Important Information On Cholesterol

Cholesteryl esters are composed of a single fatty acid esterfied to cholesterol, in which the polar component is an alcohol.

Cholesterol is normally found in the body in cell walls and membranes, vitamin D, hormones, and fat-digesting enzyme. Excess cholesterol can get deposited in the walls of blood vessels, leading to atherosclerosis, or hardening of the arteries. Atherosclerosis leads to heart attack and stroke. Cholesterol is divided into LDL ("bad" cholesterol), which carries cholesterol in the blood and can get deposited onto the walls of blood vessels, causing atherosclerotic plaques. HDL ("good" cholesterol) helps clear the blood of cholesterol, and may even remove cholesterol from atherosclerotic blood vessels.

Cholesterol is a major component of all cell membranes. It is required for synthesis of sex hormones, bile acids, and vitamin D. It is also a precursor of the steroid hormones produced by the adrenal cortex and gonads.

Dietary cholesterol is found only in foods derived from animals (meat, fish, poultry, eggs and dairy products); it is not present in plants. Saturated fats have a profound hypercholesterolemic (increase blood cholesterol levels) effect. They are found predominantly in animal products (butter, cheese and meat) but coconut oil and palm oil are common vegetable sources. Saturated fat raises blood cholesterol levels more than anything else in the diet, even more than dietary cholesterol.

Findings suggest that blood lipid cholesterol levels predict subsequent mortality in men, especially those with preexisting cardiovascular disease. Those with high blood cholesterol levels have a risk of death from cardiovascular disease, including coronary heart disease, that was 3.45 times higher than that for men with a "desirable" blood cholesterol level.

Lowering cholesterol levels decreases the incidence of heart disease. In fact, several studies have convincingly shown that adequate hypercholesterolemic treatment can not only prevent CHD, but can also reverse it.

Dietary therapy is the cornerstone of all hypercholesterolemic therapy, and it has been estimated that 65 million adult Americans may be candidates for dietary instruction.

The efficacy of hypercholesterolemic diets lowering cholesterol and in some cases, in preventing CHD, has been convincingly demonstrated. Such efficacy does depend, however, on the vigour which the physician and dietitian support dietary therapy. Many physicians have declared dietary therapy a failure without providing their patients with real dietary advice and support.

Two factors that probably contribute to physicians disinterest in dietary therapy are extensive advertising of hypercholesterolemic drugs compared with the little advertisingof dietary therapy and patient reluctance to alter diet and life-style. Getting patients to alter their life-style is often a challenging task.

To further facilitate dietary therapy, recent research suggests that certain forms of fat (eg. fish and monounsaturated fatty acids) may be hypocholesterolemic, especially if they replace saturated fatty acids in the diet. Food technology is improving daily in palatably, removing fat from items like cheese, chips, and crackers. Frozen yogurt has become a popular replacement for ice cream. Fat substitutes, as they become available, may also facilitate compliance with a low-fat diet.

Scientists first suspected a connection between soy and lower cholesterol levels after observing that people in Asian countries where diets contain much more soy than in the United States have significantly lower levels of heart disease than Americans. Experts believe natural soy compounds called isoflavones act like human hormones that regulate cholesterol levels. A 1998 study concluded that regular consumption of soy isoflavones may reduce total cholesterol levels by up to 10 percent.

A minimum of 25 grams of soy protein must be consumed daily in order to reap optimal cholesterol-lowering benefits. Good sources of soy protein include soy milk, tempeh, tofu, and textured soy protein, a main ingredient in many meat substitutes.

The amount of cholesterol synthesized and metabolized by the body is far greater than the amount usually consumed in the diet. It must also be noted that in healthy people little correlation has been found between the intake of cholesterol and blood cholesterol levels. Yet the level of cholesterol in the blood is increased with high intakes of dietary saturated fat and can be lowered by increasing the intake of linoleic acid and fiber, which leads to a reduction of cholesterol absorption from the intestine and an increased faecal excretion of dietary cholesterol.

There is some evidence indicating that other nutrients can lower blood cholesterol levels. Choline emulsifies cholesterol thus helps to control a build up. Inositol metabolizes fats and cholesterol. Vanadium inhibits the formation of cholesterol in the blood vessels and aids in preventing heart attacks. Zinc also helps to decrease cholesterol levels.

If you are on a cholesterol reducing drug, you will suffer a decrease in the absorption of Vitamin A, thus needing to increase the amount available in your diet.

Psyllium is an especially attractive hybrid intervention in that it is well tolerated, lowers LDL-cholesterol by 10% to 20%, has no adverse effects on triglycerides, high-density-lipoprotein (HDL) cholesterol, or serum glucose, and is readily available and fairly inexpensive. It has a long history of use without any evidence of long-term adverse effects. Onions, Garlic, and Ginger are also recommended for their ability to help lower cholesterol levels.

A recent article estimated that oat bran supplementation (90 gm per day) was a much more cost-effective method of lowering serum cholesterol than either cholestyramine or colestipol.

The Food and Nutrition Board's Committee on Diet and Health recommend that dietary cholesterol should be less than 300 milligrams per day.

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