Every good story has to have a good guy and a bad guy.  We like nice distinct lines so we know how to label things in our minds.  When dealing with the body and health it is not always that easy to cut a line between good and bad.  You can run into problems like “too much of a good thing” or exceptions to the good vs. bad rule.  There’s gray area when it comes to health, and cholesterol often rests within that gray area.

Understanding Cholesterol

Lets first look at this issue by exploring what is cholesterol.  Cholesterol is a waxy substance that is produced by the body for a number of different functions in the body. It is used to make hormones such as estrogen, testosterone, progesterone, and cortisol. We need cholesterol for the productiion of vitamin D in the body. We also use cholesterol to help bring stability to the cell wall’s that surround each cell in our body.

LDL and HDL

Cholesterol is transported on carriers, the main two we call LDL and HDL.  LDL carries cholesterol from the liver to the various cells of the body.  HDL carries choelsterol from the cell to the liver so it can be processed and excreted.  You may be beginning to see how both LDL and HDL are beneficial, but also why there can be a problem if there is too little HDL and too much LDL.

LDL Builds Up

If cholesterol continues to move toward the cells, carried by LDL, without enough HDL to carry it back, it is thought to be able to build up in the cells of the body.  This becomes important for heart disease because a build-up of cholesterol in the blood vessels that feed the heart can cause problems.  This build-up can cause the vessel to become blocked.  This can lead to decreased flow of blood to the heart, resulting in chest pain, heart attack, even death.

How to Control Choleterol

It is therefore important to keep LDL levels under control by consuming a diet low in saturated fat and cholesterol and high in fiber.  Consume good fats that come from nuts, seeds, fish, and olives, which can raise HDL levels.  Also avoid hydrogenated oils, which contain trans fats, because they can lower HDL levels.  Also make sure you get plenty of good exercise, since it can be helpful with your LDL levels.

Balance is the key to good health.  LDL is not bad for us, but because of our  lifestlyes, heavy meat consumption, and consumption of the wrong fats we are far out of balance.  As long as your HDL levels are healthy enough to keep up with your LDL levels, you can continue to lead a healthy life.  Taking control while it’s still early can help to avoid major problems down the road.  The best way to treat heart problems is prevention, so learning about LDL and HDL cholesterol levels before they become too unbalanced is a step in the right direction.

One pill that does it all.  Isn’t that what most Americans are looking for?  How about a powder that does a lot?  One research study showed that Nutrim powder might be as good as it gets without any crazy side effects. 

The Plan

The study was carried out in 38 middle aged, overweight males with high cholesterol and normal blood pressure.  The men were split into two groups which ate two diffent diets for 8 weeks.  The first group followed the American Heart Association (AHA) step II diet with low amounts of saturated fats and cholesterol and exercise.  The second group was given this diet with the addition of Nutrim oat bran. 

Nutrim and Cholesterol

The Nutrim group increased their HDL on average 10 points(27.8%), lowered their LDL 47(27.3%), and lowered their total cholesterol about 48 points.  The other group also saw improvements in LDL and total cholesterol, but the decrease was not as great as with Nutrim.  The other group did not see an increase in their HDL like the Nutrim group did.

Nutrim and Glucose

Fasting glucose also dropped 6 points in the Nutrim group where there was a slight increase in fasting glucose in the other group.   Both groups had significant weight loss, but the Nutrim lost more weight (13lbs compared to 8lbs in the other group.)

Tolerance of Nutrim

Even though the Nutrim was in a higher dose than normal it was well tolerated.  This study utilized Nutrim in bread, which had significantly better flavor and texture compared to the wheat bread in the other group as rated by the participants.

Total Cholesterol

Cholesterol is a substance that has many beneficial functions in the body.  When too much is consumed or produced by the body and not enough is removed you can end up with excessive amounts.  Cholesterol can build up in the arteries and cut off blood supply to the heart and other areas of the body.  Having healthy cholesterol levels has been shown to lower the risk of heart disease and stroke. 

LDL Cholesterol

LDL (low density lipoprotein) is a combination of fat (lipid) and protein. LDL is a carrier for fat and cholesterol. It takes fat and cholesterol from the liver and transports it through the bloodstream. It eventually drops of the fat and cholesterol off at the cells to be utilized. High levels of LDL cholesterol are a major risk factor for coronary heart disease.  The LDL cholesterol number is the main therapeutic target for intervention.  All of the other numbers on your blood test determine what approach the doctor will take in lowering LDL cholesterol.

HDL Cholesterol

HDL runs opposite LDL and carries fat and cholesterol from the cells, through the bloodstream, and to the liver to be metabolized or excreted. Low levels of HDL in the blood are an independent risk factor for coronary heart disease.  High levels of HDL protect the heart by carrying away cholesterol that could build up in the walls of the arteries. 

Triglycerides

Triglyceride is a term that describes a common way fat is found in the body. Triglycerides are three fat molecules attached to another molecule called glycerol. Generally, when the term triglycerides is used in your doctor’s office it refers to the amount of fat found in the blood. There is an association between high triglyceride levels and coronary heart disease.

http://www.mayoclinic.com/health/heart-disease/HB00016

http://www.americanheart.org/downloadable/heart/110141046508901%20CholLevls.pdf

One of the “good fats” is polyunsaturated fat.  This fat can be used a more health-conscious substitute for saturated fats.  It’s suggested that up to 10% of your caloric intake consists of polyunsaturated fats.  Research shows that a diet including moderation of polyunsaturated fats actually proves to be lower in LDL (or “bad”) cholesterol.

Too Much of a Good Thing is a Bad Thing

Polyunsaturated fats come from liquid fats.  If you’re careful, this fat can be considered “healthy.”  It can actually lower total and LDL cholesterol to help improve heart health.  However, if you include too much, this type of fat can make an unhealthy impact on your good cholesterol.  By reducing your HDL cholesterol beyond a healthy point, polyunsaturated fats can actually defeat the purpose of maintaing low LDL.

In addition to the issue with lowering HDL, polyunsaturated fats are still a form of fat, which means they carry some of the health threats that come with all forms of fat.  This is another reason it should only be the supply for a small portion of your caloric intake.  Any healthy diet calls for fat-control, so remember that there is such thing as “too much of a good thing.”

Out With the Bad, In With the Good

One of the major benefits of polysaturated fat is that it can be used as a substitute for saturated fats.  Rather than using the solids which are heavy in saturated fat, it is suggested that polysaturated fats are used.  This is why is it better to prepare a lean cut of meat marinaded with olive oil than to fry a a full-fat cut without oil.

It’s Natural!

Polyunsaturated fats are usually naturally-occuring.  They can be found in whole grain products, walnuts, olives, avocados, soy beans, as well as most kinds of fish.  Part of the reason health experts recommend fish oil pills to heart patients is because they serve as a reliable source of polyunsaturated fats called Omega-3 fatty acids and other good fats that help fight high cholesterol and heart disease.  These good fats can also be found in sunflower seeds and oil, olive oil and safflower oil.

An Essential to Heart Health

The National Institute of Health did research into the helpful qualities of polyunsaturated fats.  The main subject of the research was Omega-3 fatty acid, a polyunsaturated fat found in fish and certain plant seeds and oils.  The organization concluded that these were not only helpful, but in most cases necessary to a healthful approach to dietary needs.  However, the Institute also found that high doses over the recommended amount showed a decrease in overall health.

The “best” fat out there is monounsaturated fat.  While it is still a fat and shouldn’t be overdone, it’s the only fatty acid that has proven to reduce LDL cholesterol without hurting a good HDL level.  Of the fats, this one is most important to your diet and should be the largest portion of calories from fat.  Monounsaturated fats are vital to any heart-health regimen, as they are reliable reducers of unhealthy cholesterol.  Also, a person may consume more monounsaturated fat than others, because it takes more to cause harm.

A Natural Fat

Monounsaturated fats, like polyunsaturated fats, are for the most part naturally-occuring.  The primary benefit is, of course, its cholesterol-related activity.  However, monounsaturated fats are also high in beneficial fatty acids which can be helpful to healthy skin condition and reproduction of body cells.  These fats also are high in vitamin E, a nutrient which most Americans do no consume enough of.  These fats have also shown a potential for lowering risk of stroke.  Obviously, they’re a good thing.

It’s All Around Us!

This beneficial fat can be obtained from a number of different sources.  The number one source of monounsaturated fats is olive oil.  This is the speculative reason as to why heart disease and cholesterol problems are very low in the Mediterranean region, where olive oil is a staple of cooking.  Other sources of this helpful fat are canola oil, most nuts, nut-derived butters (like peanut butter), nut-derived oils, avocados, and whole olives. 

Moderation, Moderation, Moderation

Even with all the seemingly amazing benefits that it presents, there are risks to overdoing monounsaturated fats.  Like all other fats, they are high in calories.  By consuming too many, you may risk weight gain.  This once again puts you at risk for heart disease, which seems to be defeating the purpose of a heart-healthy diet.  With this in mind, experts suggest strict moderation of all fats, including monounsaturated fats.  Despite being healthy when rationed, it is not a complete cure.  It can actually pose as a risk.  So, keep in mind, moderation is a big deal with this heart-healthy stuff.

(In mg/dL)

As we stated in the previous post the main target for whether or not cholesterol therapy is recommended is based on your LDL cholesterol score.

LDL Target Goals

• Risk Factors LDL Goal (in mg/dL)
• CHD or CHD Equivalents < 100
• Multiple Risk Factors (2 or more) < 130
• 0-1 Risk Factors < 160

CHD Equivalents – As shown in the chart above these modify your LDL Goal

• Currently having a disease that involves atherosclerosis in other parts of the body (leg, neck, etc)
• Diabetes
• A combination of other risk factors that put you at >20% risk of having CHD in the next 10 years.

Risk Factors – These also Modify your LDL Cholesterol Goals

• Cigarette Smoking
• High Blood Pressure (>140/90 mmHG or on High blood pressure medication)
• Low HDL cholesterol (<40 mg/dL)
• Family History of Early CHD (Father or brother who had a heart attack before age 55 or a mother or sister who had a heart attack before age 65)
• Age
  • Male:  > 45
  • Female:  > 55

Cholesterol is produced by the body to help transport fat from the liver after it is absorbed into the body.  Some cholesterol, though, comes from food.  Most food-based cholesterol is often LDL.  LDL cholesterol travels to the cells, where it can cause damage and build-up.  HDL is carried away from the cells to the liver where it can be excreted.  Most of your body’s natural cholesterol is HDL. It is considered beneficial to have better HDL numbers and lower LDL numbers in cholersterol blood tests.

Get to Know Cholesterol

Arteriosclerosis is the the main contributor to cardiovascular disease and stroke, the number 1 and number 3 killers in America.  So what is cholesterol and is it a defect of the body that we make it? Understanding the answers to these questions can help us dispell some of our fear of cholesterol and give us a more well rounded understanding of how to approach the cholesterol issue.

Why Is It Important?

Cholesterol is a waxy substance that is produced by animals for a number of different functions in the body. It is the precursor to hormones such as estrogen, testosterone, progesterone, and cortisol, which are all valuable hormones.

We need cholesterol for the production of vitamin D in the body. We also use cholesterol to help stabilize the cell walls that surround each cell in our body. We need to think of the cells in our body as flexible, with a little bit of give to them. It may help to think about the difference between a sponge and a stone, or our skin and our bones. Our body likes to regulate how much give each cell has. Cholesterol is the key. Too much and our cells stiffen, and too little and our cells lose the ability to keep their form.

You can begin to see why too much cholesterol can lead to “hardening of the arteries.” This is not the whole story, but it helps show some of cholesterol’s role in heart disease and stroke.