Atherosclerosis is the accumulation of cholesterol in the arteries that clog the circulation and result in heart attacks and strokes. It is also the leading cause of death in the United States and most other countries in the world.
Strategy One: Lower Your LDL
Prevention and treatment efforts have centered chiefly on slowing down this process by lowering LDL cholesterol – the main lipoprotein that causes accumulation of cholesterol in the arteries. Lowering LDL cholesterol is accomplished primarily by reducing saturated fat and cholesterol in the diet, keeping blood pressure down, avoiding smoking, keeping blood sugar levels under control, and losing excess weight. All of these methods slow the development of atherosclerosis (narrowing of the arteries) by slowing the accumulation of cholesterol in the arteries.
Strategy Two: Raise Your HDL
Another strategy for preventing heart disease and stroke is to clear out the clogged arteries and restore circulation. This is called reverse cholesterol transport – opening up the arteries. This process is accomplished by the high-density lipoproteins (HDL) cholesterol in the blood.
The HDL particles help this reverse cholesterol transport. They remove excess cholesterol from the artery wall and transport it to the liver where it is excreted in the form of bile salts and cholesterol. This pathway is the only way to get rid of excess cholesterol from the body.
HDL also decreases atherosclerosis by protecting LDL cholesterol from becoming oxidized. Oxidized cholesterol is much more likely to be deposited in the artery walls than non-oxidized cholesterol. Research shows that if you increase HDL cholesterol in your blood by only 1 mg/dL, the risk for cardiovascular disease decreases by two to three percent.
Lifestyle Practices Raise HDL
By making certain lifestyle changes, you can raise your HDL cholesterol and increase reverse transport of cholesterol out of the arteries. Research shows that the following changes help raise HDL levels:
- Lose excess body weight, especially fat around the abdomin. A 10- to 15-pound weight loss can help improve HDL levels considerably.
- Get regular aerobic physical activity, 30 to 60 minutes daily. Fitness research shows that you need to get at least the equivalent of 12 to 15 aerobic miles of activity each week to get good improvements in HDL levels. Higher levels of activity increase HDL levels even further. It's considered healthy if your HDL levels are one quarter of your total cholesterol level.
- Avoid a high-carbohydrate intake, especially refined carbohydrates, and eat more calories from healthy fats and healthy proteins. A low-fat, high-carbohydrate diet will always suppress HDL levels. When healthy fats (in nuts, nut butters, olives, olive oil, and other pure non-hydrogenated vegetable oils) are used regularly, they help keep HDL levels high. The guidelines of the National Cholesterol Education Program (NCEP) recommend that we should get up to 35 percent of our daily calories from fat – but only if it's healthy fat.
- Avoid all trans fats. Hydrogenated fats, such as in hard stick margarine, shortening, and deep-fried foods, lower the needed HDL levels. Foods commonly high in trans fats include most baked goods (pastry, doughnuts, cookies, cake, pie crust), chips, French fries and other deep-fried foods, most margarines, and most packaged foods such as microwave popcorn, packaged noodle or rice dishes. You can make your own cookies using non-hydrogenated vegetable oils and eliminate the trans fat.
If you follow these guidelines, your HDL levels will increase and so will your reverse cholesterol transport.
The Importance of Fiber
When the cholesterol and bile salts are excreted into the gut, most of them will be absorbed again and recycled unless you also have a high intake of fiber, especially water-soluble fiber. The recommendation is 10 to 25 grams of soluble fiber daily for best results in trapping this cholesterol and excreting it from the body.
The best sources of soluble fiber include: oats and oat bran, peas, beans, lentils, and other legumes, fresh fruits, vegetables, and the richest source known: psyllium seed. Lowering your intake of refined carbohydrates and increasing the intake of high fiber foods can be just as effective in reducing cholesterol as decreasing saturated fat and cholesterol in the diet.
Medications
And then, sometimes drugs are needed when a person's total cholesterol level remains high – even after he or she has made every possible lifestyle change. The three main classes of drugs used to lower cholesterol are statin drugs, bile acid sequestrants, and niacin (nicotinic acid). The American Heart Association warns that a dietary supplement of niacin should not be used as a substitute for prescription niacin. This is because dietary supplements are not regulated by the FDA. This means that the amount of active niacin in a supplement can vary from pill to pill. Talk with your doctor to find out what's best for you.
Summary
Now you have two major strategies for protecting your arteries. First, reduce cholesterol levels to decrease accumulation of cholesterol in the arteries. And second, increase HDL levels to promote reverse cholesterol transport, to clean out the arteries. |
