Diet to Reduce Cholesterol
by Sue Kira, Naturopath & Clinical Nutritionist
– What is cholesterol?
– What causes high cholesterol?
– What are the complications of high cholesterol?
– Who is at risk for high cholesterol?
– What are the symptoms of high cholesterol?
– Cholesterol is a symptom not a problem itself
– How is cholesterol diagnosed?
– How is cholesterol usually treated?
– Diet & lifestyle changes to support reducing cholesterol
– Examples of foods that may contribute to high cholesterol
– Intermittent fasting to help control cholesterol
Case study: how stress can increase cholesterol
About Cholesterol
What is cholesterol?
Cholesterol is an important substance that your liver produces naturally. It is vital for the formation of cell membranes, vitamin D, and the precursor to certain hormones, like DHEA and progesterone.
Cholesterol itself is a waxy, fatty substance that does not dissolve in water and cannot travel through the blood by itself, but uses Lipoproteins, which are also formed in the liver, to help transport cholesterol through the bloodstream. There are several forms of lipoproteins that are important to your health including LDL and HDL.
Not all cholesterol is bad
Low-density lipoproteins (LDL), also known as ‘bad cholesterol’, can build up in your arteries and lead to serious health problems such as a heart attack or stroke.
High-density lipoproteins (HDL), often called ‘good cholesterol’, help return the LDL cholesterol to the liver for elimination.
Your liver produces all the cholesterol you need, but fats and cholesterol are also present in many of the foods we eat which makes the liver create more unnecessary cholesterol.
What causes high cholesterol?
High cholesterol is usually made worse by eating too many unhealthy foods that are high in cholesterol, which makes your liver produce more cholesterol such as trans fats and sugar.
Elevated cholesterol can be genetic, but usually certain conditions are required to ‘switch on’ this gene expression. This means that cholesterol is not only caused by food, but in the way your genes instruct your body to process cholesterol and fats. Other conditions such as diabetes and hypothyroidism can contribute to high cholesterol as can smoking.
Because cholesterol is produced in the liver, anything that adversely affects the liver can impact on cholesterol levels. Examples of what can stress or overburden the liver include:
- alcohol
- drugs
- caffeine
- smoking
- emotions such as anger, frustration or rage
- foods such as a high sugar diet or high fat diet
- eating more than your body needs (over-eating)
Notice that each of these are ‘self-created’ choices.
I had one client whose cholesterol was elevated purely because he ate loads of cashews for snacks throughout the day.
What are the complications of high cholesterol?
Constant elevated cholesterol can contribute to plaque formation in your arteries, which narrows your arteries, so that less blood flows through. This can lead to many life-threatening complications, including:
- heart attack
- angina (chest pain)
- peripheral vascular disease
- high blood pressure
- chronic kidney disease (when plaque builds up in the renal arteries, which supply blood to your kidneys)
Who is at risk for high cholesterol?
You may be at a higher risk of elevated cholesterol if you:
- have a family history of high cholesterol
- eat a diet containing an excessive amount of certain fats
- are overweight or obese, especially central obesity
- have diabetes, kidney disease, or hypothyroidism
- have other inflammatory conditions (see cardio article)
- have high stress (the liver increases cholesterol as a protective measure when we are highly stressed)
- have liver problems such as ‘fatty liver’ or alcoholism
What are the symptoms of high cholesterol?
In most cases, high cholesterol doesn’t create any symptoms and it’s often not until you have a check-up and a blood test that it can be picked up.
First symptoms of high cholesterol often include a heart attack or a stroke.
In rare cases, there are genetic syndromes where the cholesterol levels are extremely high (familial hypercholesterolemia). People with familial hypercholesterolemia have cholesterol levels of 300 milligrams per decilitre (mg/dL) or higher. Some may show symptoms from high cholesterol with deposits of cholesterol such as xanthomas (fatty lumps) over their tendons or under their eyelids, called xanthalasmas.
While high cholesterol affects a large amount of the population, familial hypercholesterolemia affects about one in 500 people.
I was involved in a research study in 1983 with the University of NSW at the Prince Henry Hospital in conjunction with the Oliver Latham laboratories. The Oliver Latham labs are where newborn babies heel-prick blood is tested for hereditary diseases.
We used the left-over samples for our research. This resulted in the familial type 2 hypercholesterolemia being added to the list of screenings that little ones can be tested for, which was a great honour.
Along the way, we did pick up some new born babies with this type of elevated cholesterol issue, which meant the family could be warned to ensure the baby went onto a strict diet with regular testing throughout childhood, to prevent early death from heart disease.
You wouldn’t think that infants would have an issue with cholesterol, and they may never get tested until something happens, which could be too late. It’s great to see the benefits of this research, especially when you see the diets of some young people these days.
Cholesterol is a symptom not a problem itself
High cholesterol is a symptom of a problem but not a problem itself. If your cholesterol levels are high, it almost always indicates an underlying imbalance or extra stress somewhere in your body. By correcting that imbalance or stress you can reduce your cholesterol naturally.
With that in mind, it is important for you to seek the help of a doctor as well as a naturopath to be assured that everything is considered when finding the cause of elevated cholesterol.
Yes it can be genetic, but certainly do not just settle for that. There can be many other contributors that if remedied, will lower cholesterol naturally, especially with an appropriate healthy diet.
If you have elevated cholesterol, it’s worthwhile to read the information about cardiovascular disease.
How is high cholesterol diagnosed?
High cholesterol is very easy to diagnose with a blood test called a ‘lipid panel’. Your doctor will take a sample of blood and send it to a laboratory for analysis. Your doctor may ask that you don’t eat or drink anything (fast) for at least 12 hours prior to the test.
A lipid panel measures your total cholesterol, LDL, HDL, and triglycerides.
Good levels would look something like:
- total cholesterol: less than 200 mg/dL
- LDL cholesterol: less than 100 mg/dL
- HDL cholesterol: 40 mg/dL or higher
- triglycerides: less than 150 mg/dL
How is high cholesterol usually treated?
Committing to exercise and an appropriate healthy diet is usually enough to decrease cholesterol levels, however medication may be needed if LDL cholesterol levels are very high and are unresponsive to diet and lifestyle changes.
The most commonly prescribed medications used to treat elevated cholesterol are called Statins. Statins work by blocking your liver from producing more cholesterol. These drugs also indirectly decrease the blood levels of LDL cholesterol and triglycerides and some of them may also raise the level of the ‘good’ cholesterol, HDL.
Examples of Statins drugs include:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Rosuvastatin (Crestor)
- Simvastatin (Zocor)
Diet and Cholesterol
Diet & lifestyle changes to support reducing cholesterol
Having elevated cholesterol is so common these days that most people don’t even see it as a real issue – just something that happens with aging, like elevated blood pressure and diabetes.
Having elevated cholesterol is not normal
High cholesterol doesn’t need to be a sign that you are getting older. As we age, there could be a higher risk of something going wrong with the body, but it doesn’t have to be that way.
Cholesterol is produced by the liver, so supporting the liver can help. The best way to do that is to stop assaulting it. How? Avoid toxic foods and substances such as alcohol, cigarettes, caffeinated drinks, gluten, dairy, food additives, processed foods, cooked and/or hydrogenated vegetable oils and food additives.
Instead eat foods that help the liver to do its job, such as foods that bind bile salts like Brussels sprouts, collard greens/silverbeet, broccoli and other leafy or cruciferous greens.
Other great liver supportive foods that can help lower elevated ‘bad’ cholesterol while keeping healthy cholesterol levels normal are fish, nuts, avocadoes, olive oil, garlic, grapefruit, beetroot, apples, alternative grains like quinoa, millet, and buckwheat, lemons & limes and turmeric. Drinks such as peppermint tea and dandelion tea can also lessen the load on the liver.
It’s also worthwhile to look at how to reduce or eliminate stress factors, reactions, and damaging emotions.
Moderate exercise for about 30 minutes, five days a week is also considered beneficial. Don’t rush into it; it makes sense to start slowly with low impact exercises. High impact exercise can create more cardiovascular problems if you are not used to it.
Be guided by how your body feels and the advice from your health practitioner.
The idea of a diet to reduce cholesterol is to remove foods that contribute to high cholesterol and instead enjoy a variety of delicious foods that help to reduce bad cholesterol to help your body to do its natural job of healing.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Examples of foods that may contribute to high cholesterol
- red meat, liver and other organ meats
- dairy products like cheese, milk, ice cream and butter
- egg yolks (research suggests that genuine free range eggs do not elevate cholesterol)
- deep fried foods and processed foods
- hydrogenated oils (liquid oils made into solids/margarines)
- peanut butter with added oils (raw fresh peanut butter is not as bad)
- some baked goods like muffins, cakes and pastries
- chocolate (although raw cacao is not as bad as the oils are not heated)
- alcohol, caffeine, some medications and drugs (liver assault)
Intermittent fasting to help control cholesterol
There has been recent research into the various types of intermittent fasting. This is not the ‘starve yourself for 24hrs or more’ fasting discipline, but more about elongated gaps between meals.
Spacing of meals gives your body time to repair, process the food previously eaten, clean the system, discard waste, use fat stores for energy rather than deposit it where it is unwanted (such as your arteries or waistline), and take the load off your organs e.g. the liver.
When we pile food on top of food, the body works overtime digesting, which uses up a tremendous amount of energy. Consequently the chance for the body to self-heal and repair itself falls by the wayside. It’s no wonder we get tired after a big meal.
There are various versions of intermittent fasts. Following is information on the two main ones.
The first is the 5:2 diet. This is where you eat normal healthy food three or so times per day for five days a week and have two days a week where you eat one meal of around 500 calories (2092 KJ) for women and 600 calories (2500 KJ) for men, at any time of the day that suits you.
The two ‘fasting’ days do not have to be consecutive, for example, you could pick a Sunday and Thursday.
The second style of intermittent fasting uses the principle of eating only two meals a day with one eight-hour gap and one sixteen-hour gap. For example, you may have brunch at 11am and dinner at 7pm. This becomes a regular daily event rather than something that is done twice per week. These hours can be varied to suit your work and lifestyle habits provided the eight-hour/sixteen-hour concept remains the same.
According to research, the amount of calories in intermittent fasting doesn’t seem to matter. Eat what feels comfortable for your body without overloading. Also drink plenty of water or herbal teas throughout the day to keep your fluids up and give your liver and kidneys help to flush out toxins.
More studies need to be done on humans, but research on mice have shown that these types of intermittent fasting reduce cholesterol, blood pressure, the risk of heart disease and increase longevity (the mice studied were reported to live the equivalent of an extra 20-30 human years). The studies showed a reduced risk of cancer, increased lean muscle mass, and decreased fat mass, overall delivering more energy and vitality.
There have also been human studies that have shown good results regarding health risks such as cholesterol, blood pressure and fat mass.
Before trialling intermittent fasting, I recommend consulting your practitioner to see if this is suitable for you and your current health. If given the all clear, then consider trialling both types to see what works best for you.
There are other variations you can experiment with. For example, some people I know like to have alternate days of eating three meals one day and two meals the next and this works for them.
One of my clients loved to have a complete fast one day a week, only drinking water and herbal tea. He had his dinner on Saturday night, then not eat solid food till breakfast on Monday, a total of 36hrs of fasting.
He reported feeling very energised and ready for the working week by doing this. He didn’t sleep all day as you might expect on the fasting day; he did lots of fun things like bush walking, swimming, kayaking, surfing and playing with his grandchildren.
The key is to look after your body and ensure you give it the care it deserves so you can regenerate and replenish. It’s all about falling in love…with yourself!
Case study: How stress can increase cholesterol
I have an interesting case study, which is that of my mum.
When my dad was rushed to hospital after a heart attack and put into intensive care, you can imagine the stress that created for my mum.
The doctor took one look at mum, saying, “If your husband is like this and you two have been together for the past 60 years, then surely you’ll have high cholesterol too”. So they tested her and her levels were very high.
In a panic, she rang me saying that she was likely to be in the bed next to dad any day now. After calming her down, I reminded her that she didn’t eat the same food as dad and she was also more active (mum was active and ate healthy, nutritious food most of the time, while dad loved to kick back in front of the TV and eat desserts and ice cream).
I also told her that her previous cholesterol and blood pressure readings were always low and I strongly felt that the results from the hospital tests were all to do with stress.
I suggested that she wait until everything settled down with dad then to get re-checked. She did, and her levels were all normal again.