Before I discuss ways in which we can balance cholesterol levels, it is important to understand that our bodies do need cholesterol as it provides structural support for every cell in our body, it is required in the production of all sex hormones including estrogen, progesterone and testosterone and cholesterol is required to convert sunlight into Vitamin D, an incredibly important nutrient/hormone for overall health. Due to this, our livers actually produce cholesterol and low cholesterol levels are linked to mortality.

Total cholesterol includes both HDL (high density lipoprotein) and variations of LDL (low density lipoprotein). In some cases, especially when there is damage to blood vessel walls (due to high blood sugar levels of high blood pressure, for example), tiny LDL particles stick to artery walls and get caught in the injured areas of the walls and overtime, this creates plaque build up which can block blood flow to the heart (increasing our risk for heart disease). On the other hand, HDL cholesterol actually removes excess LDL particles from the bloodstream, taking them to the liver to be metabolized and excreted. Although problems may arise when our total cholesterol is too high, when HDL is too low and when LDL levels are too high, this scenario is oversimplified. High cholesterol levels are not a sole or independent risk factor for heart disease* meaning that high cholesterol does not cause heart disease, but can increase one’s risk if there are other risk factors such as high blood pressure, etc. In saying that, however, as it is estimated that 44% of Canadians live with high total cholesterol levels, it is vital that we introduce some or all of the lifestyle changes required to ensure that cholesterol levels are balanced; that HDL is above 1.0 mmol/L* and LDL (especially VLDL levels) are below 3.5 mmol/L. 

*Low HDL levels are listed as an independent risk factor to heart disease. The best way to increase HDL is through physical activity – at least 20 minute of moderate physical activity/day along with an increased intake of Omega 3 fatty acids through fatty fish such as wild-caught salmon, mackerel, herring, sardines and a reduction in alcohol intake to a maximum of 1 unit/day for women and 1-2 units/day for men. 

Make these lifestyle changes to balance cholesterol levels naturally:

1. Avoid trans fats – Avoid foods that include trans or partially hydrogenated fats (check ingredient lists). For example, margarines, frozen pizzas, waffles, frozen fries and snack foods such as commercial cookies, crackers and pastries are often made using partially hydrogenated oils. Trans fat not only increases LDL, but it decreases HDL levels, deeming its intake to be an independent risk factor for heart disease. Fast food and deep-fried foods are also a source of trans fat if the oil is repeatedly heated to very high temperatures, changing the configuration of the fat molecules. Finally, trans fat is naturally found in all animal products, even grass-fed, but naturally occurring trans fats do not have the same health concerns as factory-made trans fats.

2. Replace some saturated fats with unsaturated fats – This one is a bit tricky. While research shows that swapping some saturated fats/animal fats with mono and polyunsaturated fats* such as avocado oil, olive oil and Omega 3’s, for example, reduces the risk of heart disease, replacing some saturated fat with starchy or processed carbohydrate-rich foods actually increases the risk of heart disease. In saying that, if you are planning to swap out some animal fats, always replace with olives, extra virgin olive oil, nuts and seeds and fatty fish and not starchy foods. 

*Unsaturated fats include mono and polyunsaturated fats.  While we find monounsaturated fats in foods such as avocados, nuts and seeds, polyunsaturated fats such as Omega 3’s are found in fatty fish (there some vegetarian sources as well such as ground flaxseeds and chia seeds and hemp hearts, but evidence is less conclusive on its role in balancing cholesterol levels). Omega 3 intake (especially from sustainable fish) directly reduces LDL levels and most importantly, can increase HDL levels.

3. Increase soluble fibre intake – Choose fibrous foods such as oat bran, barley and legumes (dried beans, peas and lentils) as well as whole grains such as rice and quinoa, colourful vegetables and fruits in order to help decrease high LDL cholesterol levels. Aim for fibre intake from whole foods and not from processed foods with added fibre. Fibre from whole foods is rich in other vital nutrients and this is not the case for processed foods. 

4. Exercise – Exercise is the best way to increase HDL levels.  Everyone can find a type of exercise that is best for their lifestyle. For example, you can join a gym or a yoga/pilates studio, or you might prefer swimming, dancing, walking, hiking, etc. The possibilities are endless and exercise is vital for optimal health and for reducing your risk of heart disease. Aim for a minimum of 20 minutes of moderate physical activity/day.

5. Maintain a healthy weight – Excess body fat (especially visceral fat in the abdomen) is associated with elevated LDL cholesterol levels (and higher triglyceride levels) and an increased risk for heart disease.  Fat loss can also increase HDL levels in those with excess body weight.

Looking for more information on reducing cholesterol levels or on heart health in general? Contact me today at nicolemarchanddietitian@gmail.com or book in for an online or in-person consultation through the website. 

Eat Well Nova Scotia,
Nicole Marchand, RD

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