Nutritional Approaches for Reducing Cholesterol Levels

Why You Should be Concerned about Cholesterol

Your body makes all the cholesterol you need. Your body uses cholesterol to produce hormones, vitamin D, and the bile acids that digest fat. When cholesterol is reabsorbed into the bloodstream, it is carried to the arteries by a lipoprotein (fat/protein complex) call low-density lipoprotein (LDL). If a large proportion of your cholesterol is combined with LDL it is more likely to be deposited in the walls of the arteries. High cholesterol is directly related to conditions such as arteriosclerosis, cardiovascular disease, circulatory problems, heart attack, and hypertension. Another lipoprotein called high-density lipoprotein (HDL) can take cholesterol out of the arteries and back to the liver, where it is broken down for removal from the body. HDL has been called “the good cholesterol” because the higher a person’s HDL cholesterol compared to their LDL cholesterol, the lower the risk for heart disease.

It is important to distinguish between serum cholesterol and dietary cholesterol. Serum cholesterol is the cholesterol in the bloodstream. Dietary cholesterol is cholesterol that is present in food. Cholesterol levels are greatly influenced by diet as well as your genetic makeup. The consumption of foods high in cholesterol and/or saturated fat increases cholesterol levels, while a vegetarian diet, regular exercise, and the nutrient vitamin C may lower cholesterol.

Diets high in soluble fiber, hence a diet high in fruits, grains and vegetables, have been shown to normalize serum cholesterol levels. Soluble fiber binds with bile acids and cholesterol, interfering with the absorption of dietary fat and cholesterol, as well as with the recirculation of cholesterol and bile acids, resulting in reduced blood cholesterol levels Vitamin C may also be a factor is lowering cholesterol. In his book The Optimum Nutrition Bible, Paul Holford presents an interesting aspect of vitamin C. Vitamin C is involved in making the collagen that keeps skin and arteries supple and during our evolution we lost the ability to manufacture vitamin C in our bodies because fruit was so abundant. However, when we did not eat enough fruit and became deficient in vitamin C, our bodies produced arterial plaque (the little fat deposits) to coat our arteries to patch up the various tears from wear and tear. The arterial plaque started out as a kind of soupy oatmeal like substance like mortar filling in bricks on a brick wall, it was doing the job of the vitamin C—repairing normal cellular damage. However, it doesn’t quite work out, and the soupy oatmeal dries to a hard coating, hardening the arterial walls, rather than keeping them supple. Hence, the importance of keeping vitamin C levels constant over time for arterial health.

What is the Recommended Level of Total Serum Cholesterol?

The National Cholesterol Education Program (National Heart, Lung, and Blood Institute) has a set of guidelines for cholesterol levels. It recommends that everyone age 20 and older should have their cholesterol measured at least once every 5 years. A blood test called a “lipoprotein profile” is considered the best way to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:

    • Total cholesterol
    • LDL cholesterol
    • HDL cholesterol
    • Triglycerides, which are another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 milligrams per deciliter of blood (mg/dL) or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done.

A total cholesterol level less than 200 mg/dL is desirable. A level of 200 to 239 is borderline high and levels over 240 mg/dL are high. A LDL cholesterol level less than 100 mg/dL is optimal. A level of 100 to 129 mg/dL is near optimal to above optimal. A level of 130 to 159 mg/dL is borderline high, 160 to 189 mg/dL is high and levels at or above 190 mg/dL is very high.

HDL cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.