How to Lower LDL Cholesterol?

Cholesterol has two types: LDL, which stands for Low-density cholesterol and HDL, which stands for High-density cholesterol. These are lipoproteins that incorporate fat (lipid) and protein. Proteins are a measure to move and transport the fats through the blood all over the body. LDL is well-known as bad cholesterol because the high LDL level can build up a fat or lipid layer in arteries. It leads to narrowing of the vessels, and it may cause hypertension and clots that can have other dangerous consequences. The LDL or the bad cholesterol collected in artery walls can risk human health and cause heart problems such as heart attacks and strokes.
Based on Dietary Guidelines 2020, the importance of limiting the intake of saturated fat is needed to support healthy dietary patterns. Staying within saturated fat limits and replacing saturated fat with unsaturated fat is essential during the adult-life stage. The prevalence of coronary heart disease increases with age, and high LDL cholesterol peaks between 50 to 59 in men and 60 to 69 in women.
We should note that all cholesterols are not bad, and some of the body's substances and functions need these lipids to have a good health condition. For example, the nervous system and the hormones are based on lipids and cholesterols.
The body can make some of the cholesterol itself, and some cholesterols are originated from the food intake. The diet has a crucial role in determining the lipid status of the body.
LDL is a droplet of outer lipoprotein and cholesterol in its center. HDL is a high-density lipoprotein, which means it carries cholesterol from all parts of the body and brings them back to the liver. The liver clears them from the body. Most of the body's cholesterol is LDL, and the HDL brings back the HDL to the liver for removing them from the body. Therefore, a high HDL level is needed to prevent heart attacks and other related diseases such as strokes.

A high LDL level means too much LDL cholesterol in the blood, and these extra lipids will form the plaque. The plaque in the arteries will make them narrower, and this condition leads to atherosclerosis.
When the plaques accumulate in the heart's arteries' inner layer, it is called Coronary artery disease. Slowing down the blood flow to the heart decreases the oxygen needed for the heart's cells, leading to chest pain or angina. If the blood flow stops and the arteries are blocked, a heart attack can occur. Coronary artery disease and peripheral artery disease are essential, and they should be prevented and under control. Blood thrombogenicity increases with high LDL cholesterol and diabetes.
The American College of Cardiology (ACC) and American Heart Association (AHA) rreleased practice guidelines for the assessment of cardiovascular risk (Stone et al., 2014). These guidelines are referred to as the Adult Treatment Panel 4 (ATP 4) and replace the Adult Treatment Panel 3 (ATP 3). Four high-risk groups are identified:
There are four high-risk groups of lipid indices of cardiovascular risk:
♦ Adults with atherosclerotic cardiovascular disease (ASCVD)
♦ Adults with diabetes, aged 40 to 75 years, with low-density lipoprotein (LDL) levels 70 to 189 mg/dL
♦ Adults with LDL cholesterol levels of at least 190 mg/dL
♦ Adults aged 40 to 75 years who have LDL levels 70 to 189 mg/dL and at least 7.5% 10-year risk of atherosclerotic cardiovascular disease

Overweight and obese people have an increase in their total cholesterol status, higher LDL level, and low status of HDL. Therefore, paying attention to the weight is essential.
Diet can help to balance weight. Some recommendations, such as avoiding the SFAs (saturated fatty acids) and restricting them, using healthy fats and oils, can modify the blood cholesterol level. Besides diet, having a lifestyle change and doing more physical activity can improve life quality. Low physical activity means weight gain and obesity, raising the LDL or the unhealthy cholesterol level.
Another lifestyle alternative is quitting cigarette smoking because smoking can decrease the level of good cholesterol or HDL. On the other hand, HDL is needed to remove the LDL from arteries. Quitting smoking is a helpful factor in healthily maintaining lipid and cholesterol levels.
Ageing can raise cholesterol levels. Menopause can harm LDL levels in women. The importance of family history is due to genetics. High cholesterol runs in generations of families. Familial hypercholesterolemia is an inherited form of high blood cholesterol.
People should notice the medicine they take because some of them, especially steroids, can raise the LDL level—for example, the medication for hypertension or HIV medicines.
Some disease conditions like chronic kidney disease, HIV/AIDS, and diabetes may lower LDL cholesterol levels.
Some races, like African Americans, have higher HDL and LDL cholesterol levels than other ethnicities.
The doctors use a calculator to determine the chance of inducing high LDL levels and heart problems. The status of your cholesterol level, age, blood pressure, smoking cigarettes or not, diabetes, family history, and taking blood pressure pills or not can affect this chance.

Lower numbers of LDL are considered a healthy state. You can see the ranges and the categories of the LDL cholesterol below:

A blood test can show the content of LDL, HDL, total cholesterol, and triglycerides.
Family history, risk factors, and age are the indicators to know when a blood test is needed for measuring the cholesterol level.

Children and teenage:
The first test can be during 9 – 11 years old.
The family history of high levels of lipids in blood, heart strokes, and attack can be an indicator for the children in those families to start the check-up at age 2
Children should have a blood test to check the lipids about every five years.

Age 20 and older:
Under 45 blood test every five years
Men 45-65 years and women in 55-65 should have a blood test every 1 to 2 years.

If you are into a condition like heart disease or diabetes, your doctor might recommend an LDL goal of 70 mg/dL or below.

One of the valuable ways of lowering the LDL level is following a Low LDL diet. How can we have a low cholesterol diet? The recommendations and modifications in lifestyle and the food intake, finding out the best foods to lower the cholesterol. To name a few:
Adding lean meats, chickens, turkey, and fish to the food list can limit the lousy cholesterol intake. Fibres (the soluble ones) can impact the digestive system and carry some of the body's excess fats and lipids. Therefore, selecting a wide variety of fruits, vegetables, legumes, and foods containing fibre that can help remove bad cholesterol is essential and needed. If you want to reduce LDL intake, you have to change the way of cooking and avoid fried, fast, junk, processed, and oily foods and focus on baked, broiled, grilled, and the low fat and prefer the steamed ways. The cholesterol content in egg yolks is very high, and the number of eggs eaten in a week should be controlled. Omega-3 fatty acids in fish like salmon, mackerel, and herring are also available in nuts and seeds such as walnuts, flaxseeds, and almonds can reduce LDL levels.
A heart-healthy eating habit that limits saturated fats and trans fats can be another way to reduce LDL content. The dietitians recommend the DASH diet and the TLC diet. If the patient with high LDL cholesterol suffers from obesity or is overweight should be under a weight management procedure. A weight-loss diet can be chosen besides the modifications in their lifestyles. For example, we suggest attending regular physical activity like 30 minutes and more three times a week.
If hyperlipidemia or high cholesterol is diagnosed, the doctor may prescribe cholesterol-lowering drugs along with diet and lifestyle changes. The treatment with Statin, Zetia, and PCSK9 inhibitors are samples. Lipoprotein apheresis is a filtering machine to remove the LDL cholesterol from the blood and is similar to dialysis, but it is suggested for people with familial hypercholesterolemia (FH).

There are several foods you can eat to lower your blood LDL cholesterol, include below list:

♦ Whole grains
♦ Okra
♦ Eggplant
♦ Onion
♦ Garlic
♦ Mushroom
♦ Avocado
♦ Pepper
♦ Salsa
♦ Brussels sprouts
♦ Kidney beans
♦ Leafy greens
♦ Squash

♦ Barley
♦ Banana
♦ Mango
♦ Citrus
♦ Pears
♦ Plums
♦ Oats and Oatmeal
♦ Apple
♦ Grapes
♦ Berries
♦ Strawberries
♦ Soybeans
♦ Tofu

♦ Soy milk
♦ Whole almonds
♦ Walnuts
♦ Pistachios
♦ Canola oil
♦ Peanut oil
♦ Sunflower oil
♦ Safflower oil
♦ Mackerel
♦ Herring
♦ Tuna
♦ Trout
♦ Salmon

And if you are looking to lower your blood LDL cholesterol, you should avoid the following foods:

♦ Lard
♦ Lam
♦ Pork
♦ Fatty beef
♦ Chicken and poultry with skin
♦ Coconut oil
♦ High-fat dairy