Do you want to lower your cholesterol level naturally and without medication? What is the scientific support that natural strategies work? In this article, we will explain how to lower elevated cholesterol levels by eating delicious and nutrient dense foods.
Elevated total cholesterol and LDL cholesterol levels increase one’s risk for atherosclerosis, coronary artery disease, and stroke. Indeed, substantial evidence implicates LDL-C as a causal factor in cardiovascular disease (CVD).1 Cholesterol itself isn’t necessarily a dangerous culprit; it is essential to our health. We need a certain amount of cholesterol for nerve insulation (myelin), vitamin D synthesis, and steroid hormones like cortisol, testosterone, and estrogen. Since the helpful cholesterol-lowering statins may produce adverse effects, people are looking for scientifically validated natural strategies for reducing high total and LDL numbers.2 3 The use of statins for two years may double the risk for diabetes in individuals who have pre-existing risk factors for diabetes 4 and escalate the progression of diabetes.5 Statins significantly reduce the risk for coronary artery disease and ischemic stroke. But considering that 1/3 of Americans have prediabetes and 1/10 have diabetes, lifestyle intervention and natural strategies for reducing elevated cholesterol are critically needed.6
The Most Dangerous Cholesterol
We need a certain amount of LDL (low-density lipoprotein) to take cholesterol to the cell membrane. Of cholesterol lipoproteins, it is the small dense LDLs (sdLDL) that promote atherosclerosis. Small dense lipoproteins penetrate faster, stay longer in the arteries, and are more susceptible to oxidation than the large LDL particles.7
Natural Strategies for Reducing High Cholesterol:
Watch Your Carbs
Increased dietary intake of simple sugars and starches with a high glycemic index (GI) can increase levels of small, dense LDL and triglycerides (blood fats).8 High glycemic intake carbs include white rice, sugar, high fructose corn syrup, refined grains, breakfast bars, chips and crackers, most fruit juices, watermelon, pineapple, desserts, dried fruits, and white potatoes. Generally, the more processed a food is, the higher it scores on the glycemic index.
You don’t need to avoid all carbs though. A meta-analysis provided consistent evidence that consuming low glycemic index foods for at least four weeks reduced total and LDL cholesterol and had no effect on HDL cholesterol or triglycerides.9 Low glycemic carbs include oatmeal (but not instant), barley, rye, bulgar, non-soy legumes, non-starchy vegetables, apples, berries, apricots, whole grapefruits and tangerines, and cherries.
However, carbohydrates rich in resistant starches decrease total cholesterol and at times elevated cholesterol. 10 Oats, cooked and cooled brown rice, barley, legumes, cooked and cooled potatoes contain considerable levels of resistances starches. It is fine to have an occasional baked or boiled white potato. Just don’t eat when it is hot and watch what you put on top of it!
Get Enough Fiber
Soluble fiber helps to decrease elevated cholesterol levels by several different mechanisms. A large meta-analysis found that consuming at least 25 grams of food fiber a day is associated with lower weight, blood pressure, blood sugars, total cholesterol, lower risk of developing or dying from diabetes, heart disease, and strokes. The study results were highly consistent and showed that the more fiber that was eaten, the better the outcomes. Sources of soluble fiber include legumes, sweet potatoes, broccoli, citrus, berries, apples, and nuts.11
Enjoy a Well-Balanced, Predominately Whole Plant Food Cuisine
Individuals who consumed 70% of their diet from plant-based food had a 20% lower risk of dying from cardiovascular disease.12 A vegetarian diet can cut heart disease risk by a third.13 Lifelong vegetarians had a 24 percent lower incidence and lifelong vegans (those who eat no eggs or dairy products) had a 57 percent lower incidence of coronary heart disease compared to meat eaters.14 A meta-analysis study of 20 previous years found that the consumption of processed meats is associated with 42% increased risk for coronary disease and 19% increased risk for diabetes.15
Helpful Compounds in Plant Foods
The amino acid, arginine, in nuts and legumes, is a precursor to nitric oxide. In moderate amounts, nitric oxide is a marvelous molecule that keeps blood vessels open and blood pressure down. It also helps to protect against atherosclerosis. More helpful compounds are the anthocyanins found in blue, red, and purple plants. They inhibit LDL oxidation and undesirable platelet clumping which can trigger a clot. Many phytochemicals reduce inflammation, a major player in the development of atherosclerosis.
Caveats for Vegetarians
In some cases unbalanced vegetarian meals may encourage the development of atherosclerosis. Substituting refined carbohydrates for saturated fats does not lower cholesterol levels. Since there is no measurable vitamin B-12 in any appreciable amount in plants, anyone eating a totally vegetarian diet must eat foods fortified with vitamin B-12 or take a B-12 supplement. Vegetarians should also be careful to get enough sun and drink soy or nut milk fortified with vitamin D. A deficiency in vitamin B-12 elevates homocysteine which encourages the development of atherosclerosis.18 Elevated homocysteine is a risk factor for atherosclerosis and promotes inflammation inside the arteries. It also impairs the ability of blood vessels to dilate and promotes clot formation. Vitamin B-12, folic acid, and vitamin B 6 work together to keep homocysteine levels within range.
Vitamin B-12 deficiency is prevalent in vegetarians.19 Vegetarians should thus take preventive measures to ensure adequate intake of this vitamin, including regular consumption of supplements containing B12.
Plant-based and vegetarian diets only improve heart health if they contain plenty of whole plant foods. In contrast, plant-based diets which include higher amounts of less healthy plant foods (refined grains, potatoes/fries, foods and beverages high in added sugar) are linked to increased risk for cardiovascular disease.20
Enjoy Foods that Fight Inflammation
Inflammation fuels all the stages of atherosclerosis development. Refined sugars and grains, fried foods, sodas, and processed red and organ meats are among the major contributors to the pro-inflammatory dietary index. In contrast, green leafy vegetables (kale, spinach, cabbage, arugula), yellow vegetables (pumpkin, yellow peppers, beans, carrots), and whole grains– all contain phytochemicals that help to quench inflammation.21
Long chain saturated fats from meat push inflammation. Red and organ meats contain Neu5Gc, a non-human sialic acid sugar molecule. Neu5Gc has been linked to cancer as well as cardiovascular and other inflammatory diseases including some bacterial infections. 22
The Fat-Cholesterol Controversy
How Much Fat?
Eating enough fats is important. As previously mentioned, a low fat vegetarian diet coupled with exercise and stress management can help to lower total cholesterol and even reverse coronary arteries disease. However, several studies show that a low-fat diet increases small dense LDLs and triglycerides. Other studies suggest that a high fat diet and even certain saturated fats may shift the very atherogenic sdLDLs into less atherogenic larger LDL particles in healthy individuals. However, the author of the review of studies on this subject concludes: “Overall dietary patterns should also be considered, as food components (macro- and micronutrients, fiber, and phytochemicals) may affect LDL size. It is suggested that further investigations address the effects of dietary patterns (whole versus refined carbohydrates, types and amounts of fat, and plant-based versus meat-based diets) on a variety of cardiovascular disease risk markers – including sdLDL particles. Moreover, it is recommended to ascertain the clinical relevance of the relative and absolute levels, size, number, and peak particle diameter of LDL particles involved with the primary and secondary prevention of CVD.” 23
The quality, rather than the quantity, of dietary fat may be more crucial in determining overall risk for cardiovascular disease.24 Diets lower in saturated fat have been associated with significantly greater reductions in LDL cholesterol and lower concentrations of large, buoyant LDL particles. Higher intakes of saturated fat have been associated with significantly greater increases in concentrations of small, dense LDL. 25
Helpful Polyunsaturated Fats
Substituting polyunsaturated fat for saturated fat reduces LDL cholesterol and the total cholesterol to high-density lipoprotein cholesterol ratio. Epidemiological studies and randomized clinical trials have provided consistent evidence that replacing saturated fat with polyunsaturated fat, but not with refined carbohydrates, is beneficial for coronary heart disease.26
Nut consumption also has favorable effects on total cholesterol ( and low-density lipoprotein cholesterol and improves the ability of the blood vessels to dilate.27 Additionally, regular nut consumption reduces elevated triglycerides.28 Omega-3 fats protect from inflammation. Plant foods rich in omega-3 fats include chia seed, flaxseed, and whole soybeans. Omega-3’s are essential for heart health.
Beneficial Monounsaturated Fats
Monounsaturated fats (MUFAs) such as olives, cold-pressed extra virgin olive oil, and nuts reduce LDL by 5% to 10%, lower triglycerides by 10% to 15%, increase HDL by 5%, decrease oxidized LDL, reduce oxidation and inﬂammation, improve erectile dysfunction, lower blood pressure, decrease thrombosis (clots), and reduce the incidence of coronary artery disease. 29
It is much healthier to obtain fats from eating avocados, nuts, seeds, and olives. If you use oil in baking or on a salad be sure to use only the cold-pressed, virgin monounsaturated oils like olive, avocado, and almond. There are many case studies which suggest that for some people with high cholesterol, avoiding any oils might be beneficial if enough nuts, seeds, and avocados are consumed.
Are Saturated Fats Really Dangerous?
A 2014 meta-analysis of 22 studies showed that saturated fat increased the risk of coronary artery disease by 15%. We also must consider that other substances in eating meat and dairy products other than saturated fats can increase the risk for cardiovascular disease.30 Some recent studies suggest saturated fats don’t affect the cholesterol level.31. This author is not ready to discard earlier studies showing that saturated fats contribute to coronary artery disease. Besides, a review of observational and intervention studies shows that partially replacing saturated fatty acid with polyunsaturated found convincing evidence of lower blood LDL-C levels and a reduced risk of CVD, especially in men.32 So, seriously limiting the intake of saturated fats and replacing them with healthful foods benefits heart and blood vessel health.
For the sake of argument, let’s ask, “Can saturated fats hurt the arteries and promote coronary heart disease apart from cholesterol?” Yes, as we shall soon see. Stay tuned.
Not all saturated fats are created equal. The current studies indicate that medium-chain saturated fats may not be as harmful as long-chained saturated fats from meats. While milk has some anti-inflammatory compounds, milk products are often combined with sugar that is pro-inflammatory. Indeed, sugar may promote atherosclerosis more than saturated fats. How? Liberal sugar consumption, for even a few weeks, has been shown to cause numerous abnormalities found in patients with coronary artery disease: elevated total cholesterol, triglycerides, LDL, oxidized LDL, uric acid, insulin resistance and abnormal glucose tolerance, low HDL, and altered platelet function.33 So dairy yogurt has its disadvantages as well as its benefits.
Even though dairy fats do not seem to provoke inflammation within the arteries as much as long-chain saturated fats from meat, they have adverse effects. For example, many dairy products such as aged cheese, ice cream, and custards contain oxidized cholesterol. There is conclusive proof the oxidized cholesterol promotes atherosclerosis.34 Moderate intake of butter increases total cholesterol, LDL, and HDL levels. 35
So as we stated above, saturated fats can hurt the arteries and promote coronary heart disease apart from cholesterol.
Additional Adverse Effects of Saturated Fats
Saturated fats decrease the anti-inflammatory effects of HDL.36 Inflammation is present in atherosclerosis. Additionally, many saturated fats are toxic to heart muscle cells.37 Saturated fats from animal products impair the ability of the blood vessels to dilate.38 Consumption of polyunsaturated fats has been linked to improved blood flow through small blood vessels. Saturated fat consumption pushes inflammation. Inflammation is involved in each pivotal step in the development of atherosclerosis.
Are Plant Saturated Oils Safer?
Are plant saturated fats different from long-chain animal fats? Probably not if you use regular store-bought coconut oil. There is early evidence that cold-pressed virgin coconut oil may have some benefits 39, but a meta-analysis of 16 studies showed that consuming the regularly processed coconut oil raises LDL cholesterol and total cholesterol.40
Trans fats have been linked to increased inflammation in the arteries. And trans fats have been found to change the composition of cell membranes making them more leaky to calcium. Inflammation, high LDL cholesterol, and calcified arteries are the signature ingredients of atherosclerosis.41 Additionally, trans fats also reduce the amount of prostacyclin needed to keep blood flowing. Prostacyclin inhibits undesirable platelet clumping. Platelet clumping increases the risk of a clot forming.42
Excess calories from any food source (including vegetarian) can be converted into cholesterol. Obesity increases cardiovascular risk through multiple risk factors such as increased fasting plasma triglycerides, high LDL cholesterol, low HDL cholesterol, preponderance of small dense LDL, elevated blood glucose and insulin levels, and high blood pressure.43 A significant study showed that overweight and obese participants who lost 5–10 % body fat showed significant reductions in triglycerides, total cholesterol, and LDL cholesterol. Patients who lost >10 % experienced significantly greater improvements in triglycerides, total cholesterol, and LDL cholesterol than patients losing less. For higher-risk patients, those who lost 5–10 % body fat significantly reduced fasting glucose, triglycerides, and total cholesterol. Those who lost >10 % improved on all risk factors (except HDL cholesterol) and to a significantly greater degree than those losing less.44
Short Fasting Periods
Short periods of fasting can limit inflammation, improve levels of sugars and fats in circulation, and reduce blood pressure.45
Consume Organically Grown Produce and Grains
It is not always possible, but when you can, eat organically grown foods. Why? There is some evidence that increased concentrations of PCBs (polychlorinated biphenyls) and other compounds in pesticides are linked to elevations in total serum lipids, total cholesterol, and triglycerides. But the patterns are different for different groups of PCBs and different pesticides. This study adjusted for age, race, gender, BMI, alcohol consumption, smoking and exercising status. However, please note that organically grown foods are not usually used in studies that show the benefits of whole grains for cardiovascular health.46
How To Reduce Elevated Small-Dense Lipoproteins
Eat More Oats and Less Wheat
Consumption of oats compared with wheat cereal produced lower concentrations of small, dense LDL cholesterol and LDL particle number without producing adverse changes in blood triglycerides or HDL cholesterol concentrations in obese men.47 If possible, use organically grown oats and wheat. Steel-cut and rolled oats are better to use than quick oats if you have a blood sugar problem.
Watch Your Choice of Fats
Consumption of dietary trans FAs (fatty acids) is associated with a deleterious increase in small, dense LDL.48 Omega-3 fats and polyphenols in olives decrease the number of small LDL particles.49 Furthermore, polyphenols in olives reduce oxidation of LDL. According to a study, one avocado a day in a heart-healthy diet decreased oxidized LDL in adults with overweight and obesity. The effect was associated with the reduction in sdLDL.50
Eating about ½ cup of walnuts every day for two years modestly lowered levels of LDL cholesterol, known as “bad cholesterol,” and reduced the number of total LDL particles and small LDL particles in healthy individuals. 51 Moderate consumption of unrefined plant foods may help to reduce elevated triglycerides too!
Spend Time in the Sunshine
Vitamin D deficiency and insufficiency are prevalent, especially among the elderly, dark-skinned individuals, and those who live a sedentary lifestyle. There is strong evidence from recent studies showing that vitamin D deficiency is associated with elevated total or low-density lipoprotein (LDL) cholesterol levels or low levels of HDL cholesterol. Additionally, vitamin D deficiency has been linked particularly to high sdLDL levels in middle-aged adults without cardiovascular disease. High sdLDL-C levels were associated with low serum vitamin D levels and were more common among cigarette smokers, alcohol drinkers, individuals with hypertension, individuals with high BMI (a person’s weight in kilograms divided by the square of height in meters), and those with high levels of fasting blood glucose and triglycerides.52 Please note: Summer’s sunshine isn’t enough for the winter! Sunscreens hinder the synthesis of vitamin D from sun exposure.
At Wildwood Lifestyle Center, in a preliminary study by Ruben Elisee, individuals with high cholesterol experienced an average drop in cholesterol within ten days on a totally vegetarian diet. This was coupled with exercise therapy and stress management counseling. Lifestyle guests in this study did not use cholesterol-lowering drugs.
Surely science-validated, natural strategies should be explored and utilized for individuals who have elevated levels of total cholesterol, LDL cholesterol, and triglycerides. We have only mentioned dietary tips in reducing high cholesterol in this article. In part 2, we will discuss other natural alternatives for high cholesterol. That being said, if you are taking a cholesterol-lowering drug, work with your doctor and a dietician skilled in plant-based nutrition before you attempt to discontinue your statins. You will need to learn how to balance a vegetarian menu and develop cooking skills, but it is an adventure worth having!
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- Our fasting bodies change how they select which fuel to burn improving metabolism and reducing oxidative stress. Please note: It is not recommended to do a total fast from food and juice for more than two consecutive days. After two days of fasting the stress hormones increase. Just fasting for 12 hours produces benefits.((Cook A and Hall, E. The Enjoyable Way to Fast, wildwoodhealth.com. August 2014.
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