How can I lower my cholesterol?

We thought we would share a recent article in the NZ Herald on lowering cholesterol, as according to the NZ Heart Research Centre 1 in 4 New Zealand adults need to manage their cholesterol levels.

Cholesterol management is important as excess amounts of LDL cholesterol can build up on the walls of the arteries, forming plaques that narrow the arteries. Narrowed arteries make it harder for blood to flow to the heart and other organs, increasing the risk of heart attack, stroke and peripheral artery disease.

How can I lower my cholesterol? by Lauren Ball and Emily Burch
Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options. Could taking supplements lower your cholesterol? In theory, yes! But you cannot rely on supplements alone to control your cholesterol. But there’s some good evidence that taking supplements, while also eating a healthy diet, can make a difference.

Why are we so worried about cholesterol?
There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins.

Low-density lipoprotein or LDL cholesterol
This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the build-up of plaque in arteries, and that leads to an increased risk of heart disease and stroke.

High-density lipoprotein or HDL cholesterol
This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are linked to a reduced risk of heart disease and stroke.

Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are well recognised. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado) and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases).

Fibre is your friend
An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more soluble fibre. This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces. You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils and you can mix psyllium fibre into a drink or add it to your food.

Fibre supplements
There are many fibre supplements and food-based products on the market that may help lower cholesterol. These include:

• Inulin (eg Benefiber) or psyllium (eg Metamucil) or beta-glucan (eg in ground oats)
• Synthetic soluble fibres, such as polydextrose (eg STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel)
• Natural insoluble fibres, which bulk out your faeces, such as flax seeds

Psyllium
This is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been studied in at least 24 high-quality randomised controlled trials. These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, can significantly lower total cholesterol levels by 4 per cent and LDL cholesterol levels by 7 per cent.

Probiotics
Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a number of mechanisms. These include helping to incorporate cholesterol into cells and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces. Most studies use probiotics containing Lactobacillus acidophilus and Bifidobacterium lactis.

Red Yeast Rice
Red yeast rice is often used in Asia and some European countries to lower cholesterol. It is another non-fibre supplement that has gained attention for lowering cholesterol. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins.

A 2022 systematic review analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins.

Diet and supplements may not be enough
Remember, dietary changes alone — with or without supplements — might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role. Speak to your GP and dietitian about your plan to take supplements to lower your cholesterol.

Time to make a change
If you are looking to make some positive changes to rebalance your cholesterol levels then don’t delay. As mentioned in this article, positive lifestyle changes and a tweak to your diet can go a long way to getting you back on track.

We have looked into the recommended supplements from this article along with some natural options from the Nature’s Sunshine range. We believe choosing high quality ingredients with names you know, are closest to their natural source, and are free from artificial colours, flavours and preservatives are the best option – but then we may be a little biased 

Benefiber orange contains Wheat dextrin, citric acid, natural orange flavour, potassium citrate, aspartame, gum acacia, acesulfame potassium, maltodextrin, lactose (milk), triglycerides, sucrose acetate isobutyrate (adds a small amount of sugar), modified cornstarch, yellow 6, red 40

Metamucil orange contains: Psyllium Husk powder, Aspartame, Citric Acid, Sunset Yellow FCF CI 15985, Maltodextrin, Artificial and Natural Orange Flavour

Citrucel orange contains: Citric Acid, Dibasic Calcium Phosphate, FD&C Yellow #6 Lake, Maltodextrin, Orange Flavors (Natural and Artificial), Potassium Citrate, Riboflavin, Sucrose, Titanium Dioxide, Tricalcium Phosphate

Nature’s Sunshine Psyllium Hulls contains: Psyllium Hulls (also available in powder) www.naturessunshine.co.nz/products/psyllium-hulls-capsules

Nature’s Sunshine Slippery Elm contains: Slippery Elm (also available in powder) www.naturessunshine.co.nz/products/slippery-elm

Nature’s Sunshine Everybody’s Fibre contains: Apple fruit pectin, slippery elm, fructooligosaccharides (prebiotics), chamomile, flaxseed, fennel seed, malic acid, marshmallow root, peppermint leaf, stevia leaf extract, asparagus stem, cat’s claw inner bark , natural peach, apricot and plum flavours
www.naturessunshine.co.nz/products/everybodys-fiber

Nature’s Sunshine Flaxseed contains: flaxseed oil, omega3,6,9
www.naturessunshine.co.nz/products/flax-seed-oil

Nature’s Sunshine Red Yeast Rice contains: Red Yeast Rice
www.naturessunshine.co.nz/products/red-yeast-rice