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Almost every day we read warnings about high cholesterol levels, yet cholesterol is essential for our bodies to work. Too much cholesterol in the blood, however, increases the risk of coronary heart and artery diseases. The average total cholesterol level in the UK is 5.5mmol/l for men and 5.6mmol/l for women – which are above recommended levels.

The National Institute for Health and Clinical Excellence (NICE) and Department of Health cholesterol guidelines state that total cholesterol should be less than 5.0mmol/l, with lowdensity lipoprotein (LPL) cholesterol less than 3.0mmol/l. However, the Joint British Societies recommend lower limits for people at risk of coronary heart disease – total cholesterol should be less than 4.0mmol/l and LDL cholesterol less than 2.0mmol/l. These levels match the more stringent European guidelines.


Knowing your good cholesterol from your bad cholesterol

Alex Shalet, Chief Nutritionist at The Nutri Centre explains the different types of cholesterol, saying: “You need to know about lipoproteins as well as your cholesterol level, to tell you about your personal risk of heart disease. Lipoproteins are special molecules that carry or transport cholesterol around the body. Low-density lipoprotein (LDL) is often known as ‘bad’ cholesterol. This carries cholesterol from the liver to the cells and, if there is more than the liver needs, it can cause harmful build-up of cholesterol.

High-density lipoprotein (HDL), or ‘good’ cholesterol, takes cholesterol away from the cells and back to the liver, where it’s either broken down or excreted.”

Alex explains further: ”Triglyceride levels are also important in cardiovascular health – and elevated levels are often seen in people who have decreased HDL (“good”) cholesterol. Triglycerides are the form in which saturated fats are transported to fat cells – to be stored when excess calories consumed in a meal are not used immediately by tissues for energy. You are in most danger of heart disease when you have high levels of LDL cholesterol and trigylcerides – and low levels of HDL cholesterol.

Overall risk is determined by a combination of factors, many of which increase with age. Men, those with a family history of heart disease, smokers, those who are overweight, have high blood pressure or diabetes tend to be at most risk. There is, however, evidence that one in 500 people who might otherwise be healthy have inherited high cholesterol – due to a condition called familial hyperlipidaemia. In fact, there are over 60 genes that appear related to HDL cholesterol – so genetic make-up may play a bigger role than we have traditionally thought”.


Cholesterol and Healthy Living

The main food culprits that contain significant amounts of cholesterol are eggs, offal and shellfish. Too much of these may encourage cholesterol build-up. Such caution needs to be kept in proportion, however, as these foods are also good sources of protein and certain minerals and vitamins. Added to this, is the fact that for the majority of people dietary cholesterol contributes very little to a body’s overall cholesterol levels – as the majority is actually made inside the body. It is also believed that the body merely compensates by producing more, if it is reduced in the diet!

What’s more important is the type of fat in the food you choose – especially saturated fat. Over-consumption of this type of fat has been linked to increases in cholesterol levels. The first steps in treating raised cholesterol levels should always be regular physical activity and healthy eating. Alex Shalet recommends cutting down on fats, especially trans fats – which are found in processed food. Replace saturated fats with unsaturated alternatives, such as olive oil – and try to eat oily fish like mackerel salmon and trout.

Introducing foods that may help to lower cholesterol levels such as garlic, soya, oats, corn and selenium-enriched cereals may be complemented by the addition of a high quality Omega 3 fish oil supplement, such as MorEPA Smart Fats. This is available in a chewable form in a choice of pleasant citrus flavours.

There are a number of foods on the market that are enriched with plant sterols/stanols, such as margarines, yoghurts and cream cheese spreads – that are felt to help maintain healthy cholesterol levels. These foods may lower cholesterol levels, but they are often loaded with refined oils and sugars – which are bad for heart health. It is probably wiser and easier to use a supplement containing plant sterols/stanols.

Alex recommends Lestrin, a dietary supplement containing two important, naturally occurring plant substances in concentrated form; Beta-sitosterol and Beta-sitostanol. These plant sterols/stanols are present in Lestrin in the same ratios as they are found in nature – and may help maintain normal cholesterol levels, as part of a healthy diet and lifestyle. Lestrin provides the plant sterols/stanols in a convenient tablet form. It can be taken whenever you want with meals – and costs less per day than eating extra cholesterol lowering dairy products that can contribute to increasing daily fat intake.


Treatment or prevention?

The number of people treated for high cholesterol has increased six fold in the last decade. Nowadays, many people are prescribed cholesterol lowering drugs called statins – often on a preventative basis. Whilst these have minimal visible side effects, there is some evidence of statins causing low risk of damage to muscles, leading to kidney failure.

Statins are also known to ‘leach’ the body of Coenzyme Q10 (CoQ10) an important heart ‘energiser’. CoQ10 is an antioxidant that is important in the biochemical processes that support healthy cellular respiration – which underpins, heart, brain, immune and periodontal health. It improves the conversion of fatty acids and other compounds into energy. When a person is suffering from cardiomyopathy and other kinds of heart failure, the supplementation of coenzyme Q10 may help the remaining muscle cells do their jobs more efficiently.

As CoQ10 levels in the body tend to drop as we grow older, Alex Shalet recommends supplementation with a highly bio-active and available form called ActivLife Q10.

There is some controversy around whether people with cholesterol levels above 5.0mmol/l are actually at risk of heart disease and should be prescribed lipid-lowering drugs; for example women who do not have weight problems and who don’t have a history of heart disease. Some doctors worry that reducing cholesterol with statins simply takes away the warning signs of heart disease – so it is important to understand the actual level of risk to an individual.

Alex Shalet also recommends a natural botanical supplement Guggul Cholesterol Compound, for people who wish to support a healthy cholesterol balance. Traditionally, the herb Guggul has been used for weight loss, so may have a role to play in helping with obesity. Modern research has demonstrated Guggul to have a good level of effectiveness in helping to reduce cholesterol and also triglyceride (fats) levels in the blood. Raised levels of both are associated with increased risk of heart disease. Guggul seems in part to exert a positive effect, by helping the liver eliminate cholesterol. Guggul exerts a more powerful effect than plant sterols, so it is probably best to try it on its own – rather than combining the two.