WHAT IT IS: Hypercholesterolemia means that you have a high level of cholesterol in your blood. It can lead to inflammation and hardening of the arteries, which can cause impotence, premature wrinkling, memory loss, a heart attack, or stroke.
YOU ARE AT INCREASED RISK IF YOU
• are a man over the age of forty-five
• are a woman over the age of fifty-five (especially if you have gone through menopause)
• are overweight
• are sedentary
• are a smoker
• have low thyroid gland activity, diabetes, or a kidney or liver disorder
• have a family history of high cholesterol
• take certain drugs such as drugs for high blood pressure, endocrine drugs, female hormones, steroids, or dermatologic drugs
FOODS TO INCREASE
• Black tea. In one study, five cups a day for three weeks reduced LDL cholesterol by 7.5 percent.
• Dark chocolate. In a Finnish study, 2.5 ounces a day for three weeks increased HDL cholesterol by between 11.4 percent and 13.7 percent.
• Yogurt. In a study, people who ate just under seven ounces of yogurt a day for four weeks reduced blood cholesterol by 2.9 percent, perhaps because of yogurt’s probiotics.
• Cinnamon. Barely a teaspoon daily for four weeks lowered LDL (bad) cholesterol between 7 percent and 27 percent in sixty people with type 2 diabetes. Cinnamon improves insulin sensitivity.
• Ground flaxseed. About 1.8 ounces a day over four weeks reduced LDL in people with normal cholesterol by 8 percent and significantly decreased both total cholesterol and LDL levels, probably because of its phytosterol content and lignan content. Two tablespoons twice daily is a maximal dose.
• Rice bran and oat bran. In a six-week study, people ate three ounces of either rice bran or oat bran. LDL levels decreased 14 percent in the rice bran group and 17 percent in the oat bran group.
• Barley. Men fed a diet that included barley (providing six grams of soluble fiber a day) for five weeks saw their total cholesterol lowered by 20 percent and their LDL cholesterol lowered by 24 percent.
• Avocado. In people with high cholesterol, a diet of two thousand calories and forty-nine grams of monounsaturated fatty acids enriched with avocado decreased bad cholesterol by 22 percent, and increased good cholesterol by 11 percent.
• Macadamia nuts. They are 75 percent fat by weight, 80 percent of which is monounsaturated. Men with high cholesterol who were given 1.5 to 3 ounces a day for four weeks decreased their LDL cholesterol by 5.3 percent, and increased HDL by 7.9 percent.
• Hazelnuts. In an eight-week study, men who ate 1.5 ounces a day for four weeks increased their HDL cholesterol by 12.6 percent. (Hazelnuts are high in soluble fiber, which lowers bad cholesterol. So do their phytosterols.)• Sunflower oil and canola oil. They both reduce LDL—even more than olive oil.
• Alcohol. One to two alcoholic drinks per day increases HDL cholesterol by about 12 percent, and decreases LDL cholesterol by 5 percent to 17 percent: the type of alcohol is not relevant.
• Egg whites. A Japanese study that gave female subjects cheese, tofu, or egg whites as 30 percent of their daily protein found that those given egg whites had lowered total cholesterol levels in the blood and increased “healthy” HDL cholesterol.
• The Mediterranean diet. A study of people aged sixty-five to one hundred in Cyprus showed that adherence to this dietary pattern, as opposed to the Western pattern, reduces total cholesterol.
FOODS TO AVOID
• Saturated fats. In an Australian study, people who ate forty grams of high-fat dairy a day for four weeks had significantly raised LDL levels. Oxidized LDL injures arteries.
• Foods with trans fats. They both lower HDL and raise LDL.
• Unfiltered coffee. Five cups of French press raises LDL and total cholesterol by 6 percent to 8 percent over four weeks because of a chemical called cafestol.
TOP CHEFMD-APPROVED RECIPES
• Cinnamon Orange Dreamsicle
• Papaya Filled with Gingered Blueberries
• Roasted Red Pepper, Wine, and Red Lentil Soup
WATER-COOLER FACT: Say adios to bad cholesterol with Fresh Tomatillo Guacamole, which will lower your LDL and raise your HDL.
A REPORTER EATS HIS WAY TO LOWER
Tom Burton is a Pulitzer Prize–winning health reporter for
the Wall Street Journal. He knew about cholesterol—both
because of his work, and because he was health conscious. A daily runner and not a bit overweight, he’d given up most
cheese and red meat because of their saturated fat. He ate
fish, whole grains, and chicken. But his (lousy) LDL was 169 milligrams per deciliter, far above the optimal 100. I knew he could do better. He was skeptical but agreed to try. He regularly filled out daily logs of what he ate and when, although as the single father of two hungry teens, he already had a lot on his plate. His logs showed that he sometimes snacked on cheese and often skipped vegetables except for rosemary potatoes caressed in Cajun slow-roasted chicken fat. And, of course, there was the chicken skin. Tom gradually eliminated the weekly chicken and potatoes and, on his own, cut out shrimp and squid, which are high in cholesterol, despite my advice: these are minor contributors to LDL. The real bonus came, however, when he added meals that actively lower cholesterol to the weekly cycle at home. He loved Mediterranean foods, so he added an eggplant skillet recipe and a white bean soup with
escarole and tomato to his repertoire. He found a steel-cut
oatmeal, rich in soluble fiber, and learned to cook unrefined
(not pearled) barley. He started using recently ground flaxseed (in his coffee grinder) and tried roasted soybeans
for a snack. He traded white pasta for whole wheat and got
his kids to try brussels sprouts. He used cholesterollowering butter substitute instead of margarine. And he was happy to hear that alcohol can raise HDL cholesterol by up
to 12 percent in just three weeks, and that his liver worked
normally. It wasn’t all easy. He took the two tablespoons of flaxseed like it was cod liver oil—just down the hatch. He had to drink more water: a high-fiber diet can cause constipation. His kids had to go along. And progress was slow: after three months, his LDL was down only 10 points. But he kept at it, and he actually accelerated his program by running six days out of seven, at least sixty minutes.
After nine months, he got a third blood test. His internist
was shocked: his LDL was 114 milligrams per deciliter and
his HDL was 75 milligrams per deciliter. His C-reactive protein and homocysteine levels, markers of inflammation
linked to heart disease, had also dropped to optimal levels.
A repeat blood test a week later showed a higher LDL—142
milligrams per deciliter—but far better than he’d expected.
His HDL remained protectively high, and his internist
judged he did not need medicine. The best part? His kids love the food. His daughter has become a steel-cut-oatmeal-for-breakfast fan and loves the split pea and carrot soup with tarragon, nutmeg, and barley Tom has mastered. And that slow-roasted chicken? Now, grilled salmon with honey-mustard marinade, his son’s favorite Sunday dinner. Hard to find that in a pill.