Cholesterol is a waxy substance found in the blood. While the word cholesterol may have a generally negative reputation, it’s vital for health. Cholesterol is a part of the structure of cells, which are the building blocks for all of the body’s functions.
Cholesterol is also necessary to make hormones such as testosterone and estrogen, as well as producing vitamins and bile (bile breaks down fats for digestion).
The liver and intestines produce about 80% of the cholesterol in the body. The other 20% of cholesterol comes from the food we eat. Too much cholesterol, or an imbalance in the type of cholesterol in the body, can be detrimental to health.
There are different types of cholesterol. Cholesterol molecules are lipoproteins. Low-density lipoproteins, or LDL cholesterol, are “bad” cholesterol.
Having too much levels of LDL cholesterol can lead to plaque buildup in arteries. These plaque deposits can restrict blood flow by forming blockages in the arteries. If a blockage occurs in a heart artery, a heart attack can occur. If the blockage occurs in an artery supplying the brain, a stroke can occur.
High-density lipoproteins, or HDL cholesterol, are “good” cholesterol. HDL cholesterol helps remove LDL cholesterol from the body and can actually be protective against heart disease. Having low levels of HDL cholesterol is a risk factor for heart disease, especially in the presence of high LDL cholesterol.
What causes high cholesterol?
Genetics can play a significant role in how high a person’s cholesterol is. As mentioned earlier, about 80% of the cholesterol in the body is produced by the body itself. The tendency to produce large amounts of cholesterol can be inherited and passed down genetically.
A condition called familial hypercholesterolemia occurs when one of the chromosomes has a defect, which makes the body unable to remove bad cholesterol from the blood. People with familial hypercholesterolemia tend to have very high cholesterol levels and may even develop heart disease at earlier ages than normal.
About 20% of the cholesterol in the bloodstream is affected by a person’s diet. Animal products contain cholesterol, such as eggs, shrimp and meat. Plants produce a minimal amount of cholesterol, but this doesn’t contribute to the cholesterol levels in humans.
People with high cholesterol should be mindful of their cholesterol intake, as some people are more sensitive to dietary cholesterol than others.
Foods rich in saturated fat can also raise bad cholesterol levels. Saturated fat is primarily in animal products such as full-fat dairy and high-fat meats. But it’s also in some plant foods such as coconut and palm kernel oil.
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What is the link between diabetes and cholesterol?
Diabetes tends to alter blood cholesterol levels, which is diabetic dyslipidemia. Diabetic dyslipidemia occurs when good cholesterol is low, and bad cholesterol is high. Studies have found that insulin resistance, which is one of the causes of type 2 diabetes, may be a precursor for diabetic dyslipidemia.
Having high cholesterol is a risk factor for developing heart disease. There is a strong correlation between diabetes and heart disease; adults with diabetes are two to four times more likely to die from heart disease than people without diabetes. Keeping both diabetes and cholesterol well-controlled are positive steps that can reduce the risk of heart disease.
Other factors besides cholesterol levels impact a person’s risk of developing heart disease. Altogether, these factors make up the ASCVD (Atherosclerotic Cardiovascular Disease) risk score, which can be determined through a visit with a healthcare provider.
How to lower cholesterol
Lifestyle changes and/or medications can reduce cholesterol. Statins are a class of drugs that can help lower high cholesterol. Their intensity level classifies them, or the ability to lower cholesterol.
There are high-, moderate- and low-intensity statins available. Statins work by blocking certain liver enzymes responsible for manufacturing cholesterol. Statins tend to lower LDL and raise HDL levels, which is ideal.
Lifestyle changes are often recommended as the primary treatment for high cholesterol. Eating a healthy diet and being physically active helps reduce cholesterol levels naturally.
Eat heart healthy foods
This is in plant foods such as fruits, vegetables, nuts, seeds, whole grains, and legumes.
There are two types of fiber: soluble and insoluble. Soluble fiber, such as the kind found in oats, legumes, flax seeds, apples, berries, and broccoli, is especially helpful for lowering cholesterol levels.
Some people prefer to get their daily soluble fiber intake through a fiber supplement such as psyllium fiber.
Increasing fiber can reduce both total cholesterol and LDL cholesterol. However, some studies find that increasing fiber as the only lifestyle makes only a small contribution to lowering cholesterol. This means that increasing fiber should be part of an overall healthy lifestyle with other healthy food choices.
Reduce saturated fat
Choosing foods low in saturated fat can also promote healthy cholesterol levels. Saturated fat is primarily in animal products.
Choosing lean protein such as skinless poultry, lean red meat, fish, and low-fat dairy are some ways to keep saturated fat intake in check.
While it’s fine to have some saturated fat, the main goal is to have a balance with plenty of plant-based foods as well.
Foods rich in unsaturated fat can help raise good cholesterol. Choosing unsaturated fat over saturated fat can help promote the lowering of bad cholesterol. Foods rich in unsaturated fat include vegetable oils, nuts, seeds, and avocados.
Choosing avocado on a sandwich instead of a cheese is an example of one way to swap out saturated fat for unsaturated fat.
Enjoy fruit and vegetables
Food enriched with plant sterols and stanols has also shown promise in their ability to lower cholesterol levels.
In fact, when taken between 2 to 2.5 g/day, products enriched with plant stanol/sterol esters can lower LDL cholesterol levels by 10% to 14% without any reported side effects. Plant sterols and stanols are in small amounts in plant foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds.
Some foods are enriched with plant sterols and stanols to help people get high enough amounts to make a difference in lowering cholesterol.
Examples of foods enriched with these beneficial sterols and stanols include certain margarine, orange juice, and supplements. Reading the nutrition facts label can tell you if a food has sterols and stanols in it.
Eat foods rich in omega-3 fatty acids
Omega-3 fatty acids are heart-healthy and may help improve cholesterol levels. Fatty fish such as salmon, as well as walnuts, flax and chia seeds, are all excellent sources of omega-3 fats.
Drink green tea
There are studies on the benefits of green tea on lowering cholesterol as well. Green tea beverages or extracts can lower LDL cholesterol, but they don’t seem to affect HDL cholesterol.
Making adjustments towards a cholesterol-lowering diet is a great step to take if you have high cholesterol. Making small, realistic changes is the best way to approach diet changes. If you make drastic, strict changes, you’re less likely to stick with them.
High cholesterol likely won’t go away permanently after dieting for just a few months, so think about goals that you can see yourself carrying out as a consistent lifestyle change.
Working to be more physically active is another helpful change towards lowering cholesterol levels.
Studies show physical activity can be effective at improving outcomes in those with cardiovascular (heart) disease. Aerobic exercise, such as walking and jogging, tends to have a positive impact on HDL cholesterol levels.
Studies on physical activity and lowering LDL cholesterol are a bit more mixed. However, raising HDL cholesterol levels can help the body get rid of excess LDL.
Adding physical activity, even in short intervals several times a day, can help you begin to lose weight. Consider:
- Taking a brisk daily walk during your lunch hour
- Riding your bike to work
- Playing a favorite sport
Smoking links with increased cholesterol levels and increased risk of cardiovascular disease and high blood pressure.
Stopping smoking can help increase HDL cholesterol levels, therefore improving the lipid profile.
Moderate alcohol intake links with an increase in HDL levels. However, it isn’t recommended to start drinking alcohol or increase alcohol intake to improve cholesterol.
In fact, studies link excessive alcohol intake with an increased risk of mortality. Excessive alcohol intake means drinking >3 drinks per day on a regular basis or >5 drinks at any one episode.
There is some evidence that certain supplements may help reduce cholesterol. Niacin (vitamin B3) and red rice yeast are popular natural supplements to lower cholesterol naturally.
Other people take fish oil for its omega-3 content, which is beneficial for reducing the risk of heart disease.
Some people prefer to try these before starting a statin. As always, it’s best to have a conversation with your healthcare provider about your risk factors and treatment options for high cholesterol. Supplements tend to affect people differently in how effective they are so that results can vary from person-to-person.
The natural alternatives for lowering cholesterol include diet and exercise changes, and possibly using supplements. If natural alternatives aren’t enough to lower your cholesterol, then a discussion with your healthcare provider is the next best step to discuss your options.