CHAPTER 29

Cholesterol

“Cholesterol plays a vital role in bodily functions. Every cell in the human body contains and requires cholesterol for life. If the AHA (American Heart Association) keeps lowering the level considered to be a normal blood cholesterol level, the incidence of heart attacks won’t even matter because life itself will cease without an adequate supply of essential cholesterol.”

– Dr. Melvin Anchell, offering his views on the AHA’s stance with regards to what’s considered normal cholesterol levels.

Cholesterol is another food ingredient that gets more than its fair share of bad press. Biochemically, cholesterol is a steroid-based molecule related to fat. Despite what you sometimes hear, cholesterol is needed in small amounts for good health. It is a major structural component of many body tissues, including the cardiovascular and nervous systems. It’s also used in the synthesis of many of the sex and adrenal hormones, as well as some digestive enzymes.

There are two primary forms of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). From a health point of view, your goal is to keep HDL levels high and LDL levels low. LDLs tend to be sticky in texture and attach more easily to arterial walls, causing blockages. If the blocked arteries happen to be located in the heart, the end result could be a heart attack. Blocked arteries in limbs can lead to cell death, gangrene, and eventually amputation. Evolution has decided that HDLs should be used to combat the destructive LDLs. HDLs attach to and carry away LDLs before they have a chance to build up on arterial walls. HDLs also carry extra cholesterol to the liver, where it is converted to bile salts and excreted. Most readers are probably aware of the risk factors that negatively impact cholesterol. While you have little control over genetics, such lifestyle factors as smoking, drinking, nutrition, and exercise can be controlled. Quit smoking (or never start), reduce your alcohol consumption, cut down on saturated and trans fat, and start exercising – including cardio (hopefully you’re already way ahead on this one!).

CHOLESTEROL BLOOD TESTS

Even if you’re following this advice it’s a good idea to have regular blood tests performed to check your cholesterol levels. Now you probably think that a blood test for cholesterol would simply tell you how much cholesterol is in your body. Well it does, but doctors actually use several measurements to deduce your risk of developing cardiovascular disease.

The three measurements are:

LDL cholesterol

HDL cholesterol

Total cholesterol

The first thing I should tell you is that total cholesterol doesn’t simply mean LDL cholesterol plus HDL cholesterol. There are additional types of cholesterol, but I really don’t need to discuss them here.

Cholesterol is measured as milligrams of cholesterol per deciliter of blood. Medical types have abbreviated it as mg/dL. In some cases only your total cholesterol will be measured, other times you will get results for all three. With regards to total cholesterol, here is a general guide:

Less than 200 mg/dL	Optimal
200–239 mg/dL	Borderline high
240 mg/dL and above	Too high

The values for HDL cholesterol are as follows:

Less than 40 mg/dL	Too low
More than 40 mg/dL	Desirable
Above 60 mg/dL	Optimal

If you are 20 years or older and have no signs of heart disease, the values for LDL cholesterol are as follows:

Less than 100 mg/dL	Optimal
100–129 mg/dL	Near optimal
130–159 mg/dL	Borderline high
160–189 mg/dL	High
190 mg/dL and above	Extremely high

Your doctor may give you these cholesterol values as a ratio of total cholesterol to HDL cholesterol. This is calculated by dividing your total cholesterol by your HDL cholesterol. According to the American Heart Association (AHA), the ratio should be below 5:1. A ratio of 3.5:1 is considered optimal.

So, you should not simply keep track of your cholesterol levels, but you should also do everything in your power to keep your LDL levels low and HDL levels high.

FOODS TO HELP LOWER CHOLESTEROL

Most of us probably realize that fried foods, ice cream, and fatty red meats raise cholesterol levels. Well here’s some great news. There are actually foods you can add to your diet to reduce your cholesterol levels. Researchers have discovered that some foods, particularly deep sea fish, oatmeal, walnuts, and foods high in plant sterols, can help regulate your cholesterol. Research has also revealed that a diet combining some of these foods may be just as effective at reducing cholesterol as cholesterol-lowering drugs (particularly LDL or “bad” cholesterol).

In no particular order, here are some superfoods that will help keep your arteries cholesterol free for decades to come!

Oatmeal and Other Fibrous Foods

Besides tasting great and being a staple breakfast food, oatmeal is loaded with soluble fiber. Soluble fiber has been shown to reduce LDL, the “bad” cholesterol. Soluble fiber is also found the following foods: brussels sprouts, pears, apples and prunes.

Some fibers – especially the gel-like soluble fiber – binds bile (which also contains cholesterol) and free cholesterol so the body can excrete it faster, thereby reducing its absorption in the intestines. You don’t need to eat whopping amounts either – just five to ten grams of soluble fiber a day decreases your LDL cholesterol by about 5 percent. One cup of cooked oatmeal provides you with a solid 4 grams of fiber.

Soy Protein

Don’t worry guys, soy protein won’t make you grow breasts, but it just may keep you from developing heart disease. The cholesterol-reducing abilities of soy protein was confirmed when the FDA approved the health claim for soy’s capability to reduce the risk of heart disease. For optimum effect, it is recommended that you consume at least four servings of about 6 to 6.5 grams of soy protein per day, totaling 25 to 26 grams. Since the health benefits claims and FDA endorsement, many supplement manufacturers have introduced soy drinks and protein bars containing 10 to 20 grams of soy protein.

Nuts

For years nuts have had a bad reputation because they are high in fat. However, most nuts, especially almonds and walnuts, have high amounts of monounsaturated or polyunsaturated fats – the “good” fats. These fats actually help to lower cholesterol levels. Researchers at Loma Linda University discovered that a diet fortified with pecans not only lowered total and LDL cholesterol significantly, but also helped keep levels of HDL high. Other studies, such as those studying Mediterranean-style diets high in walnuts, also demonstrated the cholesterol-lowering abilities of nuts. The evidence is in, so don’t be afraid to go nuts on a regular basis!

Fruits and Vegetables

While some of the foods on this list may surprise you, most readers are probably aware of the numerous health benefits of fruits and vegetables. Fresh fruits and vegetables such as apples, pears, citrus fruit, berries, green leafy vegetables and yams are high in soluble fiber and pectin. Both have shown to be beneficial in reducing cholesterol levels. Try to have at least five servings a day for the full benefits.

Flaxseed Oil

Flaxseed oil is high in alpha-linolenic acid (a polyunsaturated fat), which has been proven to lower cholesterol. Studies show that flaxseed helps lower total and LDL cholesterol levels. Other research has revealed that another ingredient in flaxseed, omega-3 fatty acid, may also help lower blood triglyceride levels and blood pressure. It may also keep blood platelets from becoming sticky and adhering to arterial walls. So if you’re already using flaxseed and/or flaxseed oil, keep doing so. If not, head to the supplement store right now. Make sure to buy whole seeds, then grind it at home and keep it in the fridge to avoid rancidity.

Olive Oil

There are centuries of evidence showing that people who follow Mediterranean diets have a low occurrence of heart attacks. One of the reasons is the high amounts of olive oil in such diets. Olive oil contains large amounts of monounsaturated fats and studies have shown that it can lower both LDL and total blood cholesterol levels. There is also evidence to suggest that olive oil reduces the clotting ability of blood; not to the point that it’s dangerous, but to the extent that it helps prevent buildup on the arterial walls. So even if you can’t afford that trip to Italy or Spain, place a bottle of olive oil on your kitchen table.

Fish

Studies from the 1970s showed that the Greenland Inuit had lower rates of heart disease than any other ethnic group living in the area. After analyzing the data, the researchers came to the conclusion that the diet of the Inuit – specifically fish, seal and whale meat – was the cause. Fish oil and sea mammals contain high amounts of omega-3 polyunsaturated fatty acids that make the blood more slippery and less likely to clot. Omega-3 fatty acids also seem to lower total and LDL cholesterol levels. The best sources of fish are salmon, herring, trout and sardines.