High cholesterol and its implications

Cholesterol is a vital molecule- a naturally occurring, fatty waxy compound, made by the liver and required by the body (in humans and animals) for the proper function of cells, nerves, and hormones. The body uses cholesterol to produce hormones (oestrogen, progesterone, testosterone, cortisol), vitamin D and fat digesting bile acids.  It is also an integral component of every cell membrane and forms part of the myelin sheath around nerve fibres. In excess it can build up and form plaque deposits on artery walls. This plaque narrows and hardens arteries and reduces blood flow. If plaque continues to build long term it significantly increases the risk of having a heart attack or stroke.

The proteins that carry the cholesterol throughout the blood stream are called lipoproteins. A lipoprotein is a vehicle that which transports fats including cholesterol around the body in the blood stream. Because blood is mainly water and water and fat don’t mix, these transport vehicles are covered in a thin coating of protein which is water soluble. (lipo means fat/ protein is the coat). They are named according to the proportion/ratio of fat to protein.

• LDL- low-density lipoproteins- is known as the bad cholesterol because it is low in proteins and high in cholesterol/fat and are less dense that HDLs. Their job is to distribute cholesterol & fats around the body. As they deposit cholesterol around the body they are thought of as “bad”. Also, cholesterol in LDLs can become oxidized by free radicals & when it ends up in the artery walls it creates plaques. This can narrow arteries (and raises blood pressure) and can also peel away blocking arteries causing strokes & heart attacks. 
• VLDL- very low-density lipoproteins also deposits cholesterol around the body and contains triglycerides (a blood fat). These can enlarge the LDLs and increases their potential to narrow the blood vessels.
• HDL- high-density lipoproteins- is high in proteins and low in cholesterol and therefore known as good cholesterol. Their job is to return the cholesterol/fats to back to the liver to be excreted as bile.
• Triglycerides- Triglycerides are a separate lipid (fat) in the blood stream that provide a way for the body to store excess energy, but if they are high is another warning sign when paired with high LDL

The important thing to watch is the ratio of ‘good’ and ‘bad’.  Total cholesterol to HDL ratio should be no higher than 4:2. A ratio below 3.5:1 is considered good.

What causes it?

• Diets high in sugar & refined carbs; processed foods, e.g. store bought baked goods, junk food, fried food, pizza.
• Sedentary lifestyle with little or no exercise
• Carrying excess weight
• Stress- Cortisol (a stress hormone) is made from cholesterol. Increased stress can mean more cortisol is released and more cholesterol required to make it.
• Genetics – it can be familial and inherited.

Guidelines

• Increase soluble fibre- e.g., 35g soluble fibre daily such as oats and oat-bran, kidney beans, apples, pears, prunes. This lowers LDL cholesterol and reduces absorption of cholesterol into blood stream or reabsorbed from the intestines. It ‘chelates’ or holds on to the cholesterol and eliminates it via the bowel. One or two tablespoons of any of the following fibre supplements can help daily – psyllium, pectin, chia seeds, oat bran, rice bran, barley bran.
• Include foods known to have cholesterol lowering effects such as artichokes, ginger, banana, onion, garlic, legumes, oranges, apples, carrots, barley, grapefruit, melons, oatmeal, cucumber (any food with pectin is good)
• Reduce trans-fats and saturated fats from diet and junk food, processed foods etc.
• Cook with extra virgin olive oil which has antioxidants that help lower LDL & preserve HDL
• Choose lean meats and avoid marbled fatty cuts and trim fat off. Remove chicken skin.
• Add omega 3 fatty acids via fish, some plants and nuts can help lower triglycerides.
• Moderate alcohol intake -1 glass daily for women and 2 for men can raise HDL.
• Look for plant sterols in foods as they help block absorption of cholesterol (displace cholesterol from intestinal micelles).
• Losing weight- can help lower cholesterol
• Increase exercise- will lift HDL levels but lower bad cholesterol. Aerobic is best, increasing heart rate.
• Don’t smoke
• Address stress and anxiety, via exercise, meditation, recreation or counselling

Diets

• Mediterranean diet – it’s not a fad, it tastes good, it’s flexible, and adaptable and recommends minimally processed foods; olive oil as a fat source; seasonally fresh fruit, vegetables, legumes, seeds and nuts etc; plus low to moderate amounts of dairy; (cheese, yogurt); fish; poultry and eggs; low amounts of red meat; and low to moderate wine preferably red.
• Pritikin diet which has been around for years and has helped many.
• Mayo Clinic Diet- recommends high fibre foods, fish and lots of omega 3 foods, nuts etc., plus exercise and portion control.
• Vegetarian, vegan and flexitarian diets are all used as well.
• DASH diet if you have hypertension as well.

Natural supplements – some suggestions that can be helpful

• Include garlic, herbs like St Mary’s Thistle, dandelion root, celery seeds and globe artichoke
• Betaglucare sachets– contains beta-glucans from oats
• Red rice yeast – traditional Chinese medicine- used for more than 2000 years
• Vitamin B3 or Niacin lifts HDL & lowers triglycerides (levels require a prescription) 1000-3000mg at night.
• Vitamin C can reduce serum LDL levels
• Vitamin E to protect against LDL oxidative damage
• Grape seeds and pine bark extracts contain antioxidants that are protective against damage.
• Magnesium and potassium for CVD function
• Ginkgo improves circulation.
• Garlic supplements- 10mg of alliin or a total allicin potential of 4000mcg.
• Add omega 3 fatty acids supplements which can help lower triglycerides (1000 EPA+ DHA daily recommended for CVD protection, but lowering triglycerides it is 3000 EPA+DHA))
• Pantethine (stable form Pantetheine) the active form of B5 (pantothenic acid). Pantethine can lower lipids at 900mg daily.

See your health practitioner for guidance in reducing cholesterol.