About Cholesterol
Cholesterol is a waxy, fat-like substance found in every cell of your body. It plays crucial roles in the production of hormones, vitamin D, and bile acids, which aid in digesting fats. Cholesterol can be divided into two main types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL):
- LDL: This is often referred to as ‘bad cholesterol’. It carries cholesterol from the liver around the body and, if supply exceeds demand, can cause harmful build-up of cholesterol. This build up may be associated with cardio vascular disease. Guidelines suggest we should have an LDL level less than: 3.0 mmol/L. It’s also worth noting that current research suggests that it’s not just the amount of LDL cholesterol but also the size and density of LDL particles that matter. Small, dense LDL particles are considered more atherogenic (more likely to contribute to plaque buildup) than larger, fluffy LDL particles.
- HDL: This is often referred to as ‘good cholesterol’. It takes cholesterol away from the body and back to the liver where it is then excreted via the faeces. Guidelines suggest we should have a HDL level greater than: 1.0 mmol/L.
- Triglycerides: High levels of triglycerides can increase the risk of stroke or cardiovascular disease. The target for triglycerides is less than 200 mg/ dL.
If your GP tests for cholesterol, it is important to ask for the levels of the lipoproteins above as well as the total number as it is the balance of these lipoproteins that is important. Ideally, we should have a ratio of LDL: HDL 3:1.
Foods Which May Balance Cholesterol
Changing your diet can impact blood cholesterol levels in as little as ten days. Below are some foods which have been shown to balance cholesterol levels:
- Soya: Soya protein has been shown to lower triglycerides. Use soya milk in your breakfast cereal, enjoy soya beans as a side dish or add tofu to stir-fry dishes.
- Nuts: Those who eat nuts like almonds or walnuts on a regular basis have been found to have a lower risk of developing heart disease. This is because nuts are rich in several heart-healthy nutrients including phytosterols, magnesium, Vitamin E and fibre. Enjoy a small handful of raw nuts, or a little nut butter on oatcakes for your mid-morning snack.
- Flaxseeds: One study found that taking 20g of ground flaxseeds a day for 60 days resulted in the same reduction in cholesterol as cholesterol-lowering medication. This is due to the fact that flaxseeds are high in fibre and Omega 3 fatty acids. Aim for a tablespoon a day. Add to cereals, bread and smoothies.
- Oily Fish: Oily fish like mackerel, trout, herring, sardines and salmon contain Omega 3 fatty acids. Omega 3 fatty acids protect against heart disease in several way. They lower triglyceride levels, prevent the blood from clotting, and regulate the heart rhythm. Aim for three servings a week.
- Oats: Studies have found that eating oats each day could protect against heart disease by lowering the so-called “bad” LDL cholesterol. This is because oats are rich in a soluble fibre called beta-glucan. Beta-glucan binds with water, forming a thick gel in the digestive tract which in turn binds to excess cholesterol so that it is eliminated from the body as waste. An optimal intake is considered to be 3g or more of oat beta glucan per day and that this can be achieved through eating 2-4 portions of oat based products. A serving is one bowl of porridge or muesli, two oatcakes or two slices of oat bread. Barley is also rich in beta-glucans and can help lower LDL cholesterol. You can use pearl barley to make risotto.
- Pulses: Pulses like lentils, chickpeas and kidney beans are rich sources of fibre which helps to lower cholesterol. A review of 26 randomized controlled studies found that eating half a cup (118 ml) of legumes per day is effective at lowering LDL cholesterol.
- Olive oil: A double-blind trial showed that a diet high in mono-unsaturated fatty acids from olive oil, lowers cardiovascular disease risk by 25%, as compared with a 12% decrease from a low-fat (25% fat) diet. The trial also found that low-fat diets decrease HDL cholesterol by 4. Try using about 2 tablespoons (23 grams) of olive oil a day in place of other fats in your diet. It can be used in cooking and added to salads.
- Avocado: Avocados are rich in monounsaturated fatty acids. Studies have shown that the daily consumption of avocado results in improved blood cholesterol with a decrease in triglycerides and LDL of around 22% and an 11% increase in HDL . Add to salads or spread onto oatcakes for a snack.
- Cinnamon: Cinnamon can reduce cholesterol levels while at the same time clearing and preventing plaque build-up. Cinnamon is also full of antioxidants which further improve cardiovascular health by protecting blood from damaging oxidation. Add to hot drinks, yoghurt or stewed apple.
- Turmeric: Curcumin, the main component of Turmeric, is a powerful anti-inflammatory. Adding turmeric to your diet can seriously reduce inflammation and damage to arterial walls which are leading causes of plaque build-up and blood clots. Furthermore, studies have shown us that the high levels of curcumin in Turmeric can aid in the reduction of fatty deposits in the arteries by up to 26% .
Foods to Limit
- Saturated fat: Studies show that too much saturated fat in the diet leads to higher LDL levels. It is found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products.
- Sugar: Recent evidence indicates that added sugar – in the form of table sugar (sucrose) or high-fructose corn syrup – is probably a greater contributor to heart disease than is consumption of saturated fat. It may also reduce HDL cholesterol. Avoid consuming foods with added sugars, particularly soft drinks and highly processed snack foods.
- Trans fats: Trans fats raise low-density lipoprotein (LDL), the “bad,” cholesterol, and lower high-density lipoprotein (HDL), the “good,” cholesterol. These fats are often founds in margarine and processed baked goods.
Tests
When it comes to assessing heart health, basic lipid profiles that measure total cholesterol, LDL (low-density lipoprotein), HDL (high-density lipoprotein), and triglycerides are commonly used. However, for a more comprehensive understanding of cardiovascular risk I often refer clients for advanced blood tests as these can provide valuable insights into lipid sub-types and particle sizes and allow for very bespoke dietary intervention.
