Heart Help
Bring your total cholesterol level down with these natural remedies.
Susan McQuillan
9/2007
9/2007
Cholesterol does a lot right for your body-digests fat, synthesizes vitamin D, maintains cell membranes, and produces sex hormones-but it's better known for what it does wrong, which is clog arteries and set the stage for heart attacks and strokes. And too many Americans-more than 100 million-have elevated blood levels of cholesterol, which means half the adult population is at risk for developing cardiovascular disease. You, too, could be in that risk pool, especially if you have a family history of high cholesterol, heart disease, or stroke, or if your cholesterol rises as you age.
"Start with your diet," advises Guarneri. "Food is still your best medicine when it comes to lowering cholesterol and preventing plaque buildup." To maximize the nutrients in your diet, fill up on fresh fruits and vegetables, and whole grains such as bulgur, brown rice, and multigrain products. Also choose vegetarian sources of protein such as edamame, lentils, and beans, and nonfat milk, cheese, and other dairy products. If you eat fish, choose those high in omega-3s, such as wild salmon, wild trout, and sardines. In a 2006 review in the Journal of the American Medical Association, evidence from several epidemiological studies clearly showed that eating fish packed with omega-3 fatty acids once or twice a week can decrease your risk of dying from a heart attack by up to 36 percent.
"People still think the amount of fat in your diet is what matters when it comes to blood cholesterol levels," says Walter Willett, M.D., chair of the Department of Nutrition at the Harvard School of Public Health. "The types of fat affect your cholesterol levels much more than the amount." Specifically, a diet high in saturated fats from meat and higher-fat dairy products increases your blood levels of total and LDL cholesterol. Maintain a good weight
Experts at the National Cholesterol Education Program (NCEP) say that being overweight can increase your total cholesterol and triglyceride levels and keep your protective HDLs at a low level. Losing just 5 to 10 percent of your weight will improve your cholesterol profile, says Karmally, who recommends controlling portions to get your weight within healthy limits.
Being sedentary has much of the same effect on cholesterol and triglyceride levels as being overweight. Researchers at Duke University Medical Center have found that all exercise improves cholesterol and triglyceride levels in both men and women. In a Duke study published in the New England Journal of Medicine in 2002, researchers showed that exercise also increases the size of HDL particles that protect against atherosclerosis. A 2002 study in the American Journal of Cardiology reported that when subjects who were following a low-cholesterol, low-saturated-fat diet added 30 minutes of aerobic and free-weight exercises to their daily routines, 89 percent lowered their total cholesterol.
A 2005 study published in Health Psychology found that a long-term effect of mental stress can be an increase in total cholesterol. Study participants with the greatest emotional response to stress were three times more likely to have high LDL levels than those who were able to cope with stress.
Plant sterols are substances derived from vegetable products that interfere with the absorption of cholesterol and can lower cholesterol levels by as much as 13 percent. You can buy them as supplements at health food stores and drugstores, or in fortified foods such as margarine, granola bars, and orange juice. The NCEP recommends 2 to 3 grams of plant sterols daily. When Pat Gidley, 59, was diagnosed with a cholesterol count of 312 mg/dL last year, her doctor prescribed medication. After experiencing side effects, Gidley stopped using the drugs and started taking half the recommended dose of a plant-sterol supplement daily. Three months later, her cholesterol was down to 287 mg/dL. She continued taking the supplement, switched from white to brown rice, and from canned to fresh fruits and vegetables. She started cycling three times a week and taking Pilates classes. This past April, Gidley's total cholesterol had dropped to 264 mg/dL.
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Fortunately, there's plenty you can do to reduce that risk, including changing your diet, exercising more, and taking supplements. For many people, these natural remedies are just as effective at improving cholesterol levels as taking medications, says Mimi Guarneri, M.D., medical director of the Scripps Center for Integrative Medicine in La Jolla, Calif.
Not all the changes you make will automatically lower your cholesterol. Some things, says Guarneri, are beyond your control. "As you age, your liver starts producing more cholesterol in an effort to boost declining levels of sex hormones such as estrogen and testosterone," she points out. "That's why women's cholesterol levels may shoot up after menopause." Still, it pays to change the factors you can control.
Foods to eat
"Start with your diet," advises Guarneri. "Food is still your best medicine when it comes to lowering cholesterol and preventing plaque buildup." To maximize the nutrients in your diet, fill up on fresh fruits and vegetables, and whole grains such as bulgur, brown rice, and multigrain products. Also choose vegetarian sources of protein such as edamame, lentils, and beans, and nonfat milk, cheese, and other dairy products. If you eat fish, choose those high in omega-3s, such as wild salmon, wild trout, and sardines. In a 2006 review in the Journal of the American Medical Association, evidence from several epidemiological studies clearly showed that eating fish packed with omega-3 fatty acids once or twice a week can decrease your risk of dying from a heart attack by up to 36 percent.
When cooking, replace butter with olive oil, canola oil, and nut oils that are rich in monounsaturated fats, the type of fat that helps lower LDL cholesterol and raise HDL cholesterol. (For the difference between LDL and HDL, see "How Lipoproteins Work.")
Be sure your diet includes soluble fiber, which blocks the absorption of dietary cholesterol from the intestine so that it's excreted from the body. "Apples and strawberries, oats and barley, and black beans and lentils are all rich in soluble fiber," says Wahida Karmally, Dr.P.H., R.D., director of nutrition at the Irving Institute for Clinical and Translational Research at Columbia University, who also advocates a vegetarian diet-or two or three vegetarian meals a week-for anyone trying to keep cholesterol levels in check. Studies have also shown that nuts like almonds and walnuts can significantly reduce LDL cholesterol.
Foods to avoid
"People still think the amount of fat in your diet is what matters when it comes to blood cholesterol levels," says Walter Willett, M.D., chair of the Department of Nutrition at the Harvard School of Public Health. "The types of fat affect your cholesterol levels much more than the amount." Specifically, a diet high in saturated fats from meat and higher-fat dairy products increases your blood levels of total and LDL cholesterol.
Trans fats-commercially produced shortenings made from hardened vegetable oils-are also linked to cholesterol because they increase the number of smaller LDL particles and lower HDL cholesterol. A 2003 study in the American Journal of Clinical Nutrition found that LDL particle size was significantly smaller in people who consumed the most trans fats. Since 2006, the Nutrition Facts box on all food labels must include the amount of trans fats per serving.
Sugars, especially table and refined sugars used in processed foods, also create plaque buildup, because the body uses them to produce fats called triglycerides, which make it easier for small LDL particles to stick to blood vessel walls. "No cardiologist focuses only on cholesterol anymore," says Guarneri. "Triglycerides are just as much a risk factor as cholesterol."
Experts at the National Cholesterol Education Program (NCEP) say that being overweight can increase your total cholesterol and triglyceride levels and keep your protective HDLs at a low level. Losing just 5 to 10 percent of your weight will improve your cholesterol profile, says Karmally, who recommends controlling portions to get your weight within healthy limits.
Get moving
Being sedentary has much of the same effect on cholesterol and triglyceride levels as being overweight. Researchers at Duke University Medical Center have found that all exercise improves cholesterol and triglyceride levels in both men and women. In a Duke study published in the New England Journal of Medicine in 2002, researchers showed that exercise also increases the size of HDL particles that protect against atherosclerosis. A 2002 study in the American Journal of Cardiology reported that when subjects who were following a low-cholesterol, low-saturated-fat diet added 30 minutes of aerobic and free-weight exercises to their daily routines, 89 percent lowered their total cholesterol.
Reduce tension
A 2005 study published in Health Psychology found that a long-term effect of mental stress can be an increase in total cholesterol. Study participants with the greatest emotional response to stress were three times more likely to have high LDL levels than those who were able to cope with stress.
Guarneri, who uses meditation, breath work, and yoga in her practice, has seen patients reduce their dosage of cholesterol-lowering medication after learning to manage stress.
Seek supplements
Plant sterols are substances derived from vegetable products that interfere with the absorption of cholesterol and can lower cholesterol levels by as much as 13 percent. You can buy them as supplements at health food stores and drugstores, or in fortified foods such as margarine, granola bars, and orange juice. The NCEP recommends 2 to 3 grams of plant sterols daily. When Pat Gidley, 59, was diagnosed with a cholesterol count of 312 mg/dL last year, her doctor prescribed medication. After experiencing side effects, Gidley stopped using the drugs and started taking half the recommended dose of a plant-sterol supplement daily. Three months later, her cholesterol was down to 287 mg/dL. She continued taking the supplement, switched from white to brown rice, and from canned to fresh fruits and vegetables. She started cycling three times a week and taking Pilates classes. This past April, Gidley's total cholesterol had dropped to 264 mg/dL.
Red Yeast Rice, a botanical with a chemical structure similar to that of the statin medications prescribed by physicians, blocks production of cholesterol by the liver. A 2004 study in Circulation confirmed previous studies documenting both the cholesterol- and triglyceride-lowering effects of red yeast rice. Guarneri warns it should be prescribed by a physician.
The B-vitamin Niacin significantly raises HDLs and can also lower triglycerides. In a 2003 review in the Journal of Nutritional Biochemistry, researchers explained that niacin causes an increase in HDL levels by blocking the body's process of breaking down and eliminating HDL. Guarneri stresses that niacin supplements should be taken only in prescribed doses under a healthcare practitioner's supervision and should be avoided in people with liver disease, gout, and ulcers.
Omega-3 Fatty Acids have been proven to reduce triglyceride levels by as much as 30 percent, according to a 1997 review in the American Journal of Clinical Nutrition. Omega-3 supplements are made from fish oils or flaxseed. Both lower triglycerides, but flaxseed oil must be taken in larger doses to get the same effect. Talk to your doctor about the correct dose.
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