Dear Dietitian


Dear Dietitian,

I have high cholesterol, and I am underweight. My total cholesterol is 260; my LDL-cholesterol level is 150. I am 5’6” and weigh 110 pounds. Is it possible to gain weight and lower my cholesterol at the same time?



Dear Paula,

You have identified two goals that, at first glance, appear to be opposites. We generally associate high cholesterol with being overweight or with an unhealthy diet. In case some readers need a review of cholesterol terms, low-density lipoprotein (LDL) is often called “bad” cholesterol, while high-density lipoprotein (HDL) is referred to as “good” cholesterol.

The best way to achieve weight gain while lowering LDL is simply to eat larger portions of healthy food. You will need to take in at least 300 extra calories every day. You may choose more fruit, lean proteins, and whole grains. Continue to eat healthy, unsaturated fats, and consume less saturated fats (animal fats). Limit refined carbohydrates and sugar.

One way to get extra calories is to drink a smoothie or a protein shake before bedtime. These shakes are a delicious, easy avenue for weight gain. You can find hundreds of smoothie recipes on the internet.

Monounsaturated fats include olive oil, canola oil, nuts, avocados, nut butters, olives, and peanut oil. Polyunsaturated fats are found in corn, safflower, and sunflower oils. Omega-3 fatty acids are also included in this category, found in walnuts and fatty fish like salmon, mackerel, trout, and sardines.

The next strategy is to raise your HDL level. Increasing your HDL will help lower your LDL cholesterol. Health experts believe that HDL acts as a house cleaner by “sweeping up” some LDL particles and carrying them back to the liver for disposal. The best way to increase good cholesterol is through exercise - just 20 minutes of moderate exercise at least four times a week.

It is also essential to avoid trans fats. While trans fats have been banned in the US, a food manufacturer is allowed to claim zero trans fat on the nutrition label even when there are 0.5 grams of trans fat per serving. If you consume only one serving once in a while, there is no problem. Look out for partially hydrogenated oils (PHOs) on the ingredients list, as these are trans fats.

Finally, consider seeing a Registered Dietitian Nutritionist (RDN), who will work closely with you to help you reach your goals. Most insurance plans pay for an RDN consult, and your doctor will provide a referral for you.

Until next time, be healthy!

Dear Dietitian

Leanne McCrate, RDN, LD, is an award-winning dietitian based in St. Louis, Missouri. Her mission is to educate consumers on sound, scientifically-based nutrition. Do you have a nutrition question? Email her today at Dear Dietitian does not endorse any products, health programs, or diet plans.