How I Stick to a Heart-Healthy Game Plan

Reviewed by Brunilda Nazario, MD on October 22, 2020

By Jenny Petz, as told to Hallie Levine

For the first 3 decades of my life, I never thought much about my diet. Then, at age 32, I sat down to nurse my 8-day-old son and noticed that I was dizzy and that my left arm had begun to tingle. When I stood up, I collapsed. I was rushed to the emergency room. It turns out I had a heart attack. One of my arteries was almost completely blocked due to high cholesterol.

I’ve since learned I have a genetic form of high cholesterol. My doctors put me on medication. They also warned me that to see real improvement, I would need to dramatically alter my diet, too. Over the last 13 years, I’ve made some easy but important changes.

A Real Wake-Up Call

It shocked me to learn that at the time of my heart attack, my total cholesterol was over 300. Up until then, I’d never thought about my diet or exercise routine. I was very skinny and always ate whatever I wanted, which usually included a lot of red meat. But I was so frightened I went to the other extreme. I became a vegetarian, and cut out all processed food, refined carbs, dairy, and saturated fat.

I spent the next 2½ years measuring everything that went into my mouth. My cholesterol was great -- under 160 -- but I was miserable. It didn’t seem healthy to obsess over every morsel. I decided it was time to relax some of my eating habits.

How I Found a Middle Ground

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photo of ashley
Drop LDL With More Fiber, Less FatThree times a day, 21 times a week, registered dietician Ashley Reaver can directly impact someone’s life. And while there’s a big focus on weight loss in our country, she says you can lower your cholesterol at the same time. What are the keys to success? 233



I'm a registered dietician.

I own a private practice

in Oakland, California,

and I teach at the University

of California, Berkeley.

I love being a dietician

and helping people

with their nutrition,

because it is an opportunity

three times a day,

or 21 times a week,

that you can directly impact

someone's life,

and their long term health.

High cholesterol is something

that is incredibly

prevalent in the US.

95 million Americans have

high cholesterol,

and cardiovascular disease

is the number one cause

of death.

So I have oriented my career

around cholesterol, because I

don't think that the resources

are available to help

this large population of people

lower their cholesterol levels

and prevent

that cardiovascular disease.

I think in the US in particular,

there is a humongous focus

on body weight.

And often, I find

with my clients,

even if they know the types

of foods

that they're supposed to be

eating for their cholesterol,

they are distracted

by the latest weight loss diet.

You can lower your cholesterol

and lower your body weight

at the same time.

Eating a diet that has more

fiber in it,

has more plants in it,

has less fat in it,

is also a diet that supports

lowering your body weight.

Oftentimes, those diets that are

weight loss diets, they are not

supportive of lowering

your cholesterol.

Fad diets usually are increasing

saturated fat and decreasing

soluble fiber.

A diet to lower your cholesterol

really should be trying

to increase that soluble fiber

and drop that saturated fat.

Soluble fiber is the type

of fiber that swells when it

comes into contact with water.

So oats, beans, whole grains,

chia seeds.

Those are things that really

should be in your diet

at least once every single day.

The other big factor

for cholesterol

is lowering the intake

of saturated fats.

And saturated fats primarily

come from animal products.

And it absolutely doesn't mean

that every single person needs

to be a vegan, that you can

never have ice cream or steak


It's just balancing how they fit

into your diet.

The key to a sustainable diet

is not deprivation, it really

is moderation.

It's finding a balance

of including all of the foods

that are going to be really

important for your health, as

well as dropping

in, occasionally, the foods that

maybe aren't

the best for your health,

but maybe satisfy other needs

that you have as well.

Fried chicken, as an example,

is probably not something

that you should have

multiple days a week.

But if that is your mom's

specialty, and when you go home,

she loves preparing that

all day, there has to be

some sort of concession

there where you can still get

enjoyment out of your food

without necessarily taking it

to the extreme where it

negatively impacts your health.

A healthy diet is one that you

can really stick

with for the rest of your life.

It is not something that you

start knowing that you can only

do it for a short period

of time.

It's one that satisfies you,

not only nutritionally,

but also emotionally

and mentally.

Crash diets, or fad diets,

promise very fast results,

and you often do see results

a lot faster.

Always, though, the downside

of any of those stricter types

of diets is that if you can't

maintain the diet,

you're also not going

to maintain the results

of that diet.

Eating more fiber and less

saturated fat

takes longer to lose weight,

but it's more of a sustainable

weight loss.

Food is just fuel in your body.

Stop putting so much emphasis

on things being perfect.

Good enough is really, really

good enough.

Taking a step

in the right direction,

making progress

towards your goals, is also more

important than not being

able to be perfect,

and then just deciding not to do

something at all.

Ashley Reaver<br>Registered Dietician /delivery/aws/fb/60/fb603c9c-888a-4048-9860-b083c6de28b3/696320f0-b9ce-4885-bf48-7db79309996b_funded-perspectives-advocate-high-cholesterol-ashley_,4500k,2500k,1000k,750k,400k,.mp412/21/2020 09:34:0018001200photo of ashley/webmd/consumer_assets/site_images/article_thumbnails/video/funded_perspectives_advocate_high_cholesterol_ashley_video/1800x1200_funded_perspectives_advocate_high_cholesterol_ashley_video.jpg091e9c5e820b0d69

Rather than cut out entire food groups, like meat, whole grains, or dairy, I decided to scale back on saturated fat and beef up my fruit and veggie intake. I discovered cauliflower rice, which is low in calories and packed with heart-healthy nutrients. I’ve also opted for dairy-free yogurt. This is more flavorful and is rich in probiotics that may improve heart health since they help lower blood pressure. When I throw burgers on the grill for my family, I make mine a turkey burger.

I’ve also made some easy tweaks when I cook, too. I’ve found a chocolate chip cookie recipe that replaces flour with chickpeas. (Some research shows that chickpeas can help lower cholesterol levels.) Tofu is a great source of heart-healthy protein -- I’ve found that if I toss tofu with oriental seasonings, coat it with cornstarch, and bake it in the oven, it’s delicious and crispy.

How I Indulge

I’ll admit, I have my weak moments: I’ve never met a nacho I don’t love. When I splurge, I opt for comfort foods like cinnamon rolls or pizza paired with a good craft beer. The truth is, I love food. You have to live and enjoy a good meal now and then. But they’re a weekly indulgence, not an everyday occurrence.

My Biggest Healthy Eating Challenge

If I get hungry, I’ll eat anything in front of me, so I try to only stock my fridge and pantry with healthy snack foods, like yogurt, low-fat granola, and fresh fruit. It’s tough not to have junk food with two teens, though. I try to buy single small packages of things like cookies or chips to limit the damage.

My Exercise Routine

Exercise is key when you have high cholesterol, because it raises levels of your HDL (good) cholesterol and lowers triglycerides. Before my heart attack, I rarely exercised. Once I “graduated” from cardiac rehab, I felt confident enough to work out on my own at home and bought an elliptical trainer. Every day, I would ride it a little faster, harder, and longer. I felt a sense of pride going from 5 minutes to 10 to 15 to ultimately a full hour.

Now, I focus more on everyday activities with my kids to stay active. I do go to my gym two to three times a week for an interval training class. I also go for a 20- to 30-minute walk most days of the week and try to do something outside with my kids every day. Sometimes it’s a bike ride, or Frisbee, or throwing a softball around. But it feels less like work when it’s a family activity.

Other Heart-Healthy Habits

I have a high-strung, type A personality. But my doctors have made clear to me that stress raises my risk for heart disease. I tried anti-anxiety medications for a while, but I didn’t find them helpful. What does work? I make sure I take some time for myself. Sometimes I just sit on my couch and watch Netflix, or sometimes I unwind with a hot bath, or sometimes I just take some deep breaths.

Sure, it’s hard to stick to a heart-healthy diet and exercise plan, but I tell myself it’s all about the small, doable changes. It’s about doing the best you can.

WebMD Feature


Jenny Petz, Omaha, NE.

American Heart Association: “Eating probiotics regularly may improve your blood pressure,” “Soy-rich foods like tofu may help lower heart disease risk.”

University of Toronto: “Lowering cholesterol by eating chickpeas, lentils, beans and peas.”

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