So what can you do to lower
your LDL cholesterols
or help your patients understand about
lowering their cholesterol?
Well, let me just say, when you're
working with patients,
nobody wants to hear,
"Eat healthy, exercise more, stop
smoking. No, no, no, no, no."
You can't approach a patient that way
and ask them to make these
really difficult changes.
So the more you can help them
understand how small changes
and just taking the next step
can help them become healthier,
the more likely they are to do it.
You know, people aren't going to go from
eating every meal in the drive-through
with french fries and American cheese,
straight to fish and broccoli, right?
So help them make some small
and move towards a healthier weight.
Help them get more active.
Again, you're not going to go from
couch potato to marathoner,
so help them take some simple steps
and being more active in walking,
or working with a personal trainer,
or joining a gym with
classes where they can get lots of support.
Now smoking, this is really a touchy issue.
People who smoke understand that
it's not healthy for them, right?
So, don't act self-righteous with them.
If you happen to not smoke, or
the worst is if you're someone
who quit smoking,
don't be judgmental with them.
Be kind and compassionate.
Smoking is one of those things
that if you've ever done it,
it's a drug that does amazing things.
I've had patients tell me,
if they're stressed and they
smoke, they calm down.
If they were lethargic and they smoke,
they get pepped up. So,
it kind of becomes this wonder drug
that does things in your brain,
whatever you need it too.
So be very patient with your patients,
and just help them learn about
taking the next step
and how they can cut back on smoking,
and then eventually, hopefully, they can move
towards stopping smoking all together.
The way we approach our patients
about lifestyle changes
plays a huge role in their ability and
willingness to take those tiny steps.
Now, after we've talked about diet and
maintaining a healthy weight
and exercise and stopping smoking,
statins and bile acid sequestrants are
the next step that we can take.
Sometimes, patients need to be
started on these medications
while they're making all those
But, you know, I know you'll read stories
or things that say, "You know,
you really can't change your LDL
levels with cholesterol
just by healthy lifestyle changes."
I totally disagree. I call bunk on that one.
I've seen what it can do, even in
my own life, and if I can do it,
I know anyone can do it.
But oftentimes, we need to
put a patient on a statin,
particularly if they have some
type of other risk factors.
So, let's walk through the
and this is going to get very
personal for lots of folks,
because we're going to ask them
to try to reduce their intake
of saturated fats to < 7% a day.
Now, what types of food are
saturated fats? Yeah,
everything that's delicious, right?
Fried, breaded, and like, oh.
If I was stuck on an island by myself, the
one food I would want would be
french fries and breakfast cereal.
Neither one of those are
good to lower my LDL.
Want them to minimize the intake
of processed foods.
Again, more deliciousness,
like crackers, or commercial bread
goods, or fried foods
and all those types of foods that
come out of a vending machine,
or that come already made.
If you open a box and just have
to heat it and eat it,
it's a processed food,
and that's not going to help your
patient lower their LDL.
The goal is to reduce your intake of
cholesterol to 200 mg a day or less,
and I know that is even more
difficult than it sounds.
Another thing you might consider
is adding more nuts.
Now be careful with the nuts because
they are high in fat. And yes,
it's a good fat, but it's also calories.
I kind of got off track the first time
when I started implementing this
and I needed to really watch my
calories a little more closely.
But consider adding nuts like walnuts,
beans or legumes, some people call
them, and more vegetables.
Okay, nothing on here really surprises you,
but these are difficult choices for people
to make in a fast-paced life, right?
We're used to convenience food or
going through a drive-through.
This is a radical change for your
patient, so be very
patient with your patients
as they think through the next best
steps in changing their diet.