According to the CDC’s Cholesterol Fact Sheet:
- 71 million American adults (33.5%) have high low-density lipoprotein (LDL), or “bad” cholesterol.
- Only 1 out of every 3 adults with high LDL cholesterol has the condition under control.
- Less than half of adults with high LDL cholesterol get treatment.
These statistics are quite worrying, as a high level of cholesterol seriously increases the risk of heart disease, which is the leading cause of death in the United States. Because high cholesterol has no symptoms and can only be detected by blood tests, it is estimated that the number of Americans who have a high LDL, and therefore a high risk of atherosclerosis, coronary heart disease and heart attacks might be even higher than what the statistics show.
Genetics can contribute to high cholesterol, an so do certain conditions such as liver or kidney disease, pregnancy, hormonal imbalances, diabetes, underactive thyroid gland or polycystic ovary syndrome, but our diet and lifestyle choices play an important part as well.
What is cholesterol?
Cholesterol is a type or organic lipid molecule, an essential structural component of all animal cell membranes. At normal levels, cholesterol is essential for the body, as it aides the production of hormones, plays an important role in digestion by helping the liver to produce the bile, it creates a protective barrier for every cell and contributes to the synthesis of vitamin D.
It is estimated that approximately 75-80% of the cholesterol is produced by our body, mainly by the liver, while the rest of 20-25% comes from the foods we eat. In ideal conditions, if we introduce in our body, through food, more cholesterol than it needs, the liver can compensate by reducing the production of cholesterol and by eliminating the excess cholesterol. But, unfortunately, not only that our genes aren’t always on our side, but also most of the times the excess cholesterol is so high, that the liver cannot possibly compensate enough to maintain normal cholesterol levels.
Cholesterol is carried to and from cells by lipoproteins. Depending on the type of lipoprotein that carries it, cholesterol can be:
Low-density lipoprotein (LDL) cholesterol – also known as “bad” cholesterol;
Very low-density lipoproteins (VLDL) cholesterol – which has been associated with plaque deposits;
High-density lipoprotein (HDL) cholesterol – also known as “good” cholesterol.
Why “good” and “bad”? HDL is considered to be “good cholesterol” because the high-density lipoproteins help the body get rid of the excess cholesterol by transporting it to the liver.
LDL, on the other hand, is known as the “bad cholesterol” because the low-density lipoproteins transport the cholesterol to the arteries, where it can cause atherosclerosis, the condition in which plaque builds up inside your arteries, which can lead to several types of complications – the plaque can break off and get carried through the bloodstream and get stuck, it can cause blood clots, which can block arteries in the brain or heart, causing a stroke or a heart attack, or it can cut off oxygen supply to the extremities, resulting in gangrene.
Triglycerides are another type of fat, the levels of which are also usually measured whenever you do a cholesterol test, as they are believed to increase the risk of plaque buildup in the arteries, when combined with a high LDL and a low HDL.
Normal cholesterol levels
According to the Centers for Disease Control and Prevention (CDC), the desirable levels of cholesterol are:
Total cholesterol: less than 200 mg/dL*
LDL (“bad” cholesterol): less than 100 mg/dL
HDL (“good” cholesterol): 40 mg/dL or higher
Triglycerides: less than 150 mg/dL
* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.
Controlling cholesterol levels – Learn the difference between different types of fat
Fatty foods represent one of the most important external source of cholesterol. But instead of eliminating them completely from your diet, the recommendation is to learn to differentiate between fats that cause your body to produce even more cholesterol and fats that can help you maintain a normal cholesterol level.
Saturated fat usually comes from animal products – such as beef, lamb, pork, poultry with skin, butter, cream, cheese and other dairy products made from whole or 2 percent milk – but also from certain plants oils and products such as coconut oil, palm oil or cocoa butter.
Trans Fats (or partially hydrogenated oils) – are created industrially by adding hydrogen to liquid vegetable oils to give them a thicker consistency or make them solid. These are found in fried foods and baked goods such as pastries, pizza dough, pie crust, cookies or crackers.
Eating foods which contain saturated fat and trans fat determines your body to produce more LDL than it can consume, which in turn causes a rise of the cholesterol level in your blood. This is why the American Heart Association recommends reducing the intake of trans fat (by avoiding foods such as doughnuts, cookies, crackers, muffins, pies or cakes) and limiting the consumption of saturated fat to 5-6 percent of the total calories your consume daily. That translates into approximately 11-13 grams of saturated day for a person of medium height and weight, who consumes around 2.000 calories / day.
Unsaturated fat, on the other hand – which can be either monounsaturated or polyunsaturated – are usually found in fish, such as salmon, trout and herring, avocados, olives, walnuts and some types of liquid vegetable oils such as soybean, corn, safflower, canola, olive and sunflower, and they can lower the level of bad cholesterol (or LDL), especially when consumed instead of saturated or trans fats.
Foods that lower cholesterol
According to Harvard Health Publishing, a division of Harvard Medical School, there are several foods that can help lower your LDL in various ways – by delivering polyunsaturated fats, by providing significant quantities of soluble fibre, which bind cholesterol and its precursors and eliminate them through the digestive system, or by delivering plant sterols and stanols, substances occurring naturally in certain plants that can block the body from absorbing cholesterol.
Oatmeal is packed with soluble fibre that helps eliminate cholesterol before it can even reach the circulatory system. You can eat them at breakfast or add them in salads or yogurts.
Barley and other whole grains
Like oats, barley and other types of whole grains are rich in soluble fiber which help lower LDL cholesterol.
All types of beans – navy, kidney beans, lentils, garbanzos or black-eyed peas – are rich in soluble fiber and they keep you satiated for a long time, which means that you’ll be less likely to snack on foods that are rich in trans fats.
Eggplant and okra
They are low in calories and rich in soluble fiber.
Almonds, walnuts and peanuts are all rich in unsaturated fats and Omega 3 that can help lower LDL cholesterol and protect the health of your cardiovascular system. Here are some highlights from two of the studies addressing the benefits of Omega 3 for reducing cholesterol and protecting the heart and arteries:
“Omega-3 fatty acids may have anti-inflammatory effects and also promote better cardiac healing” (Source: Raymond W. Kwong, American College of Cardiology. “Omega-3 fatty acids appear to protect damaged heart after heart attack.”)
“Results showed that average diastolic blood pressure — the “bottom number” or the pressure in the arteries when the heart is resting — was significantly reduced during the diets containing walnuts and walnut oil. […] These results are in agreement with several recent studies showing that walnuts can reduce cholesterol and blood pressure.” (Source: Sheila G. West, Penn State, “Walnuts, walnut oil, improve reaction to stress”)
You can help lower your LDL by replacing butter or lard with sunflower, canola or safflower oil. They contain unsaturated fats and help protect the cardiovascular system.
Apples, grapes, strawberries and citrus fruits
They are rich in pectin, a soluble fiber that helps lower LDL.
Foods fortified with sterols and stanols
Such as certain granola bars, orange juice or even some brands of chocolate. Sterols and stanols are also available as supplements and they can help lower LDL.
Studies showed that consuming 25 grams of soy protein / day (approximately two cups and a half of soy milk or 10 ounces of tofu) can help lower LDL by up to 5-6%.
They are rich in unsaturated fats and Omega 3. Replacing meat with fish can reduce the triglycerides and LDL levels.
Psyllium, for example, is a great natural source of soluble fibers, which can help lower the LDL cholesterol. You can mix them in your cereals, add them in yogurts or salads.
One avocado per day may keep high cholesterol at bay
A study published in 2015 in the Journal of the American Heart Association showed that eating just one avocado per day, as part of a moderate-fat, cholesterol-lowering diet can help with additionally lowering LDL, while maintaining the level of HDL, in overweight and obese patients. The results also showed that avocados, which are rich in monounsaturated fatty acids, have beneficial effects on cardio-metabolic risk factors that “extend beyond their heart-healthy fatty acid profile”.
Cooking tips for lowering cholesterol
In addition to recommending that we introduce in our daily diet the foods that can help lower cholesterol and eliminate, as much as possible, those that tend to raise it, the American Heart Association also offers a series of cooking tips to lower cholesterol:
- Select, whenever possible, lean cuts of meat.
- Trim the fat off meat.
- Opt for broiling instead of pan-frying.
- Drain the fat before serving the meat and replace it with marinades to keep it moist.
- You can reduce the quantity of meat you’re consuming by replacing it, whenever possible, with mushrooms, eggplants or beens.
- Cook stews, soup and stock a day before you plan on eating them. This way you can easily remove the hardened fat from the top.
- Eat chicken and turkey instead of duck and goose, which are higher in fat, and remove the skin.
- When baking, you can replace oils with pureed fruits to keep your muffins of breads moist. Bonus: you’ll also add extra nutrients.
- Use low-fat milk and other low-fat dairy products in your recipes. Most of the times you won’t feel any difference.
- When making a sauce or a gravy, let it cool first, then remove the hardened fat from the top before serving it.
- When cooking meatloaf or meatballs, instead of breadcrumbs use oatmeal to increase your intake of soluble fibers.
- Replace white rice with brown rice and your regular pasta with whole-grain pasta. They are richer in fiber and nutrients.
Maintain a healthy weight
What you eat is extremely important, but so is maintaining a healthy weight. According to statistics, approximately one in three U.S children are overweight or obese and more than one-third of U.S adults are obese. Being overweight or obese is one of the main risk factors for high cholesterol and other health problems such as heart disease, stroke, high blood pressure and diabetes.
But being overweight or obese does not only increase the cholesterol level, but also negatively influences the LDL – HDL balance. In people that are overweight or obese the levels of triglycerides and LDL tend to be high, while the level of HDL, the “good cholesterol” is in many cases too low.
Losing weight can improve your triglycerides, LDL and HDL cholesterol and significantly reduce the risk of heart disease. Start small, with the target of losing 5-10% of your body weight, or less, depending on your final goal, and work your way up until your get to a normal and healthy body weight.