Cholesterol is a type of fat that we eat and is also created by our liver. We need a small amount of cholesterol in our bodies to build cell membranes, assist in bile production, to be a building block for hormones such as oestrogen and testosterone, and to create vitamin D. However, too much ‘bad’ cholesterol can contribute towards cardiovascular disease: problems with our heart and blood vessels.
Fats, such as cholesterol, cannot dissolve in blood, and therefore are packaged up and travel in the bloodstream in particles called lipoproteins. There are several types of lipoproteins – the most well-known are LDL, HDL and triglycerides. Having a good mix of these lipoproteins in the blood is important for our health.
LDL (low density lipoprotein) cholesterol is the correct term for ‘bad’ cholesterol. LDL is the primary transport vehicle for cholesterol. The number of LDL particles and also the amount of cholesterol in these particles contribute to unhealthy arteries.
Too much LDL can increase our chance of atherosclerosis, which is the build-up of plaque in blood vessels (artery disease). Lots of LDL particles circulating in the blood causes deposits called plaque to build up in the artery wall. These plaques harden the blood vessel walls and take up space inside the blood vessels, making it hard for blood to pass through. A blocked blood vessel around your heart can cause a heart attack, and a blocked blood vessel around your brain can cause a stroke.
However, it is becoming more and more recognised that although cholesterol gets stuck in tears in the blood vessel walls, the initial damage is usually done by excess blood glucose and elevated blood pressure, both major contributors to ‘metabolic syndrome’. Cholesterol is no longer regarded as the sole cause of blocked arteries but is a factor on a long-term basis.
Anterior cut view of blood vessel artery and artherosclerotic blood vessel; ACardio_20140401_v0_002.ai SOURCE: cardio_cor-angio_anat.ai
High density lipoprotein (HDL) cholesterol is our ‘good’ cholesterol. HDL cholesterol works directly and indirectly to return cholesterol to the liver, where it is removed from the bloodstream. This means it cannot enter the artery walls and build up, causing artery disease. We want to make sure we have enough HDL cholesterol so it can perform these protective functions.
TRIGLYCERIDES AND CHOLESTEROL
Triglycerides are a source of fat that we usually consume in the diet and then are carried in the bloodstream. Eating a large amount of the wrong types of fat will cause high triglyceride levels, which can then reduce HDL cholesterol and in turn increase heart disease risk.
HEALTHY CHOLESTEROL LEVELS
You can find out your cholesterol levels by getting a blood test from your GP. Healthy levels we should aim for are:
Total Cholesterol: less than 4.0 mmol/L (individuals at high risk e.g. heart disease, overweight) or less than 5.5 mmol/L (General population)
LDL Cholesterol: less than < 1.8mmol/L (individuals at high risk) or less than 2.0 mmol/L (general population)
HDL Cholesterol: more than 1.0mmol/L
Triglycerides: less than 2.0mmol/L
Your doctor will inform you if your cholesterol levels are within normal limits for your individual circumstances.
SIGNS OF HIGH CHOLESTEROL
High cholesterol or artery disease may cause no symptoms until the build-up of enough plaque obstructs the blood flow in your arteries.
At this stage, symptoms such as these can occur:
pain in your arms or legs
shortness of breath
CHOLESTEROL LOWERING DIET
Evidence has found a Western diet pattern high in processed meats, sweets, desserts, fried food, alcohol and refined carbohydrates has a negative impact on blood vessel function, including atherosclerosis.
Eating a diet rich in fresh fruits, vegetables, olive oil, fresh oily fish rich in omega 3 fatty acids, lean proteins and nuts, and limiting processed foods high in saturated and trans fats will help to reduce elevated cholesterol levels. Other foods that may aid in reducing LDL cholesterol are plant sterols (see below) and soy protein sources e.g. tofu and tempeh.
Foods High in Cholesterol (or Cause Elevated LDL Cholesterol)
While it is important to limit cholesterol in the diet, foods that increase LDL cholesterol are mostly high sugar foods and foods high in saturated and trans fats. These include:
Fatty cuts of meat, sausages, processed deli meats
Full fat dairy e.g. milk, cheese,
Chips, lollies, chocolate
Deep fried foods
Baked goods e.g. pastries, cookies, cakes
Savoury pastries e.g. pies, sausage rolls
High sugar soft drinks
Decreasing saturated fat in the diet can cause a 35% reduction in cholesterol levels.
High sugar foods such as soft drinks, alcohol, lollies etc are not high in cholesterol but they elevate blood glucose which triggers the liver to manufacture LDL cholesterol. It might be said that too much focus is placed on fats in the diet when it comes to lowering cholesterol. The bigger issue is too many refined carbs and sugars in the diet triggering the manufacture of LDL cholesterol. Balancing blood sugar on a low carbohydrate diet loaded with protein and great fats can really help to elevated HDL and lower LDL.
Eggs are high in cholesterol and there has always been advice to reduce egg consumption. However, research has shown that egg consumption has no effect on long term LDL cholesterol levels. Therefore, I never ask my client to limit egg consumption for cholesterol.
Replacing saturated fats with sources of unsaturated ‘healthy’ fats such as avocado, nuts, seeds, vegetable oils such as olive oil can help you increase healthy HDL cholesterol levels. Other helpful diet changes include eating fatty fish (fresh salmon, tuna, mackerel, sardines, anchovies etc), 2-3 times per week, and ensuring you are getting your daily fibre requirements by consuming half a plate of mixed vegetables with every meal and 2 pieces of fruit per day.
Cholesterol Reducing Foods
As well as reducing foods high in cholesterol, there are also foods you can eat that lower LDL cholesterol, such as plant sterols. Plant sterols are components of plants. They are a similar structure to cholesterol, and our body prefers to absorb these instead of actual cholesterol. Less cholesterol that is absorbed means lower levels in the bloodstream. Foods high in plant sterols include nuts, seeds and vegetable oils. Eating 2.5-3g of plant sterols per day can cause a 5-15% decrease in LDL cholesterol.
There are other lifestyle changes you can make to help reduce your cholesterol such as maintaining a healthy weight and being physically active every day. Carrying excess weight and not exercising can cause insulin resistance, which in turn can cause an excessive manufacture of LDL cholesterol and delayed removal from the blood. This means there is increased chance that LDL can build up in the artery walls and cause atherosclerosis.
Reducing alcohol intake is vital if you are trying to reduce LDL cholesterol. The liver will manufacture LDL cholesterol in greater amounts when you consume alcohol. I find that many clients do all of the right things with diet but if they do not take alcohol out of their routine, the cholesterol does not reduce. Also, if they take the alcohol out and get the cholesterol down, when they add it back in it pops back up again. In my clinical experience, I would say that alcohol is one of the biggest factors in the production of LDL cholesterol.
If your cholesterol levels are very high, medication may be necessary. Using medication along with lifestyle changes can make a big difference.
If you feel like you need some help with changing your diet to lower your cholesterol levels, book in a consultation with me through my website.
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CLIENTS SUCCESS STORIES
Food provides our bodies with energy, protein, essential fats, vitamins and minerals to enable us to live, repair ourselves, grow and function properly.
A nutritious diet with regular physical activity assists with weight and chronic disease management whilst improving overall mental health and wellbeing.
A healthy lifestyle improves energy levels and mental health whilst reducing the impact of aging, disease and stress on you and your family.
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