How to lower your cholesterol without drugs There are many ways to lower cholesterol naturally without resorting to statin drugs that block the body’s ability to make it in the first place. The reason why this is a better place to start is firstly because it helps you address the true underlying causes of high cholesterol and secondly because cholesterol lowering drugs have significant side-effects. That being said, everything in this report can be done alongside cholesterol lowering drugs.
My one provision is to encourage you to also take CoQ10 if you are on statins. The positive changes you can make that have a direct effect on your cholesterol levels are:
• Following a low GL diet
• Increase plant sterolsPlant sterols are compounds similar to cholesterol which occur in plants. They can help to prevent cholesterol being absorbed in the body…. and soluble fibres
• Supplementing high dose niacin (B3), plus a high strength multi and extra vitamin CWhat it does: Strengthens immune system – fights infections. Makes collagen, keeping bones, skin and joints firm and strong. Antioxidant, detoxifying pollutants and protecting against… and magnesiumWhat it does: Strengthens bones and teeth, promotes healthy muscles by helping them to relax, also important for PMS, important for heart muscles and nervous…
• Increasing omega 3 fats, both from diet by eating fish, and from supplements
• Exercising and losing weight with a low GL diet
• Reducing your stress level Putting all these factors together is a winning formula.
Mike T is a case in point. “In mid-April I had my blood checked and found my cholesterol to be 6.5. I do eat really healthily and felt that my condition was due to hereditary cholesterol rather than dietary factors. A friend had reduced theirs through the supplements recommended in your book, so I thought it was worth a try. Five weeks later I went for a second blood test to find my cholesterol had dropped to 5.1. My GP couldn’t believe it! He would not wholeheartedly acknowledge the success, but he didn’t knock it either, saying whatever you are taking is working – come back in a year!”
Another success story is that of Andrew from Dublin. His cholesterol was 8.8 mmol/l. He was also gaining weight, feeling tired and stressed, and not sleeping well. He was put on statins and, six months later, it was 8.7. The lack of response, plus side-effects, led him to stop. Andrew attended one of my 100% health workshops, changed his diet and started taking supplements including high dose niacin, vitamin C and omega 3. Three weeks later, he had lost 10 pounds, his energy levels were great, he no longer felt stressed and he was sleeping much better. And his cholesterol level had dropped to a healthy 4.9. Your ideal cholesterol The medical profession’s obsession with lowering total cholesterol below 5, and some say even lower, is not consistent with the evidence of what really correlates with risk. Ideally, you want: Total cholesterol below 5.2 mmol/l HDL cholesterolHDL is short for high density lipoprotein. It is the “good cholesterol” responsible for removing harmful cholesterol from the bloodstream. High HDL levels reduce the… above 1.6mmol/l Cholesterol/HDL ratio equal to or less than 3/1 Triglycerides below 1 mmol/l Triglycerides/HDL equal to or less than 2/1 This is the Holy Grail and when you achieve this there is really no need for medication.
The low Glycaemic Load diet is the key Official diet advice is that we should eat lots of starchy carbohydrates such as bread, rice and potatoes. But it is exactly these high glycaemic load foods that raise your blood sugar and cholesterol levels; examples include the bread and cakes made from refined flour that rapidly releases glucose into the blood stream. As a way of lowering the risk of heart disease, this is far from ideal. Because they make blood sugar levels soar, high glycaemic foods cause more of the fat-storing hormone insulinInsulin is a hormone made by the pancreas. It is responsible for making the body’s cells absorb glucose (sugar) from the blood…. to be released, as well as boosting production of the stress hormone cortisolCortisol has been nicknamed ‘the stress hormone’ as it is released in higher levels during the body’s flight or fight response to stress. Levels of….
So what happens to the extra glucose sloshing about in the blood stream? It gets stored as fatThere are many different types of fats; polyunsaturated, monounsaturated, hydrogenated, saturated and trans fat. The body requires good fats (polyunsaturated and monounsaturated) in order to… and up goes your triglycerideTriglycerides are a type of fat found in the blood – the body uses them for energy. However, high levels of triglycerides can raise the… levels. In time you become insensitive to insulin, and thus make more, which pushes your cholesterol level even higher. The link between high glycaemic foods and dangerous fat levels showed up clearly in a study just published that showed mice fed a diet of high glycaemic starchy foods developed a potentially deadly condition known as ‘fatty liver’; they also had twice the amount of fat in their bodies as those on a low glycaemic diet even though they weighed the same [1].
Much more effective for maintaining a healthy heart is the Mediterranean diet. It’s based on foods that have had little processing such as fruits vegetables pulses and whole grains and as a result releases glucose much more slowly into the blood stream. It also encourages you to eat quite a lot of fat, especially olive oil and omega 3. The low Glycaemic element of the diet reduces your cholesterol levels and is also an effective way of losing weight. Meanwhile the healthy fats help to protect the heart. A recent meta-analysis of weight loss studies concluded that “Overweight or obese people lost more weight on a low Glycaemic Load diet and had more improvement in lipidFats, oils, waxes and sterols are collectively known as lipids…. profiles (cholesterol and triglycerides) than those receiving conventional (low fat, low calorieCalories are a measure of the amount of energy in food. Knowing how many calories are in the food we eat allows us to balance…) diets” [2].
Other benefits were greater loss in body fat, reductions in bad ‘LDL’ cholesterol, and increases in good ‘HDL’ cholesterol. There are lots of studies that have shown highly significant reductions in cholesterol, and increases in HDL, when people follow a low GL diet. I should point out that my low GL diet is very precise and has a lower GL per day than most of the diets used in studies. So you can expect even better results, however you will not go hungry. Increase plant sterols and soluble fibres Plant sterols are present in pulses, including beans and lentils. The most researched in this respect is soya, which is why many soya products rightly claim that they help lower cholesterol. There are also plant sterol enriched margarines, such as Benecol, which make similar claims. Studies have shown that regular consumption of one to three grams of plant sterols per day lowers LDL cholesterolLDL is short for low density lipoprotein. It is the “bad cholesterol” which collects in the walls of blood vessels, causing blockages. High LDL levels… by 5-15%. There’s also evidence that the more soya you eat, the lower your blood pressure [3].
A heart friendly diet includes 2.5 grams of plant sterols a day, which is the equivalent of 50 grams of soya – roughly a glass of soya milk, a small serving of tofu, or a small soya burger. Other foods including nuts such as almonds, most beans and lentils, also provide plant sterols in case soya isn’t your cup of tea. Soluble fibres are found in oats, okra (lady’s fingers) and aubergine. They are in the bran or rough part of oats so you need to eat whole oat flakes or rough oat cakes or add oat bran to cereals. One of my favourite sources of soluble fibre are chia seeds, as well as flax seeds (also known as linseed), although chia tastes much better. The soluble fibre rich foods become ‘glooky’ when water is added as they absorb a lot of water. Combining plant sterols with soluble fibres is actually more effective in lowering cholesterol than statins according to a study by Professor David Jenkins from the University of Toronto in Canada. “People interested in lowering their cholesterol should probably acquire a taste for tofu and oatmeal.” He said. A simple example of putting these principles into action is having hummus, made from chick peas, with rough oatcakes which gives you both plant sterols and soluble fibres. You can go one step further by adding the super soluble fibreFibre is an important part of a balanced diet. There are two type of fibre; soluble and insoluble. Insoluble fibre helps your bowel to pass…, glucomannan, to your daily diet. This extraordinary fibre, from the Japanese konjac plant, has been shown to lower cholesterol in a number of studies [4].
You need about three to five grams for the best effect, which is roughly a teaspoonful, stirred into a large glass of water, taken just before a meal. This lowers the GL of the meal and may be why it lowers your cholesterol. It’s also very good if you are prone to constipation. Ensure your omegas For decades now doctors and nutrition experts have been advising us to eat a low-fat diet, both to lose weight and to protect our hearts. However this advice looks increasingly as if it may be contributing to making the problem worse because most low fat foods are higher in carbohydrateCarbohydrates are the primary source of energy for the body as they can be broken down into glucose (sugar) more readily than either protein or…. In fact we are now eating less fat than ever before; meanwhile levels of obesity are soaring. It’s perfectly clear that the amount of fat you eat has very little to do with putting on weight. As for heart disease, higher levels of the right sort of fat – natural and largely unprocessed – protect your heart. Even saturated fatSaturated fats should be avoided wherever possible as they increase the amount of cholesterol in the blood and increase the risk of developing heart disease…. is not the demon it is made out to be. Just to give one example – there are many more – nearly 30,000 middle-aged men and women in Sweden were followed for six years and recorded their food intake. And the conclusion? “Saturated fat showed no relationship with cardiovascular disease in men. Among women cardiovascular mortality showed a downward trend with increasing saturated fat intake.” In other words the more saturated fat the lower their chance of dying from heart disease. What is far less controversial is that no healthy heart diet would be complete without omega-3 fats; many studies show it not only brings down cholesterol but also can decrease the levels of harmful triglycerides in the blood as well as the reducing inflammation that’s linked with heart disease. A review of ten randomised controlled trials showed that fish oils decrease the triglycerides by an average of 29%, lower cholesterol by 12%, lower the bad LDL cholesterol by 32% and increase HDL by 10% [5].
The UK’s National Institute of Clinical Excellence recommended all doctors to prescribe one gram of fish oil to patients who have had a heart attack for six months. Then the budget runs out. But if your budget can stand it my recommendation is to keep going, supplementing one gram of omega 3 rich fish oil, and also eating oily fish three times a week. I take, twice a day, an essential omega capsule that gives me 650mg of combined EPAEPA is short for Eicosapentaenoic Acid. It is an essential omega-3 fatty acid found in fish such as salmon, mackerel and herring, and is often…/DPA/DHA. Together with three servings of oily fish (salmon, mackerel, kippers, sardines, herrings, pilchards) a week that gives me a total daily omega 3 intake of over ten grams of omega 3’s, or 1.5 grams a day. This is equivalent to what you’d get in two high potency omega 3 rich fish oil capsules. If you have high cholesterol or have recently had a cardiovascular event, I’d recommend a daily high potency omega 3 fish oil, plus a basic essential omega supplement, plus the oily fish. Once your cholesterol statistics are back to normal you could drop the extra omega 3 rich fish oil, but keep going with the essential omegas. An alternative to the omega 3 rich fish oil is high strength cod liver oil, which is an excellent dietary source of anti-inflammatory vitamin A and D, but do check that it’s got enough EPA and DHADHA is short for Docosahexaenoic Acid. It is an essential omega-3 fatty acid found in fish such as salmon, mackerel and herring, and is often… (you want at least 500mg combined). The really bad fats you want to avoid are the heavily processed ones such as trans fats found in foods like margarines and industrially produced baked foods. Avoid these. For steam-frying use coconut butter, a little butter or olive oil. Niacin is a must for raising HDL Despite the relentless medical focus on reducing levels of LDL cholesterol as a cause of heart disease, 40% of all cardiovascular problems happen in people who have low levels of HDL (high density lipoprotein) cholesterol. So drug companies have long tried to develop drugs to increase the amount you’ve got. Unsurprisingly the drugs also do other things, which mean they can also have dangerous side-effects. In the case of one called torcetrapib these included raised blood pressure; a major clinical trial had to be abandoned because there were 50% more deaths in the group taking it than those only getting a statin. But according to a major review of what works in the New England Journal of Medicine, “the most effective way” is with vitamin B3 – niacin [6].
Niacin also comes out top in a review of the drug trials to raise HDL which describes the new medications as “disappointing ” [7]. The evidence suggests niacin becomes effective at doses of 1,000 to 2,000mg a day. That’s a long way off the RDA of 18mg. Because it is a vitamin, and so part of your body’s normal functioning, it is highly unlikely to have the dangerous adverse drug reactions triggered off by a new single molecule drug. It’s also why most doctors never think of using it. A number of studies have show that that it is effective not only in raising HDL – by up to 35% – but also in reducing LDL by up to 25%. It also reduces levels of two other markers for heart disease – lipoprotein A and fibrinogen. By way of comparison, statins only raise HDL by between 2% and 15%. So, why aren’t doctors prescribing it? It’s a good question. The lack of prescriptions certainly has nothing to do with a lack of research. Medline, the database of research for the US National Institutes of Health, quotes over 40 positive studies from the last five years recommending niacin over statins, or with statins to further improve their cholesterol-lowering effect [8].
I recommend 1,000mg a day to lower raised LDL cholesterol and raise a low HDL cholesterol. Niacin side-effects The most obvious side-effect of taking fairly high doses is a blushing effect which is diminished by taking with food, but non-blush or extended release niacin is now easily available. Other reported side-effects include dyspepsia, fluctuations in blood sugar and uric acidUric acid is a chemical created when the body breaks down substances called purines. Purines are found in some foods and drinks including liver, anchovies,… levels, although these last two have not be found in recent studies. A randomized controlled trial reports that of 148 diabetic patients, only four discontinued niacin because of inadequate glucose control [9].
Finally, niacin is best taken with high-dose homocysteine-lowering nutrients, as there is some evidence that niacin may otherwise slightly raise homocysteineHomocysteine is an amino acid found in the blood. Elevated levels of homocysteine have been associated with narrowing and hardening of the arteries, an increased… levels. In any event I’d recommend anyone with cardiovascular concerns checks their homocysteine levels. You can buy home test kits from York Test. There was a hint of a concern in one study that the combination of statins plus niacin might slightly increase stroke risk. It’s too early to say if this is really an issue, however, in an ideal world it might be better to try niacin, plus all these other recommendations first because you might just find that your cholesterol levels normalize rendering the need for statins obsolete. The form of niacin is important. While the cheapest is pure niacin, this gives a very strong blushing effect for up to half an hour. Most people find that, within a few days if you take it twice a day, the blushing subsides. If you want to try this you can reduce the flushing by starting with a low dose of 50 to 100mg per day, then double the dose each week until an effective level of at least 250mg twice a day is reached. Alternatively there are prescribable forms of niacin, such as Niaspan, that don’t cause blushing. These are available on prescription from your doctor.
There is also a non-blushing form of niacin called inositol hexanicotinate, available in health food stores. Clinical trials haven’t been done on this form so it’s hard to say whether it works as well. Another form of niacin, niacinamide, doesn’t lower cholesterol. It is possible that the blushing effect may be part of the benefit of niacin. In any event, the lowest therapeutic level is 500mg (one tablet) and the highest is 2,000mg. Learn how to handle stress A major factor usually overlooked in conventional approach to heart problems is stress – both physical and psychological. Of course stress in the form of exercise or a challenging job can be very good for you but chronic stress can damage your health and your heart and there is no mystery as to how it happens. Bad stress, which can come from poor working conditions, a bullying boss or few friends, has clear and well understood effects on your hormones – especially adrenalin and insulin – as well as your nervous system. And this is turn has direct and measurable effects on your body chemistry; in fact it produces many of the familiar heart disease ‘risk’ factors.
For instance, you respond to stress by producing adrenalineAdrenaline is a hormone produced by the adrenal glands during high stress or exciting situations. This hormone is part of the ‘fight or flight’ response…. which in turn pushes up blood sugar levels, raises blood pressure, and increases both blood clotting agents and LDL cholesterol. Meanwhile extra amounts of the stress hormone cortisol encourage the storage of dangerous “visceral” fat in the abdomen. And visceral fat is strongly connected to metabolic syndrome, which is a big risk factor for diabetes and heart disease. So a vital part of any healthy heart regime involves turning off a damaging stress response and there are plenty of ways to do it such as exercise, moderate alcohol consumption, watching your football team winning, passing an exam, organizing an enjoyable social evening. Increase magnesium The mineral magnesium lowers blood pressure by about 10% [10], as well as reducing cholesterol and triglycerides [11], thus substantially lowering the risk of death from cardiovascular disease.
Unfortunately, a lot of us are deficient in magnesium – the average intake in the UK is 272mg, while an ideal amount is probably 500mg, especially if you have high blood pressure. The richest source of this mineral is dark green vegetables, nuts and seeds, especially pumpkin seeds. However it is also worth supplementing at least 150mg of magnesium every day, and double this if you do have high blood pressure or cardiovascular disease. A few good quality multivitamin and mineral supplements will provide 150mg (most don’t), leaving a further 150mg to supplement. A particularly good form of magnesium is magnesium ascorbate, which is bound to vitamin C, effectively killing two birds with one stone since vitamin C lowers blood pressure and cardiovascular risk. Put all this together and you have a winning formula for optimal cholesterol and triglyceride levels.
REFERENCES
1. K.B. Scribner et al., “Hepatic Steatosis and Increased Adiposity in Mice Consuming Rapidly vs. Slowly Absorbed carbohydrate”, Obesity (Silver Spring), 2007 Sep;15(9):2190-2199
2. D. Thomaset al., The Cochrane Library, 2007
3. G. Yang et al., “Longitudinal study of soy food intake and blood pressure among middle-aged and elderly Chinese women”, American Journal of Clinical Nutrition, 2005; 81(5),1012-1017
4. M. Yoshida et al., “Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes”, European Journal of Clinical Nutrition, 2006 Apr; 60(4):529-3: also H. L. Chen et al., “Konjac supplement alleviated hypercholesterolemia andhyperglycemia in type-2 diabetic subjects: A randomized double-blind trial”, Journal of the American College of Nutrition, 2003 Feb; 22(1):36–42
5. A. Lewis et al., “Treatment of hypertriglyceridemia with omega-3 fatty acidsOmega-3 fatty acids are considered essential fatty acids – they cannot be made within the body so must be obtained from the diet. EPA and…: a systemic review”, Journal of the American Academy of Nurse Practitioners, 2004 Sep; 16(9):384-395
6. M.D. Ashen and R.S. Blumenthal,“Low HDL Cholesterol Levels”, New England Journal of Medicine, 2005Sep; 353;1252-1260
7. I. Singh et al.,“High-Density Lipoprotein as a Therapeutic Target A Systematic Review”, Journal of the American Medical Association, 2007 Aug; 298, 7
8. See http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-niacin.html
9. S.M. Grundy et al., “Efficacy, safety, and tolerability of once-daily niacin for the treatment of dyslipidemia associated with type 2 diabetes: results of the assessment of diabetes control and evaluation of the efficacy of niaspan trial”, Archives of Internal Medicine, 2002 Jul; 162(14):1568-76
10. W.J.Mroczek et al., “Effect of magnesium sulfate on cardiovascular hemodynamics”, Angiology 1977; 28, 720-724
11. B.T. Altura and B.M. Altura, “Magnesium in cardiovascular biology”, Scientific American, 1995; 28-36
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