warned to shun sat fat. These buoyant particles seem less likely to damage coronary arteries (Atherosclerosis, Oct., 2015).
Could a Mediterranean Diet Improve Blood Fats?
Unlike corn or safflower oil, fresh olive oil full of polyphenols that give it a flavor “bite” improve lipoprotein particle quality and overall lipid ratios (Molecular Nutrition & Food Research, July 2016). The same study showed that polyphenols from thyme are beneficial as well. These are frequent components of a Mediterranean-style diet, which is also rich in vegetables, fruit, whole grains and fish rather than meat. A diet high in fish and low in processed foods also results in favorable LDL particle size (Nutrition, Metabolism, and Cardiovascular Diseases, Nov. 2013). People who consume pistachios also improve their blood fats (Nutrition, Metabolism, and Cardiovascular Diseases, April, 2015).
Pistachios to Lower Triglycerides and Cholesterol:
Q. You’ve written about pistachios helping lower cholesterol and other blood fats, but you did not tell us the daily dose. How many pistachios would I need to eat?
A. The most recent study was a meta-analysis of 34 trials (American Journal of Clinical Nutrition, Jan. 1, 2020). It revealed that pistachio-enriched diets can lower triglycerides, LDL and total cholesterol. Sadly, it did not specify a dose.
An earlier study, however, found that 58 grams (2 ounces) could indeed lower triglycerides (Journal of the American College of Nutrition, June 2010). That works out to about 100 pistachio kernels per day.
Pistachios and Prediabetes:
In another previous study, 54 people with prediabetes consumed 2 ounces a day of pistachios or a control diet with an equivalent amount of calories (Diabetes Care, online, Aug. 14, 2014). They maintained these diets for four months. Then, after a two week wash-out period, each volunteer switched to the other diet.
Those consuming pistachios had lower blood sugar and insulin and reduced insulin resistance. In addition, their markers of inflammation also were significantly lower.
The researchers concluded that
“Chronic pistachio consumption is emerging as a useful nutritional strategy for the prediabetic state.”
Our Guide to Cholesterol Control and Heart Health offers more information on natural approaches to help your heart. Exercise and weight loss are extremely helpful for increasing particle size and reducing cardiovascular risk (Atherosclerosis, Dec. 2015; March, 2016).
Physical activity has many other benefits as well. Finding a way to move your body most days of the week while avoiding processed foods and refined carbohydrates will probably improve your triglycerides. You may find that you’ve lowered your cholesterol as well. Most importantly, activity you enjoy will certainly make you feel good. That in itself seems like a worthwhile goal.