The New Rules for Lowering Your Cholesterol

This report will clear up a lot of myths about cholesterol--where it comes from, what drives it up, and how you can bring it down, safely and easily. You may be surprised by a lot of what you read here. The latest research has reversed a lot of older ideas about cholesterol. One piece of good news is that you don't have to follow a strict, flavorless diet to keep your cholesterol levels down.

The primary source of cholesterol

First of all, let¡¦s talk about where cholesterol comes from--and where it doesn't. Cholesterol is found in many of the foods we eat. It occurs naturally in animal products, including meat, fish, and dairy products. (There is no cholesterol in plants.) But most of the cholesterol in your body right now did not come from your diet. It came from your liver.

Cholesterol is manufactured in the liver. In fact, your liver produces about 1000 milligrams of cholesterol every single day! By contrast, the average diet provides anywhere from 200 to 500 milligrams per day. But here¡¦s the thing that many people don¡¦t understand about lowering cholesterol. Your liver is programmed to keep the amount of cholesterol in your body at a certain level.

Amount of cholesterol in common foods:

Food Cholesterol Level

3 ounces beef liver 336 mg
1 large egg 212 mg
3 ounces steak 75 mg
3 ounces pork loin 70 mg
1 skinless chicken breast 44 mg
1 ounce cheddar cheese 30 mg
1 tablespoon butter 30 mg
1/2 cup ice cream 12 mg
1 cup lowfat milk 12 mg
1 egg white 0 mg
1 tablespoon olive oil 0 mg
1 cup orange juice 0 mg
Grains 0 mg
Fruits 0 mg
Vegetables 0 mg


It¦s very much like the thermostat in your house. If you set your thermostat to 70 degrees, your furnace will turn on whenever the temperature in the house dips below that temperature. If the weather outside is fairly mild, the furnace may only run a little bit. If the weather gets colder, the furnace will produce have to produce more heat to hold the indoor temperature steady.

Likewise, the amount of cholesterol produced in your body is affected by how much cholesterol you take in from your diet. If you eliminate most or all of the cholesterol from your diet, your liver will increase its production to make up the difference. If you eat more cholesterol, your liver will decrease production. The amount of cholesterol in your blood will stay roughly the same.

If you have high cholesterol, the problem is not necessarily that you eat too much cholesterol from dietary sources. More likely, it¡¦s because your body's cholesterol thermostat is set too high. Regardless of what you eat, your liver will be trying to keep your cholesterol levels at that high level. So you see why a low cholesterol diet is not the most effective solution.

One strategy for fighting high cholesterol is to reduce the amount of cholesterol that can be produced in the liver by slowing down the cellular assembly line. There¡¦s a specific enzyme, called hydroxyl-methyl-glutaryl coenzyme A reductase (or HMGR for short), that is required for cholesterol synthesis. Prescription cholesterol-lowering drugs like Lipitor work by blocking the activity of this enzyme. The drugs park themselves in the cellular parking spot reserved for HMGR. If HMGR can't enter the cell¡¦s cholesterol factory, the entire assembly line is shut down.

A more natural approach to lowering cholesterol

Another, more natural way to control cholesterol production is with natural plant extracts, such as phytosterols. These compounds don't keep HMGR from parking in its designated parking spot. They simply decrease the amount of HMGR in the blood. In other words, less HMGR shows up for work. The cholesterol assembly line functions naturally, just at a slower rate. In a recent study in the Journal of the American Medical Association, researchers found that phytosterols are as effective as cholesterol-lowering medications in cholesterol levels.

Almost all plant foods contain some sterols but the best dietary sources are raw almonds, cashews, peanuts, sesame seeds, and sunflower seeds, green peas, barley, buckwheat, and rice bran. Still, in order to get enough plant sterols to have a beneficial effect on cholesterol, you'd have to eat several pounds of these foods, every day. Taking phytosterols as a nutritional supplement is a more realistic solution. Researchers recommend 800 milligrams daily, preferably in capsule form.

Another natural approach is to increase your intake of polymethoxylated flavones (PMFs). These are compounds that occur naturally in certain citrus fruits (especially in the peels) and in palm kernels. Seeing as these aren't a regular part of most people's diet, supplements are the easiest way to ensure an adequate intake of these heart-protective nutrients.

I recommend the use of Sytrinol, which is a patented formula of citrus and palm fruit extracts. It contains a rich mix of PMFs, including nobiletin, tengeretin, and tocotrienols (alpha, beta, delta, and gamma). 300 mg per day is the recommended amount for greatest benefit.

Sytrinol has three different and complementary mechanisms of action that benefit the heart.

1. Polymethoxylated flavones (PMFs) decrease apoprotein B, a protein your body needs to make LDL cholesterol. (Lipids, Vol 39. no2., 2004)

2. Tangeretin and nobiletin decrease diacylglycerol acetyl transferase (DGAT), a liver enzyme that helps manufacture triglycerides. (Lipids, Vol 39. no2.,2004)

3. Tocotrienols inhibit HMG CoA reductase, a liver enzyme that your body uses to manufacture LDL cholesterol. (Parker et al., 1993; Qureshi et al.,2002)

Researchers believe that it is the synergistic combination of all three of these mechanisms that produces the total cholesterol, LDL cholesterol, and triglyceride-lowering effect seen in clinical trials.

Summary of research findings on Sytrinol:

Reduced total cholesterol by an average of 25%

Reduced LDL cholesterol by an average of 22%
Reduced triglycerides by an average of 28%
Reduced LDL/HDL ratio by an average of 25 %

Sytrinol has more than a dozen years of research and over a hundred studies supporting its use in promoting healthy cholesterol levels. It works within your cells to reduce cholesterol, which means that it is not affected by your dietary choices.

Reduce cholesterol without reducing fat

As you have seen, a strict, low-cholesterol diet is not a very effective treatment for high cholesterol. It¡¦s much more effective to reduce the amount of saturated fats in your diet. (Whole milk, cheese, cream, butter, and fatty cuts of meat and poultry are the chief sources of saturated fats.) Reducing the intake of saturated fat has been proven to lower LDL cholesterol. But I'd like to debunk another common myth: You don't have to eat a low-fat diet to control cholesterol. You can simply replace saturated fats with heart-healthy fats.

Fat is not the enemy. In fact, eating more of the right fats can help normalize cholesterol. While saturated fats tend to increase cholesterol, unsaturated fats tend to lower LDL (bad) cholesterol and raise HDL (good) cholesterol. When you substitute these healthier unsaturated fats for saturated fats, you can continue to eat a moderate-fat diet and still control cholesterol

Replacing saturated fat with healthy fats:

Replace this                                           with this
butter                                                    olive oil
regular mayonnaise                              canola or soy mayonnaise
red meat                                               salmon
cheese                                                  nuts
sour cream                                           avocado

The most dangerous fat of all Saturated fats (those found in meat, dairy, and eggs) contribute to high cholesterol and heart disease. Unsaturated fats (such as those found olive and vegetable oils, soybeans, nuts, avocados, and cold water fish) help to lower cholesterol and reduce the risk of heart disease. But there is one other type of fat we haven't discussed yet. It may be the most dangerous type of fat of all.

Trans fats do not occur naturally in foods. They are an unnatural type of fat formed when natural fats are heated to high temperatures (fried) or chemically manipulated (hydrogenated). Trans fats behave like saturated fats in the body¡Konly far worse. If you want to have a healthy heart, you must eliminate trans fats entirely and replace them with healthy fats such as those discussed above.

One of tricky things about trans fats is that they can be hidden in foods that we think of as healthy, like bran muffins or whole grain bread. Even foods that contain no cholesterol or saturated fat may still contain trans fats.

Up until recently, manufacturers didn't have to list trans fats on the nutrition label. Trans fats are so dangerous, however, that the government has now changed the labeling requirements for packaged foods. Starting in 2006, manufacturers will be required to list the amount of trans fats on the label. Already, many food makers have changed their manufacturing process to eliminate trans fats from their foods. I think that trend will continue, especially once the manufacturers are required to list trans fats on their labels.

In the meantime, you can identify trans fats with a little label sleuthing. If you see the words: hydrogenated oil, partially hydrogenated oil, or vegetable shortening, on the package, you can be certain that food contains trans fats and should be avoided.

Foods that may contain trans fats

Food Amount of trans fats per serving
Bakery items 1-6 grams
Breads up to 1 gram
Cake mixes 3-4 grams
Candy 6 to 9 grams
Chicken pot pie 16 grams
Microwave popcorn 9 grams
Crackers 1-3 grams
Doughnuts 3 grams
French fries 5 grams
Fried chicken 8 grams
Margarine 5 to 8 grams
Potato chips 5 grams
Salad dressing 2 grams
Shortening 7 to 9 grams

The kind of cholesterol you want MORE of

Another myth about cholesterol is that lower is always better. Not true! Your body needs cholesterol to function. It is critical to cell-to-cell communication and hormone balance. That's why your liver makes sure you have an abundant supply, no matter how much or little cholesterol you get in your diet.

Ideally, your cholesterol levels should be balanced! Not too high or too low. The optimal range for total cholesterol is below 200 mg/dL. But the latest research shows that the total cholesterol is not the most accurate picture of your heart health.

Cholesterol travels through your body in different types of packages or carriers. The two most important are high-density lipoproteins (HDLs), and low-density lipoproteins (LDLs). You have probably seen HDL called the good cholesterol and LDL called the bad cholesterol. Here's why.

LDLs carry cholesterol from the liver through the bloodstream to cells throughout the body. Normally, when the LDL reaches a target cell, it taken up by receptors on the cell¡¦s surface and the cholesterol is put to work inside the cell. If there are too few LDL receptors on the cells, less is taken up by the cell and more cholesterol stays in circulation. When cholesterol builds up in arteries and contributes to heart disease, it is always excess LDL that causes the problem. You want to keep your LDL cholesterol low.

HDLs work in the opposite direction, picking up excess cholesterol and carrying it back to the liver to be recycled. You want your HDL cholesterol to be high. The higher your HDL cholesterol, the lower your risk of heart disease. In fact, low HDL cholesterol can be even more dangerous than high LDL Even if your total cholesterol levels are normal, having low HDL puts you at an increased risk of heart disease.

In addition to reducing saturated fats and increasing your intake of phytosterols, you can help keep HDL levels up by exercising regularly and maintaining a healthy weight.

What is a healthy cholesterol level: the latest guidelines

When you have your cholesterol levels checked, the results will probably include your total cholesterol, your LDL and your HDL. They may also measure the amount of triglycerides in your blood. Triglycerides are the form of fat that your body uses for energy or stores as body fat. Together, these numbers can tell you a lot about your risk of a future heart attack. Here are the the latest, revised figures released by the National Institutes of Health.

Total Cholesterol

<200	Desirable
200-239	Borderline High
240	High

LDL cholesterol

<100	Optimal
100-129	Near Optimal/Above Optimal
130-159	Borderline High
160-189	High
190	Very high

HDL Cholesterol (remember, this is the one that you want to be high)

<40	Low
60	High

Triglycerides

<150	Normal
150-199	Borderline High
200-499	High
500	Very high

New rules for those at an elevated risk of heart disease

Up until recently, you would not have been a candidate for cholesterol-reducing therapies unless your LDL or total cholesterol levels reached High or Very High (See chart above).  But in their latest report, based on new data from the Framingham Heart Study, the Institutes of Health announced new rules that you should know about.  If you are at increased risk for heart disease (see chart below), the government now says you should take action to reduce cholesterol as soon as your levels are in the Borderline High range.

The more stringent guidelines apply to you if two or more of the following factors are true:

§         You have had a previous heart attack or stroke

§         You have a strong family history of heart disease

§         You are more than 20 pounds overweight

§         You are a smoker

§         You have high blood pressure

§         You have diabetes

§         You are a male over 45 years

§         You are a female over 55 years

Number of risk factors	Chances that you will have a heart attack within in the next ten years
0-1	less than 10%
1-2	10-20%
More than 2	greater than 20%

In my own practice, I am actually even more conservative than our government.  I think you should take control of your cholesterol levels before they take control of you. That means striving for optimal cholesterol levels, using the safest, most natural means available. Here is a quick summary of the guidelines outlined in this report that will help you achieve healthy, balanced cholesterol levels, naturally

1.  Avoid dangerous trans fats found in fried and packaged foods. (Helps lower total and LDL cholesterol)

2. Replace saturated fats with unsaturated fats. (Helps lower total and LDL cholesterol while raising HDL)

3. Nutritional supplements (such as phytosterols) to normalize cholesterol production.

4. Have your cholesterol levels checked regularly and consult a doctor about any changes in diet, supplements, or medications.

Resources:

American Heart Association.
National Center
7272 Greenville Avenue
Dallas, TX 75231
1-800-242-8721
www.americanheart.org

National Heart Lung and Blood Institute

National Institutes of Health

P.O. Box 30105
Bethesda, MD 20824-0105

www.nhlbi.nih.gov