4 Pillars to Reduce Your LDL Levels and Prevent Heart Disease
Learn about LDL cholesterol, the "bad" cholesterol that raises heart disease risk. Discover ways to lower high LDL levels through diet, exercise, weight loss and medication.
As you work to maintain your health and wellness, monitoring and managing your cholesterol levels should be a top priority.
Specifically, low-density lipoprotein cholesterol, commonly referred to as LDL or LDL-C, can have significant impacts on your health and longevity if not properly controlled.
LDL-C is often referred to as "bad" cholesterol because high levels of it in the bloodstream can lead to plaque buildup in the arteries, increasing the risk of heart disease over time.
TLDR: LDL cholesterol refers to the "bad" cholesterol that increases the risk of heart disease.
- High LDL levels are caused by diet and lifestyle factors.
- You can lower LDL levels by exercising, modifying your diet, and losing weight.
- Take cholesterol-lowering medications and supplements if needed
What Is LDL Cholesterol?
What Is LDL Cholesterol?
Low-density lipoprotein cholesterol, or LDL-C, is often referred to as “bad” cholesterol. It is a type of fat (lipid) in your blood that can build up in your arteries. When too much LDL-C circulates in the blood, it can form plaque deposits on artery walls.
This condition is known as atherosclerosis and can lead to coronary heart disease, heart attack, and stroke.
Risk Factors for High LDL Levels
There are a few factors that can contribute to high LDL-C levels:
- Diet high in saturated fat, trans fat, and cholesterol: Eating a diet high in red meat, full-fat dairy products, and fried foods can raise your LDL-C.
- Obesity and being overweight: Extra weight often means higher LDL-C levels. Losing excess pounds can help lower your LDL-C.
- Genetics: Some people are born with genes that cause them to have higher LDL-C. Genetics account for about half of your LDL-C level.
- Lifestyle: Lack of physical activity, smoking, and excessive alcohol use can all raise LDL-C.
The Role of LDL Particles in Heart Disease and Stroke
As low-density lipoprotein cholesterol (LDL-C) particles circulate in the blood, they can become damaged or oxidized. These modified LDL particles are more likely to promote the buildup of plaque in the walls of arteries - a process known as atherosclerosis.
Atherosclerosis, Heart Disease and Stroke
Atherosclerosis is a hardening and narrowing of the arteries that can lead to coronary heart disease, heart attack, and other cardiovascular events.
LDL-C particles penetrate the lining of arteries, becoming oxidized and triggering an inflammatory response. Immune cells then engulf the LDL particles and turn into foam cells that accumulate in plaques. These plaques can restrict blood flow, rupture, and form blood clots that block arteries.
If this occurs in blood vessels supplying the heart or brain, it could result in a myocardial infarction ("heart attack") or stroke.
- High LDL-C levels mean more particles are available to penetrate artery walls, fueling atherosclerosis and increasing heart disease risk.
- Oxidized LDL is particularly atherogenic, as it is more prone to being taken up by macrophages and forming foam cells.
- Reducing LDL-C levels, especially oxidized LDL, is critical for slowing or preventing plaque buildup, maintaining artery health, and avoiding cardiovascular complications.
Controlling high cholesterol, especially LDL-C, is one of the most important things you can do for your long term health and longevity. By understanding the mechanisms by which LDL impacts artery health, you can gain motivation to make lifestyle changes and adhere to medical therapies aimed at lowering your LDL-C levels.
Should I Get My LDL Tested?
Why get tested?
Regular cholesterol testing, including LDL levels, is recommended for all adults over the age of 20, especially if you have additional risk factors for heart disease such as high blood pressure or diabetes. By testing your LDL levels, you can determine whether or not you may need treatment to lower your cholesterol and reduce health risks.
How often should I get tested?
The frequency of cholesterol testing depends on your current LDL levels and heart disease risk.
For most adults with normal cholesterol levels, testing every 4 to 6 years is sufficient. However, if your LDL levels are elevated or you have other risks for heart disease, more frequent testing may be needed to monitor how well your treatment is working.
Ideal LDL Levels for Longevity
LDL cholesterol, or low-density lipoprotein cholesterol, is one of the most significant biomarkers for heart health and longevity. LDL particles carry cholesterol through your bloodstream, and high LDL levels mean there are more of these particles in your blood that can build up in your arteries.
According to medical guidelines, the ideal LDL levels for most adults are:
- Less than 100 milligrams per deciliter (mg/dL): Optimal for heart health. At this level, your risk of heart disease is lowest.
- 100 to 129 mg/dL: Near optimal. Your risk of heart disease is moderate and diet/lifestyle changes and medication may be needed to lower your LDL.
- 130 to 159 mg/dL: Borderline high. Your risk of heart disease is higher, and lifestyle changes along with medication are usually recommended to lower your LDL.
- 160 mg/dL and above: High. Your risk of heart disease is significant, and medication along with major diet and exercise changes are urgently needed to lower your LDL and protect your heart health.
Mito Health's flagship package, priced at $499, offers testing for LDL as well as 66 other carefully curated biomarkers that provide insight into various aspects of your health - this comprehensive suite of tests allows for early detection of cancer, heart disease, neurodegenerative disorders, diabetes and more.
In addition to testing, you will receive a personalized health optimization plan from our doctors incorporating supplements, nutrition, exercise and sleep strategies, and access to exclusive health and longevity events.
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How Certain Foods Impact LDL Levels
Certain foods can have a direct impact on your LDL cholesterol levels. By making smart dietary choices, you can help lower your LDL and improve your heart health.
Saturated Fats and Trans Fats
Saturated fats and trans fats are two of the worst offenders for raising LDL levels. Found in red meat, full-fat dairy products, and fried foods, these fats clog your arteries and promote plaque buildup.
Limit or avoid foods high in saturated fat such as fatty beef, pork, lamb, poultry with skin, butter, cream, cheese and other full-fat dairy products. Also avoid trans fats from partially hydrogenated oils used in fried foods, baked goods, and packaged snacks.
Cholesterol-Containing Foods
Although dietary cholesterol itself has a modest effect on blood cholesterol for most people, it's still a good idea to limit cholesterol-rich foods, especially if you have high LDL levels. These include egg yolks, shrimp, lobster and organ meats like liver. Aim for no more than 200 mg of cholesterol per day, which equals about two egg yolks.
Refined Carbohydrates
Refined carbohydrates, such as white flour and sugar, can also negatively impact LDL levels. They cause spikes and crashes in blood sugar that stimulate your liver to produce more LDL. Focus on whole foods like whole grains, legumes, nuts, and vegetables instead of refined grains and added sugars.
Healthy Fats
Some fats actually help lower LDL cholesterol.
Monounsaturated fats found in olive oil, avocados and nuts, and omega-3 fatty acids found in fatty fish promote heart health and may help reduce inflammation. Aim for at least two servings of fatty fish per week and use olive oil for cooking and salad dressings.
Adding more of these beneficial fats to your diet can help lower LDL levels when consumed in place of saturated fats.
Making smart choices by limiting saturated fats, trans fats and cholesterol while increasing intake of healthy fats and whole foods is the key to optimizing your LDL cholesterol levels and heart health. Following an overall balanced diet and exercise plan can help reduce your risk of high cholesterol and related health issues.
Exercise to Decrease LDL Levels
To decrease your LDL cholesterol levels, exercise is key. Regular physical activity helps lower LDL in several ways:
Exercise Reduces Body Fat
Carrying excess body fat, especially around the waist, contributes to high LDL cholesterol. Exercise helps shed excess pounds and trim your waistline. Losing weight can help lower your LDL cholesterol.
Exercise Increases HDL
Exercise also raises levels of high-density lipoprotein (HDL) cholesterol, the “good” kind that helps clear LDL from your arteries. Aim for at least 30 to 60 minutes of moderate exercise most days of the week. Brisk walking, jogging, biking, and strength training are all excellent options.
Exercise Improves Circulation
Exercise improves circulation, which helps your body efficiently transport LDL cholesterol out of the bloodstream. Good blood flow also allows HDL to work better in clearing away excess cholesterol buildup in your arteries.
Exercise Reduces Stress
Exercise is a great way to relieve stress and anxiety. Too much stress can raise your LDL levels, so making exercise a priority is important. Try yoga, meditation, deep breathing, or just taking time each day to unwind. Managing your stress through exercise and relaxation helps create a virtuous cycle of health benefits.
To maximize the cholesterol-lowering effects of exercise, aim for at least 30 to 60 minutes of moderate activity on most days. Walking, jogging, biking, and strength training are all excellent options. Be consistent and stick with it. Over time, regular exercise can have a significant impact on decreasing your LDL cholesterol and improving your heart health. Making exercise a lifelong habit may help add years to your life and life to your years.
How LDL-Lowering Medications Work
LDL-lowering medications work by inhibiting the production of cholesterol in the liver or by blocking its absorption in the intestines. The two most common classes of LDL-lowering drugs are statins and PCSK9 inhibitors.
Statins
Statins are the most commonly prescribed LDL-lowering medications. They function by inhibiting an enzyme called HMG-CoA reductase, which plays a key role in the production of cholesterol in the liver. By blocking this enzyme, statins reduce the amount of cholesterol produced, which in turn lowers LDL levels in the bloodstream.
Some of the most well-known statin drugs include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor).
PCSK9 Inhibitors
PCSK9 inhibitors are a newer class of injectable LDL-lowering drugs. They work by blocking a protein called PCSK9, which helps regulate the number of LDL receptors on the surface of liver cells. LDL receptors remove LDL cholesterol from the blood, so by increasing the number of these receptors, PCSK9 inhibitors help lower LDL levels.
The two approved PCSK9 inhibitors are evolocumab (Repatha) and alirocumab (Praluent). Studies show that when combined with statin therapy, PCSK9 inhibitors can lower LDL cholesterol by up to 60 percent.
Other Medications
In addition to statins and PCSK9 inhibitors, other medication options for lowering LDL include:
- Bile acid sequestrants: Bind to bile acids in the intestines to block cholesterol absorption.
- Cholesterol absorption inhibitors: Block the absorption of cholesterol in the small intestine.
- Fibrates: Reduce triglyceride levels and moderately lower LDL. Often used when statins are not tolerated.
- Niacin: Reduces the production of triglycerides and LDL in the liver. Can cause flushing, so extended-release versions are often prescribed.
By understanding how these various LDL-lowering drugs work, you can have an informed discussion with your doctor about which medication or combination of drugs may be right for your situation. The optimal treatment will depend on your LDL level, heart disease risk factors, and other health conditions.
Supplements to Reduce LDL Levels
To help lower your LDL cholesterol levels, certain supplements may be beneficial. However, you should always talk to your doctor before adding any supplements to determine if they are appropriate and safe for you based on your individual health conditions and any medications you're taking.
Omega-3 Fatty Acids
Omega-3 fatty acids have been shown to help lower inflammation in the body and decrease triglyceride levels, both of which can impact LDL cholesterol levels. Food sources of omega-3 fatty acids include fatty fish like salmon, sardines, and trout. Fish oil supplements may also help reduce LDL cholesterol.
The typical dosage is 1,000 to 4,000 milligrams per day.
Red Yeast Rice
Red yeast rice is made from a type of yeast grown on rice and contains compounds called monacolins that can help lower cholesterol levels. Studies have found that red yeast rice supplements may decrease LDL cholesterol by 10 to 33 percent.
The typical dosage is 600 to 3,600 milligrams once or twice daily with meals. However, red yeast rice does have the potential for side effects such as muscle pain and liver damage, so you should only use under the supervision of your doctor.
Phytosterols
Phytosterols are plant compounds structurally similar to cholesterol that can help block cholesterol absorption in the gut. Phytosterol supplements typically contain 1 to 2 grams of phytosterols and may lower LDL cholesterol by 5 to 15 percent when taken daily with meals.
Common sources of phytosterols include beta-sitosterol, campesterol, and stigmasterol. They tend to be well tolerated with few side effects for most people.
CoQ10
Coenzyme Q10 or CoQ10 is an antioxidant found naturally in the body that helps cells produce energy and may have some cholesterol-lowering effects. Studies show CoQ10 supplements may lower LDL cholesterol by up to 17 percent.
The typical dosage for cholesterol lowering is 100 to 200 milligrams taken two or three times a day with meals. CoQ10 can interact with some medications, so check with your doctor first before supplementing.
In summary, omega-3 fatty acids, red yeast rice, phytosterols and CoQ10 are supplements that may help moderately lower LDL cholesterol levels for some individuals. However, you should consult with your physician before starting any supplement regimen to choose what is most appropriate and safe based on your health conditions and medications. Significant reductions in LDL cholesterol often require dietary changes and statin medication as recommended by your doctor.
Conclusion
As you have learned, LDL cholesterol is more than just a number. It represents a key indicator of heart health and longevity. By understanding LDL, monitoring your levels, and taking proactive steps to lower high LDL, you are empowering yourself to lead a healthier, longer life.
At Mito Health, we specialize in advanced health diagnostics to test your LDL levels (along with 66 other biomarkers) - to form a science-based, personalized health plan to help you optimize your health. Sign up for our flagship package today to take control of your health and your future.
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