Another brilliant way to eat cauliflower
It’s true that swapping cauliflower rice in place of traditional rice is a bit of a fad, and one that not everyone is crazy about.
However, cauliflower rice is actually tasty, not overly expensive, relatively fast to fix, and easily fits into most eating plans. We’d call that a trend worth trying.
Here’s what to know about this gluten-free, low-carb vegetable dish, including its calories, carbs, and nutrition benefits. Plus, we’ve added some cauliflower rice recipes to try at home.
What is cauliflower rice?
Cauliflower rice may look just like white rice (and sometimes like couscous), but it tastes 100 percent like cauliflower. That’s because it is 100 percent cauliflower. It’s just finely chopped, usually in a food processor, to the size of rice kernels.
However, since cauliflower is a mild-tasting vegetable, it can be somewhat chameleon-like and seem just like rice after adding spices and seasonings.
Whether you prepare it rather plainly, like typical rice pilaf, or spiced up, like Spanish rice, you can serve it just like you serve rice. As a bonus, it goes from prep to plate quickly.
Cauliflower rice is “hot”
It’s a popular pick. Sales stats back that up. Google Trends finds that searches for “cauliflower rice” in the U.S. didn’t start really gaining momentum until January 2014.
According to a Neilsen report, while fresh cauliflower sales saw a slight decline in 2017, sales of cauliflower alternatives, like cauliflower rice, doubled from the previous year.
And there’s been continued interest since. In fact, it’s one of the most popular healthy alternatives that nutritionists trust. Of course, there’s been tremendous growth in all types of cauliflower products (hello cauliflower-crusted pizza).
The highest spike to date for “cauliflower rice” searches in the U.S. is January 2021, based on Google Trends findings—with Connecticut being the state with the highest interest. These peaks in interest tend to happen every January, when many people start healthy (and not-so-heathy) diets.
And if you’ve been dining out recently, you’ve likely seen “cauliflower rice” on an increasing number of menus, especially when the restaurant features items for different diet styles. For instance, Chipotle introduced cilantro-lime cauliflower rice in 2021, which aligns with their “Lifestyle Bowls.”
How to make cauliflower rice
To make cauliflower rice, ideally start with a fresh whole head of cauliflower.
Trim off the leaves and thick stalks. Then cut the remaining cauliflower into large florets.
Add them to a food processor, filling it no more than three-quarters full.
Do this in batches if you need for the most evenly-sized results. Press the pulse button several times, usually less than 10 times, until you reach desired rice-like consistency. Now you’ve got cauliflower rice that’s ready for cooking.
Other methods include using a blender, box grater, molcajete, or just a chef’s knife and cutting board.
Alternatively, you can go for a shortcut and buy fresh or frozen cauliflower that’s already riced for you.
How to eat cauliflower rice
Want to start with the basics? For a simple sautéed cauliflower rice, heat a little oil in a cast iron or other stick-resistant skillet over medium-high heat.
When the oil shimmers, add the cauliflower rice and sauté until desired brownness, about eight to 10 minutes. Then season as you wish and enjoy wherever you normally serve rice.
- Make sure the skillet is fully preheated and that you’re using a large enough skillet (hint: a wok works well) so that the cauliflower rice actually sautés rather than steams.
- If you don’t have a large skillet, consider wrapping the fresh cauliflower rice in a clean kitchen towel and squeeze any excess liquid you can from it before cooking. This will help with proper caramelization (browning).
- Don’t skimp on oil. It helps you achieve that delicious caramelization.
- Keep in mind that just like you can eat raw cauliflower florets, you can eat cauliflower rice raw. Plan to pair it with high-flavored foods, like a spicy Thai ginger-peanut “grain” bowl, for the most enjoyable cuisine experience.
- And don’t forget to use all of the cauliflower parts to prevent food waste. The stalks and leaves can be sliced and added to soups or stir-fries.
Is cauliflower rice good for you?
Yes, cauliflower rice can be tasty. But is it healthy, too? The quick answer to that is an absolute yes.
While rice, especially whole grain brown rice, is a nutritious food, cauliflower rice provides an option that cup-for-cup is significantly lower in calories and carbs and higher in vitamin C, plus offers unique nutrient benefits.
Cauliflower nutrition facts
A one cup serving of chopped raw cauliflower florets, which is equivalent to 3.77 ounces (107 grams) of cauliflower rice, provides the following nutrients:
Fat: 0.3 g (<1 percent daily recommended value, or DV)
Sodium: 32 mg (1 percent DV)
Total Carbohydrate: 5.3 g (2 percent DV)
Dietary Fiber: 2.14 g (8 percent DV)
Sugars: 2 g
Protein: 2 g (4 percent DV)
Vitamin C: 51.6 mg (57 percent DV)
Choline: 47.4 mg (9 percent DV)
Calcium: 23.5 mg (2 percent DV)
Iron: 0.45 mg (2.5 percent DV)
Potassium: 320 mg (7 percent DV)
Health benefits of cauliflower
Cauliflower, including cauliflower rice, sure puts the false notion that “white foods are unhealthy” to rest. It’s definitively a health-protective winner.
It’s low in calories and carbs
Some people may need to keep calorie or total carbohydrate intake in check, like those living with type 2 diabetes.
Since cauliflower rice is significantly lower in calories and carbs than traditional rice, it’s a definite benefit for people that fit into this diet category.
It’s rich in vitamin C
In the raw form, cauliflower rice is an excellent source of vitamin C. Surprisingly, one serving of cauliflower rice (51.6 mg vitamin C) provides the same amount of the nutrient as one small orange (51.1 mg vitamin C).
That means it can offer you all of the same antioxidant and immune-strengthening benefits, while potentially reducing the risk of mortality from cardiovascular disease, per research in the International Journal of Molecular Sciences and Nutrients.
It’s good for the gut
It’s all in the family. Since cauliflower is part of the Brassica family of plants and classified as a cruciferous veggie, it means cauliflower rice is, too.
According to a study published in Molecular Nutrition & Food Research, following a Brassica‐rich eating plan may offer potential gastrointestinal (GI) health benefits due to its effect on the gut microbiota (or microbiome).
A key reason for this is that these vegetables contain a significant amount of the prebiotic inulin, which is a fermentable fiber that helps feed good bacteria in the gut, per the American Journal of Clinical Nutrition.
Plus, even if you’re enjoying cauliflower rice just like a grain, it helps boost your overall veggie intake. And let’s face it, some folks need all the help they can get.
It may reduce risk for cancer
What’s old news is new news. Cruciferous vegetables, like cauliflower, have long been associated with cancer prevention. And there’s updated research to support this connection.
A research review published in Molecular Nutrition & Food Research suggests that bioactive isothiocyanates (naturally occurring molecules) found in cruciferous veggies may play a role in preventing and treating bladder cancer.
What’s more, research published in the peer-reviewed journal Nutrition and Cancer finds that consuming raw cruciferous vegetables may lower your risk for getting stomach cancer.
There’s still so much to learn about the health-protective and disease-fighting roles of plant nutrients.
But, here’s one researched tidbit: A review in F1000 Research points to indole-3-carbinol, the breakdown product of a phytochemical found in cruciferous veggies, which may have anti-cancer properties. It’s considered a phytohormone–or plant hormone.
It’s a grain-free alternative
Rice is gluten-free—and so is cauliflower rice. That means for people or who can only eat select grains, like those with celiac disease or a gluten intolerance, cauliflower rice provides them one more grain-style option to indulge in.
Also, for people who choose to limit their grain intake, like those following a keto or Whole30 diet, it offers them a way to do “rice” without the extra carbs. Though the questionable health benefits of these diets are another matter.
Tips for buying cauliflower
You can find U.S. organically- or conventionally-grown fresh cauliflower in farmer’s markets and supermarkets all year long, which makes it easy to savor cauliflower rice dishes any time you wish.
When buying it, look for cauliflower heads that are firm and compact with tightly attached leaves. Store in the fridge for up to a week.
And don’t just choose white cauliflower. Be on the lookout for orange, purple, and green varieties, too. The green variety is also called Broccoflower. And don’t worry, nothing funky is added to get these gorgeous shades. They all taste the same, but you do get a boost of antioxidants in the orange and purple varieties.
Buying any color of cauliflower and making your own cauliflower rice is simple.
But if you prefer simpler, peruse your local supermarket for deli-prepared riced cauliflower, fresh packaged riced cauliflower, frozen riced cauliflower, frozen riced cauliflower mixed with other veggies, and frozen prepared cauliflower rice dishes, like stir-fried cauliflower rice.
Cauliflower rice and traditional rice can coexist
While cauliflower rice can be served in place of rice, most people can absolutely enjoy both cauliflower rice and traditional rice.
For instance, plan for cauliflower rice when the rest of the meal is starchy, like a veggie burger on a big bun with corn on the cob. And if there’s no other high-carb food in the meal, like wild salmon with asparagus, brown rice would be quite nice as a pairing.
In fact, you might actually want to call cauliflower rice something other than “rice,” so you think of both foods in separate, enjoyable, and healthful ways. Some simply call it riced cauliflower. But you can give it a unique name that suits your style, like blitzed cauliflower, cauliflower gems, or pearls of cauliflower.
Simple ways to enjoy cauliflower rice
No matter what you call cauliflower rice, enjoy it in these delightful ways:
- Sauté, flavor as you wish (try lime zest, garlic, and cilantro or lemon zest, chives and dill), and serve as a simple side
- Stir-fry it as the “rice” of fried rice
- Simmer it into any soup to add rice-like texture and veggie goodness
- Cook it with marinara sauce to create a Bolognese-style pasta sauce
- Try it raw in place of any grain as a salad, like tabbouleh
Finally, I highly recommend trying my flavorful, globally-inspired cauliflower rice side dishes, Coconut Cauliflower Rice and Mexican-Style Cauliflower Rice. They’re sure to be the star of your plate.
Coconut Cauliflower Rice
Recipe courtesy of Jackie Newgent, RDN, CDN
Serving size: 1 cup each
1 large head cauliflower, trimmed and separated into large florets
2 tablespoons virgin coconut oil or avocado oil
1/4 cup (60 milliliters) organic coconut milk
3 scallions, green and white parts, minced
3/4 teaspoon fresh grated turmeric root
3/4 teaspoon sea salt, or to taste
1/4 teaspoon freshly ground black pepper, or to taste
1/4 cup fresh cilantro leaves and tender stems (or microgreens)
1/2 small red hot chili pepper, thinly sliced (optional)
In two batches, pulse the cauliflower florets in a food processor until the size of couscous. (Makes seven to eight cups uncooked riced cauliflower.)
Add the coconut oil, coconut milk, scallions, turmeric, salt, and pepper to an extra-large cast-iron skillet or a wok and heat over medium-high. Add the riced cauliflower and cook while stirring until golden brown, about 12 minutes.
Adjust seasoning, sprinkle with cilantro and hot pepper (if using), and serve.
Per serving: 140 calories, 10g total fat, 9g saturated fat, 0g trans fat, 0mg cholesterol, 490mg sodium, 10g total carbohydrate, 4g dietary fiber, 4g total sugars includes 0g added sugars, 4g protein
Mexican-Style Cauliflower Rice
Recipe courtesy of Jackie Newgent, RDN, CDN
Serving size: 1/2 cup each
2 tablespoons avocado oil or sunflower oil
1 medium head fresh cauliflower (about 20 ounces/567 grams), trimmed and separated into large florets
1 small jalapeno pepper, seeded and finely chopped
1 garlic clove, minced
3/4 cup (190 grams) tomato sauce
1/2 tsp sea salt
1/8 teaspoon ground cumin
1 tablespoon finely chopped fresh cilantro
4 lime wedges
Pulse the cauliflower florets in a food processor until the size of rice. (Makes about 4 cups/454 grams uncooked riced cauliflower.)
Fully heat the oil in an extra-large (12-inches or larger) cast iron or other stick resistant skillet over medium-high. Add the riced cauliflower and sauté until lightly browned, about 8 minutes. Add the jalapeno and garlic and sauté until the cauliflower is brown, about two to three minutes more.
Add the tomato sauce, salt, and cumin, and cook while stirring until the tomato sauce is absorbed by the cauliflower, about four to five minutes.
Remove from heat, stir in the cilantro, and adjust seasoning. Serve with the lime wedges.
Per serving: 100 calories, 7g total fat, 1g saturated fat, 0g trans fat, 0mg cholesterol, 550mg sodium, 9g total carbohydrate, 3g dietary fiber, 4g total sugars includes 0g added sugars, 3g protein
Give one of these other easy recipes a go:
Still want more? Here are a whopping 35 Recipes That Start with Cauliflower Rice.
How to lower your cholesterol level
In the hierarchy of good and bad fats, saturated fat usually occupies a place toward the unhealthy end of the spectrum. That’s because saturated fat increases low-density lipoprotein (LDL), the so-called “bad” cholesterol.
High cholesterol is strongly implicated in heart disease, including heart attacks, explains Benjamin Hirsch, MD, director of preventive cardiology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, New York.
That’s a concern for pretty much all adults, considering how prevalent cardiovascular disease is. It’s the top cause of death among both men and women in the United States.
You’d think limiting saturated fat would be the solution. But the key to healthy living is to also replace saturated fats with unsaturated fats. These healthy fats are linked with lower levels of LDL and a similarly lower risk of cardiovascular disease.
Types of fat
Fats are generally grouped into three main types—unsaturated, saturated, and trans—based on the molecular structure of the compound.
All fats are basically made up of carbon atoms with long “tails,” or chains of hydrogen atoms attached to them. The more hydrogen molecules, and the more crowded the chain is, the less healthy the fat.
Unsaturated fats, which include monounsaturated or polyunsaturated, have fewer hydrogen attachments, are less rigid, and tend to be liquid at room temperature. Case in point: olive or canola oils.
As far as healthfulness goes, the three types of fat occupy a range:
- Unsaturated fats: They’re good for your health and are an important part of a healthy diet.
- Trans fats: These have essentially no redeeming qualities in terms of your health. In fact, they’ve been banned in some locations, like the United States.
- Saturated fats: They occupy a position somewhere in between and their role in heart health has been debated.
Why do we need fat?
In a nutshell, we all need a certain amount of fat to stay alive.
“Fat helps the body absorb vitamin A, vitamin D, and vitamin E. These vitamins are fat soluble, which means they can only be absorbed with the help of fats,” says Lana Nasrallah, RD, manager of clinical nutrition at the University of North Carolina Medical Center in Chapel Hill.
Fats also pack more calories than carbohydrates and proteins, which means they provide a lot of energy, or fuel, for your body, she says. In other words, you get a lot of bang for your buck.
How fat plays a role in inflammation
Saturated fats, on the other hand, can stimulate inflammatory molecules. “That makes the artery walls more permeable to fat deposits,” says Dr. Hirsch.
And in addition to raising cholesterol levels to unhealthy heights, saturated fats are generally high in calories.
“It’s easy to overdo caloric intake, which can lead to weight gain,” says Debbie Petitpain, RDN, a spokesperson for the Academy of Nutrition and Dietetics. More pounds on your frame equals a higher risk of, well, almost everything.
Saturated fats are still being studied
“Fat, in general, is a huge category, and it’s incredibly nuanced,” says Josh Septimus, MD, an internist and associate professor of clinical medicine at Houston Methodist Hospital. “There are definitely healthy fats, like olive oil [which is unsaturated], and unhealthy fats, like trans fats.”
But there may be much more in between than we realize.
One analysis of 21 studies published in The American Journal of Clinical Nutrition in 2010 found that consuming more saturated fat was not linked with an increased risk of stroke, coronary heart disease, or cardiovascular disease. This suggests that while saturated fat can increase LDL cholesterol, their final impact on actual heart attacks and strokes still needs to be clarified. However, other research has suggested that replacing saturated fat with polyunsaturated fat does lower the risk for heart problems.
At a chemical level, the differences may have to do with how long the fat chains are. “Short-, medium-, long-, and very-long-chain fats all have different effects on health,” says Nasrallah.
Coconut oil, a saturated fat, may fall into this gray area. For now, though, coconut oil and other saturated fats are considered just that: saturated fats.
“The future could refine our advice a little bit more,” says Petitpain.
How much saturated fat should you consume?
Experts advise curbing saturated fat intake. The 2015–2020 Dietary Guidelines for Americans recommends limiting saturated fat to 10 percent of daily calories. (Overall, fat should make up 20 to 35 percent of daily calories).
The American Heart Association (AHA), which is understandably concerned about the current epidemic of heart disease, sets the bar lower, at only 5 to 6 percent of total calories each day. In general, the lower the better, says Dr. Hirsch.
Per the AHA guidelines, says Nasrallah, “if you need about 2,000 calories a day, no more than 120 calories should come from saturated fat. That’s about 13 grams of saturated fat per day.”
Limit saturated fats
When you open your refrigerator or cupboard door, you’re not likely to see anything clearly labeled “saturated” or “unsaturated.”
Most foods have some of both, although animal-based foods are typically higher in saturated fat, while plant-based foods are typically higher in unsaturated fats. The Mediterranean diet is a good model for an eating plan high in healthy fats.
One way to make sure you’re eating the right type of fats is to read the nutrition label on foods that you buy. It will give you total fat, saturated fat, and trans fat in both grams and as a percentage of daily calories. A daily value of 5 percent or less is low, while 20 percent is very high, says Petitpain.
And consider this: A 12-ounce steak has 20 grams of saturated fat. A cheeseburger has 10 grams. A vanilla shake has 8 grams. And a tablespoon of butter has 7 grams.
Sources of saturated fat
It’s best to limit your intake of the following foods, which Nasrallah names as high in saturated fat.
- Whole or reduced fat milk and dairy (look for skim or 1 percent), including ice cream
- Fatty beef
- Poultry with skin
- Chips and other “munchies”
- Coconut, palm kernel, and palm oils
Swap saturated for unsaturated
Cutting back on saturated fats only goes so far.
“The best strategy is not to just limit saturated fats,” says Nasrallah. “It is also to replace them with healthier unsaturated fats. That has more heart health benefits than cutting down or replacing them with foods of little nutritional value, like refined carbohydrates packed with added sugar.”
Sources of healthy unsaturated fats include:
- Non-tropical vegetable oils, such as olive, canola, safflower, sunflower, soybean, and peanut oils
- Nuts, including walnuts, pecans, and almonds
- Seeds, like pumpkin, sesame, and flaxseed
Try to limit processed food
There is a simpler way to look at it, which has nothing to do with counting fats, saturated or otherwise.
“We should be focusing on reducing ‘fake’ food,” says Dr. Septimus. By that he means the refined, processed foods that drive up systematic inflammation and raise the risk for cardiac and many other diseases.
That includes some of the most popular items around.
“In the United States, the biggest sources of saturated fat in the diet are pizza, cheese, dairy-based desserts, whole milk, butter, sausage, bacon, beef, hamburger, cookies, and a variety of fast food dishes,” says Nasrallah.
It helps to concentrate your energies on eating unprocessed, whole foods. “If you see ingredients on a label that your great-great-grandmother wouldn’t recognize, don’t buy it,” Dr. Septimus says.
Helpful tips for lowering saturated fat
“You can still have some foods and beverages with saturated fats, just choose smaller portions or have them less often,” says Nasrallah.
Here are some healthy substitutions for saturated fats:
- Choose lean meat and skinless poultry. Trim visible fat from meat and remove the skin from poultry.
- Use oil (top choices are olive and canola) instead of butter.
- Eat fatty fish instead of meat at least twice a week. Oily fish (salmon, tuna, and mackerel) are also rich in omega-3 fatty acids, a type of heart-healthy polyunsaturated fat.
- Favor fruits and vegetables over processed foods
Other unsaturated fats you can choose from include olives, avocados, nuts, chia seeds, and flaxseeds. Feeling hungry yet? Now would be a good time to whip up an avocado salad, olive tapenade, sweet-and-tangy salmon, or a spiced nut trail mix.
Healthy fats, not no fats
Starting in the 1970s and continuing throughout the 1990s, health experts recommended that most people eat a low-fat diet. Why? Researchers had discovered a strong link between dietary saturated fats and heart disease.
But as people began to adopt new low-fat diets and eat more low-fat foods, there were major negative consequences that people had failed to consider.
Fat gives flavor to food and helps you feel more satisfied and full for longer. So when people started eating mostly low-fat foods, some people started eating more total calories than before in order to feel full.
Many food manufacturers also switched out fat from packaged foods and replaced them with sugar and refined carbohydrates, which are chock-full of extra calories without a lot of nutritional value.
Research shows that replacing fats with simple carbohydrates like refined grains and added sugars does not reduce the risk of heart disease. And foods rich in sugars can raise circulating levels of triglycerides, or blood fats. High triglyceride levels can lead to type 2 diabetes, fatty liver disease, and heart failure.
Here’s what the experts want you to know about healthy fats, including what they are, where to find them, and why they’re so important for healthy cholesterol levels and overall good health.
The body needs fat
Nutrients in fat play a role in several important bodily processes. But the body does not produce fats, also known as fatty acids, so they must be consumed in foods.
Fats are an excellent source of calories that the body can convert into energy. Many dietary forms of fat contain twice the calories per gram as carbohydrate and protein.
Internal body fat also protects organs and helps keep us warm. Babies and toddlers in particular need fat to fuel healthy cognitive development and growth.
Fats also allow the body to absorb and use essential vitamins, such as A, E, D, and K, says registered dietitian Roxana Ehsani, a spokesperson for the Academy of Nutrition and Dietetics. Plus, she says, fat helps cells grow, helps the body make hormones, and promotes satiety, which keeps you full for longer.
Beyond that, experts say fat also gives food rich flavor and can amp up the flavor on otherwise bland or boring health food, like certain veggies.
The four types of fat
Different types of fat have different chemical structures that determine how the body uses them and how healthy they are. There are four main types of fat found in human foods, each of which has different physical and chemical characteristics:
- Saturated fat
- Trans fat
- Monounsaturated fat
- Polyunsaturated fat
Of the four types of fats, two are classified as unhealthy, and two are classified as healthy.
It’s important to note that all dietary fats contain a mix of the main types of fat; some just contain higher or lower levels of certain types.
What are unhealthy fats?
There are two primary types of unhealthy fat, most of which are found in animal products or packaged or prepared foods.
Saturated fats are so full of hydrogen molecules that they lack double bonds between their carbon molecules. This chemical makeup allows saturated fats to melt at warmer temperatures, stay solid at room temperature, and firm up or freeze at lower temperatures.
Sources of saturated fat
A lot of animal products contain saturated fat, such as:
- Fatty beef and beef fat (tallow)
- Poultry with the skin still on
- Butter and lard
- Cream and most dairy products made from whole or reduced-fat (2 percent) milk
Many baked goods, prepared foods and snacks, frozen foods, and fried foods are also rich in saturated fat. A few oils from tropical plants are also high in saturated fat, including:
- Palm oil
- Coconut oil
- Palm kernel oil
There are two types of trans fats: natural and artificial.
Naturally occurring trans fats are made in the stomach of some animals, and beef, butterfat, and lamb all contain a small amount of natural trans fat.
Artificial trans fat is made in a factory by saturating liquid vegetable oils with hydrogen to make them more solid at room temperature. Hence the name you might spot in the ingredient list of foods with trans fat: partially hydrogenated oil.
Is trans fat safe?
Food manufactures use trans fats because they are cheap, have a desirable texture and taste, and last a long time before spoiling.
But in 2015, the Food and Drug Administration (FDA) determined that partially hydrogenated oils are no longer considered Generally Recognized as Safe (GRAS) for human consumption. And as of January 1, 2020, food manufactures can no longer legally add trans fat to foods.
That is because there is clear evidence that eating trans fats raises bad LDL cholesterol levels and lowers levels of high-density lipoprotein (HDL). This so-called “good” cholesterol helps remove LDL from the bloodstream, sending the unhealthy particles to the liver to be processed and flushed from the body.
What are healthy fats?
“There are two types of unsaturated fats: monounsaturated and polyunsaturated fat. Both of these are the good, or healthy, fats,” says Ehsani.
Both types of fat are considered healthy primarily because they help remove cholesterol from the bloodstream.
Fat molecules with one carbon bond that is not saturated are called monounsaturated fats. Because they’re not saturated, these fats can bond to blood cholesterol and remove it from circulation.
Monounsaturated fats are typically liquid at room temperature and are most commonly found in vegetable oils, nuts, and seeds. Most animal fats also contain monounsaturated fats, and you can find it in wild game, beef, pork, and chicken. (More on healthy fat foods later.)
Fat molecules with more than one carbon bond that is not saturated by hydrogen are considered polyunsaturated. Because they aren’t saturated, polyunsaturated fat molecules can bind to multiple molecules of cholesterol and remove them from the bloodstream.
Omega-3 fatty acids
There are three main types of omega-3 fatty acids found in polyunsaturated fat: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA).
Omega-3 fatty acids help form and maintain membranes that surround every cell in the body. These polyunsaturated fatty acids are also crucial to several important processes in the blood vessels, lungs, heart, immune system, and endocrine system (hormone-producing glands).
Most plant oils contain ALA, including flaxseed, soybean, and canola oils. Many nuts and seed also contain ALA.
Fatty types of cold-water fish are rich in omega-3s and contain DHA and EPA. They include:
There are omega-3 foods that aren’t fish, including flaxseeds and walnuts.
Omega-6 fatty acids
There are two major types of omega-6 fatty acids, another type of polyunsaturated fat: linoleic acid and arachidonic acid. These fatty acids play a powerful role in mediating bodily processes such as blood vessel constriction, inflammation, and blood clotting.
Some healthy foods rich in omega-6 fatty acids include:
- Soybeans and tofu
- Peanut butter
Most people actually eat too much omega-6 and not enough omega-3. That is because many popular foods, like snack foods, fatty meats, cured meats, fast foods, and deserts, contain high levels of omega-6s.
What health benefits do healthy fats provide?
“Healthy fats are considered cardio-protective, meaning that they actually work to preserve your cardiac function and system. These healthy fats can lower ‘bad’ LDL cholesterol and raise ‘good’ HDL,” says Jen Bruning, RDN, a spokesperson for the Academy of Nutrition and Dietetics.
According to a 2017 review of data, most available studies show that replacing saturated fats in the diet with healthy fats reduces the risk of coronary heart disease, dying from a heart event, and the overall risk of dying.
In a 2020 study, replacing saturated fats with unsaturated fats from vegetables oils and walnuts also reduced participants’ level of total cholesterol without increasing unhealthy lipoproteins.
Healthy fats also contain vitamin E.
“[Healthy fats] also serve as anti-inflammatories all over the body,” Bruning says. “This can protect cells in the brain and other vital organs from oxidative damage.”
Some research shows that replacing simple carbohydrates with unsaturated fats can improve blood cholesterol levels, leading to higher HDL levels and lower LDL levels.
List of healthy fats
Lots of healthy foods are rich in healthy fats, whether monounsaturated or polyunsaturated. Here’s where to find each:
Foods with monounsaturated fats:
- Olive oil
- Canola oil
- Safflower oil
- Sesame oil
- Sunflower oil
- Most nuts and seeds
Foods with polyunsaturated fats:
- Soybean oil
- Sunflower oil
- Cottonseed oil
- Corn oil
- Soybeans and tofu
- Most nuts, especially walnuts and pine nuts
- Most seeds, especially pumpkin, flax, and sesame seeds
How much fat should you eat daily?
There is no set guideline on how much fat you should get each day. But keep in mind that while unsaturated fats are much healthier overall than saturated and trans fats, all fats contain around 9 calories per gram, according to the American Heart Association. That’s more than protein and carbohydrates, which each have 4 calories per gram.
Adults 19 years of age and older should not get more than 20 to 35 percent of their daily caloric intake from fats, according to information from the National Institutes of Health (NIH). Children ages 4 to 18 should not get more than 25 to 35 percent of their daily caloric intake from fats.
As for how much of each fat type to get, the National Institute on Aging says saturated fats should not account for more than 10 percent of an adult’s daily caloric intake. It also recommends eating as little trans fat as possible.
“Trans fat should be avoided completely, as it not only raises the bad LDL cholesterol but also lowers the good HDL cholesterol,” says Ehsani.
The American Heart Association advises adults to aim for a diet where only 5 to 6 percent of their daily calories come from saturated fat. For people who get around 2,000 calories per day, that would translate to no more than 13 grams of saturated fat daily.
Low-fat vs. healthy fats: Which is healthier?
In a major government-funded study called the Pounds Lost trial, people trying to lose weight who ate lower-fat diets or higher-fat diets experienced similar amounts of weight loss, and both were able to keep the excess weight off.
“In general, most people should try to substitute healthy fats for unhealthy fats,” says Tricia L. Psota, PhD, RDN, managing director of the nutrition consulting company Nutrition on Demand. “However, there are some individuals, such as those with certain lipid and metabolic disorders, who may benefit from following a dietary pattern lower in total fat.”
So for many people, eating healthy fats instead of unhealthy ones is more important than sticking to a low-fat diet.
Dr. Burning says it’s important to keep in mind that consuming excess fat from any source can cause weight gain, so balancing fat with protein and complex carbohydrates is a good idea. She recommends consulting a registered dietitian to help figure out how to balance nutrients by eating foods you already love.
How to replace unhealthy fats with healthy fats
There are many ways to help reduce your saturated fat intake and boost your healthy fat intake.
“Some healthy fat substitutions include using avocado instead of mayo as a sandwich spread and cooking in vegetable oil instead of butter,” says Psota.
Ehsani suggests ditching low-fat salad dressings or veggie dips for homemade alternatives with healthy oils. She says she always recommends eating healthy fats with meals because it makes sure you don’t miss out on absorbing vital fat-soluble vitamins.
Here are more top tips from the experts and major health authorities:
- Choose lean cuts of meat. Trim excess meat fat, and remove the skin from chicken.
- Choose nontropical vegetable oils for cooking, including olive, canola, corn, and sunflower oils. Limit tropical oils like palm and coconut oils.
- Choose low-fat or fat-free dairy products instead of full-fat or heavy dairy products like cream, ice cream, milk, kefir, and yogurt.
- Avoid processed foods that often contain saturated and trans fats, such as baked goods, chocolates, deserts, packaged dinners, chips, and frozen pizzas.
- Read nutrition labels whenever they’re available and pick products that are free of trans fat and low in saturated fat.
- Replace snack foods and processed foods with fresh fruits and vegetables and whole grains.
- Limit butter and margarine intake by not adding extra butter to breads or cooking meats, eggs, and vegetables in butter. When you’re looking to add fat, use healthy fats instead, such as cooking veggies in olive oil.
- Replace oil-based binders in recipes with applesauce or egg whites.
- Broil, grill, or bake instead of frying foods.
- Choose cooking oils with less than four grams of saturated fat per tablespoon.
High cholesterol doesn’t cause symptoms, but that doesn’t mean it’s harmless. In reality, the condition increases your risk for heart disease and stroke. High cholesterol is defined as having a total blood serum cholesterol 240 mg/dl or over. Borderline high cholesterol happens when your cholesterol levels fall between 200 mg/dl and 239 mg/dl—and it affects nearly 40 percent of American adults. But your total cholesterol doesn’t tell the whole story. It’s important to know your LDL (low-density lipoprotein, the “bad” cholesterol), HDL (high-density lipoprotein, the “good” cholesterol), and triglycerides. Now there’s a new number you should pay attention to, particularly if you have a family history of heart disease: lipoprotein(a), or LP(a), a particle that is a part of LDL cholesterol. Mike F., 50, a married father of four and a marketing professional in Denver, shares how learning about this number saved his life.
I track my cholesterol on a spreadsheet—here’s why
I have an Excel spreadsheet listing all my cholesterol data for nearly two decades. That may sound extreme, but those numbers have come to affect nearly every aspect of my life.
When I was first diagnosed with high cholesterol, I had no idea that I’d soon become an expert on it or that my very life would depend on me learning everything I could about the genetic influences on high cholesterol and how it causes heart disease.
Typical treatment for typical high cholesterol
In 2004, I was just 33 years old—and slim and fit. But I did work an extremely stressful job, and I knew that high cholesterol ran in my family.
So I wasn’t too surprised when a routine checkup showed high LDL cholesterol, low HDL cholesterol, high triglycerides, and a total cholesterol number near 300 mg/dl. (Ideally, total cholesterol should be under 200 mg/dl.)
My diet wasn’t great, and I knew there were some things I could be doing to improve my health. But I was a young dad in a demanding job, so I made half-hearted changes. I first tried to lower my cholesterol by taking fish oil supplements and exercising more.
That didn’t do the trick, so my doctor put me on a prescription statin medication. This helped immensely.
I took various statins for the next 13 years, and since my total cholesterol number was consistently in the healthy range, I assumed everything was fine.
Sudden, unexplained pain
In October 2017, I was on the StairMaster at the gym when I suddenly got a sharp pain in my back, between my shoulder blades. It was so intense that I got off the machine to loosen the muscles with foam rolling and stretching.
Thankfully, the pain subsided. A pulled muscle, I thought.
But then it happened again the next day, and the next.
By the fourth day, I began to recognize a pattern: Whenever my heart rate became elevated, hitting my workout zone, the pain appeared. When my heart rate dropped, the pain receded.
Still, I wasn’t too worried, as upper back pain isn’t a typical symptom of a heart attack, and I didn’t have any other signs. Plus, all my blood work was great, so I had nothing to worry about, right?
Wrong. On the fifth day, I got the back pain during my workout. This time it was accompanied by extreme sweating, tingles in my left arm, and chest pain. After a restless night, I went in to see my doctor.
She did an EKG, which was normal, and took some blood. She told me it was probably just heartburn, wrote me a prescription for an antacid, and sent me on my way.
A nearly fatal heart attack
A few hours later, she called me with the results of my blood work and the prognosis was dire: I was having a heart attack and I needed to go to the hospital immediately. None of my family members were around, so I drove myself to the ER, where doctors admitted me right away.
Scans showed a 90 percent blockage of my left anterior descending artery (LAD). It’s the largest coronary artery, and a block there is called a “widow-maker” because it is so often fatal.
I had cardiac surgery, during which a surgeon put a stent in my artery to widen the previously blocked pathway and allow for blood flow. My wife and I consider ourselves very fortunate that we caught my heart attack before it lived up to its terrifying name!
But while the surgery solved the immediate problem, it didn’t answer the question of why I’d had a heart attack in the first place when my cholesterol was under control and I had very few risk factors.
My lipoprotein (a) level was very high
The answer lay in a number I’d never heard of before: lipoprotein(a). The LP(a) particle is part of LDL cholesterol—you know, the bad stuff that’s associated with heart attacks.
When I first started tracking my cholesterol, my doctor noted that my LP(a) was high. But back then, not enough was known about lipoprotein(a) to draw any conclusions.
Fast forward more than a decade. New research has found that LP(a) is highly influenced by genetics, rather than lifestyle factors. It has a high correlation with heart disease, even if other cholesterol numbers are in the normal range.
After my heart attack, my doctors noticed that even though my total cholesterol was normal, my LP(a) was still extremely high. A normal LP(a) is around 30 mg/dl and no more than 50 mg/dl. Mine was 246 mg/dl at the time of my heart attack.
The bottom line: my cholesterol wasn’t too high according to traditional lipid recommendations, but it was too high for my body.
A new normal
After having a heart attack and learning about the genetic risk reflected in my LP(a) level, I knew I had to take serious steps to lower my cholesterol.
My doctor put me on evolocumab (Repatha), a type of cholesterol-lowering medication that targets hereditary heart disease. I inject it every two weeks. In addition, I take a daily prescription statin, a blood thinner, and aspirin.
Even though my risk for heart problems is largely genetic, I wasn’t going to add to the likelihood of another heart attack by following an unhealthy lifestyle. So I overhauled my diet.
I was advised to limit my intake of saturated fat to less than 12 grams per day, so I had to cut out many of my favorite foods, like hot dogs, red meat, dairy, and cake frosting.
My fitness routine needed a boost too. I increased my exercise to at least 45 minutes of cardio four to five days per week.
I also did everything I could to lessen the stress in my life, including moving to a quieter city, taking a less-demanding job, prioritizing time with my family, and spending time on my favorite hobbies: hiking, camping, and biking in the Colorado mountains.
For someone who had a nearly fatal heart attack, I’ve had a miraculous recovery. I have no lasting heart damage, and I’m able to do all the activities I enjoy with no restrictions.
Even more shocking, though, are my cholesterol numbers. My total cholesterol is now 69 mg/dl. My LDL is 16 mg/dl. And my triglycerides are in the 30s. (Yes, you read those numbers correctly!)
But those numbers don’t tell the whole story. My LP(a) is currently around 160 mg/dl. That’s much better than it was before, but it is still considered dangerously high, and I’m working with my doctor to lower it.
It’s tricky, though. While scientists know a lot more about LP(a), there’s still so much more they need to learn about it and how to treat it. This is why I enrolled in a clinical trial that’s studying LP(a), genetic high cholesterol, and its effects on the body.
Participating in this research and sharing my story is so important to me. I want to educate others about the importance of knowing their LP(a) and not just relying on the standard cholesterol numbers.
But it’s also very personal. There’s a good chance I’ve passed down my genetic susceptibility to heart disease to my four kids. And I’m going to do everything in my power to make sure they don’t have a heart attack in their 40s like I did.
—As told to Charlotte Hilton Andersen
Dietary fat: the good, the bad, and the ugly
Fat in the diet tends to get a bad rap. But the truth is, not all fats are not created equal.
There are those that do all sorts of good things for your heart health and those that can cause heart troubles when eaten in excess. And then there are the fats that offer so little nutrition and pose such a big health risk that the Food and Drug Administration (FDA) has asked food manufacturers to cut them out altogether.
Suffice it to say that fat is a somewhat complicated yet totally necessary nutrient.
“Fat isn’t all bad,” says Catherine Weichert Yeckel, MS, PhD, an assistant professor of clinical public health at the Yale University School of Public Health in New Haven, Connecticut. “We need fat because it’s part of all of our cell membranes, and getting a balance of different types of fat is important because it throws things toward a more calming state in the body.”
Ideally, your diet will primarily include healthy fats—the monounsaturated and polyunsaturated ones linked to better heart health. They’re found in vegetable oils like olive, canola, sunflower oils, nuts and seeds, avocados, and fish.
Trans fat vs. saturated fat
There are four main types of fat, and while nutrition experts recommend getting plenty of polyunsaturated and monounsaturated fats, that’s not the case for the other two types.
Trans fats and saturated fats don’t have the best reputations. They’re the so-called “bad fats” you’ve no doubt heard about. But while they’re both linked to health woes, they differ in some major ways.
Saturated fat has been demonized in the public health arena. It’s why for years health experts recommended a low-fat diet. After discovering a link between the fat and heart disease, they deemed fat in general something of a diet danger.
New research has modified that thinking (after all, mono- and polyunsaturated fats are healthy). Yes, a diet loaded with these fats is hard on your heart, but we do need some saturated fat. And even healthy foods like salmon and nuts contain some saturated fats, Yeckel says.
And on the flip side, even foods laden with saturated fats have some of the good stuff too. “Whole milk and butter have heart-healthy poly- and monounsaturated fats,” she points out.
Trans fat, on the other hand, is quite possibly the worst type of fat you can eat. It’s so bad for your health that it’s been pulled from food products (more on that later).
What is saturated fat?
Compared with trans fats, saturated fat isn’t all that bad, Yeckel says.
“Saturated fat is a type of dietary fat that is typically solid at room temperature due to its chemical structure,” explains Arielle Leben, MS, a registered dietitian and certified diabetes nutritionist at New York University’s Langone Inflammatory Bowel Disease Center in New York City.
Chemically speaking, “these fat molecules do not contain any double bonds and are saturated with hydrogen atoms.”
Here’s a quick chemistry refresher: Fats are basically a chain of carbon atoms bonded to hydrogen atoms. They can have single bonds (saturated), a double bond (monounsaturated), or more than one double bond (polyunsaturated).
“Double bonds are good,” Yeckel says. “One characteristic is that they help make membranes more fluid so cells function more optimally.”
Put another way: “They bend in the right ways and the right times,” she says.
Saturated fat and your health
Saturated fat has been shown to raise low-density lipoprotein (LDL), commonly known as “bad” cholesterol. But it’s a bit more complicated than that, Leben says.
“Research published by the Journal of the American College of Cardiology in 2015 showed that when saturated fat was cut out of the diet and replaced with refined carbohydrates, no benefit was found,” she says. “However, when saturated fat was replaced with mono- or polyunsaturated fats, there was decreased risk of heart disease.”
So while it’s important to limit your saturated fat intake, what you choose to replace these calories with makes the biggest difference in improving your health, she explains.
“Healthy foods such as salmon, tahini, and nuts often contain some saturated fat but also far healthier mono- or polyunsaturated fats,” she says. “The health benefits of these foods outweigh the potential harm from smaller amounts of saturated fats they contain.”
So how much saturated fat should you get? The American Heart Association recommends aiming for a diet where 5 to 6 percent of daily calories are from saturated fat.
The 2020–2025 USDA Dietary Guidelines for Americans suggests that saturated fats comprise less than 10 percent of total daily caloric intake. (Foods with less than 0.5 grams of saturated fat per serving size can be listed on labels as having no saturated fat.)
How to eat less saturated fat
There are some easy ways to lower the amount of saturated fat in your diet without sacrificing taste, Yeckel adds.
Start by understanding which foods have saturated fat. They include:
- Red meat, such as beef, pork, and lamb
- Poultry with skin
- High-fat dairy (butter, cream, cheese)
- Coconut oil
- Palm oil
For starters, switch to low-fat milk instead of whole milk, and trade butter in for olive oil.
“Instead of butter, smear avocado or olive oil on your toast,” she says. Both of these are rich in monounsaturated fatty acids.
Another easy swap? Don’t glob peanut butter on your sandwich. Instead, spread a light layer and then crunch walnuts on top for a healthy dose of omega-3 fatty acids.
These polyunsaturated fats can reduce the risk for cardiovascular disease, lower cholesterol and triglycerides, and lessen inflammation, among other health benefits. They’re found in a lot of fish, but there are plenty of omega-3 foods that aren’t fish.
Reading food labels carefully can help you make healthier choices. Fat is listed as “Total Fat” and also broken down so you can see how much is saturated.
Look at the recommended daily values, which are based on eating 2,000 calories a day, to keep saturated fats at less than 10 percent of total calories, according to the Academy of Nutrition and Dietetics.
What are trans fats?
Trans fats, also known as partially hydrogenated vegetable oil or trans fatty acids, are more harmful than saturated fats, Leben says.
Trans fats are a type of unsaturated fat, which come from natural or man-made sources. Naturally occurring trans fats are produced in the stomach of ruminant animals (such as cows and sheep) and can be found in certain meat and dairy products.
But most trans fat—and the type you always hear about—is industrial made. It’s created through a manufacturing process called hydrogenation. That’s when hydrogen is added to vegetable oil to convert it to a solid fat at room temperature.
“This process extends the shelf life of products,” says Leben.
Until recently, trans fats were commonly found in packaged, processed foods such as:
- Frozen pizza
- Processed snack foods
- Pie crusts
- Stick margarine
Trans fat and your health
Hands down, trans fats are more harmful than saturated fats, Leben says.
Trans fat increases LDL cholesterol, lowers high-density lipoprotein (HDL, the “good” cholesterol), and has been associated with an increased risk of heart disease and stroke.
“Artificial trans fats, those created during hydrogenation, may increase risk of type 2 diabetes,” she says.
The National Academies of Sciences, Engineering, and Medicine recommends that trans fat intake be as low as possible. The FDA agrees.
In 2015, it stated that trans fats are no longer Generally Recognized as Safe (GRAS). The FDA gave manufacturers until June 18, 2018 to stop using partially hydrogenated oils in food products. Products manufactured before this date could still be distributed to stores until January 2020 or, in some cases, 2021.
Trans fats in your food
Why are we still talking about trans fats if they’re banned? Foods containing less than 0.5 grams of trans fats per serving are labeled as having 0 grams on food labels.
Trans fats are also available in processed foods in other countries, and we don’t live or eat in silos, Yenkel says.
Plus, trans fats can be found in some natural sources, such as milk and meat. As for whether they’re as detrimental to your health as their man-made counterparts, the jury’s still out. But, says Yenkel, “these sources don’t seem to be as bad for you as the trans fats once found in processed foods.”
Fats in your diet
Gone are the days of low-fat diet supremacy. In modern times, nutrition experts recognize the benefit (and necessity) of fat in the diet. The focus, instead, is on eating the right types of fat.
“We need to destigmatize fat in the diet, but we need to emphasize that processed foods and fried foods are bad,” Yenkel says.
Her advice? Avoid trans fats. Keep saturated fats to a minimum, and replace unhealthy fats with poly- and monounsaturated fats when you can.
Stress incontinence 101
Do you pee when you sneeze? How about when you laugh, cough, or lift something heavy?
If so, you are not alone, says Elizabeth Kavaler, MD, a urologist at Lenox Hill Hospital in New York City.
These are symptoms of stress urinary incontinence, which affects as many as one in three women at some point in their lives, according to the American Urological Association.
It occurs when urine leaks out due to sudden pressure on the bladder and urethra, the tube that moves urine out of your bladder. It’s more common in women than men because anatomically, they have shorter urethras.
The problem may start when you sneeze, but left untreated, urine may begin to leak with less forceful activities like standing up, walking, or bending.
The greater the pressure, the more likely you are to leak, Dr. Kavaler says. And sneezing produces a lot of pressure.
It’s not the same thing as an overactive bladder or urge incontinence, she adds.
“With stress incontinence, there is a mechanical pressure that results in squirting,” Dr. Kavaler explains. By contrast, urge incontinence is marked by a sudden and overwhelming ‘gotta-go’ feeling.
“You put the key in the door and still can’t make it to the bathroom,” she notes. Women can have both forms of incontinence at the same time.
Here’s everything you need to know about why you pee when you sneeze, diagnosing the issue, and treatment options.
So, why do I pee when I sneeze?
What gives? The short answer is your pelvic floor.
Your pelvic floor supports your bladder and urethra, and stretching or damaging it increases your risk for stress incontinence.
Lots of things can affect your pelvic floor, including pregnancy, childbirth, surgeries in and around this area, chronic coughing, smoking, connective tissue diseases such as lupus, hormonal changes, nerve injuries, and being overweight or obese.
“As one ages, all sorts of factors contribute to developing stress incontinence,” Dr. Kavaler says.
It’s more common in women, but men can also develop stress urinary incontinence, especially after prostate surgery.
Ask a doctor about symptoms
Several types of doctors can diagnose and treat stress incontinence, including urologists, gynecologists, urogynecologists, and internists, Dr. Kavaler says. Urogynecologists super specialize in pelvic floor disorders.
If you are leaking, speak up, especially if your doctor doesn’t ask, says Melissa Laudano, MD, a urologist, and urogynecologist at Montefiore Health System and an assistant professor, urology and of obstetrics and gynecology at the Albert Einstein College of Medicine in New York.
“There is no reason to be embarrassed. This is so common and highly treatable,” she says.
Tests for stress incontinence
Some tests can help determine what’s going on, she says. “I will ask, ‘do you leak when you cough, sneeze or exert yourself?'” she says.
“If the answer is yes to any of these questions, it puts you in the stress urinary incontinence realm.”
Your doctor will conduct a physical exam with a focus on the organs in your pelvic floor.
Other tests involve coughing or bearing down with a full bladder. This is the ‘cough stress test’ and helps identify leakage on exam, Dr. Laudano says.
Pad tests may be recommended to see if you leak when you move around. There are two types: a one-hour test and the 24-hour test. After the test, the pad is removed and weighed to see how much urine leaked.
Other tests may help rule out any other potential causes of the leaking, including a urinalysis check for a urinary tract infection or blood in the urine or a bladder scan, Dr. Laudano explains.
Stress incontinence treatment
First things first, and that means experts recommend that you first try behavioral and lifestyle changes, such as fluid restriction and timed-voiding.
Timed-voiding—going to the bathroom at specific intervals rather than when you feel the need to go—can help keep your bladder from becoming too full, Dr. Kavaler says.
A typical schedule would be to take bathroom trips first thing in the morning, at least every two hours when you are awake, and once again before bed, but your doctor will determine what schedule is best for you.
Timed voiding is more effective for overactive bladder than stress incontinence, says Marisa Clifton, MD, associate professor (PAR) of urology and the director of women’s health at the Brady Urological Institute at Johns Hopkins Medicine in Baltimore, Maryland.
“It’s common for women to have a little stress and a little overactive bladder, and in this case, we treat the more bothersome one first,” she says.
It’s also wise to stay away from bladder irritants such as coffee, tea, and juices.
(Here are some things your bladder is trying to tell you.)
Do your Kegels
These are pretty easy once you get the hang of them, Dr. Laudano says. Kegels call for squeezing and then relaxing your pelvic floor muscles so they are better able to hold urine.
A pelvic floor physical therapist can help learn how to properly perform Kegels to help with stress urinary incontinence.
There’s no magic number of how many Kegels you should do and how often.
“A good rule of thumb is to do eight to twelve contractions, holding for up to 10 seconds, and relaxing in between for one to two seconds and repeat these three times a day for six months,” she says.
Kegels only work if you do them, and do them consistently, according to Dr. Laudano.
Shedding even just a few pounds can improve both urge and stress urinary incontinence symptoms, says Dr. Clifton.
“Increased weight can irritate the bladder and put additional pressure on it, causing symptoms,” she says.
(Here are 50 easy ways to lose weight naturally.)
If lifestyle and behavioral changes don’t make a dent in your symptoms, you can try incontinence devices, such as a pessary, a flexible device that inserts into your vagina to better support the urethra, or disposable tampon-like devices, namely Poise’s Impressa.
“Impressa is ideal for women who run marathons, and that is the only time they have leakage due to stress incontinence,” Dr. Clifton says. (Leak during exercise? These nine ways can make it stop.)
These devices aren’t cures, but they can stop your leaks before they start and are especially helpful if you don’t want surgery for stress incontinence, she says.
“We don’t have any medications that we can use for stress incontinence,” she adds.
Next up are injections that bulk up your urethra head to prevent leakage, she explains.
There are many types of bulking agents that can be used for these procedures. The newest, Bulkamid, is biocompatible with your body and shows great promise in terms of improving stress incontinence, she says.
Doctors give these injections in their office using local anesthesia.
“They can be a cure, but there is a portion of patients who need to have more treatments afterward,” Dr. Clifton says.
“We don’t have any medications that we can use for stress incontinence,” Dr. Clifton adds.
If you are looking for a more permanent fix, sling surgeries that use either mesh or your own tissue can create a sling under your urethra or bladder neck.
The sling supports the urethra and helps keep it closed when you cough or sneeze, Laudano says. This is a cure, she says.
It’s not for every woman, though. “If you are considering children and planning a vaginal birth, these surgeries are not ideal,” she says.
“We want to rule out any other conditions before bulking or sling surgery,” Dr. Clifton says. This typically includes a post-voiding check to make sure that your bladder is empty.
“If you are not emptying and leaking urine off of the top, we would treat it differently.”
Not everyone chooses to treat stress incontinence—and nothing will happen if you learn to live with the leakage.
But the benefits in terms of quality of life are not an overstatement, Dr. Clifton says.
“When patients have a good outcome, they say, ‘I wish I would have done this sooner,” she says.
“If you are not going out and doing activities you love or feel embarrassed, these are indications that you need to consider therapy.”
Next, check out if it’s OK to pee in the shower.
Which is the good cholesterol?
Cholesterol can be a silent killer. While the substance is flowing through your blood and clogging your arteries, there are few signs of a problem. That is, until a heart attack or stroke occurs.
“Cholesterol is one of the most important risk factors for cardiovascular disease,” says Indu Poornima, MD, a cardiologist with Allegheny Health Network in Pittsburgh. “Unless checked by a blood test, it will never be detected.”
Left untreated, abnormal cholesterol levels can lead to atherosclerosis (hardening of the arteries), which can slow or block blood flow to the heart.
That’s the bad news. But there’s an upside too.
Not all cholesterol is created equal, and one type can actually improve your health and lower your risk of heart problems. That’s right: as important as it is to prevent your LDL cholesterol from soaring, it’s just as crucial to make sure your protective HDL cholesterol is high enough.
Here’s what you need to know about this “good” cholesterol, target numbers to aim for, and what to do if your number is too low.
What exactly is good cholesterol?
Despite its link to heart disease, cholesterol is essential to the body.
Produced in the liver, the substance aids in digestion and metabolism. It also helps produce necessary vitamins, such as vitamin D for bone strength, and sex hormones, including estrogen and testosterone.
“Cholesterol is the building block of all cells,” explains Vicki Knight-Mathis, MD, a board-certified pediatrician in the Atlanta area.
It’s a tiny, “waxy” substance and a type of fat, or lipid. Because it’s not water soluble, it needs some help traveling through the blood, which is mostly water. So it joins up with protein.
This fat-and-protein particle is called a lipoprotein. There are two main types: high-density lipoprotein (HDL) and low-density lipoprotein (LDL).
When doctors refer to “good” cholesterol, they mean HDL. When they reference “bad” cholesterol, they’re talking about LDL, says Christopher Di Giorgio, MD, a board-certified cardiologist in New Jersey who is part of the Englewood Health Physician Network.
High levels of LDL can clog arteries, reducing blood flow and raising the likelihood of a heart attack.
HDL, on the other hand, is the cleanup crew. It collects fatty substances and excess cholesterol throughout the body and brings them back to the liver to be disposed.
The goal is to keep LDL numbers low and HDL levels high for optimal heart health.
Good cholesterol levels
Desirable cholesterol levels can vary based on a person’s health history and other risk factors. If you have heart disease or have had a heart attack, for instance, your doctor may suggest you aim for a target outside the “normal” recommendations.
Other factors that put you at risk for out-of-range cholesterol levels are a genetic predisposition to high cholesterol, a diet in unhealthy fats and low in healthy fats, obesity, and smoking.
The Centers for Disease Control and Prevention (CDC) recommends the following cholesterol targets for most adults:
LDL cholesterol: less than 100 mg/dl
HDL cholesterol: greater than or equal to 60 mg/dl
Total cholesterol: less than 200 mg/dl
Get a cholesterol test
A simple blood test can detect the milligrams of cholesterol per deciliter of blood in your body.
The CDC recommends healthy adults have their cholesterol checked every four to six years. For those with health issues, such as obesity or diabetes, or a family history of high cholesterol, tests should be done more often.
And it’s never too early to get a baseline cholesterol screening for those at higher risk.
“Children with a parental history of hypercholesterolemia [extremely high cholesterol] should get tested very early on between, 2 to 10 years of age,” advises Dr. Poornima.
For those with no risk factors, she recommends a baseline cholesterol screening between ages 17 to 20, as children transition from pediatric to adult care.
How to increase HDL cholesterol
Considering the work HDL does in your body, mopping up excess LDL cholesterol so that it can’t clog your arteries, it’s important to maintain adequate levels.
When HDL is too low—below 45 mg/dl in women and 40 mg/dl in men—your risk of atherosclerosis, heart attack, and stroke increases.
But there are steps you can take to elevate your levels of HDL cholesterol. Our medical experts outline seven steps to a healthy heart.
Get off the couch
Activity that gets the heart pumping and the body moving is the primary way to raise HDL levels.
This does not mean training for marathons and hours of kickboxing. Even small steps can yield big results, says Alicia Romano, a clinical registered dietitian at Tufts Medical Center in Boston.
“As little as 60 minutes of moderate-intensity aerobic exercise a week have been shown to [help raise] HDL,” she says. “That’s only 20 minutes three days a week … and totally reasonable!”
Take a walk around your neighborhood, or trying biking instead of driving, when possible, to add exercise into your daily schedule.
Shed the excess pounds
The increasing rate of obesity in the United States is the No. 1 cause of cholesterol-related issues, says Dr. Knight-Mathis. Nearly 40 percent of Americans are considered obese; nearly 10 percent are severely obese, at 100 pounds over their optimal weight.
The Covid-19 pandemic made the situation even worse.
“Over 50 percent of U.S. adults reported weight gain during Covid,” says Dr. Knight-Mathis, whose practice focuses on adolescents. “The most frequently cited number is 15 pounds, but it is likely even higher.”
Extra weight leads to more cholesterol production in the liver, including LDL. When cholesterol production shifts into high gear, there’s a whole lot of “bad” LDL for HDL to vacuum up, and it gets overwhelmed.
“Extra weight also increases the risk for diabetes, which is associated with worsening cholesterol,” Dr. Knight-Mathis says.
Extinguish the cigarettes
According to the CDC, smoking is a major cause of cardiovascular disease. In fact, it is the direct cause in 25 percent of deaths from cardiovascular disease.
More important for those with low HDL, smoking causes HDL levels to drop even more.
And smoking causes the thickening and narrowing of blood vessels, making the job of the HDL to clean up excess lipids even more difficult.
And it’s not just the smoker who suffers the health impacts. According to the CDC, breathing in secondhand smoke can be just as bad.
Once you quit smoking, you’ll see nearly immediate health benefits. According to the American Heart Association, in two weeks your blood circulation begins to improve, allowing HDL levels to also rise.
Eat heart-healthy fats
If your shelves and drawers are full of processed foods, meats, and sugary concoctions, your cholesterol levels are having a field day.
A diet chock-full of trans fats and saturated fats can cause a drop in HDL levels and a boost in LDL levels, says Romano.
Check the nutrition labels carefully and avoid anything containing “partially hydrogenated oils.” Those are trans fats.
Instead, look for monounsaturated or polyunsaturated fats. These healthy fats are found in vegetable oils (think olive, canola, flaxseed, safflower, sunflower, peanut, soybean, and sesame oils), avocado, nuts and seeds, fish, and tofu.
Saturated fats include the fat found in dairy, bacon, sausage, and the skins of poultry and meat. It’s also in tropical oils, like palm and coconut oils. Try to limit saturated fat in your diet.
Rotate in fatty fish, like tuna or salmon, instead of meat. And use sunflower oil or olive oil instead of grease or butter when frying.
It’s all about moderation, says Romano. Fried and greasy foods may taste great, but they can wreak havoc on your HDL levels.
“There are not necessarily individual foods that will keep HDL in check,” she notes. “Rather, there are collective patterns an individual can adapt in their diet and lifestyle to aid in improved levels of HDL and LDL.”
Fill your diet with plant-based foods
Your liver makes all the cholesterol your body needs to function. So any cholesterol you get from your diet is extra, which is why dietary cholesterol can lead to high LDL levels. And that leads to a decline in HDL.
Animal-derived foods—meat, poultry and dairy products—all contain dietary cholesterol and should be consumed sparingly, says Romano.
It’s fine to have hamburger and fries on occasion, but she recommends more fruits and vegetables (raw, frozen, or canned), whole grains (think oatmeal, 100 percent wheat bread, and brown rice), tofu, beans, seeds, and nuts, all of which will help increase your HDL levels.
The goal, says Romano, is a lifestyle focused on managing cholesterol, which will likely mitigate other health issues as well.
“Adapting a diet that incorporates a variety of enjoyable and accessible foods is very much in line with general recommendations for decreased risk of many chronic diseases,” she says.
If you drink, consider a glass of wine
While the jury is still out on this recommendation, several studies over the past few decades have suggested that moderate alcohol consumption may help cholesterol management.
“Moderate use of alcohol has been linked with higher HDL levels,” Romano explains. “[Moderate] would be up to one drink a day for women and men.”
While the results are promising in animal studies, human trials are still gathering information. Until then, researchers can’t say for certain whether a nightly glass of pinot noir will raise your HDL cholesterol.
“If you do not drink, I do not recommend that you start to drink to raise your HDL cholesterol,” says Romano.
Talk to your doctor about medications
Sometimes medications are needed to get cholesterol levels under control.
“For some people, no matter how meticulous they are with their diet, and no matter how much time they spend in the gym, their cholesterol levels are going to be problematic,” says Dr. Di Giorgio.
Most cholesterol medications lower LDL rather than raise HDL levels.
The combination of LDL-lowering medications and a healthy lifestyle will cause HDL to naturally rise.
Statins are the most common go-to medications for cholesterol management, according to the American Heart Association. They work by preventing cholesterol from forming in the liver. This, in turn, reduces the amount of cholesterol circulating in the blood.
If statins fail to lower LDL cholesterol to target range, doctors will look to non-statin medications.
Ezetimibe (Zetia) is the most commonly used non-statin agent, and it works to prevent cholesterol from being absorbed in the intestines. Another option are newer, injectable medications called PCSK9 inhibitors.
The drug niacin, or vitamin B3, can raise HDL when taken at higher doses. However, it can also cause unpleasant side effects, including what’s called a niacin flush.
Tackling cholesterol levels
There’s a good chance that if your HDL cholesterol level is too low, your LDL levels is too high. When faced with simultaneous low “good” cholesterol and high “bad” cholesterol, doctors often treat both issues as equally important.
“We address both [with] medications focused on treatment of high LDL and lifestyle changes as the only way to address the low HDL,” explains Dr. Poornima.
Thankfully, out-of-range cholesterol levels are manageable. If you’re willing to change your lifestyle for the healthier, you’ll likely watch your HDL cholesterol level rise.
Cholesterol is a public health issue
Think of high cholesterol as one of the world’s most notorious public-health offenders. Close to 100 million Americans have unhealthy cholesterol levels, putting them at grave risk of having a heart attack, stroke, or other cardiovascular issue.
Getting and keeping cholesterol at normal levels can greatly reduce that danger.
“Cholesterol is one of the keys to good health,” says Daniel Muñoz, MD, associate professor of medicine at Vanderbilt University Medical Center. “Part of the reason we focus so much as physicians: in general, we know by identifying opportunities early we can prevent a lot of cardiovascular disease down the road.”
Here’s what you need to now about this all-important feature of good health.
What is cholesterol?
Cholesterol is typically described as a “waxy” substance found in your bloodstream and in every cell in your body. It doesn’t start out “good” or “bad.” It’s simply necessary.
“It’s a type of fat. We need it to live,” explains Michael Goyfman, MD, director of clinical cardiology at Long Island Jewish Forest Hills in Queens, New York.
The nutrient plays a specific and necessary role in the body. “It helps build cell membranes and helps make vitamin D and hormones,” says Sonya Angelone, RDN, a national spokesperson for the Academy of Nutrition and Dietetics.
Because fats are not water soluble (remember, cholesterol is waxy), they can’t mix with blood, which is watery. So they’re transported by higher-density protein molecules via the bloodstream to every cell in the body. This combination of fats, or lipids, and proteins is called lipoproteins.
Your liver is usually capable of producing all the cholesterol it needs (that in itself tells you how essential is, says Angelone). Excess cholesterol can be made by the liver usually as a result of eating animal-based foods high in saturated and trans fats, explains Dr. Muñoz.
Types of cholesterol
There are several different types of cholesterol but two, in particular, can impact your health. The first is low-density lipoprotein (LDL), which has the reputation of being bad for you. The other is high-density lipoprotein (HDL), or “good” cholesterol.
“Density” refers to how much fat the molecule has compared with protein, explains Dr. Goyfman. Fat molecules are less dense than protein, so low-density cholesterol means there’s a lot more fat than protein. On the flip side, HDL has less fat and more protein.
HDL and LDL are, in a sense, polar opposites. Yin and yang. While too much LDL can contribute to plaque and block your arteries, “HDL functions as a law enforcement officer or scavenger to mop up excess cholesterol,” explains Dr. Muñoz.
They work well in tandem but, “like with most anything, too much and the wrong kind is bad,” says Angelone.
Less-famous types of cholesterol play additional roles in transporting cholesterol throughout the body, explains Dr. Goyfman. These include:
- Very-low-density lipoprotein (VLDL), which veers towards the “bad” end of the cholesterol spectrum
- Intermediate-density lipoprotein (ILD)
- Chylomicrons, which carry cholesterol from food
- Remnant-like particles (RLP)
Doctors sometimes calculate a person’s non-HDL cholesterol, particularly if the patient’s risk for heart problems is especially high. This number is your total cholesterol level minus HDL, and it accounts for types of cholesterol like VLDL and ILD.
How too much LDL cholesterol can lead to heart disease
HDL helps protect your health by absorbing cholesterol and bringing it back to the liver, which removes it from your body. But in cardiology the spotlight is on LDL. It is, says Dr. Muñoz, “an ingredient in the recipe of blockage.”
And blockages in the arteries are what cause heart attacks, strokes, and more. After all, your arteries are essential for supplying blood to your heart.
This is how it works: Excess LDL cholesterol can bind with other substances to form a sticky substance (plaque) that coats the walls of the arteries and narrows them. This decreases blood flow to your heart.
The eventual result is atherosclerosis, a hardening of the arteries.
If a piece of the plaque breaks off and forms a blood clot, blood flow is obstructed, possibly resulting in a heart attack (if the artery supplies the heart), stroke (if the artery feeds into the brain), or problems elsewhere in the body.
Causes of high LDL cholesterol
Unhealthy lifestyle habits are the main drivers of high LDL cholesterol.
Although diet (including eggs) plays less of a role than we used to think, foods high in saturated and trans fats (such as fatty meats and dairy, baked goods, and deep-fried and processed foods) can contribute to an overload of LDL cholesterol.
Also putting you at risk:
- Lack of exercise
- Being overweight or obese
- Shouldering a lot of stress
- Consuming too much alcohol
These are all risk factors you can control. The ones you can’t control include:
- Genetics (including a condition called familial hypercholesterolemia), which may make you more likely to develop high cholesterol
- Age—cholesterol levels rise as you get older
- Race or ethnicity, which can influence your risk for high LDL and/or low HDL levels
Some medical conditions can also cause high LDL and/or low HDL, such as diabetes, chronic kidney disease, HIV/AIDS, pregnancy, sleep apnea, and lupus.
Medications that can contribute to unhealthy cholesterol levels include some drugs for your heart (beta blockers and diuretics), cyclosporine and other immune-suppressing drugs, steroids, and retinoids for acne.
Screening and prevention
Most people with high LDL and/or low HDL don’t show any symptoms, which is why regular screening is so important.
The American Heart Association recommends that all adults age 20 and over who have an average risk for high cholesterol get their levels tested every four to six years. Once you turn 40, your doctor may recommend more-frequent checks, depending on your risk factors for heart disease.
Screening is a simple blood test called a lipid panel that’s ideally done by your doctor. The results will show total cholesterol, LDL, HDL, and triglycerides (another type of fat).
There are also home tests. According to the Food and Drug Administration, some—but not all—can be as accurate as the ones done in a doctor’s office. If you go with one of these, look for tests that are “traceable” to the Centers for Disease Control and Prevention and check the label for information on accuracy.
Healthy cholesterol levels
The National Cholesterol Education Program, part of the National Heart, Lung, and Blood Institute, provides the following guidelines for healthy cholesterol levels in adults age 20 and older.
Optimal: Less than 100 mg/dl
Near/above optimal: 100 to 129 mg/dl
Borderline high: 130 to 159 mg/dl
High: 160 to 189 mg/dl
Very high: 190 mg/dl and above
Low: Less than 40 mg/dl
High: 60 mg/dl and above (this is protective)
Desirable: Less than 200 mg/dl
Borderline high: 200 to 239 mg/dl
High: 240 mg/dl and above
While doctors do look at total cholesterol levels, “we care as much, if not more, about LDL specifically,” says Dr. Muñoz.
Lowering your LDL cholesterol with lifestyle changes
If you need to lower your LDL levels, start with the lifestyle issues that may be contributing to your too-high cholesterol.
A good place to start is your diet. Certain foods worsen the condition, but there are also foods that can help lower your cholesterol levels.
The only diets that have proven long-term beneficial effects on heart health are the DASH and Mediterranean diets, says Dr. Goyfman. Both are low in saturated fat and focus on unsaturated fats, lean proteins, fruits, vegetables, and whole grains.
Try to exercise for 30 minutes, most days of the week. And get enough quality sleep.
All of these actions will help you maintain a healthy weight, which is also critical for keeping cholesterol levels low. Losing as little as 3 to 5 percent of your body weight can alter your cholesterol levels for the better.
Lowering your LDL cholesterol with medication
You may need medication if you’ve had a previous heart attack or stroke, have diabetes, or have an LDL level above 190 mg/dl. Doctors usually first turn to statins, drugs that prevent your liver from making cholesterol.
“Most patients are easily enough controlled with statins,” says Dr. Goyfman. “That’s really the cornerstone.”
If statins don’t do the trick, your doctor may turn to non-statin cholesterol-lowering medications. Ezetimibe (Zetia) is the top option, followed by newer, injectable PCSK9 inhibitors. The PCSK9 inhibitors, Dr. Goyfman adds, “are considered game-changers. They can control cholesterol in most patients.”
Is there such a thing as too-low LDL or too-high HDL?
Technically, yes. But it hardly ever happens.
In fact, no one really knows what too-low LDL means, although some say it’s probably less than 40 mg/dl.
“Since we know that cholesterol is a component of cell membranes, you’re definitely going to have problems if it gets too low, but it’s not a problem for most people,” says Dr. Goyfman.
Levels of HDL beyond target ranges could theoretically add some benefit, but, says Dr. Muñoz, “we very rarely get to that person.”
Go low for heart health
Cholesterol is an oily, waxy substance that’s a building block for many bodily processes. It serves as the backbone for certain hormones and helps repair cells in our tissues.
But there’s a catch. Our bodies need only a little bit of cholesterol for these housekeeping activities—and according to the Centers for Disease Control and Prevention (CDC), at least 38 percent of Americans have levels that are too high.
Excess blood levels of a specific type called low-density lipoprotein (LDL) is especially likely to wreak havoc. The more LDL cholesterol you have floating around in your bloodstream, the greater your risk for a heart attack or stroke.
The link is so strong that just a 10 percent decrease in total cholesterol levels (including LDL, which makes up most of the total cholesterol in your body) can reduce someone’s risk for heart disease by as much as 30 percent.
That’s why doctors want you to know how to lower LDL cholesterol and keep it at a healthy level.
What is LDL cholesterol?
Where does your blood cholesterol come from? It’s produced by the body’s liver.
Although you can also get cholesterol from animal-based foods, like eggs and meat, dietary cholesterol doesn’t play as big a role in your heart health as once thought. Other food components, like saturated fat, are more likely to cause the liver to produce cholesterol (more on that later).
Because cholesterol is a “waxy” fat and our blood is mostly water, they don’t mix. So our body shuttles it around with cholesterol-carrying molecules called lipoproteins.
The lipoprotein’s density helps determine the type of cholesterol. Considering fat is less dense than protein, the particles with a lot of fat are considered low-density lipoprotein, or “bad” cholesterol. On the flip side, high-density lipoprotein (HDL) has more protein than fat and is considered “good” cholesterol.
Once our body extracts what it needs from these molecules—like energy from triglycerides, another type of fat—what remains is leftover cholesterol floating around in our blood.
“They’re supposed to be cleared by our liver,” says cardiologist Donald Lloyd-Jones, MD, chair of preventive medicine at Northwestern University and the president of the American Heart Association.
But some of us are less efficient at clearing those particles from the bloodstream, and at higher levels, the LDL particles carrying cholesterol can start getting into our artery walls.
“That’s when they can cause trouble,” says Dr. Lloyd-Jones.
What happens when LDL cholesterol is too high?
When these LDL cholesterol particles get into our arteries, they trigger an immune system response. The body sends in inflammatory cells to try and clear the leftover cholesterol, but that very process creates more damage, which can attract more LDL cholesterol particles.
“It becomes a little bit of a vicious cycle,” Dr. Lloyd-Jones says.
He explains that over time, this damage can make it more likely someone will form plaque in their artery walls. That narrows the arteries, limiting blood flow and significantly raising the risk of heart disease.
HDL vs. LDL cholesterol
Cholesterol is cholesterol; it’s the type of particle carrying it that makes it “good” or “bad” for our body.
Whereas LDL particles tend to deliver excess cholesterol to our tissues and arteries, HDL particles are designed to help with the body’s cleanup process.
“The HDL [cholesterol] sort of functions like a vacuum cleaner,” explains Holly Ippisch, MD, a pediatric cardiologist at Cincinnati Children’s Hospital Medical Center. “It helps pick up the LDL and take it back to the liver, where the body can get rid of it or use it for other functions.”
What causes high LDL cholesterol?
High LDL cholesterol levels are primarily driven by poor dietary habits, explains Eugene Yang, chair of the American College of Cardiology’s Prevention of Cardiovascular Disease Section Leadership Council and professor at the University of Washington School of Medicine.
The Western diet—typically high in things like unhealthy saturated fats—encourages elevated LDL cholesterol levels.
With the increasing availability of fast and processed foods, high cholesterol is a trend that’s on the rise worldwide.
According to The New England Journal of Medicine, the number of deaths attributed to high LDL cholesterol grew by almost one million between 1990 and 2017. This research also shows a drastic shift in cholesterol-related death rates from high-income regions to middle- or low-income countries, particularly in Asia.
But diet isn’t the only culprit. Genetics can influence a person’s risk for having high LDL cholesterol—and the heart problems that can occur as a result.
Dr. Yang explains that about one in 250 people has what’s called familial hypercholesterolemia, a genetic mutation that affects their ability to clear LDL cholesterol from their body.
This predisposes people to levels of cholesterol that are higher than the average person. As a result, they’re up to 22 times more likely to have coronary heart disease, according to the CDC.
However, even if you don’t have familial hypercholesterolemia, other genetic factors can mean you are at greater risk for high cholesterol and heart trouble. The good news is that even if you are at higher risk due to genetics, making lifestyle changes like healthy eating and exercise can help.
A normal range for LDL cholesterol
Dr. Lloyd-Jones says that there are average cholesterol values people can shoot for, but in general, the most optimal range for an individual can vary from one person to the next.
Still, he says that if you’re a healthy adult with no family history of high cholesterol and no personal history of heart disease, good starting points are:
- Total cholesterol: less than 200 milligrams per deciliter of blood (mg/dl)
- LDL cholesterol: less than 130 mg/dl
- HDL cholesterol: 50 mg/dl or higher
- Triglycerides: less than 150 mg/dl—ideally below 100 mg/dl
“But if you have other risk factors, like smoking, high blood pressure, or diabetes, these [average] levels might be too high for you,” he explains. “It’s important to understand the context of your personal situation so that you and your doctor can decide the right numbers for you.”
How to lower LDL cholesterol levels
When we’re born, our genetic makeup sets a range around which our LDL cholesterol levels will orbit throughout our lives, says Dr. Lloyd-Jones.
Yet while we can’t control this genetic range, we can leverage factors like our diet, lifestyle, medications to keep cholesterol levels at the lowest—and healthiest—point in that predetermined spread.
Lower LDL cholesterol with diet and nutrition
According to experts, eating patterns have a big influence on the levels of LDL cholesterol in your body.
Although some people absorb dietary cholesterol into their bodies from food more easily than others—and therefore are more affected by that extra egg yolk in their omelet—doctors say that there are general dietary guidelines that help lower LDL cholesterol.
Eat less saturated fat
“The typical recommendations are to start with decreasing saturated fats,” Dr. Ippisch says. This type of fat is known to raise LDL cholesterol levels and is one of the worst foods for cholesterol.
Limiting saturated fat means making dietary choices like choosing:
- Lower-fat dairy
- Baked or grilled options instead of fried or greasy foods
- Fiber-rich foods, like whole fruits, vegetables, and whole grains
- Lean protein like fish and poultry
Avoid trans fats
There’s a good reason the Food and Drug Administration set a target for food manufacturers to remove partially hydrogenated oils from processed foods by 2020. These trans fats raise LDL cholesterol.
This type of fat used to be in many types of margarine, baked goods (think pies and cookies), doughnuts, pizza, and fried foods.
Although removed from many products, it’s a good idea to continue to steer clear of these fats. To do that, read nutrition labels and buy products with zero trans fat on the label and no partially hydrogenated oils in the ingredient list.
Eat more healthy fats
A study from the University of California-San Diego School of Medicine also shows that when healthy fats like olive and canola oils are included in this cholesterol-friendly diet, outcomes improve even more.
To add healthy monounsaturated and polyunsaturate fats to your diet, stock up on foods like:
- Olive, canola, peanut, and sesame oils
- Nuts and nut butters
- Seeds, like flax and pumpkin
Eat more fiber
Soluble fiber—found in fruits and veggies, whole grains like oats, and legumes—is a heart-healthy choice. According to a 2019 analysis published in The Lancet, a higher intake of dietary fiber is associated with lower levels of total cholesterol.
Lower cholesterol with lifestyle changes
Don’t rely on diet alone to bring your LDL cholesterol down to a healthy level. Think of eating as just one aspect of your cholesterol-lowering plan. Then target necessary lifestyle changes.
One of the most important strategies for managing your cholesterol is to maintain a healthy weight.
A study published in Translational Behavioral Medicine found that overweight and obese adults who shed just 5 percent of their body weight reduced risk factors for cholesterol-related heart problems. And greater weight loss led to bigger improvements.
“If you’re actively gaining weight, the liver is often already packed with fat or cholesterol,” Dr. Lloyd-Jones explains.
That means it can’t clear much more cholesterol from the bloodstream, so there will be more LDL particles hanging out and causing trouble.
Quitting smoking can also influence your cholesterol management. While smoking doesn’t have a strong link to LDL cholesterol, it does tend to suppress HDL cholesterol levels.
Smoking also worsens the damage LDL cholesterol can cause our arteries, further increasing someone’s risk of heart disease.
Create an exercise routine
If you’re overweight or obese, exercise may help you lose pounds, which will help improve your cholesterol levels. But keeping a regular fitness routine is a good idea even if you don’t need to lose weight.
Research has shown that exercise can reduce cholesterol levels. And according to a study published in the journal Sports Medicine, regular physical activity can raise HDL cholesterol levels.
Lower LDL cholesterol with medication
“The most important feature that determines our LDL levels is the activity of receptors in the liver that pull LDL particles out of the blood,” says Dr. Lloyd-Jones.
He explains that cholesterol medications enhance the activity of those receptors, so our bodies can get rid of LDL cholesterol much more efficiently. Dr. Ippisch adds that this class of drugs (called statins) also works to slow down how much cholesterol is being made in our liver.
“[Doctors] look at the overall risk of the patient to determine who might benefit from medication in addition to lifestyle changes to lower their LDL cholesterol,” Dr. Lloyd-Jones says.
Higher-risk individuals can include those who already have cardiovascular disease and those with a genetic predisposition to elevated LDL cholesterol levels. But doctors may also use medication to lower LDL levels in people with health conditions like kidney disease, diabetes, or high blood pressure.
Dr. Lloyd-Jones explains that while someone may fall in the average range for LDL cholesterol, a “normal” number might be too high, depending on their additional risk factors. Medication brings it down to lower, safer levels, so there’s no additional fuel for artery-clogging plaque.
The healthy cholesterol level for you
It’s important for people to understand that there’s no “normal” LDL cholesterol level. Dr. Lloyd-Jones.
Instead, he says, you should work with your doctor to identify the level that’s most optimal for you and form a plan to get there. That begins with a cholesterol test and a discussion of your risk factors.
And if you learn your number is too high? You have a lot of potential ways to bring it back down again.
There’s a reason doctors take high cholesterol so seriously. Hypercholesterolemia, the official name for high cholesterol, is defined as having a total blood cholesterol of 240 mg/dl or higher. Borderline high cholesterol (levels between 200 mg/dl and 239 mg/dl) is also concerning, and affects nearly 40 percent of American adults. High cholesterol increases your risk for heart disease and stroke, but usually has no symptoms, making it a silent killer. There are a few conditions associated with high cholesterol, however, including lipomas, fatty tissue deposits under the skin. Here, Kris Olsen, 57, owner of Finish Line Engraving in Columbus, Ohio, shares her experience dealing with high cholesterol after learning lumps in her breast were really lipomas.
I discovered lumps in my breast
Some people describe their health as a journey. I’d say mine is more like a roller coaster—plenty of ups and some downs, along with a couple of stomach-dropping turns.
It started about 15 years ago, when I lost my best friend, my dad, and my brother to cancer in the space of three years. I’d spent so much time being a caregiver to my loved ones that I’d put my own well-being on the back burner.
I knew I’d gained some weight and was probably depressed, but I was shocked when I went in for my regular checkup and discovered how bad the numbers on my blood work really were.
Not only was I obese, but my cholesterol, triglycerides, and blood pressure were high, putting me at risk for cardiovascular disease. I knew that obesity raised my cancer risk too. This thought was at the top of my mind when I mentioned to my doctor that I had also found some lumps in my breast and armpit.
Thankfully, it wasn’t breast cancer
Several mammograms later (as if one isn’t enough fun!), we determined the lumps were knots of fatty tissue called lipomas.
The great news: the cause wasn’t cancer. The not-so-great news: my body was storing excess fat. Lipomas, I later learned, are often correlated with very high cholesterol.
My doc gave me a choice. I could drastically change my lifestyle, or he would put me on prescription meds, and a lot of them. I chose the lifestyle changes option.
I changed my diet and took up running, eventually taking part in a 5K race. Even though I had to walk sometimes, I found running therapeutic and fell in love with the sport. It also helped me mentally. Running became my “me time,” and I often cried, meditated, and sang while I worked out.
Over time, I lost the extra weight, the fatty lumps, and four inches of chest and back fat. But even more important, my cholesterol and blood pressure fell to healthy levels.
For the next decade, I kept up my healthy lifestyle. I thought, possibly naively, that I’d figured this cholesterol thing out.
Then menopause hit like a freight train
In February 2019, at age 55, I had another shocking medical checkup. My cholesterol was 275 mg/dl, a number classified as “extremely high” and dangerous.
I was totally taken aback. I didn’t have any symptoms at all! I remember feeling so scared. My mother had a heart attack when I was 16, and I was terrified of following in her footsteps.
The number was so much higher than I thought it would be, and I felt ashamed I’d let myself get to this point. I was in a fog as I listened to my doctor tell me that I needed to get these numbers under control immediately.
High cholesterol is more common in post-menopausal women, but I knew that I couldn’t use hormones as an excuse. I admitted that over the past few years I’d really let my diet and exercise habits slip. After getting an injury during a race, I’d stopped running, and I’d been comforting myself with food.
Again I was faced with a choice between going on medication or overhauling my life. Again I chose to change my lifestyle.
Managing my high cholesterol with diet and exercise
My sports doctor reassured me that I could lower my cholesterol through diet and exercise, and he recommended that I switch to eating a Mediterranean diet full of whole grains, fresh fruits and vegetables, and lean protein.
I love to cook, so I saw this as a fun opportunity to try out new recipes.
Another important factor was staying hydrated—and with the right liquids. I hadn’t been drinking much water, so I ditched sodas and juice and started downing water throughout my day. I added slices of lemons, oranges, or cucumbers to make it more fun and the water taste better.
One thing that didn’t help me was vinegar. I read on the Internet that drinking apple cider vinegar daily can help lower cholesterol. I never got to find out if it really worked (researchers are still debating this) because I just couldn’t stand the taste!
The exercise piece was a bit trickier. I couldn’t run like I used to, so my husband surprised me with an indoor bike trainer, and I took up cycling. Eventually I was able to take up running again, and I’ve rekindled my love for it.
One year later
My checkup in February 2020 went much better. In one year, I’d been able to get my total cholesterol down to 197 mg/dl—that’s in the healthy range for my age. I was so proud of my hard work, and today I feel so much healthier and happier.
But while my story worked out well, not everyone’s does. Now I make it a point to tell everyone that high cholesterol usually does not have any symptoms so it’s super important to have blood work done on a regular basis.
We can’t control all the ups and downs on our health roller coasters, but cholesterol is one area where we really can have a big effect.
—As told to Charlotte Hilton Andersen
What is a deviated septum?
Breathing is one of the traditionally more thoughtless bodily functions for many people. If you are healthy, breathing usually just sort of happens without much effort.
People with specific lung conditions, like asthma or COPD, can have difficulty breathing in general or due to certain triggers. Others may have trouble breathing just through their nose due to a cold, allergies, or other problems. People with a deviated septum are in the latter group.
A deviated septum, or nasal septum deviation, is the displacement of the wall between the nostrils. It makes it tough for people to breathe through their nose.
This wall of bone and cartilage divides the inside of the nose in half, with a nostril on each side. In the ideal scenario, both sides are even. However, a deviated septum means one nasal septum leans sideways or is off-center, making one nostril bigger than the other.
“The septum is an important internal structure of the nose,” explains Amit Kochhar, MD, a double board-certified otolaryngologist and head, neck, facial, and reconstructive surgeon of Providence Saint John’s Health Center, in Santa Monica, California. “The septum serves to not only separate the right and left side of the nose, but it also supports the bridge and tip of the nose.”
No one’s septum is perfectly midline, or straight, and about 80 percent of all septums are deviated to some degree.
Here’s what you need to know about the symptoms of a deviated septum, as well as treatments and surgery that can help correct the problem if you have one.
How does a septum deviate?
Some people are born with a deviated septum. It may also occur as the nose grows, since the septum also grows. These are typical reasons for a deviated septum.
In other cases, a deviated septum occurs after injury to the nose from things like contact sports or car accidents, for example.
Deviated septum symptoms
People with a minor or a slight deviated septum may not experience symptoms. More severe deviations could cause the following symptoms or signs of a deviated septum:
- difficulty breathing
- sinus infections
- dryness in one nostril
- snoring, loud breathing during sleep, sleep apnea
- nasal congestion or pressure
- facial pain
- sleep apnea
How to tell if you have a deviated septum
Doctors, usually an otolaryngologist or an ear, nose, and throat (ENT) doctor, diagnoses a deviated septum after a nostril and nose examination. They may look at the septum’s placement and how it impacts the size of the nostrils.
Questions about sleep, snoring, sinus problems, and difficulty breathing also help doctors indicate whether or not someone has a deviated septum.
Although there isn’t one surefire test to do at home, Dr. Kochhar says you can do a few things to possibly determine if you have a deviated septum.
First, you can look at your nose in the mirror to see if your nose looks straight.
“One finding that is commonly seen in patients when they have a deviated septum is that the outside of their nose may also be crooked,” he says.
Another way to see if your septum is deviated is to photograph your nostrils.
Although it won’t be your next profile picture, it could indicate an issue.
If one nostril is significantly larger than the other, that may be a clue that something is deviated internally, per Dr. Kochhar.
Your breathing habits
Many people with a deviated septum also complain of trouble breathing through their nose. While it is normal for one side to breathe better, this usually alternates between right and left.
However, if only one side breathes better all the time, that may be a clue that something is blocking the non-breathing side like a deviated septum, according to Dr. Kochhar.
People with a deviated septum can be at risk for nasal congestion, which can cause face pain and repeat sinus infections.
Your sleeping habits
“Lastly, if you note that when lying or sleeping on your side that you cannot breathe on one side all the time, that can also be an indication that you should see a physician to look into your nose to assess how straight your septum is,” Dr. Kochhar says.
How to fix a deviated septum
Symptom management is the name of the game when it comes to treatments for a deviated septum. Your doctor might recommend over-the-counter medicine to help relieve symptoms like congestion or headaches.
Dr. Kochhar also says another option for improving nasal breathing includes using external Breath Right strips. These nasal strips help lift the sides of the nostrils to open the nasal passages and increase airflow.
Steroid nasal sprays are also an option, like fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort).
People may also choose to undergo in-office procedures to reduce swelling of the septum or turbinates, the thin, bony plates inside the nose.
“These typically involve radiofrequency ablation or other types of thermal (heat) energy,” he says.
Deviated septum surgery
If symptoms don’t improve, septoplasty, a type of reconstructive surgery, is an option.
People who opt for this surgery usually have a deviated septum that obstructs one side of their nasal airway and/or frequent sinus infections.
The surgery consists of cutting the septum and removing excess cartilage or bone to straighten the septum and nasal passage. In some cases, the surgeon adds silicone splints in each nostril for septum support.
Your doctor might also recommend additional surgeries like sinus surgery (to open the sinuses) or a rhinoplasty (nose job), at the same time. That combination is called septorhinoplasty.
Like any surgery, septoplasty has risks and benefits.
The risks and potential complications of the procedure include bleeding, infection, and damage to the septum that can lead to scarring or possibly a perforation (a hole in the nose), says Dr. Kochhar.
However, the risk is very low, especially when done by an experienced surgeon.
“In the majority of cases, patients have minimal pain and experience a noticeable improvement in breathing two to three weeks after surgery when the internal swelling reduces,” Dr. Kochhar says.
And Dr. Kochhar finds that most patients who undergo septoplasty wish they had done it much sooner.
“The improvement in nasal breathing provides a huge impact on quality of life,” he says.
Dr. Kochhar notes that although a deviated septum may contribute to nasal obstruction and difficulty breathing through your nose, it’s not the only potential cause.
“Other causes of nasal obstruction include nasal valve stenosis (narrowing), turbinate hypertrophy and nasal polyps, or chronic sinusitis,” he says.
That’s why, if you suffer from nasal obstruction, an evaluation by a head and neck surgeon with expertise in facial plastic surgery or rhinology is key.
Next, check out the medical reasons you can’t sleep.
You may have heard the term ‘endocrine disruptor’ and wondered how concerned you need to be about these chemicals, which can be found in plastics, packaging, food, household products, and many other places.
The definition of an endocrine disruptor is any chemical or compound, either natural or man-made, that either mimics or interfere with hormones in the body.
As you may know, hormones are pretty important and act as the body’s chemical messengers to control nearly all processes, explains Linda Kahn, an assistant professor in the Department of Pediatrics at the NYU Grossman School of Medicine.
The endocrine system includes hormone-producing glands like the ovaries, testes, thyroid, pancreas, and the pituitary gland in the brain.
Since that system regulates everything from metabolism to mood, avoiding things that may disrupt the balance makes sense. In fact, endocrine disruptors have been linked to a number of health issues. (More on this later.)
Here’s everything you need to know about endocrine disruptors, also known as endocrine disrupting chemicals (EDCs).
How do endocrine disruptors affect the body?
There are a few ways that chemicals and other substances can disrupt the balance or normal function of the endocrine system and throw your body out of whack.
EDCs essentially work by fooling the body into thinking that they’re hormones, according to Heather Patisaul, an assistant professor of biology at North Carolina State University who specializes in neuroendocrinology and endocrine-disruption research.
Some of them act as hormone mimics, sending false messages, explains Kahn. Others block hormone receptors on cell surfaces, meaning they block messages from getting through.
Endocrine disruptors could affect the actual levels of hormones in the blood by affecting or interfering with how they are made, broken down, or stored. They may even make the body more or less sensitive to certain hormones.
The body makes a lot of hormones, like estrogen, testosterone, insulin, or oxytocin, but most EDCs focus on disrupting estrogen, androgen (testosterone), and thyroid hormone function, Patisaul says.
“There are likely many other means by which endocrine disruption occurs that we have not yet identified,” Kahn says.
Examples of endocrine disruptors
So it’s not shocking that they are in many everyday products, like some plastic bottles and containers, liners of metal food cans, detergents, flame retardants, food, toys, cosmetics, and pesticides, according to the National Institute of Environmental Health Sciences (NIEHS). They are also in building materials, clothing and upholstery, and thermal paper.
These could lead to contamination, and endocrine-disrupting chemical exposure, via your diet, the air, your skin, and drinking water.
Again, they are found in many everyday products—although the levels may not necessarily be high enough to cause a problem. Some of these occur naturally while others are manufactured, and some are now regulated or banned in the United States, while others are not.
Here’s a list of the most common types of disruptors:
Used in the manufacturing of detergents, cleaners, and other products. Found throughout indoor and outdoor environments, too.
Found in fish and shellfish. Inorganic forms of arsenic were previously in pesticides, paint, and wood preservatives. The use today is restricted.
Bisphenol A (BPA)
Found in some rigid plastics, and food storage or packaging materials. Many manufacturers are phasing out BPA and replacing it with chemical cousins BPS or BPF (bisphenol S and F).
(Here’s why you shouldn’t refill your plastic water bottle.)
Forms naturally in the atmosphere, occurs naturally in arid states in the Southwest U.S., and found in rocket propellant, explosives, fireworks, and road flares.
Perfluoroalkyl and polyfluoroalkyl substances (PFAS)
Found in textiles, clothing, non-stick food wrappers, microwave popcorn bags, and old Teflon cookware.
Found in personal care products, medical tubing, vinyl flooring, adhesives, and detergents.
Polybrominated diphenyl ethers (PBDE)
Found in furniture foam padding, wire insulation, rugs, draperies, upholstery, plastic cabinets for televisions, personal computers, and small appliances. It could get into the air, water, or soil and contaminate food.
Polychlorinated biphenyls (PCB)
Found in industrial solvents or lubricants and their byproducts, landfills, incineration, electrical, heat transfer, and hydraulic equipment, plasticizers in paints, plastics, and rubber products.
Found in some antibacterial soaps and body washes, toothpastes, some cosmetics, clothing, kitchenware, furniture, and toys. The FDA banned the chemical’s use in antibacterial liquid soaps in 2016. They also banned over-the-counter consumer antiseptic wash products containing triclosan, too. Many manufacturers are eliminating it from their products.
What happens after endocrine disruptor exposure?
Health concerns from exposure to endocrine disruptors are mostly about reproduction and development.
Here’s what to know.
Attention and development issues
Attention-deficit/hyperactivity disorder (ADHD) is a condition that can result in hyperactivity and/or attention problems.
Research in JAMA Network Open looked at the association between endocrine-disrupting chemical exposure in adolescents and ADHD.
The study, which was published in 2020, included 205 teens, about 19 percent who had an ADHD diagnosis. The researchers measured endocrine disruptor exposure by testing urine samples, and found that for each 2-fold increase in phthalates, there was a 34 percent increase in the risk of ADHD-related behavioral problems. The link was stronger in males than females.
Another 2020 study in Environmental Health Perspectives looked at phthalate exposure before birth and found more autism traits in boys (but not girls) later on.
The researchers found that greater concentrations of phthalate chemicals in a mother’s first-trimester urine samples correlated with increases in Social Responsiveness Scale-2 (SRS-2) scores, a measure of autism traits, at ages 3 and 4.
However, they only saw the link in children whose mothers took less than the recommended daily folic acid dose (400 micrograms) during their first trimester.
Folic acid, a man-made form of the B vitamin folate, can reduce the risk of birth defects if taken before and during pregnancy. The study suggests it might also protect against endocrine disrupters, the authors concluded, although more research is needed.
The CDC recommends all women of childbearing age get 400 micrograms (micrograms) of folic acid daily, along with food with folate from a varied diet.
A subset of EDCs, obesogens, promotes obesity, according to a 2019 report in Frontiers in Endocrinology.
EDCs might also increase the risk of non-alcoholic fatty liver disease (NAFLD) by directly or indirectly interfering with liver’s ability to process fat. NAFLD is a type of liver damage similar to that seen with alcohol abuse, however, it’s due to fat accumulation in the liver and seen in people who drink little or no alcohol.
Long-term exposure to arsenic, one type of endocrine disruptor, can disrupt metabolism, and increase the risk of diabetes and other metabolic disorders, too, according to the NIEHS.
A 2013 review in Endocrine Connections looked at the research on human infertility and exposure to endocrine disruptors.
The review found that not only may this exposure affect sperm quality in men, but female fertility, too. It all depends on the specific EDC.
For example, the report highlighted a higher risk of infertility in women with higher concentrations of BPA in their system. And exposure to pesticides and plastics in a work environment is also a known risk factor for female infertility, too, per the report. Because of this, BPA has been eliminated from many types of plastic and products for children, and BPA-free cans are now an option.
Although more research on humans is necessary, additional research in animals also found an association between adult exposure to EDCs such as pesticides and triclosan and harmful effects on adult female reproduction, according to a 2017 report in the Journal of Endocrinology.
Other health issues
A study in Environmental Research on phthalates and disease looked at 1,504 Australian men between the ages of 39 and 84. They found phthalates in 99.6 percent of urine samples.
Those men with a higher phthalate concentrations had a greater risk of cardiovascular disease, type 2 diabetes, hypertension, and chronic low-grade inflammation than those with lower levels. (There was no link to asthma or depression.)
What is unknown about endocrine disruptors
Patisaul says there is so much that is still not known about EDCs.
“We don’t know how many there are, or where they are, or how many are in our bodies at one time, although estimates are in the hundreds,” she says.
Patisaul adds more research is still necessary to understand how EDCs may affect the function of hormones other than estrogen, androgen, and thyroid hormone.
“My lab has done some work on oxytocin and vasopressin, for example, while others are looking at insulin, but very little work has been done regarding their potential effects on the hormones involved in bone endocrinology, or appetite for example,” she says.
Kahn adds that more research is also necessary on whether endocrine disruptor exposure is equally dangerous throughout life, or during specific times only.
“For example, studies have shown that exposure in utero, can affect health during throughout life, as all of the systems that regulate bodily processes are ‘wired’ during this time,” Kahn says.
“We might also ask, is exposure to chemicals that interfere with sex hormones particularly dangerous during puberty?”
Who is most at risk?
Patisaul notes that hormones are essential for proper development of nearly every organ system in the body, so exposure during fetal development is especially risky. So pregnant women should be extra careful to try to avoid them if they can.
Kahn agrees, adding that recent studies also suggest that endocrine disruptors may affect gametes (sperm and eggs), so people planning a pregnancy might also want to try to avoid exposure as well.
“Young children should also be protected as much as possible, because we know that the brain continues to develop rapidly in the first few years of life,” Kahn notes.
Puberty is also a vulnerable time, but far less research exists examining this “critical period,” according to Patisaul.
“We have almost no information about how EDCs may affect the aging brain, or women undergoing menopause, or EDC impacts in other significant life stages and transitions,” she says.
How to avoid endocrine disruptors
Since they are pretty much everywhere, it can be hard to avoid EDCs completely.
“Unfortunately, we don’t have control over everything we’re exposed to, but among the things we can control, diet and personal and home care products are major potential sources of exposure to endocrine disruptors,” Kahn says.
Avoiding fragrance is one of the easiest ways to avoid endocrine disruptors, according to Patisaul. “Fragrance mixtures often contain a number of EDCs and allergens,” she says.
Here are some other tips from Kahn and Patisaul on how to avoid endocrine disruptors:
- Avoid fragranced personal care products, detergents, cleaning fluids, and air fresheners (including plug-ins, sprays, and scented candles).
- Limit the use of plastic, particularly plastic food containers that have the numbers 3, 6, or 7 in the triangle-shaped recycling symbol.
- Avoid canned food.
- Avoid furniture and fabrics with added flame retardants.
- Regularly clean your floors with a wet mop, especially if you have children crawling around.
- Open your windows and let in fresh air as much as possible.
- Eat organic as much as possible, and spend the extra money on the organic variety of fruits and veggies that tend to have a lot of pesticides, like strawberries; greens like spinach, kale, and collard greens; nectarines; apples; grapes; cherries; peaches; and pears; as well as veggies like peppers, celery, and tomatoes.
Consider downloading apps such as EWG’s “Healthy Living” or similar to help you navigate shopping for personal care products, Patisaul suggests.
“Shoppers can also use the Mind the Store Retailer Report Card to shop at places that have made considerable efforts to reduce the presence of toxic chemicals in their full line of products,” she says.
Next, check out the best-reviewed cleaning products on amazon.
Why you want to avoid excess moisture
While moisture-wicking underwear is a good idea at any time, they might be especially helpful in the summer, if you live in a hot climate, or when you exercise. What can go wrong if you get too swampy down there?
For women, staying dry is one of the most important things you can do to stave off vaginitis, inflammation of your vagina, according to gynecologist Angela Jones, MD, who extends this definition to the vulva as well.
“My golden rule is that warm plus moist is a recipe for vaginitis; you know, lady parts (vulva and vagina) that get itchy, irritated etc.,” Dr. Jones says.
“As a woman, no one wants to go around scratching or itching her lady parts,” she adds.
Here’s everything else you need to know about moisture-wicking underwear.
The advantage of moisture-wicking underwear
If you aren’t investing in moisture-wicking underwear, or workout gear, Dr. Jones strongly advises you to do so. Her other rule of thumb is to change out of workout clothes immediately after the workout to decrease your risk of vaginitis.
“Vaginitis can be characterized by itching, burning, erythema or redness; this can be caused simply by extended contact with damp or moist workout gear or panties,” she says.
The advantage of moisture-wicking undergarments is that they give you a little wiggle room when you’re out and about during the hot, sweaty days of summer. You can’t always get home and change immediately after an outdoor workout or sports session.
Moisture-wicking underwear actually works to help keep you dry when simply changing into a fresh pair of undies isn’t an option.
“Trust me, you don’t want this to get out of hand. An itching or burning vulva or vagina is nothing you want to have to deal with over a long weekend,” Dr. Jones adds.
Opting for moisture-wicking underwear also reduces the chance of chafing.
(This is how to freshen up post-workout if you can’t shower.)
When to wear moisture-wicking underwear
You’ll want to pack a pair or two of moisture-wicking underwear on your next trip to ensure you’re keeping that area healthy and as dry as possible.
(Here’s how bad it is to re-wear sweaty gym clothes.)
The best types of moisture-wicking fabrics
What are the best types of fabric for moisture-wicking? You want a lightweight fabric, like modal, and a cotton liner, if possible.
Synthetic fabrics are hydrophobic, meaning that they resist water penetration. This is why you’ll see that a lot of synthetic fabrics—polyester or nylon in particular—are great for moisture-wicking. They’re used regularly for workout clothing as well as for moisture-wicking undies.
With that, here are some of our expert-recommended panties that help wick away moisture so you can keep cool and comfortable during hot weather, exercise, or just everyday wear.
Moisture-wicking underwear options
Warner’s Breathe Freely Brief
These Warner underwear are cute, comfy and made with a lightweight fabric designed for optimal air flow and wicking away moisture. Cool to the touch, these undies keep you dry and comfortable even on the hottest summer days.
Even better, they boast a sleek finish, so they aren’t visible under clothing. They come in a range of sizes from small to 2XL.
On Gossamer Mesh Bikini
Available in lots of shades for your every whim, these On Gossamer panties are that elusive comfortable cut that is invisible under clothes and is also cute enough to wear on a date. They are ultra light and sheer with a low cut that won’t make a cameo even under low-rise jeans and skirts.
Proof Leakproof Thong
Whether you’re dealing with periods, bladder leaks, or simply want major moisture-wicking—these are the choice for you.
The Thong features an invisible leakproof core in the gusset. Its soft and slim multi-layer core does the job without being bulky.
Fruit of the Loom Women’s Coolblend Bikini 4 Pack
Sometimes you just want to buy some cool and comfy underwear in bulk. These Fruit of the Loom CoolBlend bikinis are designed to keep you from overheating as temperatures rise and feature a soft waist and leg band.
It’s tag-free and boasts a 100 percent cotton liner for extra softness. Pair it with one of these cooling summer sports bras.
Lululemon UnderEase Midrise Boyshort
Specially designed to be worn for yoga (or just when you’re on the move, like jogging, for example), this underwear is key. Lululemon knows how to create garments that help you be more active and more comfortable.
Available in a few shades and prints, these soft boyshorts don’t dig in uncomfortably during an especially sweaty workout, so they’re sure to be the ones you’ll reach for on active days.
Silky soft, sweat-wicking, quick-drying and boasting four-way stretch, this underwear was created to sit an inch below the brand’s mid-rise bottoms, from shorts to pants to leggings.
Icebreaker Women’s Wool Bikini Underwear
We’re just as surprised as you are that merino wool is moisture-wicking, and yet, it is.
Whether you wear this pair from Icebreaker for summer or winter sports to wick away moisture and sweat, this stretch-blend pair offers a flattering, slim fit and forward set seams for a comfortable feel.
The merino wool construction works well to keep you warm if you’re a skier or snowboarder (a sweat-inducing cold-weather sport), as well.
Jockey Underwear Skimmies Cooling Slip Short
Ideal for under dresses or skirts in the summertime, these slip shorts are created to keep you as cool as possible—it’s in the name.
Machine washable, these mid-length shorts from Jockey have a cotton gusset to help protect you against chafing. They’re a nylon, spandex, and cotton blend for the ultimate in a form-fitting, seamless look underneath even the most body-con fashion moment.
Next, check out how to get the sweat smell out of clothes.
Dish towel dirt
Unlike all the things that you’re washing too often, most people are probably not throwing their dish towels in the washing machine quite often enough.
It’s easy to forget them, and after they’ve air-dried, they look ready for another use. But too often, we keep using them long after they’ve gotten dirty, like kitchen sponges. And all we’re really doing is spreading bacteria and germs on everything they touch.
“Believe it or not, dish towels can be one of the dirtiest items in your home. From cleaning up spills to wiping off counter tops, they often get used more than they’re cleaned,” said Bailey Carson, head of cleaning at Handy.
What’s on your kitchen towel
A study by the American Society of Microbiology found that half of kitchen towels tested contained some sort of bacterial growth, such as E. coli or staph. Because dish towels are so absorbent, they are the perfect home for bacteria, mildew, and even mold.
Your damp, warm towel is also the ideal breeding ground for that bacteria. That smell you associate with your dish towels and washcloths? Yup. That’s mold and mildew.
If your towels or cloths smell, it’s time for a wash in very hot water. If they come out of the dryer still smelling less than pleasant? It’s time for a new set.
How often should you wash your dish towels?
But exactly how often do you need to wash your dish towels to avoid spreading germs? That answer is: It depends on what exactly you’re using your dish towels for. Are they just for drying your hands after washing them, with maybe a quick use to mop up some spilled water or a food stain on the front of your cupboards?
In that case, Julie Finch-Scally, founder of The Duster Dollies, says that it’s all right to reuse that type of towel for three to four days.
If you’re using your dish towels to wipe up anything other than your wet hands, they’re getting more use than a towel you use after you shower, and you’ll have to wash them more often than the average amount of time you should wait between washing your bath towels.
If you’re using your dish towels to wipe down cutting boards, wash down stovetops, clean up after spills, or even for drying your dishes, you may have to replace them a bit more often.
In this case, Liz O’Hanlon, director of Metro Cleaning (UK) Ltd, says, “Ideally you should wash your dishcloths once a day. Unless you use the towel to wipe up spillages which include raw meat or fish; then the towel should be washed immediately after use.”
Of course, this doesn’t mean you have to run a load of a few towels every single day. Laura Smith, owner of All Star Cleaning Services, recommends collecting dirty towels in a small wastebasket under your sink and washing them when you’ve got a full load.
That way, once you’ve figured out how often you need to wash your bedsheets, you can throw them all in together.
Next, check out the little things everyone forgets to clean.
Setting intentions for beginners
Some trendy mental health practices have murky or hard-to-define benefits, but others can be pretty useful.
Here’s what experts want you to know about how to set intentions, what they are, and how they could benefit your mental and emotional wellbeing.
What do you mean by “intentions”
There are a few ways to interpret what intentions mean.
Sanam Hafeez, a neuropsychologist and faculty member at Columbia University in New York City, says they identify a purpose behind everything you do.
“It can be the kind of life you want to live, how you want to act in a particular situation, or what you want to get out of an experience ultimately,” she says.
Matthew Ferry, a spiritual teacher, happiness coach, and author of Quiet Mind Epic Life, says intentions are creative pursuits that help guide and direct your perspective about life, decisions, and ultimately your actions.
It’s similar but slightly different than a goal, Ferry explains.
While goals focus on a specific end point—suggesting that your current status is unacceptable or unsatisfactory—intentions are more about your mindset and mindfulness in the present as you make your way towards something that’s important to you.
They are about being in tune with an emotional state of being along the journey, rather than a specific outcome.
For example, a goal is often specific, like run a marathon. An intention could be about feeling strong and empowered, letting go of fear, or appreciating your body for what it can do.
“Goals often unconsciously imply attachment to the outcome and dissatisfaction with the current set of circumstances,” Ferry says.
Meanwhile, intentions are created knowing that although all is well, there’s still a creative pull to shift or optimize life. It’s about taking action after inspiration.
For Paul Hokemeyer, a clinical and consulting psychotherapist in New York, and author of Fragile Power: Why Having Everything Is Never Enough, it’s all about being proactive with your life.
“From a neurological perspective, it means that you live your life guided by your highest, most evolved part of your brain, which is your prefrontal cortex,” he says.”People who live lives of intention are influenced by their primitive emotions, but not enslaved by them.”
Intentions vs. affirmations
Hokemeyer says that the main difference is intentions focus on the future, “I will” statements. Meanwhile, an affirmation focuses on the present or “I am” statements.
Ferry adds that affirmations attempt to command the mind or personality to shift into a new pattern. Whereas an intention is a request for the mind or personality to shift.
“Commands create opposition and resistance,” Ferry says. “When you make a request, and give your mind the choice, you reduce resistance and open up your creativity.”
Intentions invite the mind and body into a new direction in a collaborative way.
So the intention version of the affirmation “I am a powerful and capable person” might be, “Please set the intention to be powerful and capable.”
This acknowledges you are not there yet, but want to move in that direction. You are simply pointing to the outcome you want to create, Ferry says.
“This creates openness, authenticity and creativity,” he says. “You can be at peace with where you are now, set your intention, [and be] open to what it will take.”
How to set intentions
Get quiet and reflect
Life is full of distractions, and distractions keep people stuck, according to Hokemeyer.
“When we spend a focused amount of time in quiet, our fundamental truths emerge,” he says.
Think about situations where you felt positive emotions such as happiness, pride, or passion. Then, bring your thoughts to times when you experienced negative emotions, such as disappointment or discomfort.
When considering possible intentions, remind yourself of the desire for the experience, rather than just a specific result, of the intention.
So commit to having an experience that will modify yourself or your life, Ferry says.
Pick one focus
After reflecting on the good and bad experiences and emotions, it’s time to solidify what you want to get out of your actions or your life in general, Hafeez says.
“Focus on the positive emotions you feel when doing something that you love and brings you happiness and joy,” she says. “Think about how you can achieve these feelings.”
Hokemeyer recommends choosing one focus, rather than a collection of things.
If you’re still not sure what that is, Ferry suggests considering the following questions:
- What is your most important intention right now?
- What’s important about achieving that intention?
- What’s important about the answer to question one?
- Ultimately, what will the answers to the questions above do for you?
These might help you set intentions related to spirituality, business, family, relationships, personal finance, and more.
Articulate it clearly
Describe the experience you believe the intention will create for you, Ferry says. It may be joy, peace of mind, safety, confidence, security, fun, or play.
“That word or phrase is your most cherished experience,” he says. “Now modify your intention to have that experience first and foremost.”
And try limiting your intention to one simple sentence with that word.
Write it down
Try to start each day by writing out your intention in a journal ten times, Hokemeyer recommends. Consistency and repetition are important.
Your intentions need to be clear and your efforts consistent, broken down into very small and attainable goals, according to Hokemeyer.
Ferry says that over the last 26 years, he recognized a pattern with his clients. Those who write down and review their intentions regularly increase their probability of completing them by about 70 percent, he estimates.
“If you knew 70 percent of your intentions would become reality, wouldn’t you be more inspired to do that?”
Keep your eyes and ears open
After picking and setting a clear intention and writing it down, the next step is to implement it into your life.
“Live each day actively looking for signs that you are manifesting your intention,” Hokemeyer says. “The key is to actively look and to keep your expectations low.”
Try to start each and every day with your intention.
Give it time
Remember, slow and steady wins the race.
“You are in this for the long haul,” Hokemeyer says. “You want your intention to manifest slowly and incrementally; this means it will last.”
Be gentle with yourself during this process. Especially since there’s a probability that not every intention will work, Ferry explains.
“Life is experimenting through you to find the best way to live,” he says. “Every intention is an experiment. It’s not a truth. You don’t know the future.”
Examples of intentions
If your goal is to be more positive on a daily basis, your intention would be, “I intend to wake up with a positive attitude,” for example.
Here are some other examples of intentions that might spark your own.
- I intend to wake up with a positive attitude
- I intend to embrace activities outside my comfort zone
- I intend to be loving and kind to my coworkers
- I intend to make exercise a priority
- I intend to prioritize my peace of mind
- I intend to forgive others, and myself
- I intend to do something fun today
- I intend to keep a promise to myself today
- I intend to meditate today
- I intend to accept help
How to keep intentions
The best way to keep intentions and stick to them is to understand that all your behaviors, habits, and rituals began inside of a structure, Ferry explains.
“Something outside of you created the disciplines,” he says. “As you get older, all those support systems like parents, school, or church become optional.” Now you can implement new structures to keep your intentions in place.
Things that will help you keep your intentions and move forward are joining groups that keep you accountable and tracking your progress. That might mean joining a running group or using something like the Streaks app to track how often you meditate, for example.
“Consistently remind yourself of your intentions and participate in things that make you happy and help you achieve your goals and reach success,” Hafeez says.
Still, Hafeez highlights we are all human. It’s OK if you occasionally stray away from your intentions.
“Don’t be too hard on yourself,” she says. “Simply identify that you drifted away from your intentions.”
After, try your best to redirect your focus back to your intentions. Hafeez recommends stating your intentions aloud daily to remind yourself of your purpose.
Reasons to set intentions
Setting intentions is beneficial in more ways than one.
Learn how to respond, not react
Hokemeyer says setting intentions helps people respond to life’s events rather than react to them. He says this is particularly important for people who suffer from a host of anxiety disorders ranging from panic disorders to generalized anxiety.
“For these individuals, uncertainty has a pernicious effect on their sense of safety in the world,” Hokemeyer says.
“Living an intentional life provides them with order and direction, two critically important qualities that serve to radically reduce levels of anxiety.”
Intentions allow people to be more compassionate with themselves and others, according to Hokemeyer.
“They enable us to channel our emotional, physical and spiritual resources towards a goal that is focused on our personal conceptualization of ‘better,'” he says.
In this process, people cultivate compassion for themselves, other people, and the world.
(Here are the benefits of being nicer to yourself.)
Setting intentions could move people out of feeling stuck.
“Eighty percent of the patients who come to me are stuck in a key area of their life,” Hokemeyer says. It may be a job, a toxic relationship, or a defeating mindset.
“The setting of intentions gives us a goal out of stuck to live and work for,” he adds.
Receive a dose of inspiration
“Human beings have the ability to modify and optimize their life and their existence,” Ferry says.
Setting your intention to have things be the way you want is empowering, inspiring, and uplifting.
Setting your intention gives you a higher degree of control over your life, according to Ferry.
“You can organize your life to ensure you are comfortable and your preferences are met,” he says.
“Setting your intentions and running the experiments to make them happen leads to a life of wonder, curiosity, and fulfillment.”
Attract what you desire
Setting intentions helps you start living life on your own terms or the way that you want. It’s not a silver bullet, or a guarantee, but setting your intention pushes the probability into the direction of your intended outcomes, according to Ferry.
“It’s easy to live by what you believe you should be doing,” Hafeez says. “Meanwhile, intentions allow you to concentrate on what you want to be doing.”
More happiness will come from doing things that bring you joy, rather than doing something that you believe is expected of you, she says.
Live in the moment
Setting intentions helps you focus on how you feel in the moment, and directs your mind away from thinking about your problems, according to Hafeez.
“Setting daily intentions allows you to bring a purpose to your actions which ultimately is a very effective way to achieve success,” she says.
Next, check out the ways reframing your thoughts can change your life.
Why pineapple is an underrated smoothie ingredient
Love eating a bowl of pineapple chunks? I know I do, and I wanted to share one of the best pineapple recipes with you. (Read on for more details.)
Nothing screams delicious treat quite like this tropical fruit—which also happens to taste amazing when blended into a pineapple smoothie.
Where do pineapples come from? Originally from South America, Christopher Columbus and Sir Walter Raleigh wrote about pineapples, and in the 1500s, the Portuguese introduced the pineapple to Africa, India, and other parts of the world.
Today, the pineapple is grown in India, China, Brazil, Costa Rica, and Thailand, as well as other countries.
Benefits of pineapple
No doubt you’re familiar with the tangy sweetness of pineapple. But do you also know about the health benefits of the fruit?
“A one-cup serving of pineapple offers a healthy dose of vitamin C,” says Elysia Cartlidge, a registered dietitian in Ontario, Canada.
“This not only helps improve your immune function but can also assist the body in the formation of collagen, a key contributor to wound healing.”
One cup of pineapple provides 79 milligrams of vitamin C, which is 88 percent of the daily value (DV).
You get beneficial minerals, too.
“One cup of this fruit provides an excellent source of manganese, a mineral that plays a key role in the health of bones and tissue,” says Cartlidge. You’ll also find bromelain in pineapple.
“This group of enzymes can aid with digestion and has anti-inflammatory and cancer-fighting properties,” adds Cartlidge.
Why this pineapple smoothie is so awesome
If you love pineapple recipes, you’ll truly enjoy sipping this pineapple smoothie. And now that you know of the many reasons to love pineapple, let’s talk about why you should whip up this delicious pineapple smoothie from Cartlidge.
“The combination of the coconut milk, banana, and frozen pineapple results in a rich and creamy taste and texture that’s ultra-cool and refreshing,” she says.
“The fruit provides just the right amount of sweetness so that no additional form of sweetener is required.”
Add an umbrella straw to a smoothie, and pretend you’re sipping a piña colada.
“If you’re looking to escape to an island in your backyard, this smoothie will help you do it as it has tropical vibes in every sip,” says Cartlidge.
“The flavor resembles that of your classic piña colada but without the added sugar.”
(Here’s what to know about pineapple calories.)
Nutrition of this pineapple smoothie recipe
Per each serving of this pineapple smoothie, you’ll get the following. Note that the nutrition info does not reflect optional ingredients.
- Calories: 160
- Fat: 1 gram (1 percent DV)
- Saturated fat: 1 gram (1percent DV)
- Sodium: 86 milligrams (4 percent DV)
- Carbohydrates: 40 grams (15 percent DV)
- Fiber: 4 grams (14 percent DV)
- Sugar: 34 grams
- Protein: 2 grams
- Calcium: 109 milligrams (8 percent DV)
- Iron: 1 milligram (6 percent DV)
- Potassium: 369 milligrams (8 percent DV)
Why this pineapple smoothie recipe is healthy
You already know why eating pineapple is good for you. Now, let’s talk about the other ingredients in the pineapple smoothie.
The smoothie recipe also contains bananas.
“Bananas are a source of potassium and magnesium,” notes Cartlidge.
“The combination of potassium and magnesium, along with the carbohydrates, makes bananas an optimal pre- or post-workout option for athletes—as they provide energy while also helping to reduce risk of muscle cramps.”
And bananas, like pineapple, boast fiber. “The fiber found in bananas can help keep you regular and prevent constipation,” says Cartlidge.
You’ll also find coconut milk in this smoothie recipe.
“Coconut milk contains vitamin C and vitamin E, which can help to boost the immune system,” says Cartlidge. And coconut milk contains lauric acid.
“This component helps protect against many viruses and infections, as it has anti-viral and anti-fungal properties,” she adds.
Benefits of nutrients in this recipe
In just one serving of this pineapple smoothie, you’ll get four grams of fiber.
“This can leave you feeling fuller for longer, so you’re less likely to overeat at meal times and give in to cravings,” says Cartlidge.
“Dietary fiber can also promote regularity and lower cholesterol levels—and can aid in achieving a healthy weight.”
The smoothie provides benefits for your exercise routine, too.
“If consumed post-workout, the quick-absorbing natural sugars from the fruit can help replenish glycogen stores,” adds Cartlidge.
“If you choose to add in protein powder, this can help rebuild and repair the muscle that has been broken down during your workout.”
Other substitutions to make
This recipe already fits various needs—it’s vegan, dairy-free, and gluten-free. But that doesn’t mean you can’t play around with the ingredients.
“If desired, you can substitute the coconut milk with another milk alternative such as soy or almond milk,” says Cartlidge. “However, this may alter the taste and texture of the smoothie.”
How to blend this pineapple smoothie
- 2 cups frozen pineapple chunks
- 1 medium overly ripe banana, sliced
- 1 ¼ cups canned coconut milk
- 1 scoop protein powder (optional)
- Dried and shredded unsweetened coconut flakes (optional)
Add all ingredients to a high-power blender. Gradually turn the blender up to high speed, and blend until smooth and creamy.
You may wish to add the frozen fruit in small batches and/or add additional liquid if the blender is having trouble breaking down the fruit.
For best results, serve immediately, topped with a sprinkle of coconut if desired. It makes four servings.
Ready to cook more with pineapple? Try these recipes: