In the last article we learned that cholesterol is not only good, but is an essential substance that we need for our health; however, in large amounts it becomes deadly, causing disease and death. To summarize what we learned previously, our bodies need cholesterol for various vital body functions. Our own bodies synthesize all the cholesterol we need; we do not need to get any from our diets. We learned that LDL is known as the “bad” cholesterol, because too much of it is unhealthy. Excess LDL contributes to cholesterol plaques on the blood vessel walls; whereas, HDL is referred to as the “good” cholesterol, because higher levels of this lipoprotein is protective of health. HDL cholesterol absorbs excess LDL cholesterol and carries it back to the liver, which flushes it from the body. Having high levels of HDL can reduce the risk for heart disease and stroke.

Atherosclerosis, the disease in which cholesterol plaques are deposited on the walls of the arteries, narrowing the arteries, is progressive, meaning that it gets worse with time. It can make it more difficult for blood to flow through your heart and body, putting you at increased risk of circulatory problems, heart disease and stroke Some factors that affect your LDL and HDL levels are uncontrollable, such as family history and age. Cholesterol levels naturally increase as we get older. Some people have a genetic condition that predisposes them to high cholesterol levels. Having high cholesterol does not produce any symptoms in itself. Therefore blood cholesterol levels should be checked regularly through blood tests.

But there are other factors you can control.  Diet and lifestyle can affect the amount of fat in our blood and the way it circulates around the body.  These risk factors are to blame for up to 90% of all heart attacks from cholesterol build-up. They either increase your total cholesterol level, or affect the ratio of good to bad cholesterol. Not all of these apply to us as health reformers, however knowing all the risk factors can help us when we are counselling people about their lifestyle habits which could lead to heart disease. These include:

GENETIC SUSCEPTIBILITY

Since our bodies make cholesterol, some people produce more cholesterol than can be safely handled, causing a buildup of fat and plaque in their arteries. This is a genetic condition known as Familial Hypercholesterolemia (FH). It affects 1 in 400 people in the general population. Their genetic condition makes the liver incapable of removing excess LDL. This causes their LDL cholesterol levels to be three to six times higher than normal. Because these cholesterol readings are so excessive and the cause is genetic, lifestyle modifications cannot lower them enough to fall within a safe range.

For the majority of people, there are no symptoms until they have a heart attack. Patients may have bumps [deposits of cholesterol] around the eyes, or bumps on the tendons. A white ring around the cornea of the eye is sometimes seen in patients even under the age of 45. The main symptoms are high cholesterol levels and a family history of high cholesterol. Everyone should have their cholesterol levels tested, even if they are eating a healthy diet, as they may have the inherited form of high cholesterol. Lifetime risk of a heart attack or stroke is 20 times greater for someone with this susceptibility. For women in the age group of 20 to 39, there is 125 times greater risk. Men tend to have heart attacks or strokes 10 years earlier, in their thirties and forties, and women in their fifties and sixties. Since this condition starts at birth, cholesterol is high from day one. By ages 9 to 11, all children should get screened for cholesterol levels. Then if they have the genetic form of high cholesterol, they can institute diet and exercise early on as lifestyle changes. Unfortunately, most times, lifestyle changes alone are not enough and cholesterol levels must be controlled by medication.   A diet high in saturated fat or being overweight can also “switch on” certain genes which increase cholesterol levels.

AGE/GENDER

Blood cholesterol begins to rise around age 20 and continues to go up until about age 60 or 65. Before age 50, men’s total cholesterol levels tend to be higher than those of women of the same age—after age 50, the opposite happens, as with menopause, women’s LDL levels often rise.

FATS IN THE DIET

The American Heart Association reports that eating a diet high in saturated fats can drive up total cholesterol, and increase the amount of LDL cholesterol in the body. For that reason, most nutrition experts recommend limiting saturated fat to under 10% of the daily calories. Saturated fats include fats found in meat, full-fat dairy, butter, and palm oil.  However, a handful of recent studies have questioned the link between saturated fat and heart disease. Their conclusion is that there was not enough evidence to conclude that saturated fat increases the risk of heart disease; however they also conclude that replacing saturated fats with healthy fats may reduce the risk of heart disease. Therefore, the consensus still swings towards reducing saturated fats.

Trans fats are the worst offenders and are found in many processed foods. Because the amount of trans fats must be listed on the package’s nutrition label, the amount of trans fats in food has greatly decreased. Eating foods rich in trans fats increases the amount of harmful LDL cholesterol in the bloodstream and reduces the amount of beneficial HDL cholesterol. Part of the problem with reducing unhealthy fats, is that people replace those calories with highly processed carbohydrates (sugars).

TOBACCO

Tobacco smoking will raise the levels of LDL “bad” cholesterol and reduce the levels of HDL (“good”) cholesterol. Quitting smoking can improve both LDL and HDL levels.

EXCESSIVE ALCOHOL

Both occasional heavy drinkers and regular heavy drinkers have significantly higher levels of LDL cholesterol and significantly lower levels of HDL cholesterol than non-drinkers.

HIGH BLOOD PRESSURE

Long-term exposure to the forces of higher blood pressures can cause damage to the inner lining of arterial blood vessels. The damage can attract the accumulation of cholesterol that can form plaques and clots within the arteries that block blood flow.

DIABETES

Diabetes tends to lower “good” cholesterol levels and raise “bad” cholesterol levels, which increases the risk for heart disease and stroke. This common condition is called diabetic dyslipidemia, which means your cholesterol is going in the wrong direction.

OBESITY

Generally, decreasing saturated fats and cholesterol in one’s diet works to decrease cholesterol levels; however, research shows that dietary changes are less effective at improving cholesterol levels in obese people. The body’s normal process that adjusts LDL production and removal based on the fats that are consumed does not work. Obesity increases the amount of LDL cholesterol the liver makes. It also decreases removal of LDL cholesterol from the blood. Inflammation throughout the body is a common complication of obesity. This constant inflammation decreases the body’s response to changes in dietary fat intake. Insulin resistance, common in obesity, causes changes in the enzymes that the body needs to handle cholesterol normally. The condition is worse in people who have excess fat in the abdominal area.

The eyeball test is sufficient—if someone looks fat, they are fat. Not only do extra pounds make a person more likely to get high cholesterol, they are also more prone to high blood pressure and type 2 diabetes, which affect the lining of the arteries, making them more likely to collect plaque from cholesterol. Losing weight, especially belly fat, raises your good and lowers your bad cholesterol. Gaining body fat will increase blood cholesterol. If body fat decreases, cholesterol will too. Maintaining a healthy weight will balance HDL and LDL levels.

STRESS

Over time, out-of-control stress becomes a problem. Studies have shown that stress increases cholesterol not only in the short-term but can also affect cholesterol levels even years down the road. Other studies have shown that the amount of stress itself is not as important as how an individual reacts to and manages stress. Those who manage stress in unhealthy ways (via hostility, social isolation, or self-blame, for example) tend to have lower levels of HDL (good) cholesterol and higher levels of LDL (bad) cholesterol. The more anger and hostility that stress produces, the higher (and worse) the LDL tends to be. Stress encourages the body to produce more energy, which cause the liver to produce and secrete more of the bad cholesterol, LDL. Also, stress may interfere with the body’s ability to remove LDL cholesterol.

SEDENTARY LIFESTYLE

The World Health Organization reports that 60–85% of the population worldwide does not get enough physical activity, making it the fourth leading risk factor for disease and

death. A sedentary lifestyle is a product of increased technology. Not only is the lack of exercise harmful, but the extended periods of time that people sit without moving. Even exercising for 30 minutes a day may not be able to counteract the effects brought on by a lack of activity throughout the rest of the day. Lack of physical activity has shown to increase levels of LDL cholesterol.

MEDICAL CONDITIONS

Some medical conditions and prescribed medicines can affect your cholesterol levels also. In addition to the ones already mentioned, the following are a common cause of unhealthy cholesterol levels and should be looked into and ruled out: underactive thyroid gland (hypothyroid); kidney problems; liver problems. The liver is central to the regulation of cholesterol levels in the body. Not only does it synthesize cholesterol for export to other cells, but it also removes cholesterol from the body by converting it to bile salts and putting it into the bile where it can be eliminated in the feces.

Drugs which most commonly raise cholesterol include some diuretics, steroid hormones, immuno-suppressants, beta blockers and antidepressants.  If you are on any of these drugs your doctor will monitor your cholesterol and may have to adjust your treatment to help keep your cholesterol under control. If lifestyle changes are unsuccessful or cholesterol levels are very high, cholesterol-lowering drugs may be prescribed.

WHAT YOU CAN DO TO REDUCE CHOLESTEROL LEVELS

In reviewing the list of risk factors that increase bad cholesterol while decreasing good cholesterol, almost all of these have something in common: you can do something about them. Experts agree that making a conscious effort to reduce your risk factors leads to a lower risk of heart disease from improvements in cholesterol levels.

Estimates state that by the year 2030, 86.3 percent of American adults will be overweight or obese, the prevalence of childhood obesity will double, and one out of every six health care dollars will go toward overweight and obesity-related costs. Exercising for at least 30 minutes most days of the week can help you both lower your LDL levels and increase your HDL levels. In fact, exercise is one of the few ways to actually boost the good HDL cholesterol.  More exercise is even better. Being active also helps you reach and keep a healthy weight, which cuts your chance of developing blocked arteries. It is not necessary to exercise for 30 minutes straight. Exercise can be broken up into 10-minute sessions. Aerobic exercise (cardio) such as brisk walking lowers the chance of stroke and heart disease, helps you lose weight, keeps bones strong, and is great for your mood and stress management. You can be active anywhere. Garden, play with your kids, hike, walk your dog. Even housework goes on the list if it gets your heart rate up. Do as much as possible, as often as you can, wherever your day takes you. To be effective, you should raise a sweat while exercising. Because of the negative effects of sitting for long periods of time, taking short walks frequently during the day is vital. Aim for 10,000 steps per day.

To reduce stress, make it a priority to relax. It can be as simple as taking some slow, deep breaths. You can also meditate, pray, socialize with people you enjoy, and exercise. Attend church and put your trust in God. And if some of the things that stress you out are things you can change, go for it!

You need some fat in your diet, as fats are necessary for many vital functions. However, the type of fat matters. Unsaturated fats — like those found in olive and safflower oils — lower LDL “bad” cholesterol levels and may help raise HDL “good” cholesterol.  Almonds, pecans, pistachios, walnuts, or other nuts are a tasty treat. They are high in monounsaturated fat, which lowers LDL “bad” cholesterol but leaves HDL “good” cholesterol alone. Studies show that people who eat about an ounce of nuts a day are less likely to get heart disease. Keep the portion small, so you limit fat and calories. Ensure that Omega-3s, found in flaxseed, are a part of your diet. They are a type of fat your body needs; they also help lower levels of LDL cholesterol, slowing the growth of plaque in arteries.

Soluble fiber slows the absorption of cholesterol, and reduces the amount of cholesterol the liver produces. Every 10 grams of fiber per day reduces the risk of dying by 10 percent, Oats, barley, beans, and some fruits and vegetables are all good sources of soluble fiber. Oats and barley especially are rich in a form of soluble fibre called beta glucan.  Once eaten, beta glucan forms a gel which helps bind cholesterol in the intestines and prevent it from being absorbed. Filling your diet with fiber-rich foods, such as fresh fruits, vegetables, whole grains, legumes, nuts and seeds can help decrease your LDL levels. Fiber binds to cholesterol in the digestive tract and prevents it from entering into the bloodstream. Eating whole grain foods is associated with a 15 to 25% reduction in premature death from all causes. In fact, researchers found that those who ate six or more servings of whole grains a week had less plaque in their arteries than those who ate whole grains less often. Eating three or more serving of whole grains each day means a 30% lower risk of atherosclerotic disease. However, avoid processed carbohydrates which will cause your HDL to take a nose dive. An average American eats 10 to 15 grams of fiber per day. The recommended daily amount is 20–35 grams per day. Load your plate with fruits and vegetables—aim for five to nine servings each day—to bring down your LDL level. They contain large amounts of fiber. Many of the antioxidants contained in fruits and vegetables also reduce cholesterol levels.

Excess salt intake can raise blood pressure, and increase cholesterol build up in the arteries. Dietary Guidelines state that daily sodium intake should be less than 2,300 mg a day. Numerous studies have shown that vegetarians have lower blood pressure than non-vegetarians. A low-fat, high-fiber vegetarian diet, even without reduced salt intake, can lower blood pressure by as much as 10 percent.

Watch the amount of calories that you consume, to prevent weight gain and higher cholesterol levels. To measure portion sizes, there is a “handy” way to tell. One serving of fresh fruit is about the size of your fist. And a snack of nuts or serving of cooked vegetables, rice, or pasta should fit in your cupped hand.

Overall, a diet to lower cholesterol based on plant foods—grains, beans, vegetables, and fruits—is the best way to keep saturated fat intake low and to avoid cholesterol completely. A vegan diet is free of all animal products and yields the lowest risk of heart disease. Studies show that replacing animal protein with soy protein reduces blood cholesterol levels even when the total amount of fat and saturated fat in the diet remains the same. The special proteins in soy also appear to influence how the body regulates cholesterol. Studies show you can lower your cholesterol by around 6% by including as little as 15g of soy protein per day.

A recent study showed that when participants switched to a strict low-fat vegetarian diet for about two weeks, they lowered their total cholesterol and blood pressure by 11 percent and 6 percent respectively, and men lost an average of 5.5 pounds and women an average of 2.2 pounds.

If you really want to make a dent in your cholesterol, aim for about 90% of your food intake each day to be from vegetables, fruits, beans, whole grains and nuts/seeds. By making significant changes to your diet, you should see at least a modest reduction in your cholesterol levels within 3-4 weeks.  It is important to stick to these initial changes and perhaps build on them in order to keep your cholesterol low.  It can take up to 3 or even 6 months to establish new dietary habits. But, over time, you will reduce the risk of diabetes, high blood pressure, and obesity, all which lead to higher cholesterol levels.

Herbs such as ginger, garlic, and curcumin will help with preventing plaque buildup. Ginger can increase circulation and curcumin can block cholesterol from being absorbed by the body.

The following supplements can assist in reducing cholesterol levels: Red rice yeast extract; Omega-3 oils; niacin; plant sterols.

Some experts claim that nearly all people over the age of 40 who are sedentary and eat a Standard American Diet are found to have a significant amount of atherosclerosis in their coronary arteries. In 2007, More than one million coronary angioplasties to open up blocked arteries were performed in the U.S. More than 400,000 coronary bypass operations were performed in the U.S. The cost was more than $100 billion to combat disease related to high cholesterol. However, even small reductions in LDL and small increases in HDL cholesterol can reduce the risk of heart disease, plaque buildup, and strokes.

We are responsible for obtaining knowledge on how to take care of our physical bodies. We then must choose whether we use that knowledge to improve our health. Much of what we learned about maintaining healthy levels of cholesterol is that it is within our control. Once we have knowledge, we either suffer the consequences of ignoring that knowledge, or we reap the benefits of adhering to that knowledge. The choice is ours. We are not protected from ill health if we choose to ignore God’s laws of health. Prayers for healing are only answered by God if we live up to the light that we have on health reform. Each day, knowledge about the human body increases, and we need to keep up with the most current research to have the latest information and then apply it. Missionary work in the closing scenes of earth’s history will focus on the health message. Let us all be scholars when it comes to health, not only to save ourselves, but to inform others of God’s immutable law, which includes health reform.