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Total cholesterol is a measure of lipid concentrations in the blood. This marker takes into account levels of HDL, LDL, and VLDL, and it is often associated with cardiovascular health. (source)
Generally, low total cholesterol levels are considered to be a sign of good health. These levels may stem from physiological factors affecting liver function, as the liver is primarily responsible for cholesterol synthesis. Nutritionally, a diet low in saturated fats and cholesterol-containing foods can contribute to lower serum cholesterol levels. (source, source)
Prioritize red meat: Saturated fat has been shown to promote cholesterol synthesis. (source) Red meat is a source of saturated fat. Recommendation: Consume two servings of high-quality red meat weekly.
Train regularly: Physical activity has been shown to increase HDL. (source) Aerobic exercise increases HDL cholesterol by increasing lipoprotein lipase concentration and its activity in skeletal muscles. (source)Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
Elevated total cholesterol levels can stem from physiological factors related to cholesterol metabolism, including the synthesis and regulation of cholesterol by the liver. Nutritionally, excessive intake of saturated and trans fats, as well as dietary cholesterol, can contribute to higher cholesterol levels. Elevated total cholesterol can have further implications on cardiovascular health (source, source)
Limit saturated fats: Research has shown that the replacement of saturated fats with monounsaturated and polyunsaturated fats elicits a positive effect on cholesterol. (source) Saturated fats increase total cholesterol by suppressing low-density lipoprotein receptor pathways and increasing cholesterol synthesis. (source, source, source) Recommendation: Limit saturated fat intake to less than 15 g per day.
Prioritize fiber-rich foods: Diets high in fiber have been shown to positively affect cholesterol. (source) Dietary fiber decreases cholesterol absorption, which increases excretion through bile fecal matter, thereby decreasing total cholesterol levels. (source, source) Recommendation: Incorporate fiber-rich foods with the target of at least 30 g of fiber per day.
One serving examples: Chia Seeds (2 tbs), Flaxseeds (2 tbs), Lentils (1 cup), Steel Cut Oats (1 cup), Avocado (1 medium Avocado)
Prioritize CoQ10-rich foods: Consumption of CoQ10 has been shown to positively impact total cholesterol. (source) CoQ10 aids in the downregulation of the lectin-like oxidized LDL receptor and aids in the reduction of endothelial damage caused by reactive oxygen species. It also improves HDL-mediated cholesterol efflux capacity. CoQ10 also increases fatty acid oxidation which reduces oxidative stress by decreasing mitochondrial free fatty acids and increasing triglyceride lipolysis (source) Recommendation: Eat at least one serving of CoQ10-rich foods daily.
One serving examples: Liver (3 oz), Lentils (1 cup), Salmon (3 oz), Mackerel (3 oz)
Prioritize healthy fats: Consumption of DHA and EPA has been shown to increase HDL cholesterol levels and reduce total cholesterol. (source, source) Omega-3 fatty acids aid in the reduction of total cholesterol through a variety of mechanisms. Omega-3 fatty acids enhance the processes through which cholesterol is transported throughout the body and excreted. (source) They reduce very low density lipoprotein in the liver, thereby increasing lipoprotein lipase (LPL). LPL helps to break down triglycerides and aids in the formation of HDL particles. (source) Finally, Omega-3 fatty acid consumption reduces total triglycerides, which influence cholesterol levels. (source) Recommendation: Consume at least one serving of foods containing healthy fats daily.
One serving examples: Mackerel (3 oz), Salmon (3 oz), Cashews (1 oz), Sunflower Seeds (1 oz)
Train regularly: Both resistance and aerobic training sessions are recommended for promoting healthy cholesterol levels. (source) Exercise supports healthy cholesterol levels through multiple mechanisms. Exercise stimulates cholesterol transportation pathways, supporting cholesterol metabolism and excretion. (source, source) Additionally, exercise promotes lipoprotein lipase activity, which supports triglyceride metabolism and increases HDL concentrations. (source, source, source)Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
Maintain an athletic body composition: Body fat percentage is positively correlated with total cholesterol levels. (source) Excess body fat has been shown to increase insulin resistance which has been shown to reduce lipoprotein lipase and increase hepatic lipase, negatively affecting HDL cholesterol. (source) Recommendation: Maintain a high-performance diet and exercise program that supports a body composition of no more than 15% body fat for men and 20% for women.
Supplement with CoQ10: Supplementation with CoQ10 has been shown to decrease total cholesterol. (source) CoQ10 aids in downregulation of the lectin-like oxidized LDL receptor and aids in reduction of endothelial damage caused by reactive oxygen species (ROS). It also improves HDL-mediated cholesterol efflux capacity (CEF). CoQ10 also increases fatty acid oxidation which reduces oxidative stress by decreasing mitochondrial free fatty acids and increasing triglyceride lipolysis. (source) Recommendation: Supplement with at least 100 mg of CoQ10.
Supplement with berberine: Berberine supplementation has been shown to decrease total cholesterol. (source) Berberine increases the production of cell-surface LDL receptors (LDLRs) by increasing the stability of LDLR mRNA during translation. LDLRs uptake cholesterol from the circulation into cells to compensate for the lower intracellular levels, thus lowering serum LDL levels (source, source) Recommendation: Supplement with at least 1 g of berberine daily.
Supplement with fish oil: Supplementation with DHA and EPA has been shown to increase HDL cholesterol levels and reduce total cholesterol. (source) Omega-3 fatty acids aid in the reduction of total cholesterol through a variety of mechanisms. Omega-3 fatty acids enhance the processes through which cholesterol is transported throughout the body and excreted. (source) They reduce very low density lipoprotein in the liver, thereby increasing lipoprotein lipase (LPL). LPL helps to break down triglycerides and aids in the formation of HDL particles. (source) Finally, Omega-3 fatty acid consumption reduces total triglycerides, which influence cholesterol levels. (source) Recommendation: Supplement with at least 3 grams of fish oil daily.
