Diet tips for managing high cholesterol

Could dietary changes be an important first step in managing cholesterol?


Emma Thornton
Qualified Nutritionist (ANutr)
@EmmaThornton
Ask Emma


31 October 2018

Is cholesterol really the enemy?

It’s important to remember that we actually need cholesterol. Cholesterol is a fatty substance important for supporting a number of important bodily processes; from the production of hormones and vitamin D, to the physical structure of your cells which we need to be in good working order in order for them to respond to all our circulating levels of hormones and nutrients. However, the key is insuring we keep cholesterol in the correct quantities, too much, or too much of the wrong type, and we can run into problems.

Interestingly, in most cases, elevated levels of cholesterol don’t happen as a result of eating too many foods containing cholesterol, but rather eating too many foods that drive the manufacture of cholesterol in your body. See your liver, one of your key digestive organs, is responsible for overseeing the production and breakdown of cholesterol in the body and it could be the diet’s influence on this organ, for one, that could be a major contributing factor to raised levels of cholesterol.

Here I run through my top food picks and why, for helping to support your cholesterol levels going forward.

Eat & drink more:

1 - Fruit & vegetables 

Increasing your consumption of fresh fruit and vegetables is an important first step in the management of cholesterol. Firstly, fruit and vegetables are packed full of fibre. As fibre is the indigestible portion of our diet, it helps to cleverly carry any excess cholesterol out of our bodies. 

Some specific types of fruit & veg to focus on including are firstly those which are bitter in taste, including artichoke, dandelion, chicory, broccoli and rocket and also those which act as prebiotics such as onions, garlic, asparagus and bananas. 

Bitter herbs such as artichoke can help support your liver, the proper movement of bile and the manufacture and breakdown of cholesterol, whereas prebiotics such as Molkosan more specifically help support the balance of bacteria in your gut – both of which are very important when it comes to effective cholesterol management! With the proper movement of bile, cholesterol can bind to what we call bile salts, and this is another means for excretion of any excess.

2 - Nuts, seeds & wholegrains 

Nuts, seeds and wholegrains including brown rice, oats, millet or quinoa are not only packed full of fibre, but they are also nutrient-rich options. One group of nutrients that they are particularly rich in is B vitamins

Now, although there are 8 B vitamins in total, Vitamins B1, B3 and folate are thought to be especially  important when it comes to supporting healthy cholesterol levels, so it’s important to try and get a good dose of these though our diets. Although taking a supplement may also be an option, from a naturopathic standpoint, the B vitamins are thought to work best in combination, so getting them through our diet by including lots of wholefoods is a great way to go!

3 - Olive oil 

When it comes to cholesterol, although this is a type of fat, people shouldn’t be wary of good quality fats in their diet. Research has shown that a diet enriched with olive oil, versus a low-fat diet, produced positive outcomes and significantly lowered total and LDL (bad) cholesterol levels by 9.5% and 7.4%, respectively.1 Good fats can actually help to support healthy fat metabolism in the body and remember, if we lower our consumption of fat, we risk increasing that of refined carbohydrates or sugar instead! It all seems to work in a delicate balance

4 - Oily fish 

Oily fish is rich in another type of fat that shouldn’t be overlooked when it comes to controlling cholesterol – omega-3. Research suggests that the polyunsaturated, essential fatty acid components of omega-3, EPA and DHA may have positive effects on the balance of fats in the blood, including cholesterol.2

5 – Water 

Just as much as it’s important to include sufficient dietary fibre in your diet, water is also a must when it comes to managing cholesterol levels! Water helps to keep almost every system in your body ticking over, but especially your digestive tract. By helping to keep things moving along, your body can work efficiently to excrete any excess cholesterol via the appropriate exit routes.

The egg myth! 

It’s a common misconception that eggs are a no-go if you’re trying to reduce your cholesterol levels. However, although egg yolks contain a small amount of cholesterol, as part of a healthy, balanced diet, eggs can make a good addition. 

We now understand that rather than actual cholesterol in our diet, it’s more the balance of different fats including saturated fats, trans-fats and even sugar that can influence how your body handles and manufactures cholesterol.

Eat & drink less:

1 - Sugar 

When people think of cholesterol they instantly think of the fats in their diet. But did you know that sugar and refined carbohydrates may actually be a leading cause of high cholesterol? 

Research has shown as people consume more sugars they are more likely to have higher levels of bad cholesterol (LDL or VLDL) and lower levels of the good stuff (HDL).3 This suggests that excess sugar, triggering the release of insulin, is likely to be influencing the balance of fats in our bodies.

2 – Meat 

Saturated fats have long been considered a risk factor for high cholesterol and much of this has sparked the ‘low-fat’ trends which controversially, may actually be doing us more harm than good!

When it comes to managing our intake of fat in order to support our cholesterol levels, we need to approach this with caution. Much of the original research which influenced the low fat movement, may have been slightly misleading and they may have been slightly skewed, for example, as a result of lumping all types of saturated fats into the same category, including the ‘plant-based’ saturated fats such as coconut oil which are gradually starting to be deemed healthier again. 

Honestly, it seems the evidence around saturated fat still isn’t clear cut, but it may not be as unhealthy as was once thought. On the whole, for many of us, meat is likely to be too prominent in our diets. We know that this is particularly problematic when we include poor quality, or processed meat, meats cooked at high temperature and from a practical point of view, as we include more meat in order diets, we naturally have less room for fruit, vegetables and wholegrains; the parts of our diet we know are definitely beneficial when it comes to cholesterol management. Eating more plant-based foods is always going to be a positive.

3 - Dairy 

Much like meat, there is some controversy around dairy consumption and whether or not it can have a direct impact on our cholesterol levels, so let me explain. 

Again, dairy tends to be highest in saturated fat, but now as we’re beginning to understand some of the flaws that existed in some of the studies which originally changed our whole way of eating fats, we perhaps need to think a little differently about how we approach dairy. 

It’s a common misconception that low-fat dairy is where we need to be at for managing cholesterol. These ‘low-fat’ versions are much more processed and are more likely to contain more sugar or sweeteners as substitutes for the fat portion that has been removed. We know that the movement towards more sugar definitely hasn’t been a positive one, and this ingredient is most likely to be our biggest enemy. My advice is to aim to reduce our consumption of the unnatural, low fat-versions, and don’t be afraid of using good quality dairy options, such as butter from grass-fed cows, in moderation.

4 - Vegetable oils 

With all the scaremongering around fats, it was once assumed that we needed more vegetable oils in our diet as a substitute for saturated fats, which at the time were getting a bad name. As a result, as a nation, we’ve upped our intake of poor quality, processed oils rich in polyunsaturated fatty acids and surprise, surprise; the results aren’t looking too favourable. We’re getting fatter than ever and the rates of heart disease are showing no signs of slowing down. 

I’ve done a blog around healthy oils so you can have a better idea of how to approach this going forward. 

5 - Caffeine, alcohol & sweetened drinks

As much as we’ve talked about how the foods we eat can more directly affect the balance of fats in our body, it’s also important to consider the effects foods and drinks can have on our liver – the very organ that is primarily responsible for managing the balance of cholesterol our body. 

By bombarding our bodies with stimulants such as alcohol, caffeine, or sweetened drinks our liver is under more pressure than ever and we run the risk of it not working as efficiently as we might like. That’s not to mention the activation of other hormones by caffeine, such as stress hormones, which may also have an impact on our blood sugar and fat metabolism. Research has suggested that drinking 4 or more filter coffees a day may have adverse effects on cholesterol levels4.

 

1. https://academic.oup.com/ajcn/article-abstract/47/6/960/4694787

2. https://academic.oup.com/ajcn/article-abstract/54/3/438/4694393

3. https://jamanetwork.com/journals/jama/fullarticle/185711

4. https://academic.oup.com/ajcn/article/74/3/302/4739574

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