Cholesterol makes vital contributions to health, a major component of all human cell membranes and a building block of steroid hormones, including cortisol, estrogen, and testosterone. However, high levels of cholesterol, particularly LDL cholesterol (“bad cholesterol”), have a long association with many diseases, especially cardiovascular diseases (CVD), the leading cause of death in the world. CVD are diseases of the heart and blood vessels that can cause heart attacks and stroke. More than 100 million adults in the United States have high cholesterol.
High levels of LDL cholesterol dramatically increase the risk for heart attacks, angina, peripheral artery disease, and stroke. Excess LDL cholesterol accumulation in artery walls may lead to chemical changes, including oxidation; the body interprets these changes as “danger” and responds by drawing inflammatory compounds into arteries. This process ultimately leads to both the build-up of plaque in the artery walls and chronic inflammation. Thus lowering LDL cholesterol, boosting HDL cholesterol (“good cholesterol”) and protecting cholesterol from oxidation are effective ways to maintain a healthy heart and reduce risk of heart disease.
According to recent Harvard HealthBeat report, for healthy people, an LDL of 160 milligrams per deciliter (mg/dL) was once considered acceptable; now 130 mg/dL is okay, and 100 mg/dL, ideal. For people with stable coronary artery disease, diabetes, hypertension, or other major cardiovascular risk factors, the targets are more stringent still: 100 mg/dL is okay, 70 mg/dL or less, ideal. And for patients with unstable coronary heart disease, it’s 70 mg/dL or bust.
Diet, weight control, and exercise are essential for lowering blood cholesterol. When diet and exercise alone are not enough to reduce cholesterol to goal levels, doctors often prescribe medication, the most prominent being the statins (FDA Consumer Health Information).
Dietary approaches to lower blood cholesterol and CVD risk include consuming diets low in saturated fats and trans fats and high in heart-healthy ingredients such as fish oil omega-3, soluble dietary fiber (e.g., beta-glucan rich oats and barley), soy protein, plant sterols, dietary antioxidants, etc. Botanical-based products such as cocoa, green tea and fruits contain heart-healthy flavonoids and other polyphenols that minimize oxidative stress. These heart-healthy ingredients are also commercially available in concentrated forms as nutritional supplements (powder, capsules, and tablets).
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