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How Does Fiber Lower Cholesterol Levels

What Is Insoluble Fiber

How Does Fiber Lower Cholesterol? – by Dr Sam Robbins

Insoluble fiber is generally referred to as “roughage.” Insoluble fiber promotes regularity, adds bulk and softness to stools, helps with weight regulation and helps prevent many gastrointestinal disorders. Good sources on insoluble fiber include:

  • Wheat bran and whole wheat or grain bread/bread products, pasta, cereal and crackers.
  • Vegetables.
  • Nuts.

What Is The Difference Between Hdl And Ldl Cholesterol

Cholesterol doesnt dissolve in blood. To be transported in the bloodstream, cholesterol is packed into two types of carriers: low-density lipoproteins or high-density lipoproteins . LDL cholesterol, which is sometimes known as bad cholesterol, is necessary in limited quantities , but high LDL cholesterol levels can dramatically increase your risk of a heart attack. Thats because LDL particles can contribute to atherosclerosisor clogged arteries. HDL cholesterolsometimes called good cholesterolhelps clear LDL cholesterol from the arteries.

When doctors measure cholesterol levels, they first look at total cholesterol as a quick way to assess a persons risk. For a more exact guide, they divide the total level by the HDL level. Heart attack risk is minimized by having a lower total cholesterol and a higher proportion of HDL cholesterol. The ratio of total cholesterol to HDL should be less than 4 to 1.

Unfortunately, the average American man has a ratio of 5 to 1. Vegetarians, on the other hand, average about 3 to 1. Smoking and obesity lower HDL vigorous exercise and foods rich in vitamin C may increase it.

What Are The Types Of Fiber

Dietary fiber is a good carbohydrate, also known as roughage, found in plant foods . There are two kinds, soluble or insoluble, and both are really good for us. Soluble fiber becomes a thick gel in our intestines, which slows digestion and traps fats so they cant all be absorbed . Sources of soluble fiber include oatmeal, beans, lentils, and many fruits. Insoluble fiber helps keep our stools soft and regular, always a good thing! Sources of insoluble fiber include whole grains, beans, lentils, and most vegetables. Both soluble and insoluble fiber make us feel full, which helps us to eat less.

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Design And Study Population

We performed a prospective, randomized, open label study, with parallel arms and blinded endpoints. Patients were recruited from the outpatient unit of dyslipidemias of our university. The trial protocol was conducted in accordance with the ethical standards of the institution on human experimentation and approval was obtained from the local ethics committee. Informed consent was obtained from all participants prior inclusion. Eligible patients were men and women, 30 to 75 years of age, in primary or secondary prevention of coronary heart disease, who had an indication for lipid-lowering therapy in accordance with the National Cholesterol Education Program/Adult Treatment Panel guidelines . A total of 116 subjects completed the study protocol. Patients with liver, renal or gastrointestinal disease, malignancies, uncontrolled metabolic disorder, that might affect the tolerability or safety of the treatments were excluded. Exclusion criteria during the study were low adherence to either the lipid-lowering regimen or to the daily fiber intake. The major characteristics of the study population are listed in the Table . Risk factors and metabolic syndrome were defined by the NCEP/ATP III guidelines .

Table 1 Baseline characteristics of the study population by group

More Things You Can Do To Help Lower Cholesterol And Promote Heart Health

Cholesterol How Does Fiber Help Control Cholesterol? How To Prevent ...

Itâs important to keep HDL levels high and LDL levels low to prevent plaque buildup in the arteries. However, high cholesterol isnât the only risk factor for cardiovascular disease. Along with maintaining healthy levels of cholesterol, you can do more to promote your cardiovascular health.

1. Exercise to Help Lower Cholesterol and Promote Heart Health

Get your muscles moving and blood flowing with exercise. Regular exercise is known to reduce the risk for cardiovascular health. There is a significant amount of evidence demonstrating the benefits of exercise on cardiovascular health.

2. Eat Smart to Help Lower Cholesterol and Promote Heart Health

There is an abundance of evidence that show that eating high levels of unsaturated fats and low levels of saturated fats canlower cholesterollevels and reduce risk of cardiovascular disease. That means incorporate more fruits, vegetables, legumes, nuts, olive oil, fish, and poultry into your diet, and eat less high-fat dairy products and meat.

3. Maintain a Healthy Weight

Maintaining a healthy weight is much easier said than done for many of us. Consider talking to an expert like a doctor, licensed nutritionist, or dietician if eating smart and exercising regularly are not enough to get to or maintain a healthy weight.

4. Refrain from Smoking to Help Lower Cholesterol and Promote Heart Health

5. Talk to Your Doctor


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The Link Between High Cholesterol And Heart Disease

But does lowering blood cholesterol really reduce the risk of heart disease? Some research suggests that the link between high cholesterol and heart disease is not nearly as straightforward as we have been led to believe. Although high levels of cholesterol are associated with an increased risk of heart attack, the majority of heart attack victims have normal cholesterol. And while the use of statin drugs does appear to reduce mortality, there may be other factors at work. In addition to reducing cholesterol levels, for example, statins also reduce inflammationwhich is another risk factor for heart disease.

The decision to prescribe a statin drug should ideally be based on more than just ones LDL cholesterol levels. The amount, type, and ratios of other blood fats, age, sex, personal and familial health history and other risk factors should all be taken into consideration.

But whether or not your doctor feels that a cholesterol-lowering medication is right for you, eating soluble fiber offers a variety of benefits. In addition to lowering your cholesterol, they can also help modulate appetite and help with weight management, as well as promote the growth of beneficial bacteria in your gut. You can get soluble fiber in oatmeal and oat bran as well as apples, pears, plums, barley, chicory root, Jerusalem artichokes, mushrooms and garlic. Fiber supplements made from psyllium husk or wheat dextrin are also good sources.

Dietary Intake Weight And Body Mass Index

The analyses of the dietary recall have shown that the consumption of cholesterol and dietary fiber did not differ between groups monounsaturated, polyunsaturated, or trans-fatty acids were also similar. Energy intake was reduced at the 12 weeks , with energy from carbohydrates, fatty acids, and proteins being comparable among groups. The estimated daily fiber intakes, obtained from dietary recall were not different along the study, when fiber supplementation with passion fruit peel flour was not counted .

Table 2 Characteristics of the diet consumed at baseline and 12 weeks, by group

Desmosterol and phytosterols

Desmosterol plasma levels presented interaction between groups. Subjects receiving rosuvastatin have shown decreased levels of desmosterol in comparison with the subjects treated with simvastatin plus ezetimibe

Sterol intestine absorption markers, campesterol and -sitosterol, are presented in Table . There was a decrease in campesterol plasma levels at the end of treatment , with lower levels observed in subjects receiving fibers and treated with simvastatin plus ezetimibe . Campesterol levels were lower for those subjects taking soluble fibers on week 12 as shown in Figure . There was a decrease in plasma levels of -sitosterol with a trend for lower levels in the group receiving fibers plus ezetimibe . Fiber intake status did not affect -sitosterol plasma levels.

Glucose, glycated hemoglobin and C-reactive protein

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The Link Between Dietary And Blood Cholesterol

The liver produces as much cholesterol as your body needs. It packages cholesterol with fat in whats called very low-density lipoproteins .

As VLDL delivers fat to cells throughout the body, it changes into the more dense LDL, which carries cholesterol wherever it is needed.

The liver also releases HDL, which then carries unused cholesterol back to the liver. This process is called reverse cholesterol transport, and it protects against clogged arteries and other types of heart disease.

Some lipoproteins, especially LDL and VLDL, are prone to damage by free radicals in a process called oxidation. Oxidized LDL and VLDL are even more harmful to heart health .

Although food companies often advertise products as being low in cholesterol, recent research has shown that dietary cholesterol actually has only a small influence on the amount of cholesterol in the body .

This is because the liver changes the amount of cholesterol it makes depending on how much you eat. When your body absorbs more cholesterol from your diet, it makes less in the liver.

Current guidelines by leading U.S. health organizations for lowering risk of heart disease no longer contain specific recommended levels for dietary cholesterol, including the:

  • American Heart Association (
  • 7 )

The guidelines do recommend moderating cholesterol consumption, but this is more to limit the saturated fat that often accompanies cholesterol in foods than to limit intake of cholesterol itself .

The Role Of Fiber In Our Bodies

How Fiber Lowers Cholesterol

Dietary fiber is a plant-based nutrient, and it is a type of carbohydrate that our bodies cannot digest or absorb. Instead, it passes through your stomach, small intestine, and colon and out of your body, helping with digestion and relief from constipation. Food rich in dietary fiber includes fresh fruits and vegetables, legumes, and whole grains. There are two types of fiber important for health, digestion, and disease prevention: soluble and insoluble.

Soluble fiber attracts water while its in your gastrointestinal tract and turns to a gel during digestion, which slows the digestion process. Soluble fiber is found in barley, oats, peas, nuts, seeds, beans, lentils, and some fruits and vegetables like apples, citrus fruits, and carrots. It is also found in psyllium, which is a common ingredient in fiber supplements .

Insoluble fiber is found in whole wheat flour and bran, whole grains, nuts, beans, potatoes, and vegetables like cauliflower and green beans. It promotes movement of food through the stomach and intestines by providing bulk to stools, helping to alleviate constipation.

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Cholesterol And Its Role In Our Bodily Functions

What is cholesterol, and why can it be harmful?

Cholesterol is a type of fat found throughout our bodies. You may think that all cholesterol is badânot true. Cholesterol plays a role in important bodily functions like stress responses, reproduction, nutrient absorption, and the protection of our cells. Cholesterol becomes problematic when excess cholesterol starts traveling through and sticking around in our blood. If too much of it builds up inside our arteries, the build-up of plaque increases the risk of heart attacks and strokes. In short, high cholesterol is a risk factor for developing coronary heart disease.

How do cholesterol levels rise?

Molecules known as lipoproteins carry cholesterol from the liver, where cholesterol is made, to the cells that need it to carry out critical bodily functions. These lipoproteins also carry cholesterol back to the liver to be eliminated from the body. Lipoproteins called low-density lipoproteins take cholesterol to the bodyâs cells, while high-density lipoproteins facilitate the removal of the cholesterol from the body. Because LDLs work to distribute cholesterol through the bloodstream, whereas HDLs work to rid the body of excess cholesterol, LDLs and HDLs are often referred to as âbadâ fats and âgoodâ fats, respectively. When people have âhigh cholesterol,â it means that they have elevated levels of LDLs, or âbad fatsâ in their blood.

How can fiber combat high cholesterol?

How Does Fiber Lower Cholesterol

  • Grabs on to fats and cholesterol in the small intestines so that its excreted instead of absorbed into the bloodstream.
  • Reduces the amount of bile salts reabsorbed from the intestine. The body then needs to make more bile salts and uses cholesterol to do this.
  • Slows digestion, which slows how fast blood sugar rises after eating. High blood sugar can cause more triglycerides to be formed, which can cause more cholesterol to be formed.
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    Type Of Soluble Fiber

    Soluble fiber from oat products, psyllium, pectin, and guar gum each significantly lowered total cholesterol . One gram of soluble fiber from oats, psyllium, pectin, or guar gum produced changes in total cholesterol of 0.037, 0.028, 0.070, and 0.026 mmol/L , respectively, and in LDL cholesterol of 0.032, 0.029, 0.055, and 0.033 mmol/L , respectively. These values were slightly higher when the meta-analysis was repeated for the practical dose range. Psyllium and guar gum lowered HDL cholesterol significantly but minimally . None of the soluble fibers affected triacylglycerols. Type of soluble fiber was not a significant predictor of lipid changes after the initial lipid concentration was controlled for by linear regression. We were unable to compare effects of guar with those of the other fibers because of the limited number of studies using 210 g/d.

    Net change in total cholesterol. The net effect of consumption of different dietary fibers on total cholesterol concentrations for oat products, psyllium, pectin, and guar gum. Note that one guar study did not include measures for total cholesterol. The bars represent the width of the 95% CIs for each study. The overall effect estimates and 95% CI are provided for each fiber.

    A Special Word About Oat And Barley Fibre

    #hdlcholesterol does an increase in fiber lower cholesterol?

    Oats and barley contain a special form of soluble fibre called beta glucan which, as part of a healthy diet, has been shown to lower cholesterol. Beta glucan works by forming a gel in the gut which can bind with cholesterol-rich bile acids and stop them being absorbed into the body.

    You need 3g of beta glucan a day to help actively lower cholesterol. You can get this by eating 3 servings of the foods below, in any combination.

    Eat three servings of these foods each day

    • A bowl of porridge
    • 13g of oatbran sprinkled onto cereals, or added to casseroles, soups or smoothies
    • 250ml of oat drink
    • 1 oat breakfast biscuit
    • 1 serving of oat breakfast cereal flakes
    • 3 oatcakes
    • Recipes providing at least 30g of oats per serving that are also low in saturated fat
    • 75g cooked pearl barley you can add these to stews, casseroles, salads or use them instead of rice to make a risotto
    • 40g of barley flakes

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    What Are Saturated Fats

    Saturated fats are generally solid or waxy at room temperature and are most often found in animal products and tropical oils. The following foods contain saturated fats:

    • Fatty cuts of beef, pork, lamb, veal, and the skin of poultry.
    • Hot dogs, bacon and high-fat luncheon meats, such as salami and bologna.
    • Full fat and processed cheeses, cream cheese.
    • High-fat dairy products, such as whole milk, cream, half and half, butter and sour cream.
    • Lard, bacon fat, sauces and gravies made from animal fat.
    • Most fried foods and fast foods.
    • Tropical oils – palm, palm kernel and coconut.
    • Baked goods made with lard, butter or tropical oils.

    Eggs And Oat Bran: The Cholesterol

    If cholesterol from food doesn’t affect blood cholesterol levels, why does eating soluble fiber reduce cholesterol? Nutrition Diva explains this apparent paradox.

    • Cholesterol from food has only a negligible effect on most people’s blood cholesterol levels. Most of the cholesterol in your body is manufactured by the liver.
    • Soluble fiber can reduce blood cholesterol levels, but not necessarily by blocking the absorption of cholesterol from foods.
    • Soluble fiber also helps promote the growth of beneficial bacteria in the gut.

    Dan writes:

    We’re told that eating foods like oatmeal, which contains soluble fiber, can help lower cholesterol. My understanding is that this works because the fiber binds to the cholesterol in your food, preventing its absorption.

    But we’re also told that the amount of cholesterol in your food doesn’t make much difference because, if you get more in your diet, your body just produces less.

    If the soluble fiber is reducing absorption of dietary cholesterol, but dietary cholesterol doesnt matter, then why would that reduce your serum cholesterol?

    This is a great question but one that requires a bit of a deep dive to answer. But if this is not the place for deep dives into nutrition nerd-dom, I dont know where is!

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    Where To Get It

    A variety of foods contain soluble fiber. By consuming the recommended amounts of fruits, vegetables, whole grains, and legumes in the Food Pyramid, you should be able to obtain the recommended amount of soluble fiber each day.

    While fiber supplements can be used to fulfill this requirement, it is not recommended that you use them as a substitute for eating a healthy diet. Fruits and vegetables also contain important nutrients, such as vitamins, that cannot be obtained through a fiber supplement.

    What Are Trans Fatty Acids

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    Trans fatty acids are formed when a liquid fat is changed into a solid fat through a process called hydrogenation. Many manufacturers use hydrogenated fats in their ingredients because it creates a product with an extended shelf life and better consistency.

    Trans fatty acids are especially bad for you. They raise the levels of LDL cholesterol in your blood and lower the levels of high-density lipoprotein cholesterol.

    There are currently no safe levels of trans fat to consume each day, so avoid them completely or eat them as little as possible.

    Many manufacturers have stopped using or greatly reduced the amount of trans fats in their foods. But, check the label and avoid:

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    Dietary And Lifestyle Changes

    Dietary and lifestyle adjustments are key to making lasting changes in cholesterol levels.

    Although they might not produce results as quickly as medications do, a person may notice their cholesterol levels drop in just a few weeks or months if they stick to a healthy diet and lifestyle plan.

    Increase intake of plant foods

    Plant foods are rich in vitamins and nutrients, and they do not contain cholesterol. Most plant foods also do not contain saturated fats, which may increase cholesterol in the body.

    A 2017 study found that the people who ate vegetarian diets had significantly lower cholesterol levels than the participants following omnivorous diets.

    The authors also note that some targeted diets using plant foods might cause stronger effects. For example, a diet rich in soluble fiber, plant sterols, and vegetable protein sources, such as soy and nuts, reduced LDL cholesterol by an average of 28.6% in just 4 weeks.

    These effects continue over the long term. A 2018 study estimates that this type of diet reduces the 10-year risk of coronary heart disease by about 13%.

    People who need to reduce their cholesterol quickly can work with a dietitian to create a targeted diet plan.

    Increase fiber intake

    While adding plant foods to the diet increases fiber intake naturally, it may also be helpful to take a fiber supplement or over-the-counter fiber drink to support the body.

    Fiber keeps the digestive system healthy and may help prevent the body from absorbing cholesterol.



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