Natural Agents for Managing Cholesterol and Heart Health

Managing lipid levels in the blood is crucial for maintaining cardiovascular health, as high cholesterol and triglyceride levels can lead to heart disease and other related conditions. Several natural agents have been identified for their antihyperlipidemic properties, and integrating them into a balanced diet can contribute significantly to cholesterol control.

Soluble Fiber: This type of fiber is abundant in foods like oats, beans, lentils, and various fruits. Soluble fiber helps reduce the absorption of cholesterol in the bloodstream by binding to cholesterol-rich bile acids in the intestines, which are then excreted from the body. This not only lowers total cholesterol levels but also helps reduce low-density lipoprotein (LDL), commonly known as "bad" cholesterol.

Psyllium: Derived from the husks of Plantago ovata seeds, psyllium is a highly effective source of soluble fiber. When taken regularly, it can lower cholesterol by forming a gel-like substance that traps cholesterol-rich bile acids, preventing their reabsorption. Research shows that psyllium can lower total cholesterol by up to 7% and LDL cholesterol by up to 9%.

Phytosterols: These compounds, found in nuts, seeds, and whole grains, closely resemble cholesterol in structure. Phytosterols work by blocking the absorption of cholesterol in the intestines, effectively reducing LDL cholesterol levels. Consuming 2 grams of phytosterols daily can lower LDL cholesterol by 6-10%.

Soy Protein: Foods like tofu, soy milk, and edamame contain soy protein, which has been shown to reduce LDL cholesterol by 3-5% when consumed regularly. Soy’s cholesterol-lowering effects are partly due to its isoflavones, which improve lipid profiles.

Garlic: Garlic is renowned for its cardiovascular benefits, including its ability to reduce total and LDL cholesterol levels. Studies suggest that regular consumption of garlic supplements can lower total cholesterol by 10-12%.

Red Yeast Rice: This traditional Chinese remedy contains monacolin K, a compound structurally similar to statins, which are prescription drugs for lowering cholesterol. Red yeast rice can reduce LDL cholesterol levels significantly, with some studies showing reductions of up to 20-30%.

Ginger: Ginger has shown promise as a lipid-lowering agent. Its bioactive compounds, such as gingerol, have been found to reduce cholesterol and triglyceride levels, contributing to improved heart health.

Flaxseed: Rich in omega-3 fatty acids and fiber, flaxseed can help lower cholesterol and reduce the risk of heart disease. Flaxseed lignans and alpha-linolenic acid (ALA) have been associated with reductions in total cholesterol and LDL levels.

These natural agents offer valuable cholesterol-lowering benefits and can be easily incorporated into a heart-healthy diet. However, it is essential to consult a healthcare provider before making significant dietary changes or starting any new supplement regimen.
Natural Agents for Managing Cholesterol and Heart Health

Understanding LDL and HDL: Keys to Cardiovascular Health

Low-density lipoproteins (LDL) are widely recognized for their association with heart disease. Among LDL particles, type-B LDL particles are particularly linked to health problems, including cardiovascular disease, due to their small, dense nature which makes them more likely to infiltrate arterial walls.

Cholesterol in the blood is transported by LDL and high-density lipoprotein (HDL), while triglycerides are primarily carried by very low-density lipoprotein (VLDL). LDL particles are larger, lighter, and richer in cholesterol compared to HDL particles, which are smaller, denser, and have a higher protein content relative to their cholesterol content.

When LDL levels in the blood are high, cells lining the arteries can transport LDL and its cholesterol load into the artery walls. This process contributes to the development of atherosclerosis, a condition characterized by the buildup of fatty deposits inside the arteries. LDL cholesterol circulates in the blood, moving cholesterol around the body for cell repair and other functions. However, when LDL deposits cholesterol inside artery walls, it can lead to plaque formation and artery narrowing, increasing the risk of heart attacks.

Both LDL and HDL carry cholesterol, but their impact on heart disease risk differs significantly. Elevated LDL concentrations in the blood are a strong indicator of high heart attack risk, whereas elevated HDL concentrations are generally associated with a lower risk. HDL helps remove cholesterol from the bloodstream, transporting it to the liver for excretion, thus providing a protective effect against heart disease.

Individuals with high levels of total cholesterol, LDL cholesterol, or triglycerides, and low levels of HDL, have an increased risk of coronary heart disease (CHD). To mitigate this risk, total cholesterol levels should be kept below 200 mg/dL. Maintaining healthy cholesterol levels is crucial in preventing the onset of CHD and managing cardiovascular health effectively.

In conclusion, understanding the roles and impacts of different types of lipoproteins on cardiovascular health is essential. Managing LDL and HDL levels through diet, lifestyle, and, if necessary, medication can significantly reduce the risk of heart disease and promote long-term heart health.
Understanding LDL and HDL: Keys to Cardiovascular Health

Cholesterol in human body

Cholesterol is a waxy, fat-like substance found in the walls of cells in all parts of the body, from the nervous system to the liver to the heart. Cholesterol is a lipid that has multiple functions. It is of great importance for cell membrane structure and function in vertebrates.

Human body needs cholesterol to build healthy cells, but high levels of cholesterol can increase the risk of heart disease.

Cholesterol is an amphipathic sterol present in higher animals. It’s a waxy lipid and distributed in body tissues. Cholesterol can be toxic in the form of polar lipid. Its molecular formula is C27H46O and molecular weight is 386.65354.

Every cell in the body needs cholesterol, which helps the cell membranes form the layers. These layers protect the contents of the cell by acting as the gatekeeper to what things can enter or leave the cell.

The body uses cholesterol to make hormones, bile acids, vitamin D, and other substances. Metabolites of cholesterol viz. bile salts, steroid hormones and oxysterols, fulfill important biological functions.

Cholesterol travels within the body by forming a complex with some proteins which are termed as lipoproteins. These lipoproteins include:
*Low density lipoprotein, or LDL (bad cholesterol)
*High density lipoprotein, or HDL (good cholesterol)
*Very-low-density lipoproteins (VLDL)

With high cholesterol, it can develop fatty deposits in the blood vessels. Over time, this builds up and is called plaque. The plaque can narrow vessels and make them less flexible. This buildup of plaque is known as atherosclerosis or “hardening of the arteries.” It can lead to coronary artery disease, where your coronary arteries become narrow or even blocked.

High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases the chance of getting a disease. In fact, the higher blood cholesterol level, the greater risk for developing heart disease or having a heart attack.

If body cholesterol levels are high, the condition is called hypercholesterolemia. If cholesterol levels are low, the condition is called hypocholesterolemia.

Total cholesterol levels under 200 mg/dl are healthy for adults. Doctors treat readings of 200–239 mg/dl as borderline high, and readings of at least 240 mg/dl as high.

What food causes high cholesterol? Full-fat dairy. Whole milk, butter and full-fat yogurt and cheese; Red meat- Steak, beef roast, ribs, pork chops and ground beef; Processed meat; Fried foods; Baked goods and sweets; Eggs; Shellfish; Lean meat.
Cholesterol in human body

A blood test “lipoprotein profile”

Lipoprotein is a protein that transports cholesterol in the blood. High levels of lipoprotein in the blood can increase the likelihood of plaques or blood clots forming in the arteries.

Lipoprotein analysis (lipoprotein profile or lipid profile) measures blood levels of total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, and triglyceride.

Cholesterol is an important precursor of bile acids, which is crucial for fat absorption, is a precursor for steroidogenesis in the adrenal glands, gonads and placenta, and is an essential component of the cell membrane.

Triglycerides are essential for the transport and storage of energy within the body. Only small amounts are found in the blood. Having a high triglyceride level along with a high LDL cholesterol may increase chances of having heart disease more than having only a high LDL cholesterol level.

Everyone ages 20 and older should have their cholesterol measured at least once every 5 years. Experts recommend that men 35 and older and women 45 and older be screened for lipid disorders more often. This blood test is done after a 9- to 12-hour fasting.

Total cholesterol level in adults:
Normal: Less than 200 mg/dL
Borderline high: 200 to 239 mg/dL
High: At or above 240 mg/dL

LDL cholesterol for adult:
Optimal: Less than 100 mg/dL (This is the goal for people with diabetes or heart disease.)
Near optimal: 100 to 129 mg/dL
Borderline high: 130 to 159 mg/dL
High: 160 to 189 mg/dL
Very high: 190 mg/dL and higher

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.
A blood test “lipoprotein profile”

Almond can reduce risk of coronary heart disease

Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 oz (42.5 g) of nut intake may reduce the risk of cardiovascular disease.

Almonds are found to be rich in monounsaturated fat, fiber, α-tocopherol, copper and magnesium, and phytochemicals including phytosterols and polyphenols.

The health benefits of almonds can be attributed to their healthy fatty acid composition, high vitamin E and fiber content, as well as other nutrients.

Almonds reduce cardiovascular disease risk via cholesterol reduction, anti-inflammation, gluco-regulation, and antioxidation. Approximately 35–39% of the population of the United States and 33–40% of the population in the United Kingdom have serum HDL cholesterol below normal.

Research shows that a significant reduction in LDL-C levels with almond consumption. Eating almonds have been results in significant reductions in total cholesterol, LDL-C, and triglycerides levels, while having no significant impact on HDL-C levels.

Almonds, along with other tree nuts, are good sources of mono- and polyunsaturated fats that have been shown to lower blood lipid levels.
Almond can reduce risk of coronary heart disease

What is plaque?

Plaque is a fatty material made up of fat, cholesterol, calcium, and other particles found in the blood. Scar tissue and calcium from vessel injury can also add to the plaque buildup. The process leading to this may begin in childhood. It takes decades before it causes serious health problems.

A piece of plaque can break off and be carried by the bloodstream until it gets stuck. Over time, plaque hardens and narrows the arteries. The plaque makes arteries less flexible, a condition called atherosclerosis or “hardening of the arteries.”

Early observations that cholesterol is a key component of arterial plaques gave rise to the cholesterol hypothesis for the pathogenesis of atherosclerosis.

This process can happen to blood vessels anywhere in the body, including those of the heart, which are called the coronary arteries. If the coronary arteries become partly blocked by plaque, then the blood may not be able to bring enough oxygen and nutrients to the heart muscle. This can cause chest pain, or angina. If an artery supplying oxygen to the extremities (often the legs) is blocked, gangrene, or tissue death, can result.

There are often no signs or symptoms of high blood cholesterol. A high level of cholesterol in the blood is due to abnormal levels of lipoproteins. These are the particles that carry cholesterol in the bloodstream. This may be related to:
• Diet
• Weight
• Lack of physical activity
• Genetic factors and
• Presence of other diseases (diabetes, underactive thyroid, etc.)

Smoking makes fatty deposits more likely to form, and it accelerates the growth of plaque.
What is plaque?

Low-density lipoprotein

Both cholesterol esters (CE) and triacylglycerols (TG) are insoluble in water (plasma); hence they are packaged as lipoproteins comprising an inner core of cholesterol esters and triacylglycerols with a surface coat of apolipoproteins, free cholesterol and phospholipids. Packaged as lipoproteins, they can be transported to various tissues where needed.

There are five different lipoproteins:
*chylomicrons,
*very low-density lipoproteins (VLDL),
*intermediate density lipoproteins (IDL),
*low-density lipoproteins (LDL) and
*high-density lipoproteins (HDL)

Low-density lipoprotein (LDL) transports cholesterol in the bloodstream and plays an important role in the development of cardiovascular diseases, in particular atherosclerosis.

Whereas LDL particles carry about two-thirds of plasma cholesterol and can infiltrate the arterial wall leading to atherosclerosis, HDL particles are antiatherogenic as their role is to deliver cholesterol to the liver to be metabolized and eliminated.

On average, LDL particles have a diameter of 22 nm and contain ~3000 lipids. Their density ranges between 1.019 and 1.063 g/ml, highlighting that quite a heterogeneous group of particles can be called LDL. Most abundant lipid species in LDL are triglycerides and cholesteryl esters assumed to reside in the core of the particle, while different phospholipids are expected to be located on the surface.

In the initial stages of atherogenesis, LDL-derived lipids accumulate in the arterial intima, and high LDL levels have been shown to increase the risk of atherosclerosis. This together with formation of plaque on arterial walls leads to the narrowing of arteries, rupture, clotting, and potential death.

Since most of the cholesterol in serum is transported via LDL, measuring serum LDL levels could be useful to predict the risk for atherosclerotic cardiovascular diseases.

A predominance of small, dense LDLs is seen in patients with ischaemic heart disease and non-insulin-dependent diabetes, and is more common in men than in women. Because small, dense LDLs are associated with increased levels of triglyceride and low levels of high-density-lipoprotein cholesterol.
Low-density lipoprotein

What are lipids?

Lipids are organic compounds that contain hydrocarbons which are the foundation for the structure and function of living cells.

Lipid molecules contain large hydrocarbon portion and not many polar functional group, which accounts for their solubility behavior. Their intermolecular interactions are dominated by the hydrophobic effect and van der Waals interactions.

Lipids are water insoluble organic compounds. They are hydrophobic (nonpolar) or amphipathic (containing both nonpolar and polar regions)
*Free fatty acids
*Triacylglycerols
*Phospholipids
*Glycolipids
*Steroids

Fatty acids are “carboxylic acids (or organic acid), often with a long aliphatic tails (long chains), either saturated or unsaturated.” When a fatty acid is saturated it is an indication that there are no carbon-carbon double bonds and if the fatty acid is saturated it is an indication that it has at least one carbon-carbon double bond.

Lipids are major components of cell membranes, and are responsible for most of the permeability filter functions of membranes. Membranes act as barriers to separate compartments within eukaryotic cells, and to separate all cells from their surroundings.

A lipid abnormality is one of the causal factors of cardiovascular disease. Excess LDL cholesterol (say a total serum cholesterol > 4-5mmol/L) is the most widely accepted risk factor for heart disease. Excess triglycerides (say >1.8mmol/L) are probably important in CHD but this is controversial. A low concentration of HDL cholesterol (say less than 1.0mmol/L) is also accepted as a major risk factor.
What are lipids?

What is high blood cholesterol?

Chemically, cholesterol is a fatlike compound – actually an alcohol – in which in its pure form appears as pearly flakes.

A high blood cholesterol level means that the person has more cholesterol in the bloodstream than the body needs.

A high level of cholesterol in the bloodstream is recognized as a major risk factor for the development of atherosclerosis and is therefore also a risk factor for coronary artery disease.

In atherosclerosis, which deposits of cholesterol and other lipids, along with cellular reactions, thicken artery walls. This process gradually reduces the caliber of the artery and restricts blood flow.

In adequate blood flow may cause injury to or death of tissue beyond the site of reduced flow. In the coronary arteries, this leads to myocardial infarction or sudden death.

In general, the causes of high blood cholesterol or hypercholesterolemia, can be regroup into two major categories:
*Life style factors
*Genetic factors

Lifestyles factors that can contribute to high blood cholesterol include; obesity, lack of physical activity or exercise and consuming an unhealthy diet that contains excessive cholesterol.

The principal nutritional factors identified with high blood cholesterol and the development of coronary heart disease are dietary fat, approximately saturated fatty acids and cholesterol and energy imbalance leading to obesity.
What is high blood cholesterol?

Blood lipid

Lipid is a broad term for fats and fatty substances in the bloodstream including fatty acids, phospholipids, lipoproteins, triglycerides and cholesterol and other sterols.

Lipids do not dissolve in water, thus move through the bloodstream suspended in protein carriers- lipoproteins. All of these lipoprotein contain phospholipids, triglycerides, and cholesterol but in varying amounts.

Lipids are considered structural, rather than chemical, fats and are important for many body functions, including cell maintenance and repair, dissolving fat-soluble vitamins and other nutrients and storing energy.

High levels of lipid may result from genetic makeup or lifestyle choices or both. Lifestyles factors such as high-fat diet, obesity, smoking, and physical inactivity can cause or contribute to high cholesterol levels, increasing an individual’s risk for atherosclerosis. Cholesterol is an important lipid in the blood.

When the level of lipids in the bloodstream become too high (hyperlipidaemia), lipid droplets can settled out of the blood flow and accumulate along the inner walls of the arteries, forming blockages (occlusions) and eventually compacting into arterial plaque, a brittle layer incorporating other debris such as blood cells that causes the arteries to become stiffened and inflamed.

Abnormalities of blood lipid level are best determined by measurement of the lipoproteins rather than the analysis of the blood lipid fractions alone. Thus disorders on blood lipid level are classified according to the concentration of the lipoproteins.
Blood lipid

Papaya can reduce blood cholesterol levels

Papaya prevents the formation of urinary stones, prevents intestinal infection by parasites and aids in the proper functioning of the body’s immune system. The fruit contains papain and lipase help in metabolism of fatty foods.

Papaya along with fruits contains zero cholesterol and the high content of fiber will also help lower high cholesterol levels. Papaya keeps the arteries supply, soft and flexible, thus not allowing formation of cholesterol in the blood.

It also normalizes blood pressure due to tension, depression, anxiety and increase in cholesterol level; thus affecting smooth circulation of blood.

Papaya fruit have the potential to lower lipid levels and thus reduce cardiovascular disease.
Papaya can reduce blood cholesterol levels

Food and heart disease

Some foods are found to increase the risk of coronary heart disease, while others may protect against it.

High blood total cholesterol and low density lipoproteins (LDL) cholesterol levels are major modifiable risk factors in the development of heart disease.

One group of fats have emerged as a major cause of cell damage leading to diabetes, a heart disease, cancer and many other conditions and these are trans fats. People with diabetes have a higher risk of heart disease and stroke.

Trans fats are found in almost every baked product, to prolong shelf life including potato chips, donut, and most popular breakfast cereals.

In epidemiological studies, fruits and vegetables has been an associated with decreased mortality from a variety of health outcomes including obesity, hypertension, metabolic syndrome and cardiovascular disease.

Higher consumption of fruits and vegetables has been associated with a lower risk of coronary heart disease.

In the early 1970s scientists found that Greenland Eskimos has extremely low incidence of heart disease and arthritis despite the fact that they consumed a high fat diet.

Scientists discovered that Greenland Eskimos consumption of omega 3 fatty acids play a crucial role in the prevention of atherosclerosis, heart attack, depression, and cancer.

Scientist research found that monounsaturated fatty acids (such as in olive oil), polyunsaturated fatty acids (such as in vegetables oils) and omega 3 fatty acids (such as in fish) may help lower blood lipids.

Diets high in soluble fiber such as in oat or rice bran, oat meal, legumes, barley, citrus fruits and strawberries may help lower LDL cholesterol.

The scientific evidence establishes that diets low in saturated fat and cholesterol are associated with decreased levels of blood total cholesterol and LDL cholesterol and thus decreased risk of developing coronary heart disease.
Food and heart disease

What is cholesterol?

Coronary heart disease is leading cause of death of Americans and preventive measures have emphasized reducing risk factors such as high blood cholesterol levels.

What is cholesterol? Cholesterol is one of the most vital and important biochemical compounds in nature. It is a combination of two acetate molecules that join to form a waxy substance.

Cholesterol naturally present in everywhere in the body, including the brain nerves, muscles, skin, liver, intestines and heart.

Humans manufacture 80% to 90% of their cholesterol within their own cells. Cholesterol is produced in the liver, which can make all the cholesterol that the body needs.

All cell membranes are composed of cholesterol and cholesterol-derived compounds. Brain and nerve tissue contain the highest proportion of cholesterol on the body.

Cholesterol is used in the production of certain vitamins and hormones, such as vitamin D, cortisol, estrogen and testosterone. It takes only small amount of cholesterol to meet these needs.

Cholesterol and other fats cannot dissolve in blood. They have to be carried to and from the cells through a special medium called lipoproteins. Cholesterol must be attached to transport molecules lipoproteins to remain in circulation.

When the body have high levels of bad cholesterol (LDL), fatty deposits may form in the artery walls, which the process known as atherosclerosis. It could lead to heart attack.
What is cholesterol?

LDL (Low density lipoprotein) and heart disease

Studies have shown that higher levels of type-B LDL particles (as opposed to type-A LDL particles) are associated with health problems, including cardiovascular disease.

Cholesterol is transported on LDL or HDL (high density lipoprotein); triglycerides are primarily carried on very low density lipoprotein (VLDL).

LDL are larger lighter and richer in cholesterol while HDL are smaller, denser and packaged with more protein.

This protein contains a high percentage of cholesterol relative to protein and when LDL levels in the blood are high cells lining the inside the arteries transport LDL and its cholesterol load into the artery wall.

Both LDL and HDL carry cholesterol but elevated LDL concentrations in blood are a sign of high risk of heart attack, whereas elevated HDL concentrations are usually associated with a low risk.

If the person has high levels of total cholesterol, LDL cholesterol or triglycerides or decreased levels of HDL, he has an elevated risk of coronary heart disease (CHD).

It is known that low density lipoprotein (LDL) can be deposited in the artery wall and setting stage for atherosclerosis. Total cholesterol levels should be kept below 200 mg/dL to reduce the risk of CHD.
LDL (Low density lipoprotein) and heart disease

Red meat

Atherosclerosis

Coronary heart disease (CHD) is caused by atherosclerosis, a slow, progressive, hardening and narrowing of the artery by deposits of fat, cholesterol, and other substances followed by scarring and deposits of calcium or calcification.

It is common cause of cardiovascular disease in the United States. The substance block and narrow the coronary vessels in a way that reduces blood flow to the myocardium.

When serious, atherosclerosis may result in angina pectoris or myocardial infarction (heart attack).

Gross anatomy identifies arthrosclerosis as a focal thickening of the wall of medium-sized and large arteries. In its advanced stages, it consists of a central core of yellowish toothpaste-like gruel surrounded by a leathery capsule - the fibrous cap.

Atherosclerosis of the cerebral arteries leading to the brain can cause a stroke. Atherosclerosis, is one type of arteriosclerosis, which literally means ‘hardening the arteries’.

Arteriosclerosis is category of disease that involves hardening of the arteries. Arterio indicates arteries; sclerosis indicates a loss of elasticity or flexibility.

Atherosclerosis involves a repetition inflammatory response to injury of the artery wall and subsequent alteration in the structural and biochemical properties of the arterial walls. It is thought to began as fatty streaks of lipids that deposited in the intima of the arterial wall.

Many outcomes of atherosclerosis are quite bad. Atherosclerosis contributes to one half of deaths in North America and is number one killer worldwide.

It is commoner in older age groups, but in those with diabetes disorders of fat metabolism and high blood pressure, its appearance may be earlier.
Atherosclerosis