What Makes Your Cholesterol High or Low?

If you think that only by eating more cholesterol will raise your blood cholesterol, then think again! If you think that only by eating more cholesterol will raise your blood cholesterol, then you are wrong. The cholesterol levels in your blood depend not only on how much cholesterol you eat but also on the rate of manufacturing and disposing of cholesterol by your body and several other factors. These factors are:

Heredity.

Your genetic make up has significant influence on your cholesterol levels [1].
In familial hypercholesterolemia, there is a genetic mutation in (the LDLR gene) the LDL receptors of the liver causing high levels of blood LDL cholesterol [2]

Obesity

Obesity or overweight has been associated with high cholesterol level[5, 6, 7]. If you are overweight or obese and have a high LDL-cholesterol level or high triglyceride level, losing weight may help you lower it. Weight loss also facilitates raising levels of good (HDL) cholesterol.

Diet

Saturated fat, trans-fat and cholesterol in diet are the major cause of rise in blood cholesterol due to diet [8, 9, 10]. Saturated fat and cholesterol are found mostly in foods of animal origin. Trans-fats are found in deep fried snacks, baked snacks and anything made using hydrogenated vegetable oil (vanaspati). Reducing the amount of dietary saturated fat, trans-fat and cholesterol is a very important step in lowering your blood cholesterol levels. Some of the excess dietary cholesterol is disposed by the liver. Still, the American Heart Association (AHA) recommends that healthy people should limit their average daily cholesterol intake to less than 300 milligrams. This limit for people with heart disease is less than 200 mg per day [11].

Dietary Fiber

There is ample scientific evidence that consumption food rich in dietary fiber (fibre) can positively influence your health, especially your heart-health, by lowering levels of LDL cholesterol in the blood. [Refs. 13 to 28]. Increasing dietary fiber (fibre) has been recommended as a way to lower blood cholesterol levels.

Dietary fiber or roughage is a plant substance that is resistant to digestion by enzymes present in human gastrointestinal tract. There are two types of dietary fiber: soluble and insoluble in water. It has been suggested that consumption of soluble fibers (e.g. psyllium, guar gum, oats, pectin, etc.) lower total and LDL (bad) cholesterol in the blood.

Physical Activity (Exercise)

Physical inactivity is a major risk factor for heart disease. Regular physical activity may lower LDL-cholesterol and raise HDL-cholesterol levels [12]. Higher HDL cholesterol is associated with lower risk of heart disease. Physical activity also helps reduce weight, blood sugar in diabetic and high blood pressure. Aerobic (cardio) physical activity enhances the strength of heart and lungs. Regular medium intensity physical exercise such as brisk walking, jogging and swimming also gives the body a nice shape. Other moderate-intensity activities which can be done daily are walking for pleasure, housework, gardening, yard work, dancing etc.

Smoking and Tobacco:

Consumption of tobacco in any form like smoking, tobacco chewing or gutkha is one of the major risk factors of heart disease which are under your direct control. Smoking lowers Good (HDL) cholesterol levels and raises the tendency for blood to clot.

References:

  1. Austin MA, Brunzell JD, Fitch WL, Krauss RM. Inheritance of low density lipoprotein subclass patterns in familial combined hyperlipidemia. Arteriosclerosis. 1990 Jul–Aug;10(4):520–530.
  2. Austin MA, Hutter CM, Zimmern RL, Humphries SE. Familial hypercholesterolemia and coronary heart disease: a HuGE association review. Am J Epidemiol. 2004 Sep 1;160(5):421-9. Review
  3. Brook GJ, Keidar S, Boulos M, et al. (June 1989). "Familial homozygous hypercholesterolemia: clinical and cardiovascular features in 18 patients". Clin Cardiol 12 (6): 333–8
  4. H Allayee, B E Aouizerat, R M Cantor, G M Dallinga-Thie, R M Krauss, C D Lanning, J I Rotter, A J Lusis, and T W de Bruin Families with familial combined hyperlipidemia and families enriched for coronary artery disease share genetic determinants for the atherogenic lipoprotein phenotype. Am J Hum Genet. 1998 August; 63(2): 577–585.
  5. Carla J. H. van der Kallen, Christine Voors-Pette and Tjerk W. A. de Bruin Abdominal Obesity and Expression of Familial Combined Hyperlipidemia. Obesity Research (2004) 12, 2054–2061; doi: 10.1038/oby.2004.256
  6. Quiñónez Zarza C, Silva Ruiz R, Torres Juárez JM. Obesity, arterial hypertension, metabolic disorders, and polycystic ovary syndrome Ginecol Obstet Mex. 2000 Jul;68:317-22.
  7. Y. Alamanos, K. Tsamandouraki, A. Koutis, C. Lionis and M. Fioretos. Obesity, Hypertension, Hypercholesterolemia and Diabetes Mellitus in Women Aged 20–69, Living in a Highland Community of Crete. he European Journal of Public Health 1991 1(2):65-67; doi:10.1093/eurpub/1.2.65
  8. Rianne M Weggemans, Peter L Zock and Martijn B Katan Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a meta-analysis American Journal of Clinical Nutrition, Vol. 73, No. 5, 885-891, May 2001
  9. PN Hopkins Effects of dietary cholesterol on serum cholesterol: a meta-analysis and review Am. J. Clinical Nutrition, Jun 1992; 55: 1060 - 1070.
  10. SL Roberts, MP McMurry and WE Connor American Journal of Clinical Nutrition, Vol 34, 2092-2099 Does egg feeding (i.e., dietary cholesterol) affect plasma cholesterol levels in humans? The results of a double-blind study
  11. http://www.americanheart.org
  12. DW Quig, FW Thye, SJ Ritchey, WG Herbert, BA Clevidence, LK Reynolds and MC Smith. American Journal of Clinical Nutrition, Vol 38, 825-834. Effects of short-term aerobic conditioning and high cholesterol feeding on plasma total and lipoprotein cholesterol levels in sedentary young men
  13. Ripple Talati, William L. Baker, Mary S. Pabilonia, C. Michael White, and Craig I. Coleman The Effects of Barley-Derived Soluble Fiber on Serum Lipids; CONCLUSION: Barley-derived β-glucan appears to beneficially affect total cholesterol, LDL-cholesterol, and triglycerides, but not HDL-cholesterol.
  14. E. S. Eshak, H. Iso, C. Date, S. Kikuchi, Y. Watanabe, Y. Wada, K. Wakai, A. Tamakoshi, and the JACC Study Group Dietary Fiber Intake Is Associated with Reduced Risk of Mortality from Cardiovascular Disease among Japanese Men and Women J. Nutr., August 1, 2010; 140(8): 1445 - 1453.
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  20. Marlett JA, Hosig KB, Vollendorf NW, Shinnick FL, Haack VS, Story JA. Mechanism of serum cholesterol reduction by oat bran. Hepatology. 1994;20:1450-1457.
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