"75-80% of the cholesterol in your body is made by the body"
Generally, when we eat more cholesterol, the body makes less and vice versa. This is why health guidelines no longer focus on the cholesterol content of foods (although if you have high cholesterol and it runs in your family your dietitian may advise you to limit your dietary cholesterol too). We know that other dietary factors have far more influence on how much cholesterol your body produces.
Being a fat however, cholesterol can’t be carried around in the blood on its own – just think of trying to mix oil and water. Instead it is carried in particles made with a coating of proteins called lipoproteins (lipid + protein). There are different types of lipoproteins, each with varying amounts of cholesterol as they have different roles in the body.
The major ones of interest are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL particles are the richest in cholesterol and their job is to deliver cholesterol to cells around the body.
LDL is often called ‘bad cholesterol’ because when there are too many of these particles in the blood they can stick to the artery walls where they are then involved in the development of artery-clogging plaques – the process called atherosclerosis. So we clearly need some LDL, but having too high a level can be problematic.
HDL is often called ‘good cholesterol’ because it’s job is to pick up unused cholesterol around the body - some HDL can even sweep up cholesterol from plagues - and deliver it back to the liver for excretion. High HDL is therefore protective for cardiovascular health.
A further complication is that not all LDL (or for that matter HDL) particles are the same in terms of risk. This may explain why some people have high LDL but never have a problem, while others with seemingly normal LDL levels do. It seems that the particle size matters. Small, dense LDL particles seem to be readily incorporated into arterial plagues, whereas large fluffy LDL particles ‘bounce’ off the artery walls instead.
"A further complication is that not all LDL (or for that matter HDL) particles are the same in terms of risk"
While there are now advanced blood tests that can measure things like particle size, most doctors agree that this is not necessary as risk of cardiovascular disease can be assessed accurately from looking at total cholesterol, LDL, HDL and triglycerides (other fats). Some may also measure CRP and they also take your other risk factors into account before recommending a treatment plan.
So how can you manage your blood cholesterol levels to lower your LDL and increase your HDL? Here are the key factors under your control:
1. Avoid trans fats and choose mostly unsaturated fats
While the link between saturated fat and heart disease has been called into question, what is clear is that it is what replaces the saturated fat that is crucial. Saturated fats tend to raise LDL, but they do also raise HDL. Whether these effects cancel each other out is not yet known.
But what we do know is that when we choose polyunsaturated and monounsaturated fats instead these both lower LDL and raise HDL – exactly what we want. So if you have high cholesterol skip the butter, fatty meats, especially processed meats, coconut and palm oils, and instead opt for extra virgin olive oil, nuts, seeds, oily fish, avocado and hummus.
"Opt for extra virgin olive oil, nuts, seeds, oily fish, avocado and hummus"
Trans fats are the worst kinds of fats, so much so that some authorities around the world have banned them completely in our food. To avoid them ensure you skip the commercial pastries, biscuits and cakes, fried fast foods and anything with hydrogenated oil in the ingredients list.
"Trans fats are the worst kinds of fats, so much so that some authorities around the world have banned them completely in our food"
2. Eat more plant food
Plant foods may be so effective in managing cholesterol levels for several reasons. Firstly, they are fibre rich and some fibre types are especially effective at binding cholesterol in the gut and carrying it out of the body. They also fuel the good gut bacteria and the resulting fermentation process releases short chain fatty acids that are absorbed into the bloodstream where they influence cholesterol production by the liver.
One fibre that is most effective for cholesterol management is a soluble fibre called beta-glucan found in oats and barley. 3g of beta-glucan has been shown to significantly reduce both total cholesterol and LDL, making it an attractive, natural way to manage your cholesterol levels.
Since you’d need to eat a lot of oats or barley to get 3g, I recommend taking it as a supplement drink. Beta Heart is my product of choice as it is easy and pretty delicious to get into your day. All you need do is enjoy one serving a day mixed with water, milk or in a smoothie to give you your 3g of beta-glucan. It has nothing artificial added, no added sugar and it’s low GI – it can even help with blood glucose control and gut health at the same time.
"3g of beta-glucan has been shown to significantly reduce both total cholesterol and LDL, making it an attractive, natural way to manage your cholesterol levels"
3. Avoid or strictly limit your intake of highly refined and processed grains
That means those with too much added sugar and/or based on white flour. These foods have a negative impact on your blood cholesterol levels. Swap them out for the nutritious whole foods above and it’s not just your heart that will benefit, but your overall health and vitality.
4. Get regular exercise
Exercise not only helps to keep your entire cardiovascular system healthy, it also helps to lower LDL and raise HDL.
5. Get your weight under control
If you’re overweight, especially where you are carrying too much fat around your middle, this tends to raise your LDL and push down HDL. Losing weight, especially around the middle, is crucial.
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