Italian version of this article available

Below you’ll find a chart that will help you understand  what a correct cholesterol value is.

Cholesterol has the reputation of being one of the great enemies of our health. It’s actually an undeserved reputation, because cholesterol performs some useful functions too. All of our cells contain cholesterol and our brain contains very high quantities of it, without which it would not function; most of the hormones made in our bodies have cholesterol as their basis; cholesterol is also thought to have the function of controlling the production of free radicals and to keep in check the development of degenerative diseases.

Furthermore, HDL Cholesterol (the “good cholesterol”) keeps the arteries free and prevents arteriosclerosis. This is well known by the Japanese, who take Co-enzyme Q10 to improve cardio-circulatory functions and to contrast the negative effects of statins.

The number of people in the world who use supplements like Co-enzyme Q10 or the Omega 3’s related to fish or substances with a strong stimulating effect on mitochondria such as Inositol are countless by now.

Statins, the drugs that theoretically fight the growth of cholesterol levels in the blood, are at the center of huge commercial interests. Sales of this group of drugs are the highest in the world, which explains why communications on this problem may be biased by interests that are not only scientific but commercial. It is an established fact that there’s no value in reducing cholesterol values past the age of 65, but half of the proceeds come from elderly people who take statins to lower it! If an individual who follows a good diet and has high HDL cholesterol lowers his cholesterol level, he runs the opposite risk, the risk of hemorrhage instead of the risk of thrombi (see original articles in the links of related news in right-hand menu).

The relevant cholesterol values are not the ones of total cholesterol or LDL (“bad”) cholesterol: what counts is the following ratio: total cholesterol divided by HDL cholesterol. Ideally, this ratio should be between 4 and 5.

Recommended links for further reading

Anyone interested in learning more about the topic of high cholesterol and in general on lipoprotein disorders may consult the pages extracted from the Merk manual (Lipoprotein disorders). Also look at the Wikipedia page on cholesterol (Cholesterol. From Wikipedia, the free Encyclopedia).

There’s also an interesting article in English extracted from the list of diseases by the Karolinska Institutet of Stockholm: it deals with the effects of statins on muscles (Statins and muscle). On the topic of statins, read the Wikipedia description of how they affect the metabolic cholesterol production (Statin. From Wikipedia, the free encyclopedia)

The right cholesterol value

In order to know the ratio of total and HDL cholesterol, divide total cholesterol by the value of HDL cholesterol. A ratio between 4 and 5 means cholesterol is not a risk factor in coronary heart disease (heart attack).

Some examples

Tot. Chol. 280

HDL Chol. 60

Ratio 280:60 = 4.65

Cholesterol level is not a risk

________________________

Tot. Chol. 197

HDL Chol. 21

Ratio 197:21 = 9.38

Cholesterol level is very high. Immediate measures must be taken even though total cholesterol seems normal. This is typical of people who have bad eating habits and no physical activity.

________________________

Tot. Chol 330

HDL Chol. 70

Ratio 330:70 = 4.71

Cholesterol value is perfect. When total cholesterol is above 320, however, it is wise to take triglycerides and other fats in the blood to keep the sum of all circulating fats under control.

Anti-cholesterol drugs are doubtlessly very effective, but they should only be used, under medical prescription, by a very small percentage of the population, i.e. by those individuals whose values are really high and who cannot bring them back to normal through diet or other appropriate behavior. Most of all, they should take the drugs only if other well-defined risk factors are present.

Anti-cholesterol drugs, in practice, are only useful to those people who belong to high coronary heart disease risk groups, which means people who have already had a heart attack or who have hard to control diabetes or severe hypertension or are obese or are smokers. Researchers like Ornish, at any rate, documented that even these people can cut cholesterol levels down to normal and improve their general well-being by being patient and paying attention to their own diets.

What to do

In all other cases, when cholesterol levels are higher than normal, diet is the first thing that must be put under control. Intake of all those foods that make HDL (“good”) cholesterol level go up should be increased.

Among these we mention a moderate consumption of red wine (one glass per meal), raw garlic, extra-virgin olive oil, fish containing EPA and DHA, i.e. Omega 3 fats. Getting back to ideal weight is also important; so is light and prolonged aerobic physical activity (walking, light bicycling, slow swimming). Physical activity must be performed almost daily in order to have any effect.

Another aid: search for food intolerances , for instance through a DRIA test. The stress on the immune system caused by the persistent presence of reactions to food could cause total cholesterol to increase. A scientific study presented at the Vancouver World Conference on allergology documented this type of effect on people who followed a controlled diet based on their food intolerances.

Watch out for margarine

Food labels often mention “hydrogenated vegetable fats ”: they’re those “thickening” elements used in the food industry to show a consumer a product with certain characteristics of shape and substance, which nevertheless have no value from a nutritional point of view.

Hydrogenated vegetable fats are just margarine, and they’re present in almost all daily foods: pastries, breadsticks, crackers, cookies, sweets, peanuts, many types of bread and, alas, in many other foods (see the hydrogenated vegetable fats profile).

All of these products contain particular fatty acids in “trans” shape, which significantly affect the body’s regulatory processes of cholesterol values.

It takes very little to reach a daily intake of “trans” fatty acids sufficient to interfere with cholesterol. For example, a 150 gram steak has the same amount of “trans” as a single cookie (see table below).

Two crackers and a cookie are enough...

(Extracted and adapted from “New England Journal of Medicine” of December 23, 1993)

If you eat a small croissant for breakfast (3.20 g), a small portion of French fries for lunch (3.40 g), two cookies with the afternoon tea (1.75 g) and three melba toasts during the day (1.25 g) you are ingesting a total quantity of 9.6 grams in “trans” fatty acids, which corresponds to about 5% of a total ingestion of 1800 calories. This amount is enough to defeat the purpose of any anti-cholesterol diet, however well you follow it.

A correct diet that takes insulin and carbohydrates into account

In the past few years we have learned that a harmful rise in cholesterol is almost always related to insulin resistance. High cholesterol is “bad” when glycemia, triglycerides and body fat are rising at the same time.

Accordingly, the diets that should balance out this aspect must keep insulin under control, be in synchrony with physical exercise and limit carbohydrates more than fats. The GIFT diet is oriented towards this direction and takes into account a person’s need to embrace its rules and models in a gradual way.

Some remedies

A rise in cholesterol is, partly, the body’s attempt to compensate for an increase in oxidizing stress. In this sense antioxidants can be precious in balancing out the situation.

First of all the minerals that oppose oxidation, such as Zinc, Copper, Chromium, Selenium and Manganese. Intake of these minerals reduces the production of free radicals and protects from cardiovascular disease.

More specifically, you can take one dose of Selenium Vitamin C and one dose of Manganese Copper Zinc per day, or an equal mix of zinc oxiprolinates, manganese, chromium, copper and pidobase (2.5 ml two times a day), which function specifically as antioxidants.

Vitamin E and vitamin C have the same function. Even more relevant is the effect of an indispensable vitamin such as B3 or PP (niacin or nicotinic acid); normal daily requirement of this substance is about 20 mg per day, but higher dosages (50-100 mg three times a day) have a very strong effect on HD cholesterol. Use only when prescribed by a doctor, however.

As nutritionists have known for years and some official studies have recently confirmed, nicotinic acid and vitamin E can greatly reduce vascular risk. It is usually preferable to use them rather than their pharmacological derivatives that are currently used in therapy.

It may be wise to improve the functioning of the liver and of biliary drainage, since most of the body’s cholesterol transits through there. Draining remedies like the glycerite extract of “Rosmarinus officinalis” 1DH (40 drops in the morning in a large glass of warm water): it’s diuretic and it balances out the body’s fats, at least partly. Inositol is also useful to balance out the hepatobiliary function.

Another interesting product is glucomannan, whose fibers tend to link with cholesterol and sugar and take them down the intestinal drain, thus preventing absorption.

A good soy lecithin with a high rate of polyunsaturated lecithin, associated with a bit of vitamin E in order to avoid the damages of polysaturated fats helps to keep cholesterol in check. (Caution: many people – about 30% -- have become intolerant or allergic to soy and its derivatives, and utilizing it can be counterproductive).

Blackcurrant oil seems to act in the same way thanks to its content of special polyunsaturated fats that have a good effect on fat metabolism. In this case too, it is preferable to take it together with small quantities of vitamin E. Fish oil, which is rich in EPA and DHA, helps regulate cholesterol.

Finally we can say that, within the context of a balanced diet, frequent physical activity and good adaptation to stress, it is probably more harmful to eat a croissant in the morning (if you do it every day) than to eat a double cheeseburger or cheese fondue with your friends every once in a while.

In most cases, cholesterol levels are not as high as they’re reputed to be, especially in Italy where olive oil and wine help increase HDL. Using anti-cholesterol drugs could be harmful when it is in fact sufficient, most of the time, to pay closer attention to diet and to dedicate some time to a moderate amount of physical exercise. We wish to point out that there is increasing evidence of the possible damage induced by statins. It seems they might cause the loss of Co-enzyme Q10 , thereby interfering with the heart’s ability to contract (see articles on right-hand side).

Rather than eating crackers, bread sticks or industrial sweets, go back to whole wheat bread and jam for breakfast and eat homemade cake as a sweet.

Doctor Attilio Speciani
Clinical Allergist and Immunologist

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• Selenium Vitamin C

• Rosmarinus officinalis

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Italian version of this article available