Repetition of Lifestyle Changes to Lower LDL Cholesterol Levels (Nursing)

00:00 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.

00:22 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.

00:31 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 dietary changes and move towards a healthier weight.

00:45 Help them get more active.

00:47 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.

01:01 Now smoking, this is really a touchy issue.

01:04 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.

01:20 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.

01:30 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.

01:37 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.

01:49 The way we approach our patients about lifestyle changes plays a huge role in their ability and willingness to take those tiny steps.

01:58 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.

02:08 Sometimes, patients need to be started on these medications while they're making all those lifestyle changes.

02:13 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.

02:27 I've seen what it can do, even in my own life, and if I can do it, I know anyone can do it.

02:34 But oftentimes, we need to put a patient on a statin, particularly if they have some type of other risk factors.

02:40 So, let's walk through the diet recommendations, 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.

02:53 Now, what types of food are saturated fats? Yeah, everything that's delicious, right? Fried, breaded, and like, oh.

03:02 If I was stuck on an island by myself, the one food I would want would be french fries and breakfast cereal.

03:07 Neither one of those are good to lower my LDL.

03:11 Want them to minimize the intake of processed foods.

03:14 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.

03:25 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.

03:33 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.

03:41 Another thing you might consider is adding more nuts.

03:44 Now be careful with the nuts because they are high in fat. And yes, it's a good fat, but it's also calories.

03:51 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.

03:58 But consider adding nuts like walnuts, beans or legumes, some people call them, and more vegetables.

04:06 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.

04:17 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.