Supplements, Diet and Lowering Your Cholesterol

How-You-can-Lower-Your-Cholesterol-with supplementsI’m not a doctor, or a nurse, or a nutritionist, or any other kind of health care professional. What I am, at the time of writing this, is a 50 year-old male who was told five years ago by his family doctor that he needed to go on statin drugs because of high cholesterol (medical term: hypercholesterolemia).

At age 45, my total cholesterol had been hovering around 200 for years, right over the edge, but the last few checks it had been 220+. The doc chalked it up to age and genetics (my family has a horrible history of cardiovascular disease) and told me it was time I got started on Lipitor.

Particularly alarming was my HDL, also know as the “good cholesterol”. It was 21. That gave me an Cholesterol/HDL ratio of 10+. An optimal ratio is 3.5 or less, the lower the better. The higher the ratio, the greater the risk of heart disease. My 10+ was bad. REAL bad.

But I didn’t want to to start Lipitor. I wasn’t ready to be on medication for the rest of my life.

I told my doc I wanted to do some research. He shrugged, having already tuned me out. I’m sure he heard people denying their health problems all day.

Some Background

At the time, I thought I was living a healthy lifestyle. I exercised regularly — weights 3 -4 times a week and 20 -30 minutes of cardio on my non-weight days. I’d been putting in a steady 5-6 days and around 10 hours a week of gym time and physical activity for over 30 years.

At 6 feet tall I weighed 185, a weight I’d been steady at since my late 20s. Yeah, that gave me a Body Mass Index (BMI) of 25.1, just over the edge into overweight, but I’d had my body fat levels measured several times while I was in the military and I was always around 14 – 15%. I still fit into clothes I’d bought over 20 years before.

I didn’t over eat, but I wasn’t paying much attention to what I ate either. Red meat 2-3 times week, chicken and turkey a bit more often than that. Maybe 1-2 servings of veggies a day. Breakfast was a banana and peanut butter. Lunch (taken to work in the same cooler I’ve been carrying since 1989) was two turkey or ham sandwiches on whole wheat with mayo. An apple every afternoon on the ride home. Dinner with the family. Snacks included trail mix, fig newtons, a few chips now and then, the occasional Hershey’s with almonds or Reese’s Peanut Butter Cups. I drank one – two cups of coffee a day, moderate cream, no sugar. No soft drinks. Unsweetened tea. Maybe an omelet on the weekend. Pizza 1 -2 times a month.

So while you can see my diet wasn’t great, it’s wasn’t something that should have been digging my grave. But with my exercise on point, that had to be it.

I won’t go through all the tedious details of my research, but the changes below are the ones I ended up making. I managed to solve my cholesterol problem without having to resort to a lifelong prescription for statins and thought there might be other people interested in what I did.

I don’t know what I did will work for you, but it worked for me.

Dietary Changes

I greatly reduced bread, pasta, and other high glycemic index carbs (“fast” carbs). Two sandwiches a day works out to 4 servings of bread daily, or 28 servings a week — and that’s not counting any other bread products I might be eating. I cut out the sandwiches and started eating a grilled chicken salad I made myself: 1 pound grilled chicken breast, 1 bag of salad mix, add in sunflower seeds, raisins, almond slices, tomatoes, with oil and vinegar dressing.

On Sunday, I grill 6-8 chicken breasts and put them in the fridge. Each night, I slice up a pound’s worth and make my salad… which I take to work in the same cooler. I eat half the salad mid-morning (10-ish), and the other half mid-afternoon (1-ish). I workout when I get home from work, which is around 3:30.

I still eat dinner with the family, but limit the size of my carbohydrate portions, especially pasta. I eat larger servings of vegetables. Red meat is now down to 1-2 times a week, mostly chicken the rest of the time (I eat A LOT of chicken).

No more Hershey’s, fig newtons or trail mix (all of which have a lot of sugar). Coffee intake remains the same. I stopped eating the apple. I still eat a banana with peanut butter for breakfast. When I snack, I go for raw or roasted almonds or mixed nuts (low or no sodium).

I still eat fruit, but more as a treat now instead of regularly. Apples, plums, grapes, watermelon, cherries….

I want to make a particular point about sugar, and even more specifically fructose. There have been some recent studies (here’s one) that implicate fructose as raising triglyceride and low-density lipoproteins (LDL) levels. This rise was NOT evidenced from glucose consumption. In general, I think it’s better to avoid added sugar altogether, but to specifically avoid fructose.

Supplements

Fish oil.
I was already taking fish oil at the time the doctor wanted to put me on Lipitor. I upped the dosage from 1,300mg (1 cap) to 5,200mg a day (4 caps). I take 2 in the morning and 2 after dinner. There’s been some recent studies lately that indicate fish oil might not do anything for cholesterol, so it seems to be an unknown for now. Nevertheless, I still take it.

Fish oil deserves a more in-depth examination. While fish oil supplementation by itself had a negligible impact, supplementing fish oil and garlic together showed a substantial improvement in cholesterol numbers.

Baby aspirin.
I added this in every night before bed. Not so much for cholesterol, but simple for it’s cardiovascular protection. It’s pretty firmly established that a baby aspirin a day reduces risk of heart attack and stroke, even more so in people over 50.

Niacin.
This is the nicotinic acid, not inositol hexanicotinate or niacinamide. There’s plenty of evidence that nicotinic acid raises HDL levels and reduces LDL and triglycerides. Remember: my HDL was 21 at the start of this.

There are three forms of niacin:

  • nicotinic acid
  • inositol hexanicotinate
  • niacinamide

When taking nicotinic acid, many people experience an uncomfortable flushing reaction, especially in the head, neck and shoulders. It can be so uncomfortable that many people stop taking niacin, or try what’s called “no-flush niacin” which is either the inositol hexanicotinate or niacinamide version.

While both inositol hexanicotinate and niacinamide are useful for treating vitamin B deficiency and as a vitamin B vitamin, it is NOT effective for improving your cholesterol profile. For that you need nicotinic acid.

I’ll say it again so you don’t fall for all the hucksters trying to sell you no-flush niacin:

If you want to use niacin to treat elevated cholesterol you HAVE TO USE THE NICOTINIC ACID FORM.

Vitamin D.
Almost everyone in the United States is deficient in vitamin D due to the amount of time we spend indoors, particularly in the winter months. Vitamin D’s relationship to cholesterol isn’t firmly established, but overall it’s a good supplement to take.

Alpha Lipoic Acid.
This is an anti-oxidant that is both water and fat soluble. Some studies suggest it can help regulate blood sugar levels and  improve brain function. There’s also been some recent evident that it can help reduce levels of oxidized low-density lipoproteins (LDLs).

Garlic.
Garlic is used for many conditions related to the heart and blood system, including high blood pressure, high cholesterol, coronary heart disease, heart attack, and atherosclerosis. Garlic may be effective in slowing the development of atherosclerosis and seems to be able to reduce blood pressure. As mentioned above, the positive effects of garlic supplementation in relation to cholesterol were enhanced when combined with fish oil.

Magnesium Oxide.
Magnesium supplements appear to slightly decrease low-density lipoprotein (LDL) and total cholesterol levels, and slightly increase high-density lipoprotein (HDL) cholesterol levels in people with already high cholesterol. Interestingly enough, this slight increase was not seen when using other forms of magnesium (such as magnesium citrate), so get the oxide form.

Exercise

I was already exercising and didn’t make any changes here. I still do:

  • Weights: Monday/Wednesday/Friday (each workout is about an hour)
  • Jogging: Tuesday/Thursday/Saturday (20 – 25 minutes)
  • I’m also a kickboxing and boxing instructor and a personal trainer. Unfortunately because of my job during the week, I’m only able to indulge this “hobby” on Sundays. This ends up being about 4 hours of low impact steady state cardio every weekend.

My Results

I went back the doctor after three months of my new diet and supplement regime. I don’t remember all the numbers, but I do remember:

  • My total cholesterol was down to 198 and my HDL was 62 — yep, 62 — giving me a ratio of 3.19, significantly better than the 10+ I had before. I don’t remember my LDL, VLDL or triglycerides, but they were lower.
  • My doc was completely uninterested in the changes I’d made. I guess he doesn’t get a kickback from patients who make changes on their own without using the medications he gets paid to subscribe.

Yes, I changed my doctor….

And here I am today, five years later. I turned 50 over the summer and recently had my every-5-years physical. Part of that was a fasted blood draw. Here are the results after 5 years of 90% compliance (yes, I cheat occasionally and drink too much craft beer):

  • Total Cholesterol: 205 (borderline, range is 100 – 200)
  • Triglycerides: 72 (optimal, range is 0 – 149)
  • HDL Cholesterol: 67 (optimal; above 60 is considered protective against heart disease)
  • LDL – 124 (above optimal, under 100 is good, under 70 is best)
  • VLDL – 14 (normal, range is 5 – 40)
  • Cholesterol/HDL ratio: 3.05 (placing me in the “very low” risk category for cardiovascular disease)

I’d like to get my LDL lower. I still don’t eat much fish and probably eat too much meat (even though it’s primarily chicken). I think by eating more fish, or cutting back on meat, I might be able to get that down.

As you can see, I’m in a much better situation as far as my risk of cardiovascular disease.

Summary

Everybody likes a TLDR, amirite? Here’s the plan to reduce your total cholesterol, including triglycerides and LDL while at the same time increased HDL:

  • Reduce high glycemic index carbs: bread, pasta, white rice, chips, cookies…. replace with low glycemic index carbs like black beans, pinto beans, brown rice, lentils, chick peas (humus), and fibrous fruits like apples, peaches and pears
  • Eliminate added sugar as much possible (all of it if you can), especially fructose – read food labels, you’ll be surprised at how much sugar there is in things, even thing you thought were “healthy”
  • Do a minimum of 3 hours of physical activity a week (I do around 10)
    • 3 x 30 minutes of moderate effort cardio (fast walk or slow run)
    • 3 x 30 minutes of resistance training – did you know resistance training is the number one thing you can do to retain muscle mass and mobility as you age? Well, now you do!
  • Take the following supplements (my daily doses – 185 pound male – listed):
    • Fish oil – 5,200 mg daily, 2 x 1,300 morning, 2 x 1,300 evening
    • Baby aspirin – 88mg before bed
    • Niacin – (nicotinic acid NOT inositol hexanicotinate)  – 2,000mg daily, 1,00mg morning, 1,000mg evening
    • Vitamin D – 5,000iu morning
    • Alpha Lipoic Acid – 600mg morning
    • Garlic – 1,000mg morning, 1,000mg evening
    • Magnesium Oxide – 500mg morning, 500mg evening

If you give my protocol a try, let me know in the comments how well it worked for you!

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One Comment

  1. Nutribody

    From scott:

    Hi, I wanted to make sure you were aware of the relatively new research on niacin that shows despite the improvement in blood lipid tests there is no reduction in heart attack or stroke and there are some negative side effects such as increased risk of bleeding, diabetes, and infection. The overall effect is to raise overall mortality. I suppose the situation is not too different than with statins, where they were able to alter a lab marker for cardiovascular disease without actually achieving the desired endpoint for most of the population. This article gives a good summary of the research:

    http://www.cbsnews.com/news/taking-niacin-for-the-heart-may-pose-serious-health-risks/

    My interest in this topic comes from being diagnosed with fatty liver (non alcoholic) despite being thin and having a reasonable but not perfect diet. My lab values aren’t terrible either, though my triglycerides are stubbornly a bit elevated and LDL, HDL and total cholesterol all borderline. I have found exercise and the supplements I take to have no effect on the labs, but I have had success in altering my lab values with coconut milk/oils, EVOO, and grass fed whole milk (not the case with the cheaper dairy products organic or not–after that experiment my doctor almost put me on statins!). As with niacin, who knows if the lab values are accurate predictors, but at least there is some good research on these types of fats. Also I am interested in supplements or food components such as polyphenols or vitamin K2 that might lower risk significantly without affecting labs.

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