How does cholesterol form?
Atherosclerosis refers to clogging of the arteries, which is the underlying cause of cardiovascular disease (which still remains the #1 cause of death in North America). The clogging beings with damage or dysfunction to the walls of the arteries due to oxidative damage such as smoking, insulin resistance, impaired ability of your body to repair the damage, among many others. Once the walls of the arteries (the endothelium) have had enough damage, the sites of injury are essentially susceptible to the binding of cholesterol. The cholesterol plaques continue to grow until the artery is blocked or ruptures and forms a clot, causing a heart attack or stroke. There are many natural supplements to help reduce cholesterol but exercise and diet are integral to prevent and reduce the accumulation of plaque in the arteries.
If you are on a statin, CoQ10 supplementation is highly recommended
Statins work by inhibiting an enzyme called HMF CoA reductase, which makes both cholesterol and CoQ10. CoQ10 is used to make ATP, creating the energy for all of our cells. The common side effects of statins are fatigue and muscle weakness, which are directly due to statins effect of reducing CoQ10. CoQ10 is extremely important to provide energy to the heart muscles, thus protecting your heart. In addition to this, CoQ10 increases energy in all of your cells, therefore making you feel more energetic!
Diet truly is key
Research has shown time and time again that people who follow or start following a traditional Mediterranean style diet are able to reduce cholesterol and their risk of cardiovascular disease. In my clinic, I combine this with an anti-inflammatory diet to further decrease inflammation in the arteries. The basics of the Mediterranean & anti-inflammatory diet are:
- Predominantly plant based foods: fruits, veggies, legumes, nuts and seeds (these all contain soluble fiber, which is extremely effective and important in lowering cholesterol. Harvard has done studies on the protective benefit of fiber and found that men who ate a diet high in fiber were 40% less likely to develop coronary artery disease. Try and get at least 35 grams per day to lower cholesterol—you can find the fiber content of different foods on many websites.)
- To further decrease inflammation, reduce wheat and gluten consumption and eat primarily whole, unrefined grains such as quinoa, amaranth, oats, buckwheat, and millet
- Use olive oil as your principle source of fat
- Avoid highly processed foods
- Eat locally grown foods that are in season
- Red meat is consumed in low amounts (lean red meats 3-4 times per month)
- Use fresh fruit as dessert instead of cakes, cookies, ice cream, etc.
- Fish is consumed regularly
- Poultry and eggs are consumed in moderation (up to four times per week)
- Refined sugar intake is limited, with honey being the main sweetener
Although always easier said than done, weight loss does directly decrease blood pressure. If you are not overweight, exercise itself decreases cholesterol and blood pressure. If you are eating well and exercising at least 45 minutes per day but still not losing weight, it would be worth asking your ND or MD to check your thyroid blood levels (I always recommend a full thyroid panel: TSH, free T3, free T4, TPO antibodies).
Very cliché but true. If you are not doing anything to relax and decompress, here is yet another reason to start. This looks different for everyone—yoga, bath, walk, hike, puzzle, meditation, cooking, etc.
Supplements to decrease cholesterol & blood pressure
If you are taking cholesterol or blood pressure lowering medications, always make sure you talk to your ND before starting supplements. These are just a few suggestions, there are many, many more. It is also important to make sure you are getting good quality supplements—many inexpensive supplements are not absorbed as well as professional grade products and therefore you will not experience the same degree of benefit.
- Vitamin B6:
- Vitamin B6 reduces homocysteine levels in the blood. Higher levels of homocysteine are associated with increased atherosclerosis (and increased atheroscleroris, or clogging of the arteries, causes an increase in blood pressure. Therefore, supplementing with vitamin B6 has been shown to lower systolic blood pressure (the top number) and decrease clogging of the arteries. Always talk to your ND or MD before taking high doses of Vitamin B6.
- Fish oils
- There has been a lot of research on fish oils in the past several years clearly demonstrating people who consume higher Omega 3s (EPA) have a lower risk of congestive heart disease. The overall effect on actual blood pressure is low, however fish oils are extremely anti-inflammatory, decreasing damage to the arteries and reducing plaque. The dose needed for protection against cardiovascular disease is at least 1000mg per day of EPA (this is not EPA and DHA combined–you need to check the label of the fish oil you are taking to make sure the actual EPA you are getting is 1000mg per day).
- Our modern day soils and foods are very low in magnesium, and a high intake of magnesium is associated with lower blood pressure. Magnesium relaxes the muscles and arteries, allowing the blood to move through the vessels more easily. The most highly absorbed form of magnesium is bisglycinate and it does not cause a laxative effect. Citrate, oxide, chloride, malate, and carbonate and others irritate the bowels and act as laxatives in high doses.
- Vitamin C
- Supplementing with as little as 500mg per day of vitamin C can decrease systolic blood pressure. In addition to this, Vitamin C is the main precursor to collagen, which helps strengthen blood vessels. It also is an antioxidant and works at scavenging free radicals, thus decreasing inflammation and damage to the arteries and reducing your risk of cardiovascular disease.
- As talked about earlier, CoQ10 provides essential energy to the muscles of the heart. In addition to protecting the heart and muscles, it also reduces both systolic and diastolic blood pressure, with further evidence showing that people who supplement with 225mg/day were able to discontinue their blood pressure medication after 4 months. It usually takes 1-3 months for a reduction in blood pressure with CoQ10 supplementation.
- Niacin (Vitamin B3)
- Effective at lowering cholesterol and also actually decreasing mortality (versus some medications that decrease cholesterol but don’t actually decrease your risk of mortality). To avoid the irritating flushing effect of Niacin, there are many non-flushing forms out there. Niacin should be taken at night, because this is when your body forms cholesterol.
- Plant sterols
- To explain this very generally, these are very similar in structure to cholesterol and therefore block your body’s absorption of ‘bad’ cholesterol consumed through the diet. Plant sterols are not absorbed well by your body and therefore are excreted, while helping excrete ‘bad’ cholesterol as well. The overall effect is a lowering of cholesterol.
- Garlic has been shown to lower LDL (or ‘bad’) cholesterol levels, and increase HDL (or ‘good’) cholesterol levels. Even though the overall cholesterol lowering effect is not as large as with other supplements, it lowers the cholesterol: HDL level, which decreases your risk for heart disease.
Don’t be discouraged, many people can get their cholesterol levels back in range with diet and exercise alone. It is always best to talk to a professional before starting supplements, especially if you are already taking medications. Good luck on your journey to a healthy heart!