Cholesterol: sure-fire ways to lower cholesterol

 

According to the World Health Organization, more than one in three people worldwide suffer from high cholesterol. Medications such as statins can protect you from heart problems caused by high cholesterol levels. But the right diet – that is, a low cholesterol diet – and an appropriate exercise routine can also help promote a normal cholesterol level.

For a long time, eggs were demonised because of their high cholesterol content. But not all cholesterol is alike. In medicine, we differentiate between healthy HDL cholesterol and unhealthy LDL cholesterol. And eggs are bursting with healthy HDL cholesterol, which can even protect you from cardiovascular disease.

Find out what cholesterol does for your body and why LDL cholesterol can be so harmful to your health. Let us inform you of ways to lower cholesterol – be it through a low cholesterol diet or exercise – and generally how to maintain a normal cholesterol level.

What is cholesterol?

Cholesterol is a lipophilic substance produced in the liver. This blood fat stabilises our cell membranes and helps with digesting fat. The body produces crucial hormones such as oestrogen, cortisol and vitamin D from cholesterol. We also consume cholesterol through our diet – the more cholesterol we consume, the less cholesterol the liver produces. [1, 2]

LDL versus HDL cholesterol: what’s the difference?

Cholesterol does not flow freely through the body; it is found in two special proteins: HDL and LDL proteins. While HDL proteins absorb cholesterol from the body cells and transport it to the liver, LDL proteins incorporate cholesterol into the cell membranes. High levels of LDL cholesterol cause health problems such as high blood pressure and other cardiovascular diseases.[1]

Did you know that 75 per cent of the total cholesterol in our body is tied to LDL proteins?[3]

What happens if your LDL is too high?

The ratio of LDL and HDL cholesterol is highly relevant for your health – the concentration of LDL cholesterol should not be higher than the HDL cholesterol!

If the proportion of LDL cholesterol in your total cholesterol level is too high, and that of HDL cholesterol is too low, more and more proteins are deposited in the cell membranes. The LDL cholesterol takes them there, but the HDL cholesterol cannot transport them away fast enough. Over time, your blood vessels calcify, increasing the risk of heart attacks, strokes and blood clots. In addition, because blood flow is disrupted, vital nutrients cannot reach the body’s cells.[1, 4]

What are causes of high cholesterol?

Elevated LDL and low HDL levels are detrimental to your heart health. Both lifestyle and genetic predisposition can affect your cholesterol levels.[1, 4]

What is a normal cholesterol level?

Lipid values

Normal cholesterol level[5]

Total cholesterol

= 5.0 mmol/l

LDL cholesterol

< 2.59 mmol/l

HDL cholesterol

> 0.9 mmol/l

LDL–HDL ratio

< 3.0

What causes elevated cholesterol?

There are numerous causes of high cholesterol. Cholesterol from food is probably not one of them – food has a very small effect on blood cholesterol. This means that high cholesterol foods do not actually deserve their bad reputation. But this still leaves us with the question: why are my cholesterol levels elevated if it’s not due to my diet?

It’s true that our genetic predisposition influences how high our cholesterol levels are. Additional causes of high cholesterol include:[1, 2]

  • Gender and age – older men have higher average LDL levels than young women
  • Menopause – LDL values increase during menopause
  • Smoking and alcohol consumption
  • Lack of exercise and obesity increase LDL and decrease HDL values
  • Diabetes, kidney, liver and thyroid disorders

Are there ways to lower cholesterol?

There are many ways to lower cholesterol – be it through diet, exercise or medication. No other drug is prescribed as frequently worldwide as statins – the medication used to treat high cholesterol. As soon as high cholesterol levels are detected in your body, those affected can take additional measures to lower their levels in addition to statin treatment. A number of exercises and the right low cholesterol diet can help.[6]

Ways to lower cholesterol

Are there any ways to lower cholesterol naturally?

A 2017 study from the journal Lipids in Health and Disease explains that aerobic exercise can help lower cholesterol in addition to statin treatment. Physical activity plays an important role in increasing HDL and reducing LDL cholesterol. Aerobic training includes sports such as running, cycling, swimming and Nordic walking.[7, 8]

How can I maintain a low cholesterol diet?

To combat high cholesterol and achieve a normal cholesterol level, you should avoid foods that increase LDL levels. In addition to the good foods listed below, you should make sure you consume enough omega-3 fatty acids. These can support statin treatment. You should also pay attention to a diet rich in fibre, as dietary fibres can reduce LDL levels.[1]

Foods that increase LDL levels

Foods that reduce LDL levels and  increase HDL levels 

Rapeseed oil, coconut oil[9, 10]

Olive oil[11]

Chips, fried foods, bagged snacks[12]

Dark chocolate[13]

Sweets[14]

Eggs[15, 16]

Processed meat[17]

Psyllium seed husk[18]

Alcohol

Salmon[19]

Pasteurised dairy products[20]

Turmeric[21]

White flour products, white rice[22]

Green tea[23]

 

Low cholesterol diet: choose your fats wisely

If your cholesterol levels skyrocket, you should reduce the amount of saturated fats in your diet. If you have high cholesterol levels, it is best to consume a maximum of 70 grammes of fat per day. Make sure that at least half of the fat comes from olive oil, walnut oil, fish and eggs.

As far as cheese and cured meats are concerned, you can certainly opt for low-fat varieties. But be careful: low-fat products may contain a lot of sugar to give the food more flavour. You should therefore take a look at the nutritional information on the packaging.

You should prepare meals with a low-fat content – that is, by steaming, braising or grilling them. Although dietary cholesterol does not affect blood cholesterol, you should not consume more than 300 milligrammes of cholesterol per day. Researchers are not yet in complete agreement as to whether higher amounts might influence cholesterol levels.[8, 24–26]

Foods

Cholesterol in milligrammes per 100 grammes

Butter

240

Liver sausage

160

Eggs (size M)

115

Chicken breast

60

Gouda

59

Milk (3.5% fat)

13

Margarine

7

Olive oil

1

Egg whites

0

 

Ways to lower cholesterol with fibre

Fruits, vegetables and wholegrain cereals not only provide us with important vitamins, but also with fibre, which can have a positive influence on cholesterol levels.

Dietary fibre are found in the cell walls of plant-based foods and are an indigestible component of food. They keep us feeling full and help to eliminate toxins. Our gut microbiome – that is, our gut bacteria – love fibre, and fibre-rich foods play a significant role in boosting our gut health.

The German Nutrition Society recommends a minimum intake of 30 milligrammes of fibre per day. Fibre can also reduce the risk of colon cancer. The fibre pectin found in apples, oranges, pears and berries and beta-glucan from oats are used to lower cholesterol. Pectin stimulates the liver to produce important bile acid from the body’s own cholesterol; as a result, LDL values decrease.[8, 27, 28]

What about cholesterol in plant-based foods: do sterols reduce cholesterol?

Plant-based foods contain sterols and sterols, which are similar to cholesterol in animal foods. However, they have a different effect. Sterols prevent food cholesterol from entering the bloodstream. As a result, the body uses more of its own cholesterol, which lowers LDL levels.

Sterols are found in abundance in nuts, seeds and vegetable oils. Margarine, dairy products and soy milk are now also enriched with sterols. However, you should not rely exclusively on these products when on a low cholesterol diet. Sterols can interfere with the absorption of vitamins, so avoid consuming too much of them.[29]

The European Food Safety Agency recommends a maximum intake of 2.4 grammes of plant sterols per day. As little as 100 grammes of fruit can provide you with sufficient amounts of sterol.[1] 

Are you on a vegan diet? Head over to our blog article to discover more about the benefits of a vegan diet and which nutrients you need to incorporate into your diet as a vegan.

Does niacin really lower cholesterol?

Like vitamin B12, niacin belongs to the group of B vitamins. Research has shown that niacin supplements can increase HDL cholesterol by up to 30 per cent. However, you should only take these supplements after consulting with a doctor.

Take turmeric for normal cholesterol level

Can I check my cholesterol at home?

A cholesterol test provides you with clarity about your cholesterol levels. This can be useful if you belong to one of the risk groups, such as an elderly man or a woman going through menopause, if you smoke or are overweight. A visit to your family doctor or an at-home health test ordered online from various health retailers can measure your total cholesterol, LDL and HDL levels.

Additionally, triglyceride levels are often examined. Triglycerides are fat molecules that are absorbed through your diet. Elevated triglyceride levels are associated with elevated cholesterol levels and a high risk of developing cardiovascular disease.

For a conclusive result, a cholesterol test should always be performed on an empty stomach. It is best if you have not eaten for twelve hours before collecting the blood sample.[2]

Ways to lower cholesterol – at a glance

What is cholesterol?

Cholesterol is produced in the liver and ingested through food. It serves as an initial substance to promote the production of vitamin D, oestrogen and cortisol. In the blood, cholesterol is bound to LDL and HDL proteins. LDL cholesterol is considered a risk factor for cardiovascular diseases. HDL cholesterol breaks down LDL cholesterol.

What are typical causes of high cholesterol?

High cholesterol levels are dependent on sex, age, genetic predisposition, alcohol and nicotine consumption as well as existing diseases such as diabetes.

Are there any ways to lower cholesterol?

Ways to lower cholesterol include taking medication, following a low cholesterol diet and exercising regularly. More specifically, doctors prescribe statins that are proven to effectively lower cholesterol levels. In addition, a proper diet with cardio exercises such as running may help. Eating fibre-rich foods and healthy fats from salmon, walnuts and olive oil as part of a low cholesterol diet can help optimise your LDL and HDL levels.

Sources

  1. Schweizerische Gesellschaft für Ernährung: Merkblatt Ernährung und erhöhter Cholesterinspiegel, http://www.sge-ssn.ch/media/merkblatt_ernaehrung_und_erhoehter_cholesterinspiegel_2011.pdf
  2. Pschyrembel Online | Cholesterin, https://www.pschyrembel.de/Cholesterin/K04TU/doc/
  3. Martin, S.S., Blumenthal, R.S., Miller, M.: LDL cholesterol: the lower the better. Med. Clin. North Am. 96, 13–26 (2012). doi:10.1016/j.mcna.2012.01.009
  4. Badimon, L., Vilahur, G.: LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos. Ann. N. Y. Acad. Sci. 1254, 18–32 (2012). doi:10.1111/j.1749-6632.2012.06480.x
  5. Schäffler, Arne: Laborwerte für Heilpraktiker. Georg Thieme Verlag (2014)
  6. Taylor, F., Huffman, M.D., Macedo, A.F., Moore, T.H.M., Burke, M., Davey Smith, G., Ward, K., Ebrahim, S.: Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst. Rev. CD004816 (2013). doi:10.1002/14651858.CD004816.pub5
  7. Wang, Y., Xu, D.: Effects of aerobic exercise on lipids and lipoproteins. Lipids Health Dis. 16, (2017). doi:10.1186/s12944-017-0515-5
  8. Pharmazeutische Zeitung: Hypercholesterinämie: Das richtige Fett essen, https://www.pharmazeutische-zeitung.de/ausgabe-342009/das-richtige-fett-essen/
  9. Brouwer, I.A., Wanders, A.J., Katan, M.B.: Effect of Animal and Industrial Trans Fatty Acids on HDL and LDL Cholesterol Levels in Humans – A Quantitative Review. PLoS ONE. 5, (2010). doi:10.1371/journal.pone.0009434
  10. Kokosöl: Wunderwirkungen sind nicht zu erwarten, https://www.bzfe.de/inhalt/kokosoel-31592.html
  11. Violi, F., Loffredo, L., Pignatelli, P., Angelico, F., Bartimoccia, S., Nocella, C., Cangemi, R., Petruccioli, A., Monticolo, R., Pastori, D., Carnevale, R.: Extra virgin olive oil use is associated with improved post-prandial blood glucose and LDL cholesterol in healthy subjects. Nutr. Diabetes. 5, e172 (2015). doi:10.1038/nutd.2015.23
  12. Anand, S.S. et al.: Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system. J. Am. Coll. Cardiol. 66, 1590–1614 (2015). doi:10.1016/j.jacc.2015.07.050
  13. Mursu, J., Voutilainen, S., Nurmi, T., Rissanen, T.H., Virtanen, J.K., Kaikkonen, J., Nyyssönen, K., Salonen, J.T.: Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. Free Radic. Biol. Med. 37, 1351–1359 (2004). doi:10.1016/j.freeradbiomed.2004.06.002
  14. Te Morenga, L.A., Howatson, A.J., Jones, R.M., Mann, J.: Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am. J. Clin. Nutr. 100, 65–79 (2014). doi:10.3945/ajcn.113.081521
  15. Mutungi, G., Ratliff, J., Puglisi, M., Torres-Gonzalez, M., Vaishnav, U., Leite, J.O., Quann, E., Volek, J.S., Fernandez, M.L.: Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet. J. Nutr. 138, 272–276 (2008). doi:10.1093/jn/138.2.272
  16. Kanter, M.M., Kris-Etherton, P.M., Fernandez, M.L., Vickers, K.C., Katz, D.L.: Exploring the factors that affect blood cholesterol and heart disease risk: is dietary cholesterol as bad for you as history leads us to believe? Adv. Nutr. Bethesda Md. 3, 711–717 (2012). doi:10.3945/an.111.001321
  17. Rohrmann, S. et al.: Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition. BMC Med. 11, 63 (2013). doi:10.1186/1741-7015-11-63
  18. Patade, A., Devareddy, L., Lucas, E.A., Korlagunta, K., Daggy, B.P., Arjmandi, B.H.: Flaxseed reduces total and LDL cholesterol concentrations in Native American postmenopausal women. J. Womens Health 2002. 17, 355–366 (2008). doi:10.1089/jwh.2007.0359
  19. Bulliyya, G.: Influence of fish consumption on the distribution of serum cholesterol in lipoprotein fractions: comparative study among fish-consuming and non-fish-consuming populations. Asia Pac. J. Clin. Nutr. 11, 104–111 (2002)
  20. Ebringer, L., Ferencík, M., Krajcovic, J.: Beneficial health effects of milk and fermented dairy products--review. Folia Microbiol. (Praha). 53, 378–394 (2008). doi:10.1007/s12223-008-0059-1
  21. Qin, S., Huang, L., Gong, J., Shen, S., Huang, J., Ren, H., Hu, H.: Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials. Nutr. J. 16, 68 (2017). doi:10.1186/s12937-017-0293-y
  22. Feng, R., Du, S., Chen, Y., Zheng, S., Zhang, W., Na, G., Li, Y., Sun, C.: High carbohydrate intake from starchy foods is positively associated with metabolic disorders: a Cohort Study from a Chinese population. Sci. Rep. 5, (2015). doi:10.1038/srep16919
  23. Kim, A., Chiu, A., Barone, M.K., Avino, D., Wang, F., Coleman, C.I., Phung, O.J.: Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis. J. Am. Diet. Assoc. 111, 1720–1729 (2011). doi:10.1016/j.jada.2011.08.009
  24. Deutsches GrĂĽnes Kreuz fĂĽr Gesundheit e. V.: Cholesterinmenge in Lebensmitteln, https://dgk.de/gesundheit/ernaehrung/cholesterinbewusste-ernaehrung/cholesterinmenge-in-lebensmitteln.html
  25. Herzstiftung: Cholesterin: Wie können sich Herzpatienten schützen?, https://www.herzstiftung.de/cholesterin.html
  26. Bundeszentrum für Ernährung: Cholesterin: Mythos Frühstücksei: Fettbewusst essen – worauf es ankommt, https://www.bzfe.de/inhalt/erhoehte-blutfettwerte-ein-risiko-fuer-herz-und-kreislauf-2026.html
  27. González, M., Rivas, C., Caride, B., Lamas, M.A., Taboada, M.C.: Effects of orange and apple pectin on cholesterol concentration in serum, liver and faeces. J. Physiol. Biochem. 54, 99–104 (1998)
  28. Braaten, J.T., Wood, P.J., Scott, F.W., Wolynetz, M.S., Lowe, M.K., Bradley-White, P., Collins, M.W.: Oat beta-glucan reduces blood cholesterol concentration in hypercholesterolemic subjects. Eur. J. Clin. Nutr. 48, 465–474 (1994)
  29. Pflanzliche Sterole (Phytosterole, Phxtosterine) | transGEN Datenbank, https://www.transgen.de/datenbank/zutaten/2166.pflanzliche-sterole.html
  30. Mayo Clinic: Niacin to boost your HDL, “good,” cholesterol, http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/niacin/art-20046208
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