All About Cholesterol
Cholesterol Defined:
Cholesterol is a steroid compound produced in the liver to be delivered systemically. You may be familiar with measures like “total cholesterol” or subtypes like LDL (low-density lipoprotein), HDL (high-density lipoprotein), and VLDL (very low-density lipoprotein). HDL, LDL, and VLDL are lipoproteins, meaning they are part lipid (fat) and part protein. The lipids need to be attached to the proteins in order to travel systemically through the blood. Our bodies need a maintained amount of cholesterol to help manufacture hormones, vitamin D, and certain substances that help the body digest food.
· LDL – Termed “bad” cholesterol; functions to systemically deliver cholesterol to your tissues for cell maintenance/repair and steroid synthesis. High LDL levels lead to plaque buildup in the arteries (atherosclerosis).
· HDL – Termed “good” cholesterol because of it’s scavenging activity; carrying cholesterol from your tissues back to your liver. Your liver then removes the cholesterol from your body.
· VLDL– Although termed “bad” cholesterol, VLDL mainly carries “Triglycerides”. VLDL also contributes to the plaque buildup in the arteries.
Why healthy cholesterol levels are important:
Cardiovascular disease is still the number one culprit for taking the lives of Americans. The majority of heart attacks occur because of atherosclerotic plaque, but atherosclerosis can remain asymptomatic, causing delay of treatment until it is largely progressed. If large deposits of plaque in your arteries are present, any area of that plaque can rupture or break away, giving rise to a blood clot to form on the surface of that plaque. If this clot enlarges enough, it can block your coronary arteries, which provide a fresh oxygen blood supply for the heart. When this oxygen-rich blood is blocked from your heart cells, chest pain (angina) or heart attack occurs. Plaque buildup can also happen in other areas of the body, leading to carotid artery disease, stroke, and peripheral artery disease.
Cholesterol Support
When cholesterol is elevated, this may be the body’s route of signaling an underlining inflammation or infection. This inflammation stems from a climate of stress within the body, whether it be gastrointestinal, cardiovascular, or etc. Oftentimes, visceral fat (fat accumulation around internal organs) is a hidden culprit of releasing more inflammatory markers, hormones, and immune reactivity into the blood stream. Reducing oxidative stress, with better stress management skills and antioxidant support can help moderate inflammation status and cell damage. Further studies show food intolerances, low thyroid function, low testosterone, low vitamin D levels and low B12 status as factors for managing cholesterol. Interestingly, estrogen is protective in managing lower LDL levels, which can help explain why high cholesterol is commonly seen in women after menopause.
To get a full and holistic picture of your metabolic health and your personal risk for CVD related events, specialty lab testing like hsCRP, ApoB, adiponectin, leptin, insulin, and homocysteine can be looked at in addition to the standard lipid profile.
Diet-exercise-stress reduction-inflammation-anti-oxidants-metabolism-hormones
Choosing a diet that is high in fiber and phytosterols/phytonutrients, and is rich in omega 3 fatty acids will benefit all factors of cholesterol health. Maintaining a balance of higher omega 3 to omega 6 ratio relates to an overall lower inflammatory profile. Fish oil contains high quantities of omega-3, and has been found through studies to reduce inflammation, lower triglyceride levels, and increase LDL size, thus restoring LDL cholesterol to healthier levels. Adding flaxseed in your diet, either its seeds or oil are also beneficial in raising your HDL levels. Additionally, supporting liver health through incorporating bitter greens and herbs such as dandelion root and artichoke, can support healthy cholesterol production and metabolism. Exercise is furthermore linked with lowering heart disease risk factors, as well as lowering LDL cholesterol levels and increasing HDL cholesterol levels.
Finding a personalized approach is key in supporting healthy cholesterol levels. Naturopathic medicine can be incredibly helpful for investigating the multi-factorial root causes of high cholesterol, as well as, determining how best to reduce your risk through a preventative and individualized lens. In our extended visits, we can dive into intensive dietary and lifestyle counseling that makes an incredible impact on outcomes. Compared with participants in the control group, at 52 weeks those in the naturopathic group had a reduced adjusted 10-year cardiovascular risk and a lower adjusted frequency of metabolic syndrome.
Dr. Nicole Shusterman, ND and Dominique Alexander
References:
1. Stephen W. Parcell, ND. (2013 September). Preventive Cardiology. https://www.naturalmedicinejournal.com/journal/2013-09/preventive-cardiology
2. Groeneveld, I., Proper, K., Van der Beek, A., Hildebrandt, V., & Van Mechelen, W. (2010). Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease – a systematic review. Scandinavian Journal of Work, Environment & Health, 36(3), 202-215. Retrieved May 31, 2021, from http://www.jstor.org/stable/40967848
3. Blood Cholesterol. https://www.nhlbi.nih.gov/health-topics/blood-cholesterol
4. Kawakami Y, et al. (2015). Flaxseed oil intake reduces serum small dense low-density lipoprotein concentrations in Japanese men: A randomized, double blind, crossover study.
ncbi.nlm.nih.gov/pubmed/25896182
5. Ruiu G, et al. (2008). Phytosterol-enriched yogurt increases LDL affinity and reduces CD36 expression in polygenic hypercholesterolemia.
ncbi.nlm.nih.gov/pubmed/18998188
6. Seely D, Szczurko O, Cooley K, et al. Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial [published correction appears in CMAJ. 2016 Sep 6;188(12 ):901]. CMAJ. 2013;185(9):E409-E416. doi:10.1503/cmaj.120567