less likely to have hypertension. Not only do these foods provide a great source of calcium, which helps keep your arteries strong and flexible, but with DASH, they also replace less-healthy saturated fats and processed foods.
DASH and Cholesterol
Your doctor, your family, and even your TV set are always nagging you about cholesterol. Why do they care, and what exactly is the stuff, anyway? Cholesterol is a waxy substance that comes from your diet but is also made by your body. Although it’s often lumped in with fats, it’s technically a lipid, a broader category that also includes fats. There’s a lot of confusion between dietary cholesterol and the cholesterol made by your body, so we want to clear things up.
Why cholesterol matters
The two types of cholesterol circulating around in your blood that you need to concern yourself with are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL is the “bad” cholesterol because it’s the one that clogs up arteries. You need a little bit of it to keep your cell membranes healthy, your brain working smoothly, and your hormones at healthy levels, but most people’s bodies make far more than they need. Most of the LDL swimming through your bloodstream is generated in your liver, a highly creative organ that can make cholesterol out of just about any sort of food. Dump in a load of saturated fat (coconut oil, animal fats) and it goes to town. Trans fat (found in partially hydrogenated oils, especially hard margarine and shortening, and many processed baked goods) revs up the liver’s cholesterol-creation system even more. Carrying around some extra body fat, especially the type that collects around your tummy, also boosts LDL production. Smoking does too.
HDL is the good stuff that works to protect your blood vessels. It works in opposition to LDL, pulling bad cholesterol out of the arteries and taking it back to the liver to be processed and eliminated. In general, the higher the HDL the better. Monounsaturated fats (from olive oil, avocados, and nuts), exercise, and alcohol in moderation raise HDL. Think “H is for happy; L is for lousy” if you have trouble remembering which cholesterol is which.
If your LDL level is high, then you may be more likely to suffer a heart attack or stroke, whereas high levels of HDL may help protect you. The optimal levels vary, depending on your other risk factors. These include hypertension, diabetes, smoking, and whether you’ve already started to develop cholesterol plaque in your arteries. For more about cholesterol and how to figure out your ideal numbers, check out Chapter 7.
TAKING A CLOSER LOOK AT YOUR LIPID PROFILE
Sometimes doctors refer to non-HDL cholesterol. Basically, this includes LDL and all the other forms of not-so-good cholesterol, including VLDL (very low-density lipoprotein) and IDL (intermediate density lipoprotein). These two bad actors are closely connected to triglycerides, another undesirable.
Triglycerides aren’t technically in the cholesterol family, but they’re part of the standard lipid profile blood test. These “blood fats” go up with foods that are high on the glycemic index (that is, foods with simple carbohydrates that quickly raise blood sugar and insulin response). Total carbohydrate intake isn’t as important as the intake of those simple carbs. Processed sugary foods are triglycerides’ best friends. It’s no surprise that a high triglyceride level is often considered a marker for an unhealthy lifestyle. High levels of triglycerides in the blood have been linked to higher risk of heart attack.
How DASH can help
The effect of a strict DASH diet on cholesterol is modest yet still meaningful. In a study comparing DASH to a standard Western control diet, with no weight loss allowed, LDL dropped nearly 11 points. The diet, if followed to the letter, will actually drop HDL a little and have no effect on triglycerides.
If your LDL needs some work, back off the red meat, baked goods, and coconut oil, and add in more fiber (oats, beans, apples) and some soy-based foods (such as soy nuts, edamame, and tofu).
If your HDL is running low, try working in a few more monounsaturated fats and omega-3 fatty acids, found in foods such as olive oil, nuts, and fatty fish.
We show you more ways to make the DASH diet work for you in the recipes in Part 4.
Battling the Bulge
If you’re struggling with your weight, you have plenty of company. More than two-thirds of Americans are overweight, and more than 40 percent are medically obese. A DASH meal plan can help reduce risk factors for heart disease, diabetes, and cancer. According to the Centers for Disease Control and Prevention (CDC), heart disease, stroke, type 2 diabetes and certain types of cancer that are some of the leading causes of preventable, premature death.
Globally, the numbers continue to grow. As of 2017, 39 percent of adults were overweight with 13 percent classified as obese. Though genetics may play a role, there are three times as many people struggling with obesity as there were in the 1960s. These statistics result in 4.7 million premature deaths annually.
Why weight matters
Stepping on the scale may feel like an act of courage, and sometimes it’s just easier to convince yourself that maybe your body weight is only skin-deep. In truth, it’s much more than a cosmetic issue. People come in all sizes and shapes, and there’s a wide range of healthy body weights, but after you cross the threshold into obesity, you open yourself up to a host of medical problems.
