Cholesterol: The Good and the Bad

The fat we call cholesterol is widely misunderstood. We believe all cholesterol is bad, or that eggs raise our cholesterol, or that everything raises our cholesterol, and so we should ignore it because we can’t do anything about it anyway.

Well, we do need to pay attention to our cholesterol. We need to do what it takes to make sure our cholesterol level goes up. Yes, our good cholesterol needs to be raised. While we often focus on lowering our total cholesterol or decreasing our bad cholesterol, we do need to be on a mission devoted to raising our good cholesterol.

Bad Cholesterol

When we hear that our cholesterol levels need to be below 200, we are talking about total cholesterol. This is all cholesterol, including both the good and the bad. This number is much too simplistic. The balance of good to bad is critical. (All cholesterol levels are given in mg/dl of blood. Proper testing should include all three cholesterol types mentioned here as part of a lipid profile or lipid panel.)

Bad cholesterol is often known as LDL or Low Density Lipoprotein. This cholesterol is ‘bad’ because it does not stay in the blood, instead it enters into the walls of arteries. Hiding under the protective artery lining, it builds up into a plaque, blocking the proper flow of the blood.

The blockage can seriously obstruct blood flow, and if a clot forms against the damaged lining, it may completely block the vessel. This will cause death to the tissue beyond that block, such as heart muscle in a heart attack or brain tissue in a stroke.

Bad cholesterol should not be above 130 in the blood. If you do not have diabetes or heart disease, and no more than one risk factor for these diseases, it appears to be safe if your LDL is below 160. But if you have coronary heart disease, you should keep your level below 100.

Good Cholesterol

HDL or High Density Lipoproteins are often referred to as good cholesterol. This is because HDL actually helps prevent the bad cholesterol from entering into the arterial walls. It is also believed to remove some of the bad cholesterol that has already built up the plaque and deliver it to the liver where it is altered or excreted.

Good cholesterol not only helps prevent heart disease, but is able to help reverse artery damage to some extent. With low levels of LDL’s and high levels of HDL’s, it is possible to increase heart health.

How Can I Increase My Good Cholesterol and Lower the Bad?

To increase the heart-healthy good cholesterol levels of the blood, it is important to carefully follow two paths of change – diet and exercise. Achieving and maintaining low levels of bad cholesterol also depend on the same actions.

Exercise is critical to raising good cholesterol levels. The exercise needs to be regular, not occasional muscle damaging sporting events. Avoid the soreness and exercise regularly. Three to five times a week of moderate to somewhat hard exercise will help to promote healthy good cholesterol production. The exercise must be maintained to keep levels high.

Diet does not mean ‘to diet.’ It means all that you eat and drink. The major features of a healthy diet include eating high amounts of fruits, vegetables, nuts, beans, and whole grains. It also includes limiting saturated (animal) fats, eliminating trans fats, and ingesting heart healthy fats, such as those rich in omega-3’s and olive oil.

Top Food Choices for Cholesterol Health

Oatmeal and oat bran contain good levels of soluble fiber that helps eliminate cholesterol. Kidney beans, apples, barley and similar legumes, fruits and whole grains are also great sources of soluble fiber.
Walnuts and almonds have both been shown to have significant effects on lowering the bad cholesterol. These and other nuts and seeds are great additions to our meals, just be careful of the total number of calories. These nuts combine both fiber and healthy fats as part of their beneficial effects.
Fish and other forms of omega-3 fatty acids (oil building blocks) provide heart strengthening effects in more ways than positively affecting cholesterol levels. Two servings a week of salmon, albacore tuna, lake trout, and mackerel provide good levels of these oils. Plant sources include ground flaxseed, pumpkin seeds, and walnuts. Canola oil has good levels of the omega-3’s for cooking purposes.
Special plant chemicals that can block cholesterol absorption are sterols and stanols. These are found in a variety of plants we eat, but when foods and drinks fortified with sterols and stanols are consumed, the high level can help lower the level of bad cholesterol.

Pharmaceutical Intervention for Unsafe Cholesterol Levels

If lifestyle changes don’t bring cholesterol levels into safe range, it may be necessary to use drugs to achieve proper levels. These drugs usually have one or more effects: lowering LDL levels, raising HDL levels, and/or lower triglyceride levels.

Pharmaceuticals must be prescribed and monitored by a physician. All drugs have side effects, and a major problem with these drugs is that they may harm the liver. This is where cholesterol is made and processed by the body, and these drugs will act as poisons to the liver. Liver enzymes must be checked regularly to find out if damage is occurring. A guide to these pharmaceuticals may be found at MayoClinic.com.

A Simple Trick to Lower Cholesterol

There is a simple method that helps lower blood cholesterol. It’s so simple that most people, as well as physicians overlook it. This ‘trick’ takes advantage of the attempt of the body to rid itself of too much cholesterol. The “trick” is called fiber. Here’s how it works:

The liver takes excess cholesterol and secretes it into bile which enters the gall bladder. This bile is then ‘dumped’ into food as it exits the stomach and moves into the small intestine. One of two possibilities exist for what happens to this unwanted cholesterol. One is the natural process of elimination that helps maintain health. The other subverts normal physiology and ends up with higher cholesterol levels.

The body’s natural method involves normal healthy eating, which is how our body has historically dealt with high cholesterol. When food is eaten and digested, the fiber in the food holds onto the cholesterol. The fiber-cholesterol combo then transits the digestive tract and is removed from the body as part of the feces. This includes cholesterol from the bile as well as the cholesterol found in the food eaten.

The development of processed food in the early 1900’s has undermined our normal digestive physiology. Instead of consuming fiber-rich foods that help remove the excess cholesterol, we eat foods in which all or most of the fiber has been removed through mechanical and chemical processing. This includes white rice, pasta, sugar, most breakfast cereals and white and ‘wheat’ flour. Without the fiber, the cholesterol in the bile juice is not able to attach to it and it then is reabsorbed into the blood.

While the liver is attempting to rid the blood of the bad cholesterol, poor food choices allow this damaging cholesterol to return to the blood. This keeps the blood cholesterol levels high.

Since bile is released into the partially digested food when it leaves the stomach, it is best to ingest some fiber-rich food every time you eat, whether a meal or a snack. Vegetables (especially fresh), fruits, whole grains, beans and nuts are great sources of fiber. Commercial fiber products also work, sometimes very well, but are not as enjoyable as eating good quality foods with high fiber.

When choosing breads, make sure the bread is 100% whole grain. Using names such as wheat or multi-grain might have little or no whole grain content. Even cereals should be all or primarily made from whole grains.

Making fiber-rich foods an important part of every snack and meal is a trick that is helpful in achieving and maintaining healthy cholesterol levels. Some specific foods may help maintain healthy cholesterol levels because many of these are fiber-rich or contain other chemicals which reduce cholesterol. Great examples are broccoli, tomatoes, pecans, and black beans.

This fiber-every-time-you-eat method should be only a part of your attempts to control cholesterol. These should include exercise, healthy eating, reducing saturated and trans fats, fish oil, and possibly the need for medical care.

Even with a fiber-rich diet, medications may be needed if you have high cholesterol levels. But fiber and other healthy ideas might help you avoid the pharmaceutical path. It is always best to work with your physician to assure healthy choices and proper medical care.

Nutrition and Diet Advisor

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