So you have just received a high cholesterol diagnosis. Lowering it to healthy levels immediately becomes a priority goal. This means eating a healthy diet, staying active and exercising. But can including certain supplements, like probiotics & psyllium in your diet, form part of the solution to help you achieve your goal?
What does research say?
Firstly, why is high cholesterol bad?
To comprehend the role of supplements in cholesterol management, it’s crucial to recognise the significance of maintaining healthy cholesterol levels. Cholesterol comes in two primary types, each impacting your risk of heart disease and stroke. Both types circulate in your bloodstream within molecules known as lipoproteins.
- Good Cholesterol (HDL – High-Density Lipoprotein): HDL cholesterol is considered “good” because it helps remove excess cholesterol from your bloodstream and takes it to your liver for processing and removal. High levels of HDL are associated with a lower risk of heart disease.
- Bad Cholesterol (LDL – Low-Density Lipoprotein): LDL cholesterol is often referred to as “bad” because it can build up in the walls of your arteries, forming plaque. This plaque can narrow and block blood flow, increasing the risk of heart disease. Lower levels of LDL cholesterol are generally better for your heart.
High levels of bad cholesterol are actually extremely common, affecting approximately 41.9% of Australian adults. The prevalence of high cholesterol is highest among those aged 55 to 64 years of age.
High cholesterol levels can harden the arteries, affect your blood flow and increase your risk of developing blood clots. It can increase your chances of developing heart disease, suffering from stroke, and more.
Your diet plays a crucial role in lowering your bad blood cholesterol levels. Making heart-healthy dietary choices is a well-established strategy for achieving this. These choices involve increasing your intake of unsaturated fats, such as those found in olive oil or avocados, while reducing the consumption of saturated fats (commonly found in animal products) and trans fats (typically present in certain commercially produced foods like cookies, pastries, and some pizza crusts).
The impact of different supplements on cholesterol
You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference.
Soluble fibre
Soluble fibre operates by forming a gel-like substance when it comes into contact with water. Once it transforms into a gel, it reduces cholesterol absorption by binding to cholesterol molecules and expelling them from the body. You can find sources of soluble fiber in whole foods like fruits, vegetables, oats, barley, beans, and lentils. Additionally, there are various formulations of soluble fiber supplements available:
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Natural soluble fibers: These include insulin (e.g., Benefiber), psyllium (e.g., Metamucil), or beta-glucan (e.g., found in ground oats).
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Synthetic soluble fibers: Options in this category encompass polydextrose (e.g., STA-LITE), wheat dextrin (also found in Benefiber), or methylcellulose (e.g., Citrucel).
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Natural insoluble fibers: These fibers add bulk to your stool and include options like flax seeds.
Of these, psyllium stands out as a fiber supplement with robust evidence supporting its effectiveness in improving cholesterol levels. Extensive research, encompassing 24 high-quality randomised controlled trials, has explored the impact of psyllium. The findings consistently demonstrate that consuming approximately 10g of psyllium per day (equivalent to 1 tablespoon), as part of a healthy diet, can lead to a significant reduction in total cholesterol levels by approximately 4% and LDL cholesterol levels by approximately 7%.
Konjac glucomannan, a unique soluble dietary fiber derived from the root of the Konjac plant. It’s known for its exceptional viscosity, making it one of the most potent soluble fibers found in nature.
Back in 2008, a systematic review took a close look at Konjac’s potential health benefits. The findings were promising: konjac might have the ability to reduce total cholesterol levels, including the “bad” LDL cholesterol, and even triglycerides.
A later study highlighted its effectiveness in lowering LDL cholesterol levels, which is a significant step towards reducing the risk of cardiovascular disease.
Probiotics
Probiotics are believed to contribute to the reduction of cholesterol levels through various mechanisms. These include aiding in the integration of cholesterol into cells and modulating the gut microbiome to promote the elimination of cholesterol through bowel movements.
In a comprehensive analysis that combined findings from 32 separate studies, researchers discovered that individuals using probiotics experienced a significant decrease in their overall cholesterol levels, with reductions of up to 13.27%.
It’s worth noting that majority of these studies utilise probiotics that include strains like Lactobacillus acidophilus and Bifidobacterium lactis.
Whey protein
Whey protein and casein, most commonly found in cow’s milk, may potentially decrease your bad cholesterol levels. A meta-analysis of 22 studies suggests that the consumption of whey protein could potentially decrease total cholesterol levels by 10.88% and LDL cholesterol levels by as much as 8.47%. Amino acids in whey protein affect cholesterol absorption, preventing it from oxidising and collecting in the arteries.
However, research on this topic is still in its preliminary stages.
Red yeast rice
Red yeast rice is a product derived from yeast, specifically monascus purpureus, cultivated on white rice. This yeast-rice mixture in powdered form has been a dietary staple in Asian cultures and has a history of use in traditional Chinese medicine.
A systematic review conducted in 2022 examined data from 15 randomised controlled trials. The review revealed that taking red yeast rice supplements appeared to be more effective in reducing blood triglyceride levels but less effective in lowering total cholesterol levels.
However, it’s important to note that these trials do not provide conclusive evidence regarding the long-term effectiveness and safety of red yeast rice.
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