What should you do if you have high cholesterol?
5 minute read
Cholesterol is an important component of our cell membranes, but having too much cholesterol in our blood stream is a risk factor for cardiovascular disease as it can contribute towards the buildup of plaques in blood vessels - potentially leading to heart attacks, stroke and heart disease.
If you have high LDL cholesterol, (or high Apo-B), that is typically a sign that you are at greater risk of cardiovascular disease and it is worth taking action on.
Your doctor may recommend taking statins if you have high cholesterol, but you can also naturally lower your LDL cholesterol and total cholesterol by making simple changes to your lifestyle. Taking medication is a personal choice and one which you should consult your doctor with before deciding whether or not you wish to.
Will weight loss help to lower your cholesterol?
Many people who are overweight or obese have high total cholesterol and/or high LDL cholesterol, however, the research is actually conflicting as to how much of an effect that BMI influences serum cholesterol and whether losing weight does actually improve cholesterol levels in the long term. More recent research actually suggests cholesterol levels are more influenced by changes in diet and lifestyle habits, rather than body weight.
So yes, while making the following changes to decrease cholesterol may also result in weight loss, it is completely possible to lower cholesterol independently of weight loss as well.
9 ways to lower cholesterol:
1. Stop smoking
Since the 1960’s, despite the average BMI of adults in Western Countries increasing, average total cholesterol levels have actually decreased. Based on survey data, it is unlikely that the decrease in cholesterol is due to positive changes in diet or exercise, and although it could be in part due to the rise in the prescription of statin medication - this only really occurred in the 1990’s onwards, and is unlikely to have greatly influenced the average population’s cholesterol levels very much. What is a more likely hypothesis is that smoking has become less and less popular each decade since the 1960’s, thus reducing the average total cholesterol of adults. Smoking cigarettes is known to be linked to coronary heart disease and this implies that it could partly be due to smoking's effects on total and LDL cholesterol.
2. Exercise
A study published in 2012 investigated the effects of exercise in sedentary, overweight individuals and found that even in the absence of weight loss or changes to diet, exercise had beneficial effects on reducing LDL cholesterol and lowering serum triglycerides. So yes - even if you are not changing your diet or losing weight - you are still making a positive difference to your health by incorporating exercise into your daily life. The World Health Organisation suggests aiming for 150-300 minutes of moderate intensity exercise each week, as well as resistance training exercise at least twice a week for cardiovascular disease prevention and optimal health.
3. Increase fibre take
Fibre is the non-digestible component of plants- meaning that it passes through the digestive system intact. There are different types of fibre, which can be categorised into either soluble fibre or insoluble fibre. All types of fibre have health benefits - but soluble fibre in particular is known to have cholesterol-lowering effects. Soluble fibre is able to absorb water in the digestive tract and form a gel which can ‘collect’ excess cholesterol found in bile, thus lowering cholesterol levels in the body. Foods such as oats, apples, carrots, citrus foods, peas, beans and psyllium husk are all excellent sources of soluble fibre and are great to include regularly in the diet.
4. Decrease saturated fat intake
Saturated fats, including those found in animal based foods, coconut oil and palm oil, have been well studied to show that consumption increases both total cholesterol and LDL cholesterol. By reducing the amount of fat consumed from animal based products - for example choosing low fat dairy, lean cuts of meat, or choosing more plant based protein options - you can lower LDL cholesterol levels and your risk of cardiovascular disease is likely to decrease. Likewise, trans-fats, which are found in deep fried foods and some packaged foods (although they are now banned from being added to processed foods in some countries), are even worse for raising cholesterol levels and increasing risk of cardiovascular disease, and should be kept to a minimum in the diet.
5. Increase polyunsaturated fat intake
Polyunsaturated fats are found in vegetable oils and oily fish. Multiple studies have shown that when an equivalent amount of calories from foods such as butter (which is high in saturated fats) are replaced with calories from an oil such as sunflower, rapeseed (canola) or soybean, LDL-cholesterol levels will decrease. Therefore, by making a conscious effort to replace saturated fats in the diet with unsaturated fats - you will be able to effectively lower LDL-cholesterol.
6. Take phytosterols
Phytosterols are compounds naturally found in vegetable oils, wholegrains, nuts and seeds - but are also often added to foods like margarine, some types of yoghurts and orange juice. There is evidence to suggest that consuming phytosterols can reduce cholesterol levels in the bloodstream by inhibiting the absorption of cholesterol. It is difficult to get enough phytosterols in the diet to make a significant impact on cholesterol levels, however - through supplementation or by using fortified foods (such as margarine, etc.), by achieving an intake of 2 grams of phytosterols consumed per day, this will have a significant effect on lowering LDL cholesterol.
7. Add soy to your diet
Soy containing foods, such as edamame beans, tofu, tempeh and soy milk, may influence blood cholesterol levels by lowering LDL cholesterol as well as total cholesterol. Further research is needed to confirm the exact mechanisms by which this occurs, and it is suggested that in order for soy to have the most positive effect on blood cholesterol levels - enough would need to be consumed so that it replaces animal protein in the diet (equivalent to at least 250-500 grams tofu per day). There is inconclusive evidence that specific components of soy protein can lower cholesterol, but it could simply be that consuming less animal based foods and more plant based foods (including soy protein) has a more significant effect.
8. Manage any potential thyroid health conditions
Thyroid hormones have an important role in cholesterol metabolism by modulating the rate of cholesterol synthesis. Therefore, if thyroid conditions happen to be present in a way which compromises thyroid hormone production, it is possible that cholesterol levels in the blood will increase in a negative way. If you are suspicious that you may have an issue with the function of your thyroid, and you also have high cholesterol, it will be a good idea to ask to have your thyroid checked by your doctor - in which case thyroid medication or dietary changes to support your thyroid may help to also lower your cholesterol.
9. Reduce stress
Stress is well known to impact eating and activity behaviours - for some people it increases the desire to consume more highly palatable food high in saturated fat and refined carbohydrates, it may also impact motivation to engage in physical activity, and/or increase smoking consumption. All of these activities are known to have an impact on serum cholesterol levels. In addition, there may also be physiological effects caused by stress hormones (namely cortisol) that can affect cholesterol levels as well. Stress hormones increase free fatty acid circulation in the bloodstream as well as decrease insulin sensitivity - both of which can lead to an increase in LDL cholesterol.
Conclusion
If you are over the age of 45, have any metabolic health issues or if you have a family history of high cholesterol, it is a good idea to check your cholesterol levels on a routine basis. If you do have high cholesterol and/or high LDL cholesterol, by focusing on what you can control through diet and lifestyle, you may be able to avoid needing to take medication to manage your health, or you can better support the efficacy of cholesterol-lowering medication if you do need to take it.
If you need help with understanding what to eat to improve your health, or you struggle with motivation or accountability when it comes to eating and exercise, please don’t hesitate to get in touch for a free discovery call. As a Registered Nutritionist and Personal Trainer, I can assist you with meal plans, exercise plans, coaching and more.
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