When total cholesterol begins to creep up past 200 mg/dL, it's time to change diet [1]. If it reaches 240 mg/dL or higher, then the body is at high risk of coronary artery disease and cardiac death [1]. The risk is only accentuated if LDL cholesterol is higher than 160 mg/dL and HDL cholesterol is lower than 40 mg/dL (50 for women) [1].
So, what can be done? Takng cholestyramine and colestipol will help promote excretion of bile [2]. The "statins" atorvastatin, lovastatin and simvastatin can block key enzymes that synthesize cholesterol [2]. Even niacin in the form of nicotinic acid can help through its effects on widening blood vessels [3]. But the benefits of these drugs and the vitamin are extremely limited, because if treatment is stopped, cholesterol can and probably will go back up again unless there is a change of diet [4]. The drugs can also have possible side effects such as liver damage, muscle pain and break down, and kidney problems [4].
A change in diet and lifestyle is most important. Regular exercise, particularly aerobic exercise, increases HDL cholesterol, which in turn helps to lower total cholesterol and LDL cholesterol [5]. In addition, according to Mayo Clinic, the top five foods for lowering cholesterol are oat bran (soluble fiber), nuts, fish oil, olive oil, and plant sterols [6]. Soluble fiber included with meals may reduce absorption of cholesterol, nuts like walntus and almonds can replace high-saturated fat and high-cholesterol foods because their lipid profile includes PUFAs, fish helps to lower TGs through its content of omega-3 oils, olive oil PUFAs and antioxidants help (avoid lite olive oil), and plant sterols block absorption of cholesterol [6].
References
1. Mayo Clinic. Cholesterol levels: What numbers should you aim for? Available at: http://www.mayoclinic.com/health/cholesterol-levels/CL00001. Accessed on November 25, 2008.
2. Tortora GJ, Derrickson B. Principles of Anatomy and Physiology, 11th ed; 2006. New York: John Wiley & Sons.
3. Grundy SM, Mok HY, Zech L, Berman M. Influence of nicotinic acid on metabolism of cholesterol and triglycerides. Available at: http://www.jlr.org/cgi/content/abstract/22/1/24. Accessed on November 25, 2008.
4. Mayo Clinic.Statins: Are these cholesterol-lowering drugs right for you? Available at: http://www.mayoclinic.com/health/statins/CL00010. Accessed on November 25, 2008.
5. Stein RA, Michielli DW, Glantz MD, Sardy H, Cohen A, Goldberg N, Brown CD. Effects of different exercise training intensities on lipoprotein cholesterol fractions in healthy middle-aged men. Am Heart J.1990 Feb; 119(2 Pt 1): 277-83. Available at: http://grande.nal.usda.gov/ibids/index.php?mode2=detail&origin=ibids_references&therow=282138. Accessed on November 25, 2008.
6. Mayo Clinic. Cholesterol: The top 5 foods to lower your numbers. Available at: http://www.mayoclinic.com/health/cholesterol/CL00002. Accessed on November 25, 2008.
