High Cholesterol

Cholesterol is a waxy substance that accompanies fat in animal foods and is manufactured in the human body. Many of its functions are necessary for good health. For example, the body uses cholesterol to make vitamin D, bile, sex hormones and the protective myelin sheath that surrounds nerves. Cholesterol in its proper place is good, but it also has a dark side. High blood cholesterol is a risk factor for heart disease because it is a component of plaque that corrodes arteries and eventually impedes the flow of blood.

      The average American has a cholesterol level of 205. About 30 percent of Americans have been told that they have high cholesterol. The risk of a heart attack from high cholesterol is strongest among young and middle-aged men.

      The body makes all the cholesterol it needs. In fact, most of the cholesterol in the body is home-made and not obtained from food. Eating cholesterol will not raise blood cholesterol much because the body will reduce its production. However, most high cholesterol foods are also high in saturated fat. And that's what the body uses to manufacture cholesterol.

      To lower a high cholesterol level you must limit foods that are high in saturated fat as well as trans fat. Saturated fat is found in fatty meats, bacon, sausage, hot dogs, gravies, butter, whole milk products, ice cream and animal fats used for frying. Trans fats are formed when liquid oils are processed with hydrogen gas, transforming them into a semi-solid. Also recognized by the term partially-hydrogenated oil, they are found in margarines, shortening and many snack and convenience foods.

      A study evaluating 80,000 women found that trans fat posed more of a cardiovascular disease risk than saturated fat. Investigators concluded that cutting intake of trans fat by only 2 percent reduces the risk of coronary heart disease by 53 percent. In contrast, lowering consumption of saturated fat by 5 percent reduces risk by 42 percent.

      Traditionally, low-fat diets alone have not been all that effective in lowering cholesterol. What is now known is that it's not just about what you exclude from your diet but also what you include. Foods that have a beneficial effect on cholesterol metabolism are fish, sea vegetables (seaweed), garlic, onions, ginger, soyfoods, green tea, nuts, seeds, peanuts, olive oil, flaxseed, brown rice, barley, oats, avocado, artichoke, cabbage and yams. The Food and Drug Administration has approved heart health claims for soy protein, oats, barley and vegetables, fruits and grains high in dietary fiber.

      Many of these foods contain sterols-compounds that compete with cholesterol for absorption and facilitate its excretion. One study found that a low-saturated fat diet that included almonds, soy protein, psyllium seed fiber and plant sterols was statistically as effective as the cholesterol-lowering drug lovastatin in lowering LDL cholesterol.

      According to a team of Dutch researchers, a "polymeal" consisting of wine, fish, dark chocolate, fruit, vegetables, almonds and garlic if eaten daily, with fish eaten four times a week, could reduce the risk of dying from cardiovascular disease. This finding was a response to the concept of a "polypill"-a drug cocktail containing several medications to lower cholesterol and blood pressure and reduce blood platelet stickiness. The meal was based on the ability of each ingredient to reduce heart disease risk by reducing blood pressure, cholesterol and other risk factors. Effects of the meal on survival were calculated on the basis of data from the famous Framingham heart study and its official off-shoot studies. According to the scientists' calculations, the polymeal would reduce cardiovascular events by 76 percent and increase total life expectancy of men by 6.6 years and that of women by 4.8 years. 

Ten Commandments 

High Cholesterol 

1. Maintain a healthy weight. 

2. Become more active. Exercise raises the level HDLs ("healthy cholesterol"). 

3. Don't smoke cigarettes. 

4. Divide daily calories into three meals plus one or two snacks. 

5. Limit saturated fat (fatty meat, butter, cheese, whole milk, ice cream and fast foods) and trans fat (fried foods, most margarines and foods containing hydrogentated oils). 

6. Avoid sugar and other refined carbohydrates including cookies, pies, cakes, pastries, candy, soda pop, sugary cereals and white flour products. 

7. Eat cholesterol-lowering foods everyday such as fish, sea vegetables, soyfoods and soy protein, garlic, onions, ginger, green tea, nuts, seeds, peanut, oats, brown rice, barley, avocado, artichoke, cabbage, yams, olive and flaxseed oils, maitake mushroom, lecithin and nutritional yeast. 

8. Obtain adequate fluids (water, tea, broth, vegetable juices, dilute fruit juices). Limit or avoid coffee, especially that which is prepared by boiling or French press. 

9. Supplement with multiple vitamins and minerals. Specific nutrients that can lower cholesterol and/or boost HDLs are C, E, niacin, chromium, calcium, magnesium, zinc, iodine and carnitine. 

10. Consider natural cholesterol-lowering products such as psyllium fiber, polycosanol, guggul, red yeast rice, pantethine and plant sterols/stanols. 

© Copyright 2008 Ken Babal

Selected references: Br Med J 329:1447-1450, 2004; JAMA Vol. 290 No. 4, July 23, 2003.