How to lower cholesterol? We know 20 foods to help get it under control

The name "cholesterol" comes from the Greek. Chole translates as "bile" and stereos means "solid" in Greek. It got its name because it was first isolated from gallstones.

Without it, our bodies would not function

Cholesterol is formed directly in the body, namely in the liver, in the skin, in the adrenal cortex, in the intestines, in the testicles, etc. The daily production of cholesterol is quite sufficient for the body, namely approximately 1 g of cholesterol. Approximately 0.3 g of cholesterol is consumed in the diet.

The importance of cholesterol for the human body is really wide. It is the basic building block of all cells. Specifically, it is found in all cell membranes of animal (eukaryotic) cells. It is also the precursor of all steroid (e.g. sex) hormones and is also the precursor of the body's essential vitamin D3.

Cholesterol is also used in the synthesis of bile acids, which have an emulsifying function and facilitate the absorption of fats from food. It is a component of nerve sheaths and is also found freely in the blood. Because it is a fat particle, it is not readily soluble in water and therefore not readily available in the blood.

In order for the body to make the best use of it, it must be transported in the blood from the site of internal synthesis (in the liver) and external absorption (from the intestine) to the site of its use, i.e. into the cells of all tissues and organs.

For this transfer and absorption it needs "carriers".

Which cholesterol is good and which is bad?

The carriers of the cholesterol molecule are protein particles called apolipoproteins. These apolipoproteins differ in structure and density.

It is the density of these particles that determines the properties and the historically accepted division of cholesterol into 'bad' and 'good' cholesterol.

The combination of very low density lipoprotein (VLDL) apolipoprotein and cholesterol leads to the formation of very low density lipoprotein (VLDL) cholesterol in the liver. Later, due to the loss of triglycerides, its density increases and it becomes low density cholesterol (LDL).

Receptors for LDL cholesterol are located on the surface of cells and transport cholesterol across the cell membrane into the cells.

When LDL cholesterol is present in excess or in the absence of LDL receptors on cells, these particles are taken up by cells of the immune system, called macrophages.

The macrophages, however, cannot process this fat any further and store it, turning it into foam cells. The formation of foam cells is the cornerstone for the development of atherosclerosis, or the corrosion of blood vessels.

In the liver and intestines, high-density lipoprotein apolipoprotein and cholesterol combine to form the particle high-density cholesterol (HDL).

These particles loosen trapped cholesterol from the walls of the blood vessels. They act as a kind of broom that cleans the arteries. HDL cholesterol is therefore presented as 'good cholesterol' and an excess of it is good for the body.

The process of corroding blood vessels

Atherosclerosis, in layman's terms the corrosion of the arteries, is a disease which, together with its complications, is a major cause of morbidity and death from cardiovascular disease.

Atherosclerosis is a dynamic process. Inflammatory cells, cholesterol and other risk factors are important components of this process.

Uncontrollable risk factors:

• Age
• Gender
• Genetic factors

Controllable risk factors:

• Hyperlipoproteinemia (dyslipidemia)
• Cigarette smoking
• Arterial hypertension
• Diabetes mellitus

At the beginning of the process of atherosclerosis is endothelial dysfunction, i.e. damage to the inner epithelial lining of blood vessels.

This damage can arise from mechanical, biological and chemical irritation, e.g. high blood pressure, exposure to nicotine, viruses and bacteria. Elevated cholesterol levels can themselves act as an irritant on the endothelium of blood vessels.

LDL cholesterol particles readily penetrate the damaged vessel wall. They are taken up by inflammatory macrophages, which turn into foam cells.

The accumulation of foam cells in the vascular wall gives rise to so-called fatty streaks, which are an early stage of atherosclerotic plaque. The fatty streaks can continue to grow and form a lipid core and a fibrous cap on top of it.

This formation is considered to be a mature atherosclerotic plaque that is at high risk of developing one of a number of cardiovascular diseases.

What is the optimal blood cholesterol level?

The optimal cholesterol level depends on the age and gender of the individual. It is also important what cholesterol we monitor and whether our goal is to lower LDL cholesterol only or also to raise HDL cholesterol.

Total cholesterol levels in young adult men and women (aged 15-40 years) should be between 3.1 and 5.2 mmol/l. At the age of 40 and over, the optimal total cholesterol level is between 3.8 and 5.8 mmol/l.

Elevated cholesterol levels are between 5.2 and 6.2 mmol/l. Any values above 6.2 mmol/l are very risky.

Optimal LDL cholesterol levels are divided into three age categories and two gender categories.

A summary of all optimal values is given in the following table, cholesterol values are given in units of mmol/l

Monitoring HDL cholesterol levels is as important as LDL cholesterol levels in terms of preventing atherosclerosis. For women, it is best to maintain values between 1.3 and 2.3 mmol/l, for men the optimal range is 1.1 to 2.1 mmol/l.

• Calculator: what is my cholesterol (HDL, LDL, triglycerides): good or bad?

Watch out for children, they are not automatically protected!

It might seem that high cholesterol, i.e. hypercholesterolaemia, is only a problem for the older adult population. However, this is not the case. High cholesterol can also be a problem for children, and therefore especially for their parents.

It is estimated that more than 50% of the child population currently has high cholesterol.

It may be the result of inborn errors in fat metabolism, but the other part suffers from elevated cholesterol as a result of a long-term inappropriate diet full of animal fats that the child's body cannot process.

Such a fat imbalance can cause not only cardiovascular disease in the developing child as well as in the adult, but also other diseases such as congenital developmental defects of the central nervous system.

The fact that high blood cholesterol levels also lead to atherosclerosis in children's bodies has been confirmed by numerous studies, which have shown that fatty streaks are present in one third of children by the age of three.

The risk is multiplied if the child suffers from obesity or diabetes.

The most common inborn errors of fat metabolism or transport are diseases caused by mutations in genes for carrier proteins or apolipoproteins.

In addition, cell surface receptors for LDL cholesterol or enzymes that process cholesterol into other products may be damaged by the mutation.

Congenital hyperlipoproteinemias are called primary, and the following are most common in children:

• Familial combined hyperlipidemia
• Familial hypercholesterolemia
• Hyperapobetalipoproteinemia
• Familial hypertriglyceridemia

In these diseases, there is usually elevated LDL cholesterol in the blood (familial hypercholesterolaemia, hyperapobetalipoproteinaemia) or a combination of high LDL cholesterol and high triacylglycerol (familial combined hyperlipidaemia).

Optimal cholesterol levels in children are determined on the basis of their age and sex according to percentile tables.

If a child's total cholesterol and LDL cholesterol levels are above the 95th percentile, it is pathological. This means that 95% of children of the same age and sex have lower cholesterol levels.

The HDL cholesterol level is also monitored. It should not be lower than the 5th percentile value for the age and sex of the child.

LDL cholesterol levels above the 95th percentile and HDL cholesterol levels below the 5th percentile for the age and sex of the child are referred to as "proatherogenic"-that is, they have a high risk of atherosclerotic plaque formation on the walls of blood vessels.

Children can be divided into three groups based on their cholesterol levels:

• Children with optimal cholesterol levels (total cholesterol below 4.5 mmol/l, LDL cholesterol below 2.8 mmol/l)
• children with borderline levels (total cholesterol 4.6 to 5.2 mmol/l, LDL cholesterol 2.9 to 3.4 mmol/l)
• children with cholesterolaemia at risk (total cholesterol level above 5,2 mmol/l, LDL cholesterol level above 3,4 mmol/l)

For children with high cholesterol levels, dietary changes and dietary measures should be introduced. However, introducing an appropriate diet in children is much more difficult than in adults.

Children are still developing and need increased intakes of macronutrients and micronutrients for growth, e.g. large amounts of fat-soluble vitamins.

Severely limiting the intake of fats and other essential nutrients can result in impaired growth and slowed psychomotor development in the child.

Therefore, any therapeutic diet for a child is guided by the physician with careful and regular monitoring of the child's blood count, height, weight and psychomotor pace.

In general, no diet or dietary restrictions are recommended during the growth spurt period. This is the period of the most intense growth of the child and lasts until about 2 years of age.

Read also: How to prevent cardiovascular disease?

What can you do for the health of your blood vessels?

To keep your blood vessels healthy and flexible for as long as possible, you should try to keep your cholesterol levels at an acceptable level.

An effective way to do this is through an appropriate lifestyle, regular exercise and maintaining an ideal weight.

Superdiet and 20 suitable foods

Create a new superdiet that ensures you get enough essential nutrients but keeps fats at bay. It is advisable to include foods with a low total fat content.

Foods high in animal fat include, but are not limited to, full-fat dairy products, cheese, butter, eggs, fatty meats, bacon, lard, sausages, etc. These should be limited as much as possible.

Foods high in fibre are good for our blood vessels. These include fruit, especially apples, and vegetables such as onions and garlic. Wholemeal bread is recommended for its high fibre content.

Legumes are a good source of protein. Meat products include poultry, rabbit and sea fish.

See the list of 20 foods that have been shown to lower blood cholesterol:

1. Garlic and
2. Onions - Both kitchen helpers contain derivatives of a substance called S-allylcysteine, which has a natural statin effect (cholesterol-lowering drug), preventing LDL cholesterol from oxidizing and depositing in the blood vessels. It also prevents blood clots from forming, thus acting as a thromboembolic disease preventative.
3. Oats - Of the cereals, oats contain the most beta-glucans. These are substances that prevent the absorption of bile acids from the intestines, which is associated with a reduction in LDL cholesterol in the blood. In addition, it also contains tocotrienols, which inhibit the synthesis of cholesterol in the liver.
4. Chinese tea tree has a high content of flavonoids, which, in addition to lowering LDL cholesterol and its oxidation, increase the beneficial HDL cholesterol.
5. Artichokes - These young and tasty fruits can lower blood triacylglycerol and raise HDL cholesterol.
6. Reishi - Its lesser-known name is glossy cordgrass. It lowers blood cholesterol by up to 20%.
7. Sea buckthorn - In addition to being a well-known immunity starter, it is also a great cholesterol-lowering aid.
8. Chlorella or even other types of freshwater algae limit the absorption of bile acids and cholesterol.
9. Avocado is one of the healthiest plant sources of fat that even lowers cholesterol. Substitute it for butter in your favourite savoury spreads, for example.
10. Chinese chasteberry, also known as goji. These small and tasty red berries contain high levels of sterols, which prevent cholesterol from being absorbed from the intestine.
11. Olives - The oil from these fruits is a staple of Mediterranean cuisine, and is said to be the healthiest.
12. Rice - A simple and affordable food that, in addition to fiber, contains a sterol complex and alpha-linolenic acid, which increases levels of beneficial omega-3 fatty acids.
13. Oyster mushroom - Contains polysaccharides that block the absorption of cholesterol in the intestines.
14. Purple coneflower - Extracts from the root of this herb have a wide range of uses, including raising HDL cholesterol levels.
15. Spirulina - Another freshwater algae, readily available in forms such as a fine powder. It lowers total cholesterol and as a bonus raises good HDL cholesterol.
16. Grapes - Yes, the classic grape or grapes. It contains high levels of antioxidants that prevent oxidation of LDL cholesterol.
17. Ginger - We know it helps with colds or stomach upset. But did you know it also effectively lowers cholesterol?
18. Soy - After replacing some animal meat and cheese products with products from this plant-based delicacy, LDL cholesterol is significantly reduced.
19. Gymnema sylvestris - An exotic plant whose leaves contain a complex of saponins. These reduce triacylglycerols, but also blood sugar levels. Therefore, this plant is considered a natural antidiabetic drug!
20. Saccharomyces boulardii yeast - This beneficial yeast is an excellent probiotic that prevents the absorption of cholesterol and bile acids in the intestines.

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