Các chỉ số HDL, LDL, triglycerides là gì ?
Natural Remedies for Cholesterol – How Effective Are They?
Dr Jayaprakash, the Ayurvedic healer and Managing Director of Dharma Ayurveda in Trivandrum, India, believes that ‘people whose blood cholesterol is low become just as atherosclerotic as people whose cholesterol is high. Only when LDL is converted into a toxic form of oxidized LDL by oxygen free radicals in the blood, does it become truly dangerous. And it can occur in a person with low LDL too. Ayurveda remedies intervene at the very genesis of atherosclerosis, blocking the toxic transformation of LDL. Thus it is not only beneficial to the ones with high cholesterol, but everyone who is keen in preventing atherosclerosis and its grave hazards’.
Following are the Ayurvedic measures to control and maintain optimum cholesterol levels:
Drink 6 to 8 glasses of water daily.
Start your day with fresh fruits and grains such as oats that are high in soluble fiber.
Minimize consumption of animal products including dairy products. This is because animal foods are high in saturated fatty acids and dietary cholesterol.
Consume fish viz salmon, sardine and tuna as well as oysters, clams and mussels. These help lower LDL and improve HDL.
Restrict consumption of Omega-6 rich oils such as corn oil and safflower oil. Instead, use olive oil, sesame oil and rapeseed oil that have ‘good fat’.
Eat a lot of anti-oxidant foods such as strawberries, apples, nuts, carrots, broccoli and spinach.
Use turmeric and curry leaves when cooking dishes. They have cholesterol lowering properties.
Ayurvedic remedies to fight cholesterol:
1. Boil water with 2 tsp coriander seed. Strain and drink this water twice daily. It helps reduce cholesterol, flushes out toxins, and improves digestion.
2. Guggulu (Commiphora mukul) is effective in lowering cholesterol. Buy it from any reputed Ayurvedic store and use it as per instructions on the container.
3. Grill 1 or 2 small cloves of garlic and take it daily with your main meal.
4. Take 1 to 2 capsules per day of Arjun (Terminalia arjuna) extract available in a capsule form. Arjun is rich in co-enzyme Q-10 (CoQ10) that helps lower LDL cholesterol and enhances HDL recovery.
What should we eat to improve HDL, LDL, triglycerides?
Asked by Kashif, Houston, Texas
What should we include in our diet to increase HDL and lower LDL and triglycerides?
Hi Kashif. This is an interesting question, as different components of the diet can be more important for different types of cholesterol abnormalities. Knowing which of your numbers are too low or too high can help you focus your efforts more effectively, although getting to and staying at a healthy weight and eating an overall heart healthy diet like the one that I discussed in an earlier response is the most important overall strategy.
Here is a little primer on where your levels should be in general and how to get them there.
LDL (low-density lipoprotein) or “bad” cholesterol: Elevated LDL cholesterol is highly associated with heart disease. Lowering levels to less than 100 mg/dL (less than 70 mg/dL if you are at very high risk of a heart attack or sudden cardiac death) is very important for reducing your risk of heart attack and stroke.
There are several ways to lower LDL, including limiting saturated fat to less than 7 percent of your total calories; avoiding dangerous trans fats (hydrogenated oils) as much as possible (aim for less than 1 percent of your diet per day or less than 2 grams total if you are consuming 2,000 calories per day); and increasing your intake of soluble fiber found in things such as oatmeal, whole grains, barley, beans, peas, apples, strawberries and psyllium. Try to consume a variety of soluble fiber containing foods every day.
HDL (high-density lipoprotein) or “good” cholesterol: HDL cholesterol is important for transporting less-healthy cholesterol away from the heart, thereby preventing the buildup of unhealthy cholesterol in your coronary arteries. Low levels increase your risk of heart disease. Women should aim for a level of 50 mg/dL or more and men should aim for a level of 40 mg/dL or more.
While it is more difficult to raise good cholesterol, there are a several things that you can do, including losing weight (particularly the unhealthy fat that accumulates around your midsection); exercising (at least 150 minutes a week); drinking moderate amounts of alcohol (1-2 servings a day but don’t feel like you need to start drinking if you don’t already and avoid sugar-filled cocktails); and taking an omega 3 fatty acid supplement (1 gram of fish oil per day) or eating fatty fish such as salmon, sardines and tuna at least twice a week.
Triglycerides: These are another type of fat in the blood that is associated with an increased risk of heart disease. High levels of triglycerides (greater than 150 mg/dL) are often found in conjunction with low levels of HDL (good cholesterol) and suggest a condition known as metabolic syndrome that represents a constellation of findings that may also include high or high/normal blood sugar, waist size greater than 35 inches for women and 40 inches for men, and high blood pressure.
Metabolic syndrome can significantly increase your risk of heart disease and diabetes, and the best treatment is weight loss. In my clinical practice, which is guided by current research, I find that overweight patients with metabolic syndrome tend to respond better to a lower or moderate carbohydrate/higher protein diet.
I highly recommend against cutting carbohydrates completely, as the lack of fiber in your diet may cause the bad cholesterol to increase (aim for about 3 servings of whole grains per day). It is particularly important to limit refined sugar and highly processed carbohydrates if you have elevated triglycerides. Higher levels of omega 3 fatty acids (2-4 grams per day) may also help lower triglycerides, but talk to your doctor first.
Raising Your HDL Levels
Increasing the GOOD cholesterol
HDL cholesterol, or “good” cholesterol, appears to scour the walls of blood vessels, cleaning out excess cholesterol. It then carries that excess cholesterol — which otherwise might have been used to make the “plaques” that cause coronary artery disease — back to the liver for processing. So when we measure a person’s HDL cholesterol level, we seem to be measuring how vigorously his or her blood vessels are being “scrubbed” free of cholesterol.
HDL levels below 40 mg/dL result in an increased risk of coronary atery disease, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dL are considered “normal.” However, HDL levels greater than 60 mg/dL may actually protect people from heart disease. Indeed, for several years, doctors have known that when it comes to HDL levels, the higher the better. Click here for a quick review of cholesterol and triglycerides.
How can We Increase Our HDL Levels?
Aerobic exercise. Many people don’t like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL choleserol. But any aerobic exercise helps.
Lose weight. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your waist-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.
Stop smoking. If you smoke, giving up tobacco will result in an increase in HDL levels. (This is the only advantage I can think of that smokers have over non-smokers — it gives them something else to do that will raise their HDL.)
Cut out the trans fatty acids. Trans fatty acids are currently present in many of your favorite prepared foods — anything in which the nutrition label reads “partially hydrogenated vegetable oils” — so eliminating them from the diet is not a trivial task. But trans fatty acids not only increase LDL cholesterol levels, they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels. Click here for a quick and easy review of trans fatty acids and the heart.
Alcohol. With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure — and there are individuals who will develop such problems even when limiting their alcohol intake to one or two drinks per day. Click here for a quick and easy review of alcohol and the heart.
Increase the monounsaturated fats in your diet. Monounsaturated fats such as canola oil, avocado oil, or olive oil and in the fats found in peanut butter can increase HDL cholesterol levels without increasing the total cholesterol.
Add soluble fiber to your diet. Soluble fibers are found in oats, fruits, vegetables, and legumes, and result in both a reduction in LDL cholesterol and an increase HDL cholesterol. For best results, at least two servings a day should be used.
Other dietary means to increasing HDL. Cranberry juice has been shown to increase HDL levels. Fish and other foods containing omega-3 fatty acids can also increase HDL levels. In postmenopausal women (but not, apparently, in men or pre-menopausal women) calcium supplementation can increase HDL levels.
What about a low-fat diet?
While Americans traditionally have ingested too much fat in the diet, and while limiting total fat in the diet is useful not only for cholesterol control but also for weight reduction, evidence is emerging that too little fat in the diet can be dangerous. A diet in which fat has all but been eliminated can result in a deficit in the essential fatty acids – certain fatty acids that are essential to life, but which the body cannot manufacture itself. Furthermore, ultra-low-fat diets have been reported to result in a significant reduction in HDL cholesterol in some individuals.
The best advice regarding fat in the diet appears to be this: 1) reduce the fat intake to 30 – 35% of the total calories in the diet – but probably no lower than 25% of total calories; 2) try to eliminate saturated fats and trans fats from the diet, and substitute monounsaturated and polyunsaturated fats instead. (That is, eliminate animal and dairy fat, and substitute unprocessed vegetable fats. Click here for a quick review of the various types of fatty acids.) Such a diet will avoid the problems seen with an ultra-low-fat diet, and should help raise HDL cholesterol levels.
What about drugs for raising HDL cholesterol?
Drug therapy for raising HDL cholesterol levels has, so far, been less successful than for reducing LDL cholesterol. Statins, in particular, are often not very effective at increasing HDL levels.
Of the drugs used to treat cholesterol, niacin appears to be the most effective at raising HDL levels. Niacin is one of the B vitamins. The amount of niacin needed for increasing HDL levels are so high, however, that it is classified as a drug when used for this purpose. Furthermore, “niacin” takes several forms, including nicotinic acid, nicotinamide, and inositol hexaniacinate – and all of these are labelled as “niacin.” Unfortunately, only nicotinic acid raises HDL cholesterol, and this drug can be difficult to take because of its propensity to cause flushing, itching and hot flashes. In general, taking niacin to treat cholesterol levels should be supervised by a doctor. ( Read about niacin here.)
A three-drug regimen of niacin, cholestyramine, and gemfibrozil has been shown to increase HDL cholesterol substantially, but this drug combination can be particularly difficult to tolerate.
Now that HDL levels are attracting more and more attention, several drug companies are attempting to develop new drugs aimed specifically at increasing HDL. Unfortunately, there have been early disappointments and it will be several years before we can expect to see such drugs on the market.
Tell us how you raised your HDL. Raising your HDL levels can be a challenge, because it usually requires lifestyle changes rather than simply taking a pill. So every bit of encouragement we can give each other will help. Share with other readers what you did to raise your HDL levels.
Click on the link (under “Readers Respond,” below) to participate.
Rosenson RS. HDL metabolism and approach to the patient with low HDL-cholesterol. UpToDate. May, 2007. (UpToDate.com)
High Cholesterol: Raising Your HDL Level