Everyone knows high cholesterol is not good. High cholesterol often leads to atherosclerosis, or plaque buildup on the inner walls of your arteries, which can block the flow of blood and is a major contributing factor to heart disease, stroke, and peripheral vascular disease, a circulatory disorder.

High cholesterol usually refers to high LDL cholesterol, or low-density lipoprotein. This is known as the “bad” cholesterol. By contrast, HDL, or high-density lipoprotein, is considered “good” cholesterol and can lower your risk for heart disease and stroke.

Our understanding of diet and what foods help to lower LDL cholesterol is continuously evolving and can sometimes be confusing.  For those seeking to lower their cholesterol, Theresa Halloran, FNP-BC, a Nurse Practitioner at Mount Sinai Heart, has some simple suggestions. These can help you make better, healthier choices, like switching out that chip and dip snack for veggies and hummus. And they still taste great.

Eggs

Egg yolks are high in cholesterol. Eggs are still a healthy source of protein, and it is more important to reduce foods high in saturated fat than foods containing cholesterol. One suggestion: If you have two scrambled eggs for breakfast, discard one yolk. Or use egg whites from a carton and add some fresh vegetables to make a healthy omelet. Egg whites contain no fat and no cholesterol. Substitute two egg whites for one egg in recipes.

Meat, poultry, and seafood

We suggest a maximum of two servings of meat, chicken, or seafood in your diet daily. Red meat, such as beef, lamb, or pork, contains saturated or unhealthy fat. Those seeking to reduce their cholesterol should consider limiting the amount of saturated fat in their diet by reducing or eliminating red meat. Another good option is choosing lean cuts and trim any fat before eating. White meat chicken contains less saturated fat than the dark meat and chicken skin is high in fat. The best option for eating chicken is skinless chicken breasts. Fish and seafood, such as crab, shrimp, clams, scallops, or lobster, are low in saturated fat. But note that six shrimp have the equivalent cholesterol of one egg yolk, and squid is even higher in cholesterol, so have them only occasionally.

Oils and fats

Healthy fats, such as mono-saturated or unsaturated fats, are found in cold water fish such as salmon, mackerel, tuna, sardines, and herring. They are also found in some plants like avocados. Be sure to include some of these foods in your diet. Baking or broiling are low-fat cooking methods. When ordering in restaurants, choose foods cooked with these low-fat methods. If cooking at home, use healthy fats such as olive oil, and reduce or eliminate butter, which is high in saturated fat.

Milk, dairy desserts, and cheese

Use skim milk or one percent milk rather than whole milk. Sorbet, low-fat frozen yogurt, and ice cream made from skim milk are good substitutes for regular ice cream. Low-fat cheeses with no more than 2 to 3 grams of fat per ounce may be substituted for regular cheese.

Fiber

There are two main types of fiber: soluble and insoluble. Most high-fiber foods contain both.

• Soluble fiber helps lower cholesterol. When mixed in water, soluble fiber forms a gel. It binds with cholesterol in the intestines and prevents absorption or reabsorption of the cholesterol into the blood stream. The cholesterol then gets eliminated. Foods that are high in soluble fiber include oatmeal; hummus; legumes such as kidney beans, lima beans, and lentils; and Brussels sprouts.
• Insoluble fiber is most important for the health of your intestines. It helps to remove toxins from your body and is found in cereals, leafy greens, whole wheat products, corn, seeds, and nuts.

Key takeaway: Read the label on the package. If it doesn’t specifically say soluble fiber, it probably isn’t.

Whether you are just starting to work out or committed to a regular workout program, the right nutrition can help you feel better, recover quicker, and get more out of your workouts. Brittany DeLaurentis, RD, CDN, a Clinical Nutrition Coordinator at Mount Sinai West and Mount Sinai Morningside, provides some valuable tips on what to eat before and after your workout.

Should I eat before a workout?

You definitely don’t want to go into your workout feeling hungry. However, you don’t want to have a large portion or eat the wrong things, otherwise you may feel fatigued or groggy during your workout. It also matters how soon you plan to work out after eating. For example, if you have a light meal or a snack—like a banana, an energy bar, or a smoothie—I’d recommend postponing your workout for one to three hours. If you have a larger meal, you want to wait a full three or four hours, just to make sure that the meal is well digested. In the morning, I’d stick to a small meal or a snack—just so you’re in that shorter window of one to three hours.

What foods would you recommend eating prior to a workout?

Make sure that you’re loading your body with carbohydrates. That said, the type of carbohydrates really matters. So choose complex carbohydrates—like a piece of whole grain toast or some whole grain cereal—over simple carbohydrates—like candy or packaged baked goods. It’s important that you choose complex carbohydrates, because simple carbohydrates can cause your body to crash and burn from the sugar high.

What about the trend of taking a scoop of dry protein before a workout?

Dry scooping is a very dangerous trend. Many protein powders have a large amount of caffeine. For comparison, a single scoop can have 200 mg caffeine as opposed to 65 mg in a small cup of coffee. Ingesting this plain without dilution can cause damage to the heart arteries, which can lead to a heart attack and organ failure. It also should be remembered that protein powders are not regulated by the FDA, so it is difficult to even know what they truly contain.

What foods would you avoid?

High fat foods like fried foods can make you feel bloated and groggy during your workout. And again, avoid simple carbohydrates so you don’t have that sugar high, and then a crash and sudden fatigue.

What drinks would you recommend during a workout?

Water is very important. You want to make sure that you’re going into a workout having had a minimum of two to three cups of water. And throughout the workout, you should also be hydrating. The general recommendation is about a half cup to a full cup every 15 to 20 minutes of working out. And, of course, the amount of hydration needed depends on the weather. If it’s a hot and humid day, you’ll need more.

Also, don’t forget to hydrate after your workout. Avoid sugar-filled beverages like soda or lemonade, and opt for plain water. The recommendation is to drink at least eight ounces of water afterwards. But, if you have completed a more intense workout, such as running, cycling, tennis, you might want to include a beverage that contains electrolytes, like Gatorade.

What foods are best to eat after a workout—and how soon after?

After a workout, you want complex carbohydrates to replenish the glycogen that your body just ran through as well as protein because working out actually breaks down your muscles. The ratio of your post-workout meal should be three to one, with carbohydrates being the majority, and you should eat within two hours of exercising, to replenish your glycogen stores and help your muscles recover.

Examples of post-workout meals could be yogurt and fruit, a peanut butter sandwich, turkey on whole grain bread, oatmeal with protein powder and fruit, or grilled chicken with vegetables. It depends on the time of day—but you want to make sure you’re combining carbohydrates and protein.

How should I change my eating habits, depending on whether I work out in the morning or in the evening?

In the morning, I would recommend sticking to a small meal or a snack. For most people’s schedules, it is probably better to only wait one to three hours before exercising. You also want to make sure that you are drinking water before working out. Also, studies show that drinking caffeine is beneficial before working out, so a cup of coffee is definitely appropriate if you like an early workout.

In the evening, I recommend having a post-workout meal, but make sure that you allow your body time to digest before going to bed. Give your body a good three to four hours before bedtime.

Should I change what I eat depending on whether I’m doing cardio or weightlifting exercises?

If you are doing endurance activities that involve aerobic exercises like running or swimming, your body burns through your glycogen stores more quickly. So you will need more carbohydrates when you are engaging in those types of workouts.

But whether you are doing cardio or weightlifting, you want to have carbohydrates before, and carbohydrates along with protein afterward.

Every day, there seems to be a new diet trend: keto, paleo, Atkins, the Mediterranean diet, or the South Beach diet. To someone trying to lose weight or eat healthier, the choices can be overwhelming. We sat down with Jennifer Cholewka, RD, CNSC, CDCES, CDN, Metabolic Support Dietitian at The Mount Sinai Hospital, to separate myths from facts and to get some guidance as to where to start.

As I look at the wide variety of diets out there, where do I begin?

To your point, diet trends are always evolving and changing. One minute, everyone’s talking about a superfood that’s good for you, and next year, all of a sudden, that food is bad for you and “out.” We’ve seen that with eggs, coffee, fats, carbs, and all kinds of things. But the first thing to ask yourself is, “What’s my goal?” If your goal is weight loss, the answer might be different than if you’re trying to live heart-healthy.

The word “diet” isn’t a great word in the world of dietitians. People see the word “diet” and often think of a quick fix. But we should really be thinking in terms of “lifestyle” instead. Whatever diet you choose, it should be sustainable, obtainable, and reasonable within your current life.

A lot of people are attracted to some of the extreme diets, like keto, Atkins, or paleo, because they want to lose weight quickly. And you will see weight loss quickly, but it’s not something that you can maintain for your life. These diets usually restrict entire food groups, which forces your body to change the way your metabolic processes work. For example, the keto and Atkins diets restrict carbohydrates, including sugars, grains, and certain vegetables and fruits, while the paleo eliminates foods like grains and most dairy products.

Is that unhealthy?

Yes, I think it’s unhealthy. People have a tendency to “yo-yo” with these diets, or in other words, lose the weight and then regain it. Because you’re restricting entire food groups, your body can’t stay on it forever. That’s why the first thing you should think about is, “What is sustainable?”

What do you mean by “sustainable?”

Your lifestyle plays an important role in what type of diet you should follow. For example, intermittent fasting is a very popular diet lately. There are many different types of intermittent fasting, but one example would be to only eat between noon and 8 pm. For many people, that’s not possible because of their work schedule or their home life. The extreme diets we mentioned are not sustainable because they eliminate entire food groups. They force our bodies into unnatural metabolic processes, and you can’t keep it up. That’s why we need to shift our mindset from “diet” to “lifestyle.”

It’s better when a person makes small changes that are manageable and attainable. You probably shouldn’t change every aspect of your diet at once. Maybe you’ve identified that you need to stop drinking soda, decrease fast food consumption, and exercise more. Doing all three of those at once may be overwhelming and frustrating. Implement changes that are doable, and tackle those goals, one by one. And acknowledging your accomplishments is key.

So say my goal is losing weight. What’s the best diet for weight loss?

I’m not a huge fan of any one diet in particular, but if your goal is weight loss, my No. 1 recommendation continues to be Weight Watchers, which allows you to eat all kinds of foods but carefully track what you eat. It has a lot of those things that I view as very important—including balance and portion control. I feel the Weight Watchers approach is very manageable for a lot of different lifestyles. It’s doable whether you work 9-5, work nights, or travel. I find it to be a very reasonable and sustainable approach. You’re able to treat yourself if you want, but you’re encouraged to eat foods that are much healthier, such as lots of fruits and vegetables, and lean proteins. The support aspect of Weight Watchers is also very helpful for people, whether it’s going to an in-person meeting or getting connected to a coach who can help you.

The Mediterranean diet, which focuses on vegetables, fruits, whole grains, seafood, and olive oil, has a lot of pros, as well. It encourages balance; it encourages eating more whole foods; it’s low in processed foods. It also allows alcohol, which is important to some people.

The DASH diet, or Dietary Approaches to Stop Hypertension, is a diet developed through research sponsored by the National Institutes of Health. The DASH diet is similar to the Mediterranean diet and is a low-sodium diet that’s heart healthy. These three diets are almost always the top diets recommended by U.S. News & World Report. Their recommendations are updated every year and they list their top diets for different goals. That’s a good place for people to start.

And if your goal is weight loss, “calories in, calories out” is really going to drive weight loss. So portion control is critical, as is exercise. Again, make small changes that are sustainable. You won’t be able to hit the gym five days a week to start. You might try committing to walk one day a week on the treadmill for 30 minutes. Or walking instead of taking the subway. It sounds small, but you’ll see changes that last over time.

People are always going to look for ways to lose weight as fast as they can and keep it off. But there’s never going to be a quick fix for anything.