UNIT TWO LESSON 6Cholesterol

Objectives

At the end of the lesson, participants should be able to:1. Describe the relationship between diabetes and heart disease

2. Explain good and bad cholesterol

3. List foods that are high in cholesterol

4. Describe ways to lower LDL cholesterol and raise HDL cholesterol

5. Set goals to lower LDL cholesterol and raise HDL cholesterol

6. Describe feelings and experiences about living with diabetes

7. Identify ways to modify everyday recipes to fitinto the diabetes meal plan

L-esson

Diabetes and CholesterolIf you have diabetes what should you know about cholesterol?• High levels of blood cholesterol can lead to heart disease

• Heart disease is more common in people with diabetes

• People with diabetes and heart disease are two to four times more likely to die from heart disease

• You should have your blood cholesterol level checked by your doctor at least once a year

The Good NewsA person with diabetes who lowers his or her LDL cholesterol can reduce cardiovascular complications by 20-50%.

What You Should Know about Cholesterol

The body makes cholesterol

It is found in all cells of the body

It is only found in animal products

What You Should Know about Cholesterol

Foods high in cholesterol:

Beef

Veal

Lamb

Pork

Liver and other organ meats

Egg yolk

Types of CholesterolLDL “bad” cholesterol HDL “good” cholesterol

LDL “bad” CholesterolLDL stands for low density lipoprotein

It is called the “bad” cholesterol because it carries cholesterol to your arteries and increases the risk of a heart attack

LDL “bad” CholesterolThe higher the level of LDL cholesterol in the blood, the

greater your risk for heart disease

Lowering your level of LDL cholesterol lowers your risk of heart disease

The goal for a person with diabetes or heart disease is to have a blood cholesterol level below 100 mg/dL

Diabetes and High LDL Cholesterol

1. People with diabetes generally have excess glucose in the blood

2. The excess blood glucose sticks to the LDL cholesterol

3. This glucose-coated LDL stays in the blood longer and forms plaque, beginning the process of heart disease

Ways to Lower LDL “bad” Cholesterol

Control body weightExcess weight raises your level of

LDL “bad” cholesterol and increases your risk for developing heart disease

Being overweight also makes it difficult for your body to use the insulin it makes and to remove glucose from the blood

Ways to Lower LDL “bad” CholesterolLimit or eat less of foods that are high in trans fat,

saturated fat, and cholesterolTrans and saturated fat raise blood levels of LDL

cholesterol more than cholesterol from the food we eat It is important to read food labels carefully so that you are

aware of the foods that provide trans fat and saturated fat

Trans Fat and Saturated FatFoods that contain

trans fat:

Doughnuts, cookies, cakes, French fries, onion rings

Foods that containsaturated fat:

Fatty meats, chicken skin, whole milk and whole milk products, butter, lard

Ways to Lower LDL “bad” CholesterolInclude oats, oatmeal, dried peas and beans, and fruits

and vegetables in your diet dailyThese foods are good sources of soluble fiber that

have been shown to lower LDL cholesterol

Use fat-free or low-fat (1%) milk, milk products, and cheeses

Ways to Lower LDL “bad” CholesterolIncrease your intake of good oils, such as canola and

olive oil, and good fats, such as avocado and walnuts

Decrease your intake of solid fats, such as butter, lard and shortening

Ways to Lower LDL “bad” Cholesterol

Take medication as prescribed by your doctor

Sometimes making changes in your diet and increasing exercise is not enough to lower your level of “bad” cholesterolYour doctor will decide which type of medication is

best to lower your cholesterol

HDL “good” CholesterolHDL stands for high density lipoprotein

This is called the “good” cholesterol because it moves cholesterol from tissues to the liver. Good cholesterol does not clog up the arteries of the heart

The higher the level of HDL in the blood, the lower your risk for heart disease

HDL “good” CholesterolPeople with diabetes tend to have low HDL cholesterol

levels in the blood which increases their chances of getting heart disease

You want your level of HDL to be “high,” or greater than 60 mg/dL

Ways to Raise HDL “good” Cholesterol

Take part in 30 minutes or more of physical activity on five or more days of the week

Avoid smokingSmoking lowers your level of HDL

Lose excess weight

Ways to Raise HDL “good” Cholesterol

Use olive and canola oils in cooking

Use soy-based products, such as tofu and soy milk

Add more fiber to your dietThe fiber found in oats, fruits,

vegetables, and peas and beans can raise HDL cholesterol and lower LDL cholesterol

What You Should Know about Triglyceride

Most of the fats in food and in our bodies are in the form of triglycerides

When diabetes is not controlled triglyceride levels are high

People with high triglyceride levels also have high LDL and low HDL cholesterol levels

What is normaltriglyceride level?

People with diabetes should have a blood triglyceride level less than 150 mg/dL

Ways to lowerTriglyceride Level

Lose weight

Be involved in physical activity such as walking, biking, dancing, and swimming for at least 30 minutes on five or more days of the week

Ways to LowerTriglyceride Level

Eat less beef, beef fat, veal, lamb, pork, lard, poultry fat, butter, cream, milk, cheeses and other dairy products made from whole and 2 % milk

Ways to LowerTriglyceride Level

Use olive and canola oils and liquid margarine

Limit alcohol. Even small amounts can raise triglyceride levels

Ways to lowerTriglyceride Level

Improve blood glucose control

Putting it togetherShare what you learned about diabetes and cholesterol

E-mpowermentDiabetes Education Series: Cholesterol

Diabetes Education Series

How would you describe your experiences and feelings living with diabetes and cholesterol?

What was most difficult for you?

What are ways that you could overcome some of these difficulties?

A-ctionDid you accomplish the goal you set last week?

Your goal is to have your LDL , HDL cholesterol and triglyceride levels checked.

This is a goal on your Diabetes Checklist.

R-eal-Life Problem SolvingMonica’s Story

Monica’s Story

Questions aboutMonica’s Story

What is Monica’s problem?

What are some ways in which she can solve her problem?

What do you think would work best for her and why?

What would you do if you were in Monica’s situation?

Questions aboutMonica’s Story

Please find the Real-Life Problem Solving handout for this lesson in your folder

These questions will help with your understanding of Monica’s story

N-utritionMenu

Vegetable Fried RiceFresh Peaches in Yogurt

See you next week!Topic: The Diabetes Food Pyramid

Date:

References:

Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE Irene Hong-McAtee, MD, MCR

Adrienne Glodt, B.S., Graduate Student Laura Hieronymus, MSEd, APRN, BC-ADM, CDE Cheryl Case, M.S., Harrison County Ann Hollon, M.A., Wolfe County 

Hazel Forsythe, Ph.D., R.D., L.D., CFCS Stephen D. Perry, M.S., R.D., L.D. Pam Sigler, M.S. Lynn Blankenship, M.S., Metcalfe County Theresa Scott, M.A., Floyd County Tamara Thomas, M.S., Franklin County

Rusty Manseau, B.A., Graphic Artist

Author: Ingrid Adams, Ph.D., Assistant Professor , Nutrition and Food Science, University of Kentucky

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