The Stress Factor
"Stress will always increase cholesterol," says Peter Langsjoen, MD, a researcher and integrative cardiologist in Tyler, Tex. Stress triggers more production of cortisol, the fight-or-flight hormone, he explains, and because cholesterol is a building block of the hormone, the body must produce more cholesterol to satisfy extra cortisol demand. As an example, Studies of accountants show that their cholesterol levels increase significantly at tax time.
Exercise and diet don't always reduce cholesterol. And reducing cholesterol doesn't necessarily lower heart disease risk. However, "Reducing stress levels will always lower cholesterol," says Langsjoen.
Cholesterol-lowering statins are the best-selling family of drugs in the history of medicine, with annual sales exceeding $27 billion. But dollar figures don't reflect human costs, namely the side effects of liver damage, memory impairment, muscle weakness, and pain. Although listed on product packages, such statin-related symptoms are often dismissed by doctors, according to research at the University of California, San Diego, which also found the drugs can cause severe irritability, insomnia, and nightmares.
Many people who start taking statins don't continue, and seek natural approaches, most often through diet. For example, the majority of people who look for drug alternatives online search for cholesterol-lowering foods and diet plans, rather than information about dietary supplements and exercise. What you may be surprised to learn, however, is that supplements and exercise, along with weight loss, can be important components for moderating cholesterol and maintaining a healthy heart. "Your body manufactures five times more cholesterol than you can take in from food," says Richard Collins, MD, cardiologist and director of wellness at South Denver Cardiology Associates. And that manufacturing process can be controlled. Read on to discover ways to easily get a handle on high cholesterol-and protect your precious heart in the process.
"Exercise makes the liver burn fat in the bloodstream as energy," says Collins. In essence, the liver multitasks all the time, and making cholesterol is only one of its duties. When you exercise enough, or when you eat fewer calories than you burn (which results in weight loss), the liver has to work harder to generate energy, and cholesterol production decreases. It's somewhat like a person multitasking; when one task demands more attention, other tasks drop in priority. With exercise and calorie reduction, cholesterol production gets lower priority on the liver's "to-do" list.
Exercise can also raise HDL ("good") cholesterol and reduce triglycerides, another type of blood fat that doctors check along with cholesterol. Elevated triglycerides are associated with increased risk for diabetes and stroke, and in rare cases, extremely high levels of this blood fat can lead to pancreatitis, an inflammation of the pancreas.
Exercise reduces levels of triglycerides and can help to normalize cholesterol. To reap these benefits, Collins recommends a 45-minute workout, three times a week, including aerobic and resistance exercise.
Eat Smart: Top Foods and Remedies for High Cholesterol
When it comes to food, all the basics of a healthful eating plan are recommended for managing high cholesterol: limiting saturated fats, eating fish and nuts for healthful fats, choosing unrefined carbohydrates, limiting sugary foods, and eating plenty of fruits and vegetables. For fiber, Collins recommends flaxseed, as it contains healthful omega-3 fats. And, he says, consider replacing some animal protein with soy "meats." To reduce triglycerides, cut back on carbohydrates, especially the refined or sugary types.
Collins also recommends these special foods and supplements:
A waxy substance found in plants, sterols are added to many cholesterol-lowering foods. Research shows that 2 grams daily of plant sterols can lower cholesterol by 8 to 14 percent, and there are many types of foods with added sterols: English muffins, bread, granola bars, milk, rice milk, low-fat cheese, orange juice, buttery spreads, yogurt, some snack foods, and chocolate. Sterols, which can be taken with statins, are also available as dietary supplements. Plant sterols need to be in an esterified form in foods.
Omega-3 fats in fish oil can raise HDL and reduce triglycerides by 20 to 50 percent, according to Collins. Essential for overall and heart health, omega-3 fats also help to control blood pressure and reduce inflammation, and are a key nutrient for preventing heart disease, diabetes, and virtually all other chronic health conditions. If you don't eat fish on a regular basis, aim to get 1,500 mg of omega-3 oils (not just fish oil) daily. Enteric-coated fish oil pills are designed to dissolve more slowly and eliminate fishy aftertaste.
One or two cloves a day of fresh garlic can help to get cholesterol in line, and there are a variety of garlic supplements. Studies of garlic's cholesterol-lowering abilities are not totally consistent but on average, according to Collins, garlic can reduce cholesterol by 4 to 12 percent in anywhere from 4 to 25 weeks. He recommends 200 to 400 mg, three times daily, of a standardized garlic powder with 1.3 percent allicin content. Aged garlic extract (see p. 34 for more detailed information) is another option.
Red Yeast Rice
Part of the cholesterol-lowering property of red yeast rice comes from a statin that is naturally present in the supplement. Because the natural statin works the same way as statin drugs, by inhibiting an enzyme the liver requires to produce cholesterol, red yeast rice can, potentially, cause liver problems, but to a lesser degree than statin medications. Other natural ingredients in red yeast rice provide benefits above and beyond the statin effect. The typical dose is 1,200 mg twice daily with food. Red yeast rice should not be taken with statin drugs. You will want to take 75 mg of CoQ10 per day as well. Like statins, red yeast rice can lower CoQ10 levels, but to a lesser degree.
Derived from sugar, policosanol, says Collins, reduces production and recycling of cholesterol in the liver, and can lower LDL ("bad") cholesterol by 11 to 31 percent and increase HDL cholesterol by 7 to 9 percent. Because the supplement is also an anticoagulant, it can increase risk of bleeding if taken with blood-thinning medications such as aspirin or warfarin. The usual dose is 5 to 10 mg twice daily, and may take up to 12 weeks to produce measurable effects.
The guggul plant has a long tradition of use in Ayurvedic medicine for prevention and treatment of disease. Today, various forms of the plant are found in supplements to promote healthful cholesterol levels. By reducing absorption of dietary fat, says Collins, guggul can lower total and LDL cholesterol by 11 to 12 percent and triglyceride levels by up to 16 percent. Supplements may contain different forms of guggul, labeled as guggulipids, guggulsterones, or guggul gum, and dosages will vary, so follow product directions. Guggul can cause stomach upset, nausea, and headache, which is mostly a result of using the crude extract. These symptoms do not occur with a standardized extract. It can also reduce the effect of some blood-pressure-lowering medications.
Also known as vitamin B3, niacin, in high doses, can raise HDL cholesterol and lower triglycerides. Because therapeutic, high doses can also cause some side effects, such as uncomfortable flushing, stomach upset, and in rare cases, liver dysfunction, it's advisable to work with a health care professional when using niacin as cholesterol therapy.
Try Special Cholesterol Busters
These proprietary ingredients, available as stand-alone supplements and in combination formulas with other heart-healthful ingredients, such as CoQ10 or plant sterols, can also help:
Two types of nutrients in Sytrinol, citrus bioflavonoids (beneficial nutrients in citrus fruits) and tocotrienols (nutrients in the vitamin E family that are extracted from the fruit of the palm tree), have a synergistic effect in promoting heart health. Both bioflavonoids and tocotrienols, studied individually, have been found to lower cholesterol. In Sytrinol, a proprietary combination of the two ingredients, they work together as an antioxidant, improve cholesterol levels, lower triglycerides and inflammation, and reduce plaque deposits and platelet aggregation.
Three studies, published in Alternative Therapies in Health and Medicine, examined the effects of Sytrinol on a total of 190 people. Researchers found that 300 mg daily of the supplement reduced levels of total cholesterol by 20 to 30 percent, reduced triglycerides by 24 to 34 percent, and increased HDL ("good") cholesterol by up to 4 percent, as well as reducing inflammation.
Aged Garlic Extract
A proprietary form of garlic, aged garlic extract (AGE) has been tested on people with high cholesterol who were taking statin drugs and aspirin. In one study, published in the Journal of Nutrition, participants took 1,200 mg daily of AGE or a placebo in addition to their medications. Risk for heart attack among those taking AGE was 1.5 times that of healthy people, compared to a whopping 13-fold risk among people who took only statins and aspirin.
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