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WN Radio. Well, hello, and welcome to Fearless Fabulous You. I am your host, Melanie Young, and welcome to what's starting to be my tenth season. Ten years that I have been hosting this show. Wow, amazing, how far I've come. This show started as a way to empower women to take charge of their health because I had recovered from breast cancer and was rethinking my health and how I took care of myself as well as what
I wanted to do with my life. And from that I wrote a book called Fearless Fabulous You, Lessons on Living Life on your Terms and thought, how am I can I promote this book? And I said, oh, I'm gonna shore our show called Fearless, Fabulous You and find amazing women to interview about how we all can live life on our terms in good health. So if you do follow me, you know that hard health is a recurring
theme. I always do at least two shows on hard health and other health topics at least in one season, and today we're going to address it again. I have hit the ripe old age of over sixty. I'm north of sixty, and I have learned, as many of my friends and followings and followers also north of sixty, that your metabolism just changes. It actually starts
to change in your fifties, but it keeps changing. And a recent visit to my primary care position, because I am very good at going to all my scheduled duchess appointments, revealed that my cholesterol was a bit high and my
weight was definitely too high for my small frame. And granted I live a life of incredible travel and eating and drinking good food and writing about wine, reporting on all that on my other show that Connect a Table, but it was kind of a wake up call, particularly after knowing that I have heart disease in my family. My grandmother died of cardiac arrest very suddenly, and my father had ongoing heart issues which resulted in a quintuple bypass surgery and a
stent. It's not what ultimately did him in he died of metastasized pustate cancer. But knowing that I have a family history of heart condition, and knowing that my cholesterol was high, and knowing that my weight was even higher, I gave myself a six week turnaround plan. Obviously, nothing really can happen. Everything can't be achieved in six weeks, but you can make headway.
And I'm a believer that you do this by diet and exercise. In Changing habits doesn't mean giving up everything you love, particularly if it's what pays your bills, like wine and wine writing. But it means moderation and making smarter decisions. So I am going to be addressing this today with an expert on my show. We are going to be speaking with doctor Elizabeth Clotis, who is a board certified practicing cardiologist, founder of the Preventative Cardiology Clinic near Minneapolis,
Minnesota, and she trained at Mayo Clinic and John Hopkins. She's got alf of information. She's also founder and chief medical officer of Step one Foods, which we will discuss at the end of the show is foods that are to help with managing and lowering your cholesterol. Which we're going to talk about what you know you should be eating, and I always hate talking about what you should not be eating, but we're going to talk about adding in more
because it's about crowning out bad stuff and adding in good stuff. Before we get into the conversation, I did like I always do, I popped on over to the Center of Disease Control CDC website to get some facts to set this up. Cholesterol high Total cholesterol in the United States is pretty big topic. Between two thousand and seventeen and twenty twenty twenty recent stats, ten percent of adults aged twenty or older had total cholesterol levels above two forty milligrams.
At about seventeen percent had high deads the high density lipoprotein HDL or good cholesterol levels below forty milligrams. That's a lot of technical talk for some of you, so I'll let the doctor weigh in. But here's the thing. In summary, high cholesterol has no symptoms, so many people don't even know that their cholesterol is too high. We're going to talk about how you can check
it. We're also going to talk about why it matters because, according to the CDC, having high cholesterol raises the risk for heart disease, the leading cause of death and stroke the fifth leading costs of death stroke and for women, heart disease and cardiac aris is like number one as from per the American Heart Association. So women have a high risk for heart disease and often, as I have explained on this show, symptoms are not like men and they're
different. So we're going to dive into all this, and most importantly the takeaway is what can you do starting now to maintain a healthy cholesterol for you through lifestyle changes. So, doctor Elizabeth cloonas Liz, as you said before we went on, Welcome to Fearless. Fabulous you, Melanie, thank you
so much for having me. I'm excited to be here with you. And honestly, as I was listening to the intro, we you know we could sit down and have coffee and talk about this for hours because our I think approach to heart disease prevention and interest in this area obviously is very much on the same page. So I really look forward to our conversation today. Absolutely. You know, I always like to start with a little backstory because I'd like to explain who my guests are, which I semi did. But I
am curious why you decided to become a cardiologist. Was there something in your own life that said, I want to know, there's always a reason you become a doctor, and it is a long road, and becoming a specialist is that even longer road? So what inspired you? Well, yeah, the long road is for sure true. I mean from the time I graduated high school so they to the time I hung up my cardiology shingle was fourteen years of uninterrupted education. So it's a it's a very long road to get
here. And actually it's interesting because I didn't get here kind of the way a lot you know, I didn't pick the specialty the way a lot of people picked their specialties. Right they had you know, they broke their leg when they were young, so they became an orthopedic surgeon, or you know, their mom had cancer, so they became an oncologist. Actually, my just like in your family a history of cancer or a personal history of cancer.
My my family as cancer everywhere and yet that's not that's not why. And I didn't become an oncologist. I chose cardiology honestly because of a mentor that I had during medical training. Um. It's you know, I did a rotation on cardiology when I entered internal medicine. Because it's a it's a
layered um um, it's a layered education process. First, you you know, oud your medical school, then you do an intro introl medicine residency, and then you specialize and go on to cardiology, which then you can further subspecialize into things like electrophysiology or congestive heart failure, you know, transplant management, things like that. Anyway, Um, but it was literally on the first day of my cardiology rotation that that my mentor inspired me. He just
um, his name is pures Batarad. He's he's retired, but this was at Mayo Clinic and he just made every single patient and every single cardiology problem seemed fascinating and and it's an amazing being filed. I mean, the heart is a miracle if you think about it. I mean, it beats, it pumps blood, you know, just all on its little all on its little loan. Sixty times a minute, sixty minutes an hour, twenty four hours a day, seven days a week, fifty two weeks a year,
for you know, a hundred years. It just keeps going. It's amazing. There's there's no engine that does that, so quite an engine. And it is, you know, what keeps us living because technically, if your heart isn't beating, you're dead. You know, you can be brain dead, but your heart can keep beating, right, Yeah, it's it's obviously
it's an incredibly important organ. And you know, and I think the other thing honestly that attracted me to cardiology is because you can do so much, you know there, you know you can, and it's and it's such a wide breadth of almost subspecialties within cardiology. You can almost be a you know, a radiologist in some sense and read heart ultrasounds and heart sets and heart MRIs. Or you can be almost a surgeon and in cert stents and you
know, or you know, the pacemakers. You can um you know, be like what I what I do, which is be on the prevention end. And actually, you know, my hope is to put myself out of work, is so people don't don't need us anymore. So I always said that when I wrote my book to help women diagnose with breast cancer, I hope no one ever has to buy my book. You know, you know it's amazing, um, doctor Clote, is that we take our hearts for granted. You know, we talk about women talk about love. They're always
looking for love, They're always looking for their soulmate. They're always you know, expressing themselves and you know, I love you and emoging their heart. But we mistreat it by not taking care of it. And it is really the beating heart is what defines you as living. And if you've ever held someone like I have, who watched their the heartbeat die, which I did with my mother, I watched a heartbeat die, it is a very powerful thing to watch someone who is dying. And the last thing you see is
a beating heart. It is the last thing to go. And we take it for granted, don't you agree? I? You know, very much so. And I think it's because it just kind of keeps doing its job right and and and it can take an awful lot of abuse, which is you know what, which is which is amazing. And again, our bodies are so incredibly resilient, but at some point we you know, we exceed
the capacity of our bodies to make up for what we're doing. And that's why it's so important to start early in terms of your prevention efforts, because both the building of disease or the prevention of disease are cumulative of you know, those those efforts or those habits, you know, multiply over time. And you're right in terms of women, this is our disease. You know, we we think about and you've had breast cancer, so I don't in any way want to diminish breast cancer as a you know, as a as
a health threat. It's a terrible disease. It takes, it takes a lot of women's lives. But you know, one out of thirty women will die from breast cancer, one out of three will die from heart disease. So so heart disease is our disease, and it is almost entirely preventable. Eighty percent of it need not exist. And you know, a family history is a risk factor for sure, but family history genetics are not destiny.
Genetics are a you know, a risk factor. They add about twenty percent, they account for about twenty percent of your risk, which means eighty percent is something you have some troll over. If you have family history, right, you're you're starting a little bit behind an eight ball, but it doesn't mean you're faded to this, and this is an avoidable disease, absolutely, and with all risk predension. I like to start with I have a little
quadrant, but the two big ones nutrition and movement. I never say exercise as say movement, but it's exercise, and those are the two that can help reverse a lot of damage. But you do have to start early. And what's interesting is so many parents should be aware that it starts with teaching good habits as children to their children, so that you know they're not sedentary, they're not eating the wrong foods, they're eating balanced diets, and they're
leading an active life. I want to this show is about cholesterol because a lot of people don't even understand what cholesterol is. And it is a big term, and there's different terms. So I want you to define the different types of cholesterol because people here there's good cholesterol, people here there's bad cholesterol.
They hear of diet. There's a lot of terms. Yeah, So so first of all, just in general, what is cholesterol well, cholesterol is a waxy, fat like substance that can be found in all sorts of places inside our body. Every cell wall of every cell within our bodies has some cholesterol. We use cholesterol to make hormones, bile acids, vitamin D, and other substances. So cholesterol is actually important for our body structure and
function. The problem is, if there's too much cholesterol circulating in the bloodstream, some of the excess can be it can be contrapped in artery walls, and this buildup is called plaque. And if enough of it accumulates, that plaque can narrow blood vessels and make them less flexible, causing what's you know,
typically referred to as hardening of the arteries. And it is this process, that accumulation of plaque in our arteries that leads to these potentially devastating health events like heart attacks and strokes or the need for procedures such as you know, bypass surgery instants. So it's a you know, this is a progressive
disease. And to your point, it starts early, you know, autopsy data, this buildup of gunk inside our arteries, it starts very early, you know, in autopsy studies performed on soldiers killed in the Korean and Vietnam War. So these are young men in their twenties and thirties. They were already seeing significant plaque build up when autopsy's done on children. What a tragic thing to do an autopsy on a child. But we're starting to find the
earliest precursors of plaque in children as young as ten. So the earlier we start with, you know, preventive measures, the better. Okay, Now, cholesterol, so we talked about kind of what it is generally the way to you can't, for the most part, feel that you have high cholesterol. By the time you feel things like a heart attack, stroke bypass, you've had cholesterol for a high cholesterol phone off, well, young time. Really, the only way to know if you have an abnormal cholesterol profile is
to get checked with a blood test. And when you do that, you will get four numbers. One is the total cholesterol, and then you'll get HDL cholesterol, LVL cholesterol, and trigolysterides. Okay, total cholesterol. The total cholesterol is the sum of all the cholesterol in your body, so it's kind of everything that's below the line. Those those three other numbers. Those three other numbers make up the total cholesterol. The total cholesterol should typically be
under two hundred. It's melligrams, prodest leader or the units, but we'll stop talking about the units because they're all the same anyway. It should be under two hundreds. But the total cholesterol is actually less important than what it's made up out of, right, because I just said there's good cholesterol, bad cholesterol, triglysrides, and you can have various combinations of those three things and end up with the same total, but with very different health implications.
Okay, let's start with good cholesterol HDL. HDL is the good cholesterol. It's the happy cholesterol. You want to keep it high if it helps you remember which is which. HDL is the cholesterol that is not depositing in our arteries. It's on its way out. So we actually want this number as high as possible. In women, we're happy to see it should be over fifty, so you know that's where you should be. If you have an HDL cholesterol under fifty, that's its own risk factor for earlier atheroscurosis, So
it should be over fifty. LDL is the bad stuff. This is the cholesterol that's potentially depositing in our arteries. It's the lousy cholester. You want to keep it low. This is the cholesterol that you know, all physicians obsess over because LDL cholesterol is most tightly linked to heart disease risk. It's almost, you know, a linear line between LDL and heart disease risks.
So the higher it is, the higher your risk. Most cardiologists, actually all cardiologists would say, you know, everyone should be under one thirty for LDL as you accumulate risk factors, and that could be a family history of heart disease, or you have high blood pressure, you're a smoker. At some point, under a hundred would be better. Once you have documented heart or vascular disease, so you've had a heart attack or stroke, or bypassers
or your stent, your LDL should fall under seventy. Now the vast majority of us will require medications to get there, and there's even data to show that under fifty is additionally protective. So the main message around LDL is the lower, the better. The last component of a cholesterol profile are the triglycerides. Triglycerides are not much of a cholesterol particle, they're actually mostly fat, so if you try to add up the three numbers, you won't get to
the total. It doesn't add up right. So the formula is actually good cholesterol plus bad cholesterol plus one fifth of the triglysrides get you to the total. Triglyceride levels should be under one fifty and in everyone but the But the range of triglyceterides is very broad, so it's just a different animal. It lives on a different scale. The lowest triglysides I've ever seen in someone on no medications is twenty seven, but the highest I've ever seen is in the
thousands, So it's a ginormous range. But everyone should be under one fifty. Triglycerides on their own are not much of a risk factor for heart disease per se. They tend to be more of an indicator of metabolic health. You know, the higher your triglycerides are, the more likely things are out of whack. You know your weight's not right, you're eating poorly, you're
not exercising, you're drinking too much. You know that triglycerides will give you up, like they'll be the first ones to rise and say like something's not quite right here. That makes a lot of sense. So just to recap LDL. You want your LDLs low right, yes, you want your HDLs high m and you want your triglycerides low yeah, right, And you should go to the doctor like I do with a shopping list. I got with a checklist. Now't ever go to your doctor unless you have a checklist.
And I have a checklist. If everything I want check because I swear if they if I don't have that, they won't do it. So you got to go in there and demand that you get all the necessary tests so that you can have them as a benchmark and read the results because you get them in your portal. It's it's your benchmark to see what you need to do if you need to do any adjusting. Now, the logical way that these get adjusted from a physician standpoint is to prescribe medication. Right yep, high
cholesterol. Here's a pill and that would normally be what that would normally be a stat And so these are you know, medications that most people are familiar with because they've heard them, because they're because they're so frequently prescribed. The original ones were you know, called lipatore and crest store um, now they're all basically all generic. So that was a penalty for maybe a Torvos stat and YAP or Suba stat and Simba stat and so that. So that's the
category of arts. It's actually the most widely one of the most widely prescribed drug categories on the planet exactly besides an indepressants and most of the relaxers. I could go on because I do have and I do like my primary care physician, but he loves to prescribe things, and I hate taking pills. So my husband's taking satins. I'm not because I don't. So there's a big reason I don't like taking drugs prescription medication unless absolutely necessary. And the
biggest reason is that I write about wine. It is a job, and I know that there are interactions, and I read interactions carefully. I also know that you can't operate a car, and there are certain things that affect your decision making. And I am one of those people who does not do well on prescription medication. I get foggy. I have had reactions from itching to brain fog to whatever. And I also know that you have to be very careful if you drink wine. You've got to watch that and if you
offer any machinery, So for me, very few work. And my mother was the same way. She would have reactions. You've got to be very careful. It's not that they're bad, as you have to do what's right for you. My husband is taking a statin. However, I'm a big believer that you you know, change a start with you and not what you pop. And it's not what the pillow you pop in your mouth, but the food you pop in your mouth. And if you want to get rid of the gunk, get rid of the junk. Could not have said it
better myself. I'm going to use that line. I do like to speak credited, but that is something I say quite a bit, and you know, I'm a big believer in it. It's hard, it's not easy to follow. But you go into the doctor and you find out your twenty five pounds overweight, in your cholesterols high, you go, I think I'm going to do something about it because I don't want to get sick. So again,
this is a blood test anyone can have it. Is there a certain age that people should be starting to get their cholesterol check or should just be part of your and so so actually, um, you know, it's it's recommended that the first cholesterol check happen in childhood. And and you know a
good rule of thumb. And this isn't exactly you know, like the you know, US Preventative Services Task Force would say, but it's close enough and it's really easy to remember once you know, before you turn ten, you know, um, twice in your sorry, once in your teams, twice in your twenties, you know, three times in your thirties, four times in your forties, at least every other year in your fifties, and then yearly sixty onwards. So it's you know, it's it's something that should increase
in for extent. It assumes your your your numbers are normal, right, you may need more free quin checks if they're abnormal or you're being started on a therapy or you're using diet to modify this, so then you're going to need more frequent assessment. But but if otherwise everything looks good, that's that's a pretty good way to think about it, and it's easy to remember.
Also if you're having life changes, I am going to safely assume that if you're pregnant or you're going through menopause, or you're in some kind of treatment that you have to watch things because there are certain types of things that will increase your cholesterol based on that. Yeah, yeah, so with pregnancy we can see changes in cholesterol, but honestly, we don't really measure cholesterol during
this time. We don't do anything about it because there are no safe treatments for cholesterol during pregnancy, not because they're they're intrinsically unsafe, it's just they've not been tested and so, you know, and this is actually a big problem in general for women who are are pregnant or of childbearing age. They're typically excluded from all trials, right because no one, no one wants to, you know, do anything that could in any way potentially you know,
hurt the fetus. So so we have a big gap in knowledge as to what to do, you know, in in that patient population. UM. But you know, once you're once you're you know you're not going to have any more children, you're using contraception, or you're you know, past past reproductive age. UM, you know that obviously we can use all sorts of medications. There's there's all sorts of options for that UM, which is where a diet becomes really important, you know, for for um women in during
their reproductive years, and lifestyle becomes really important in terms of menopause. Um, boy, that is a big time where cholesterol profiles can change. So remember how at the beginning I said, you know, we use cholesterol for all sorts of things, right to make cell walls, to make hormones, to make file um well in order to use them. The truth is we can actually make most of the cholesterol we need for those functions inside our cells.
We actually don't need a lot of circulating LBL cholesterol to be around to to to use. But if we're if we're going to use but if it's out there in the bloodstream, it's kind of like sound money. It's like one both making it and inside we you need just grab it, you know,
take it inside the cell and use it for what you need. But in order to grab it, you need a receptor, and that receptor has to be primed and active to pick up an LDL particle, So a bad cholesterol particle from you know, from the storage time, from from the bloodstream and bring it inside the cell. Okay, Estrogen up regulates LDL receptors.
It makes them way more active. So when we have estrogen around, our LDL levels are lower, our cholesterol, especially that the bad cholesterol levels are lower because we're very efficient at grabbing it from our bloodstream and bringing it inside ourselves. When we lose estrogen during menopause, you know, when we go through menopause, that that protective sort of booster for those LDAL receptors goes away, and all of a sudden we're left with kind of lazy LDAL receptors.
And so what a lot of women experience is like, wait, my weight's the same, I'm exercising the same, I'm eating the same stuff, and my ld all just went through the roof. It's your it's that estrogen loss is what happened. Wow, that's interesting. I have no ESG because I went to menopause and I had estrogen receptor positive cancer, so they blasted me
with romatise inhibitors. So I have no estrogen, although I feel very presitive, fabulous, But you know, that's probably another reason why my cholesterol went a little off. But like I said's under control. But it was off, but a lot of it was lifestyle. So let's talk about diet. First of all, exercise is critical. It goes hand in hand with diet. Really can't do one without the other. They are the handsel and Gretel.
They are the tweedledee and tweedledum. They work together. You can't just exercise it keep eating what you want, and you can't just you know, stop eating and that exercise they are essential. There are other things as well, right, sleep, dress, management, your mental health. Those are all that not the exactly, but it's really critical. So let's talk about
diet because there are foods that can help lower cholesterol. It's not they're not magic pills, but they are easy to add into a diet and to replace other things. Right, So give us some examples. Okay, so I'll talk a little bit more in generalities, so more categories of food. So the things that influence and I'm just going to focus on LDL because that's that's that's that's the particle we're really you know, laser, you know laser focused
on in cardiology. So the things that are going to impact your LDL level from a dietary perspective are going to be the types of fats you eat and the types of carbs you eat. It hasn't very little to do with how much cholesterol you consume. It has very little to do with how much protein you consume, So you can kind of leave those those two things to the side. So let's do the fats first. The fats that you should be avoiding are saturated fats. Those are fats that are solid at room temperature.
They come primarily from animal sources butter, cheese, the marbling, and beef the fat and chicken. Saturated fats at best are going to be neutral, meaning they're not going to help you. In many people, they raise LDL cholesterol, and they do that through kind of the same way as losing estrogen. They down regulate LDL receptors, and in some people that can be a really profound effect, Like you know, some people go on a keto diet
and their LDL goes through the roof. So saturated fats are going, if anything, they're going to raise LDL. They're also pro inflammatory, and all of these things that we're actively trying to avoid, cancer, dementia, heart disease, these are all driven in part by inflammation. So you don't want to be throwing, you know, you want to be tamping that down, not throwing gasoline on a fire. Right Now, that doesn't mean you should.
You need to eat a low fat diet. Unsaturated fats, so those fats that are liquid at room temperature, so fats like olive oil, the oils and nuts and seeds, oils and fish, avocados, those fats are perfectly fine to eat. They're at worst neutral, so they're not going to hurt you. In more people, they upregulate LDL receptors so your LDL levels fall. They also help raise HDL cholesterol and lower triglyceride, so they give
you an overall better cholesterol profile and their anti inflammatory. The only caveat I'm going to put around um unsaturated fats is that you should eat them as close to their original form as possible. So when I'm talking when I say fish, I mean like you know, broiled or you know, or poach salmon, I'm not talking you know fish sticks. And I'm talking raw nuts right, not roasted, salted, you know, barbecue flavored almonds right like that.
I think that's not it because those those unsaturated fats are pretty delicate, and the more we mess with with the food, the more we potentially the nature the benefits to those fats and the benefits that they carry, and we add things that we don't need. Okay, that's the fat story. Well I also want to just interject one thing, and it's also about using measuring spoons. Because Marion Nessel, who is uh this heads the NYU Center for
Food Studs and is a right your dietitian. You know, they all have calories. So it's not like you can just drizzle your olive all all over the place lavishly, because I think it's a tablespoon of oil no matter what is about one hundred and twenty calories. Yes, you know, absolutely so, so thanks for pointing that out, because it's it's you know, there is a calorie. You know, there is a calorie um you know price here. So so it's not about drinking a gallon of a you know,
olive oil every day. But but but but if you're if you're going to have some fat in your diet, it's it should be unsaturated. Right. Oh oh, quick note about coconut because it comes from plant bas sources. But it's but it's solid at room temperature. From a cholesterol perspective, it's much more like beef fat than it is like olive oils so um. You know, coconut oil is wonderful on your body less so inside your body exactly.
And I'm a big believer. I'm putting it on your body. It to me it's lotion, but it's not what you want to jest And I think just that whole visual of if it's a solid room temperature, that kind of gives it away. Maybe that's not your best bat Yes, yes, okay, moving onto the carbs. So carbs, you know it's not about a low carb diet. It is about a very choosy carb diet. So
what you want to avoid are simple processed carbohydrates. You want to just like for the unsaturated fats, you want to eat your carbs as close to their original form as possible. So brown rice, not rice crispies, an apple not apple sauce or apple juice, right, go upstream as far as you possibly can. And the reason for that is because whether carbs are superprocessed or whole and unprocessed, all carbo hydrates are ultimately digested and absorbed as sugar.
And it's just kind of how quickly does that digestion happen and how high does the sugar go? If you eat a bowl of rice crispies. Your body looks at that and says like child's play, Like I can digest it like that. I mean, it's just the inner most part of a rice grain. It's been milled, it's been puffed, it's been extruded. You know, I'm you know, this is going to take me nothing to digest. It's predigested for me. And that's what happens. It gets broken down quickly,
absorbed quickly, and your blood sugar spiral upwards. And what happens next Insulin spikes and insulin is there to put you all the sugar away. But insulin is a storage hormone. It shifts our body into storage mode. What's the storage from of cholesterol? LDL? LDL levels go up when insulin levels are high. What's the non storage from of cholesterol hdl? HDL levels and be depressed when in some levels are high. What's the storage form of sugar?
It's actually triglysterrides. You can think of our body as having kind of covered space to put sugar, you know, away, because we need it in reserve, you know, if you're we needed for instant energy. So it's good to have some sugar like ready to go, but that covered space is finite. And and if you just ate a big bowl of rice crispies and you and your bide just got flooded with sugar, the bid says, well, okay, I filled, I filled my covers, but I still
all this sugar floating around. What am I going to do with it? Oh? I know, I'll concentrate it. I'll turn it into fat and triglystride levels go up. So some of the worst cholesterol profiles I've seen have been in people who eat a no cholesterol, no fat diet, and they will say, like, look, zero zero zero on the package. It's like this is great for me, And I go like, no, you're
eating rice cakes and fat free cookies. You know stop that. You're you're inadvertently triggering a biochemical response that is completely counterproductive to what you're trying to achieve. Okay, Now, if you eat the brown rice, right, the brown rice hits your digestive system and the body looks at and says like, oh, well, thanks a lot. It's gonna take me a while. I've got brand, I've got germ. I got to break this down.
It's gonna you know it's gonna take me a while. So instead of blood sugars you know, just zipping up like crazy, you know, they kind of go low and slow, so your your insulin levels are much lower and you're not triggering this counterproductive response. The other thing that whole carbohydrates bring to the party are fiber and plants, steriles, fiber works. So let me go back. So there's a natural elimination process for LDL. We didn't talk
about that, and that's related to making bile. So you can think of a big funnel of LDL coming back to the liver where it gets taken up and turned to bile, and then that bile gets dumped in the digestive system when we eat, gets used up in the digestive process, and out it goes. So that's kind of an exit strategy for LBL. Now, most of us are pretty efficient and so instead of just letting all that bile run out, we will reabsorb any bile that doesn't get used up in the digestive
process. We put it back so it's ready for the next meal. Okay, what does that mean, Well, it means that funnel of LBL doesn't have to be nearly as big, right, and so we can keep more LBL floating around in the bloodstream. This is actually the mechanism that the original cholesterol lowering drugs used. They're not we don't prescribe them anymore, but they were called bile acid resins and they literally bound violent digestive system and you eliminate
through the stool and it worked. LBL levels dropped. The problem was they were messy powders. You had to take eight pills a day, People got digestive upset. It was really very unpleasant. So when statins came along, like wait, one little pill versus all this, like I'm than that. So we don't use them much anymore. But the process they were leveraging is continuing to happen in our body. So back to food and back to whole
unprocessed carbs because they help leverage this mechanism. So whole unprocessed carbohydrates bring fiber and plant sterols to the party. Fiber works because we can't digest it, So you get a fiber molecule. Bio acid molecule tries digest it, tries to suggest it, you know, can't do it, and before it figures out like I'm not getting anywhere. It's past the point of no return.
So in many ways, fiber acts like those medications. It traps bile in the digestive system, so you escorted out of your system, so your LBL levels drop. Plant sterols are natural plant components found in whole, unprocessed foods, and they're actually the plant version of cholesterol. Remember how I said everything cell in our cell wall in our body has, you know, has some cholesterol in it. Well, same thing goes in plants. Plants have their
own cells and cell walls, and they contain their version of cholesterol. And that sounds crazy, like why would you eat cholesterol the lower cholesterol? But the reason why this works is because plants steriles are similar but different. They're similar enough that when they're in our digestive system, the body looks at them and says like, oh, hey, you're like one of those bile guys. I'm supposed to be absorbed. Oh you're really important. Here's your absorption
site, welcome back. Well, the plants sterile shows up and it's just slightly different enough that it can't get through and so it blocks an absorption site, meaning while behind it has one less storway to get back in and we waste more bile. So this is why you know, whole food vegans and vegetarians tend to have significantly lower cholesterol than most of us. They're you know, they're eating a lot of fiber and plants steriles naturally, so they're really
leveraging this you know, this um you know, elimination pathway. They're also not triggering that counterproductive insult response because all the carbs they're eating are complex. Oh and by the way, all their fats or plant baste, right, so they're so they're not eating saturated fat that's causing the their you know, receptors to downregulate. So anyway, there you go, watch your fats,
watch your carbs exactly. And you know, when you eat healthy carps, you're you're fuller longer also, which is important to undercrutely, so you don't tend to overrate. I mean, you know, oh, I'm going to zero in on one, you know, oatmeal um to keeps you full for hours. Yeah, well you know, and I know I had Step one, the company that you found it that focuses on foods that lower cholesterol. I sent some samples. I'm not an energy bar girl. But I I
do. I make myself heat oat meal. Here's my tip if you don't like oatmeal. I don't like hot oatmeal. So what I do is I make overnight oats. For some reason, I like it with it's chilled and small, not a big bowl, because you are so full from it versus hot, which just feels like it's not for me. But so if you don't like something one way, chill it or sprinkle it, so you have
some that you sprinkle on top of other things. You can sprinkle and it still provides you fiber and you do feel fuller, because I think that's the one thing. If I have it oatmeal in the morning, I am. And I've been doing a lot of weightlifting because I'm also really ramping up the way I exercise because I plateaud So that's been helping in terms of that. Another one. You know, there are fruits and vegetables high and fiber. An apple. You know, there's a reason they say an apple a day,
right, Yes, keep the doctor away. Yeah. So other than oat meal, and whether you sprinkle it or overnight it or anybody, just don't happen in a cookie, sugar and everything. Yeah, yeah. Yeah. What are the other foods that you would recommend that are high end that are hid fiber um? You know, boy beans, lagus um, you know, super high end fiber. Actually, avocados are high fiber. People don't think about that, but they are. And there they also have all
those good fats. So it's another reason why when you eat some guacomole, you're like, I'm full, like um, so it just don't eat it with tons of chips. You know, good I to do guacamole? Is I buy carrot strips? Yeah? Those are my crunch or you can cut up a cucumber crunch or something that has crunch basically, and when my husband's eating the chips, I hit for the strips. Yeah, excellent, excellent. Yeah. So you know, I mean really almost any whole fruit or
vegetable is going to have to have fiber. You know, leafy greens, you know, high and fiber. It's it's all. Any you know, any plant based food, so long as its whole is going to is going to give you fiber. And you know, and and it's only when we mess with things that that we start to strip those you know, some of
those beneficial that beneficial roughage out. So if you you know, if you crave orange juice, have the orange instead eat the orange because you know, the orange juice when you when you squeeze it, you leave the pulp and piff and and that's that's where the magic is. And if you must buy orange juice, get it with the pulp of the bed. I'm not a big juice or I do. I like juice, but I watch sugar like hawk, so I stay with vegetables. But yeah, again you lose the
fiber aspect of it. So why did you decide to create Step one foods um which was your product? Just to be clear, I have no affiliation, but it is it is for people who can't figure it out themselves. Yeah, yeah, you know, I mean along the way, you know, I mean literally, you know, we started talking about, you know, high cholesterol. Here's a phill. Well that's what physicians are taught to do. And you know, and and and as I look back on my
education, I was educated some pretty you know, some wonderful institutions. Um, I got the wrong advice. You know. It's the all the things that I'm treating with drugs, high cholesterol, high blood pressure, you know, high blood, sugar, um. You know, these are conditions that are caused in part or in whole by food. And if something is caused in part or in whole by food, step one should be change change the
food. The problem is that if you're trying to actually influence a you know, a cholesterol number or blood pressure number, you know, you really have to know what you're doing, like you know, it's it's not just a matter of eating better, although that'll help, but but it's really about being strategic and making sure that you get enough fiber, enough you know, plants, steriles, enough healthy fats, those Omega three fatty acids, enough antioxids
to actually you know, get a benefit. And this is where it gets really hard for people because you know, they try, but they just don't can't do it quite right because it's hard. You know, you're measuring your you're buying all sorts of ingredients. Things go bad in your fridge. So so the whole idea behind Step one foods was Okay, let's just make this easy. You know this this is we know what people need, we can deliver it in just two small servings of food a day. We don't have
to own your stomach from from morning tonight. We can just you know, we can just supplement what you're doing with this and then you know, let's see what happens and lo and behold, you know, people can see just with this tiny, tiny, little intervention. And the foods by the way, you know, for for listeners, are snack bars there, you know, the things that people are eating already, So snack bars, instant oatmeal, pancake mix, moodie mix. Um. You know, there's there's a
you're talking about a sprinkle. There's like a sprinkle product which you can just you know, add to like yogurt or something else that you're eating to really boost the nutritional content of that and kind of gets you to the nutrient levels you need to affect cholesterol levels. And sorry, go ahead, Yeah, no, Sprinkles are easy for people that can't deal with other things. Sprinkling is good, you know, and other things to sprinkler nuts, you know,
unsalted nuts or seeds. You know, we sprinkle a lot on our salads. We sprinkle a lot on our Sprinkling is good if you're sprinkling right. Thing. Just don't sprinkle sugar, you know, think about what you sprinkle. Um, and and it does work, and you know, at something with oats is good, but again look for stuff that's low and sugar. We only have about a minute left. I do need to ask you, is there anything on the front of reducing cholesterol managing it that you're excited
about that hasn't in your crystal ball? Well, you know, my hope is that while we develop new drugs, and you know, and I'm not anti drug I prescribe medications all the time. Some patients need them. They're they're important, they can be life saving. But I hope that in my lifetime we see a change in the food environment. Look, we we live
in a dysfunctional food environment. We are surrounded by hyperpalatable, calorie dense, nutrient poor foods that are delicious, made to be addictive, inexpensive, and advertising NonStop. What could go wrong? Well, what can go wrong is the health of our country. And you know, and we need a different path. And I'm hoping that Step one foods can be you know, the little standard bearer of how we can do things differently and how we can yield
measurable health improvements in as little as thirty days. I mean, our clinical trial showed that some people had medication level staton level cholesterol reductions with our too little you know, too little servings a day intervention in thirty days. I mean, if you're someone who can't tolerate statins, you don't want to take them. You've tried them and you know they did they didn't you know they didn't work out for you, Like this could be a game changer, and
you don't need to commit to it forever. It's just thirty days and you can see whether or not it works for you. Well, I know I'm doing thirty days right now of working with and I just want to in order to wrap this appropriately, if you are considering making changes, particularly in your diet, make sure you do it with the advice and the consent of your
primary care physician. So and don't do anything dramatic. I mean, I've consulted with my doctors, my gastroentologists because I had some GI issues and my PCP before I even started adjusting things in my diet. And I have a pretty healthy diet as is, but we're testing a few things to take out to see if it will help the GI track. And I also ramped up
my exercise. So the bottom line is you have the power within you, because I say at the endividually, you have the power within you blend of the good Witch to make the changes you want to stay healthy for the long term. But you have to do it today, and you have to commit to it, and you have to do it in cooperation with the people that are your board of advisors, which are your physicians, and you have to
make the change. I want to thank you again, doctor Elizabeth Clotas, who is a board certified cardiologist, for sharing your expertise today on Fearless Fabulous Shoe. I think it was very helpful. I thought you opened a lot of answered a lot of questions about cholesterol. You know, listen to the doctor, not doctor Google. Get your information from credible sources, and that's what I ask everybody to do. And don't share things that you are not
expert in. Listen to experts. You've been listening to Fearless Fabulous Shoe. I hope you enjoy this. You can listen to all my shows on iHeart, Spotify, Apple On about thirty five other podcasts on demand anytime, so check it out and check me out at Melanie Young dot com and Melanie Fabulous. I thank you again for joining me, Doctor Clotis, and to all my listeners you got this day fearless and fabulous cast to play usual Ton