Does Weight Loss Reduce Cholesterol?

 
 
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Cholesterol is a topic that I think we all find somewhat confusing.  You probably know about good cholesterol and bad cholesterol. You might think that your diet can affect your cholesterol, and that’s probably about it. Because that’s all I knew before I sat down to write this blog.

It was one of those topics that I just sort of ignored throughout my career because it had never come up - and every time I did look into it, I couldn’t find any clarification on it either.

But worry no more.

I have educated myself which means I can now make it as simple and straightforward for you as well so that we are all on the same scientific page when it comes to cholesterol, weight loss and fitness.

My aim for this Blog post is to make sure you never have to worry about the ins and outs of cholesterol ever again…

And of the day ever comes when your Doctor says you have high cholesterol - you will know exactly what to do about it.


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What is the difference between good and bad cholesterol?

Low-density lipoproteins (LDL) are known as bad cholesterol

High-density lipoproteins (HDL) are known as good cholesterol.

A lipoprotein is a molecule that transports essential things through your body. Things like cholesterol, fat and fat-soluble vitamins which are needed for the functionality of your organs and hormones. Cholesterol is naturally produced in the liver, and it automatically regulates how much cholesterol to produce based on your body’s needs.

This is one of the key arguments against why you don’t need to worry about eating a “low-cholesterol diet” to lower the risk of heart disease - your liver is always responding and eating foods “high in cholesterol” and your liver will respond and produce less naturally.

In fact, the American Heart Association, American College of Cardiology and the 2020-2025 Dietary Guidelines for Americans have all removed specific levels and recommendations for cholesterol in their advice to citizens.

LDLs (Low-Density Lipoproteins) are molecules that transport fats to your body. HDLs (High-Density Lipoproteins) are molecules that clear out unused cholesterol and take it back to your liver and out of your blood. This is why HDLs protect you against heart disease and clogged up arteries.

This is why you want fewer LDLs chilling out in your bloodstream, and more HDLs to make sure your LDLs get cleared away.


Negative effects of having high LDL levels:

When your Doctor says that you have “high cholesterol” they are referring to elevated LDL levels in your arteries, and this can have negatively effect your health by causing:

  •  Strokes

  • Clogged arteries

  • Kidney failure

  • Heart attacks

It’s not a great list - and there are many other effects on the body that having clogged arteries can cause.

This is why you want to get the right combination of HDLs and LDLs in your body.


How To Reduce Cholesterol?

Remember, we want to reduce LDL (bad) and increase HDL (good) cholesterol.

So really the title of this section could be '“how to get the right balance of cholesterol in your bloodstream”.

There are many factors that affect your cholesterol levels - and it splits into two categories: Diet and Exercise - a cliche I know.

Within those two there are nuanced principles that you will want to focus on.

Let’s start with diet advice:

Diet: Lower Your Trans Fat Intake

It used to be a belief that by eating less fat you will mean less cholesterol in your body.  This isn’t quite true because dietary fat is more complex than one single umbrella term of “fat”.

There are actually four types of dietary fat and each has advantages and disadvantages for your health. The main thing to remember when discussing dietary fat and weight loss is that dietary fat has 9kcals per gram, compared to protein and carbohydrates which only has 4kcals per gram. 

To create a better balance between LDL and HDL cholesterol you want to eat less trans fats which can be found in foods like:

  • Croissants

  • Deep Fried Foods

  • Donuts

  • Cookies

  • Microwave popcorn

  • Cakes

  • Margarine

These are tasty AF but trans fats actually cause a double whammy of lowering HDL and increasing LDL.

As the CDC state [1]:

Evidence from experimental studies, dietary trials, and prospective observational studies in which TFAs are measured by biomarkers or dietary records consistently shows that intake of TFAs, from either industrial or natural sources, can increase low-density lipoprotein (“bad”) cholesterol levels, decrease high-density lipoprotein (“good”) cholesterol levels, and is associated with an increased risk of coronary heart disease (CHD) morbidity and mortality and all-cause mortality


Diet: Increase Your Monounsaturated Fat Intake

This is the opposite double-whammy to Trans Fats. Monounsaturated Fats increase HDL and lower LDL levels.

It’s a win-win.

The best way to think of how to get these into your diet is to envisage a “Mediterranean Diet”.

These Monounsaturated Fats can be found in foods such as:

  • Nuts such as almonds, cashews and pistachios

  • Avocado

  • Nut Oils

  • Olive Oil

  • Olive oil

In a study by The University of California [2] called they found:

The Mediterranean diet resulted in a small but significant increase in HDL-C levels and a small decrease in both LDL-C and TG levels”

The same study also said this:

Another meta-analysis reported a 4.6mg/dL decrease in LDL-C and a 0.61mg/dL increase in HDL-C

Diet: Eat More Polyunsaturated Fats

The reason that polyunsaturated fats and monounsaturated fats are considered better for your cholesterol levels is because of the way fat molecules are bonded together.

“Poly” meaning many, means there are many double bonds between molecules, compared to the other types of dietary fat that there are.

A good list of Polyunsaturated Fats:

  • Salmon

  • Mackeral

  • Tuna

  • Canola Oil

  • Flaxseeds

  • Walnuts

The other advantage of these types of fats is they contain Omega 3 and Omega 6.

Polyunsaturated fats have been found to help with lowering LDL.

In fact this study [2] from Oslo, Norway took 115 participants and replaced their regularly consumed foods such as margarine, fat for cooking, cheese, bread and cereals with polyunsaturated fats and reduced LDL levels by 10% over an 8-week period.


Diet: Eat More Soluble Fibre

This isn’t groundbreaking science, and you will see this feature in a lot of my work: Eat more fruits and vegetables.

In short, the soluble fibre ends up in your gut microbiome as a probiotic, which can help lower your LDL levels.


A final word on Cholesterol and Diet

The first thing I want to say is that you shouldn't now go and gorge on Avocados and Almonds.

Fat does still contain 9kcals per gram, and having a higher body weight does increase the risk of developing high cholesterol and other cardiovascular diseases.

Your diet should still only have about ~20-35% of your calories coming from dietary fat, but your choice of dietary fat can be crucial in this conversation.

It is worth noting that although diets can impact your cholesterol, this isn’t a solution outside of medical help.

A paper called: The Effect of Diet on Cardiovascular Disease and Lipid and Lipoprotein Levels [3] concludes:

“While diets can significantly affect lipid levels it should be recognized that the effect is typically relatively modest compared to drug therapy.”

But it also states:

“However, diet therapy can be initiated early in life and has the potential to result in long-term decreases in lipid levels. Given that studies have shown that long-term modest reductions in LDL-C levels can have major effects on the risk of CVD by up to 16-18%…Thus, long-term reductions in lipid levels induced by diet therapy may reduce the lifetime risk of developing CVD”

There is great value in managing your diet before it becomes too late.

Therefore if you can implement some of the recommendations in this article it will not only help you


Movement: Cardio Work

Sadly, Carrie, I don’t think shopping is intense enough to help lower your LDL and improve your HDL levels.

Unless its 17:00 on Christmas Eve and you are looking for this year’s “hot toy".

With regard to your cardio levels, you want to be working at an intensity of 75% of your capacity.

In real terms, this would like being quite breathless and finding it hard to talk whilst moving.

Think of between 7-8 on the RPE (rate of perceived exertion scale).


READ MORE ABOUT WORKOUT INTENSITY HERE:


In fact, there is a study [4] that looks directly into the effect Cardio has on your HDL levels and LDL levels.

HDL cholesterol increased by 4.6 % while triglyceride levels fell by 3.7 % and LDL cholesterol fell by 5 %. Total cholesterol remained unchanged, although the HDL:LDL cholesterol ratio improved considerably.

Again, a double whammy!

When you look a bit deeper, its actually a triple whammy, because the Cardio Exercise you have to do in order to achieve these results is just 150mins per week.

That breaks down to just 20mins a day.

This doesn’t mean hitting the treadmill every day for 20 minutes.

It could simply be a walk with the dog.

I can’t think of the right word for the feeling of walking at 75% of your capacity to help guide you.

The only thing I can think of is this:

I hope that helps.

Movement: Resistance Training

Again the news here is really good. You get exactly the same benefits as you get from doing Cardio work: lower LDL levels and higher HDL levels.

You also don’t have to work particularly hard in the gym to get these effects.

One researcher noted [4]:

The authors concluded that low- to moderate-intensity resistance training results in greater benefit to the lipid profile than high-intensity resistance training, although the mechanisms underlying this difference are unclear.

This is good news because if being in the Gym is something you aren’t overly confident about, or that you are overly feeling cautious about, you don’t have to go very hard to achieve better cholesterol levels.

There are many benefits outside of improved cholesterol to working to a correct intensity when you workout - but that’s another blog for another day.

The same study makes recommendations on what exercise to do based on your cholesterol levels:

If you have high cholesterol, then it would be easy to get caught up on exactly what to do and how to do it - but like with most things in health and fitness, moving the dial at all is going to help you.

My best recommendation would be to just get moving in a way you find most enjoyable, try to achieve a feeling of va-va-voom and you won’t go far wrong if you keep it up for 3 months or more.


Does Weight Loss Actually Reduce Cholesterol?

It will come as no surprise to you that eating a diet with fewer trans fats in it and increasing activity might help you lose weight as well as improve your cholesterol.

But what you might find surprising is how much weight you need to lose or not to actually see a significant improvement in LDL and HDL levels.

A study published in the Translational Behavioral Medicine Journal [5] found the following:

Five to 10 % weight losses produced improvements in cardiovascular risk factors, but greater weight losses were associated with even greater improvement.

I think that feels pretty achievable.

Especially when you consider the more excess weight you may have, the easier
it would be to lose such a percentage.

I also think that the act alone of losing weight was probably not the sole reason that the cholesterol levels were improved. We know which behaviours help with cholesterol improvements and it just so happens that these behaviours are likely to align with an element of weight loss as well so long as calories are controlled.

Reading the study further you can see that patients who lost weight also exercised more. They were encouraged to hit the 150min per week mark over the 15-week period that they were in the study for.

The diets were calorie controlled as well to help elicit the weight loss required.


 
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As always if you have any questions you only have to ask me.

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References:

1. (n.d.). Global Surveillance of trans-Fatty Acids. https://www.cdc.gov/pcd/issues/2019/19_0121.htm.

2. Ulven SM, Leder L, Elind E, Ottestad I, Christensen JJ, Telle-Hansen VH, Skjetne AJ, Raael E, Sheikh NA, Holck M, Torvik K, Lamglait A, Thyholt K, Byfuglien MG, Granlund L, Andersen LF, Holven KB. Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial. Br J Nutr. 2016 Oct;116(8):1383-1393. doi: 10.1017/S0007114516003445. Epub 2016 Oct 14. PMID: 27737722.

3. Feingold KR. The Effect of Diet on Cardiovascular Disease and Lipid and Lipoprotein Levels. [Updated 2021 Apr 16]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570127/

4. Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med. 2014 Feb;44(2):211-21. doi: 10.1007/s40279-013-0110-5. PMID: 24174305; PMCID: PMC3906547.

5. Joshua D. Brown, Ph.D., Joanna Buscemi, Ph.D., Vanessa Milsom, Ph.D., Robert Malcolm, M.D., Patrick M. O'Neil, Ph.D., Effects on cardiovascular risk factors of weight losses limited to 5–10 %, Translational Behavioral Medicine, Volume 6, Issue 3, September 2016, Pages 339–346, https://doi.org/10.1007/s13142-015-0353-9