You’ve read plenty of articles on how to lower cholesterol. But that’s not the whole story. Instead of focusing only on how high or low your numbers are, think about optimizing cholesterol.
Understanding Cholesterol Markers
Low-density lipoproteins (LDL) and high-density lipoproteins (HDL) are usually classified as “bad” (LDL) or “good” (HDL) cholesterol. But recent studies have pointed out the importance of LDL particle size. Research shows that people who have a higher quantity of small, dense LDL particles and a lower quantity of large, fluffy LDL particles have a three times greater risk of heart disease. Small, dense LDL particles are more likely to enter blood vessel walls, become oxidized, and trigger the process of atherosclerosis, which increases the risk of heart attack. Large, fluffy LDL particles, on the other hand, may be protective against heart disease.
Other studies show an inverse relationship between triglyceride levels and LDL particle size—higher triglycerides correlate with small, dense LDL particles, and lower triglycerides correlate with large, fluffy LDL particles. An LDL particle number (called LDL-P) may be more important than the total amount of cholesterol within these particles. Think of cars on the highway: the number of cars on the road (LDL particle concentration) is more likely to cause a traffic jam than the number of passengers in the car (total LDL cholesterol).
The bottom line? HDL and LDL levels, LDL particle size and concentration, and triglyceride levels are all important factors in your total cholesterol profile. So instead of just lowering your cholesterol, focus on fixing it. Here’s how: ‘
7 Steps to Optimize Your Cholesterol
1. Slim Down
Even a few extra pounds can contribute to heart disease, and losing as little as five percent of your body weight can significantly improve your cholesterol profile. Studies show that obese people tend to have a higher ratio of small, dense LDL particles, low HDL levels, and high triglycerides, and losing weight can have a dramatically beneficial effect on cholesterol size and numbers. In fact, one study found that weight loss was superior to exercise in reducing small, dense LDL particles.
Note that this isn’t an excuse to avoid exercise. Studies show that 9–10 miles of walking or jogging per week results in a 13 percent increase in HDL cholesterol levels and a 14–20 percent decrease in LDL cholesterol levels. Other studies show that even moderate exercise can increase LDL cholesterol sizes and reduce the number of small, dense particles.
2. Sleep well
Sleeping too much or too little can have a negative impact on cholesterol. In one study, researchers found that sleeping fewer than five hours a night increased triglycerides and reduced HDL levels in women; conversely, women who slept more than eight hours showed similar results. Too little sleep can also lead to high LDL levels and make heart disease more likely. Studies have shown that people who sleep less than six hours a night significantly increase their risk of cardiovascular disease.
It is thought that the genes responsible for cholesterol transportation are not as
active in people who suffer from sleep deprivation, and it is possible that too much sleep may also impact those genes. Other studies have linked sleep deprivation with increased belly fat, which can also impact cholesterol levels. And further research suggests that improving sleep quality can reduce the number of small, dense LDL particles.
3. Eat a heart-healthy diet
Dozens of studies have shown a link between diet, healthy cholesterol levels, and heart disease. Focus on foods that have been shown to improve cholesterol and keep your ticker strong:
Healthy fats. Olive oil, nuts, and avocados are rich in monounsaturated fats, linked with reduced risk of cardiovascular disease and improved lipid profiles.
Fish. Omega-3 fatty acids in salmon, sardines, tuna, and mackerel have been shown to lower triglycerides, which is associated with a decrease in small, dense LDL particles.
Fiber. Soluble fiber in oats, oat bran, sweet potatoes, beans, lentils, and vegetables has been shown to lower total LDL as well as reduce the number of small, dense LDL particles.
Fruit. Apples, grapes, strawberries, and citrus are high in pectin, a form of soluble fiber that lowers LDL levels.
4. Kick the carbs
A high-carb diet has been linked with elevated triglycerides, which are associated with an increase in small, dense LDL particles. In fact, studies show that when the carb content of the diet increases, fat in the diet goes down but the content of fat (triglycerides) in the
blood rises—a condition known as carbohydrate-induced hypertriglyceridemia, and one reason why a low-fat, high-carb diet does not protect against heart disease. A diet high in refined grains also leads to insulin resistance, inflammation, and metabolic syndrome, also linked with increased triglycerides.
The solution? Banish refined sugars, sweets, and grains from your diet. This means avoiding candy, cookies, pastries, fruit juice, white flour, and alcohol—even a small amount can trigger elevated triglycerides. Focus instead on high-fiber, nutrient-dense carbs such as sweet potatoes, beans, winter squash, rutabagas, quinoa, and buckwheat; studies show fiber lowers both LDL and triglycerides.
5. Supplement with sterols
Found naturally in a variety of foods, plant sterols (phytosterols) work by interfering with the body’s absorption of dietary cholesterol. Some studies show that taking 2 grams a day can lower LDL cholesterol by as much as 20 percent. Other studies suggest that a diet enriched with plant sterols can decrease small, dense LDL cholesterol levels.
Some foods, such as margarine spreads, orange juice, or cereals, are fortified with plant sterols, but those foods tend to be high in calories and sugars, defeating the purpose of a heart-healthy diet. Natural food sources include vegetable oils, nuts, legumes, peas, cauliflower, broccoli, oranges, tangerines, and mangos, but only in small amounts. Intestinal absorption of these phytosterols is also low, which is why supplements are important. Aim for 800 mg to 2 grams per day of plant sterols, but check with your doctor first.
6. Take high-dose niacin
Also known as vitamin B, niacin has been shown to lower total LDL, increase HDL, reduce triglycerides, and lower elevated levels of small, dense LDL particles.
Be sure to buy the right kind of niacin: nicotinic acid is the form that’s been shown to
improve cholesterol, and typical doses are 1–3 grams per day. Other forms, including niacinamide and inositol hexanicotinate, have little or no effect on cholesterol. Sustained-release niacin can cause less flushing, but may be less effective and can increase the risk of liver toxicity. No-flush niacin has little or no effect on cholesterol. Check with your doctor before supplementing with niacin.
7. Try red yeast rice
A traditional culinary and medicinal compound in China, red yeast rice is made by fermenting a type of yeast called Monascus purpureus with rice, which turns the rice a deep red. Red yeast rice supplements contain significant amounts of monacolin K,
a compound that’s chemically identical to lovastatin, a prescription cholesterol-lowering drug. Red yeast rice works by lowering the liver’s cholesterol production, and it can decrease total cholesterol by 13 percent and LDL cholesterol by 19 percent. One study found that 600 mg a day of red yeast rice significantly lowered both LDL and total cholesterol. It’s shown to be as effective as prescription cholesterol drugs, without the associated muscle fatigue.
What's the leading cause of heart attack and stroke? It's not elevated cholesterol—it's high blood pressure. Known as “the silent killer,” high blood pressure has no symptoms—yet it can be deadly. Blood pressure is the amount of force (pressure) that blood exerts on the walls of the blood vessels as it passes through them.
When the pressure in your blood vessels becomes too great, the arterial walls may narrow or thicken, putting an extra burden on the heart.
- Adopt a low-sodium diet.
- Get regular exercise in your routine
- Drink beetroot juice: This ruby red veggie is high in nitrates, which the body turns into a gas called nitric oxide. Nitric oxide relaxes the smooth muscles in your blood vessels, which helps your arteries stay properly dilated.
- Take Nattokinase: This is an enzyme from fermented soybeans that acts like a natural ACE inhibitor. Early trials suggest that nattokinase can lower systolic blood pressure by up to 10.9 percent and diastolic pressure by 9.7 percent—and it works quickly, often within eight weeks.
- Consume Aged Garlic Extract (AGE): This heart-healthy remedy is created by naturally aging organic garlic in special stainless steel tanks under carefully controlled conditions for up to 20 months. One clinical study of 79 patients published in the
European Journal of Clinical Nutrition found that AGE possessed blood pressure-lowering properties in those with uncontrolled systolic (the top number) pressure by 9.3 mmHg compared to a placebo. AGE is even more effective at reducing blood pressure when combined with nattokinase and L-theanine, which has also been found to lower blood pressure.
Understanding Statin Drugs
Designed to help you maintain healthy cholesterol levels, statin drugs such as Lipitor
and Zocor are the most widely prescribed medications in America. Statins block HMG-CoA reductase, an enzyme that causes the liver to produce cholesterol. This effectively prevents excess amounts of cholesterol from entering the bloodstream. But, while statins can aggressively lower LDL levels, they come with a host of side effects such as muscle pain and weakness, nerve damage, liver damage, heart failure, and rhabdomyolysis—the breakdown of muscle tissue that can lead to potentially fatal kidney failure. Recent research in the Journal of the American Medical Association also suggests that high-dose statin therapy may increase the odds of developing type 2 diabetes.
Another drawback to statin therapy is that it robs the body of CoQ10. CoQ10 is essential for providing energy to cells, especially the cells in the heart, and low levels of this critical nutrient are linked to nearly every form of cardiovascular disease, including angina, hypertension, cardiomyopathy, and congestive heart failure. The problem is, CoQ10 supplements are poorly absorbed by the body. Fortunately, studies show that a more bioavailable form of CoQ10 called ubiquinol provides 60 percent better absorption than standard CoQ10 supplements. Over the past decade, studies have demonstrated that ubiquinol effectively inhibits LDL oxidation and may have a direct effect on the progression of atherosclerotic lesions. Ubiquinol has also been found to improve the symptoms of congestive heart failure.
To get the most out of your supplemental CoQ10, choose carefully. With nearly 200 brands of ubiquinol on the market today, picking the right supplement may seem overwhelming. Ubiquinol supplements may be labeled “CoQ10 Ubiquinol,” “Super Ubiquinol CoQ10,” “Ubiquinol QH,” or any combination of various names. Don’t let these combinations confuse you. Just look for the word “ubiquinol” on the Supplement Facts panel. This form of CoQ10 is much more bioavailable and beneficial than conventional CoQ10.