Therapeutic lifestyle changes in controlling high cholesterol levels

What is cholesterol?

Cholesterol is a fat-like substance which is constituents of cell membranes and precursors of some hormones in the body. Cholesterol is not an essential nutrient, as our body can make it in the liver. According to the data from the World Health Organization (WHO), Ischemic heart disease is the leading cause of death in western countries, and a third of that will be attributed to high levels of blood cholesterol.

There are two kinds of cholesterol in the blood: Low-Density Lipoprotein (LDL), “the bad” one and High-Density Lipoprotein (HDL), "the good" one. However, what is the difference? The answer is, higher LDL levels increase cardiovascular diseases whereas higher HDL levels have a protective effect against cardiovascular diseases (CVD), as it removes the LDL from blood and brings it back to the liver for disposal.

In this article, we’ll talk about some steps we can take to improve serum cholesterol. In addition to taking your medications prescribed by your doctor, having a healthy body weight, healthy eating pattern, and physical activity can all help to reduce high serum cholesterol levels and in turn prevent from developing cardiovascular diseases.

Healthy Diet 

Having a healthy diet can help in controlling cholesterol levels. A nutritionally balanced diet with a low intake of trans saturated fats, and incorporation of food sources rich in soluble fibre, and plant sterols can decrease LDL levels.

While insoluble fiber mostly helps in regularity and healthy digestion system, soluble fibre (gel-forming fibre) can have a significant effect in lowering cholesterol, it's lowering-cholesterol effect has been attributed to its high-viscosity, it binds to lipids, and bile acids increasing excretion of each by decreasing serum cholesterol. Try to incorporate at least 10 g of soluble fibre into your diet, legumes, Beta-glucan, passion fruit, avocado are some rich sources of soluble fibre to name.

Cholesterol and Fats

Data from clinical trials show that trans fats elevate LDL-C and decrease HDL-C. According to current guidelines, it should be less than 1% of total energy intake. Trans fats naturally occur in lamb, beef, and dairy products, it can also form during food processing. It has been recommended to choose from lean parts of meat and lower-fat dairy products, as higher-fat ones are even higher in saturated fat.

On the other hand, consuming polyunsaturated fats in moderation have excellent benefits for your body. Replacing foods high in saturated and trans-fat with polyunsaturated fats can lower LDL-C and the ratio of LDL-C to HDL-C in the blood. Nuts, flaxseed, chia seed, fatty fishes like Salmon, Mackerel, Sardines, and trout are some excellent sources of unsaturated fats.

Phytosterols are compounds similar to cholesterol which occur in plants and vary only in carbon side chains; they partly limit cholesterol absorption in small intestine. Phytosterols are found in some vegetable oils, nuts, and legumes. Plant sterols are also added to certain foods in Canada like some spreads and juices. Taking a supplement also can be considered. Plant sterols should not be prescribed to children under five years old, pregnant and breastfeeding mothers.

Also, last but not the least, maintaining healthy body weight, not only is beneficial for optimum serum cholesterol levels, but also it can prevent from other health conditions including, but not limited to high blood pressure, diabetes type 2, cancer, etc. In addition to regular physical activity, calorie restriction can result in weight loss; but make sure you have a nutritionally well-balanced diet that includes healthy foods from all groups; fruits and vegetables, meat and alternatives, whole grains and healthy fats.

References

• L Kathleen Mahan; SykviaEscott-Stump; Janicel Raymond, (2012); Krause’s Food and Nutrition Care Process, 13 Edition.
• Evidence-based Practice in Nutrition (PEN); Dietitians of Canada, Eating Guidelines for People with High Blood Cholesterol Levels, 2013. 
• Johnson W. McRorie, Jr, Ph.D.; Nicola M. McKeown, Ph.D., (2016); Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber, Academy of Nutrition and Dietetics, vol.117, no. 2: 261-264.
• Hooper L, Martin N, Adbelhamid A, Dave Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2015 Jun 10;(6): CD011737. doi.10.1002/14651858.CD011737.
• https://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/
• https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/health-claims/assessments/plant-sterols-phytosterols-foods-nutrition-health-claims-food-labelling.html