Managing High Cholesterol

What is Cholesterol?

Cholesterol is a type of fat which is part of every cell in the body. Two interesting facts about cholesterol: 17% of brain tissue is cholesterol, the body produces 80% of the cholesterol we need and diet provides the rest. It is important to understand the role of cholesterol in the body in helping understand why balance is key.

Importance of Cholesterol

• An essential substance which bile and many hormones are derived
• Integral part of cell membranes
• Essential for normal immune function
• Helps conduct nerve impulses

Types of Cholesterol

It is important to distinguish that cholesterol itself is not harmful.It is the type of cholesterol and the ratio that matters! 

HDL is known as the “good” cholesterol and LDL is known as the “bad” cholesterol. But there are 2 particle sizes with LDL- Large (safe) or small, dense and dangerous (V)LDL.

Limits for Blood levels of Cholesterol

LDL: considered high 129mg/dl or 3.3mmol/l or more

HDL: Considered normal 40-49 mg/dl for men and 50-59mg/dl for women. Desirable levels are 60 mg/dl / 1.6 mmol/l or more

Cholesterol levels are considered too high when total cholesterol levels are higher than 200mg/dl (5.2 mmol/l) .

The ratio of total cholesterol levels to HDL is a better indication of Cardiovascular disease (CVD) than total cholesterol. This ratio is calculated by dividing total cholesterol by HDL. The ideal ratio is between 3.5:1 – 5:1

Blood cholesterol levels over 240 mg/dl or over 6.2 are dealt with by taking cholesterol lowering drugs. The side effects of these types of drugs can be serious including liver damage and Increased risk of cancer and stroke.

It is important to note that these drugs can also cause cholesterol to be too low resulting in other negative consequences such as:

• Lack of concentration
• Depression
• Neurological disorders

A 2009 study showed 75% of heart attack patients had normal or low cholesterol levels. Another study showed heart attack patients with low cholesterol levels were twice as likely to have a fatal heart attack in 3 years after a cardiac event.

If cell membranes don’t have enough cholesterol, immune resistance is reduced and cancer risk increases. This is why a balance of the right amount and type of cholesterol is key!

When we hear the world cholesterol we think of Cardiovascular Disease. But the reality is, cholesterol is just one small piece of a larger picture. Accumulation of plaque in the arteries leads to narrowing and hardening of the arteries. But why does plaque accumulate to begin with?

Plaque is deposited in an attempt to heal tissue. We must consider why there is tissue damage in the first place. There are a variety of factors that lead to tissue/arterial lining damage, but one of the most significant causes of cellular damage is free radicals.Free radicals are unstable molecules which damage our cells.  When there is damage to cells in our arteries, the body will respond by laying down a variety of substances which make up plaque, one of those substances is Cholesterol. However, cholesterol is the last constituent to be laid down as plaque, not the first.

There are two ways we should look at managing cholesterol. One is to address the root of arterial plaque accumulation. We must control the damage! By reducing our free radical load, we will protect our cells from damage.

The second is to support our body so it can eliminate excess cholesterol.

Controlling the Damage:

Dietary sources of free radicals include:

• Preservatives in processed meats (nitrates)
• Polyunsaturated oils that have been heated/damaged
• Alcohol
• Sugar

Two of the primary dietary factors that contribute to damage of the arterial tissue and high blood cholesterol are sugar and polyunsaturated/damaged fats.

Sugar is sticky and it adheres to the lining of the arteries, causing damage and buildup. High blood sugar levels result in the liver converting sugar into cholesterol and fat.

Both cholesterol and triglyceride levels tend to rise in response to dietary sugars, caffeine and alcohol more than they do in response to dietary fats or cholesterol.

Fats

There has been plenty of controversy over dietary fats and cardiovascular disease. This has led to fear of animal fats and trends for low fat diets. But fat is crucial to our health, this is where we get our fat-soluble vitamins such as vitamins E, D, A and K (which protects against free radical damage) are critical for brain and nervous system function. 

Going back to cellular damage, different types of fats are more stable than others. The more saturated the fat, the more stable the oil is. The more unsaturated the fat, the less stable the oil. Unstable fats create free radical damage.It is the quality of fatswhich contributes to cardiovascular disease risk. Damaged/rancid oils including altered fats such as hydrogenated fats lead to cellular damage, it is important not to heat or cook oils that are polyunsaturated (liquid at room temperature) with the exception of certain oils that have a high smoke point.

Environmental/Lifestyle sources of free radicals:

• Cigarette smoke
• Heavy metals- found in soil and drinking water
• Radiation- x ray, cell phone etc.
• Stress and overwork

We have a control over the food we ingest and can reduce our environmental exposure to free radicals.

Only aiming to lower cholesterol through misleading/dangerous low fat diets or drugs is a one sided approach. Supporting our body so it can eliminate excess cholesterol is the second part to the equation.

How to support our body to eliminate excess cholesterol:

• Stress Management: Stress and release of stress hormones- raises blood sugar levels, causing liver to produce more cholesterol
• Increasing water intake and food rich in lecithin (eggs, soybeans, organ meats) aids removal of cholesterol via bile. Removal of cholesterol from the body depends on bile.
• Proper elimination- bile is eliminated via the stool, constipation contributes to excess cholesterol accumulation
• Supporting the Liver/gallbladder- Liver congestion/ gallbladder blockages slow the body’s ability to remove excess cholesterol
• Exercise- Aim for at least 30 minutes of moderate exercise 5 days a week for maintenance. Lack of exercise slows the elimination of cholesterol from the body

Fear comes from the unknown. Once we understand the relationship between diet, lifestyle, environment and as well as the types and benefits of cholesterol we can relax and not make decisions based out of fear but knowledge!

Disclaimer: Please consult a physician before attempting to alter or reduce any medications.

References:

• “Read this if you have a Heart” 2013 Dr. Elie Klein BSc, ND
• Sachdeva A, Cannon CP, Deedwania PC, Labresh KA Smith SC Jr, Dai D, Hernandez A, Fonarow G.C, “Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalized with Get With The Guidelines”. AM Heart J.2009 Jan; 157 (1): 111-117
• Al-Mallah MH et at. “Low admission LDL- cholesterol is associated with increased 3-year all- cause mortality with patients with non-ST segment elevation myocardial infarction.” Cardiol J. 2009;16 (3): 227-33
• The Nutrition Bypass, Reverse Atherosclerosis without surgery David W. Rowland 2013
• Nutritional Pathology Second Edition Brenda Lessard-Rhead BSc, ND 2013