Understanding High Cholesterol

You take an occasional walk; try not to eat too much fast food, and even get enough sleep (except when there's a good late night movie on). Yet perhaps a health care provider has told you that your cholesterol is too high, or a relative has mentioned that he or she has high cholesterol. The result: you care about your health and want to learn what you can do to minimize your risks and improve your health.

We've all seen those ads on TV or in magazines about the latest prescriptions or food products designed to lower cholesterol levels. Curious about whether such remedies are your only alternative? Here's what you need to know to make a decision.

High Cholesterol Tests

Experts generally agree that cholesterol tests should be performed annually after age 40. For those who have a family history of high cholesterol, it is recommended that the testing process be started at a younger age. Be sure to alert your doctor of your family history. Typically, the cholesterol test is done in the morning, following an eight to 12 hour fast.

Medical studies indicate that the more important cholesterol number is the low-density lipoprotein (LDL) or "bad" cholesterol. Ideally, it should be less than 100, lower for diabetics. The high-density lipoprotein (HDL) should be greater than 45 for men and greater than 55 for women. However, having a low total cholesterol level should not be regarded as the ideal, according to noted expert Patrick Holford. For example, a research group in Japan "found that while high levels are associated with cardiovascular disease…low levels are associated with strokes" (Holford, The New Optimum Nutrition Bible, page 200).

Causes of High Blood Cholesterol
The old saying, "You are what you eat," is valid with regard to your cholesterol levels. Some foods contain fats that have been shown to result in higher cholesterol levels, while other fats, so-called "good" fats, do not have a negative impact on your cholesterol and can actually improve your health. Here's how to know the difference:
When you eat foods containing saturated fats, it causes your LDL cholesterol level to go up.
The same negative impact on your body occurs when you eat foods containing trans fatty acids (trans fats). Trans fats are created when vegetable oil is hydrogenated to harden it. This process may make those packaged crackers and other snack foods taste delicious - but the result on the cholesterol level is far from positive. "When our body tries to use trans fats, they block normal biochemistry, inhibiting the function of enzymes that are involved in the synthesis of cholesterol and fatty acids" (Lipski, Digestive Wellness, page 147).
So-called "good" fats can actually improve your health. These fats can be found in seeds and nuts such as sesame seeds and almonds, cold-water fish such as salmon and sardines, and cold-pressed seed oils such as "an oil blend or hemp oil" (Holford, The New Optimum Nutrition Bible, page 79).

In addition, weighing more than is optimal for one's height and bone structure may result in a higher LDL level and lower HDL level. Inactivity also may negatively impact cholesterol levels, while exercising can assist in lowering the LDL level and improving the HDL level.

Genes, age, and sex also impact cholesterol levels. The U.S. Department of Health and Human Services' National Heart, Lung, and Blood Institute reports that "high blood cholesterol can run in families. An inherited genetic condition (familial hypercholesterolemia) results in very high LDL cholesterol levels. It begins at birth, and may result in a heart attack at an early age." In addition, the institute notes "starting at puberty, men have lower levels of HDL than women. As women and men get older, their LDL cholesterol levels rise. Younger women have lower LDL cholesterol levels than men, but after age 55, women have higher levels than men" (National Heart, Lung, and Blood Institute Web site; "High Blood Cholesterol": http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html).

High Blood Cholesterol Concerns
Having high cholesterol does not result in symptoms, so you may think that it's not risky. However, according to the National Heart, Lung, and Blood Institute, "People with high blood cholesterol have a greater chance of getting heart disease… Cholesterol can build up on the walls of your arteries (blood vessels that carry blood from the heart to other parts of the body)" (ibid), which is known as plaque. Plaque can result in narrowed arteries, a medical condition called atherosclerosis.
"There is no doubt that high blood cholesterol represents a risk factor for arterial disease" (Holford, The New Optimum Nutrition Bible, page 201). The good news for those who have high blood cholesterol or are concerned about it: dietary and lifestyle changes, as well as nutritional supplements, can help to reduce risk and improve heart health.

Nutritional and Lifestyle Recommendations
These general guidelines can help to enhance the health of the heart and reduce the risk of cardiovascular disease:

Reduce the amount of foods high in saturated fats and do not put salt on your food. For example, consume less meat and fried food. Substitute oily fish (for example, salmon and herring).

Enjoy generous amounts of vegetables and fruits, in particular beans and green, leafy vegetables, and snack on seeds such as pumpkin seeds.
Do not smoke.

"Keep fit, not fat," and "take a supplement of antioxidant nutrients, including at least 600 IU of vitamin E and 2 g of vitamin C, plus the omega-3 fats EPA and DHA and a multivitamin containing B6, B12, and folic acid" (Holford, The New Optimum Nutrition Bible, page 207).

Take 1 gram daily of no-flush niacin if you have low HDL and an EPA fish oil supplement of 1,000 mg of EPA if you have high cholesterol. If you also have high lipoprotein A, "take a supplement of at least 5 g of vitamin C and 3 g of lysine." In addition, if you also "have high homocysteine, increase your intake of vitamins B6, B12, and folic acid (ibid).

Make fiber your friend. In addition to helping to "prevent obesity by slowing down digestion and the release of glucose and insulin, fiber has been shown to normalize serum cholesterol levels. High-fiber diets reduce the risk of heart disease, high blood pressure, and certain types of cancer" (Lipski, Digestive Wellness, page 158).

Enjoy generous amounts of fruits and vegetables. "They are rich in nutrients and fiber, contain no cholesterol, and are low in fat" (Lipski, Digestive Wellness, page 164).

Special Cautions and Related Issues
We all enjoy an occasional meal in a restaurant or fast food drive-through. However, be cautious and inquire about the ingredients used and preparation of foods. For example, French fries often contain saturated and/or trans fats. For that reason, it is best to minimize meals eaten in fast-food restaurants; when you do, request a salad with fat-free salad dressing and without cheese or croutons.

In addition, you may want to discuss your homocysteine level with your health care provider. This dangerous amino acid has been shown to be linked to heart disease. In addition, homocysteine "damages cholesterol, making it accumulate in arteries," which means "lowering your homocysteine can be expected to lower your cholesterol too" (Holford, The New Optimum Nutrition Bible, page 206).

References

National Heart, Lung, and Blood Institute. High Blood Cholesterol. Retrieved April 12, 2006, from http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_WhatIs.html

Holford, P. (2004). The New Optimum Nutrition Bible. Berkeley: The Crossing Press.

Lipski, E. (2005). Digestive Wellness. New York: McGraw-Hill.