Guide to lower cholesterol

The majority of the world has combined the term cholesterol with negative health conditions, such as stroke and cardiovascular disease. Despite the dangers of elevated cholesterol levels, cholesterol plays a crucial role in health and body functioning.

Anti-lipidemic drugs, such as statins, are the main way of treating high levels of cholesterol. Nevertheless, they have several side effects. But is there any way to treat cholesterol without using drugs? The answer is yes, and lies in nature.

What is cholesterol?

It is a form of fat and a structural component of cell membranes. Cholesterol is produced in the liver (85%) and only a smaller part comes from the diet (15%). Cholesterol, in order to be transferred in the blood, is linked with proteins, known as lipoproteins.

What is LDL and HDL cholesterol?

There are two types of lipoproteins. LDL cholesterol, known as the bad cholesterol (70% of total blood cholesterol), is a lipoprotein that transfers cholesterol molecules from the liver to tissues. On the opposite, HDL cholesterol, the good cholesterol, is the transport of cholesterol from the organs and tissues back to the liver.

Causes of high cholesterol levels

The causes of hypercholesterolemia are heterogeneous, however, the primary cause of elevated cholesterol levels is the lifestyle. Even if diet plays a very important role, the genes we inherit from our parents seem to be of equal importance, as hypercholesterolemia can also be hereditary. Causes that lead to high cholesterol levels are:

• Unhealthy lifestyle.Bad and poor nutrition. Increased consumption of saturated and trans fats.
• Lack of physical activity. Increased sedentary life.
• Smoking
• Familial hypercholesterolemia. Mutations in genes that lead to elevated cholesterol levels even from an early age.
• Pathological conditions. Certain conditions may increase cholesterol levels, such as diabetes, chronic kidney disease, HIV, hypothyroidism, obesity and polycystic ovarian syndrome.
• Medication

What is the significance of cholesterol for health?

The role of cholesterol in the body is extremely important. Cholesterol is a structural component of body cells. It is used for the production of hormones, helps in the production of vitamin D and takes part in the digestion and metabolism of dietary fats, as well as in the synthesis of biliary fluids.

Normal values

Normal cholesterol values are differentiated according to the stage of development and the individual’s medical history. People of high cardiovascular risk need to achieve lower blood lipid levels. As desirable values for healthy adults are defined:

Cholesterol and effects

Increased levels of cholesterol significantly increase the risk of atherosclerosis, atherosclerotic plaque formation, coronary heart disease, angina, heart attack, peripheral arterial disease and stroke.

Treatment

The treatment of hypercholesterolemia is multifactorial, as serum cholesterol levels are affected by many different factors.

Cholesterol and nutrition

Food cholesterol affects very little (15%) serum cholesterol levels. Foods rich in cholesterol (eggs, meat, seafood, shellfish and fish) are not forbidden, however, some limitation is recommended. Nutrition, although, plays a crucial role in reducing cholesterol. A general recommendation is to adopt the Mediterranean diet or the DASH diet. Additionally, the following are recommended:

• Reduce the intake of saturated and trans fats
• Increase omega 3 fatty acid uptake
• Increase fiber intake (at least 25gr./day)
• Increase fruits and vegetable consumption
• Restriction of simple and refined carbohydrates (white cereals, refined cereals, sugar etc)

Lifestyle

• Healthy weight. For those who are overweight or obese, it is recommended to lose weight and to achieve a healthy body weight. Weight loss of 3-5% can significantly reduce serum cholesterol, levels, while weight loss of 5 to 10% is recommended within 6 months period.
• Physical activity. Exercise and physical activity can significantly reduce levels of LDL cholesterol and serum triglycerides, as well as increase HDL cholesterol levels.
• Quit smoking. Smoking significantly reduces levels of HDL cholesterol, while also increases the risk of thrombosis and atherosclerosis.

Cholesterol and anxiety

Many studies have shown that chronic stress can increase serum LDL cholesterol levels as well as lower HDL cholesterol levels.

Food supplements

Red Yeast Rice

It comes from the fermentation of Monascus purpureus and thanks to the monacolines, it has strong anticholesterolemic action. Monacolin K has a similar structure to lovastatin. According to many studies, monacolin K reduces endogenous cholesterol production, leading to a reduction in total serum cholesterol levels (10-33%) and LDL cholesterol. Dose 200-600 mg daily.

Artichoke

It is a vegetable that has been found to effectively reduce total cholesterol in healthy people who have moderately high cholesterol levels. Artichoke leaf extract (ALE) is rich in cynarine, a substance that is the main active ingredient of artichoke and helps in lowering cholesterol. In addition, studies have shown that ALE increases HDL cholesterol. Dose 150-500 mg per day.

Vitamin B3 (Niacin)

Belongs to vitamins of B complex and according to studies, it can effectively reduce LDL cholesterol, several atherogenic lipoproteins, and serum triglyceride levels (30-50%). Niacin reduces the production of LDL and VLDL lipoproteins in the liver. Because it does not interact with common medications, it can be used safely along with statins. Dose 250-500mg daily.

Vitamin E

It is a fat-soluble vitamin that refers to a group of vitamins, tocopherols and tocotrienols. It is used to treat cholesterol and blood pressure, as well as to reduce total cardiovascular risk. Studies have shown that vitamin E reduces LDL cholesterol levels and thanks to its strong antioxidant action also reduces the oxidation of LDL cholesterol. Administration of vitamin E at doses of at least 400iu daily can reduce the risk of atherosclerosis and cardiovascular disease, protecting the vessels and the heart from oxidative damage.

Pectin

It is a complex of plant fibers (polysaccharides) that are found in the cell walls of various plants, such as apples. Pectin, in the presence of water, is converted to a gel, which affects the time of passage of food in the gastrointestinal tract, nutrient absorption as well as the absorption and secretion of cholesterol. Based on the above properties, it has been found that pectin can reduce serum cholesterol levels (3-7%) through hepatic cholesterol production. Dose 6gr. daily.

Garlic

It comes from Allium sativum L. and has been found to reduce cholesterol levels (8%) while increasing HDL cholesterol levels. The main active ingredient of garlic is allicin and the sulfur compounds derived therefrom. According to studies, garlic affects blood coagulation while also reduces the rate of LDL oxidation, thus protecting from atherosclerotic plaque formation, cardiovascular diseases and stroke. Dose 400-1000 mg per day.

Phytosterols

Insoluble substances that, as their name implies, derive from plants such as cereals, fruits, vegetable oils and fruits. There are over 100 types of phytosterols. They are absorbed by the body by only 5-10% and through studies have been found to reduce total and LDL cholesterol levels. They are safely combined with common anti-lipid medicines. Dose 2-3gr. daily.

Psyllium

Soluble plant fiber (polysaccharide) derived from the plant Plantago ovata. It has the property of absorbing large amounts of fluids in its molecule and decreasing the absorption of cholesterol, improving the lipid profile. Requires abundant fluid consumption. Dose 3-45gr. daily.

Omega 3 

Fatty acids essential for cardiovascular health (α-linolenic acid, EPA – docosahexaenoic acid, DHA – Docosahexaenoic acid). They help reduce total cholesterol levels as well as LDL cholesterol. They reduce platelet aggregation and clot formation, preventing atherosclerotic plaque formation and reducing cardiovascular risk. Dose 1-3gr. (EPA / DHA) daily.

Chitosan

It comes from chitin, a substance found in the shell of shellfish. It is a polysaccharide which is not digested and has the property of binding fat to its molecule, thus preventing its absorption by the body. It helps reduce total cholesterol (~ 6-42%) and serum LDL cholesterol (~ 15-35%). Dose 1.5-3gr. daily.

Guggul

Derives from the Indian plant Mukul Myrrh (Commiphore mukul) and thanks to the Guggulsterones, reduces the levels of LDL cholesterol and serum triglycerides. It protects against oxidative damage, has anti-inflammatory action and prevents atherosclerosis. Dose 150-500 mg per day.

People taking statins or the elderly are recommended to receive Co-enzyme Q10 (Co-Q10).