Posted on August 26 2021
"But dietary cholesterol who't give you cholesterol. So eat all the eggs, meat and cheese you want."- Says only an uneducated Instagram influencer.
Dietary cholesterol is closely linked to blood cholesterol. We know this since the 1900's when cholesterol was first researched.
Ever since the new normal and work from home policies, there has been a drastic change in lifestyle and eating patterns.
People are getting more stressful schedules and have become dependent on ready to eat and processed foods. I am now, more than ever seeing patients with high cholesterol and triglycerides.
Bad eating habits and factors like obesity, sedentary lifestyle etc cause high cholesterol. There are two types of cholesterol in our body- good (HDL) and bad (LDL). We will look into them in detail in the later section.
Elevated cholesterol levels act as a silent killer for heart diseases and strokes. Research shows that just making nutritional changes alone is enough to see serum cholesterol levels drop in as little as six weeks. This is also my experience working with thousands of clients over the years.
Cholesterol is a fatty and waxy substance produced by the liver, that produces in our body. It helps to builds cell walls and aids in the production of some vitamins and hormones. In contrast, triglyceride is a type of fat cell that the body uses for energy. So essentially, you could have high triglycerides and normal cholesterol or vice- versa. Elevated levels of either are dangerous.
Doctors often recommend a plant-based diet to reduce elevated cholesterol and triglycerides.
Renowned clinical researcher and current president of The Physicians Committee for responsible medicine said "Cholesterol is an interesting molecule. It has all kinds of functions in the body. In fact, cholesterol is necessary. Dietary cholesterol is not necessary. Your body makes about 1 grams of cholesterol per day and that is all that you need."
Besides dietary cholesterol, saturated fats coming from Ghee, cheese, bacon and cured meat also increases serum cholesterol. For every 1% increase in the consumption of saturated fats through diet, there is an approximate 2% increase in LDL cholesterol. Ghee too!! Watch this:
If nutrition helps, lets now discuss what nutritional changes are important.
What is Cholesterol, and why is it essential for the body?
Cholesterol is a waxy solid found only in animals. Plants do not make cholesterols. They instead make phytosterols, that help reduce cholesterol.
Cholesterol is a waxy type of fat or lipid, and it moves throughout our body in our blood. Substances like lipids do not dissolve in water; hence they also do not come apart in blood.
Every cell in our body requires cholesterol to assist in cell membranes formation. Think of a plant, plant's have a cell- wall. Thus, they cannot uproot themselves and start moving around. Human's, instead have a cell- membrane. This gives us the ability to move around. Cholesterol is what keep's our cell- membrane flexible.
Cholesterol is also required to produce vitamin D and create certain sex hormones. So too much cholesterol can boost your testosterone (think muscle mass in men but PCOS like symptoms in women) but also boost estradiol (think body fat in both genders).
What are the different types of Cholesterol?
Lipoproteins in our blood carries cholesterol all over the body. These lipoproteins include:
- Low-density lipoprotein (LDL) is the first primary lipoprotein. It is also termed as 'bad cholesterol.'
- High-density lipoprotein (HDL) is the second primary lipoprotein. It is also termed as the 'good cholesterol.'
- Very-low-density lipoproteins (VLDL) are particles in the blood responsible for carrying triglycerides.
Too much Cholesterol can cause severe problems. The condition when our cholesterol levels increase is hypercholesterolemia. The condition when our cholesterol levels decrease is hypocholesterolemia.
So what is the ideal cholesterol level?
What is low-density lipoprotein (LDL)?
LDL is the bad cholesterol because once it builds up on the walls of your arteries, it makes them narrower. Further, it can also cause fatty deposits to form plaque. This plague lines your arteries to cause blockages. This build-up is called atherosclerosis.
Arteries are the blood vessels that are responsible for carrying oxygen-rich blood. They carry the blood from your heart to all organs of the body.
Saturated fats and trans-fats are the fats linked to LDL cholesterol levels. These are the ones that you should omit from your diet. Saturated fats at room temperature are solid or wax-like. These fats are present in products from animals, like cheese, meat, milk, and butter.
We get trans-fats when the liquid fats undergo the hydrogenation process to become solid. This type of fat exists in fast foods, fried foods, and processed foods. Processed foods like cookies, crackers and bakery items!
What is high-density lipoprotein (HDL)?
HDL is the "good cholesterol." It carries away other kinds of Cholesterol (including LDL) away from our arteries. HDL also drops off other types of cholesterol for the liver to be removed from the body. Higher levels of HDL can reduce the risk for heart disease.
What kind of test measures Cholesterol?
Doctors recommend that people over the age of 20 should check their cholesterol levels once every five years. Your healthcare provider will check the cholesterol levels through a blood test. Additionally, the provider might also order a lipid panel or a lipid profile. The lipid panel will give you the following numbers:
- Total Cholesterol
- LDL levels
- HDL levels
- VLDL levels and triglycerides
- Non-HDL Cholesterol
- The ratio between Cholesterol and HDL
What is Familial Hypercholesterolemia?
Familial hypercholesterolemia (FH) is a genetic condition.
It presents itself by rising LDL cholesterol levels in the blood and normal triglyceride levels. It is a hereditary defect in the body's ability to recycle LDL (bad) cholesterol.
Familial hypercholesterolemia raises the chance of cardiovascular disease. Subsequently, the symptoms appear earlier in life.
LDL levels will rise if a person cannot clear LDL and/or has a reduced ability to do so.
Familial hypercholesterolemia (FH) is inheritable from either one or both parents . People with this condition can have elevated LDL levels despite following a healthy lifestyle and nutrition plan.
In people with FH, cholesterol deposits exist in the Achilles tendons and tendons of the hands and elbows. Cholesterol deposits can also form in other body areas, such as a white ring around the eyes. This is called corneal arcus.
Only diet and exercise aren't enough to treat familial hypercholesterolemia.
Physicians usually prescribe a statin pill. But, in some cases, other cholesterol-lowering medications, such as ezetimibe, are also essential.
LDL apheresis is a treatment used to treat people who have high LDL cholesterol. PCSK9 inhibitors, which are injectable drugs, can also help to decrease cholesterol levels. These drugs target and prevent a protein that frees up more receptors on liver cells. It allows LDL cholesterol to eradicate from the blood.
What are the treatments for High Cholesterol?
High cholesterol is inheritable only in the case of FH. But most of the time, it results from unhealthy lifestyle choices. Elevated cholesterol is both preventable and treatable. With a well-balanced diet, regular exercise and lifestyle modification, you can reduce high cholesterol. What exactly does lifestyle modification mean though? Watch this to understand:
The University of Toronto conducted a study that showed that people following a plant- based diet tend to have 30% lower total cholesterol level's than those eating dairy and meat.
The recommended food for lowering cholesterol levels include:
- Oats, pulses, barley, and other foods high in soluble fibre such as vegetables.
- Soy beans/ tofu and tempeh
- Nuts and seeds
- Wheat germ, wheat bran, Brussels sprouts, and other foods with concentrated phytosterols (plant sterols that help lower cholesterol).
Two-thirds of adults in their mid-forties suffer from atherosclerosis. So this is a warning sign if you're in your mid-40s or older and think your arteries are in good shape. If you are older than 43, you're more than 40% likely to notice an artery deterioration.
Multiple factors raise cholesterol, sleep habits and food habits are two of them. According to the PESA study, if you adopt the habit of sleeping 7- 8 hours every night, you'll have a lower chance of plaque progression.
Ironically, if you skip breakfast, you're more likely to develop subclinical atherosclerosis. In addition, people who said they skip breakfast regularly had a 2.5-fold increased risk of generalised atherosclerosis.
Although, think of it this way, people who tend to skip breakfast also tend to be in a rush every morning. Thus, their stress levels are elevated and this could be a contributing factor to cholesterol. I would not rule out intermittent fasting as being unhealthy. Read the below blogs for a better understanding:
- 21 Benefits Of Intermittent Fasting That Will Surprise You!
- Intermittent Fasting Diet Plan For Vegetarians.
Above all, a well structured fitness regimen is essential if you want to manage cholesterol. You can start the regime anytime- be it in your twenties, thirties, forties, fifties, or even sixties!
How can I lower cholesterol with diet?
Diets high in trans-fats, saturated fats, and cholesterol raises cholesterol levels and risks of a heart attack. Cholesterol is present in foods like meat, dairy products, and eggs. Here is an interesting read about eggs:
Plants are deficient in saturated fat and are free of cholesterol. Additionally, they are also rich in soluble fibre and help to lower cholesterol. Soluble fibre slows down the absorption of cholesterol. It also decreases the cholesterol amount that the liver produces. Your plate should look like the power plate depicted here:
Penny M. Kris-Etherton, the professor of Nutritional Sciences at Evan Pugh University and a fellow of the American Heart Association, stated, "What we know is that saturated fat and dietary cholesterol both contribute to raising cholesterol levels in the blood." She further adds, "Eating more fibre-rich foods like fruits, veggies, whole grains, and legumes can also lower your numbers."
Mills adds, ‘We should be getting like 25 to 30 grams of fiber each day. A quarter of should be from soluble fibers. These include foods like apples, blueberries, beans, nuts, and seeds. Getting around 5-10 grams of soluble fiber a day can lower your LDL. In short, it lowers the "bad" Cholesterol, by 5 to 11 points, sometimes more.’
Mills further adds, ‘Plant-based foods like whole grains, fruits and veggies have healthy substances. These are sterols. Eating 2 grams of sterols each day can lower your LDL cholesterol by 5% to 10%.’
There is no nutrient in a glass of milk that your body needs. Plant's are rich in calcium, proteins and all other micro- nutrients. Meat is carcinogenic and not the best source of proteins as it is acidic.
Aim to consume grains and lentils instead of meat and fruits and vegetables instead of dairy. You can always try non- dairy alternatives like vegan milk, cheese and plant- based meat to help you make the switch.
Following a proper diet and lifestyle are essential to lower cholesterol levels.
- Eating a heart-healthy diet
- Exercising daily
- Quit smoking
- Maintaining a moderate weight
Statins: Good or Bad?
Plant-based diets lowers LDL cholesterol by over 30% in a couple of weeks. It is equivalent to many standard cholesterol-lowering statin drugs without potential side effects.
But do statin's offer any benefits?
The body uses cholesterol to make estrogen. In healthy amounts, estrogen is important to prevent breast cancer. Plant-based diets that have plenty of phytosterols that may also offer protection against breast cancer.
Some studies show that women on statins had lower breast cancer risk. Yet, some showed an increased risk.
There is growing evidence that a reduction in LDL cholesterol reduces atherosclerotic cardiovascular disease.
Discontinuing statin treatment may be a life-threatening mistake for those who regularly take them. It translates into about one excess death for every 83 patients who discontinued treatment within four years.
On the contrary, around 10-25% of patients placed on statins complain of muscle problems. Statins are also associated with elevated blood glucose levels and brain degenerative diseases.
FDA issued new side effect warnings about an increased risk of neuro side effects. These include memory loss and confusion, high blood sugar levels, and new-onset diabetes.
Research now suggests that for every 200 people taking a statin, one will develop diabetes.
Sure, heart disease remains our number one killer. It means most people need to take a statin drug like Lipitor every day for the rest of their lives. But it cannot be denied that lifestyle modifications and nutritional changes can help you achieve the same effects without the need for a drug.
So why not try adopting a whole-food, plant-based, limit-added-oils and work on a sustainable fitness regimen.
Statins, whether good or bad, are open to more research and discussion. The important thing to remember is to use it as a last resort and not the only solution.
Foods and herbs to Eat for lowering Cholesterol levels
As we have already read, a low- fat plant- based diet is the most effective to lower cholesterol
But are there certain herbs that work better than the others? Let's explore:
Fenugreek or methi: Fenugreek seeds contain steroidal saponins that prevent the absorption of cholesterol in the intestines. Aim to include a pinch of fenugreek powder daily.
Amla: Truly the magic food. This fruit has ten times the antioxidants of berries. We will explore how this helps manage cholesterol later in this article.
Nuts: Walnuts and almonds are rich in vitamin E and omega-3 fatty acids. Nuts help maintain HDL levels. HDL reduces the LDL levels in the body. Aim to consume 30- 40 grams of nuts/ seeds through the day.
Oats: Oats have high amounts of soluble fibre. The soluble fibre prevents plaque formation and ensures smooth blood circulation. Target to start your day with a bowl of oatmeal 3-4 times a week.
Garlic: Garlic contains a bioactive component called Allicin. Allicin aids to reduce blood lipids and prevents the formation of plaque. One clove of garlic in the morning can reduce bad cholesterol levels.
Let's see the second segment that focuses on understanding triglycerides. We will also understand ways to keep triglycerides under control.
Does Amla Help With Cholesterol Management?
Indian gooseberries, popularly known as Amla, have numerous benefits. From a cancer fighter to a hair tonic to even a snake venom detoxifier, the powers of Amla are multiple.
In one study, a reduction in cholesterol was visible when Amla was compared to simvastatin drug treatment. In comparison to other drugs, the benefits of Amla to manage cholesterol are plenty. Studies show that Amla extracts as liquids or in dried form reduce cholesterol levels in par with statins.
But the interest of the drug manufacturing sector in patenting Amla's benefits is low. This dilutes the possibilities of extensive and impactful research on the effectiveness of Amla.
For Indian gooseberries to become relevant clinically, More research needs to be conducted. But seeing no economical benefits or patenting this fruit, there is little interest. Without patents, the pharmaceutical industry wouldn't bother to invest in research.
Is Dietary Cholesterol Linked To Cancer?
There is a strong association between animal protein intake and colon cancer mortality.
Dietary cholesterol is considered a co-carcinogenic for human colon cancer. When rats in labs are injected with carcinogens, the cholesterol-eating rats developed tumours in half the time VS those not given added cholesterol. Yet, the applicability of animal studies to human situations is questionable.
However, we don't need to consume any cholesterol as our bodies produce it in plenty. Even if we do, the quantity of cholesterol our bodies can absorb is within a limit.
As a result, the cells that line our colon are exposed to faecal cholesterol. That is the area where colon cancer develops. The amount of cholesterol we consume can influence the rate at which a tumour develops or spreads.
A substantial nationwide population case study investigated the association between cholesterol intake and various forms of cancer. There were findings of dietary cholesterol intake linkage to an elevated risk of malignancies. It means that a low-cholesterol diet may help in the prevention of certain cancers.
The study findings can thus be evidence that a diet high in meat, dairy products, and eggs is an adverse predictor of common cancers.
When tested for endometrial cancer, the risk is quadrupled. It means even just one daily omelette might increase cancer risk by about 20%.
If you have a genetic deposition for cancer already, then diatery cholesterol might not do you any good.
What are Triglycerides?
Triglycerides are a type of fat or lipid found in your blood. Excess calories consumed are stored as body fat or triglyceride cells.
When your body is not optimal in using using glucose . Then, during periods of starvation, hormones release triglycerides for energy. You may have hyper triglycerides if you consume more calories than you burn.
Why do Triglycerides Matter?
High triglycerides harden the arteries or thicken the artery walls. The condition is called arteriosclerosis. Arteriosclerosis increases the risk of stroke, heart attack and other heart diseases. Additionally, high triglycerides may cause acute inflammation of the pancreas (or pancreatitis).
High triglycerides can also be a sign of the following:
- Type 2 diabetes or prediabetes
- Metabolic syndrome: A combination of high blood pressure, obesity and high blood sugar. These conditions occur together, thus increasing your risk of heart disease.
- Reduced production of thyroid hormones (known as hypothyroidism)
- Certain rare genetic conditions affect how your body while converting fat to energy.
Sometimes high triglycerides also result from side effects of taking certain medications. Medications like:
- Estrogen and progestin
- Some immunosuppressants
- Some HIV medications
How are Triglycerides different from Cholesterol?
Both cholesterol and triglycerides perform different functions in our bodies. But, both are important markers for health. As such, we should always keep both within the recommended ranges.
- Triglycerides: As already mentioned, these are a type of fat or lipid in the blood. The American Heart Association (AHA) considers triglycerides one of the most common types of body fat. They store excess energy from the food a person eats.
- Cholesterol: Cholesterol is a waxy substance known as a lipoprotein. The liver handles the production of cholesterol. Cholesterol has different body functions, including food digestion, hormone production, and vitamin D generation.
Certain factors may raise triglyceride levels in our bodies. Some of these include:
- Excessive alcohol use
- Family history of high Cholesterol
- Liver disease or kidney disease
- Medications, including diuretics, hormones, corticosteroids and beta-blockers
- Thyroid disease
- Uncontrolled diabetes
- A diet rich in sugar and fats
What are the worst foods for high cholesterol?
If you have high cholesterol, you must be extremely cautious about what you eat. Dealing with high cholesterol may be difficult, so avoiding foods that might raise your cholesterol levels is a wise idea. Saturated fats from dairy, particularly Ghee and meat are two of the biggest culprits.
Besides that, excess sugar, oil’s or harmful fats like trans fats, or hydrogenated fat, are the worst foods for high cholesterol. Foods that you would want to avoid are as follows.