Natural Cholesterol Lowering

Keeping cholesterol levels healthy is a key factor in maintaining a healthy heart and circulatory system. After much consideration by the authorities of both the risks and benefits of statin drugs for cholesterol lowering, they have been made freely available without prescription from your Pharmacist. However, as potent and licensed medicines there are risks of side effects, and although rare, they can also be very serious indeed.

For this reason many people prefer to seek alternative ways to lower cholesterol before taking up the statin option. The good news is that there are plenty of effective and natural approaches that can be used to lower and maintain cholesterol levels.

Cholesterol Lowering Diets

Modifying the diet to avoid cholesterol rich foods is always a positive first step towards reducing cholesterol and triglyceride levels. In particular, avoiding foods such as shellfish, fatty meats and meat products such as sausages, pate, as well as unhealthy foods which are high in refined carbohydrates is a lifestyle change every individual can take.

However, dairy foods and hard cheese are particularly high in cholesterol, and are also a primary source of calcium in the diet. Avoiding all dairy products is likely to result in a calcium deficiency, and this is potentially an issue in relation to both the health of the heart and circulatory system, as well as the health of bones. Calcium is an essential nutrient for normal cardiovascular function, and a long term deficiency can also increase the risks of developing osteoporosis. Therefore, the best option with respect to dairy foods and cholesterol lowering is to select low fat options wherever possible. If dairy foods are cut out altogether, try to substitute with other calcium rich foods or consider taking a daily calcium supplement to achieve at least the Recommended Daily Allowance of 800mg/day.* with an optimal intake in the region of 1200 – 1500 per day for most people.

In addition to these steps, increasing the dietary intake of Phytosterols in the daily diet can reduce cholesterol levels by 10% or more. For maximum cholesterol lowering benefit, these phytosterol rich roods should be eaten about half an hour before a meal with cholesterol content, such as meat. If phytosterol rich foods are eaten at the same time as foods containing cholesterol they will still produce cholesterol lowering effects, but to a lesser extent.


Phytosterols - What Are They And Why Do They Lower Cholesterol?

Phytosterols, and in particular Beta-Sitosterol are the plant world’s equivalent of cholesterol. In terms of chemical structure, Beta-Sitosterol and cholesterol are very nearly identical to each other. However, the key difference as far as we human beings are concerned is that our body cannot burn beta-sitosterol and other phytosterols for energy, and the body can only absorb a very small amount of beta-sitosterol into the bloodstream.

When we eat foods rich in beta-sitosterol and other sterols, the evidence suggests that these compounds occupy the special cholesterol and fat absorption sites in the intestines and block cholesterol from being taken up into the bloodstream. Instead, the cholesterol is excreted with other waste matter. This reduces the amount of LDL ‘ bad’ cholesterol absorption from the diet, reducing blood cholesterol levels overall.

However, our body does need some cholesterol for health and metabolism. Therefore, once the amount of LDL cholesterol in our bloodstream falls too low, the body will compensate by increasing its production of HDL or ‘good’ cholesterol to maintain total or overall cholesterol levels at the correct balance that is needed for health.

A very small amount of beta-sitosterol is absorbed by the body (about 10%), and is broken down by the liver and excreted.


So What Foods Are Rich In Phytosterols? How Can They Be Increased In The Diet?

Phytosterols are found to a small extent in all plants, but in high concentrations in nuts, seeds and wholegrains. Unfortunately, modern food processing methods remove more than 90% of these substances from foods so to increase these naturally, opt for unprocessed, wholegrain foods which includes plenty of beans and pulses and organic unprocessed wholegrain rice or soy. Alternatively there are now a number of phytosterol enriched foods available on the market, such as yoghurts and spreads. However, whilst these will limit cholesterol absorption from these food types which are also sources of calcium such as yogurt drinks etc, they need to be consumed about half an hour before any main meals to have a maximal effect on cholesterol absorption from meat and meat products.

As an additional alternative, there are also beta-sitosterol food supplements available extracted from soy and rice which can be taken with a glass of water half an hour before a meal. The advantage of these is that they are concentrated forms of phytosterols with no added calorie content, and it is easier to assess how much you have increased your dietary phytosterol intake.

Studies show that for the best cholesterol and triglyceride lowering effects, between 1 - 2g of phytosterols need to be consumed every day.

Are There Any Other Effects Of Increasing Phytosterols In the Diet?

There are quite a few clinical and epidemiological (population group) studies that show that increasing dietary phytosterols can have benefits in helping to keep the male prostate gland healthy and reduce the symptoms associated with a condition called Benign Prostatic Hypertrophy. Whether these benefits are in fact more associated with an overall reduction in cholesterol levels (which is also positively linked to a reduced risk of prostate disease) or arise from other mechanisms of action of beta-sitosterol in the blood is not yet fully clear. What is known is that the activity of 5 alpha reductase, (the enzyme that converts testosterone to dihydrotestosterone (DHT)) within the prostate is reduced when dietary phytosterol content is high; this is important as elevated levels of DHT are known to stimulate excessive prostate cell growth. Additionally, beta-sitosterol has a particular affinity for prostate cell membranes, and appears to block the passage of cholesterol into prostate cells reducing DHT production. Increased DHT production is also linked to elevated cholesterol levels and elevated levels of DHT are also linked to Male Pattern Baldness. Traditional herbal remedies such as Saw Palmetto are thought to exert their beneficial effects primarily as a result of their beta-sitosterol content.

Safety

There have been over a 1000 different studies on beta-sitosterol and its cholesterol lowering effects, and no serious side effects have been recorded from increasing dietary levels. Individuals can expect stools to become softer however, as more cholesterol is excreted.

A small number of people suffer from a genetic condition called sitosterolaemia, which means that they cannot metabolise and excrete absorbed sterols, and a build up occurs. This is a condition that tends to be identified in early life as these components are widely found in the diet and is very rare. Anyone who suffers from this condition is simply advised to avoid foods containing phytosterols.

How Does Increasing Phytosterols In the Diet Affect Someone Already Taking A Statin?

Phytosterols work by reducing the amount of cholesterol that can be absorbed from food, whereas Statin drugs work inside the body on the processes that control Cholesterol metabolism. As a result of this, whilst there is no evidence of a direct interaction between statins and phytosterols, the cholesterol lowering effects of each approach are additive.

So that your health providers can monitor and look after health properly, they always need to know if an individual has chosen to increase phytosterols through either diet or supplements, as this may mean that a lower dose of statins may be advisable, and this should be monitored.

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