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7 Ways to Improve Cholesterol Through a simple healthy diet Dr. Phil Maffetone A healthy diet can improve your cholesterol: specifically, by reducing both the total and LDL cholesterol, and raising the good HDL fraction. Blood cholesterol has been a hot health topic for decades, but recently a push to put more people on cholesterol‐lowering pharmaceuticals has brought issues surrounding cholesterol and heart disease into tighter focus. Despite the knowledge that cholesterol is not the greatest risk for heart disease, the media, pharmaceutical companies and many healthcare organizations continue to promote cholesterol‐lowering drugs. The result is the encouragement of fat and dietary cholesterol phobia, the increased side effects from drugs, and neglecting a healthy diet. In addition, extreme measures to reduce cholesterol are often compensated by the body with negative consequences. For example, cholesterol‐ lowering margarine products containing synthesized sterols which block cholesterol production in the liver can result in a significant increase in the absorption of cholesterol. Consuming natural foods offers a healthy, effective and safer approach to improving cholesterol. Our blood cholesterol comes from three main sources: • Most cholesterol comes from normal production in the liver. That’s because cholesterol is an important substance for our health, including the regulation of hormones. • Much smaller amounts of cholesterol comes from the foods we eat via its absorption from the intestines. • And moderate amounts of cholesterol can come from its re‐absorption; our liver gets rid of the cholesterol is doesn’t need by sending it through the intestines for removal. Liver Production of Cholesterol Production of cholesterol in the liver takes place via a key enzyme, HMG‐CoA reductase. Cholesterol‐lowering drugs (the statins) work by inhibiting this enzyme. However, a number of natural substances help regulate this enzyme, thereby helping the liver better control cholesterol production, especially LDL. These include tocotrienols, an important part of the vitamin E complex, and compounds in citrus peel. 1. Tocotrienols. Natural tocotrienols can lower plasma concentrations of LDL cholesterol by reducing the HMG enzyme. Tocotrienols are four key parts of the vitamin E complex (alpha, beta, gamma, and delta). In addition, tocotrienols help prevent LDL from oxidizing – the problem that gives this cholesterol fraction its “bad” name. At least 20 mg of tocotrienols are needed for the cholesterol‐ lowering effect, an amount one could consume in the diet with adequate fresh vegetables, nuts and seeds Beware! Taking high doses of vitamin E, 400 IUs or more of alpha tocopherol, can actually inhibit the tocotrienols’ cholesterol‐lowering action. 2. Citrus peel. Known to have a variety of health benefits including anti‐inflammatory and anti‐cancer properties, the natural oils in the peel of citrus contains the bioflavanoids naringin and hesperidin which can also control cholesterol through regulation of the HMG enzyme. 2008 Philip Maffetone www.philmaffetone.com 3. Reducing Refined Carbohydrates. Carbohydrate intolerance (CI) is an important risk factor for high cholesterol because of its relation with insulin resistance. This risk factor is at least as important in heart disease as is cigarette smoking. CI causes increased production of cholesterol in the liver. Eliminating refined carbohydrates is important for anyone with abnormally high cholesterol. (Even better – take Dr. Phil’s Two Week Test, especially if you also have high triglycerides.) Cholesterol Absorption Most of the concern about cholesterol absorption is really reabsorption of cholesterol from the liver. The amount absorbed from the diet is almost insignificant. Two important dietary components can help. 4. Phytosterols. Plant sterols, or phytosterols, are unsaturated fats that reduce the absorption of cholesterol from the gut. Phytosterols are present in all vegetables and fruits, with high amounts found in nuts and seeds, citrus peel, palm fruit, apples, cabbages and other leafy vegetables. Most of the cholesterol in our intestine is not from the diet, but is being disposed of by the liver, and in many patients the lack of natural sterols in the diet allows re‐absorption of this cholesterol. The high intake of phytosterols by humans thousands of years ago is believed to be a key dietary component that maintained proper cholesterol balance despite very high saturated fat (and cholesterol) intakes. 5. Fiber. Certain plant fibers can perform the same or similar action on cholesterol in the gut as phytosterols. These include psyllium, oat bran and rice bran. In addition, foods such as olive oil, almonds, garlic, fenugreek and buckwheat can help reduce blood cholesterol levels. All these natural approaches result in total and LDL reductions without loss of HDL fractions. Other Metabolic Benefits Two other methods of reducing cholesterol include snacking and fish oil. The mechanisms may include an indirect effect on the gall bladder and liver in removing cholesterol, and by improving other factors that effect cholesterol such as insulin production. 6. Snacking. Consuming five or six smaller balanced meals or snacks daily, rather than the common two or three, not only improve cholesterol levels, but provides other healthy benefits as well, including improved insulin and blood‐sugar control, and even weight loss. Don’t just add more calories, but spread out your day’s food into five or six meals. 7. Fish Oil. EPA and DHA from fish oil can help lower the total and LDL cholesterol and raise HDL. EPA may also help thyroid function in hypothyroid patients as these individuals often have poor cholesterol function. The effects of EPA are much more clear on other factors associated with cardiovascular disease. These include reducing triglycerides levels, lowering blood pressure, and improving insulin action to reduce carbohydrate intolerance. 2008 Philip Maffetone www.philmaffetone.com