Wednesday 13 December 2017

Dietary changes can balance cholesterol levels

Daniel Davey

Last week, I defined types of cholesterol, their function, and the consequences of cholesterol imbalance. This week's article focuses specifically on the dietary choices that you should make in order to balance your cholesterol levels and thereby possibly reduce the risk of cardiovascular disease.

First let me briefly reiterate a few important points:

• Cholesterol is a tiny organic molecule that presents as a soft, waxy substance in the body

• It can be consumed through the diet but the vast majority of cholesterol present in the body is produced by the liver

• Cholesterol is required for cell protection, hormone production and the making of bile

• A huge number of factors such as genetics, nutrition, exercise and other lifestyle factors can influence the type and amount of cholesterol in the body

• Cholesterol is essential for life and it is only when cholesterol imbalances occur as a result of poor lifestyle and nutrition choices that it becomes a risk factor for disease.

Dietary Choices

If you are seeking to improve your cholesterol levels, start by removing processed foods that contain sugar, sweeteners, preservatives, additives, industrial oils and processed fats like hydrogenated trans-fats. Cholesterol imbalances and elevated LDL ("bad" cholesterol) levels are most often explained by frequent consumption of those kinds of foods.

The focus should be to consume a diet that is rich in essential fats, quality protein, and antioxidant-rich vegetables and fruits.

In order to lower your cholesterol, you do not need to avoid foods that contain dietary cholesterol, such as eggs and good quality red meat. Combining these diet principles with sound lifestyle choices (eg keep stress levels in check) and ample physical activity will play a vital role in creating an optimal cholesterol balance.

Alcohol

Reducing alcohol consumption is an important consideration for improving cholesterol levels. While moderate consumption of alcohol, in particular red wine, has been shown to reduce the risk of cardiovascular disease, consuming too much alcohol will have the opposite effect.

Plant-based foods

Plant-based foods contain antioxidants, fibre, vitamins and minerals that not only help to keep your body fit and healthy but also help to maintain optimum cholesterol levels.

Fibre-rich foods, and in particular cruciferous vegetables, are known to lower cholesterol, so aim to get at least five servings of fibre-rich vegetables and three servings of fruit daily.

I am a strong believer that correct dietary choices will go a long way to helping you correct any cholesterol imbalance, but if you struggle to consume this quantity of fresh vegetables, a fibre supplement might be worth considering. Both oat beta-glucan and psyllium are fibre-rich powdered supplements derived from natural food sources and have been associated with reducing cholesterol levels in clinical studies.

Omega-3 fats and oily fish

Ironically, considering how vilified fats have been for the past 30 years, healthy sources of dietary fat are suggested to have the greatest influence on restoring cholesterol balance. Foods such as fresh fish, nuts, seeds, flaxseed and avocados are all excellent sources of the essential fats our body needs. In particular, omega-3 fats found in some oily fish (eg salmon, mackerel and sardines), nuts, seeds and plants have been found to lower LDL cholesterol as well as helping to reduce inflammation. If you don't eat fish, you can use a fish oil supplement.

Walnuts

Regular consumption of walnuts (two handfuls, three to four times per week) may help to lower LDL cholesterol and improve blood vessel health. Walnuts contain omega-3 fats, plant sterols known to lower cholesterol, and vitamin E, all of which may offer a protective effect to the body.

Regularly including some walnuts in your diet is a simple and effective way of helping to reduce cholesterol and your risk of cardiovascular disease. Eating from the hand or simply adding walnuts to salads is an excellent way to get in some extra omega-3 into your diet.

Plant sterols

Plant (or phyto-) sterols are plant components that have a chemical structure similar to cholesterol except for the addition of an extra methyl or ethyl group.

One difference is that plant sterol absorption in humans is considerably less than that of cholesterol. In fact, consuming plant sterols is suggested to then reduce cholesterol absorption and thus reduce circulating levels of cholesterol. Vegetables, legumes, nuts and seeds have relatively high concentrations of phytosterols.

Research suggests that just 2g daily of phytosterols is required to be effective in lowering LDL cholesterol. This can be consumed naturally through increased intake of phytosterol-rich foods (think nuts and seeds again, along with greens such as lettuce and asparagus) as well as foods with added phytosterols like natural, unsweetened yoghurt.

You will, of course, see a range of foods such as mayonnaise, margarines and fruit juices on the market making "heart-healthy" claims, but I am not suggesting you start adding copious amounts of those foods to your diet. The principal of no processed food still applies, so be cautious.

Niacin

Although most of the focus on cholesterol is on reducing LDL cholesterol, as I said last week, raising HDL ("good") cholesterol is also hugely important (regular exercise is one way to increase HDL). Niacin, a B vitamin, has long been used to increase HDL cholesterol.

Although niacin has been found to be effective, it often is not recommended as a viable option due to the large dose (2g to 3g) required to obtain the benefits.

Studies have found that taking niacin in large amounts can result in something called "the niacin flush", which is a temporary and sometimes itchy or tingling redness of the skin that lasts about 30 to 60 minutes. This is suggested to be a harmless side-effect but often puts healthy professionals off recommending it.

If you are thinking of using niacin, then it is best to use it under the supervision of a healthcare provider.

Daniel Davey BSc MSc, CSCS, NEHS is a performance nutritionist

Irish Independent

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