The Cholesterol Story

Dr Jacqueline E Campbell, is a family physician. She tells us how many persons become frightened when told that their cholesterol levels are elevated. They immediately assume that just the elevation of cholesterol puts them at "heart attack's door". There's more to it. High cholesterol does not reliably
identify all people with hidden heart disease, nor does just lowering it cure anyone of heart disease she

Image Courtesy: Life Line CD MD

Dr Campbell goes on to explain that cholesterol is a soft, waxy substance made by the body. It is found
among the fats in the bloodstream and in all your body's cells. She says that cholesterol is not a "bad guy ". It is actually beneficial to the body. Our bodies need it to form cell membranes, to produce bile
acids for digestion and also to make hormones and vitamin D.

Important to note that cholesterol and other fats cannot dissolve in the blood. They have to be
transported to and from the cells by special carriers called 'lipoproteins'. There are several kinds, but
the ones to focus on are low-density lipoprotein (LDL, the so-called "bad cholesterol") and high-density
lipoprotein (HDL, the "good cholesterol").

LDL transports cholesterol TO the cells, whereas HDL transports cholesterol AWAY from the cells.

When one has excess LDL, too much cholesterol can be deposited into the walls of the arteries. On the other hand, insufficient HDL impairs cholesterol transport away from the walls of the arteries for disposal in the liver. Therefore, too much LDL and or not enough HDL can set the stage for atherosclerosis.

She continues to explain that this is the process in which deposits of fats, cholesterol, cellular waste
products, calcium and other substances build up in the inner lining of an artery forming plaque. Plaques can grow large enough to significantly reduce the flow of blood through an artery. They can rupture and cause blood clots to form. These clots can block blood flow or break off and travel to another part of the body.

If either happens and blocks a blood vessel that feeds the heart, it causes a heart attack. If this occurs in
the brain, it causes a stroke. And if blood supply to the arms or legs is reduced, it can lead to poor

Research has shown that it is the oxidation of LDL that causes the most damage to the arteries. Oxidation
or free radical development is the process that changes the composition of this essential nutrient, turning it into a destructive compound. This oxidised LDL injuries the innermost lining of the arterial wall called the endothelium and causes inflammation. So it is the absolute LDL level and LDL oxidation that are involved in atherosclerosis and increasing heart attack risk.

Dr Campbell says that apart from LDL-cholesterol, there are other risk factors for developing a heart
attack or stroke. They include high levels of homocysteine, fibrinogen, triglycerides (another blood
fat) and C-reactive protein. The presence of high levels of these other risk factors can result in a
person suffering a heart attack or stroke, even though their cholesterol level is low.

Low cholesterol
Studies have shown that low total cholesterol levels are associated with depression and anxiety, perhaps
because low cholesterol may reduce levels of the brain chemical serotonin. Some research suggests that low LDL levels may be associated with an increased risk of certain types of cancer. Pregnant women who have low total cholesterol may be more likely to give birth prematurely and have low birth weight babies.

A low HDL level increases the risk of heart disease.

For menopausal women, a low HDL level coupled with excess weight may increase the risk of breast cancer.

Dr Campbell answers the question: What about cholesterol and diet?

Typically the body makes all the cholesterol it needs. The liver manufactures about 800-1500 mg of
cholesterol per day, and this contributes much more to total body cholesterol than does diet. The liver can
also make cholesterol from carbohydrates, proteins or fat.

Only animal foods - egg yolks, meat (that includes mutton and oxtail!), poultry, shellfish, milk and
cheese - contain cholesterol. Foods from plants do not contain cholesterol. The intake of saturated fats and trans fats in the diet is the main culprit in raising blood cholesterol.

She explains that trans fat is made when manufacturers add hydrogen to vegetable oil - a process called
hydrogenation; this increases the shelf life and flavor stability of foods containing these fats. They
can be found in vegetable shortenings, some margarines, cookies, snack foods, and foods made with
or fried in partially hydrogenated oils.

She maintains that simple changes can reduce your bad cholesterol and increase the good.

Here is her recommendation:

. Maintain a level of physical activity that keeps you fit. Walk or do other activities for at least 30 minutes on most days. If you need to lose weight, do enough activity to burn more calories than you eat every day.

. Limit your intake of foods that are high in calories and low in nutrition; especially limit foods like soft
drinks and candy.

- Add foods that are high in soluble fibre - whole grains, oats, legumes, fruits, vegetables, nuts, and seeds.

-Research suggests that the Mediterranean diet - low in saturated and trans fat, high in healthy unsaturated fats, and low in calories - reduces LDL cholesterol significantly better than other diets.
This diet is rich in vegetables, lean fish, and chicken and low in red meat. A really low- or no-fat
diet does a good job of lowering LDL, but may also reduce HDL.

-Eating foods and drinks with added phytosterols (plant stanols and sterols) is another way to drop
your LDL. The American Heart Association recommends 2 to 3 grams a day of plant sterols.

In addition Dr Campbell also recommends the following supplements:

. B Vitamins in particular B 6, B 12, folic acid and Niacin. Niacin, is particularly effective at promoting
a healthy balance between LDL and HDL cholesterol. Take a minimum of 100 to 200 mg a day. It can cause the skin to turn red and tingly.

. Fish oil 1,000 to 3,000 mg daily

. Antioxidants. These include garlic, Vitamins A,C,E, the mineral selenium.

. Red Yeast Rice extract 600 to 1,200 mg a day. Do not use this supplement if you are taking a statin
(prescription medication for lowering cholesterol).

. Artichoke leaf extract: Take 1800 mg daily.

. Policosanol: Take 10 mg daily

. Coenzyme Q 10: This antioxidant is essential for the production of energy in little cellular engines called
mitochondria. Statins deplete the body's natural supply of this antioxidant. Take 100 to 200 mg daily.

Life Line CD
February, 2009