All my adult life, I had higher than normal “Cholesterol levels”. What is Cholesterol and what we can do to improve and maintain healthy levels?

Cholesterol

What causes a person’s LDL level to be high? Most of the time Cholesterol isn’t entirely the health villain it’s made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease. Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.

What is “bad” about cholesterol isn’t the substance itself – in fact, we can’t live without it, but how much of it is in the bloodstream.

The body packages cholesterol in two main particles: low-density lipoprotein (LDL), the so-called bad cholesterol, and high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.

diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.

If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.

11 foods that can help lower your cholesterol

Focus on fiber-rich foods and avoid saturated fats.

If your cholesterol level has crept up over the years, you may wonder whether changing your diet can help. Ideally, your total cholesterol value should be 200 milligrams per deciliter (mg/dL) or lower. But it’s the harmful LDL cholesterol value that experts worry about the most. Excess LDL builds up on artery walls and triggers a release of inflammatory substances that boost heart attack risk.

“To prevent heart disease, your LDL should be 100 mg/dL or lower,” says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women’s Hospital. But many Americans have LDL values that are less than optimal (100 to 129 mg/dL) or borderline high (130 to 159 mg/dL).

If you fall into either of those categories, you may be able to nudge down your LDL to a healthier level by changing what you eat, particularly if your current diet could use some improvement. However, most people with higher LDL values likely will also need to take a cholesterol-lowering drug, such as a statin, says Dr. Plutzky.

Dietary directives

Avoiding foods that are high in cholesterol isn’t the best way to lower your LDL. Your overall diet — especially the types of fats and carbohydrates you eat — has the most impact on your blood cholesterol values. “As the American Heart Association has noted, you’ll get the biggest bang for your buck by lowering saturated fat and replacing it with unsaturated fat,” says registered dietitian Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital.

That means avoiding meat, cheese, and other high-fat dairy products such as butter, half-and-half, and ice cream. Equally important is replacing those calories with healthy, unsaturated fats (such as those found in vegetable oils, avocados, and fatty fish) rather than refined carbohydrates such as white bread, pasta, and white rice. Unlike healthy fats, these starchy foods aren’t very filling, and they can trigger overeating and weight gain.

The other big problem with refined carbs? They’re woefully low in fiber, which helps flush cholesterol out of the body (see “The fiber factor”).

The fiber factor

Your body can’t break down fiber, so it passes through your body undigested. It comes in two varieties: insoluble and soluble. Fiber-containing foods usually feature a mix of the two.

Insoluble fiber does not dissolve in water. While it doesn’t directly lower LDL, this form of fiber fills you up, crowding other cholesterol-raising foods out of your diet and helping to promote weight loss.

Soluble fiber dissolves in water, creating a gel. This gel traps some of the cholesterol in your body, so it’s eliminated as waste instead of entering your arteries.

Soluble fiber also binds to bile acids, which carry fats from your small intestine into the large intestine for excretion. This triggers your liver to create more bile acids – a process that requires cholesterol. If the liver doesn’t have enough cholesterol, it draws more from the bloodstream, which in turn lowers your circulating LDL.

Finally, certain soluble fibers (called oligosaccharides) are fermented into short-chain fatty acids in the gut. These fatty acids may also inhibit cholesterol production.

The “best” foods

The following 11 foods are good sources of fiber or unsaturated fat (or both). But they’re not in any particular order and are simply suggestions. Most whole grains, vegetables, and fruits are good sources of fiber. And most nuts and seeds (and the oils made from them) provide monounsaturated or polyunsaturated fats.

1. Oatmeal. This whole grain is one of the best sources of soluble fiber, along with barley (see “Grain of the month,” at right). Start your day with a bowl of steel-cut or old-fashioned rolled oats, topped with fresh or dried fruit for a little extra fiber.

2. White beans. Also called navy beans, this variety ranks highest in fiber content. Try different types of beans as well, such as black beans, garbanzos, or kidney beans, which you can add to salads, soups, or chili. But avoid prepared baked beans, which are canned in sauce that’s loaded with added sugar.

3. Avocado. The creamy, green flesh of an avocado is not only rich in monounsaturated fat, it also contains both soluble and insoluble fiber. Enjoy this fruit sliced in salad, pureed into dip, or mashed and spread on a slice of whole-grain toast.

4. Eggplant. Although not everyone’s favorite, these deep purple vegetables are one of the richest sources of soluble fiber. One idea: oven-roast or grill whole eggplants until soft and use the flesh in a Middle Eastern dip called baba ghanoush.

5. Carrots. Raw baby carrots are a tasty and convenient snack — and they also give you a decent dose of insoluble fiber.

6. Almonds. Among nuts, almonds are highest in fiber, although other popular varieties such as pistachios and pecans are close behind. Walnuts have the added advantage of being a good source of polyunsaturated, plant-based omega-3 fatty acids.

7. Kiwi fruit. Contrary to popular belief, you don’t need to peel these fuzzy, brown fruits. But to avoid the skin, slice one in half and scoop out the inside with a spoon for an easy, fiber-rich, sweet snack.

8. Berries .Because these fruits are packed with tiny seeds, their fiber content is higher than most other fruits. Raspberries and blackberries provide the most, but strawberries and blueberries are also good sources.

9. Cauliflower. This cruciferous veggie not only provides fiber; it can also serve as a substitute for white rice. Just shred or whirl in a food processor until it resembles rice, then sauté with a little olive oil until tender.

10. Soy. Eating soybeans and foods made from them, such as soy milk, tofu, and tempeh, was once touted as a powerful way to lower cholesterol. More recent analyses showed the effect is modest, at best. Still, protein-rich, soy-based foods are a far healthier choice than a hamburger or other red meat.

11. Salmon. Likewise, eating cold-water fish such as salmon twice a week can lower LDL by replacing meat and delivering healthy omega-3 fats. Other good fish options include chunk light canned tuna and tinned sardines.

Supplements for three common conditions

Certain herbs, vitamins, minerals, and other compounds may help control cholesterol, blood pressure, and anxiety.

High cholesterol, high blood pressure, and anxiety are three common conditions that are often treated with medication. But sometimes people can’t tolerate those drugs or are reluctant to use them. In these instances, dietary supplements may be an option, says Dr. Donald Levy, medical director at the Osher Clinical Center for Integrative Medicine at Brigham and Women’s Hospital and assistant clinical professor of medicine at Harvard Medical School.

Studies have shown that some herbs, vitamins, minerals, and other substances, alone or in combination with traditional treatments, may be effective in treating these conditions, and are largely safe to use — provided your doctor approves.

High cholesterol

Statins are the most commonly prescribed class of medication to improve high cholesterol, but there are alternatives for people who can’t take them.

Vitamin D₃. If you cannot tolerate a statin medication and have a vitamin D deficiency (which Dr. Levy defines as a blood level below 32 nanograms per milliliter), a vitamin D₃ supplement could help, according to Dr. Levy. “It’s interesting, because after taking the supplement, some people are then able to tolerate statins when they couldn’t in the past,” he says.

Phytosterols. Phytosterols (also called plant stanols or sterols) are derived from the cell membranes of plants and can be taken in pill form. They are also found naturally in foods such as nuts, beans, fruits, and vegetables. Studies show that phytosterol supplements can lower “bad” LDL cholesterol by up to 14% in people taking 2,000 to 3,000 milligrams (mg) a day, says Dr. Levy. When choosing a product, look for a quality seal (see “Worried about supplement safety? Here’s what you should consider”), and also look for a product that contains phytosterol esters, says Dr. Levy.

Red yeast rice. Red yeast rice supplements are made from a type of yeast that is grown on white rice. Red yeast rice has long been used in Chinese medicine, and modern studies show that people taking 2,400 to 3,600 mg a day for six months were able to reduce their LDL cholesterol by 20% to 25%, says Dr. Levy. One 2008 study published in The American Journal of Cardiology found that red yeast rice was also effective in reducing deaths and recurrent heart attacks in nearly 5,000 people who took the supplement after having a heart attack. Look for a high-quality product, says Dr. Levy, because red yeast rice can contain a dangerous contaminant, citrinin, which is a toxin produced by fungus that can cause food poisoning, kidney damage, and immune system problems.

Worried about supplement safety? Here's what you should consider

While some supplements are potentially helpful (or at least harmless), a lack of regulatory oversight of these products means that others might be ineffective or dangerous, or might contain hazardous contaminants. Identifying the safe choices requires a little detective work, says Dr. Donald Levy, medical director at the Osher Clinical Center for Integrative Medicine at Brigham and Women’s Hospital and assistant clinical professor of medicine at Harvard Medical School. Before taking a supplement, always talk to your doctor to make sure that it’s safe for any medical conditions you may have and that it won’t interact with any medications you are taking.

Although supplement makers must follow FDA rules for good manufacturing practices, the agency does not require testing the estimated 9,000 products on the market to make sure they do contain the ingredients they claim, and don’t contain contaminants, such as dangerous bacteria, arsenic, cadmium, or lead. This means there is no guarantee that any particular product is effective or safe. To add a degree of protection, look for products that have voluntarily gone through quality testing, which is certified by a seal on the packaging. Some good ones to look for are those from U.S. Pharmacopeia, ConsumerLab.com, and NSF International.

High blood pressure

A few supplements have been shown to be effective in reducing high blood pressure, says Dr. Levy

Magnesium citrate or glycinate. Some people are deficient in the mineral magnesium. But blood tests aren’t good at detecting total magnesium levels inside the body, because much of your body’s magnesium is stored within cells. Many people find the deficiency only after a nutritionist analyzes their diet, says Dr. Levy. In those individuals, supplements can boost magnesium levels and help reduce high blood pressure when taken along with traditional blood pressure treatments. It typically takes up to six weeks for the supplements to show an effect. However, not everyone should take magnesium, particularly those with kidney disease, says Dr. Levy, so be certain to consult with your doctor or integrative medicine specialist before taking it.

Lycopene. An antioxidant supplement that may also help reduce high blood pressure is lycopene, which gives vegetables like tomatoes their red hue. While tomato-based products, including canned sauces, contain lycopene, those foods often have a lot of sodium. So, it’s better in many instances to opt for a supplement. Look for one that also contains tomato extract for an added benefit, says Dr. Levy. Typically, people need to take 15 to 25 mg of lycopene daily to see a reduction in blood pressure.

Anxiety

Problems with anxiety are common, especially around the time of menopause.

Chamomile extract. This extract, which comes from a flower, has long been used as a therapy for anxiety. Anxiety often goes hand in hand with sleeplessness, so it’s no surprise that chamomile is also often recommended as a sleep aid. Many people drink chamomile tea, but taking a supplement may be more convenient (and require fewer late-night trips to the bathroom if taken before bed). Studies have found that people who took chamomile supplements saw a significant reduction in anxiety when compared with people who took a placebo, says Dr. Levy. Typically, it’s best to start by taking one 220-mg capsule daily. Look for one that contains 1.2% of a substance called apigenin.

I know that is a lot of information to take on and digest, but the subject matter is so complicated and involved and I had to keep it as short as possible, after all, my goal here is to give you as much information as I possibly can without have you or me get a degree in the subject matter. With my own research, I was able to put this information together and to make it as understandable as possible. I hope you have enjoyed reading it and found it educational and interesting at the same time.