Increase your fiber so you can avoid side effects of statins

The topic of cholesterol used to be pretty straightforward: Oatmeal was good, eggs were bad. Total cholesterol less than 200 was good, more than 200 meant, well, more oatmeal.

Nowadays, total cholesterol doesn’t really matter as much as the breakdown of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol.

Think of LDL as the “bad” cholesterol that deposits cholesterol in your arteries, while HDL is the “good” cholesterol that comes through like a broom, clearing it out. Maintaining healthy levels of HDL and LDL cholesterol continues to be a prime focus in the prevention of heart disease.

Statin drugs such as Lipitor and Crestor have proven effective, but their potential side effects have prompted some people to seek more natural approaches to reduce cholesterol levels.

Red yeast rice is one such alternative. Supplementing with 1,200 milligrams twice daily can lower LDL cholesterol levels by as much as 33 percent. But since red yeast rice contains substances similar to statin drugs, it has the potential to cause similar side effects, including elevated liver enzymes and muscle pain. Supplementation should be monitored by a physician.

Niacin is another compound that occurs naturally. It can raise HDL cholesterol considerably, often with better results than prescription drugs. It also reduces LDL cholesterol, although less significantly. As with red yeast, high-dose niacin can result in altered blood sugar levels and elevated liver enzymes, so physician monitoring is essential.

Sterols and stanols are two more drug-free options to improve cholesterol levels. These plant-based compounds block the absorption of cholesterol from the digestive tract, which helps to lower total and LDL cholesterol with a minimal effect on HDL cholesterol or triglycerides. Sterols and stanols are sold in supplement form or as an ingredient in foods such as yogurt drinks (Promise Super Shots) and buttery spreads (Benecol and Promise active), with a recommended dose of 2 to 3 grams daily.

If opting for fortified foods, be sure to account for the extra calories added, using these products in place of other drinks or spreads.

Soluble fiber can also help block fat and cholesterol from being absorbed into the bloodstream, translating to a reduction in total and LDL cholesterol. For maximum benefit, aim for at least 10 to 25 grams of soluble fiber per day, if not more. Gradually increase your fiber intake (and drink plenty of fluids) to minimize intestinal discomfort.

It’s not hard to find soluble fiber in food. Cheerios gets much of the glory as a cholesterol-lowering cereal. It’s a good option, but it’s not your only option: Single servings of Quaker Oat Bran cold cereal and All-Bran Bran Buds cold cereal have 2 and 3 grams of soluble fiber, respectively, compared to Cheerios’ single gram of soluble fiber.

Hot oatmeal and oat bran also have 2 to 3 grams of soluble fiber per serving. Same goes for a half-cup serving of legumes such as red beans or black beans. Fresh fruits and vegetables provide 1 to 3 grams per serving. Ground psyllium (the main ingredient in Metamucil) ranks highest, with more than 6 grams of soluble fiber per tablespoon.

It’s important to be aware of the difference between soluble fiber and other types of fiber. All fiber has various health benefits, but it’s primarily soluble fiber that helps to lower cholesterol levels.

Soy protein is another natural option that may modestly reduce total cholesterol and LDL cholesterol levels, particularly when consumed in place of other (often higher-fat) protein sources.

Aim for at least 25 grams of soy protein daily, with common sources including soy protein powder, soy milk, and soy-based cereals and meat substitutes.

Along with nutritional improvements, maintaining a healthy weight will help to improve your cholesterol and triglyceride levels (just one more reason to shed those extra pounds).

Exercising at least 30 minutes on most days will help you achieve and maintain a healthy weight, and can also raise your good HDL cholesterol levels.

Keep in mind that even natural supplements can have side effects, including interactions with medications. Always check with your physician and pharmacist before beginning any supplement regime.

Molly Kimball is a registered dietitian in New Orleans. She can be reached at eatingright@timespicayune.com