A Few Tips On Managing Cholesterol

Understanding Cholesterol

Although it has earned itself a bad reputation, cholesterol plays some essential roles in proper function of the human body.  Cholesterol is a crucial component of cell membranes and is necessary for the synthesis of vitamin D and steroid hormones (including those that help you cope with stress, as well as those for proper functioning of men and woman). 

Formation of cholesterol plaque in artery

Cholesterol’s reputation is not unfounded.  The association between an elevated low density lipoprotein cholesterol (LDL-C) and developing cardiovascular disease is well known.  Furthermore, research has shown that LDL can become oxidized in vivo and that oxidized LDL is atherogenic (has the ability to initiate or accelerate the deposition of atheromas, calcium, and lips in the lumen of arteries). 

However, although research suggests a possible causal association between having high cholesterol (hypercholesterolemia) and developing cardiovascular disease, reducing serum cholesterol levels may not always result in improved health.  Since cholesterol is a precursor for cortisol and is needed for tissue repair, high cholesterol may be a body’s response to arterial inflammation, injury, or other stressors.  Therefore, practitioners should examine the reasons for their patient’s high cholesterol before driving the cholesterol level below a dictated “set point”.  Such caution may avoid interference with the body’s ability to heal itself and deal with various stressors. 

Below is a list of dietary suggestions to consider when your doctor has determined it is time to manage your cholesterol.

Food to Avoid:

Eggs: The majority of studies have shown that regular consumption of eggs (up to 28/wk) has no significant effect on serum cholesterol levels. However, because each person is different, some people do show substantial increases in serum total and serum LDL-C levels while eating eggs.  Therefore, it is important to speak with your naturopathic physician to decide if eating eggs is appropriate.

Trans Fatty Acids: Consumption of trans fatty acids has been shown to increase levels of LDL-C and decrease levels of HDL-C.  Furthermore, consumption of trans fatty acids has been associated with an increased risk of cardiovascular disease in humans.  Therefore, they are to be avoided. Examples include: Margarine, high-fat baked goods (especially doughnuts, cakes, and cookies), products for which the label says “partially hydrogenated vegetable oils”, French fries, potato chips and many crackers and corn chips. 

Sugar: The consumption of sugar, a refined carbohydrate, leads to an elevated level of insulin in the body.  Higher insulin levels are associated with an increased risk of cardiovascular disease due to its ability to raise the levels of cholesterol, triglycerides and blood pressure.  Therefore, it is wise to decrease all sources of refined sugar, including desserts, pastries, candies, white bread, sweetened cereals, and any other foods containing refined carbohydrates.

Beef: Some studies have shown that beef greatly increases cholesterol levels, while others have not.  However, an association between cardiovascular disease and beef has definitely been found.  This is most likely due to the formation of advance glycation end products and cholesterol oxides, rather than due to its effects on cholesterol levels. Therefore, consuming beef may be bad for your heart, regardless of whether or not it increases your cholesterol level.

Cheese: Is high is both saturated fat and cholesterol. Although it also contains vitamin K2, which may help prevent arterial calcification, avoiding cheese until cholesterol levels normalizes is suggested.

Coffee: Studies have shown that consumption of both filtered and unfiltered coffee increases serum total and LDL levels (although unfiltered seems to cause more of an increase). 

Foods to Include:

Monounsaturated Fats: The most important example here is olive oil.  Monounsaturated fats have been found to not only reduce serum total and  LDL-C levels, but olive oil specifically has also been found to inhibit LDL oxidation (oxidized LD is atherogenic).  Furthermore, olive oil is less likely to reduce HDL levels. Other examples of monounsaturated fats are avocados, nuts, and seeds.

Nuts: Walnuts, almonds, pistachios, hazelnuts, pecans, and macadamia nuts have all been shown to have a beneficial effect on cholesterol levels.

Seeds: Sesame seeds have been shown to reduce LDL levels. This effect may be due to the presence of sesamin in sesame oil.  Studies of rats have shown that sesamin inhibits both HMG-CoA reductase activity and cholesterol absorption. 

Dietary Fiber: Certain types of dietary fiber help reduce cholesterol levels. Water-soluble fibers such as pectin, psyllium and beta-glucan from oat bran are more effective than insoluble fiber, such as wheat bran. Soluble fibers may lower cholesterol levels by increasing fecal excretion of bile acids, which results in increased conversion of cholesterol to bile acids in the liver.

Oat Brain: As mentioned above, the cholesterol-lowering effects of oat bran may be due to a component called beta-glucan.  Oat bran binds bile and cholesterol in the intestines and promotes their excretion.  This action helps raise HDL levels, the "good" cholesterol, and lower LDL.

Barley: Like oats, barley contains beta-glucans. In addition, barley also contains d-alpha-tocotrienol, which reportedly inhibits cholesterol synthesis. 

Other Suggestions:
Meal Frequency and Pattern: Eating breakfast, eating smaller, more frequent meals, and having a regular eating pattern (i.e. same number of meals each day), may all lower serum total and serum LDL-C levels.

Fish Oil: Most studies have shown that fish oil supplementation did not decrease serum total or LDL-C levels.  However, it has been reported to lower triglyceride levels and has a number of positive cardiovascular effects. Therefore, it would be suggested to take fish oil as a means of preventing cardiovascular disease, but not for reducing cholesterol levels in particular.

Supplements:

There are a number of supplements that may be employed if diet alone does not achieve wanted results.  This area can be explored with your naturopathic physician after at least a one month trial period of dietary intervention.