High Cholesterol

High Cholesterol

The cholesterol story began in 1951, when the Pentagon sent pathologists to Korea to study the bodies of servicemen lost in the war there. The pathologists autopsied some 2,000 soldiers.

Although almost no one under 35 dies of coronary heart disease, more than 75 percent of the soldiers, average age 21, had yellow deposits of atherosclerotic plaque on their artery walls. These artery-clogging deposits, doctors had wrongly assumed, were only prevalent in much older men. The reports of the Army pathologists shocked the medical community. Before the Korea autopsies, doctors didn't realize how early the process of heart disease begins.

Not long afterward, a waxy substance in the blood--cholesterol--was identified as a major contributor to the buildup of plaque and to heart disease risk. More recently, scientists have discovered that for every 1 percent drop in cholesterol levels, there is a 2 percent decrease in heart attack risk.

Understanding the Numbers

The total cholesterol level of the average American is higher than 200 milligrams per deciliter (mg/dl) of blood. Because heart attack risk rises sharply above that level, the American Heart Association urges everyone to take measures to reduce cholesterol if it's anywhere near that high.

How far below 200 should you go to feel that your risk is significantly less? That's not entirely clear, but research suggests that very low cholesterol levels, below 150 or so, increase risk of death from other causes, including liver cancer, lung disease and certain kinds of stroke. My reaction is that people should strive for a cholesterol range of 170 to 190.

To make matters more complicated, there are two kinds of cholesterol--low-density lipoproteins (LDL), which increase risk of heart attack, and high-density lipoproteins (HDL), which actually reduce it. You want to get your total cholesterol down below 190. But if you have high cholesterol, your doctor may focus specifically on your LDL levels and have you work to reduce those, since the "bad" kind is most clearly linked to heart disease.

An estimated 25 percent of Americans have cholesterol levels high enough to place them at risk for heart attack, and 10 percent have levels so high that doctors are quick to prescribe drug treatments. But they're far less likely to tell you the Green Pharmacy ways to reduce your heart disease risk.

Fiber Power

Any and probably all plant fibers can lower cholesterol. That means eating a diet that includes lots of fruits, vegetables and whole grains, hopefully one with a minimum of fats.

In one study, a high-fiber supplement (Fibercel, which is still being tested and not available for commercial sale) was added to the diets of laboratory hamsters, enough to constitute 5 percent of their daily calorie intake. The Fibercel lowered their total cholesterol by 42 percent and their "bad" LDL cholesterol by 69 percent. Beneficial HDL increased 16 percent.

Oat bran has gotten a lot of publicity as a cholesterol reducer, but it's just one of many high-fiber foods. Fruits, vegetables and grains have similar effects. In fact, oat bran is far from the best fiber for lowering cholesterol. Hamsters fed a diet with 5 percent oat bran showed reductions in total cholesterol and LDL of only 19 and 29 percent, respectively, a weak showing compared with that obtained with Fibercel.

The components of oat bran that lower cholesterol are beta-glucans. But here again, oat bran is not the richest source. Barley contains up to three times more beta-glucans than oats, and beans are also significant sources.

The good news is that often it isn't necessary to resort to drugs. There are plenty of foods and herbs that can help bring cholesterol levels down.

Green Pharmacy for High Cholesterol

Along with getting adequate fiber from the foods you eat, there are a number of individual foods and herbs that can prove helpful.

Carrot (Daucus carota) and other foods containing pectin. Scottish studies showed that over a period of three weeks, a daily snack of two carrots lowered cholesterol levels by 10 to 20 percent in study participants. Carrots are high in the fiber pectin. Other good sources of pectin include apples and the white inner layer of citrus rinds. Enjoy these foods on a daily basis. (Yes, if you're eating an orange, nibble on a little of the white stuff.)

I know that juicing is really big these days, so I'd like to offer a little advice. If you want to take these fruits and vegetables in beverage form, fine. But don't use a juicer on them if you want to get the full benefit of their pectin content. Just whir them in a blender instead. If you use a juicer, you extract most of the fiber, and only about 10 percent of the cholesterol-lowering pectin remains.

You can also take supplements. University of Florida scientists reported that three tablespoons of grapefruit pectin daily, taken in capsules or as a food additive, can lower cholesterol by about 8 percent. If you go the supplement route, however, you should be aware that this type of fiber interferes with the uptake of certain important nutrients, including beta-carotene, boron, calcium, copper, iron and zinc. This is less of a problem when you consume the whole plant, because the plant itself supplies extra nutrients. But if you take pectin capsules, remember to eat your fruits and vegetables at a later meal to make sure you don't trigger any deficiencies.

Avocado (Persea americana). Avocado is one of the highest-fat fruits, so people with heart disease often avoid it. But according to a report in the Lawrence Review of Natural Products, a respected newsletter, avocado can help reduce cholesterol. In one study, women were given a choice of a diet high in
monounsaturated fats (olive oil) with avocado or a diet rich in complex carbohydrates (starches and sugars.) After six weeks, those on the olive oil-avocado diet showed an 8.2 percent reduction in cholesterol.

I'm not advocating that you should cut back on complex carbohydrates, which are important to a healthy diet, but I am suggesting that you enjoy an occasional avocado. It contains some unique chemicals that you may not be getting elsewhere.

Beans (Phaseolus, various species). Beans are high in fiber and low in fat--just the ticket for lowering cholesterol. And they contain lecithin, a nutrient that also helps cut cholesterol. One study showed that a cup and a half of dried lentils or kidney beans a day, about the amount in a bowl of bean soup, can lower total cholesterol levels by 19 percent.

Celery (Apium graveolens). In one study, researchers fed laboratory animals a high-fat diet for eight weeks, which raised their cholesterol levels. Then they gave some of them celery juice. The juice significantly lowered total cholesterol and LDL levels in the animals. It isn't clear whether eating celery would help reduce cholesterol levels in humans, but it certainly can't hurt to include more of this delicious vegetable in your diet.

Garlic (Allium sativum) and onion (A. cepa). Many studies show that the equivalent of one clove of garlic a day (or half an onion) lowers total cholesterol levels by 10 to 15 percent in most people. In one study, people given 800 milligrams (about one clove) of garlic daily experienced lower cholesterol levels as well as lower blood pressure. Garlic is an approved remedy in Europe for cardiovascular conditions, especially high cholesterol.

In another study, two to three tablespoons of onion oil a day helped to lower cholesterol in about half of people with moderately high cholesterol. Their blood cholesterol levels fell 7 to 33 percent while they were taking the onion oil.

It sounds to me as if it would be a good idea to include generous amounts of both of these tasty herbs in your daily diet.

Ginger (Zingiber officinale). Many studies show that ginger helps lower cholesterol. Why not add some ginger to spice up other cholesterol-lowering foods?

Fenugreek (Trigonella foenum-graecum). This herb is rich in a soothing fiber called mucilage. Its cholesterol-lowering activity has been demonstrated in laboratory experiments with animals and has also been demonstrated in humans.

Nuts. You might think that people with high cholesterol should avoid high-fat nuts, but a study of more than 25,000 Americans showed that those who eat the most nuts are the least likely to be obese. These subjects were all healthy, so I wouldn't recommend nuts to those with heart disease or high blood pressure. But for reasonably healthy folks, nuts don't seem to do much harm and are better than too much meat.

It's possible that the nuts help produce feelings of satiety. Walnuts, for example, contain the neurotransmitter serotonin, which is involved in the sensation of satiety.

High nut consumption, by the way, was also associated with lower incidence of fatal and nonfatal heart attacks. This should be of interest to anyone who is at risk because of high cholesterol levels.

Safflower (Carthamus tinctorius). One study showed that switching from other oils to safflower oil for eight weeks reduced total serum cholesterol levels by 9 to 15 percent and LDL cholesterol by 12 to 20 percent.

Sesame (Sesamum indicum). All plants contain phytosterols, compounds that can be absorbed into the bloodstream, nudging out some of the cholesterol that's there. In my database, the food that shows up the highest in phytosterols (based on dry weight) is sesame seeds.

Other foods that contain high amounts of phytosterols, in descending order of potency, include lettuce, sunflower seeds, hazelnuts, cucumbers, asparagus, okra, cauliflower, spinach, figs, onions, strawberries, pumpkin or squash, radishes, apricots, tomatoes, celery and ginger.

You could easily use this information to concoct cholesterol-lowering salads and soups to replace cholesterol-raising meats. A high-phytosterol fruit salad, for example, would include figs, strawberries and apricots with ginger.

Shiitake (Lentinus edodes). These delicious mushrooms contain the compound lentinan. According to the Lawrence Review of Natural Products, lentinan has cholesterol-lowering action, along with anti-tumor, antiviral and immune-stimulating effects. In experimental animals given a low dose of a compound related to lentinan, cholesterol levels fell 25 percent.