Recent updates to the American Heart Association/American College of Cardiology guidelines reinforce something functional medicine has long emphasized: heart health cannot be understood from one cholesterol number alone.
Today, we look beyond LDL cholesterol to consider triglycerides, ApoB, lipoprotein(a), family history, metabolic health, coronary artery calcium and more.
The good news? Lifestyle still matters—a lot. Your physician can help you understand your overall cardiovascular risk, while many of the factors that influence that risk are affected by the choices you make every day.
1. Don’t fear fat—focus on quality
Not all fats are “bad,” and carbohydrates matter too.
Limit foods high in saturated fat, added and refined sugars, sodium and ultra-processed ingredients. Instead, choose plenty of vegetables, fiber-rich foods and healthy unsaturated fats from foods like avocado, olives, olive oil, salmon, nuts and seeds.
Think less about eliminating fat and more about choosing whole, minimally processed foods most of the time.
2. Pay attention to triglycerides and metabolic health
Elevated triglycerides often go hand-in-hand with insulin resistance, fatty liver, abdominal weight gain and increased cardiovascular risk.
Ask your doctor whether triglycerides and ApoB should be part of your next lab evaluation. Supporting healthy levels starts with simple habits: eat plenty of fiber, limit added sugars and refined carbohydrates, moderate alcohol and prioritize regular movement.
3. Move consistently
Exercise can improve triglycerides, insulin sensitivity, blood pressure and overall cardiovascular health—and you don’t need a punishing workout to benefit.
Walk regularly and include some resistance, flexibility and balance work each week. Even a 10–15 minute walk after meals can help support healthy blood sugar.
Need help staying consistent? Make a specific plan, write it down and consider recruiting a friend, family member or trainer for accountability.
4. Protect your sleep and manage stress
Heart health is about more than diet and exercise. Poor sleep and chronic stress can contribute to higher blood pressure, impaired blood sugar regulation, inflammation and insulin resistance.
Aim for 7–9 hours of restorative sleep and find stress-management strategies you can actually stick with—walking, breathwork, meditation, yoga, time outdoors or simply creating more downtime in your day.
5. Know your individual risk
Your cardiovascular assessment may also include:
- ApoB
- Lipoprotein(a)—ideally checked at least once in adulthood
- Family history
- Blood pressure and metabolic health
- Coronary artery calcium scoring
The goal isn’t simply to “lower cholesterol.” It’s to understand your unique cardiovascular risk and create a realistic plan to reduce it over time.
Make an appointment with your Carolina Total Wellness physician and health coach to better understand your numbers and build a personalized plan for long-term heart health.
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