Heart disease, despite all the interventions we have made, remains the biggest killer of Australians. It is estimated that almost four million Australians are affected by heart disease and more than 50,000 die as a result of heart disease every year. High cholesterol remains one of the most significant risk factors for heart disease and more than 50 percent of Australians over 25 have high cholesterol levels.

To cope with the threat that these high cholesterol levels pose to our national health, doctors will usually prescribe pharmaceutical drugs to get levels down to a safe range. The problem is that costs for these drugs are spiralling out of control and, more importantly, they can have some unpleas ant side effects. It is important then to understand what your aims are with cholesterol, the pitfalls of the pharmaceutical approach and your natural alternatives.

Cholesterol low-down

Too much cholesterol is a bad thing but it is a vitally important substance for your health. Cholesterol is critical in the liver for bile production, in the brain and nerve cells, in the skin for the production of Vitamin D, in the ovaries and testes for production of oestrogen and testosterone, and in the adrenal glands for the manufacture of hormones like cortisol. Some cholesterol is consumed in the diet but around 70 percent is made by your body.

When you get a cholesterol reading the total cholesterol should measure below 5.5 mmol/l. However the total cholesterol measurement doesn’t really tell you your risk for heart disease. For that you need to know the ratio of your “good” cholesterol, the high density lipoproteins (HDLs) and the “bad” type, the low density lipoproteins (LDLs).

HDL cholesterol is good because it collects fats that have deposited in your arteries and delivers them back to the liver to be made into bile so you can digest your next fatty meal. The LDLs on the other hand deliver cholesterol to places in the body where it is needed and deposits it there. If LDL levels are too high cholesterol becomes deposited in arteries and problems can follow.

Abnormal cholesterol levels are a major health risk and management of cholesterol is big business.

“Normal” cholesterol levels
Total Cholesterol – 3.9-5.5 mmol/l
HDL Cholesterol (male) – 0.8-1.7 mmol/l
HDL Cholesterol (female) – 0.9-2.1 mmol/l
LDL Cholesterol – 1.7-4.5 mmol/l 

Pharmaceuticals

The most popular pharmaceuticals used to treat high cholesterol levels are the statins. The problem with statins is that they are not without side effects. In fact, the University of California San Diego has set up a website (www.statineffects.com) for people to record their own adverse experiences with statins. Side effects include muscle pain, muscle weakness and also nervous system problems. A recent study from New Zealand reported that statins have been reported to be involved in depression, memory loss, confusion and aggressive reactions (1).

When taking statins it is wise to supplement with co-enzyme Q10 as statins appear to deplete natural levels of CoQ10 in the body. Q10 is an energy booster and antioxidant and levels tend to be lower in people with high cholesterol.

Ezetimibe- cancer concerns

The link between cholesterol-lowering drug ezetimibe (marketed as Vytorin) and cancer is still not clear (2). However a report of a combination trial using a statin drug (simvastatin) and ezetimibe found that the treatment did not show impact on cardiovascular events in general, but there appeared to be a rise in cancer incidence and cancer deaths in the treatment group compared to the placebo group. It is early days in this research and so while no definite link can be made, it makes sense to start with gentler but effective natural approaches to cholesterol management. 

Food truths

A natural approach to balancing cholesterol begins with diet. It is important to remember though that it is not the cholesterol you consume that matters, it is the cholesterol that your body makes. Foods rich in saturated fat and refined sugars encourage the manufacture of cholesterol. This is why although eggs are recognised as being high in cholesterol, they do not significantly raise your cholesterol levels.

Make sure your diet is higher in vegetable fats (unsaturated) rather than animal fats (saturated). Use extra virgin cold pressed olive oil for cooking (being careful to cook at low temperatures). Legumes (such as lentils) have a cholesterol regulating effect. The blood of vegetarians shows markedly less cholesterol than meat eaters.

Avoid trans fatty acids as these can be as damaging as saturated fats. This means cutting down on processed and snack foods. High fibre diets are important, so supplement with soluble and insoluble fibres. Fibre attaches to cholesterol in your digestive tract and transports it out through the bowel thus lowering total overall cholesterol. Oats are a great source of soluble fibre for your diet but if you find yourself tiring of porridge you can try some supplement options.

Psyllium

Psyllium husks are a fibre source that comes from the seeds of Plantago ovata plant. A meta-analysis of studies done on psyllium found that consumption of 10.2g psyllium per day lowers total cholesterol by four percent and LDL cholesterol by seven percent (3). It can be sprinkled over cereal, mixed up with juice or water or taken as a capsule.

PHGG

Partially hydrolyzed guar gum (PHGG) is a water-soluble dietary fibre. One study looked at the effect of green tea extract either with or without PHGG. Only in PHGG treated groups was there a drop in total cholesterol (4).

Lecithin

Lecithin is not another fibre but is a nutrient that helps transport and metabolise cholesterol and improves liver function. It can be obtained in supplement form or lecithin granules make a great addition to your morning cereal or your health shake.

Foods that improve cholesterol metabolism

• Fish
• Ginger
• Turmeric
• Garlic
• Onions
• Whole Grains
• Oats

Love your liver

Since the liver is so intimately involved in the metabolism of cholesterol, supporting your liver will help normalise overall cholesterol levels. Herbs such as Milk Thistle and Dandelion are excellent liver herbs. Milk Thistle acts as an overall tonic supporting all liver functions while Dandelion root acts to promote bile flow. Since bile consists largely of bile salts made from cholesterol, this assists with maintenance of cholesterol levels.

Perhaps the premier cholesterol-lowering herb though is Globe Artichoke. In a recent study (5) people with mild to moderately high cholesterol levels took either 1280mg of globe artichoke (Cynara scolymus) extract daily and after eight weeks had a four percent reduction in their total cholesterol levels.

Lactobacillus acidophilus and bifidobacteria inhibit the synthesis of cholesterol in the liver. So a probiotic supplement will also support your liver.

Exercise

Exercise has many health benefits and it is known to increase good HDL cholesterol levels. One study recently evaluated 25 different studies on exercise and cholesterol to establish just how much exercise is needed to boost HDL (6). It was found that for exercise to have an effect on HDL cholesterol, participants needed to exercise for about two hours per week, consistently and the longer the individual session, the greater the HDL boost.

Powerful poli

Policosanol is a natural product, derived from the waxy coating of sugar cane. Studies have shown that supplementing with policosanol does exactly what is desired in terms of cholesterol; it lowers both total cholesterol and “bad” LDL cholesterol plus increasing “good” HDL cholesterol.

With such a wide array of natural strategies to choose from, get your cholesterol tested now and begin your natural regime before drugs become an issue.

This information was kindly provided by GNC Livewell

1) Drug Reactions 2007

2) NEJM September 2008

3) American Journal of Clinical Nutrition 2000

4) J Pharmacy and Pharmacology 2005

5) Phytomedicine 2008

6) Archives of Internal Medicine 2007