I was amazed to learn that high cholesterol affects almost half of Canadians aged 40 to 59 and more than a quarter aged 20 to 39 (see here). Those are significant percentages, to be sure. One option is to take a statin, which is a class of cholesterol-lowering medications. About one in ten Canadian adults takes a statin; however, there’s evidence that more than half of us stop them within the first year. A study found that there were a variety of reasons for this. Roughly half of the participants doubted they were necessary or weren’t aware of the efficacy of the medication, about a quarter were worried about joint and muscle side effects or had experienced these, and about a quarter stopped due to practical problems, such as issues with medication packaging.
Lifestyle Choices To The Rescue
Let’s face it, even if everyone who was prescribed a statin actually took it, statins are a band-aid solution that does not get to the root of the cholesterol problem. While our genes can indeed have an impact on cholesterol, we know that our lifestyle choices play a much more significant role. We also know that a combination of weight loss and a healthy diet can lower LDL (‘bad’) cholesterol levels up to 30%, which is similar to taking a statin. I find this both impressive and reassuring. It’s good to have options, right? Let’s take a look at some specific day-to-day choices we can make that may lower our cholesterol or prevent it from ever getting out of whack.
#1 Decrease Saturated Fat Intake
Consuming saturated fat is associated with higher cholesterol levels (e.g. here). The same holds true for trans fats, but these are less common in Canada thanks to the ban on artificial trans fats. Consuming cholesterol-containing foods elevates our blood cholesterol to a lesser degree than saturated and trans fats do.
Saturated fat and cholesterol are found in all animal products including meat, fish, dairy and eggs. Plants do not contain cholesterol, and the only plant-based ingredients naturally high in saturated fat are coconut, palm, and cocoa (except cocoa powder because it has been defatted).
Lightening up on or eliminating these fats may not be as difficult as you think. Our palate can adjust as we turn to many other options that are delicious and satisfying.
#2 Increase Soluble Fibre Intake
Soluble fibre becomes gel-like or thick and gummy when mixed with water. It can bind cholesterol in the intestine and remove it from our bodies.
University of Toronto professor David Jenkins, MD, PhD, DSc, not only invented the Glycemic Index, but also created the Portfolio Diet as a way to reduce blood cholesterol through food. One of the four components of the diet is to eat 20 grams of soluble (also known as viscous) fibre per day, which has been shown to reduce LDL cholesterol by 5 to 10%.
Some foods high in soluble/viscous fibre recommended by Dr. Jenkins are oatmeal, lentils, chickpeas, barley, cereals enriched with psyllium or oat bran, vegetables (especially eggplant and okra) and fruit (especially apples, oranges and berries). Here’s a handy list of the viscous/soluble fibre content of some foods to help hit the 20-gram goal.
Each of the remaining three components of the Portfolio Diet is also expected to drop LDL cholesterol by 5 to 10%. Dr. Jenkins’ research showed that study participants who adopted all four components along with consuming a low amount of saturated fat, decreased their cholesterol by almost one third (significantly more than participants who followed a low-saturated-fat diet only). Here are the remaining components:
Nuts – 45 grams daily
Plant protein – 50 grams daily
Plant sterols – 2 grams daily
#3 Achieve and Maintain a Healthy Body Weight
Losing weight can lower our cholesterol. If you’re looking for up-to-the-minute, evidence-based weight-loss strategies, I highly recommend Michael Greger, MD’s 2019 book How Not to Diet. He walks us through the “dietary attributes that could be used to create the most effective eating plan for losing weight”. To give you an idea, one dietary attribute is low in calorie density, and another is microbiome-friendly. He also includes what he refers to as “Weight Loss Boosters” such as negative calorie preloading. Finally, he outlines “21 Tweaks” for weight loss, some of which go beyond our food choices. A couple of examples are timing our exercise, so it’s done in a fasted state, and getting at least seven hours of sleep. You can check out the 21 Tweaks through his free Dr. Greger’s Daily Dozen app.
#4 Try Amla
Dr. Greger strikes again for raising Western civilization’s awareness about the wonders of amla! The medicinal use of amla stretches back for centuries in India, and the clinical trial results linking amla intake to decreased cholesterol are quite remarkable (see here). You’ll see here some clinical trials in which amla performed comparatively well to two different statins.
Amla is simply Indian gooseberries that we can purchase in a powder format and mix into a food or beverage. Be sure to purchase the pure organic powder, with the amla/gooseberries being the sole ingredient. Dr. Greger mixes one teaspoon into his morning smoothie. The powder has a very bitter taste, which is why some turn to the capsules. Positive results have been shown with amounts smaller than a teaspoon per day, so if a teaspoon doesn’t work for you, just go with however much you can manage!
Amla is one of the most antioxidant-rich foods, which is likely why it has been shown to have a powerful effect not only on blood cholesterol, but also on blood glucose regulation and inflammation.
Whether you’re battling high cholesterol, or concerned about developing it, I hope this post is an enlightening and encouraging resource for you. Your food choices can truly make a difference.