High levels of cholesterol in the blood are one of the many risk factors for serious future health problems (see the Cardiovascular Disease section for information on other risk markers). Too much cholesterol can increase the chances of developing heart disease (including possibly fatal heart attacks) and stroke. By inhibiting circulation, too much of this substance can also cause gallstones, impotence, high blood pressure, and loss of mental acuity.
Cholesterol isn’t all bad, however. Your body requires it in moderation for the proper function of cells, nerves, and hormones. It is an essential component of every cell in your body, and life without it would be impossible. To distribute cholesterol through- out the body, substances called lipoproteins transport it in the blood. One class of lipoproteins, called low-density lipoproteins, or LDLs for short, carries cholesterol from the liver, where it is produced, to the cells that need it. Then another kind of lipoprotein, called high-density lipoproteins, or HDLs, picks up the excess cholesterol from the cells and takes it back to the liver, where it is broken down and excreted from the body or reprocessed.
Under normal conditions, the lipoproteins keep cholesterol
levels in balance. But this carefully calibrated system can be overtaxed when the body creates more cholesterol than HDL can sweep away. After the cells take what they need, the existing HDLs remove what they can, and the extra cholesterol simply remains in the blood. Then if cholesterol becomes oxidized (especially LDL cholesterol) and attaches to the artery walls, it sets the stage for inﬂammation of the arteries. This chronic inﬂammation contributes to further buildup and deposition of cholesterol and plaque on the interior walls of the arteries. We call this buildup, which narrows the arteries and limits the amount of blood that can pass through them, arteriosclerosis or hardening of the arteries. Arteriosclerosis is the ﬁrst stage of heart disease; when left untreated, it will lead to a heart attack or stroke. For more information about arteriosclerosis, see Car- diovascular Disease.
Normal Cholesterol Levels Total cholesterol: 165–200 mg/dL. LDL cholesterol: below 130 mg/dL. HDL cholesterol: 50 mg/dL or higher.
Total cholesterol/HDL ratio: less than 3.7
LDL/HDL ratio: less than 3.0
Note: The relative amount of total cho- lesterol to HDL, and the ratio of LDL
to HDL is considered more important than total cholesterol.
Getting More Speciﬁc with Cholesterol
Apolipoprotein B (apoB) is a cholesterol particle that is believed to promote heart disease by affecting how cholesterol is transported into the arteries and the tissues. ApoB is found in low density lipoprotein (LDL) and other potentially harmful cholesterols, such as very low density lipoproteins (VLDL). Conversely, apolipoprotein A (apoA-1) is found in HDL cholesterol and provides a protective effect against heart disease.
A large study known as the AMORIS (Apolipoprotein-related Mortality Risk) measured the levels of apoA-1 and apoB, as well as other lipids, in more than 175,000 men and women in Sweden. Researchers found that people at greatest risk of dying from a heart attack tended to have the
highest ratios of apoB to apoA01. In this study, these newer markers were more predictive of a heart attack than were the typical total, HDL, and LDL cholesterol and triglycerides. Men with the highest apoB/apoA-1 ratio had almost four times the risk of a fatal heart attack, compared to those with the lowest ratios; and in women the relative risk was threefold. ApoB appears to be an impor- tant marker for people with normal to low LDL cholesterol, as well as for those with diabetes and insulin resistance.
ApoB reference range: 55–125 mg/dL
Apo A-1 reference range: 125–215 mg/dL ApoB/ApoA-1 ratio reference range:0.30–0.90
Elevated cholesterol levels are often caused by the standard Western diet, which relies heavily on animal products, saturated fats, and reﬁned carbohydrates. It can also be caused by heredity conditions or preexisting diseases like diabetes and insulin resistance, or syndrome X. Although, in these cases, diet usually plays a role as well. It stands to reason, then, that high cholesterol can often be treated with dietary changes and exercise. Speciﬁc supplements discussed in this section are also excellent non- pharmacological ways to normalize cholesterol levels. Stress reduction has a bene- ﬁcial effect as well. It is strongly suggested that you employ these natural strategies before trying any of the cholesterol-lowering medications on the market. These drugs, while effective at reducing cholesterol, are potentially toxic to the liver and may cause nutritional deﬁciencies. While they may be necessary in some cases, many doc- tors prescribe them as a matter of routine—often because they’re afraid that their patients won’t make the lifestyle changes that can lower cholesterol naturally. If your doctor wants to prescribe a cholesterol-lowering agent for you, explain to him or her that you’re willing to embark on a new regimen in the hopes of avoiding a lifelong dependency on drugs. Whatever your decision, be sure that it is based on your physician’s and your analysis of your individual situation.
Often, there are no symptoms of high cholesterol, so it’s important to have your doc- tor perform a blood analysis regularly. One sign of high cholesterol can be a buildup of cholesterol rings on the skin under the eyes. Make an appointment if cholesterol or heart problems run in your family, or if you experience any of the following:
• Mental confusion or dullness
• Circulatory problems
• Difﬁculty breathing after minor exertion
• Poor diet, especially one high in cholesterol, saturated fats, and reﬁned carbohydrates
• Hereditary tendency to high cholesterol
• Diabetes, insulin resistance
Total cholesterol, HDL, LDL, VLDL, Apolipoprotein B, Apolipoprotein
A-1—all are blood tests
See the Cardiovascular Disease section for a review of all cardiovascular markers that should be tested.
Oxidative damage—blood or urine
Just as a poor diet is a primary cause of high cholesterol, dietary changes are one of
the best ways to treat it. One major key to balancing cholesterol levels is to consume a diet that’s high in ﬁber. This means increasing the amount of vegetables, fruits, nuts, seeds, and whole grains in the diet. Soluble ﬁber is a great choice. This type of ﬁber does not dissolve in water and binds cholesterol as it passes through the digestive tract. Oat bran is a great example of soluble ﬁber, and more than twenty studies show that it reduces total and LDL cholesterol when consumed on a daily basis. One bowl of oatmeal can lower cholesterol levels between 8 and 23 percent in just three weeks. Pectin, found in the skin of apples, is also effective, as is ground ﬂaxseeds.
The reduction of fats in the diet, especially the harmful fats described in the side- bar, is important as well. In addition, eating less sugar products and reﬁned carbohy- drates can make all the difference in the world for some people’s cholesterol levels. Finally, many people with diabetes and insulin resistance ﬁnd that cutting down on simple carbohydrates and increasing the consumption of protein foods can dramati- cally reduce cholesterol levels.
Soluble ﬁber can dramatically decrease cholesterol levels (along with your risk of developing many other diseases). Oats, brown rice, beans, and fruits are all good sources; have some at every meal. For breakfast, you might like to have a bowl of hot oatmeal, ﬂavored with soy milk, bananas, and a little molasses, and an orange or a half grapefruit on the side.
The molecules in cholesterol are highly vulnerable to damage by free radicals. Reduce your risk of developing heart disease and other serious degenerative illness by increasing your consumption of deeply colored fruits and vegetables. Eat a wide variety for the broadest protection, and try for at least ﬁve raw or lightly cooked serv- ings every day.
Not all fats are forbidden to people with elevated cholesterol. Essential fatty acids
actually have a heart-protecting effect, so be sure to incorporate cold-water ﬁsh like salmon or mackerel into your meals several times a week. Flaxseeds are another good source of EFAs; you can sprinkle them over salads or use the oil as a dressing.
Olive oil increases levels of HDL (the “good cholesterol). The uses for this fruity oil are numerous: it can enrich pasta sauces, or you can add a little to a skillet and sauté your favorite vegetables.
Garlic and onions are savory complements to vegetarian meals—and they help lower LDL cholesterol while raising HDL.
Add spices to your meals, such as cayenne, basil, rosemary, and oregano. These spices are rich in antioxidants to prevent cholesterol oxidation.
Nuts, such as walnuts, have been shown to reduce cholesterol and trigylceride lev- els. Eat a handful daily.
Food to Avoid
Fats that are saturated, hydrogenated, or partially hydrogenated tend to increase cho- lesterol levels. By avoiding foods that contain the bad fats, you can decrease choles- terol and improve your cardiovascular health. Fried foods, sweet baked goods, and most crackers are all dangerously full of fats. Even margarine and vegetable shortening—
Hydrogenated and Partially Hydrogenated Fats
Hydrogenation is a process that turns vegetable and seed oils into soft or solid fats that, unlike the oils in their natural state, can be used as table spreads and that hold up when used in cooking or baking. During hydro- genation, the oil’s carbon molecules are saturated with hydrogenation and exposed to extremely high heat. The oil is kept in the heat until it reaches
the desired consistency. Shortening, for example, remains in the heat until it is completely solid; it is said to be a hydrogenated fat. Margarine, on the other hand, is removed from the heat before the oil completely hardens, just as it reaches a soft, “spreadable” consistency. Products like margarine are called partially hydrogenated oils.
It’s ironic and unfortunate that margarine and even vegetable shortening are touted as heart-healthful products. For years, doctors have told us to replace butter with margarine, and most brands of shortening loudly pro- claim that they have less saturated fat than butter does. But as you have probably heard, researchers have discovered that the hydrogenated process produces altered molecules called trans-fatty acids. These substances appear to pack a double whammy: not only do they raise LDL, they lower HDL and cause free radical damage. Not even butter does that kind of damage to your arteries. Scientists still have to perform more studies before they can pro- nounce their ﬁndings conclusive, but no matter what the ultimate results
are, the fact remains: it’s never a good idea to eat processed and chemically altered foods, even those that are claimed to be good for you.
This news is not a reason to eat all the butter and saturated fat you like.
It’s far wiser to cut down on three kinds of fats: saturated, hydrogenated, and partially hydrogenated. Instead, eat cold-water ﬁsh and sauté your vegeta- bles and dress your salads with oils like olive, canola, and ﬂaxseed. These foods ﬁll you up, while raising your “good” cholesterol levels. Remember, though, that they’re still fats. Enjoy them in moderation.
items that cholesterol patients often use as substitutes for butter and lard—are high in partially hydrogenated fats, which are even deadlier than the saturated kind.
Sugar and alcohol stimulate the liver to produce more cholesterol. Avoid alcoholic beverages and all sources of reﬁned sugar, including sodas, candy, and low-fat baked goods.
An excess consumption of caffeine has been linked to high cholesterol. You don’t need to cut out your coffee or black tea completely—just keep your intake down to a cup or two a day. Green tea is a much better choice, as it is rich in antioxidants that have been shown to prevent cholesterol oxidation.
Most people who have high cholesterol levels have been eating toxic foods. Detox- ify your body (especially your liver) with a one- to three-day vegetable juice fast. As mentioned earlier, you may also ﬁnd that a juice fast is an excellent way to break old eating habits.
Super Seven Prescriptions—High Cholesterol
Super Prescription #1 Policosanol
Take 10 to 20 mg each evening. Numerous studies show that policosanol reduces total and LDL cholesterol, lipoprotein(a), and increases the good HDL cholesterol.
Super Prescription #2 Red yeast rice (Monascus purpureus)
Take 1,200 mg twice daily. This extract has been shown to reduce cholesterol lev- els and increase HDL. The type of product used in successful studies contained 10 to 13.5 mg of monacolins per day. Note: Take 100 mg of CoQ10 daily when using this product.
Super Prescription #3 Garlic (Allium sativum)
Take 300 to 500 mg twice of aged garlic daily. It reduces cholesterol levels and
increases HDL cholesterol.
Super Prescription #4 Niacin (inositol hexaniacinate, or IP6)
Take 1,500 to 3,000 mg daily of the no-ﬂush form (inositol hexaniacinate). It reduces cholesterol levels and increases HDL cholesterol.
Super Prescription #5 Fish oil
Take a daily dosage of a ﬁsh oil product containing at least 480 mg of EPA and 360 mg of DHA. Fish oil reduces inﬂammation in the arteries and lowers cholesterol and triglyceride levels.
Super Prescription #6 Guggul (Commiphora mukul)
Take a daily total of 1,500 mg standardized to 5 percent guggulsterone (equivalent to 75 mg of guggulsterones). This Ayurvedic herb reduces cholesterol levels and increases HDL.
Super Prescription #7 Antioxidant formula
Take a complex of antioxidants or a multivitamin, as directed on container. Sev- eral of the antioxidants prevent cholesterol oxidation.
Pantetheine is a metabolite of vitamin B5 that has been shown in studies to reduce total and LDL cholesterol, as well as to increase HDL. It can be particularly effec- tive for people with diabetes. Take 600 to 900 mg daily.
twelve-week study demonstrated that 1,500 mg of guggulipid reduced total cholesterol by an average of 22 percent and triglycerides by
25 percent. A different study of 233 people with elevated choles- terol levels showed that Guggul worked better than the choles- terol-lowering drug cloﬁbrate. Only peo- ple who took Guggul had improvements in HDL cholesterol.
Numerous studies have shown that vitamin C reduces the risk of dying
from heart disease. One of the mecha- nisms, in addition to its ability to prevent cholesterol oxidation, is that it is involved in the formation of bile salts. Bile is produced by the liver and released by
the gallbladder to digest fats. Cholesterol is converted into bile salts and eliminated through the digestive tract. Vitamin C enhances this process by improving bile salt formation and thus cholesterol elimination.
Soy protein has been shown in studies to reduce total and
LDL cholesterol and to increase HDL. Take 25 to 50 grams daily.
Reishi (Ganoderma lucidum) is a mushroom extract that reduces cholesterol. Take 800 mg two to three times daily.
Vitamin E prevents LDL oxidation. Take 400 to 800 IU of a mixed blend daily.
Vitamin C reduces total cholesterol and LDL levels and acts to prevent their oxidation.
Chromium reduces total cholesterol and increases HDL lev- els. Take 200 to 400 mcg daily.
Green tea contains potent antioxidants known as polyphenols that reduce cholesterol oxidation. It has also been shown to reduce total cholesterol levels, while increasing good HDL cholesterol.
Cholesterol Drugs and CoQ10
The cholesterol-lowering drugs known as “statins” are among the most widely prescribed drugs today. These “statin” drugs work by inhibiting the liver enzyme HMG CoA reductase, which acts to help the liver synthesize cholesterol. This same enzyme is also involved in the synthesis of CoQ10, a vital nutrient that’s required for proper heart function. A 1993 study in the Journal of Clinical Pharmacology found that the use of statin drugs reduced CoQ10 levels by an average of 40 percent after three months of use. Other studies have also found CoQ10 depletion effects. In one study, 100 mg per day of supplemental CoQ10 reversed this effect.
If you have cardiovascular disease, see a licensed homeopath for a constitutional remedy.
See pages 668–675 for information about acupressure points and administering treatment.
• Keep blood ﬂowing to your heart and chest by working Heart 3 and 7.
• If you can feel your chest tense up when you’re under pressure, take some time
out to work Conception Vessel 17.
• Pericardium 3 is another point for anxiety and chest pain.
• Should tension and anxiety bring on heart palpitations, work Pericardium 6.
If you have high cholesterol, your blood may not be able to travel through your body, especially to your extremities, as quickly as it used to. Massage can’t directly lower your cholesterol levels, but it can greatly improve your circulation, as well as strengthen your heart and reduce stress. For maximum circulatory and heart beneﬁts, a full-body massage is recommended.
Work the areas corresponding to the heart, the chest, the adrenals, the liver, and the thyroid.
Juniper oil will help release toxic buildup in your body. Add some to a bath, or com- bine it with a carrier oil and use it in a massage.
No essential oil can lower your cholesterol, but several have soothing properties that can help you relax and reduce stress. You can experiment with any of the relax- ing oils mentioned on page 658, but you might like to start with lavender, marjoram, or ylang ylang. You can use any of these oils in a bath or a massage or add them to a diffuser and let the scent linger in your room or ofﬁce throughout the day.
General Stress-Reduction Therapies
Persistent, unresolved stress has been linked to high cholesterol problems, as well as to heart disease and stroke. Stress reduction should be part of a comprehensive approach to preventing heart disease.
• Know your cholesterol and cardiovascular risk marker levels—all of them. Get regular checkups, and ﬁnd a doctor who is willing to explain the numbers to you.
• Smoking is the number-one risk factor in heart disease. If you smoke and have high cholesterol, you’re in grave danger of having a heart attack. People who smoke must quit immediately; even if you’ve never picked up the habit but are exposed to secondhand smoke, you must ﬁnd a cleaner environment in which to live or work.
• Exercise lowers LDL levels, while raising those of HDL. Find an activity you enjoy, and pursue it regularly. A brisk thirty-minute walk every day does won- ders for almost everyone.
• If you have diabetes or hypothyroidism, work with a doctor to keep your dis- ease in check and to devise an individual plan for controlling your cholesterol.
• Many cholesterol patients are told to lose weight. The dietary suggestions here will help most people take off excess pounds, but if you’re more than twenty pounds overweight, you may need additional help. See Obesity for further suggestions.