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Cholesterol - The highs and the lows!

Updated: May 28

Have you been told you have high cholesterol? Have you been offered a statin? Are you confused by all the conflicting information? Not sure what you should be eating to lower those numbers?





Then read on! 😊



With this blog, I aim to explore the topic of cholesterol while helping you understand the many myths and misconceptions you have probably heard, and why you may still be hearing them. 🙃


Although the topic of cholesterol often involves conflicting viewpoints, my concern and aim, shared by the numerous clients I have helped, revolves around the steps required to reduce the risk of future illness and help you secure a healthier future. I have included some extra resources at the bottom for a more in-depth explanation and reference.


I have included the most important areas to understand when faced with how to improve your cholesterol numbers. At the end, you will find a plan of action to get you started. 👍 I've also headed each section. ( As it's a long one!) So, feel free to skip to the sections that help you the most.



Cholesterol: Essential for life


Although demonised for causing heart disease, cholesterol is a crucial molecule essential in the body

Although demonised for causing heart disease, cholesterol is a crucial molecule essential in the body for cell membrane integrity, synthesis of hormones including cortisol, estrogen, progesterone, and testosterone, bile production, and the synthesis of vitamin D. It is also crucial for the functioning of the nervous system, the brain and immune system.



The liver actually makes 75% of cholesterol with 15 - 25% coming from your diet, and despite its importance in the body, cholesterol, usually along with dietary fats, and dietary cholesterol found mainly in animal products, are still demonised as being the cause of atherosclerosis, the buildup of fat in your arteries contributing to heart disease.


However, research shows it is not so simple!




What do your numbers mean



"The most important thing when we consider your cholesterol numbers is your overall risk of heart disease"


The most important thing when considering your cholesterol numbers is your overall risk of heart disease. LDL cholesterol, your supposed "bad" cholesterol, is often used as a marker of risk, and although raised LDL is shown to contribute to plaque buildup on the arterial wall, the size and density matter.


What the tests carried out by your GP are measuring is the particle size, the lipoproteins that transport cholesterol around the body. The cholesterol itself is not good or bad, it is just cholesterol. The size of these particles, however, determines their ability to cause damage to the arterial wall and contribute to cardiovascular disease. Sub particles of LDL, very low-density lipoproteins (VLDL) for example, are shown to be more damaging than larger less dense LDL particles. (There are other proteins and carriers involved that can also be measured but we'll keep it simple here.)


Therefore, breaking down your LDL figures and knowing your very low-density lipoproteins (VLDL) can help you understand your risk and underlying cause. This can be determined through further testing or estimated using an equation calculator.


Several factors that influence very low-density lipoproteins (VLDL) production include;


  • Genetics

  • A high carbohydrate diet, especially refined carbohydrates and sugars stimulate the production of VLDL particles in the liver

  • Raised triglycerides

  • Alcohol

  • Processed foods

  • Insulin resistance - VLDL are associated with high blood glucose levels, metabolic syndrome and type 2 diabetes.




Dietary Cholesterol


Dietary cholesterol is not associated with an increased risk of heart disease


What has been known for a long time and is even acknowledged by the American Heart Association and several large-scale studies is how little dietary cholesterol found mainly in animal products, eggs and shellfish impacts your blood cholesterol levels. Dietary cholesterol is not associated with an increased risk of heart disease for most people. Eggs, for example, are high in cholesterol but do not increase the risk of heart disease.



Fats: The Healthy and Not So Healthy


The impact of saturated fat consumption on LDL cholesterol may not accurately reflect its effect on cardiovascular disease risk


The consumption of fat in the diet, however, is not as clear-cut. Dietary fats play a crucial role in supporting overall health. They provide essential fatty acids necessary for cell function, support the optimal function of the brain, immune and nervous system, regulate inflammation levels in the body and aid in the absorption of fat-soluble vitamins (A, D, E & K). Eating fat with your meal can help with satiety, fills you up, keeps you full and prevents overeating.



Saturated fats, commonly found in animal products like meat and dairy, as well as some plant sources like coconut oil do increase LDL cholesterol. Your supposed "bad" cholesterol. However, this does not mean they are bad for you and should be eliminated from your diet. As mentioned above, it is the VLDL that is the most atherogenic, plaque-causing, and this is increased by mainly simple carbohydrates and sugars, alcohol and processed foods. Furthermore, when carbohydrates replace saturated fat, it lowers LDL cholesterol but also reduces HDL cholesterol and increases triglycerides, a type of fat (lipid) found in the bloodstream. This lipid profile increases your risk of heart disease.


The most important thing to recognise is the effect of saturated fat consumption on LDL cholesterol may not accurately reflect its effect on cardiovascular disease risk, and some saturated fats may have health benefits so do not need to be totally eliminated from your diet.


Unsaturated fats, including monounsaturated fats found in olive oil, avocados, and nuts, and polyunsaturated omega-3 fats found in fatty fish, flaxseeds, and walnuts, are considered heart-healthy and can help lower LDL cholesterol levels.


Transfats and processed damaged fats found in partially hydrogenated oils and processed foods, baked goods, packaged snacks and processed meats are harmful and have been linked to an increased risk of heart disease and increased inflammation levels in the body.


Omega-3 fatty acids, mainly in fatty fish like salmon and mackerel, as well as flaxseeds and chia seeds, reduce triglycerides, modify LDL cholesterol to become less harmful and plaque-causing, increase HDL and lower inflammation.


The most important thing is to eat good quality natural fats, not damaged by excess heat or processing and in moderation. Ideally grass-fed, high-welfare meat and wild fish instead of farmed.


Some factors to consider;



Your LDL-C (Low-Density Lipoprotein) - This can be broken down further into Very Low-Density Lipoproteins (VLDL) to ascertain your risk of heart disease. Your HDL-C (High-Density Lipoprotein) - HDL cholesterol returns excess cholesterol to your liver, which is broken down and removed from the body. HDL also has anti-inflammatory and protective antioxidant properties.


Your Triglycerides - Triglycerides are a type of fat found in the bloodstream. Elevated triglyceride levels are often associated with an increased risk of heart disease and can indicate poor metabolic health. Triglycerides are influenced by factors such as a high carbohydrate diet, processed food, physical activity, alcohol and genetics.



Your cholesterol/HDL ratio - also known as the total cholesterol to HDL cholesterol ratio, is another marker used to assess cardiovascular risk. It is calculated by dividing your total cholesterol level by your HDL cholesterol level. This ratio provides information about the balance between total cholesterol and HDL cholesterol in the bloodstream. A high cholesterol/HDL ratio is associated with an increased risk of cardiovascular disease.



Triglycerides: HDL ratio - A diagnostic marker for metabolic syndrome, an increased TG: HDL ratio suggests there is a high amount of triglycerides which is associated with insulin resistance and raised blood glucose levels. A raised TG: HDL ratio is shown to increase the risk of heart disease more so than your total cholesterol and total cholesterol: HDL ratio.



Oxidation and inflammation play pivotal roles in the development and progression of heart disease. We can also look at oxidised LDL (oxLDL) sub-particles with further testing. When LDL cholesterol becomes oxidized it can trigger inflammatory responses in the arterial walls and promote the formation of atherosclerotic plaques. These plaques can narrow the arteries and restrict blood flow, leading to cardiovascular events such as heart attacks and strokes.


Look at other risk factors for cardiovascular disease and metabolic syndrome alongside cholesterol and triglycerides. This can provide information on underlying health, risk of further illness, reasons for raised cholesterol and guide dietary and lifestyle recommendations. When working with clients I offer a cardiometabolic profile which includes a detailed look at cholesterol numbers, and areas such as inflammation levels, blood sugar and insulin resistance, homocysteine, B6, B9, B12, and other useful markers for assessing cardiovascular disease risk,





Plan of action to improve your cholesterol profile


The most important thing is the overall pattern of your diet - i.e. anti-inflammatory, heart healthy, high in fibre, colourful, full of fruits and vegetables, and plants rich in vitamins, minerals, phytochemicals.



🍃Prioritise a diet rich in fruits, vegetables, herbs, spices, legumes (beans, soybeans, lentils, and green peas), nuts, and seeds. These foods provide fibre, antioxidants, and phytonutrients that support heart health. Increasing soluble fibre can help lower LDL cholesterol by binding to it in the intestines and promoting excretion. Vitamins, minerals and phytonutrients provide therapeutic properties to support healthy lipid profiles, reduce LDL cholesterol oxidation and inflammation in the arteries, and support cardiovascular health.


☘️ One quick, easy way to include lots of these foods together is to make a green smoothie with leafy greens, avocado and frozen or fresh berries. For an extra boost add a dessert spoon of oatmeal, ground flax or lecithin or a tablespoon of nut butter.


🌷Choose Healthy Fats - Include sources of healthy fats such as avocados, olives, nuts, and seeds. These provide heart-healthy fats to fill you up and keep you full at meal times.


🌻 Increase Omega-3 Fatty Acids - Consume fatty fish (anchovies, herring, mackerel, salmon, sardines, and trout) two to three times per week. Also flaxseeds, chia seeds, and walnuts for their omega-3 fatty acids. Omega-3s help lower triglycerides and have anti-inflammatory effects.


🌿 Reduce processed fats found in fried foods, baked goods, packaged snacks, and processed meats which are often high in transfats and damaged fats.


🌸 Eat saturated fats such as grass-fed meats, butter, full-fat dairy and coconut oil in moderation. (I know! What does moderation even mean? 🤷‍♀️ Guidelines consist of daily saturated fat amounts i.e. 6 - 11% of your daily calorie intake but generally, to err on the side of caution you can still enjoy that steak, which is high in protein, heam iron, zinc, B vitamins and other essential nutrients once or twice a week, or small amounts of good quality saturated fats as part of the dietary pattern discussed here.


☀️ Improve Insulin Sensitivity - Fasting may enhance insulin sensitivity, which is beneficial for those with insulin resistance or metabolic syndrome. Improved insulin sensitivity can also positively influence lipid metabolism. Some studies suggest that intermittent fasting may also lead to a reduction in LDL cholesterol and triglyceride levels. Aim for a minimum of 12 hours overnight and 5 hours between meals.


🌼 Limit added sugars and refined carbohydrates and don't overdo the bread, pasta and processed wheat products -  High carbohydrate diets contribute to elevated VLDL and triglyceride levels.


☘️ Moderate Alcohol Consumption - If you consume alcohol, do so in moderation or think about reducing your intake. Excessive alcohol intake can raise triglycerides and VLDL.

 

🥀 Stay Hydrated: Drink plenty of water throughout the day. Staying hydrated supports overall health and has positive effects on lipid metabolism.


🌾 Consider supplementation -  Supplementation alongside the changes above may help improve your cholesterol, overall health and risk of heart disease. The following are shown to be beneficial.

 

• Omega-3 Fatty Acids - Fish oil supplements, rich in EPA and DHA, are commonly used to support heart health and may help lower triglycerides.

• Plant Sterols and Stanols - Plant sterol and stanol supplements may be considered to help lower LDL cholesterol.

• Red Yeast Rice - Red yeast rice supplements contain compounds that may have a cholesterol-lowering effect.

• Berberine - A compound found in certain plants has been studied for its potential to support cholesterol and glucose metabolism.

• Coenzyme Q10 (CoQ10) - Individuals on statin medications should consider CoQ10 supplementation as statins can reduce CoQ10 levels in the body.

• Niacin (Vitamin B3) - Niacin supplements are shown to improve cholesterol profiles and lower triglycerides.

• Added fibre – Consider a fibre supplement daily to support healthy digestion, cholesterol clearance, and blood sugar levels. Psyllium husk is an easy to find supplement to take daily. 

 







If you would like a comprehensive evaluation of your metabolic health, I

I offer comprehensive testing to identify risk factors for cardiovascular disease, metabolic syndrome and diabetes to help you make informed decisions and guide you back to optimal wellness. Testing assesses your cholesterol profile, risk factors for cardiovascular disease, and type 2 diabetes.


Maybe you have a test result indicating a problem, have received a diagnosis, or just want to feel better about your diet and health. I will meet you where you are, and together, we will address the root causes of your health issues, optimise your nutritional status, and support your body's natural ability to heal and thrive through personalised nutrition and lifestyle interventions


If you have any questions please do get in touch!


I would love to hear from you.


Julie x


Helping you live a healthier, happier life










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