Lowering Cholesterol with a Healthier Way of Eating

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Lowering Cholesterol with a Healthier Way of Eating

How is high cholesterol defined?

http://www.whfoods.com/genpage.php?tname=asknutr & dbid=103

 

 

High cholesterol or hypercholesterolemia is defined as

total

cholesterol greater than 200 mg/dL with the high risk

category greater than 240

mg/dL.

 

At these levels, particularly when the ratio of LDL to

HDL cholesterol

is greater than 4:1, risk of cardiovascular disease is

significantly

increased.

 

The ratio of LDL: HDL should be at least 4:1 because

each HDL can pick

up and transport 4 LDL back to the liver.

 

If I have high cholesterol levels, can a healthy way

of eating help me

lower them into a normal range?

Absolutely! In fact, a study published in the July

2003 issue of the

Journal of the American Medical Association in which a

whole foods diet

was compared head-to-head with treatment by statin

drugs found the whole

foods approach to be so effective that the Comment

accompanying this

JAMA article is entitled, " Diet first, then medication

for

hypercholesterolemia (high cholesterol). "

 

(For more discussion of recent studies see below:

Research Studies

Confirm the Importance of Healthy Foods and Healthy

Cholesterol Levels.)

 

What foods may help me lower my LDL cholesterol and

maintain or improve

my ratio of LDL to HDL to healthier levels, e.g., 175

mg/dL with a 4:1

ratio of LDL:HDL ?

 

A diet low in saturated fats and high in soluble fiber

from foods such

as oats, peas and beans (especially soy beans), has

been found to lower

elevated levels of LDL and improve the ratio of LDL to

HDL.

 

Cold water fish, garlic and onions, olive oil and

other sources of

monounsaturated fats have also been shown to lower

LDL, while cranberries,

soy foods and niacin have been found to raise HDL.

 

Supplemental niacin has also been found to not only

help reduce LDL

levels, but to raise levels of protective HDL;

however, it is important

that you check with your health care practitioner

before taking

supplemental niacin for this purpose. Niacin is

available in a number of

different forms, one of which may be significantly

more helpful for you than

another. In addition, some forms of niacin may cause

unpleasant flushing

in some individuals. Your health care practitioner can

help you

maximize the benefits and minimize the potential side

effects of supplemental

niacin.

 

If you want to lower your cholesterol levels or even

if you¡¯ve never

had any problems with high cholesterol and just want

to maintain healthy

levels, enjoying a Healthier Way of Eating with the

World¡¯s Healthiest

Foods can help keep your cholesterol levels in check.

 

Cholesterol is Not Inherently Bad for the Body:

In fact, without cholesterol, your body would be

unable to make

hormones, cell membranes or vitamin D. Normally,

cholesterol flows through the

blood vessels without causing any damage or the

build-up of

atherosclerotic plaques. It¡¯s only if cholesterol

becomes oxidized by free

radicals in the body that it can become problematic.

That is why eating foods

rich in antioxidants is so important. Foods rich in

antioxidants, such

as vitamins E, C and beta carotene, can help prevent

the oxidation of

cholesterol and the damage it may cause to blood

vessels.

 

(For more information on cholesterol, see below: What

is cholesterol,

and why should I be concerned if my cholesterol levels

are too high?

What causes high cholesterol?)

 

EAT MORE:

Foods for Healthy Cholesterol Levels

Nutrient Foods Benefits

Soluble fiber* Oat bran, barley, peas, beans (all

types, especially

soy) Lowers LDL and improves ratio of LDL to HDL

Niacin* (if LDL levels are already high, supplements

may be necessary

to reduce levels) Salmon, tuna, chicken, calf liver,

halibut, asparagus,

crimini mushrooms Helps decrease the body's production

and increase its

elimination fo cholesterol, prevents oxidation of LDL

and can increase

levels of HDL cholesterol

Antioxidants:

Vitamin E* Swiss chard, sunflower seeds, spinach,

kale, mustard greens

Helps prevent prevent the oxidation of LDL cholesterol

 

Vitamin C* Citrus fruits, broccoli, red bell peppers,

kale, Brussels

sprouts, kiwi fruit Helps prevent the oxidation of

cholesterol

Beta carotene* Carrots, sweet potatoes, winter squash,

kale Helps

prevent the oxidation of LDL cholesterol

Polyphenols, including pterostilbene Cranberries,

grapes, blueberries

Help prevent oxidation of cholesterol and increase

levels of HDL

cholesterol

Unsaponifiables Brown rice Lowers LDL cholesterol

Foods rich in taurine and omega 3 fatty acids (e.g.,

cold water fish),

monounsaturated fats (e.g., olive oil, avocado,

walnuts, almonds) and

the allium family of vegetables (e.g., garlic, onions)

can also be

helpful. These foods' cholesterol-lowering benefits

are discussed below

under " How Foods Help Lower Cholesterol " .

*Click on link for a complete list of foods rich in

these nutrients.

 

AVOID:

Saturated fats and cholesterol Red meat and other

animal products

Strong association with atherosclerosis and heart

disease

 

Trans-fatty acids (hydrogenated fats) Margarine,

coffee creamers, many

processed foods Increase LDL cholesterol and

lipoprotein(a) levels

 

Eating a Variety of Cholesterol-Lowering Foods Has

Additive Beneficial

Effect

A study published in the October 2004 issue of the

British Journal of

Nutrition underscores the additive beneficial effects

that result when

foods independently known to lower cholesterol are

combined in a healthy

way of eating. In this study of 12 patients with

elevated LDL

cholesterol levels, a diet containing soy protein,

almonds and other nuts, plant

sterols (also found in nuts), and soluble fiber (in

high amounts in

beans, oats, pears) reduced blood levels of all LDL

fractions including

small dense LDL (the type that most increases risk for

cardiovascular

disease) with near maximal reductions seen after only

2 weeks.

 

Want suggestions for some delicious

cholesterol-lowering meals and

recipes?

Just click here for our Atherosclerosis Meal Planner.

 

How do these foods help lower LDL cholesterol and

maintain healthy

levels?

Soluble Fiber:

Soluble fiber significantly reduces blood cholesterol

levels by several

different mechanisms:

 

Decreasing the absorption of dietary cholesterol

Increasing the removal of bile

Increasing the breakdown of blood cholesterol to

produce more bile

Decreasing the activity HMG Co-A reductase, a key

enzyme involved in

the production of cholesterol by the liver

First, soluble fiber in the intestines binds to bile

from the liver, so

the bile is carried out of the body as waste instead

of being

reabsorbed. In order for the body to make more bile,

which is necessary for

digestion, it must break down more cholesterol,

removing it from the

bloodstream. In addition, because bile is needed for

the absorption of

cholesterol from food, binding the bile makes it less

able to assist in

cholesterol absorption, so less dietary cholesterol is

absorbed from food as

well.

 

Secondly, when normal levels of bacteria are present

in the colon, they

are able to break down some of the soluble fiber into

what are called

short-chain fatty acids. In addition to being the

preferred fuel of

colon cells and thus essential for good colon and

digestive health, some

short-chain fatty acids are absorbed into the

bloodstream, where they

travel to the liver and decrease the action of HMG

Co-A reductase, one of

the main enzymes involved in the production of

cholesterol.

 

Diets high in soluble fiber have been shown in some

studies to lower

total cholesterol and LDL cholesterol as much as

20-30%. The soluble

fiber used in these studies was the

naturally-occurring fiber found in oat

bran, beans, and other food sources. In these same

studies, the use of

cooked soy beans, a rich source of both soy protein

and naturally

occurring soluble fiber, led to a decrease in total

cholesterol of 30% and a

decrease in LDL cholesterol of 35-40%.

 

(For more information, see below: Research Studies

Confirm the

Importance of Eating Healthy Foods on Healthy

Cholesterol Levels.)

 

Cultures in which soy foods constitute a major portion

of the diet

typically have much lower rates of heart disease than

cultures with a low

consumption of soy. In addition to this

epidemiological data, clinical

studies have shown that soy foods are protective

against the development

of heart disease and its associated mortality. The

beneficial effects

found in these studies are due to an intake of whole

soy foods and not

the isolated soy components that are currently

available in supplement

form. Soybeans and foods made from them have been

found to significantly

decrease the risk of heart disease and heart attack

via several

mechanisms. Soy can help prevent the oxidation of LDL

cholesterol and soy

foods have been shown to decrease LDL by 35-40% and

total cholesterol

levels by 30%, to decrease triglyceride levels, and to

decrease platelet

aggregation reducing the risk of blood clots. Soy

foods may also increase

levels of HDL (beneficial) cholesterol.

 

Research presented at the 2004 annual meeting of the

North American

Menopause Society held October 6-9, 2004 in

Washington, D.C., and a study

published in the November 2004 issuye of the American

Journal of

Clinical Nutrition suggest that soy offers special

cholesterol-lowering

benefits for premenopausal women: the isoflavones in

soy appear to work with

a woman's own estrogen to decrease cholesterol and

increase bone mass.

For a summary of this research, see below: Research

Studies Confirm the

Importance of eating Healthy Foods on Healthy

Cholesterol Levels.)

 

For more information about soy, click Soybeans.; on

fiber, click

Dietary Fiber.

 

Niacin:

Niacin, also known as vitamin B3, has been shown to

decrease the

activity of HMG Co-A reductase, a primary

rate-limiting enzyme involved in

the production of cholesterol, thus causing a decrease

in the body¡¯s

production of cholesterol. Niacin also helps increase

the breakdown of

cholesterol to bile, decreases the proliferation of

smooth muscle cells,

helps to prevent LDL oxidation, reduces platelet

clumping, lowers

lipoprotein(a) levels, and can increase levels of HDL

by as much as 15-40%.

Increasing HDL levels, particularly through diet, can

significantly

decrease atherosclerosis progression.

 

Niacin has been shown to decrease cholesterol levels

by 10-26% and to

decrease heart attack recurrence by 29%. Niacin given

to patients after

a heart attack reduced non-fatal heart attack

recurrence by 27% and

decreased long-term overall mortality by 11%.

 

For more information, click Niacin.

 

Vitamin E:

Vitamin E prevents oxidation of LDL cholesterol,

prevents the growth of

blood vessel plaques, and has been shown to reduce the

risk of heart

attack and deaths related to heart disease.

 

The primary fat-soluble antioxidant in the body,

Vitamin E is the

antioxidant found in highest quantities in LDL

cholesterol particles, which

it protects from oxidation. As the main antioxidant

defender of lipids

(fats) in the body, Vitamin E is responsible for

putting a halt to

chain reactions of lipid peroxidation anywhere in the

body.

 

Vitamin E has also been shown to decrease platelet

clumping, prevent

the rupture of existing atheromas, decrease the

migration of macrophages

to atheromas, prevent the inhibition of nitric oxide

production, and to

decrease the expression of adhesion molecules on the

surfaces of

endothelial cells (which form the outermost layer of

blood vessel walls),

thereby reducing the amount of binding that can occur

with monocytes and

other immune cells.

 

(For more information, see below: Research Studies

Confirm the

Importance of Eating Healthy Foods on Healthy

Cholesterol Levels.)

 

Why Whole Foods are Better than Vitamin E Supplements

The potential downside of taking vitamin E as a

supplement is that

large amounts have been associated with a possible

increase in oxidation.

This is because, in order to prevent the oxidation of

fats, the vitamin

E itself must become oxidized. If all of the vitamin E

in an LDL

particle becomes oxidized, it is then able to cause

oxidation of the LDL

cholesterol. A way to prevent this from happening is

to make sure that

enough of the antioxidant vitamin C is available.

Vitamin C is very

effective at restoring oxidized vitamin E back to its

non-oxidized,

antioxidant form. For this reason, studies recommend

that an increase in vitamin

E intake be accompanied by an increase in vitamin C

intake.

 

One more caution for those interested in taking

supplemental vitamin E.

Because of its ability to decrease platelet clumping

and clot

formation, supplemental vitamin E should not be used

by those taking blood

thinners unless they are being closely monitored by

their doctor. Getting

your vitamin E from foods, however, is highly unlikely

to cause such

problems. Just remember to include foods rich in

vitamin C (discussed next)

in your meals as well.

 

Vitamin C:

The body's primary water-soluble antioxidant, vitamin

C is needed for

the proper function of blood vessels, regenerates

vitamin E, and can

help decrease cholesterol levels through several

mechanisms. Although

vitamin C is not found in LDL cholesterol particles

because it is not

fat-soluble, it does play a large role in the

prevention of LDL oxidation.

In addition to restoring antioxidant function to

vitamin E, vitamin C

also eliminates many free radicals produced by normal

body metabolism,

thus preventing them from damaging cholesterol.

 

Low levels of vitamin C have also been associated with

higher levels of

total cholesterol and LDL cholesterol, and lower

levels of HDL

cholesterol. Vitamin C is required for the breakdown

of cholesterol to bile in

the liver and also for the uptake of LDL cholesterol

into cells for

normal use. Vitamin C use is therefore associated with

a decrease in total

and LDL cholesterol levels as well as an increase in

HDL levels. These

effects seem to be most pronounced in men and tend to

take about six

months of increased vitamin C intake to be

significant.

 

Low vitamin C levels are associated with an increase

in cholesterol

deposition in the aorta, the main artery leaving the

heart. Vitamin C has

been shown to decrease the binding of monocytes to

atheroma lesions,

thereby reducing the rate of atheroma growth. It is

especially beneficial

in preventing the negative effects of smoking on the

blood vessels and

heart. Vitamin C also reduces the deactivation of

nitric oxide (a

chemical messenger that tells blood vessels to dilate)

and actually

increases its production, leading to decreased vessel

spasm and increased

vasodilation.

 

For more information, click Vitamin C and see below,

Research Studies

Confirm the Importance of Eating Healthy Foods on

Healthy Cholesterol

Levels.)

 

Beta Carotene:

Beta-carotene is another antioxidant found in foods.

Although it is not

found in high quantities in LDL cholesterol particles,

it has been

shown to prevent the oxidation of LDL cholesterol.

Beta-carotene, like

vitamin C, is also able to increase vessel dilation

and reduce vessel

spasm. One study has shown that patients with the

lowest level of

beta-carotene intake had almost twice the risk of

having a heart attack compared

to those with the highest intake. The group of

patients taking the

highest intake of beta-carotene had about 1/3 the risk

of fatal heart

attack and about 1/2 the risk of cardiovascular death

as those in the group

with the lowest intake.

 

For more information, click beta-carotene and see

below LDL Cholesterol

Protected by Beta-Carotene.)

 

Taurine:

Fish are the best sources of taurine. Cold-water fish

such as salmon

and cod are recommended as these are also rich in

beneficial omega-3

essential fatty acids. Taurine is an amino acid

component of protein

particularly common in fish protein. It has been shown

to decrease elevated

cholesterol levels by decreasing the absorption of

cholesterol in the

intestines in addition to increasing the conversion of

cholesterol into

bile, thereby removing it from the body. Studies have

shown that

individuals with higher intakes of taurine have a

lower risk of death from

ischemic heart disease. To gain the maximum protective

benefit, eat a

serving of fish at least 5 days a week.

 

For more information about fish, serving ideas and

recipes, click cod,

halibut, salmon, scallops, shrimp, snapper, yellowfin

tuna

 

Foods Rich in Omega-3 Fatty Acids

Best Food Sources of Omega-3 Fats: cold-water fish

such as salmon and

cod and their oils, flaxseed and its oil, walnuts, and

purslane.

 

Frequent consumption of fish, especially cold water

fish since these

contain the most omega-3s, is associated with a

decreased risk of heart

attack. A high intake of omega-3 fats, when part of a

diet low in

saturated fat, has also been found to help decrease

cholesterol. Foods rich

in omega-3s should be used to replace foods high in

saturated fats such

as meat and dairy products.

 

Monounsaturated Fats:

Best Food Sources of Monounsaturated Fats include:

olive oil, high

oleic sunflower oil, avocado, almonds, cashews,

peanuts, sesame seeds,

pumpkin seeds and walnuts.

 

Monounsaturated fats are a unique type of fat found in

particularly

high quantities in olive oil. These stable fats

decrease the oxidation of

LDL cholesterol, help reduce cholesterol levels, and

may partly explain

why the ¡°Mediterranean Diet,¡± which is high in

monounsaturated fats

as well as whole foods, is protective against heart

disease.

 

Studies have revealed that populations that follow the

 

¡°Mediterranean¡± diet, which is high in vegetables

and whole grains, and low in

saturated fats, but relatively high in total fat due

to a high intake of

olive oil, tend to have fairly low rates of

cardiovascular disease and its

associated mortality. Based on studies of fat intake

and heart disease

in many countries, it would be expected that these

populations would

have high rates of heart disease because of the level

of fat in their

diets. However, the opposite is true.

 

Recent studies have shown that LDL cholesterol

particles that contain

monounsaturated fats, such as from olive oil, are much

more resistant to

oxidation that those that contain high levels of

polyunsaturated fats,

such as from other vegetable oils like corn or

safflower oil. In

addition, the substitution of monounsaturated fats for

saturated fats in the

diet has been shown to decrease total cholesterol by

13.4% and to

decrease LDL cholesterol by 18%.

 

The most important aspect of the use of

monounsaturated fats is that

they be used in place of saturated fats. Adding olive

oil to a diet that

is already high in saturated and/or trans fats can

have negative

effects on heart disease progression and risk. Olive

oil should instead be

used to replace animal sources of fat and other

vegetable oils. Even

though olive oil is a relatively stable fat, it is

important not to use

olive oil when cooking foods as high temperatures.

Exposing even this more

stable oil to high temperatures may cause it to

oxidize. Instead, use

our Healthy Saut;é or Healthy Stir Fry to cook the

food, then after

removing it from the heat, add the olive oil. You'll

add all its delicious

flavor and health-giving benefits to your food,

without potentially

adding damaged fats that might cause damage to the

fats, including

cholesterol, in your own body.

 

 

 

Polyphenols, including Pterostilbene

Pterostilbene, a powerful antioxidant compound found

in cranberries,

grapes and blueberries, activates a type of cell

receptor involved in

absorbing lipids, including cholesterol, into cells

for use in energy

production. A study published in the July 2004 issue

of the Journal of

Agricultural and Food Chemistry found that

pterostilbene was as effective

as the lipid-lowering drug ciprofibrate in activating

this cell

receptor, called PPAR-alpha. (For more on this

research see below: Research

Studies Confirm the Importance of Eating Healthy Foods

on Healthy

Cholesterol Levels.

Allium Family Vegetables:

Best Sources of Allium Vegetable Compounds: Fresh, raw

garlic and

onions contain the highest amounts of these beneficial

compounds.

 

Allium family vegetables contain compounds that have

been shown to

modestly lower total cholesterol levels, lower blood

pressure in cases of

hypertension, and slow the rate of plaque growth. One

of these

compounds, S-propyl cysteine, has been shown to

decrease the liver cells¡¯

secretion of apolipoprotein B100 (apo B-100). Apo B

100 is virtually the

only protein component of LDL, which is composed of

both protein and

cholesterol. Apo B-100 is that portion of the LDL

molecule that allows it to

bind to receptors on other molecules, such as those

that make up the

lining of the blood vessels. Having a high level of

apo B-100 in the

blood is therefore a potent risk factor for developing

cardiovascular

disease.

 

Other S-Alk(en)yl cysteines found in garlic have been

shown to inhibit

cholesterol synthesis by lowering the activity of

HMG-CoA reductase

30-40%. Garlic incorporated into high fat diets in

animal studies has

significantly decreased lipid peroxidation (damage to

fats such as

cholesterol) and the activity of a number of enzymes

involved in cholesterol

synthesis including HMG CoA reductase.

 

In a randomized, double-blind, placebo-controlled

study involving men

with high cholesterol, total cholesterol was lowered

7% and LDL

cholesterol 10% among those given aged garlic extract,

and in animals receiving

garlic, blood levels of total cholesterol and

triglycerides dropped by

15 and 30% respectively. In later test tube studies

using cultured rat

liver cells, garlic, specifically its water-soluble

sulfur compounds,

was found to inhibit cholesterol synthesis 44-87%. Of

all these

compounds, S-allylcysteine, was the most potent

inhibitor of cholesterol

synthesis. In other test tube studies, evidence has

been presented that shows

several garlic compounds can effectively suppress the

oxidation of LDL,

and in human subjects, short-term supplementation of

garlic has been

shown to increase their LDL's resistance to oxidation.

 

 

What foods should I consume sparingly or avoid to

promote healthy

cholesterol levels?

Saturated Fat and Cholesterol

Excessive dietary intake of foods rich in saturated

fat and

cholesterol, which are found primarily in meat,

particularly red meat, and other

animal products, is strongly associated with increased

risk of

atherosclerosis and heart disease.

 

Iron

High levels of stored iron are associated with

increased free radical

production and therefore increased risk of heart

attack, especially in

individuals with high cholesterol levels.

 

Hemochromatosis, a condition of iron overload, is

common in Caucasian

males.

 

Iron is a transitional metal that can catalyze the

formation of free

radicals called hydroxyl radicals, which can damage

cholesterol and have

been linked to cardiovascular disease. Recent studies

suggest that the

heme-iron from red meat is more likely to produce

hydroxyl radicals

than the heme-iron in chicken, fish or vegetarian

sources of protein

(e.g., beans, nuts and seeds, eggs, and low fat dairy

products). Using these

sources of protein as your dietary staples and

limiting red meat

consumption is therefore recommended.

 

Trans-Fatty Acids (Hydrogenated Fats)

Trans fats are so-called since their chemical

structure is the mirror

opposite of that found in vegetable oils. These

abnormally structured

fats can be made from vegetable oils by subjecting

them to a chemical

process that transforms them into solid fats. Also

called hydrogenated

fats, trans fats increase LDL cholesterol and

lipoprotein(a) levels, may

be more damaging to the heart and blood vessels than

saturated fat, and

should be eliminated from the diet. These unnatural

fats are virtually

absent from whole foods, but are the predominant

component in margarine

and are frequently added to processed foods, baked

goods, coffee

creamers, and snack foods.

 

Vitamin D

Although necessary for bone strength, excessive

amounts of vitamin D

are associated with plaque build-up, especially in

those with low

magnesium intake. Increase magnesium intake rather

than avoid vitamin D-rich

foods such as salmon, tuna, liver, eggs and milk;

these foods provide

numerous important health benefits. Excellent sources

of magnesium

include Swiss chard and summer squash. Very good

sources include spinach,

turnip greens mustard greens, pumpkin seeds, broccoli,

, flax seeds, green

beans, collard greens, kale, sunflower seeds, sesame

seeds, quinoa,

buckwheat, salmon, and black beans.

 

Research Studies Confirm the Importance of Eating

Healthy Foods on

Healthy Cholesterol Levels

Combining Cholesterol-Lowering Foods as Effective as

Statin Drugs

If you have high cholesterol, chances are your

physician has suggested

a statin drug to reduce your blood levels of LDL (bad)

cholesterol.

Statin drugs work by blocking the enzyme HMG-CoA

reductase, which is

involved in the body's production of cholesterol.

Although statins are

effective in lowering LDL, they have numerous side

effects.

 

Well-known lesser side effects of statin drugs include

nausea,

diarrhea, constipation, muscle aches, pains and

weakness. In some individuals,

statin use causes an increase in liver enzymes,

indicating abnormal

liver functioning. If the increase is only mild, your

doctor will likely

tell you to continue taking the drug; if it is too

abnormal, you'll be

told to stop, which usually reverses the liver

problem.

 

More serious potential side effects include

rhabdomyolysis—severe

muscle pain accompanied by the destruction of muscle

cells. When this

occurs, the muscle cells release a protein called

myoglobin into the

bloodstream. Myoglobin can impair kidney function and

lead to kidney failure.

 

Lesser known side effects include changes in memory,

attention, or

concentration, irritability and depression, and a

higher risk of suicide

and accidents.

 

Perhaps the most important side-effect of statin

drugs, which is likely

a contributor to many of the above noted side effects,

is that all

statins deplete the body of CoQ10, a critically

important antioxidant

enzyme in our cells' energy production process. Our

bodies produce CoQ10

using the same biochemical pathway that creates

cholesterol, including the

enzyme HMG-COA reductase, which statin drugs block.

 

Since muscle cells, especially heart muscle cells, and

brain cells are

those that use the most energy, adequate supplies of

CoQ10 are

essential for health. It's not surprising that statin

drugs are accompanied by

an increased risk of muscle pain, wasting and heart

failure.

 

Fortunately, a study published in the February 2005

issue of the

American Journal of Clinical Nutrition shows that

dietary approaches

combining cholesterol-lowering foods offers another

option to statin drugs.

 

In this study, 34 patients with high cholesterol

underwent three

1-month treatments in random order: a

very-low-saturated-fat diet (the

control diet), the same diet plus 20 mg lovastatin

daily (statin diet), and a

diet high in plant sterols, which included soy-protein

foods (soy milks

and soy burgers), almonds, oats, barley, psyllium,

okra and eggplant

(portfolio diets).

 

During each of the three diets, fasting blood samples

were taken at

weeks 2 and 4.

 

The results? All 3 diets lowered total cholesterol,

which dropped an

average of 8.5 on the control diet, 33.3 on the statin

diet, and 29.6 on

the portfolio diet after 4 weeks. However, the

portfolio diet lowered

LDL cholesterol as well as the statin diet, and nine

study participants

(26%) achieved their lowest LDL cholesterol level

while on the

portfolio diet. Given the risks—and expense—associated

with statin drugs, if

you have high cholesterol, ask your doctor about a

month's trial to see

if a dietary approach combining cholesterol-lowering

foods can lower

your LDL cholesterol as well as a statin drug.

 

LDL Cholesterol Lowered by a Whole Foods Diet:

In a landmark study, the effects of consuming a diet

high in

vegetables, fruits, soy foods and nuts were compared

to either a control diet

that was very low in saturated fat and based on milled

whole-wheat cereals

and low-fat dairy foods or the same diet plus the

statin drug,

lovastatin. Study participants, a group of 46 adults

(25 men and 21

postmenopausal women with high cholesterol whose

average age was 59) were randomly

assigned to follow one of these three diets for one

month. At the end

of the month, all three groups showed a decrease in

LDL (bad)

cholesterol and C-reactive protein (a marker of

inflammation that is a risk

factor for cardiovascular disease).

 

In those on the control diet, LDL dropped an average

of 8%, and

C-reactive protein dropped an average of 10%.

 

In those on the whole foods diet, LDL dropped an

average of 28.6%, and

C-reactive protein dropped an average of 28.2%. In

those on the control

diet plus lovastatin, LDL dropped an average of 30.9%,

and C-reactive

protein dropped an average of 33.3%.

 

No matter your age, education, smoking status or

physical activity, the

more fruits and vegetables you eat, the lower your

blood level of LDL

(potentially harmful) cholesterol, suggests research

from the National

Heart, Lung, and Blood Institute published in the

February 2004 issue of

the American Journal of Clinical Nutrition.

Researchers used data from

the Family Heart Study to compare the amount of fruits

and vegetables

consumed to LDL levels in 4,466 men and women ranging

in age from 37 to

66. The higher participants¡¯ intake of fruits and

vegetables, the

lower their LDL levels. Participants who ate the most

produce (4 or more

servings a day) had LDL levels about 7% lower than

those who ate the

least (0 to 1.9 servings daily).

 

 

 

Pterostilbene, in Cranberries, Blueberries and Grapes,

Lowers

Cholesterol

Pterostilbene (pronounced TARE-oh-STILL-bean), a

powerful antioxidant

compound found in grapes, cranberries and blueberries,

which is already

known to fight cancer, may also help lower

cholesterol.

 

In a study using rat liver cells, scientists at the

USDA Agricultural

Research Service compared the cholesterol-lowering

effects of

pterostilbene to those of ciprofibrate, a

lipid-lowering drug, and resveratrol,

another antioxidant found in grapes with a chemical

structure similar to

pterostilbene that has been shown to help fight cancer

and heart

disease.

 

They based their comparison on each compound's ability

to activate

PPAR-alpha (short for peroxisome

proliferator-activated receptor alpha).

The PPARs are a family of receptors on cells all

throughout the body that

are involved in the absorption of compounds into cells

for use in

energy production. PPAR-alpha is crucial for the

metabolism of lipids,

including cholesterol. Pterostilbene was as effective

as ciprofibrate and

outperformed resveratrol in activating PPAR-alpha. The

take away message:

turn up your cholesterol burning machinery by eating

more grapes,

blueberries and cranberries.

 

Beta-glucan in Barley Lowers LDL, Increases HDL

Fractions

Adding barley to your healthy way of eating may help

you significantly

lower your total and LDL cholesterol, suggests a study

published in the

November 2004 issue of the American Journal of

Clinical Nutrition.

 

In this study of 25 individuals with high cholesterol

(9 postmenopausal

women, 9 premenopausal women, and 7 men), adding

barley to the American

Heart Association Step 1 diet resulted in a

significant lowering in

total cholesterol in all subjects, plus their amount

of large LDL and

large and intermediate HDL fractions (which are

considered less

atherogenic) increased, and the smaller LDL and VLDL

cholesterol (the most

dangerous fractions) greatly decreased. One reason for

these very beneficial

effects¡ªa compound found in barley's fiber called

beta-glucan. Beta

glucan lowers cholesterol by binding to bile acids

(which the body uses to

digest fats and makes in the liver from cholesterol)

and ferries it out

of the body in the feces. So, the body must make new

bile acids, and to

do so, the liver must use up more cholesterol, thus

lowering the amount

in circulation.

 

 

 

Unique Antioxidant in Oats Protects LDL Cholesterol

Oats, via their high fiber content, are already known

to help remove

cholesterol from the digestive system that would

otherwise end up in the

bloodstream. Now, the latest research suggests they

may have another

cardio-protective mechanism.

 

Antioxidant compounds unique to oats, called

avenanthramides, help

prevent free radicals from damaging LDL cholesterol,

thus reducing the risk

of cardiovascular disease, suggests a study conducted

at Tufts

University and published in the June 2004 issue of The

Journal of Nutrition.

 

In this study, hamsters were fed saline containing

0.25 grams of

phenol-rich oat bran, after which blood samples were

taken at intervals from

20 to 120 minutes. After 40 minutes, blood

concentrations of

avenanthramides had peaked, showing these compounds

were bioavailable (able to be

absorbed).

 

Next, the researchers tested the antioxidant ability

of avenanthramides

to protect LDL cholesterol against oxidation (free

radical damage)

induced by copper. Not only did the avenanthramides

increase the amount of

time before LDL became oxidized, but when vitamin C

was added, the oat

phenols interacted synergistically with the vitamin,

extending the time

during which LDL was protected from 137 to 216

minutes.

 

In another study also conducted at Tufts and published

in the July 2004

issue of Atherosclerosis, researchers exposed human

arterial wall cells

to purified avenenthramides from oats for 24 hours,

and found that

these oat phenols significantly suppressed the

production of several types

of molecules involved in the attachment of monocytes

(immune cells in

the bloodstream) to the arterial wall¡ªthe first step

in the development

of atherosclerosis.

 

Oat avenanthamides suppressed production of ICAM-1

(intracellular

adhesion molecule-1) and VCAM-1 (vascular adhesion

molecule-1), E-selectin,

and the secretion of pro-inflammatory cytokines KL-6,

chemokines IL-8

and protein MCP-1 (monocyte chemoattractant protein).

Our advice: Cut an

orange in quarters or pour yourself a glass of orange

juice to enjoy

along with your oatmeal. If you prefer some other

grain for your

breakfast cereal, top it with a heaping spoonful of

oat bran.

 

 

 

Whole Brown Rice Lowers LDL Cholesterol

Here's yet another reason to rely on whole foods, such

as brown rice,

for your healthy way of eating: the oil in whole brown

rice, not its

fiber, lowers cholesterol.

 

When Marlene Most and colleagues from Louisiana State

University

evaluated the effects of rice bran and rice bran oil

on cholesterol levels in

volunteers with moderately elevated cholesterol

levels, they found that

rice bran oil, but not rice bran, lowered their LDL

(bad) cholesterol.

 

The study, published in the January 2005 issue of the

American Journal

of Clinical Nutrition, was divided into two parts.

First, 26 subjects

ate a diet including 13-22g of dietary fiber each day

for three weeks,

after which 13 switched to a diet that added defatted

rice bran to

double their fiber intake for five weeks. In the

second part of the study, a

randomized crossover trial, 14 subjects ate a diet

with rice bran oil

for 10 weeks.

 

While the diet including only defatted rice bran did

not lower

cholesterol, the one containing rice bran oil lowered

LDL cholesterol by 7%.

Since all the diets contained similar fatty acids, the

researchers

concluded that the reduction in cholesterol seen in

those receiving rice bran

oil must have been due to other constituents such as

the unsaponifiable

compounds found in rice bran oil. The scientists

suggest that the

unsaponifiables present in rice bran oil could become

important functional

foods for cardiovascular health. But why extract just

one beneficial

compound from brown rice when you can reap all the

cardioprotective

benefits supplied by the matrix of nutrients naturally

present in this

delicious whole food? In addition to unsaponifiables,

this whole grain also

supplies hefty doses of heart-healthy fiber,

magnesium, and B vitamins.

 

 

 

Walnuts Lower Cholesterol and A Whole Lot More

A study conducted at the Lipid Clinic in Barcelona,

Spain, and

published in the April 2004 issue of Circulation

suggests that walnuts protect

the heart by doing much more than just lowering

cholesterol.

 

For four weeks, 21 men and women with high cholesterol

followed either

a regular, low-calorie Mediterranean diet or one in

which walnuts were

substituted for about one-third of the calories

supplied by olives,

olive and other monounsaturated fats in the

Mediterranean diet. Then, for

a second four weeks, they switched over to the diet

they had not yet

been on.

 

Not only did the walnut diet significantly reduce

total cholesterol (a

drop that ranged from 4.4 to 7.4%) and LDL (bad)

cholesterol (a drop

ranging from 6.4 to 10%), but walnuts were also found

to increase the

elasticity of the arteries by 64%, and to reduce

levels of vascular cell

adhesion molecules, a key player in the development of

atherosclerosis

(hardening of the arteries).

 

The researchers found that the drop in cholesterol

correlated with

increases in blood levels of alpha-linolenic acid, a

key essential fatty

acid from which omega 3 fats can be derived, and

gamma-tocopherol, a form

of vitamin E. Walnuts are uniquely rich in both of

these nutrients,

which have shown heart protective benefits in other

studies. The Food and

Drug Administration has recently cleared the health

claim that " eating

1.5 ounces per day of walnuts as part of a diet low in

saturated fat

and cholesterol may reduce the risk of heart disease. "

 

 

" This is the first time a whole food, not its isolated

components, has

shown this beneficial effect on vascular health, " said

Emilio Ros, who

led the study at the Hospital Clinic of Barcelona.

 

LDL Cholesterol Lowered by a High Fiber Diet:

A study published in the November 2003 issue of the

journal Metabolism

also suggests that a diet low in saturated fat but

high in fiber,

almonds, soy proteins, and plant sterols (called a

portfolio diet by the

researchers) can produce reductions in cholesterol

equal to those reported

in recent studies using statin drugs. In this study of

25 individuals

with high cholesterol, for 4 weeks, 13 followed a

portfolio diet while

12 ate a low-saturated fat diet based on whole-wheat

cereals and low-fat

dairy foods. The groups then switched diets for a

second 4 week period.

 

While the low-fat diet was far less effective than

statins, reducing

LDL cholesterol by 12%, the portfolio diet, which

reduced LDL cholesterol

by 35%, was just as effective as statin drugs. The

portfolio diet also

improved the ratio of beneficial HDL-cholesterol to

LDL cholesterol by

30%. The researchers concluded that combining a number

of foods known

to help reduce levels of LDL cholesterol may be as

effective as taking

statin drugs.

 

Fiber's ability to decrease cholesterol is one reason

that studies

consistently report that people whose diets contain

the most fiber have a

significantly reduced risk of cardiovascular disease.

A study published

in the September 8, 2003 edition of the Archives of

Internal Medicine

suggests that eating high fiber foods, such as beans,

flaxseed, apples,

bananas, barley, oats and prunes, helps prevent heart

disease. Almost

10,000 American adults participated in this study and

were followed for

19 years, during which time 1,843 cases of coronary

heart disease (CHD)

and 3,762 cases of cardiovascular disease (CVD) were

diagnosed. People

eating the most fiber, 21 grams per day, had 12% less

CHD and 11% less

CVD compared to those eating the least, 5 grams daily.

Those eating the

most water-soluble dietary fiber fared even better

with a 15% reduction

in risk of CHD and a 10% risk reduction in CVD.

 

LDL Cholesterol Lowered and Protected by

Monounsaturated Fats:

Recent studies have shown that LDL cholesterol

particles that contain

monounsaturated fats, such as from olive oil, are much

more resistant to

oxidation that those that contain high levels of

polyunsaturated fats,

such as from other vegetable oils like corn or

safflower oil. In

addition, the substitution of monounsaturated fats for

saturated fats in the

diet has been shown to decrease total cholesterol by

13.4% and to

decrease LDL cholesterol by 18%.

 

 

Studies in weight-stable persons have shown that a

diet including a

moderate amount of fat results in lower blood levels

of triglycerides and

higher levels of beneficial HDL cholesterol than a

low-fat diet. Now a

new study suggests that a weight-loss diet high in

monounsaturated fat

and moderate in total fat may be more heart-healthy

than one that¡¯s

low in fat.

 

In this new study, published in the February 2004

issue of the American

Journal of Clinical Nutrition and funded by the Peanut

Institute, 53

overweight and obese men and women were randomly

assigned to follow

weight-loss diets for that were either very low in fat

(18% of calories from

fat) or moderate in fat (33% fat, with half the fat

from peanut

products). Participants consumed the weight-loss diet

for six weeks, after

which they followed a weight maintenance diet for an

additional four

weeks.

 

After the six week weight-loss period, both groups had

lost about 15

pounds and lowered their levels of potentially harmful

LDL. However,

while those on the moderate fat diet kept their

protective HDL cholesterol

at the same level, thus significantly improving their

ratio of HDL:LDL,

those on the low-fat diet saw their HDL cholesterol

drop by 12%, so

their ratio of HDL:LDL did not improve ¡ªoffsetting

some of the heart

benefits. In addition, during four weeks of weight

maintenance, HDLs

remained high in the moderate-fat group, who also

further lowered their

triglyceride levels, while triglyceride levels

rebounded in those on the

low-fat diet. (High triglycerides are a problem

because they promote fat

absorption in the artery wall.) The message: moderate

consumption of

healthy monounsaturated fats, such as are found in

olive oil and nuts,

e.g., peanuts, appears to lessen risk of

cardiovascular disease more than

a low-fat diet. We'd add that the moderate fat diet is

easier to follow

since a little healthy fat adds satiety and a lot of

flavor to your

meals.

 

LDL Cholesterol Lowered by Allium Family Vegetables:

Compounds found in garlic called S-Alk(en)yl cysteines

have been shown

to inhibit cholesterol synthesis by lowering the

activity of HMG-CoA

reductase, the key enzyme involved in cholesterol

production, by 30-40%.

 

Garlic incorporated into high fat diets in animal

studies has

significantly decreased lipid peroxidation (damage to

fats such as cholesterol)

and the activity of a number of enzymes involved in

cholesterol

synthesis including HMG CoA reductase.

 

In a randomized, double-blind, placebo-controlled

study involving men

with high cholesterol, total cholesterol was lowered

7% and LDL

cholesterol 10% among those given aged garlic extract,

and in animals receiving

garlic, blood levels of total cholesterol and

triglycerides dropped by

15 and 30% respectively.

 

In later test tube studies using cultured rat liver

cells, garlic,

specifically its water-soluble sulfur compounds, was

found to inhibit

cholesterol synthesis 44-87%. Of all these compounds,

S-allylcysteine, was

the most potent inhibitor of cholesterol synthesis. In

other test tube

studies, evidence has been presented that shows

several garlic compounds

can effectively suppress the oxidation of LDL, and in

human subjects,

short-term supplementation of garlic has been shown to

increase their

LDL¡¯s resistance to oxidation.

 

LDL Cholesterol Protected by Vitamin E:

Studies have shown that people with lower vitamin E

levels tend to have

a higher rate of ischemic heart disease mortality and

vice versa. One

study found that people with the highest intake of

vitamin E from

dietary sources had less than half the risk of cardiac

events when compared

to those with the lowest intake. Other studies have

shown that the use

of vitamin E supplements has produced a 50% reduction

in the progression

of atheroma growth, a 63% decrease in coronary heart

disease death, a

34% reduction in risk of cardiac events in women, a

77% decrease in the

reoccurrence of non-fatal myocardial infarction, and a

39% decrease in

risk of heart disease in men. Overall, the use of

vitamin E supplements

at any time was associated with a 47% decrease in

heart disease related

mortality.

 

LDL Cholesterol Protected by Beta-Carotene:

Although beta-carotene is not found in high quantities

in LDL

cholesterol particles, it has been shown to prevent

the oxidation of LDL

cholesterol. Beta-carotene, like vitamin C, is also

able to increase vessel

dilation and reduce vessel spasm. One study has shown

that patients with

the lowest level of beta-carotene intake had almost

twice the risk of

having a heart attack compared to those with the

highest intake. The

group of patients taking the highest intake of

beta-carotene had about 1/3

the risk of fatal heart attack and about 1/2 the risk

of cardiovascular

death as those in the group with the lowest intake.

 

HDL Cholesterol Increased by Cranberries:

A human study has recently shown that drinking

cranberry juice can

cause a significant increase in HDL cholesterol

levels.

 

In this three month study, researchers measured

cholesterol levels in

19 subjects with high cholesterol after a fasting,

baseline blood

sampling, followed by monthly samplings. Ten of the

subjects were given

cranberry juice with artificial sweetener, while the

other subjects drank

cranberry juice with no added sugars. Like typical

supermarket cranberry

juices, the drinks all contained approximately 27%

pure cranberry juice

by volume. Each subject drank one 8-ounce glass of

juice a day for the

first month, then two glasses a day for the next

month, and finally,

three glasses a day during the third month of the

study. Subjects were

not monitored with respect to exercise, diet and

alcohol consumption.

 

Although no changes occurred in their overall

cholesterol levels, study

subjects' HDL cholesterol increased by an average of

10% after drinking

three glasses of cranberry juice per day. While the

mechanism by which

cranberry juice changes cholesterol levels has not

been clearly

established, the researchers have theorized that the

effect is due to the

fruit's high levels of polyphenols, a type of potent

antioxidant.

 

 

 

Compounds in Oranges and Tangerines May Lower

Cholesterol Better than

Statin Drugs

A class of compounds found in citrus fruit peels

called

polymethoxylated flavones (PMFs) have the potential to

lower cholesterol more

effectively than some prescription drugs, and without

side effects, according

to a study by U.S. and Canadian researchers that was

published in the

May 2004 issue of the Journal of Agricultural and Food

Chemistry.

 

In this study, when hamsters with diet-induced high

cholesterol were

given the same diet containing 1% PMFs (mainly

tangeretin), their blood

levels of total cholesterol, VLDL and LDL (bad

cholesterol) were reduced

by 19-27 and 32-40% respectively. Comparable

reductions were also seen

when the hamsters were given diets containing a 3%

mixture of two other

citrus flavonones, hesperidin and naringin.

 

Treatment with PMFs did not appear to have any effect

on levels of

beneficial HDL cholesterol, and no negative side

effects were seen in the

animals fed the PMF-containing diets.

 

Although a variety of citrus fruits contain PMFs, the

most common PMFs,

tangeretin and nobiletin, are found in the peels of

tangerines and

oranges. Juices of these fruits also contain PMFs, but

in much smaller

amounts. In fact, you'd have to drink about 20 glasses

of juice each day to

receive an amount of PMFs comparable in humans to that

given to the

hamsters. However, grating a tablespoon or so of the

peel from a

well-scrubbed organic tangerine or orange each day and

using it to flavor tea,

salads, salad dressings, yogurt, soups, or hot

oatmeal, buckwheat or

rice may be a practical way of achieving some

cholesterol-lowering

benefits. The researchers are currently exploring the

mechanism of action by

which PMFs lower cholesterol. Based on early results

in cell and animal

studies, they suspect that PMFs work like statin

drugs, by inhibiting

the synthesis of cholesterol and triglycerides inside

the liver.

 

 

 

Soy Offers Special Cholesterol-Lowering Benefits for

Premenopausal

Women

Soy foods may offer special benefits for the hearts

and bones of

premenopausal women, suggest two studies conducted at

Wake Forest University

Baptist Medical Center and presented at the annual

meeting of the North

American Menopause Society, Washington, D.C., October

6-9, 2004. The

results of these studies indicate a beneficial synergy

between

isoflavones, the weakly estrogenic compounds in soy,

and the body's own estrogen

in decreasing cholesterol and increasing bone mass.

 

In the first study, cholesterol levels in monkeys fed

a soy-based diet

were improved compared to those of monkeys given a

diet of milk and

animal protein¡ªand the most improvement occurred in

those monkeys at

highest risk for heart vessel disease. A low ratio of

total cholesterol to

HDL (good) cholesterol is considered healthier. In

monkeys at highest

risk for heart disease, the cholesterol ratio

decreased by 48% in those

given soy compared to those receiving milk and animal

protein. Even in

the monkeys at low risk for atherosclerosis that ate

soy, the

cholesterol ratio dropped 33%.

 

Lead researcher in this study, Jay Kaplan, PhD, noted

that a 48% drop

in the cholesterol ratio would likely equate to a 50%

reduction in the

size of plaques in the arteries, which can rupture

causing heart attacks

and strokes. He also added, " Studies have shown that

heart vessel

disease, or atherosclerosis, begins in the 30s and 40s

in women. From our

work in monkeys, we believe the time to prevent

cardiovascular disease in

women is before menopause, not after. Soy seems to

provide a potent

protection in monkeys, in terms of cholesterol levels,

which is a good

marker for general cardiovascular risk. We presume the

benefit would apply

to premenopausal women as well. "

 

In the second study, monkeys eating soy were found to

have an increase

in bone mass compared to those not given soy.

According to lead

researcher in this study, Cynthia Lees, D.V.M., Ph.D.,

" The increase was

small, but this suggests the possibility that if women

consumed soy on a

regular basis before menopause, it could benefit their

health after

menopause. " Kaplan also noted that because the

soy-estrogen combination

caused improvements in both cholesterol and bone, it

might also positively

impact other areas of the body affected by estrogen,

including the

brain.

 

In both 12 month long studies, the monkeys were

selected to represent

women in their 30s and 40s. Half consumed soy with

isoflavone levels

equal to a human intake of approximately 129

milligrams a day, about twice

the amount typically consumed by women in Asia.

 

Next on the researchers' agenda will be a study using

lower levels of

isoflavones over a longer period of time to see if

this will be as

effective¡ªan outcome that appears to already be

supported in a human trial

published in the November 2004 issue of the American

Journal of

Clinical Nutrition. In this study, which included 1033

pre- and postmenopausal

women (361 meat-eaters, 570 vegetarians, and 102

vegans), eating

moderate amounts of soy foods as part of a regular

diet was associated with a

lower ratio of total to LDL cholesterol, but not with

a lowering in the

level of beneficial HDL cholesterol. In those women

eating 6 or more

grams of soy protein daily, blood levels of LDL

cholesterol were 12.4%

lower than those in women who ate less than .5 grams

of soy protein

daily.

 

What is cholesterol, and why should I be concerned if

my cholesterol

levels are too high?

Cholesterol is a necessary substance that is produced

by the body from

fatty acids, especially saturated fats, in the diet.

Ready-made

cholesterol is also absorbed from foods derived from

animals. From the

bloodstream, cholesterol is taken up by cells and used

to make cell membranes,

hormones and vitamin D.

 

Cholesterol is produced in the liver by a number of

steps involving

several different enzymes. One of the main enzymes

involved is called HMG

Co-A reductase. This enzyme has the single most

control over how much

cholesterol is produced. HMG Co-A reductase usually

ensures that just

enough cholesterol is produced for normal function,

but sometimes,

especially when the diet is high in saturated fats, it

shifts into overdrive

and contributes to elevated cholesterol levels. If the

diet is also

high in cholesterol-containing animal foods, then

cholesterol levels may

rise even more.

 

Once produced, cholesterol is carried in the blood by

lipoproteins such

as very-low-density lipoprotein (VLDL), low-density

lipoprotein (LDL),

lipoprotein (a), and high-density lipoprotein (HDL).

VLDL and LDL

distribute cholesterol throughout the body to where it

is needed. HDL

collects any extra cholesterol not needed by cells and

returns it to the

liver, thus removing it from the bloodstream where it

has the potential to

cause damage to blood vessels. For this reason, HDL is

often referred

to as the ¡°good¡± cholesterol. The most potentially

damaging form of

cholesterol is lipoprotein (a). Lipoprotein (a) is a

cholesterol-carrying

molecule like LDL that also contains a sticky

molecule, apolipoprotein,

which enables it to adhere more easily to the lining

of the blood

vessel walls and contribute to atherosclerosis.

 

Normally, cholesterol in the body that is not used to

produce hormones,

vitamin D, or cell membranes is eliminated by the

liver. The liver

converts the cholesterol to bile, which is stored in

the gall bladder until

it is needed in the intestines. When bile is released

into the

intestines, it aids digestion by making dietary fats

easier to absorb. Much of

the bile that passes into the intestines is reabsorbed

and recycled for

future use. However, if it binds to certain food

substances, like

fiber, it passes out of the body in the stools, so new

bile must be produced

from cholesterol to replace the bile that is

eliminated. This is one of

the reasons why fiber-rich foods such as legumes and

whole grains can

help lower cholesterol.

 

When cholesterol in food becomes oxidized, either by

heat or free

radicals, before it is consumed and absorbed in the

intestines, or if

cholesterol from food or cholesterol produced by the

liver is oxidized by

free radicals in the body, it can become dangerous.

Oxidized LDL

cholesterol is directly toxic to the endothelial cells

that line blood vessel

walls. It increases the adhesion of immune cells

called monocytes and

macrophages to vascular lesions (damaged areas in the

blood vessel wall),

increases the proliferation of smooth muscle cells in

the blood vessel

wall, increases platelet clumping and clot formation,

and inhibits the

production of nitric oxide, a messenger chemical that

tells blood

vessels to relax and dilate.

 

When macrophages and monocytes are exposed to

undamaged cholesterol,

they only take in small amounts, but when they are

exposed to oxidized

(damaged) cholesterol, they take in large amounts,

causing them to

greatly increase in size. A high blood level of

oxidized LDL cholesterol is

therefore a strong contributing factor in the

initiation and growth of

atheromas (cholesterol-filled plaques in the walls of

the arteries) and

the progression of heart disease.

 

Atheromas are especially problematic when they develop

in the blood

vessels of the heart, also known as the coronary

arteries, where they may

decrease the amount of blood that is available to feed

the heart

muscle, or where they may eventually lead to a heart

attack, (in medical

terminology, a myocardial infarction or MI), heart

damage, and possibly

even death.

 

By contributing to the formation of atheromas, high

cholesterol can

lead to atherosclerosis, heart disease, heart attack

and stroke. Over half

of all cases of coronary heart disease in the United

States are

attributed to abnormalities in the levels and

metabolism of cholesterol and

other lipoproteins. On the bright side, even a small

decrease in

cholesterol correlates with a modest decrease in the

risk of heart disease.

 

What causes high cholesterol?

The primary causes of high cholesterol include diet,

obesity, a

sedentary lifestyle, heredity, and stress. Obesity and

cigarette smoking are

correlated with decreases in the protective HDL

fraction of cholesterol.

 

Secondary causes of high cholesterol include

hypothyroidism, diabetes

mellitus, nephrotic syndrome, and obstructive liver

disease.

 

Drugs known to cause high cholesterol as a side-effect

include anabolic

steroids, progestins, most diuretics, and some beta

blockers.

 

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