Cholesterol - how to reduce despite a healthy diet?

[Zippee]

My wife (33 year old) has been told she has a high cholesterol reading of 6.5, something that has been common in the female side of her family for a few generations. She eats healthily and doesn't eat much high fat food or red meat but is there anything she can do/eat that will actively help to reduce the level of cholesterol she has? Shes been told by the doctor that they want to do another check in 3 months time but have not given her any advice on what to do/eat in the meantime...
Any advice before she has to start popping pills?

[Silver993tt]

Lots of excercise such as running 3-4 times a week for around 45mins each session. That shoule be outside, not in a gym on a machine. If she does this for at least 6 months she should see an impact on he cholesterol counts.

[maddog993]

It's a fairly obvious list really; Plenty of Fruit & Veg, Oats, Nuts (especially almonds, walnuts, hazelnuts), lean white meats, 'oily' fish (salmon, tuna, mackerel, etc), Flora Pro-Active/Benecol, low-fat dairy and dressings, Olive oil, high fibre/wholegrains/wholewheat, Red wine.
Avoid trans-fats, processed meats. A decent combination of any/all these should make a significant contribution to lowering LDL cholesterol and Triglycerides while boosting HDL levels.
(When checking cholesterol remember the important distinction between LDL and HDL cholesterol along with Triglycerides/VLDL rather than merely focussing on the total cholesterol figure.)

[croyde]

I had 6.1 cholesterol but no amount of healthy dieting or exercise would shift it. My brother is the same and he runs marathons. Some people are just naturally high in the stuff.

Thanks to a heart attack in April, complete surprise as I am pretty fit and was only a tad overweight, I am now on a lot of pills a day including statins and on my last blood test my cholesterol was down to 3.9.

If dieting does not help maybe you should ask your doc about taking statins.

[ShadownINja]

That's annoying if you're so fit.

Do you eat oats? I heard eating oats eg porridge was good for lowering cholesterol.

[456mgt]

croyde said:

If dieting does not help maybe you should ask your doc about taking statins.

As above. Cholesterol comes from your diet and is produced by your liver; you can control the former but not the latter. If it's still high regardless of diet & exercise, your best bet is to go onto a statin.

[croyde]

ShadownINja said:

That's annoying if you're so fit.

Do you eat oats? I heard eating oats eg porridge was good for lowering cholesterol.

I eat porridge virtually every morning now as well as a lot of oily fish and salads.

[ShadownINja]

But does it help?

[1]

Apparently exercise will only effect it by around 1 point. It really is diet, more of the good stuff and less of the saturated fat.

[oldbanger]

ShadownINja said:

But does it help?

These are my thoughts too.

Cholesterol is considered a "risk factor" for heart disease - there is no direct linear correlation between mortality and cholesterol score.

Unfortunately low cholesterol increases your risk of cancer, stroke, depression and cognitive decline. Some sources recommend a bottom limit of 5.2 before these issues become a problem.

Plant sterols are linked to increased incidence of some types of heart disease, even if they reduce this one "risk factor". E.g. they've been found to collect in your heart valves.

Statins have not been shown to be of benefit to women, in any trial so far conducted. However they are linked to increased incidence of cancer, depression, aggression, suicide and memory problems. Total mortality tends to increase in those taking the drug, even *if* mortality from heart disease falls (and it has only been shown to be of benefit for older men who already have heart disease). Also, if your wife wants to have children in the future, she definitely must not be on statins during the pregnancy.

In older adults, particularly women, higher cholesterol is associated with a longer life.

However, if you are still interested in lowering your score some of the things that you could do include: reduce intake of starch and sugar, including fructose (insulin is an atherosclerotic and also causes raised blood pressure, starch/sugar intake causes raised tryglycerides), improve your vitamin D3 status (high "bad" cholesterol is indicative of low vitamin D and this deficiency is a definite heart attack risk), eat more saturated fat (increases "good" cholesterol, not actually linked to increased incidence of heart disease).

This information is available within the academic medial literature (e.g. see BioMed Central), however another good source is the blog of cardiologist Dr William Davis http://heartscanblog.blogspot.com/

[ShadownINja]

Thanks for that. Why are statins given to women then? And why does their cholesterol level drop?

Also, doesn't increasing saturated fat intake increase cholesterol levels (bad and good)? I thought that is why people have high levels?

[oldbanger]

ShadownINja said:

Thanks for that. Why are statins given to women then? And why does their cholesterol level drop?

Also, doesn't increasing saturated fat intake increase cholesterol levels (bad and good)? I thought that is why people have high levels?

Statins are given to women, cause thems the rules. And yes cholesterol levels will fall, but incidence of heart disease and death from heart disease won't. Doctors get paid for low cholesterol scores in their patients via the QOF, not total incidence of heart disease in patients, and not for the mortality of those patients.

British doctor Dr Malcolm Kendrick has written a lot about the subject of cholesterol and heart disease risk. If you're at all interested, one of his lectures has even made it onto youtube
http://www.youtube.com/watch?v=XPPYaVcXo1I

Most people don't eat that much in the way of saturated fat, to be honest. High cholesterol seems to be linked to low vitamin D3, high inflammation and high starch intake, not saturated fat intake e.g. see http://www.drbriffa.com/blog/2009/07/20/study-demo...

Edited by oldbanger on Sunday 20th September 14:08

[ShadownINja]

So (not a confrontational "so") why does everyone say to eat less fatty foods?

(Thanks for the links.)

PS Can I go mental with my love of donner kebabs, then?

Edited by ShadownINja on Sunday 20th September 15:17

[ShadownINja]

Reading the second link, it seems that people have been encouraged to eat more carbs (not sure why unless they are training for a marathon).

[King Herald]

456mgt said:

croyde said:

If dieting does not help maybe you should ask your doc about taking statins.

As above. Cholesterol comes from your diet and is produced by your liver; you can control the former but not the latter. If it's still high regardless of diet & exercise, your best bet is to go onto a statin.

Cholesterol only occurs in about three or four natural foods, eggs yolks, some shellfish, and I forget what else, which is what annoys me when everything from margarine to marzipan is advertised as 'new, healthy low cholesterol formula'.

[maddog993]

456mgt said:

croyde said:

If dieting does not help maybe you should ask your doc about taking statins.

As above. Cholesterol comes from your diet and is produced by your liver; you can control the former but not the latter. If it's still high regardless of diet & exercise, your best bet is to go onto a statin.

Only about 20% of the body's own cholesterol is produced by the liver, the rest is mainly synthesised by the intestines, the adrenal glands and reproductive organs. Diet does have a direct bearing on the body's synthesis of cholesterol in that a higher dietry intake results in a net decrease of endogenous cholesterol production and vice versa regulated by Sterol Regulatory Element Binding Proteins.

Edited by maddog993 on Sunday 20th September 16:25

[oldbanger]

ShadownINja said:

So (not a confrontational "so") why does everyone say to eat less fatty foods?

Because an influential doctor called Ancel Keys had a theory in the 1950s and at the time it was considered too important for the public health to wait for clinical evidence.

I am not medically qualified, merely medically educated, so obviously this is just information, not medical advice. I am more than satisfied that not following mainstream dietary advice on the issue will be better for me in the long term, and usually I (metaphorically) bite my tongue whenever people talk about cholesterol online or IRL, as I understand full well how controversial this is at the moment.

Edited by oldbanger on Sunday 20th September 16:26

[oldbanger]

ShadownINja said:

Reading the second link, it seems that people have been encouraged to eat more carbs (not sure why unless they are training for a marathon).

Have you ever heard of the food pyramid? The food pyramid is what is meant by a "balanced" diet:

[maddog993]

ShadownINja said:

So (not a confrontational "so") why does everyone say to eat less fatty foods?

(Thanks for the links.)

PS Can I go mental with my love of donner kebabs, then?

Fats are a vital part of any diet - carrying vitamins, helping regulate body temperature and maintaining tissues & organs, however as a general rule polyunsaturated and monounsaturated fat is 'good' - helping to lower LDL levels and saturated and Trans (trans-iomer) fats are bad - raising LDL levels. The Doner's unfortunately are stuffed with Saturates and Trans fats.

[Silver993tt]

oldbanger said:

ShadownINja said:

Reading the second link, it seems that people have been encouraged to eat more carbs (not sure why unless they are training for a marathon).

Have you ever heard of the food pyramid? The food pyramid is what is meant by a "balanced" diet:

Well, that depends on who you believe. Quoted from the following link which contains other very useful links:

"The modern USDA Food Pyramid is based on principles that have never been proven in any scientific study, and it is heavily influenced by food supply politics, and the food manufacturing and agricultural lobbying. You can read about the history of the USDA Food Pyramid here."

http://www.healthy-eating-politics.com/food-myths....