Bipolar disorder and high cholesterol can sometimes go hand in hand; here’s how to win the battle:
By Tricia Silverman
Are you tired of taking foods out of your diet to lose weight, reduce cholesterol, and improve your health? The good news is that to lower your cholesterol you may need to add food! Check out simple, new, sumptuous ways to enjoy the super cholesterol-lowering foods below.
Those who have bipolar disorder often struggle with high cholesterol as a result of gaining weight. Gaining weight, combined with a poor diet and lack of exercise, are surefire ways of increasing total and the “bad” low-density lipoprotein (LDL) cholesterol and decreasing the protective “good” high-density lipoprotein (HDL) cholesterol.
High total and LDL cholesterol levels indicate a high level of cholesterol circulating in your blood that can attach to and clog up your arteries, leading to heart disease and heart attacks. The HDL cholesterol is protective since it appears to take cholesterol away from the arteries. To see how your cholesterol numbers measure up, check out the accompanying sidebar.
Winning the weight battle
Jean, who has bipolar disorder, lost more than 80 pounds through a combination of weight loss and walk therapy with an innovative therapist. “Whenever I came in for therapy, she would put sneakers on with her business suit, and we would walk and talk for 45 minutes,” she says. Jean started writing down everything she ate and began using the Weight Watchers’ program. “They teach a program for lifestyle change, rather than weight loss,” she says. “I am now a lifetime member.” Jean’s success may also be due to the focused increase of fish and fresh vegetables in her diet.
Along with the drop in Jean’s weight, her total cholesterol healthfully plummeted from 357 to 176 mg/dL. Her good HDL cholesterol rose from 28 to 49 mg/dL, and her bad LDL cholesterol dropped from 210 to 99 mg/dL.
Ellen Tobias, MA, RD, dietitian at the Greater Bridgeport Community Mental Health Center in Bridgeport, Connecticut, has noticed that her clients with bipolar who start to gain weight often use the weight gain as an excuse to eat even more calories, which can cause weight and ultimately cholesterol to spiral out of control. According to Tobias, “losing excess weight is the most important strategy for lowering cholesterol.”
Watch out for the “baddies”
Foods high in saturated fat will raise your cholesterol levels. Limit your intake of meat (beef, pork, lamb, and products made from these meats) and avoid eating the skin of poultry. To help select the leanest cuts of beef, go to www.beefitswhatsfordinner.com and click on “Download your ‘29 lean cuts’ wallet card.” Curb your intake of cream and switch to lower- and non-fat milk, yogurt, and cheese. Cut down on your butter and shortening use. Be aware that coconut oil and palm oil (often used to replace trans fat in foods) are highly saturated and that you should use more healthful oils.
Hydrogenated oils, also known as trans fat, are oils that have been chemically manipulated to foster a more stable type of fat that can withstand higher temperatures and longer storage. Consuming foods containing trans fat can raise cholesterol. Look at your ingredient labels and avoid foods that contain partially hydrogenated oils. Dietary cholesterol, which is found in animal foods such as egg yolks, meat, dairy, seafood, and poultry, also plays a role in increasing blood cholesterol. A smart move would be to follow the American Heart Association’s recommendation of not eating more than six ounces of lean meat, fish, and poultry per day and to use fat-free and low-fat dairy products.
Fabulous foods to cut cholesterol
Foods known to lower cholesterol may be even more effective when eaten together, according to David Jenkins, MD, PhD, DSc, professor of nutritional sciences at the University of Toronto in Ontario, in a study that was published in March 2006 in the American Journal of Clinical Nutrition. Following a low-saturated fat and low-cholesterol diet that is rich in fruits and vegetables and combined with soy, almonds, fiber, and plant sterols, helped study participants achieve cholesterol-lowering results similar to the results achieved when taking statin drugs.
The following foods have been shown to help increase heart health, many through the action of lowering cholesterol.
Optimal oats: Oats and barley are two grains that contain a good portion of soluble fiber, the type that helps reduce cholesterol. Heat up a packet of oatmeal and add a teaspoon or two of natural nut butter, such as almond butter, cashew butter, or peanut butter. Oat cereals, such as Cheerios and Kashi Heart to Heart, are marvelous choices to help give cholesterol the heave-ho.
Outstanding omega-3 fatty acids: “For overall heart health, it is important to eat fish,” says Rosie Schwartz, RD, a consulting dietitian in Toronto and author of The Enlightened Eater’s Whole Foods Guide (Penguin, 2003). Fish, as well as walnuts, ground flax seeds, pumpkin seeds, soy foods, and canola oil contain omega-3 fatty acids. This important type of fat may help treat and prevent heart disease and arthritis, and may help lessen the severity of symptoms in mental health conditions, such as bipolar disorder, schizophrenia, and Alzheimer’s disease. Salmon cakes, recommends Schwartz, can easily be made by combining canned salmon with chopped onions, whole grain bread crumbs, and egg whites. Form into patties and cook over medium heat in a lightly oiled pan, flipping the patties periodically. Serve on a whole grain English muffin or hamburger bun with your favorite condiments. Another easy-to-fix dish packed with omega-3s, and suggested by Schwartz, is canned sardines, chopped and mixed with grated apple, onion, and light mayo with a twist of lemon. This can be eaten in a sandwich or over your favorite greens.
Nutritious nuts: In the 1980s, many people became fat-phobic and shunned nuts because of their fat content. We now know that it is the type of fat in foods that is important; nuts are high in unsaturated oils, the kind that are good for us. However, since they are high in fat, it means they do pack a lot of calories, so portion size is important. Be sure to buy nuts raw or dry-roasted and unsalted. Schwartz recommends planning wise snacks, so you have healthy, available ammunition when hunger strikes. “Buy nuts, seeds, and dried fruit in bulk; then make several packets of two tablespoons of nuts and two tablespoons of dried fruit and keep in your fridge,” she says. Since the fruit is dehydrated and the nuts have a lot of calories, portioning them into packets is a wise move for your waistline.
Splendid soy: Replacing some foods that are high in animal protein with soy foods, such as edamame (soy beans), tofu, soy butter, soy nuts, and some soy burgers, may help keep your arteries clean and your heart healthier. A wholesome fast food meal to try at a Chinese restaurant is steamed tofu (bean curd) over steamed mixed vegetables and rice (preferably whole grain brown rice). Order ginger or garlic sauce on the side and use sparingly.
Beautiful beans: Beans are a quick source of soluble fiber and protein. Schwartz suggests tossing them into salads, soups, and pasta. A simple, tasty, cholesterol-lowering dish of beans and melon, such as kidney beans and honeydew melon or black beans and cantaloupe, is recommended by Elizabeth Snell, BSc, RD, consulting dietitian/nutritionist and president of Snell Associates Nutrition Consultants in Toronto.
Fantabulous fruits: To wake up the flavor in fruit and make it more appetizing, consider mixing it with other tasty ingredients. Snell suggests mixing berries (strawberries, blueberries, raspberries, blackberries, etc.) with cottage cheese or yogurt. Snell’s tasty banana treat is a snap to prepare: Slice a banana lengthwise, spread almond butter between the two halves, place back together, and cut into banana wheels. Oranges are particularly helpful in lowering cholesterol, so Snell recommends this as a great addition to an oatmeal breakfast.
Valuable vegetables: Eating a variety of greens could not be easier. Microwavable bags filled with cut and washed greens, such as spinach, kale, and broccoli rabe, are now available in your supermarket. There are no stems to snip and no pots to wash. Snell recommends keeping baby carrots on hand and dipping them into hummus, a super-healthy bean spread. This also works well with other raw vegetables, such as broccoli and cherry tomatoes.
Grand garlic: Garlic adds a tantalizing flavor and aroma to many foods, and goes especially well with greens. A great time-saver is buying fresh minced garlic in a jar; heat one teaspoon of minced garlic in a pan with a tablespoon of olive oil for several minutes, and then mix in your favorite steamed or microwaved greens. A touch of black pepper, oregano, and rosemary will give a beautiful flavor that you are sure to enjoy.
Foods fortified with plant sterols and stanols: Some margarines, orange juice, cereals, breads, and granola bars have been fortified with plant derivatives that have been shown to help reduce cholesterol. These compounds are found naturally in small amounts in fruits, vegetables, beans, grains, nuts, and seeds, so eating more of these types of nutritious foods and less junk food will help keep high cholesterol at bay.
It may take six to 12 months to see results from adding cholesterol-lowering foods, reducing cholesterol-increasing foods, and increasing your exercise, so hang in there and enjoy the cholesterol-lowering ride. The habits you form will reward you for the rest of your life.
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There are two important strategies for raising the protective HDL cholesterol: exercising and quitting smoking. If you are not currently exercising, Elizabeth Snell, BSc, RD, consulting dietitian/nutritionist, recommends taking two 10-minute walks a day. Add two minutes each week until you work up to 60 minutes in a day. Always check with your doctor before starting an exercise program.
These are general guidelines. Check with your doctor to help set personal cholesterol goals.
Less than 200 mg/dL Desirable
200–239 mg/dL Borderline high
240 mg/dL and above High
Less than 100 mg/dL Optimal
100–129 mg/dL Near optimal/above optimal
130–159 mg/dL Borderline high
160–189 mg/dL High
190 mg/dL and above Very high
Less than 40 mg/dL Low: major risk factor for heart disease
60 mg/dL and above Helps lower risk for heart disease
Source: National Cholesterol Education Program, U.S. Department of Health and Human Services.
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Printed as “Cutting cholesterol (and loving your diet)”, Fall 2006
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