How to lower high levels of LDL cholesterol

Having high levels of LDL cholesterol can heighten your risk of heart attach and stroke. Here we explain what LDL cholesterol actually is, and how you can reduce it.

Cholesterol is a lipid found in the membranes of every human cell, where it functions as a flexible waterproof gap sealant.

It is also used in the body to synthesize vitamin D and a number of hormones important for aging (such as cortisol, estrogen and testosterone).

Each day, the human body makes about 1000 milligrams of cholesterol, and takes in approximately 200 mg from the diet. If we don’t eat any cholesterol, the body will simply make up the difference. Equally if we eat too much cholesterol, our liver will simply make less.

Any food that contains animal fat will contain cholesterol, especially egg yolk, beef, poultry and prawns. Even a liter of plant oil contains far less cholesterol than a single egg yolk.

Oil does not dissolve in water, nor does cholesterol, so to transport it around the body it must be packaged in water proof containers (called lipoproteins). The best known are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL is considered the ‘bad cholesterol’ because it can carry cholesterol around the body and deposit it in the walls of our arteries. LDL cholesterol levels increase as we get older, particularly after the menopause in women. The LDL particles deposit their load of cholesterol in the walls of our blood vessels, resulting in stiffening and narrowing, and ultimately our aging.

The lower our LDL cholesterol levels, the lower our risk of heart attacks, strokes and other diseases of the blood vessels.

Evidence indicates that lowering high levels of LDL cholesterol results in reduced risk of heart attack and stroke, as well as a longer and more disease-free life. For example, for every 1 mmol/L we lower high levels of LDL cholesterol, our risk of dying from a heart attack lowers by 20%.

Another way to deal with high levels of LDL cholesterol is to offset it with the good cholesterol contained in HDL particles.

This is called reverse cholesterol transport, where cholesterol is removed from the walls of blood vessels and is transported back to the liver for excretion or safer storage sites.

Individuals with high levels of HDL cholesterol have lower risk of heart disease and stroke, and a greater chance at longevity. Physical activity is very effective at increasing your HDL levels, while smoking and physical inactivity reduce HDL cholesterol levels.

How to lower high levels of LDL cholesterol

Reduce saturated fat by:

  • Reducing your intake of saturated fats including butter, dairy blends, cream, sour cream, ice cream, full cream milk, cheese, cream cheese and mayonnaise
  • Choosing low-fat options, but be careful of sugar content in low-fat products such as yoghurt
  • Avoiding fatty meats, sausages, bacon and luncheon meat such as salami, Devon and chicken
  • Choosing low-fat cuts from organic and grass fed meats and poultry
  • Avoiding commercial cakes, biscuits, pies, pastries and desserts
  • Not eating takeaway food and commercial snack foods such as crisps and chocolate
  • Reducing your intake of palm and coconut oil, coconut milk and cream, and products labelled as vegetable oil, fat or solids
  • Checking food labels for products with less than 10 g total fat per 100 g and less than 3 g saturated fat per 100 g
  • Checking the ingredients list for ‘hidden’ saturated fats such as vegetable shortening, milk solids, tallow, lard, beef fat, animal fat, palm oil and vegetable oil
  • Avoiding foods that contain trans fats such as biscuits, chips and fried foods
  • Increasing your intake of omega-3 fatty acids either with food or supplements
  • Including phytosterols or stanols in your diet – plant sterols help reduce cholesterol absorption and are naturally high in vegetable oils, nuts, seeds, fruit, vegetables, legumes and some fortified spreads

Increase polyunsaturated and monounsaturated fats by:

  • Using a variety of oils for salads and cooking (e.g. olive, canola, sunflower, safflower, soybean, peanut, sesame and rice bran oils)
  • Trying other spreads and fillings in sandwiches such as avocado or 100% peanut butter rather than butter or cheese

Boost your Omega-3’s by:

  • Eating fish (canned or fresh) at least twice a week. In particular, include oily, deep-sea fish (e.g. salmon, sardines, tuna, mackerel)
  • Eating walnuts – use in cooking and salads, or as a snack each day
  • Adding linseed to your diet by eating them ground and adding them to cereal, or having soy and linseed bread
  • Using canola oil
  • Increasing your intake of soy bean products such as soy beans, soymilk, tofu, tempeh, and soy and linseed bread
  • Choosing water-washed soy as it preserves its antioxidant content when compared to the more common commercial method of alcohol washing
  • Taking a supplement

Eat plenty of soluble fiber from wholegrain cereals, fruit and vegetables by:

  • Switching to multi-grain bread and crackers
  • Using barley in cooking
  • Including 2 tsp psyllium husks to your breakfast cereal or smoothies
  • Having oat-based cereals such as porridge, natural muesli and oatbran
  • Including legumes in your diet, such as baked beans, kidney beans, lentils and chickpeas

Get help from your doctor if you have high levels of LDL cholesterol (LDL > 3.5mmol/L) or if your risk of heart disease is too great (you have high blood pressure, diabetes or a family history, for example).

This is an excerpt from Fast Living, Slow Ageing.

References

  1. Boekholdt SM, Hovingh GK, Mora S, et al. Very low levels of atherogenic lipoprotein and the risk for cardiovascular events. J Am Coll Cardiol 2014

Last reviewed 03/Mar/2017

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Dr Merlin Thomas

Professor Merlin Thomas is Professor of Medicine at Melbourne’s Monash University, based in the Department of Diabetes. He is both a physician and a scientist. Merlin has a broader interest in all aspects of preventive medicine and ageing. He has published over 270 articles in many of the worlds’ leading medical journals
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