This is part 1 of a 3-part series on cholesterol. Part 2 gives a comprehensive diet plan for managing cholesterol levels. Part 3 sheds some light on cholesterol’s shady past.
The Skinny on Cholesterol
Cholesterol levels have become known as being dangerous for the heart and blood vessels, but it is also a very important substance in the human body. Cholesterol is needed for strong cell walls, as a precursor for hormone production, and as a coating around nerves.
Unfortunately, it’s not as simple as saying it’s healthy or not. What makes cholesterol either “good” for us or “bad” for us is the types of cholesterol we have, the amounts, and the ratios between the different types.
A general rule is that, like anything else, cholesterol can create a problem when total levels (all types together) in the blood are too high; generally, high total cholesterol is defined as levels that are greater than 5.2 mmol/L (measured as 200 mg/dl in the US).
HDL cholesterol (i.e., high-density lipoprotein) is considered to be beneficial – it works to carry cholesterol away from the blood and back to the liver where it can be processed and removed from the body. Generally, more is better. Healthy ranges in the blood are considered at or above 1.0 mmol/L for men and above 1.3 mmol/L for women (above 40mg/dL and 50mg/dL, respectively in the US). HDL can be even more protective at higher levels, up to 1.6 mmol/L (60 mg/dL in the US).
LDL cholesterol (i.e., low-density lipoprotein) is generally thought to be more harmful to the body – it is one of the “bad” types that carry cholesterol into the bloodstream and can place it into the lining of the arterial walls, thereby promoting plaque formation and heart disease. Generally, less is better, although there is such a thing as going too low as well. Blood levels should generally be under 2.6 mmol/L (below 100 mg/dL in the US).
A new measurement being added to routine blood work is the non-HDL cholesterol, which measures everything that is considered cholesterol that is NOT the protective type, HDL. This is in fact a better marker for risk of heart disease than LDL alone because it takes into account other damaging types of cholesterol. These levels should be kept low, below 3.4 mmol/L (130 mg/dL in the US).
A final number that is being looked at is the ratio between total cholesterol and HDL (TC/HDL ratio) and can tell you how good your cholesterol is overall by looking at what percentage of the total amount is the good type. TC/HDL ratio numbers should be no more than 3.5 (ie. total is no more than 3.5x the protective HDL).
It may sound like alphabet soup, but the good news is that these numbers don’t have to spell heart disease for you. Nor must you take the infamous “Statin” drugs that carry their own significant risks (muscle pain and damage, liver damage, increased risk of developing diabetes, and neurological damage, and memory loss, to name a few).The best way to measure your risk of heart disease is actually with the Framingham Risk Calculator, which you can read about here. Simple lifestyle, dietary, and supplement recommendations can make all the difference to your numbers, and to your heart.
- Regular aerobic/moderate exercise
- Regular exercise contributes to higher levels of HDL cholesterol and reduces the risk of heart disease
- Yoga or qigong for relaxation and improved blood circulation
- Minimize stress
- Get adequate amounts of daily sunlight – a lack of sunlight has been shown to adversely affect cholesterol levels
- Weight reduction (if appropriate)
- Eat a high fiber, medium-fat diet
- Reduce animal products and other sources of saturated fats if you are consuming a great deal of them– e.g., red meats, eggs, dairy products, palm oil, coconut oil. Saturated fats should be no more than 10% of the daily calorie intake. For more information about fats (the good, the not-so-bad, and the really bad), click here
- Increase fruits, vegetables, grains, and legumes
- *Reduce sugar and salt intake
- Calorie percentages for reducing cholesterol should be as follows:
- 40-45% complex carbohydrates – e.g., brown rice, oats, millet, beans
- 15-20% protein – e.g., tofu, beans, fish
- 30-40% fat – e.g., fish, olive oil, flaxseed oil, nuts, seeds
- Consider occasional short fasts
- e.g., once a month, fast for 24 hrs on juices or 1 tbsp Spirulina and lemon water. *Consult a medical professional before beginning fasts and any kind of Spirulina supplement; these interventions can interact with medications and autoimmune diseases.
Therapeutic Foods and Supplements
- Oat bran and brown rice bran – these are the best foods for lowering cholesterol
- Apples, bananas, carrots, grapefruit, celery, dried beans (especially navy, pinto, and kidney beans), garlic, olive oil, and cold water fish (salmon, herring, mackerel) – these are also cholesterol-lowering foods
- Barley, beans, flax seeds, brown rice, fruits, and oats – such foods contain water-soluble fiber, which is beneficial in reducing cholesterol
- Ground Flax Seeds
- Grind whole seeds in coffee grinder (cleaning grinder well each time) and add to cereal, yogurt or smoothies
- 2 Tablespoons provides adequate fibre per day
- Spirulina is a form of blue-green algae that is rich in beta-carotene, iron and B complex vitamins.
- When taken on a daily basis, Spirulina has been shown to decrease cholesterol levels but can increase auto-immune conditions and cause upset stomach and potentially liver damage if used long term in high doses.
- Raw unsalted almonds
- Almonds are rich in the amino acid arginine which has been shown to decrease cholesterol within a four-week period. Eat 1 serving (1/4) cup daily.
- Green tea
- regular intake of green tea has been shown to decrease LDL and total cholesterol levels while increasing HDL
- For maximum benefits, one should drink at least 3 cups daily of whole leaf green tea
Other beneficial foods include:
- Omega 6 fatty acids – evening primrose oil, flaxseed oil (also contains omega 3 fatty acids), black current oil, and other vegetable/nut/seed oils
- Liquid chlorophyll, alfalfa sprouts, buckwheat, watercress
- Onions, beans, legumes, soy, ginger, yogurt
- Fresh juice made with any combination of the following: carrot, beet, celery, pineapple, parsley, alfalfa, spinach, asparagus, chlorophyll and honey. Note: Carrot juice helps to flush out fat from bile in the liver and this helps to lower cholesterol.
- Niacin is well established as being effective in the treatment of high cholesterol levels – specifically, it reduces total cholesterol, LDL cholesterol, and triglycerides while increasing HDL
- Guggullipid is the standardized extract of the mukal tree (Commiphora mukal) which is native to India
- Several clinical studies have confirmed its ability to lower both cholesterol and triglyceride levels
- Typically, total cholesterol will drop 14-27%, LDL by 15-35%, triglycerides by 22-30%, and HDL will increase by 16-20% with 12-36 weeks of supplementation
- The effect of guggullipid on cholesterol and triglyceride levels is comparable to that of lipid-lowering drugs but without the side-effects
- Mechanism of action: guggullipid increases the liver’s metabolism of LDL
- Other benefits: it has been shown to prevent the formation of atherosclerosis and aid in the reversal of atherosclerotic plaques in animals
- Balances cholesterol levels by impacting both excessive manufacture and impaired breakdown of cholesterol levels.
- Policosanol has been shown to reduce both total cholesterol and LDL cholesterol levels, also shown to effectively decrease cholesterol levels in tissues like the heart, liver and fatty tissue.
- Policosanol can be used as an alternative to aspirin as an anti-platelet agent. Policosanol is also a powerful antioxidant.
You can manage your cholesterol
Cholesterol doesn’t have to be big and scary- it’s very manageable with a good naturopathic approach. See Cholesterol part 2 for a perfect sample diet plan you can follow to help move your cholesterol levels in the right direction.
- Textbook of Natural Medicine by Pizzorno & Murray. Churchill Livingstone: 1999;
- Textbook of Nutritional Medicine by Werbach. Thrid Line Press, Inc: 1999
- Make sense of your cholesterol tests, Harvard Health, https://www.health.harvard.edu/heart-health/making-sense-of-cholesterol-tests
- Statin side effects; weigh the benefits and the risks, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013
- Mediterranean diet guidelines https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y
- Fats, good and bad,. Harvard, https://www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good