Natural Blood Cholestrol Control
By Stephen Holt, MD
Blood Cholesterol Breaks Your Heart
An ever increasing number of scientific articles clearly document the relationship between high blood cholesterol and triglycerides and heart disease. However, cholesterol is not the only type of blood fat (lipid) that influences health. There are good and bad types of cholesterol. Good cholesterol is high-density cholesterol (HDL) and bad cholesterol is low density lipoprotein (LDL). Prevention of coronary artery disease is possible with interventions that lower specific types of blood lipids (fats). Overall, it is believed that a high total blood cholesterol, a high LDL, a high very low-density lipoprotein level (VLDL), a high triglyceride level (TG), and a low HDL are all deleterious to health.
Low-density lipoproteins (LDL) carry cholesterol in the bloodstream. When LDL is oxidized, it is more likely to be deposited in the lining of arterial vessels leading to atheroma. Oxidized LDL (and peroxidated polyunsaturated fats) enhances atheroma formation (clogging of arteries). Natural ways to combat the oxidation of bad cholesterol (HDL) are very valuable in preventing heart disease. This can be achieved by taking dietary components that are rich in antioxidant components, eg. fruits, vegetables, and certain minerals or vitamins.
In contrast to the characterization of LDL and VLDL as “bad types” of cholesterol, HDL is considered a “good type” of cholesterol. In simple terms, HDL draws cholesterol into the circulating blood away from a tendency to be deposited in arterial blood vessel walls, causing “clogged arteries.”
Optimal Blood Lipid Levels
The levels of blood cholesterol, triglycerides and other lipids that can be considered healthy for an individual cannot be determined precisely. In May 2001, new guidelines were issued for the definition, prevention and management of high blood cholesterol. These guidelines were proposed by the National Cholesterol Education Program in conjunction with the National Heart, Lung and Blood Institute. Acceptable levels of blood fats have been revised downwards. In fact, these new definitions have revised down optimal levels of bad cholesterol (LDL) and triglycerides, while revising good cholesterol (HDL) upwards (Table 1). For sure, people with heart disease, or at high risk, must be meticulous about cholesterol control.
Total cholesterol Desirable: Less than 200 mg/dL
Borderline high: 200 to 239 mg/dL
High: Greater than 240 mg/dL
LDL cholesterol Optimal: Less than 100 mg/dL
Near optimal: 100 to 129 mg/dL
Borderline high: 130 to 159 mg/dL
High: 160 to 189 mg/dL
Very high: 190 mg/dL and greater
HDL cholesterol Low: Less than 40 mg/dL
Optimal: 60 mg/dL
High: greater than 60 mg/dL
LDL to HDL ratio Less than 4:5
Triglycerides 50 to 150 mg/dL (more aggressive controls recommended)
Table 1: A guide to the levels of blood lipids. Note: These guidelines were proposed by the National Institutes of Health in May 2001. These are new targets for blood lipids which are recommended with more holistic efforts to reduce cardiovascular risks. Opinion differs in some medical circles on ideal targets for blood lipids. In the presence of heart disease, controls of blood cholesterol are necessarily more stringent.
First-Line Approaches are Natural Not Drugs
One may reflect on pharmaceutical TV adverts for cholesterol lowering that start by dismissing the correct first-line approaches of diet and exercise for health. More than one of these TV commercials reflect that diet and exercise did not, or does not, work, while the message is to “peddle a drug prescription” for lowering cholesterol.
There are several natural ways to reduce blood cholesterol and, in turn, reduce risks of cardiovascular disease. Conventional medicine has not acknowledged or realized the power of these natural approaches. When combined, natural cholesterol-lowering strategies can often achieve what most drugs cannot. Lifestyle changes and natural substances have fewer side effects than drugs and they provide a sustainable outcome and global health advantages, with less cost.
Blood Homocysteine and Cardiovascular Disease
High blood levels of homocysteine have been linked to cardiovascular disease and an increased risk of blood clotting. Elevations in blood homocysteine form independent risk factors for heart disease and heart attack. Just like the high blood cholesterol, elevated blood homocysteine must be considered to be dangerous to health. This “homocysteine theory” in cardiovascular disease is not in opposition to the cholesterol theory of heart disease, but it helps to complete the picture of the link between diet and heart disease.
Not only does elevated blood homocysteine cause heart disease, it can be associated with an increased risk of stroke, poor circulation in the extremities and even osteoporosis. Several studies have shown that the important vitamins folic acid, vitamin B12 and vitamin B6 (pyridoxine), together with an important supplement called betaine (trimethylglycine), can effectively lower homocysteine in a beneficial manner for cardiovascular and general health. So important is the role of homocysteine in heart disease that it is shocking that many people do not consider lowering blood homocysteine at the same time as lowering blood cholesterol.
Homocysteine control is so important that I consider supplements for cholesterol control that do not also assist in blood homocysteine control are quite inadequate in their formulation.
Exercise A panacea health effect, eg. approx. 5% to 10% reduction in blood cholesterol
Reduce saturated fats and intake of transfatty acids in the diet Approx., 15% reduction in total blood cholesterol with lowering of LDL and triglycerides
Increase fruit and vegetable intake Approx., 10% cholesterol reduction
Moderate alcohol intake
Added dietary supplements for cholesterol
control: oat bran concentrate, phytoesterol
concentrates from soy, policosanol and red yeast rice
Reducing blood homocysteine levels
New studies show reductions in occurrence of diabetes mellitus with moderate drinking and several studies show benefits of moderate alcohol intake on HDL and lowering of total blood cholesterol
May cause a cholesterol reduction of up to approx. 25%
Vitamin B6 (pyridoxine), folic acid, vitamin B12 and trimethylglycine
Lifestyle and Supplement Synergy for Heart Health
I believe that combined natural strategies to lower blood cholesterol can work together in an additive manner. The options provided in table 2 involve a change of lifestyle and the addition of nutritional agents. These provide a pathway for a highly significant reduction in total blood cholesterol. I would go as far as saying that compliance with this kind of natural program may be an equivalent in benefit to the use of some cholesterol-lowering drugs alone.
There are individuals who claim that they are “non-responders” to combined natural strategies to control blood cholesterol. I believe that many of these people are not compliant with the types of “first-line,” natural approaches that I propose. While there are no direct comparisons of drug treatments with the combined natural approaches that I describe, much “corroborating science” exists to support my statements. There have been several advances in natural agents to control blood cholesterol profiles and these nutritional advances are combined in the product Ultimate CholesAid™. Each component of Ultimate CholesAid™ is backed by modern science and worthy of review.
The Power of Policosanol
Policosanol is a mixture of compounds isolated from plant waxes. Plant waxes from sugar cane and yams are preferred sources of this important complex, natural product. Policosanol has been shown to inhibit blood clotting, have favorable effects on lining cells in blood vessels and have significant benefits for controlling blood cholesterol. These plant wax components are known to decrease the stickiness of blood platelets which are involved in unwanted blood clotting; and this valuable action is complemented by supporting the health of the lining cells of blood vessels. It is negative changes in blood clotting and lining cells of blood vessels that cause the buildup of plaque in arteries (atheroma). Atheroma causes heart disease, heart attack, stroke and poor circulation.
It appears that policosanol inhibits the synthesis of cholesterol in the body and it may increase the breakdown of bad cholesterol (LDL) by the liver. Animal studies have shown that policosanol may even prevent, and in some cases, reverse atheroma and thrombosis in blood vessels. In addition, it is a powerful antioxidant that prevents the formation of damaging types of oxidized cholesterol.
Short-term studies have compared the effectiveness of policosanol versus a popular type of a “statin,” cholesterol-lowering drug. These studies that compared policosanol with a statin-type drug show similar decreases in bad cholesterol with similar increases in good cholesterol with each “treatment” (Benitez M and colleagues, Curr Ther Res, 58, 859, 97). In addition, other benefits have been noted with policosanol supplementation including: favorable changes in blood pressure, improvements in symptoms of coronary heart disease and better blood circulation to the extremities.
Special Types of Oat Fiber and Health: Beta Glucan
While everyone recognizes the general health benefits of dietary fiber, modern research has started to pinpoint the active constituents of soluble fiber that make a real difference to cardiovascular health. Using special manufacturing processes, oat fiber can be concentrated and the special health-giving fractions of fiber called “oat beta glucans” can be isolated in high concentrations.
The described cardiovascular benefits of beta glucan-enriched types of oat soluble fiber include well described benefits in lowering blood cholesterol with secondary improvements in blood pressure and even assistance with control of blood sugar, or benefits in the nutritional management of diabetes mellitus. There are dozens of scientific studies which show the versatile and potent cardiovascular benefits of the special type of soluble fiber known as “oat beta glucan.”
Recently, food scientists have been able to make concentrates of beta glucan in excess of 50% and this provides the ability of giving the concentrated and active components of soluble fiber in a convenient form in a capsule or tablet. While many people are aware of cereal fiber claims on TV (eg. Cheerios), there is now an approved claim that oat fiber in certain doses and concentrations, as used in Ultimate CholesAid™, may reduce the risk of heart disease.
Phytosterols: Plant Equivalents of Cholesterol
Scientists have recently clarified the nature and biological effects of phytosterols. This complicated word comes from “phyto” meaning plant and “sterols” meaning chemical similarity to cholesterol. Cholesterol itself does not occur in plants, but there are sterols that are like cholesterol occurring in many botanical extracts. Sterols help antagonize “cholesterol excesses.” It is clear that vegetarians have a higher intake of plant sterols and this may be one of several reasons why vegetarians have better cardiovascular health than people who eat a lot of meat products.
Much science shows the ability of phytosterols to lower blood cholesterol and they do this primarily by inhibiting the absorption of cholesterol from the diet or stopping the reabsorption of cholesterol in the gastrointestinal tract. This is an interesting trick of Nature where a compound that resembles cholesterol tends to “cheat the body,” by reducing cholesterol input and increasing cholesterol elimination in the stool. Phytosterols have complicated chemical names and they are most often produced by processing soybeans.
Common types of phytosterols include beta-Sitosterol, stigmasterol and campesterol. Not only are these sterols important in the promotion of cardiovascular health, they are also beneficial for prostate health. Phytosterols provide an excellent additive component to cholesterol control and cardiovascular health in the dietary supplement Ultimate CholesAid™.
Red Yeast Rice
Many people are taking “statin types” of cholesterol-lowering drugs. These drugs are highly effective at reducing blood cholesterol, but they have unfortunate adverse effects. Adverse drug effects with statin medications include liver toxicity and sometimes serious damage to muscle tissue. Statin drugs deplete the body of the important energizing compound co-enzyme Q10 (CoQ10). I believe that CoQ10 should be replaced in everyone taking a statin drug.
Nature has provided us with our own natural types of “statin compounds.” Red yeast rice contains a substance called mevinolin, which acts like a statin-type drug by blocking the enzymes involved in the synthesis of cholesterol in the body (HMG CoA reductase). Red yeast rice has been marketed in the US as a dietary supplement, but it has been the subject of much debate among lawmakers. No doubt, the manufacturers of statin drugs felt challenged by a “natural statin” effect in plants.
One may reflect that there are many natural substances from herbs or botanicals that act like a drug and many prescription drugs have their basis in plant extracts. Red yeast rice is known to be effective at lowering cholesterol with good tolerance by its users.
Controlling high blood cholesterol and homocysteine are important issues in the promotion of cardiovascular health. First-line options to deal with lowering blood cholesterol and homocysteine do not include drugs, for many people. Lifestyle changes from negative to positive, together with well planned nutritional interventions can make a real difference to the cardiovascular health of the US nation.