The pros and cons of statins are constantly in and out of the news. More and more of us are being prescribed them to lower cholesterol, so what are the questions you should be asking your GP before you take them? We ask Dr Sarah Brewer…
What is cholesterol and why is it bad?
Despite its ominous reputation, cholesterol is a fatty substance that is actually vital for our bodies to function properly and is used to make a number of essential hormones. In order for cholesterol to be transported around the body to where it is needed, it must be packaged with proteins to form ‘lipoproteins’. Those with more fat to protein are known a low density lipoproteins (LDL) and those with a higher density (i.e. less fat to protein) are known as high density lipoproteins (HDL).
LDL is traditionally thought of as the ‘bad’ type of cholesterol and too much is thought to be harmful – clogging arteries, which can result in a heart attack. HDL is good for the body as it has protective properties. Although new thinking suggests that perhaps not all LDL cholesterol is the same and larger, more bouyant forms of LDL may not be as harmful as small dense forms.
What causes high cholesterol?
Some people are genetically predisposed to high cholesterol as the body naturally produces too much LDL and not enough HDL (this is known as familial hypercholsterolemia). For others it is often caused by lifestyle factors. One common culprit is diet. Saturated fat is traditionally thought to increase LDL cholesterol, but this is being now being questioned although advice to lower intake is still important to follow. Excess sugar and trans fats can also result in an increase as it can fuel cholesterol production. Important to note is that cholesterol in foods does not result in increased blood cholesterol, hence the recent u-turn on advice about egg consumption.
Are there ways other than taking statins to lower levels of bad cholesterol?
You can reduce your levels of LDL cholesterol by eating a balanced diet. Advice is to switch from saturated fats to healthy fats. Refined carbohydrates are now thought to be just as detrimental as saturated fat. Exercise more and avoid smoking and smokey environments.
There are some foods you can also look to include more in your diet as they have protective functions, these include:
- Barley and other whole grains such as oats contain soluble fibre which helps remove cholesterol from the body (beta glucan is one such fibre). Beans and pulses are also a useful source of soluble fibre and support weight loss which may be a factor in cholesterol levels.
- Certain nuts have been shown to help lower cholesterol when included in the diet. They are rich in healthy monounsaturated fats as well as a plant sterol known as beta sitosterol.
- Apples, pears and citrus fruits are high in a type of fibre called pectin which has been shown to help reduce LDL.
- Foods fortified with plant sterols have been shown to help reduce LDL by up to 10%.
- Soy protein has been shown to help lower LDL. 25g per day has shown a reduction in LDL of around 5%. Try including some edamame (highest concentration), tofu or miso paste.
- Oily fish helps to increase your levels of HDL cholesterol which is beneficial and in turn may reduce LDL.
At what age should you start worrying about cholesterol?
Unless you have familial disease then this is a problem traditionally associated with adults aged 40 onwards. However, it is prudent to try and follow a healthy balanced diet throughout your life to try and avoid raised cholesterol.
If you have to take statins, what can you do to reduce side effects?
Side effects from statins can include fatigue, muscle weakness and/or pain, shortness of breath with exertion and impairment in short-term memory. Many of these are thought to be due to the fact that as well as lowering cholesterol, statins also lower levels of a naturally-occuring substance called co-enzyme Q10 (CoQ10). CoQ10 plays a key role in helping cells to produce energy. As statins lower coQ10 production, it seems prudent to take a supplement to top up levels – ideally ubiquinol, which is the bioavailable form of coQ10.
To find out further information on CoQ10 visit http://nutritionexpert.healthspan.co.uk/
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