Good Cholesterol Levels

• 1 Tbsp. flaxseeds, ground
• ½ cup fresh fruit—blueberries, a peach, kiwi, banana, or whatever you like
• 8 oz. organic rice milk, organic skim milk, organic yogurt, or unsweetened juice (you can also use water or a combination)
• 1 serving size (follow directions on package) of soy or whey protein powder

Some of the most commonly prescribed drugs for maintaining good cholesterol levels are statins like Zocor (simvastatin), Lipitor (avorastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Lescol (fluvastatin).

These drugs can be dangerous if taken with high levels of long-acting niacin (vitamin B3). Side effects also include dizziness, headache, extreme fatigue, swelling of the ankles, muscle weakness, and liver toxicity.

In both men and women, statins may weaken the heart muscle because they lower CoQ10 levels. In women especially, statin drugs may deplete levels of CoQ10, contributing to a weakened immune system.

Still, if you have moderate to severe heart disease involving multiple vessels, I recommend statin drugs to help you obtain and maintain healthy cholesterol levels. In addition, I recommend the following natural solutions:

• Make sure you take a minimum of 150 mg of standard CoQ10 per day, or 50–60 mg of the hydrosoluble form, to offset the drug’s depleting effect.
• Niacin is one of my favorite cholesterol-lowering agents if you are not on a statin drug, because of its ability to increase HDL cholesterol (the “good” cholesterol) and lower LDL cholesterol levels (the “bad” cholesterol). Low doses in the range of 100–300 mg three times daily are often effective without resulting in side effects of flushing, heartburn or gout attacks. A prescription form called Niaspan (750–1,500 mg) appears to be well-
  tolerated by most people with minimal side effects.
• Tocotrienols are antioxidants in the vitamin E family. Research suggests that they act much like statin drugs, minus the adverse side effects, by interfering with the liver’s ability to produce cholesterol. As little as 50 mg per day can have a positive effect.
• My Pan-Asian Modified Mediterranean-type diet (PAMM) is great for this and for overall cardiovascular nutrition. It’s rich in fiber, healthy fats (omega-3s from fish and fish oil), garlic and onions (two potent cholesterol-busters), and fresh fruits and vegetables. Fiber helps soak up cholesterol and cleanse the colon, preventing rapid absorption of cholesterol.
• Flaxseed is high in alpha linolenic acid and fiber, vital for healthy heart function.
• Soy helps prevent the oxidization of LDL and subsequent buildup of artery-clogging plaque. Soy also can help with reducing cholesterol levels, help ease menopausal symptoms, and may help protect against cancers of the breast and prostate.
• L-arginine—2–4 grams three times a day. TwinLab and Great Earth make good supplements that are widely available in health food stores.

HMG-CoA reductase inhibitors, more commonly known as statins, are among the most aggressively marketed drugs for producing good cholesterol levels. In clinical studies, statins achieved a striking reduction in cardiovascular problems such as heart attack, bypass, and hospitalization.

Statins are potent anti-inflammatory drugs that have been shown to be able to do a good job of reducing cholesterol levels, while also decreasing the number of deaths from heart attack and stroke. However, they do come with a host of side effects, including a slight increased risk of breast cancer for women taking statin drugs. Because of the studies, I prefer to err on the side of caution when it comes to their use.

In my next blog post, I’ll share safe, natural solutions that can help you maintain healthy cholesterol levels.

Lipoprotein(a), or Lp(a), is a component of LDL or “bad” cholesterol. LDL cholesterol levels that are too high can lead to cardiovascular problems and thus increase your risk of heart disease. Many factors influence blood levels of Lp(a).

According to an article in a 1997 Journal of the American Medical Association (JAMA), Lp(a) appears to regulate clot formation (thrombosis) and inhibit blood thinning. We know that Lp(a) increases in unstable diabetics and menopausal women with elevated levels due to lowered estrogen levels. This may be why the incidence of cardiovascular problems among menopausal women quadruples.

Conversely, Lp(a) decreases with estrogen replacement therapy. For this reason, it’s imperative that all menopausal and perimenopausal women with a strong family history of heart disease and other cardiovascular problems have their Lp(a) levels checked by their doctor. Further, post-menopausal women with multiple risk factors for heart disease should consider natural, topical estrogen replacement therapy, particularly if their Lp(a) is elevated.

Research shows that elevated Lp(a) levels appear to be even stronger predictors for the development of premature heart disease in men. JAMA reported a study of 2,191 men, ages 20 to 54, confirming this.

Lipoprotein(a), or Lp(a), is a component of LDL or “bad” cholesterol. LDL cholesterol levels that are too high can lead to cardiovascular problems and thus increase your risk of heart disease. Many factors influence blood levels of Lp(a).

According to an article in a 1997 Journal of the American Medical Association (JAMA), Lp(a) appears to regulate clot formation (thrombosis) and inhibit blood thinning. We know that Lp(a) increases in unstable diabetics and menopausal women with elevated levels due to lowered estrogen levels. This may be why the incidence of cardiovascular problems among menopausal women quadruples.

Conversely, Lp(a) decreases with estrogen replacement therapy. For this reason, it’s imperative that all menopausal and perimenopausal women with a strong family history of heart disease and other cardiovascular problems have their Lp(a) levels checked by their doctor. Further, post-menopausal women with multiple risk factors for heart disease should consider natural, topical estrogen replacement therapy, particularly if their Lp(a) is elevated.

Research shows that elevated Lp(a) levels appear to be even stronger predictors for the development of premature heart disease in men. JAMA reported a study of 2,191 men, ages 20 to 54, confirming this.

Diabetes. Diabetic women have a higher risk for heart disease than diabetic men. This is because the incidence of diabetes and its complications (including heart disease) is much higher in women. If you are a diabetic woman, your risk for heart disease is five to seven times normal, compared with a risk of only two to three times normal for a diabetic man. For you, proper heart sense means you should increase your physical activity and watch your diet to maintain a healthy body weight.

Overweight. Women have a higher heart disease risk from being overweight than men do. Recent studies indicate that being only 20 pounds overweight doubles your risk of heart disease. If you are overweight, I don’t want you to go on a diet. Instead, get physically active—it’s your most powerful weapon against fat—and begin eating more fresh fruits and vegetables, pasta, fish and lean poultry.  Eating this way is what I call “healthy heart nutrition” and it just makes sense. (See other blog entries for additional advice on cardiovascular nutrition.)

Cholesterol. Women have a higher risk for heart disease than men if they don’t have good cholesterol levels. More specifically, if they have have low levels of HDL (“good” cholesterol) they increase their heart risk factors.

You probably already know that there are two types of cholesterol. LDL is the “bad” cholesterol, which oxidizes in your blood and forms the plaque that clogs arteries. HDL carries LDL out of your blood vessels before it can do its damage. Volumes of data have shown that a high LDL is a powerful risk factor for heart disease in men. But for women, the story is different. Recent research indicates that a low HDL, not a high LDL, is the more significant risk factor for a woman to develop heart disease. (This means that some women may need to increase HDL cholesterol levels.)

The good news is that HDL is sensitive to factors such as smoking, obesity and lack of exercise. If your HDL is low (less than 35 mg/dL) you can raise it by quitting smoking and dropping excess weight through a combination of smart eating, healthy heart nutrition, and physical activity such as walking and dancing. If you are postmenopausal, you might also consider estrogen replacement therapy (ERT), which raises HDL, lowers LDL, and has other beneficial effects on your heart. Have your HDL level checked six weeks after you start an HDL-raising program. Chances are you will see a change for the better.

High Triglycerides. When you get your cholesterol checked, I also want you to have your doctor check to see if you have healthy triglycerides levels. Triglycerides are another type of blood fat. A high triglyceride level is more dangerous for women than for men, so if your triglycerides are elevated (above 200 mg/dL), I want you to put some effort into lowering them, especially if you are a diabetic. This is because if you are a diabetic woman who also has high triglycerides, your risk of developing heart disease increases to 200 times normal. Please stop and think about this. You can lower your triglycerides using the powerful combination of exercise and weight control.

Many of today’s fad diets revolve around modifying insulin resistance by consuming low-carbohydrate, high-protein foods and also advocate eating foods high in saturated fats and dairy products. This type of diet is likely to contain high levels of insecticides, pesticides, and radiation, which in the long run may increase your risk of cancer of the bowel, prostate, and breast and can increase your heart risk factors.

Also, as you start to lose weight and your body is forced to break down stored fat for energy, your good cholesterol levels may be challenged and it may become difficult to keep them within the recognized cholesterol guidelines. This may be an artificial rise in cholesterol, however, it is a good idea to be cautious and work with a physician if you decide to start one of these diets.

Based on this, I suggest that anyone trying to lose weight adhere to a diet akin to my Pan-Asian Modified Mediterranean diet, making sure to eat fresh fish at least two to three times a week. You’d can also enjoy fresh fruits, legumes, cold-water fish such as salmon, sardines, and mackerel or fish oils, particularly docosahexaenoic acid (DHA), which blocks the inflammatory and blood-clotting capabilities of Lp(a).

I’d also urge you to omit saturated fats. Instead, choose monounsaturated fats like olive oil and polyunsaturated fats like alpha-linolenic acid, found in flaxseed.

Historically, it was assumed that if you couldn’t keep good cholesterol levels, you were at risk for coronary artery disease and other cardiovascular problems. But there is now evidence that elevated homocysteine levels is another serious heart risk factor. 

Multiple studies have confirmed the connection between high-plasma homocysteine levels and occlusive artery disease, including coronary atherosclerosis, peripheral vascular disease, and carotid artery disease. In fact, some research shows that 42 percent of strokes, 28 percent of peripheral vascular disease, and approximately 30 percent of premature cardiovascular disease are directly related to excessive levels of homocysteine.

High homocysteine levels can be caused by foods—red meat, avocados, sunflower seeds, wild game, poultry, and ricotta cheese. These foods contain the amino acid methionine. If you don’t get enough B vitamins, your body cannot break down methionine, resulting in homocysteine.

These deficiencies can be further exacerbated by caffeine and alcohol, which cause excessive urination and wash out precious B vitamins from our bodies. (That’s why it is so important to adhere to the healthy heart nutrition tips I often share here in this blog.)

Research also shows that five percent of the population may have inherited a rare genetic enzymatic defect that leads to higher homocysteine levels and premature heart disease (which can lead to heart attack and stroke). Because of this new genetic data, the evaluation of serum homocysteine levels should become standard in preventive cardiology, especially in anyone with a family history of premature heart disease.

When Should You Get Your Homocysteine Tested?

If you eat a healthy diet, supplement with vitamins and minerals, exercise, and have no family history of heart disease and or other heart risk factors, then you don’t need to be tested for homocysteine. But if there was a sudden death of a family member at a young age from stroke or heart disease, or if you have heart disease (especially if you are under age 60), you should be tested for homocysteine.

Research has shown that 400 mcg of folic acid a day will help prevent high homocysteine levels. However, to be safe, I recommend 800 mcg folic acid and 20 mg of vitamin B6 per day. Natural sources of folate include dark green leafy vegetables, beans, legumes, oranges, orange juice, and fortified cereals.

Ground flaxseed has the ability to lower your blood pressure levels and to help you to reach good cholesterol levels. It can also reward you with healthier skin, improved digestion, and a cleaner bowel, which results in less energy drain on the liver – the most important filter of the body.

You see, you can get two key types of essential fatty acids from flaxseed because it contains 19 percent activated omega-6s and 48 percent of an omega-3 precursor, alpha linolenic acid. This makes it a perfect food for people who are looking for natural ways to lower blood pressure and maintain overall good health.

In general, freshly ground flaxseed is better than flax oil because you’re assured the oil in the seed is fresh, plus you’re getting extra fiber and plant lignans. Simply grind two tablespoons of flaxseed and sprinkle on food or blend in a breakfast drink three to four times per week.

Click here for a delicious smoothie recipe using flaxseed and here for the recipe for a heart healthy flaxseed bran muffin to go with it!

It’s one thing to say “eat more soy” to help maintain good cholesterol levels or as part of a plan for reducing cholesterol. It’s quite another to actually put that advice into action. So here are my top recommendations of soy-based foods and how to use them.

Soy is known to be one of the two most genetically modified foods in the United States (corn is the other). Given this, I strongly recommend sticking with “true” soy foods, meaning edamame (the beans themselves), tofu, and tempeh (fermented soy). And always, always choose organic.

Easy Edamame

Edamame is the easiest of the three to work with! For a delicious finger food (and great alternative to greasy, unhealthy chips), steam edamame, toss with sea salt, and enjoy!

I also like to toss edamame into my salads for a quick hit of protein. In fact, 1/2 cup of edamame gives you 150 mg soy isoflavones a day.

Turn Up Your Tofu

Let’s face it, tofu is rather bland. But that doesn’t have to be the case! Tofu is like a culinary chameleon, meaning that whatever you add to tofu, it magically “becomes.” Therefore, the secret to tofu is marinade and spice.

The easiest tofu recipe I know is to mix 2/3 cup tamari sauce, 2/3 cup olive oil, and 1/3 cup balsamic vinegar. Add 2-3 tablespoons of your favorite spice mix and blend well. Cut tofu block into five slices. Add to marinade and refrigerate (covered) for at least four hours. Lightly sauté and you have a delicious meal that can be pair with virtually any side dish!

You can also “soak” tofu in your favorite barbeque sauce, cut into slices, and grill. So delicious! Pair with a salad and some roasted vegetables and you have an easy, delicious, healthy meal in no time. And, just one cup of tofu provides 70 mg soy isoflavones as part of a healthy cholesterol loweing diet.

Tempting Tempeh

This one seems to baffle even the most devout soy lover. The simplest answer? Treat like ground meat. Simply crumble tempeh and lightly sauté with onions and peppers. Add some diced tomatoes and your favorite blend of Italian spices and you have a delicious pasta sauce!

Another favorite? Add tempeh to chili to give it a protein-powered boost without altering the flavor of your favorite recipe. Again, crumble the tempeh to achieve the best texture and mouth feel. And, like tofu, just one cup of tempeh gives you 70 mg soy isoflavones.

If you have any recipes, tips, or questions regarding healthy heart nutrition, please send them in so we can share them with other healthy epicures!

More than 30 clinical studies have shown that soy is highly effective as part of a cholesterol-lowering diet. Case in point, an August 1995 meta-analysis from the New England Journal of Medicine found that people who ate an average of 47 grams of soy protein per day had a 13 percent decrease in LDL cholesterol levels, a 10.5 percent decrease in triglycerides, and a nine percent decrease in total cholesterol levels.

A November 2001 issue of Archives of Internal Medicine also found that a high consumption of legumes, including soybeans, meant a lowered risk of coronary heart disease (CHD). They concluded that increased legume intake may be an important part of a dietary approach to preventing CHD.

Additionally, a report in the August 2002 issue of Arteriosclerosis, Thrombosis and Vascular Biology found that a diet rich in tofu and other soy products may help protect postmenopausal women from arterial disease. According to researchers, phytoestrogens were associated with less arterial stiffness among more than 400 postmenopausal women. The benefit was most pronounced among the oldest women, or those who had been postmenopausal the longest.

Surprisingly, even the FDA agrees that soy is beneficial for maintaining good cholesterol levels. In 1999, they authorized of the use of health claims on the labeling of foods containing soy protein, based on research which shows that soy foods may reduce risk of coronary heart disease by lowering blood cholesterol levels. According to the FDA, foods must contain 6.25 grams per serving of soy protein in order to qualify for the claim, and a daily intake of 25 grams is recommended in order to achieve a significant cholesterol-lowering effect. Now that's healthy heart nutrition!

You’ve heard me say time and again that reducing cholesterol is not the magic bullet that will prevent heart attack and stroke. I stand by this statement wholeheartedly—but I don’t want you to interpret it to mean that cholesterol is unimportant.

Optimum cardiovascular health requires maintaining a healthy cholesterol ratio—that is, keeping your LDL cholesterol levels (the so-called “bad” cholesterol) in proper balance with your HDL levels (the “good” type of cholesterol). It also calls for minimizing the amount of Lp(a) in your blood, and not letting your triglyceride levels get out of hand.

Although regular exercise and a cholesterol lowering diet will go a long way toward helping you achieve these goals, I also recommend that you try some targeted nutritional supplements for an extra boost. One of them is niacin (vitamin B3). It’s a fantastic nutrient that can help you increase HDL cholesterol, as well as lower both triglycerides and the dangerous subtype of cholesterol known as Lp(a).

These are huge benefits. For me, keeping HDL levels high and Lp(a) down are more significant than lowering LDL or even total cholesterol. Elevated Lp(a) is a serious, widespread, and underemphasized problem, and niacin is probably one of the best nutrients to lower it. And the higher your good cholesterol levels, the more protection you have in your blood vessels.

The only downside to niacin is the flushing sensation it generates. This hot, tingly, pins-and-needles feeling is disconcerting to a lot of people, but it usually lasts no more than 30–60 minutes, and it is most pronounced during the first week or so that you take the supplement (it can also occur when you increase your dosage). You can find no-flush forms of niacin, but they’re not as effective. I would stick with the regular kind.

I recommend taking 1–2 g a day in divided doses with meals. Start with 250 mg and slowly work your way up to minimize the flushing effect. Let me know how it works for you!

 

One of the most important parts of maintaining healthy cholesterol is understanding how your body uses and manages this essential lipid. Why? Because having a cholesterol level that is too low is just as dangerous as having a cholesterol level that is too high. Most people don't realize it, but blindly following the cholesterol guidelines put forth by pharmaceutical companies (whose primary interest is to sell you their drugs, not to make you healthy) could put your long-term health in jeopardy.

To help you get some perspective on what constitutes a good cholesterol level, I've identified 10 vital facts about cholesterol in the body. Keep them in mind the next time your doctor raises the issue of reducing cholesterol, and make sure that any decision to do so is truly in your best interest (and if you must improve your numbers, opt for natural therapies such as a cholesterol lowering diet, as well as lifestyle changes and nutritional supplements that can help increase HDL cholesterol and reduce LDL cholesterol levels).