This post is a follow up from my cholesterol testing post of a couple of days ago. It's for my family, who all were wishing for a little bit better results on their cholesterol test, but the principles are sound and apply to all.
The first and most important thing you can do is not eat any cholesterol. Period. You don't need it. Your body makes all you need, and for some of us, more than you need. Some people are better cholesterol producers than others and, for these people, it's even more important that they not consume cholesterol.
So, how can you avoid cholesterol? Avoid all animal products. Cholesterol is in all animal products, with cheese and egg yolks being particularly good sources of cholesterol. However, it's in all animal products - even fish. Fish is not your friend. It is, in fact, in addition to being mercury and other toxin laden, is higher in cholesterol than other animals (chicken, cows). Cholesterol is not in plant based food. It's not in grains, veggies (starchy or not), fruits, beans or even nuts and seeds. However nuts and seeds can cause problems of their own. This brings me to the second point.
Avoid added fat. For those who are good cholesterol producers, this is really important. Your body takes fat and uses it to produce cholesterol, even if you don't need more cholesterol. Oil, even olive oil, is a a big no. It's just fat. There is nothing redeeming about it unless you are starving when your body needs any calories it can get. Very few, if any, Americans fall into that category.
Also high in fat, though, while still being plant food, are olives, avocados, nuts and seeds. If you have a healthy body weight and your cholesterol is 150 or under, then these foods are okay as long as you don't consume so much that your weight or cholesterol starts creeping up. However, if you have weight to loose or your cholesterol is over the magic 150 number, where heart attacks simply don't happen, then you should not eat these foods! (There is one caveat, which I'll get to in a bit.)
Yes, it's true that you need some fat, but the amount needed is very small and is supplied by the healthy plant foods you eat. Some examples; 12% of the calories from kale are fat, 14 % for quinoa, 5% for oranges, 13% for chickpeas. These are enough fats for most people, while growing children and athletes with healthy body weight and cholesterol do well to supplement with some whole food fats such as those nuts, seeds, avocados, and olives we were just talking about.
Next, exercise is important. Simply walking for about three hours in a week will help. More strenuous exercise helps more with cholesterol levels. Exercise, in addition to helping you to maintain a healthy body weight (while not making it happen alone - food matters most!), also increases your HDL, which is the healthy cholesterol. Why is this cholesterol healthy? Because it's on it's way out of your body. That's the only reason it's good. Raising your HDL means you're cleaning out the cholesterol.
Certain plant foods are better than others for lowering cholesterol. Oats, beans and barley, for example, are high in soluble fiber. Soluble fiber is the stuff that passes through your digestive system. The other, insoluble or dietary fiber, is the stuff that helps with digestion and healthy poops. Both are important, but, in terms of cholesterol, soluble fiber is the one to look for. It lowers both overall cholesterol and LDL, the bad, or lethal, cholesterol. Many fruits and veggies are also high in soluble fiber.
Soy products have a bit of a bad rap, but it seems to be mostly undeserved. The studies showing that soy isn't good have been funded by the meat industry who've made good use of the media to disseminate that "knowledge." Many studies show that soy is healthy and good for a variety of reasons. One of those reasons is that it lowers cholesterol. Try not to be scared of soy.
Okay, here's that caveat I promised. Almonds and walnuts have been shown to lower cholesterol. They are high fat, yes, but studies show that eating 3 ounces a day for 4 weeks has a cholesterol lowering effect. Knowing this, I'd recommend these nuts for a certain subset, but not necessarily for everyone. Anthony, who is at or below his ideal body weight and is very active, but still has high cholesterol, is a good candidate for eating those 3 ounces a day. Anyone who is overweight should look elsewhere for their cholesterol lowering foods.
Some, but not all, studies show that garlic can lower cholesterol. 1/2 to 1 clove a day is the amount used in the studies that did show effectiveness. If you like garlic, there is no reason not to give this a go.
Fruits and vegetables, in addition to their soluble fiber, being cholesterol free and being low in fat, also contain beta-carotene, vitamin C and vitamin E. This is good for those with high cholesterol because these vitamins can reduce the damaging effects of cholesterol in your blood.
In Dr. McDougall's Digestive Tune Up, he recommends the use of probiotics in certain situations. One of those is if you have a healthy diet, but your cholesterol remains high. (He also suggests probiotics if you've had a month or so to adjust to a high fiber diet and still have offensive smelling flatulence, as an aside.) Probiotics helps your gut develop good flora. This helps with digestion, which helps a whole host of issues. Most people eating healthy foods will have good guts naturally, but some need a little help. Priobiotics do not have any bad side effects, other than, perhaps, cost, so it doesn't hurt to give it a go. Do not get your priobiotics from yogurt, though, as that is counter to the number one principle - no animal foods. You can get priobiotics all on their own from health food stores or online.
What numbers are the goal for all of this cholesterol lowering? Let's review the numbers. Your overall cholesterol should be 150 or lower because that is the magic number at which people just don't have heart attacks. The US government states that your LDL should be lower than 100. However, many scientists believe that it should be more like 70, particularly for high risk patients (overweight or diabetic persons would fall in this category). Your risk of heart problems continue to decrease until your LDL is 40, though, so lower is better. As for HDL, the only reason it's healthy is because it's on the way out. Higher is better here, but, if your overall cholesterol is 150 or lower, it doesn't really matter. A good goal to aim for, though, is about 1/3 of your total cholesterol being HDL. So, if you have an overall cholesterol of 150 (heart attack proof), then 50 is a good HDL number to aim for.