Improving Your Cholesterol and Heart Health
Cholesterol. It's something that you've probably have had checked at least once in your life. You may recall your doctor talking about your "LDL and HDLs" and how it's important to have healthy levels of both. But do you know why?
In this post I will go over the essential to-know facts about cholesterol, why it's important, and ways you can improve it safely and naturally.
The Essentials
What is cholesterol?
A waxy, fat-like substance---cholesterol is both made by your liver and absorbed through the food you eat. It is an essential component of all cell membranes and is used by the body to produce hormones, vitamin D, and substances your body needs for digestion.
In your bloodstream, cholesterol travels by way of lipoproteins---small packages that are made of fats on the inside and proteins on the outside. Two main types of lipoproteins are important for you to know and will be mentioned throughout this article: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types is important. But why?
The Good vs the Bad
LDL - "The Bad Cholesterol"
LDL is considered bad cholesterol because it is what contributes to plaque build-up along your artery walls---thick, hard deposits that cause vessels to harden and become narrower---leading to coronary artery disease (heart disease or atherosclerosis). When a chunk of plaque breaks off and blocks the artery, you get a heart attack or a stroke. Plaque buildup in your leg vessels causes what is called peripheral vascular disease (peripheral artery disease, or PAD), which leads to diminished blood flow to your limbs and pain upon walking.
The higher your LDL level,
the HIGHER your chances are of getting a heart attack or a stroke.
HDL - "The Good Cholesterol"
HDL, on the other hand, is considered good cholesterol, because it actually helps remove the bad LDL from your arteries. It acts as a scavenger, carrying LDL away from your vessels and back to your liver, where it is broken down and excreted from the body. Therefore, high HDL levels protect your body against heart attacks and strokes, while low levels of HDL expose you to the harmful factors that cause them.
The higher your HDL level,
the LOWER your chances are of getting a heart attack or a stroke.
What Do Your Numbers Mean?
Although your personal "LDL goal" can depend on the presence of other risk factors (eg. age, family history, overall health...) and is something that should be discussed between you and your doctor, if you already know your numbers, below is a helpful chart that you can use to gauge where you are and where you should be. Notice that your "total cholesterol" is not simply a sum of LDL and HDL. This is because this number also takes into account your triglyceride level, another type of fat in your blood.
Tips for Improving Your Cholesterol
With that in mind, let's discuss some easy ways in which you can improve your cholesterol naturally. Even if you are already on a cholesterol medication, incorporating these changes into your life can help lower the dosage you need while contributing to your overall heart health.
Tip #1 Embrace Soluble Fiber
- What it improves: LDL
There are two main types of fiber that comes in food: insoluble fiber (found in wheat and whole grains)---which mainly maintains your gut health---and soluble fiber, which is more beneficial for cholesterol. While getting both types is important, for cholesterol benefits, you should aim to increase your soluble fiber intake. In your small intestines, soluble fiber works to bind to compounds that make up LDL cholesterol, helping you excrete it rather than absorb it, subsequently lowering your bad cholesterol.
While soluble fiber can be found in many foods---barley, oats, brown rice, legumes, carrots, split peas, corn and fruits (especially apples, plums, citrus, strawberries, and blueberries)---barley and oats are particularly beneficial in that they are fantastic sources of beta glucan, a soluble fiber that has been well-studied and shown to be effective at helping cholesterol.
What should be your daily goal for fiber intake? Below are the current recommendations:
Total Daily Fiber (Soluble + Insoluble)
Under 50 years: Women = 25 grams Men = 38 grams
Over 50 years: Women = 20 grams Men = 30 grams
For cholesterol benefits, aim for 10-15 grams of this to come from soluble fiber.
Need some help? While it’s always best to obtain your fiber from foods that are also rich in other nutrients, taking a fiber supplement can help if you are having difficulty incorporating enough into your diet. Psyllium, such as Metamucil (sold as a bulk-forming laxative) is high in soluble fiber and is the most extensively studied.
Other fiber products include methylcellulose, calcium polycarbophil, inulin, and guar gum. However, these products may not contain as much soluble fiber as products containing psyllium nor do they have as much evidence supporting their effectiveness.
Note: When increasing fiber intake, upping it gradually while drinking plenty of water can help prevent bloating or flatulence.
Tip #2 Bump Up Your Omega-3
- What it improves: HDL
Foods high in omega-3 fatty acids can help increase the HDL levels that help protect your heart. While they do not significantly affect LDL, they can reduce your triglycerides if they are high and also help improve your blood pressure.
Oily fish is a great source of omega-3's, with salmon, mackerel, and herring being the best choices...followed by tuna and sardine. Other good sources of omega-3 fatty acids include walnuts, almonds and ground flax seeds. Aim to get at least two servings per week of these.
A note on fish oil supplements: Fish oil capsules are usually recommended for the lowering of triglyceride levels, but as they do not improve your LDL, unless recommended by your doctor, stick with food sources for your omega-3's. But if you are shopping for one, be sure to check the label specifically for the EPA and DHA levels (as those are the effective ingredients), and choose the one with the highest content.
Tip #3 Eliminate Trans Fats and Saturated Fats
- What it improves: LDL
Trans fats are created by adding hydrogen to a liquid fat to help it solidify and are used because they extend the shelf life of packaged baked goods. Although trans fats are being phased out of the food industry due to their known adverse health effects, they haven't disappeared entirely. Therefore, I would still recommend taking a moment to scrutinize the labels on your food packages, avoiding anything that has "partially hydrogenated" listed in the ingredients.
Saturated fat---found primarily in red meat, dairy products, butter, lard, and shortening---plays a major role in raising your LDL level and contributes to plaque buildup in your arteries. As a rule, you should try to get no more than 7% of your daily calories from saturated fat. Rather, choose leaner cuts of meat, low-fat dairy products, and vegetable oils instead.
On the other hand, unsaturated fats---such as monounsaturated and polyunsaturated fat---are considered healthier, because they do not raise your LDL level like its saturated counterparts. They are found in olive, canola, sesame, and other vegetable oils, as well as in avocados, nuts, flax seeds, soybeans, margarine, and seafood.
Tip #4 Choose Olive Oil
- What it improves: HDL
Olive oil, in particular, offers several health benefits. While it does not significantly alter LDL levels, it is considered heart-healthy in that it raises your good HDL levels. Extra-virgin olive oil is the best as it is less refined and contains significantly more antioxidants than other versions (eg. 'virgin,' 'refined,' and 'pure' olive oils). For this reason, avoid olive oils labeled as "light" as those are also more refined. To reap the most health benefits, use about 2 tablespoons (23 grams) of extra-virgin olive oil in place of other fats in your diet each day.
Tip #5 Find Foods Fortified with Plant Sterols
- What it improves: LDL
Phytosterols (referred to as plant sterols and stanols) are compounds structurally similar to cholesterol found in plant cell membranes that work by partially blocking the absorption of cholesterol from your small intestines. They help by lowering levels of LDL but have little effect on your HDL level.
Phytosterols are naturally present in small quantities in vegetable oil, nuts, legumes, whole grains, fruits and vegetables. However, since the amount of stanols and sterols in these foods aren’t usually sufficient to produce a benefit, some foods---such as juices, salad dressings, cereals, and breads---are now being fortified with these compounds.
The American Heart Association currently recommends incorporating 2 grams daily of phytosterols into the diets of those with high cholesterol. Consuming more than 2 grams has not been shown to be more effective.
Tip #6 Adopt a Healthier Lifestyle
- What it improves: LDL and HDL
Lose some weight: You don’t have to lose a lot of weight to lower your cholesterol. If you are overweight, dropping just 10 lbs will improve your LDL. To keep off the pounds, do it gradually, aiming for 1 to 2 pounds a week.
Get moving: Incorporating at least 2 ½ hours a week of physical activity will lower your LDL as well as improve HDL levels. Be sure to always check with your health care provider before starting an exercise program, especially if you have heart problems.
Cut the tobacco: One of the many harmful effects of tobacco use is its ability to raise cholesterol and worsen existing heart disease and increase your chances of heart attacks and strokes. If you currently smoke, please consider cutting down or quitting.
A Word on Supplements
You might have noticed that while there are many natural supplements out there claiming to lower cholesterol, none of them have been mentioned in this article. That is because the only one that has been proven to work is red yeast rice--but the problem with red yeast rice is that it carries a significant potential for liver toxicity. Therefore, I would only recommend starting it if it is under the supervision of a doctor and if your liver function can be regularly monitored. As for garlic, grape seed, and vitamins C, E, and D---while they have other benefits---there is no real evidence that they improve cholesterol and therefore I would not recommend taking them for this purpose.
With that said, here's to eating healthy for a healthier heart!
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References:
Brown, L., Rosner, B., Willett, W. W., & Sacks, F. M. (1999). Cholesterol-lowering effects of dietary fiber: a meta-analysis. The American journal of clinical nutrition, 69(1), 30-42.
Clifton, P. (2002). Plant sterol and stanols—comparison and contrasts. Sterols versus stanols in cholesterol-lowering: is there a difference?. Atherosclerosis Supplements, 3(3), 5-9.
Hardman, A. E. (1999). Role of exercise and weight loss in maximizing LDL cholesterol reduction. European heart journal supplements, 1(S), S123-S131.
Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. circulation, 106(21), 2747-2757.
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*The information presented in this article is only for educational purposes and is not to be used in place of medical advice. Always have a discussion with your trusted health care provider before starting any supplements, medications, or exercise programs.
