Increase HDL Cholesterol

HMG-CoA reductase inhibitors, more commonly known as statins, are 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 phenomenal job of reducing cholesterol levels, while also decreasing the number of deaths from heart attack and stroke.

Interestingly, these drugs are particularly effective for men, but less so for women. And, there’s a slight increased risk of breast cancer for women taking statin drugs. Because of the studies, and the fact that statins are still relatively new, I prefer to err on the side of caution when it comes to their use.

Common Statin Drugs

Some of the most commonly prescribed statin drugs include 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 good cholesterol levels.  In addition:

• 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 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.     

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.

Let’s take a look at how women’s risk factors for heart disease are different from men’s.

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.

For more information on heart risk factors for women, visit www.drsinatra.com.

I can’t say enough about the health benefits of exercise. It strengthens the heart and circulatory system, builds stamina, and improves mood. It’s also an effective means for lowering blood pressure levels, increasing HDL cholesterol, and improving poor blood circulation.

I’m often asked what the best form of exercise is. I say it’s the one you will consistently do! Walking, dancing, cycling, lifting weights—it doesn’t matter. The goal of exercise is simply to get out and get moving.

That said, I have to admit I’m a big fan of walking. It’s simple, doesn’t require special equipment or a gym membership, and it can help reduce your risk of heart attack and stroke. In a study reported in the Journal of the American Medical Association (JAMA), 4,065 nurses ages 40 to 65, without cardiovascular disease or cancer, completed detailed physical activity questionnaires. The surveys revealed that walking was associated with reduced risk of stroke.

Walking is easy to incorporate in your day. Walk up and down stairs instead of taking elevators. Steadily increase the distance while walking your dog. Instead of parking in the closest space to the store or office entrance, park at the far end of the parking lot. Consider walking short distances for errands instead of driving.

If you’ve been inactive for a while, start slow. Walk 10 minutes every other day for one week. Each week, increase your time by increments of 5 or 10 minutes. Within a month, you’ll be taking 30-minute strolls. Do this every other day, and you’ll have a good workout routine. Five days a week is optimal.

As for speed, you don’t have to maintain a brisk pace. Actual walking speed isn’t as important as we’ve been led to believe. In fact, researchers in the JAMA study I mentioned found that speed didn’t matter; it was the length of time women walked that was significant.

Simple, right? If you agree, lace up those sneakers and get out there. It’s one of the simplest—and most effective—steps you can take (literally) to prevent heart attack, stroke, and other cardiovascular problems.

 For more information on how to prevent heart attack and stroke, visit www.drsinatra.com.

Now that the summer is in full force, you are likely hooking up the barbecue and gathering with friends to enjoy dinner in the great outdoors. As enjoyable as these get-togethers can be, research has shown that grilling meat at high temperatures can create a number of harmful compounds.

High heat from an open flame creates COPs, highly carcinogenic compounds that are similar to the oxidized cholesterol found in your bloodstream. Along with the COPs, high heat creates other groups of harmful compounds, including heterocyclic amines (HCAs), compounds that have been found to increase your risk of several of the most common kinds of cancer, including breast, prostate, colon, and stomach cancers.

Tasty Ways to Protect Your BBQ

Fortunately, a marinade consisting of 10 percent plain soy sauce and one percent sugar has been found to cut the production of COPs by more than 60 percent. Plus, additional research also shows that adding tart cherries, red grapes, or plums (all good sources of pigmented antioxidants) to hamburger meat can cut HCA formation by 94 percent.

While it’s easy enough to mix some soy sauce or a handful of crushed cherries or grapes into a pound of lean hamburger or ground turkey, I prefer to use a marinade for my favorite fish. Not only do you get delicious protection from the potentially harmful side effects of grilling, but you get the heart-health benefits of omega-3s, including increased HDL cholesterol and LDL cholesterol levels, improved blood circulation, and reduced risk for heart attack and stroke.

So eat up and enjoy how delicious healthy heart nutrition can taste!

A Taste of the Orient

This taste delight combines the protection of soy sauce with the essential fatty acid and fiber benefits of nuts. I find this marinade works best with a mild fish such as halibut.

1/2 cup organic almond butter

1/3 cup soy sauce

2 tablespoons lime juice

1 tablespoon raw honey

1/2 teaspoon powdered ginger

1/8 teaspoon cayenne pepper

1. Warm almond butter in small saucepan over medium low heat.
2. When slightly softened, add soy sauce and remaining ingredients and blend well.
3. Remove from heat and pour into large, shallow bowl.
4. Add your fish and marinate in refrigerator for one to three hours.
5. Can also be used as a sauce. 

 To see more delicious healthy heart recipes visit, www.drsinatra.com. 
  
 

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!

For more information on how to increase HDL cholesterol while lowering LDL cholesterol levels, visit www.drsinatra.com.

 

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).

It's been a week since those New Year's resolutions kicked in, and I hope you still feel enthusiastic about the changes you want to make. I also hope that one of your goals is to live a healthier lifestyle, whether through regular exercise, a more nutritious diet, or a new outlook that helps reduce stress.

I'd like to add another item to your list, if I may--and that's to tune out all of the fear-mongering about cholesterol.

Based on the amount of attention it receives from doctors and the media, you might think cholesterol is the biggest cardiovascular problem we face. After all, we're constantly told that reducing cholesterol is a must if we want to prevent a heart attack or stroke. However, statistics bear out a much different story: half of all people who die of heart attacks have healthy cholesterol levels.

The idea that cholesterol will kill you is one of the most misrepresented "problems" in medicine, and the relative risk of not reducing cholesterol has been grossly oversimplified. For example, we're told, "LDL is bad." In fact, LDL is dangerous only when you also have one or more of the following:

• Too much of the wrong subtype of LDL (high levels of Lp(a) are especially problematic).
• Low levels of HDL.
• A family history of cardiovascular problems.
• Abnormally high inflammatory markers (homocysteine, fibrinogen, or C-reactive protein). 
• Other heart risk factors, such as insulin resistance or high blood pressure.

Meanwhile, no one ever talks about the ways in which cholesterol is essential for good health. Every day, your body uses cholesterol to make adrenal and sex hormones, bile acids, and nutrients such as vitamin D. Cholesterol is also needed to construct cell membranes, heal wounds, and make repairs to the endothelial lining inside artery walls. And if that weren't enough, it's absolutely essential for clear thinking--large amounts of cholesterol are used by the brain to facilitate cell communication and memory.

What's more, cholesterol levels fluctuate a great deal. You can have different cholesterol levels at different times of the day. Cholesterol tends to rise in the winter and fall in the summer. And because it is a healing agent, cholesterol will soar after any kind of injury or surgery.

Years of research show that there is a "sweet zone" for cholesterol, and that problems occur when you go too far above it or below it. I believe this is part of the body's innate intelligence. It makes the amount of cholesterol it needs--and if that level is higher than it should be, it makes sense to determine why. When the cause is successfully treated, cholesterol often comes down.

The bottom line is this: If your doctor says you need to reduce your cholesterol, it's wise to thoroughly assess all of your risk factors. But don't jump to the conclusion that you're in serious trouble just because you're outside of the normal range.

Still, I'm sure there are some of you who are wondering what range I consider to be "normal." Ideally, I like to see total cholesterol between 150 and 200 mg/dL; LDL between 90 and 130 mg/dL; and HDL between 40 and 120 mg/dL (for women), or 35 and 120 mg/dL (for men). But more important than these specific ranges is the ratio between your LDL and HDL. Aim for no greater than a 5:1 ratio (LDL:HDL). Ratios higher than 5:1 have been associated with increased risk of heart attack.

For more information on reducing cholesterol, visit www.drsinatra.com.