Although it has a bad reputation cholesterol is in fact vital to the proper functioning of the body’s cells and nerves.

It is a component of cells that regulates their structure making sure they’re ‘flexible’ enough for appropriate transference of materials in and out of cells.  It also insulates nerves to allow fast conduction of impulses.

It synthesises vitamin D and is vital to the production of hormones – oestrogen, progesterone, testosterone, adrenaline and cortisol in particular. In addition, it protects the skin, ensuring it is properly hydrated. Its final function is its role in the breakdown, digestion and absorption of fats as a major component of bile.

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HDL and LDL Cholesterol

Cholesterol is found in two forms within the body.  Low Density Lipoprotein (LDL) cholesterol is responsible for transporting cholesterol to tissues and cells where it is needed.  If there is an excess of LDL cholesterol, however, it can line the arteries, causing hardening (or atherosclerosis).  It also causes blood platelets to become ‘sticky’ which can lead to blood clotting.

Around 70% of the body’s cholesterol is LDL cholesterol.

High Density Lipoprotein (HDL) cholesterol transports excess LDL cholesterol out of the body, taking it to the liver where it is removed via bile.  The ratio of HDL:LDL cholesterol is vitally important – a lack of HDL cholesterol can lead to an excess of LDL cholesterol whereupon the furring of the arteries will result.

It is therefore essential that we maintain adequate levels of HDL cholesterol.

Where does Cholesterol come from?

Contrary to popular belief, only around 20-40% of the cholesterol needed by the body comes from the diet (for most people at least!)  It’s found in foods containing saturated fats: eggs, dairy and meat products.  Up to 80% of the cholesterol needed is made by our bodies – metabolised in the liver.

So what’s the problem with High Cholesterol?

When doctors diagnose high cholesterol they’re looking at the level of LDL cholesterol – the damaging cholesterol, and comparing the ratio with HDL, which is frequently lacking. Although we normally do not eat enough cholesterol to meet our body’s needs, some people with diets high in saturated fats do find themselves with raised LDL cholesterol levels.

This is normally compounded by a lack of foods that help maintain high levels of HDL cholesterol.

And oxidation of LDL cholesterol compounds the problem. If cholesterol becomes oxidised it is more likely to form a plaque on arterial walls, leading to the blockages that can result in a coronary attack or stroke.

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So what can you do?

The best strategy for managing your cholesterol levels is to increase your ability to produce HDL cholesterol to help with ‘clearance’ of LDL cholesterol.  You also need to ensure that your digestion is working effectively to ensure elimination of cholesterol. And thirdly, by increasing your intake of antioxidant rich foods you’ll be better able to offset the oxidation of LDL Cholesterol so that it doesn’t become problematic.

There are a number of measures that can be taken to protect against High Cholesterol, to reduce Cholesterol levels or to correct an imbalance between HDL and LDL cholesterol levels.

The Mediterranean Diet

The Mediterranean diet is founded on the diet eaten in Crete in the 1960s where researchers identified a much lower incidence of heart disease and other chronic conditions than present in the rest of the Western world.   This style of eating incorporates all of the foundations of a cholesterol-lowering diet:

 Reducing saturated fats: eat limited meats, dairy produce including eggs.

 Reducing sugar: because of sugar’s influence on fats (triglycerides) its important to reduce sugar as much as possible.

 Limiting alcohol consumption to 1-2 units per day, preferably, red wine. It contains Resveratrol a powerful antioxidant that has been found to increase HDL levels.

 Reducing trans fats and hydrogenated fats – found mainly in processed foods.  Make meals from scratch where possible.

 Increase consumption of oily fish, which contain essential fats found to lower blood pressure, and help transport LDL cholesterol to the liver. They also improve epithelial function and arterial flexibility, and prevent saturated fats from sticking together.

Increase fruit and vegetables for their antioxidant content and fibre – helps protect agains oxidisation of LDL cholesterol and elimination of bile containing LDL cholesterol from the body.

Increase wholegrains – oats and barley in particular contain beta glucans, which can reduce LDL cholesterol levels. Flaxseed can also reduce LDL cholesterol.

Increase soy protein – tofu, tempeh and miso have been found to lower cholesterol and improve HDL ratios.  Use soy protein to replace some animal protein.

Increase olive oil – replace margarines and spreads with olive oil. It is known to reduce LDL cholesterol without impact on HDL cholesterol.

Increase legumes (beans) – again are shown to decrease levels of LDL cholesterol.

Lifestyle factors

Gentle exercise – even walking – has been found to increase the protective HDL cholesterol, so try to incorporate at least 20 minutes. This will also reduce LDL cholesterol and, if part of a weight loss programme, can result in some weight loss.

Smoking is a high risk factor for cholesterol and should therefore be abandoned where possible!  It reduces levels of HDL cholesterol and is closely linked to heart attack.

Research has found that in men, stress and hostile thoughts are linked closely to heart attack, and also to raised LDL cholesterol.  It is important therefore that these feelings be addressed, to facilitate a calmer emotional base.

Weight gain reduces HDL cholesterol, so a general weight loss or weight management programme should be followed where appropriate.

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