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3 cholesterol myths debunked

<p>For years, cholesterol has been seen as the villain in your diet – responsible for many of the health woes people experience daily. But many of the “facts” about cholesterol are actually just misconceptions. So let’s clear up some of these myths now.</p> <p>As with everything to do with your diet, any major changes should be made in consultation with your healthcare professional or a nutritionist to make sure it’s right for you.</p> <p><strong>Cholesterol is bad for you</strong></p> <p>Just like cake, cholesterol should be enjoyed in moderation. Interestingly, it actually performs many important functions. It helps produce cell membranes, vitamin D, hormones, and helps with digestion. It also plays a role in helping to form memories. </p> <p>And, believe it or not, cholesterol is naturally created by your body. So most of the cholesterol in your bloodstream is not there because of your diet.</p> <p><strong>Eggs are the enemy</strong></p> <p>People with high cholesterol levels used to be advised to avoid eating too many eggs, but they’ve recently been put back on the “safe list.” Research at Yale University actually showed that even people with coronary heart disease could eat two eggs each day for six weeks without any effect on their cholesterol levels.</p> <p><strong>Low-fat diets are the best</strong></p> <p>While saturated fats do increase the “bad” cholesterol (LDL), it also increases the levels of “good” cholesterol (HDL). A study published in Annals of Internal Medicine showed no link between the consumption of saturated fats and an increased risk of heart attacks. </p> <p>Foods that are high or low in saturated fat can have a positive, negative, or neutral effect on your body – it all depends on the type of food. A diet that is low in carbohydrates is more effective at raising the levels of “good” cholesterol in your system.</p> <p><em>Image credits: Getty Images</em></p>

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How can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?

<p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options.</p> <p>Could taking supplements over this time help?</p> <p>You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference.</p> <h2>Why are we so worried about cholesterol?</h2> <p>There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins.</p> <p><strong>Low-density lipoprotein or LDL cholesterol</strong></p> <p>This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an <em>increased</em> risk of heart disease and stroke.</p> <p><strong>High-density lipoprotein or HDL cholesterol</strong></p> <p>This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a <em>reduced</em> risk of heart disease and stroke.</p> <p>Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases).</p> <h2>Fibre is your friend</h2> <p>An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">soluble fibre</a>.</p> <p>This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces.</p> <p>You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils.</p> <h2>Fibre supplements, such as psyllium</h2> <p>There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include:</p> <ul> <li> <p><strong>natural soluble fibres</strong>, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats)</p> </li> <li> <p><strong>synthetic soluble fibres</strong>, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel)</p> </li> <li> <p><strong>natural insoluble fibres</strong>, which bulk out your faeces, such as flax seeds.</p> </li> </ul> <p>Most of these supplements come as fibres you add to food or dissolve in water or drinks.</p> <p>Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials.</p> <p>These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%.</p> <h2>Probiotics</h2> <p>Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces.</p> <p>Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising.</p> <p>In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%.</p> <p><a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings.</p> <p>Most of these studies use probiotics containing <em>Lactobacillus acidophilus</em> and <em>Bifidobacterium lactis</em>, which come in capsules or powders and are consumed daily.</p> <p>Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet.</p> <h2>Red yeast rice</h2> <p><a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins.</p> <p>A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins.</p> <p>However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results.</p> <h2>Diet and supplements may not be enough</h2> <p>Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol.</p> <p>But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role.</p> <p>Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211748/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher &amp; Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-i-lower-my-cholesterol-do-supplements-work-how-about-psyllium-or-probiotics-211748">original article</a>.</em></p>

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9 natural ways to lower cholesterol

<h2>What is cholesterol?</h2> <p>Cholesterol is a waxy, fat-like substance that is made in your liver and travels throughout your bloodstream. It may not sound particularly good for your body, what with the “waxy” and “fat-like” descriptors, but cholesterol does have some merit.</p> <p>It’s one of the ingredients the body needs to make new cells. And it’s essential for creating vitamin D, bile acids, and hormones such as progesterone and oestrogen.</p> <p>But having too much cholesterol can put you at risk for cardiovascular disease and stroke. That’s why it’s so important you know your level and, if it’s high, take action. These nine lifestyle tips will help you control your cholesterol naturally.</p> <h2>It takes a multifaceted approach</h2> <p>Lowering cholesterol takes a multifaceted approach. It’s not enough to switch from donuts to oatmeal for breakfast or swap out butter for olive oil.</p> <p>Slashing high cholesterol numbers requires you to make healthy lifestyle choices daily. That means looking at all aspects of your routine, from what you eat, to the activity you get, to bad habits you have.</p> <p>One word of warning: if you’re currently taking medication, this isn’t a time to go cold turkey. Stay with your current medication dosage and schedule.</p> <h2>Get plenty of soluble fibre</h2> <p>Fibre comes in two types: soluble and insoluble. Both types are an essential part of a healthy diet. But studies show that soluble fibre, found in high-fibre foods like whole grains, fruits, vegetables, seeds and legumes, can reduce LDL cholesterol by 5 to 10 per cent.</p> <p>Soluble fibres dissolve in water and other bodily fluids. They don’t stick around long, escorting cholesterol to the toilet, so to speak. “Soluble fibre binds to cholesterol in the intestines and causes the cholesterol to be excreted in the stool,” says Dr Colleen Tewksbury, a senior research investigator and bariatric program manager at Penn Medicine in Philadelphia.</p> <p>Insoluble fibre, on the other hand, absorbs water and other materials to form regular stools. You need both types, so be sure you get half of each, totalling about 25 to 30 grams per day.</p> <h2>Eat unsaturated fats</h2> <p>By now, we know that we should limit saturated fats in our diets because it raises levels of bad cholesterol in the blood. But in addition to that, we should also be upping our intake of monounsaturated and polyunsaturated fats.</p> <p>The unsaturated fats from foods like fatty fish, olive oil, vegetables, nuts and seeds are much healthier for the heart.</p> <p>Case in point: a study in the Journal of the Academy of Nutrition and Dietetics found that diets rich in unsaturated fats can improve overall cholesterol levels. Not only were higher intakes of polyunsaturated fats associated with healthier total cholesterol levels, but higher intakes of monounsaturated fats were linked to healthier HDL levels too. “They improve cholesterol likely by requiring less work and leaving fewer/preferred by products of converting by the liver for transport to your cells,” says Tewksbury. Interestingly, the healthiest high-fat foods you should be eating may surprise you. Eggs, for example, are well known for their high cholesterol, but the truth about eggs is that it’s the saturated fats, not the cholesterol, that causes health problems for most people.</p> <h2>Choose foods that contain plant sterols</h2> <p>Plant sterols (also known as phytosterols) are found in foods such as whole grains, fruits, vegetables, vegetable oil, nuts and legumes. “They directly block the absorption of cholesterol,” Tewksbury says. Research published in 2018 in Nutrients indicates that consuming 1.5 to 3 grams of plant sterols per day could decrease LDL cholesterol levels by as much as 12 per cent. Plant sterols occur in small quantities, so food manufacturers fortify cereal, crackers, orange juice, margarine, and other products with them. Then they market the products as “heart healthy,” says Tewksbury. That means some of these so-called “heart healthy” foods are also loaded with saturated fat and sugar. Be sure to check the label and leave the ones high in saturated fat and sugar on the supermarket shelf.</p> <h2>Sprinkle on spices to flavour food</h2> <p>Isn’t it a pleasant surprise to know something you’re probably already eating could help lower cholesterol? Well there’s a good chance you’re already ticking off this cholesterol to-do, at least to some degree. Sprinkling cinnamon in your coffee or oatmeal and cooking with garlic are probably things you’re already doing – without realising they could improve your cholesterol. “Studies suggest consuming certain spices, such as cinnamon and garlic, can help lower cholesterol,” says Tewksbury. Garlic has the potential to regulate slightly elevated cholesterol concentrations, while cinnamaldehyde, the active component in cinnamon, improves lipid and glucose metabolism.</p> <h2>Try a plant-based diet</h2> <p>To bring those high cholesterol numbers down, you might want to consider transitioning to a plant-based diet. “There is a plethora of literature supporting the use of a plant-based diet to treat and reverse multiple chronic diseases, especially heart disease and high cholesterol levels,” says dietitian Dana Hunnes.</p> <p>That likely includes the 2019 ACC/AHA Guidelines on the Primary Prevention of Cardiovascular Disease. The guidelines stated that eating a plant-based protein diet reduced amounts of cholesterol (and sodium) compared with an animal protein diet. Which means replacing animal proteins (think meat and poultry) with plant proteins (like tofu, beans and quinoa) can reduce the risk of plaque build-up in the arteries, a precursor to cardiovascular disease.</p> <h2>Ditch the processed foods</h2> <p>Processed foods are often high in LDL-raising saturated fat. But they come with an additional warning. The trans fats, refined sugars and carbohydrates in processed foods trigger inflammation in the body, says cardiologist Dr Neel Chokshi. “High cholesterol, in combination with inflammation, is what leads to atherosclerosis, or blockages in the walls of your arteries,” he says.</p> <h2>Exercise</h2> <p>You may not know this, but exercise ranks nearly as important as the food you eat when it comes to lowering cholesterol naturally. A huge body of research shows exercise reduces the unhealthy fats circulating in your blood – both LDL and triglycerides. “Cholesterol and fats provide fuel for your body,” Dr Chokshi says. “Exercise raises your body’s energy expenditure and, in turn, burns more of these fats.” Despite the evidence, exercise is rarely the favoured option to lower cholesterol. Some people may think it’s boring, unpleasant, or hard to squeeze into a busy schedule. But that’s not the case – you don’t have to grudgingly drag yourself to the gym in order to reap benefits. “All activity counts as exercise, so choose something you enjoy,” says Dr Chokshi. Better yet, grab some friends or family for fun and accountability. The key to lowering cholesterol is consistency. “We recommend at least 150 minutes of moderate-intensity activity per week, or 75 minutes of high-intensity activity per week,” he says. Beginners can start by walking 30 minutes a day at a comfortable pace, and then build to moderate-intensity activity. Doing two, 20-minute resistance training sessions a week can also help lower cholesterol by increasing muscle mass and raising your metabolism, Dr Chokshi adds.</p> <h2>Shed some weight</h2> <p>If you’re overweight or obese, aim to drop some kilos. Even a little weight loss goes a long way towards achieving lower cholesterol. Research in Translational Behavioral Medicine found that people who lost 5 to 10 per cent of their weight showed a reduction in total cholesterol, LDL and triglycerides. And the numbers got even better when people lost more than 10 per cent. Losing weight will lower your cholesterol and decrease your risks for diabetes and cardiovascular diseases.</p> <h2>Quit smoking</h2> <p>The association between smoking and cholesterol is twofold. For starters, smoking makes LDL cholesterol stickier, so it clings to artery walls. As we know, clogged arteries hinder blood flow and can lead to heart problems. Secondly, smoking lowers HDL cholesterol. That isn’t good because the job of HDL is to escort LDL out of the arteries. Quitting can make a big difference. A review of studies found that HDL levels increase by as much as 30 per cent just after three weeks of stopping smoking. As strong as the argument to quit smoking is, it’s rarely easy to do.</p> <p><strong>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/9-natural-ways-to-lower-cholesterol?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.</strong></p> <p>Image: Shutterstock</p>

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Everything you need to know about cholesterol

<p><span style="font-weight: 400;">Did you know more than a third of all adult Australians suffer from high blood cholesterol? Thankfully there are simple and effective habits you can adopt to help manage the condition.</span></p> <p><span style="font-weight: 400;">Unfortunately, many of us are forced to confront the reality of high cholesterol and its potentially negative impact on our health at some point in our lives. Though cholsterol is not necessarily inherently bad, high blood cholesterol has been linked to a slew of health problems. Fortunately, there are many simple ways to manage high cholesterol.</span></p> <p><strong>So, what exactly is cholesterol?</strong></p> <p><span style="font-weight: 400;">Cholesterol is a fatty substance that is produced naturally within the body. It is an essential part of all animal cell membranes as the sterol helps maintain membrane structure and fluidity. Blood cholesterol is created in the liver then disseminated through the blood stream. Normal levels of the modified steroid are beneficial for general health, but high levels of blood cholesterol can lead to heart disease and long-term health risks.</span></p> <p><strong>The numbers</strong></p> <p><span style="font-weight: 400;">According to the Heart Foundation high cholesterol is the second greatest contributor to heart disease, accounting for more than 36% of cases. Statistics reveal that men and women essentially have an even risk of developing high total cholesterol. The age group most at list? Those of us who are aged 55 to 64 are most at risk of developing cardiovascular and other diseases as a result of high total cholesterol, with almost one in two of us suffering from the imbalance.</span></p> <p><span style="font-weight: 400;">Many cases of high cholesterol often go unnoticed. In a recent study even though 32.8% of Australians had abnormal or high total cholesterol levels, only 10.1% self-reported having high cholesterol. So many of us are unaware of the condition and the potential negative effects it may be having on us.</span></p> <p><strong>Good and bad cholesterol</strong></p> <p><em>There are two main types of blood cholesterol.</em></p> <ul> <li><span style="font-weight: 400;">Low-density lipoprotein (known as LDL) is the bad kind of cholesterol associated with plaque in the heart's arteries, heart disease and other illnesses.</span></li> <li><span style="font-weight: 400;">High-density lipoprotein (HDL) is known as ‘good’ cholesterol because it aids in cell recovery and can help prevent heart disease.</span></li> </ul> <p><span style="font-weight: 400;">Not surprisingly, doctors suggest to aim to keep LDL levels low and HDL levels high.</span></p> <p><span style="font-weight: 400;">High blood cholesterol is not associated with any overt symptoms and many sufferers report no difference in their overall wellbeing, which is why regular blood tests are important. A positive blood test can help you understand the severity of your condition and its many treatment options. Speak to your GP for a more in-depth run-down of your options.</span></p> <p><strong>What causes it?</strong></p> <p><span style="font-weight: 400;">'Dietary cholesterol' refers to animal products that naturally contain cholesterol. However high cholesterol levels in the blood are caused by foods that are high in saturated and trans-fats. High blood cholesterol levels develop as a result of a poor diet.</span></p> <p><span style="font-weight: 400;">There are also a significant number of people who have a genetic pre-disposition to cholesterol, with many suffering despite a nutritious and healthy diet. Depending on your family history, a unique genetic structure may inhibit the natural production of cholesterol lowering sterols. In these cases, medication is often the best option. Your health expert will advise you.</span></p> <p><strong>Treatment</strong></p> <p><span style="font-weight: 400;">Thankfully there are many ways to treat high cholesterol levels. Lifestyle and dietary changes are the easiest and least invasive ways of dealing with a positive diagnosis. Those who are particularly at risk of heart related events may be prescribed medicines such as statins to help manage the illness on a pharmaceutical level.</span></p> <p><strong>Lifestyle changes</strong></p> <p><span style="font-weight: 400;">If you've been diagnosed with high LDL cholesterol levels (and medication is not called for), simple dietary and lifestyle changes can make a huge difference. Here are 8 tips from the CSIRO for reducing your blood cholesterol levels.</span></p> <ul> <li><span style="font-weight: 400;">Reduce saturated and trans-fats in any way possible!</span></li> <li><span style="font-weight: 400;">Stay away from cakes, biscuits and pastries - they are heavy in unnoticed fats.</span></li> <li><span style="font-weight: 400;">Consume reduced fat milk and polyunsaturated or monounsaturated margarine.</span></li> <li><span style="font-weight: 400;">Remove fat from meats (red and white) and choose lean, heart-healthy cuts.</span></li> <li><span style="font-weight: 400;">Eat more fish - twice a week has been said to reduce the risk of heart disease.</span></li> <li><span style="font-weight: 400;">Eat foods of plant origin, nuts, legumes (high fibre) and especially fruit.</span></li> <li><span style="font-weight: 400;">Lose weight and exercise more consistently.</span></li> <li><span style="font-weight: 400;">Avoid smoking and excessive alcohol abuse. </span></li> </ul> <p><span style="font-weight: 400;">Seeking more information to help managing high blood cholesterol? The CSIRO's Healthy Heart Program is a comprehensive program including healthy eating plans, a 12-week menu with hundreds of recipes and details of an easy exercise routine.</span></p> <p><span style="font-weight: 400;">The best news is that simple changes you make can really help. Why not start today?</span></p> <p><em><span style="font-weight: 400;">Republished with permission of </span><a href="https://www.wyza.com.au/articles/health/nutrition/what-you-need-to-know-about-cholesterol.aspx"><span style="font-weight: 400;">Wyza.com.au.</span></a></em></p>

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Do you have high cholesterol? Here’s what you need to know

<p><em><strong>Dr Ross Walker is a leading Sydney Cardiologist based in Lindfield who specialises in stress echocardiography and preventative cardiology. He has published 7 best-selling books on preventative cardiology and lectures both nationally and internationally on this subject.</strong></em></p> <p>As one Australian dies every 12 minutes from cardiovascular disease, typically coronary heart disease, stroke or heart failure, it’s important to know the best type of care for you, or a family member.</p> <p><strong>What is cholesterol?</strong></p> <p>Cholesterol is a fatty substance produced by the liver and carried around the body in your bloodstream. Many of us consider cholesterol to be bad, or unhealthy, but there is a good side to it.</p> <p>Your body needs cholesterol for many essential processes, including building healthy cell membranes, bile salt &amp; vitamin D metabolism, and is the basic ring for steroid hormones.</p> <p>Cholesterol may become a problem when there’s too much of the incorrect sub components, leading to health problems, such as coronary heart disease, stroke and heart failure.</p> <p><strong>Myth – The two types of cholesterol</strong></p> <p>Cholesterol is an essential part of our body, and in the correct levels, necessary for helping to digest food, produce hormones and generate vitamin D. Your body generates cholesterol itself, although we do ingest it from some foods. There is a common misconception that there are two types of cholesterol: low-density-lipoproteins (LDL), and high-density lipoproteins (HDL), also known as ‘bad’ and good’ cholesterol.</p> <p>But, this is far too simplistic and inaccurate. Low-density lipoproteins (LDL) and high-density lipoproteins (HDL) are further subdivided into small and large components. It is the small components that are the main causes of atherosclerosis (the progressive build-up of fat, inflammatory cells and calcium within the walls of your arteries over many decades. Small LDL is pro-atherogenic (i.e. puts fat in the arterial wall), whilst small HDL is proinflammatory.</p> <p>Large high-density lipoproteins (HDL) transport excess cholesterol from your cells back to your liver, to be used again, or removed from your system. As this cholesterol is removed from your system, it doesn’t contribute to any build up in your arteries. Large LDL builds healthy cell membranes, bile salt &amp; vitamin D metabolism, and is the basic ring for steroid hormones.</p> <p><strong>How to treat high cholesterol </strong></p> <p>If your cholesterol levels are high, your GP has probably prescribed you statin medication. Around 2.2 million Australians take statins to control cholesterol levels. Statins are used to lower LDL cholesterol, by blocking cholesterol production in your liver, which helps lower your risk of cardiovascular disease.</p> <p>Statins also reduce the size of existing fatty plaques in the arterial wall. When there’s less cholesterol in your blood stream, due to the statins, your body will begin to reabsorb excess cholesterol, resulting in a reduction of levels in your arteries.</p> <p>One of the side effects of statins is its reduction in your body’s level of the naturally-occurring Coenzyme Q10, which can lead to tiredness, muscles fatigue and soreness and more serious health issues. It is my opinion, with the mounting scientific evidence, that all people taking statin drugs should be taking Ubiquinol.</p> <p>If your doctor hasn’t already recommended or prescribed it, include the supplement Ubiquinol, an active form of the naturally-occurring antioxidant CoQ10, as part of your daily health plan. Ubiquinol is more easily absorbed than CoQ10 and has been shown to help maintain a healthy heart and also reduce small LDL cholesterol levels.</p> <p>Talk to your GP or health professionals for advice on Ubiquinol.</p>

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How old is too old for cholesterol lowering medications?

<p><em><strong>Sophia Zoungas is Professor and Head of the Diabetes and Vascular Medicine Research Program at the School of Public Health and Preventative Medicine at Monash University.</strong></em></p> <p>There is growing debate about whether doctors should prescribe statins to otherwise healthy older people to reduce their risk of developing their first <span style="text-decoration: underline;"><strong><a href="https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia" target="_blank">heart attack or stroke</a></strong></span>.</p> <p>Now the debate has reignited with the publication of a <span style="text-decoration: underline;"><strong><a href="http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2628971" target="_blank">new analysis</a></strong></span> that casts doubt on their benefit for people over the age of 65, and raised concern of the potential for harm in people aged over 75.</p> <p><span style="text-decoration: underline;"><strong><a href="https://www.healthdirect.gov.au/statins" target="_blank">Statins</a></strong></span> are the most commonly used cholesterol lowering medications in Australia. In <span style="text-decoration: underline;"><strong><a href="http://www.pbs.gov.au/info/statistics/expenditure-and-prescriptions-30-06-2011" target="_blank">2010-2011</a></strong></span> they were taken by 2.6 million Australians with 16 million scripts dispensed from June 2011 to June 2012.</p> <p>They are prescribed to <span style="text-decoration: underline;"><strong><a href="https://theconversation.com/some-things-you-should-know-about-statins-and-heart-disease-19655" target="_blank">lower blood lipid levels</a></strong></span> and so reduce people’s chances of heart disease, including stroke, and to prolong life.</p> <p>In particular, this class of drugs inhibits how the body makes <span style="text-decoration: underline;"><strong><a href="https://www.heartfoundation.org.au/your-heart/know-your-risks/blood-cholesterol" target="_blank">low-density lipoprotein cholesterol</a></strong></span> or bad cholesterol.</p> <p>Different statins reduce bad cholesterol to different extents. For example, <span style="text-decoration: underline;"><strong><a href="https://theconversation.com/weekly-dose-lipitor-the-highest-selling-drug-of-all-time-55706" target="_blank">atorvastatin</a></strong></span> and rosuvastatin produce larger reductions in bad cholesterol per milligram of drug than a different statin, pravastatin (<span style="text-decoration: underline;"><strong><a href="http://thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext" target="_blank">about 50 per cent vs 30 per cent</a></strong></span>).</p> <p>The issue of whether to prescribe statins for older people is particularly important given the growing segment of our population living into their <span style="text-decoration: underline;"><strong><a href="http://www.aihw.gov.au/australias-health/2016/" target="_blank">70s and 80s</a></strong></span>.</p> <p>About <span style="text-decoration: underline;"><strong><a href="https://www.mja.com.au/journal/2012/196/1/national-census-medicines-use-24-hour-snapshot-australians-aged-50-years-and?0=ip_login_no_cache%3Db2b572005b77c06053d179b7c8ddb535https://www.mja.com.au/journal/2012/196/1/national-census-medicines-use-24-hour-snapshot-australians-aged-50-years-and?0=ip_login_no_cache%3Db2b572005b77c06053d179b7c8ddb535" target="_blank">one third</a></strong></span> of Australians over the age of 70 years are taking statins. And they could potentially be used by more older people as, based on their age alone, these are the people at highest risk of heart disease or stroke.</p> <p>In people who already have heart disease or who have had a stroke, the benefits of statins are clear. Taking statins <span style="text-decoration: underline;"><strong><a href="http://thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext" target="_blank">reduces your chance</a></strong></span> of another cardiovascular event whatever your age.</p> <p>Doctors justify prescribing statins for this group by looking at a figure called the “<span style="text-decoration: underline;"><strong><a href="http://www.thennt.com/thennt-explained/" target="_blank">number needed to treat</a></strong></span>”. In the case of statins, researchers <span style="text-decoration: underline;"><strong><a href="https://doi.org/10.1016/j.jacc.2007.06.063" target="_blank">calculate</a></strong></span> 28 people with existing heart disease or who had had a stroke would need to be treated for five years to prevent one death, a figure low enough to warrant treatment.</p> <p><strong>Mixed evidence</strong></p> <p>In people without heart disease or who have not had a stroke, <span style="text-decoration: underline;"><strong><a href="http://insights.ovid.com/pubmed?pmid=24866986" target="_blank">the benefits of statins are less clear for those aged 70 years or older</a></strong></span>. Most national and international guidelines, including those from the <span style="text-decoration: underline;"><strong><a href="https://www.heartfoundation.org.au/" target="_blank">Heart Foundation</a></strong></span>, have not been able to make strong recommendations to guide prescribing for older people. And any recommendations they do make are mostly based on trials of statins in people under the age of 70.</p> <p>Some trials including older people without heart disease have reported <span style="text-decoration: underline;"><strong><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)11600-X/fulltext">no</a> <a href="http://www.nejm.org/doi/10.1056/NEJMoa1600175">benefits</a></strong></span> whereas others have reported <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946369/pdf/nihms174735.pdf" target="_blank">large benefits</a></strong></span>.</p> <p>To complicate things further, <span style="text-decoration: underline;"><strong><a href="http://circ.ahajournals.org/content/135/20/1979.long" target="_blank">pooling</a></strong></span> results of two of these trials finds statins reduce cardiovascular events in people aged under 65 years (by about 25 per cent), 65-70 years (by about 50 per cent) and over 70 years (by about 25 per cent).</p> <p>Due to the conflicting figures, researchers have not pooled the results to calculate a “number needed to treat” for healthy older people taking statins to prevent their first heart attack or stroke.</p> <p>The debate about the benefits of statins for older people also needs to take into account the increased likelihood of side-effects from medications in this age group.</p> <p>Researchers have not well studied side effects with statin use in older people. However, the issues <span style="text-decoration: underline;"><strong><a href="https://www.fda.gov/Drugs/DrugSafety/ucm293101.htm" target="_blank">most likely</a></strong></span> to be of concern to older people are muscle aches and weakness, muddled thinking and diabetes.</p> <p><strong>What does the latest evidence say?</strong></p> <p>The latest <span style="text-decoration: underline;"><strong><a href="http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2628971" target="_blank">analysis</a></strong></span> revisits selected results from a large trial completed some 13 years ago. The researchers considered data from 2,867 participants over 65 without any evidence of heart disease who were randomly assigned to the statin pravastatin or usual care, then followed for over 4.5 years.</p> <p>The researchers looked at the effects of the statin on deaths from any cause, and deaths from heart disease and heart attacks in people aged 65-75 and over 75. They found no difference in any of these outcomes for either of the age groups and even raised concern of the potential for harm in people aged over 75.</p> <p>The study authors concluded that the benefits previously ascribed to statins may have been overstated for older people.</p> <p>To gauge what these new findings mean, we first need to consider the statin used in the study, pravastatin. Doctors don’t prescribe this so commonly to lower cholesterol nowadays because it has been replaced by stronger statins.</p> <p>Second, by the end of the study many people in the statin group had stopped their treatment while people in the usual care group had started treatment, either on pravastatin or another statin. This makes it very hard to see which outcome could be the result of the drug itself.</p> <p>Also, the study may not have included enough older people. Studies aiming to prevent disease in healthy people need many thousands as most will not suffer heart attacks and strokes irrespective of which treatment group they are in.</p> <p><strong>So where does that leave us?</strong></p> <p>To plug this gap in the research, we are conducting the <span style="text-decoration: underline;"><strong><a href="http://www.staree.org.au/" target="_blank">first trial</a></strong></span> of its kind in the world to look at the effects of statins on healthy ageing.</p> <p>This statin trial, which is unusual as it is not funded by the pharmaceutical industry, is the first randomised controlled trial of statins in healthy older Australians (aged 70 or older) living independently in the community.</p> <p>When the results from its 18,000 participants are in, we will have a clearer picture of the effects of statins on overall survival, survival free of dementia and disability, as well as cardiovascular events over an average five years of treatment.</p> <p><strong>If you’re on statins, what should you do?</strong></p> <p>Older people <em>with</em> heart disease or who’ve had a stroke should continue taking their prescribed statin as the benefits are clear. However, they should discuss any side effects with their doctor.</p> <p>Older people <em>without </em>heart disease or who have not had a stroke should discuss the potential benefits and harms of statins with their doctor before starting or continuing treatment.</p> <p>This discussion should take into account a person’s preference for statins and other measures to reduce their risk of heart disease, include having a healthy diet, being physically active and stopping smoking.</p> <p><em>Written by Sophia Zoungas. First appeared on <a href="http://theconversation.com/" target="_blank"><strong><span style="text-decoration: underline;">The Conversation</span></strong></a>. </em><img width="1" height="1" src="https://counter.theconversation.edu.au/content/78102/count.gif?distributor=republish-lightbox-advanced" alt="The Conversation"/></p>

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5 foods that lower your cholesterol

<p><strong><em>Nutritional scientist and accredited practicing dietitian, Dr Joanna McMillan, outlines some foods you can eat to lower your cholesterol.</em></strong></p> <p>There are many risk factors for heart disease and the more of these factors affect you, the higher your overall risk is. Your cholesterol levels are one such risk factor. In other words, if you have no other risk factors this may not be a problem, but since it is one risk factor that in most people is responsive to changes made in your diet and your lifestyle, then it’s worth your while giving it some attention.</p> <p>When it comes to cholesterol you want to know your profile including total cholesterol, LDL (so called “bad” cholesterol) and HDL (so called “good” cholesterol). Studies have shown that reducing your LDL cholesterol by 10 percent reduces your risk of having a heart attack or stroke by 20-30 percent. You also want HDL to be high as this is involved in collecting cholesterol from around the body and returning it to the liver. One of the best indicators of risk is the total to HDL cholesterol ratio. Finally, your triglyceride level is also important, with lower levels associated with lower risk.</p> <p>So what foods can you eat to improve your cholesterol profile? Here are my top five:</p> <p><strong>1. Nuts</strong></p> <p>Eating a handful of nuts a day has been shown to lower your risk of heart disease by 30 to 50 per cent. That’s pretty extraordinary for one little plant food. The benefits are likely to come from a number of factors. Nuts are rich in unsaturated fats and when these replace saturated fats in the diet they reduce LDL and boost HDL – exactly what we want. Nuts also help to lower triglycerides and total cholesterol levels. For best cholesterol lowering results aim to eat two handfuls a day. All nuts are beneficial and so mix them up for variety.</p> <p><strong>2. Oats</strong></p> <p>Oats are probably the most famous cholesterol lowering food. They contain a special type of soluble fibre called beta-glucan that has been clinically proven to lower total and LDL cholesterol levels. Soluble fibres absorb water in the gut to form a gel and this has a number of benefits. It slows down digestion, so that any carbohydrates consumed at the same time are absorbed more slowly, helping you to control your blood glucose levels. Beta-glucan has the added benefit of binding cholesterol from bile acids and from foods consumed, carrying them out of the body. Plus, many toxins are bound up and safely excreted. The fibres also then act as gold start fuel to the beneficial bacteria living in the colon – this has a further influence on cholesterol production in the liver. So all up, oats are a pretty fabulous food for heart health.</p> <p><strong>3. BetaHeart</strong></p> <p>The only trouble with oats is getting enough beta-glucan to make a real difference. Studies show that you need 3g of beta-glucan for a clinical effect and that takes around three bowls of oatmeal. This is where <a href="https://www.betaheart.com.au/" target="_blank"><strong><span style="text-decoration: underline;">BetaHeart</span></strong></a> makes things easy. It is an all-natural supplement drink made from oats and barley (the other major food source of beta-glucan). Each sachet contains 3.4g of beta-glucan so all you need is one a day. They are low GI and will have the added benefit of helping in blood glucose control, have no added sugar and nothing artificial added. I recommend BetaHeart as an all-natural way of assisting in the management of high cholesterol. Even if your doctor has prescribed a statin drug to treat your cholesterol, BetaHeart can offer a synergetic benefit.</p> <p><strong>4. Extra virgin olive oil</strong></p> <p>The Mediterranean diet is one of the most studied dietary patterns and the evidence is compelling proving this to be one of the healthiest ways to eat. There are many aspects of this diet that contribute to its benefits, but undoubtedly the use of extra virgin olive oil as the principle fat is one of them. It really is a unique oil in that it is simply the juice of the olive fruit and is not refined in any way, unlike highly processed and refined seed oils. The resulting oil is rich in phytonutrients with antioxidant and other protective properties. The fat itself is predominantly monounsaturated and therefore stable for cooking, while helping to lower LDL and boost HDL. All up its head and shoulders above all other oils and fats for heart and overall health.</p> <p><strong>5. Avocado</strong></p> <p>Aside from olives, the only other fruit with significant fat is the avocado and it has similar heart health benefits. The fat is mostly monounsaturated, so particularly if you use avocado in place of a saturated fat like butter, you can make a significant difference to your cholesterol profile. Avocadoes are also good for fibre, they provide vitamin E and folate – all important nutrients for overall and heart health.</p> <p>Do you think we’ve left any foods off the list? Let us know in the comments below.</p> <p><strong>Related links:</strong></p> <p><a href="/health/body/2016/09/the-truth-about-eating-small-frequent-meals/"><strong><em><span style="text-decoration: underline;">The truth about eating small frequent meals</span></em></strong></a></p> <p><a href="/health/body/2016/09/is-wheat-really-killing-us/"><strong><em><span style="text-decoration: underline;">Is wheat really killing us?</span></em></strong></a></p> <p><a href="/health/body/2016/09/simple-trick-to-losing-weight/"><strong><em><span style="text-decoration: underline;">The simple trick to losing weight</span></em></strong></a></p>

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