LDL Cholesterol Levels

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.

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.

Crushed flaxseed is a perfect food for a cholesterol-lowering diet. It contains essential fatty acids, high-quality protein, vitamins, precious phytonutrients, and lignans, as well as soluble fiber and insoluble fiber, all of which promote healthy cholesterol. In fact, research on soluble fiber shows that total cholesterol can be reduced by 11 percent and LDL cholesterol by 18 percent over a two- to three-week period.

For now, I hope all of you—even those of you whose cholesterol levels are in the normal range—will drink one flax shake a day. Many of my patients have lowered their cholesterol and lost weight when I 've put them on a flax shake. Give it a try!

 

You may remember that last month, I wrote about breast cancer awareness and the importance of raising awareness about this dreaded disease. Today I want to share another message of urgent importance to women: As bad as breast cancer may be, you are far more likely to die of heart disease. 

Women are often surprised to learn that their chance of dying from heart disease is six times greater than their chance of dying from breast cancer. But statistics show that while four percent of women will die of breast cancer, more than 30 percent will die of heart disease. So you need to pay attention to your heart risk factors, especially as you pass menopause and lose the natural protection against heart attack and stroke provided by estrogen.

Fortunately, you can reduce your chance of heart attack and stroke by eating a healthy PAMM diet, exercising regularly, and taking nutritional supplements that support heart health (fish oil and CoQ10 are two of my favorites). You should also do the following:

• Get regular blood tests to monitor your heart risk factors. Cholesterol fractionation tests are essential. Known as the VAP and LPP, these tests measure the various components of cholesterol and more accurately assess your risk of heart disease than standard blood lipid tests. The tests also measure Lp(a), a highly inflammatory form of LDL cholesterol that causes blood clots. Lp(a) rises in menopausal women so it’s important to watch your level. In addition, ask your doctor to check your levels of C-reactive protein (CRP), homocysteine, and fibrinogen. These biochemicals help predict cardiovascular disease. CRP is a marker of chronic inflammation, and homocysteine is a toxic amino acid involved in the early stages of arterial damage. Fibrinogen is a protein with inflammatory and clot-forming properties. It rises during menopause, particularly among smokers.

• Refuse to take cholesterol-lowering statin drugs unless you have evidence of inflammation, advanced cardiovascular disease, or have had a prior cardiac event or procedure. Many doctors prescribe statins at the first sign of high cholesterol, but I believe statins should be prescribed only to people with advanced arterial disease. Not only do the drugs inhibit your body’s production of CoQ10, but depletion of CoQ10 levels can lead to low energy and muscle weakness. Moreover, statins may increase Lp(a), one of the most dangerous heart risk factors.

• Avoid hormone replacement therapy that uses synthetic hormones. Conventional HRT drugs (Premarin, Provera, Progestin) have been documented as dangerous to the cardiovascular system. I recommend biodentical hormones instead. These natural plant-based substitutes that have chemical structures identical to those in the body, and they achieve excellent results without serious side effects.

• Lower your stress level. Happiness is a healer. Stress is a killer. Be happy—and stay healthy!

 

With all of the unnecessary attention lavished on HDL and LDL cholesterol levels, the importance of healthy triglycerides has been largely lost. And that’s too bad—because keeping them in a healthy range is essential to heart health.

Triglycerides are the chemical form of most fats in the body. The triglycerides in your blood come from dietary sources, primarily fats and carbohydrates. I consider a healthy triglyceride level to be 50–150 mg/dL. Levels above that have been linked to coronary artery disease and metabolic syndrome.

Given that the typical American diet is laden with processed and fast foods, it’s no surprise that high triglyceride levels are a problem for many people. To bring them down, cut back on the amount of sugar and carbohydrates in your diet, and eat more protein. I would also strongly recommend that you exercise regularly. Lifestyle changes such as these are very effective in keeping triglycerides in the healthy zone. Remember, the lower your weight, the lower your triglycerides, so weight loss and weight management are KEY to success!

Another good option for lowering triglycerides is a high-quality fish oil supplement. Start with 2–3 grams daily in divided doses, and let me know how it works for you.

 

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!

Now that the summer is in full force, you are likely hooking up the barbeque 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.
    

Earlier this week, a new study by Kaiser Permanente reported an association between high cholesterol levels and increased risk of Alzheimer’s disease or dementia. Researchers followed close to 10,000 people for 40 years and found that people who had high or borderline high cholesterol levels at ages 40–45 had much greater chances of significant mental decline later in life. Risk was 66 percent higher for people with high cholesterol (>240 mg/dL), and 25 percent higher for people with borderline high levels (200–239 mg/dL).

Alzheimer’s is a frightening condition, and these results are provocative. I have no doubt whatsoever that somewhere there’s someone saying, “This is another reason why we need to keep reducing cholesterol.”

But when it comes right down to it, these results merely show that people with high cholesterol tended to have a higher incidence of dementia. They don’t prove that reducing cholesterol will prevent future illness.

If there’s one point I want you to take away from this study, it’s this: Cholesterol is no more than a biological marker that can reveal what’s going on in the body. When it’s high, it usually means there’s usually an underlying problem somewhere—and in this case, those problems also may have had an effect on brain health.

For example, the study provided no information about the general health of the participants, so it’s impossible to know if they had health conditions—such as diabetes, metabolic syndrome, or being overweight—that would predispose them to inflammation and higher LDL cholesterol levels. (Inflammation has also been linked to Alzheimer’s, and more closely.) We also don’t know about their lifestyle habits. Did they eat diets high in carbohydrates, sugar, or trans fats? These, too, stoke inflammation, and trans fats, specifically, have been shown to destroy brain cells.

If you have high cholesterol, rest assured that you’re not destined for Alzheimer’s. However, I would encourage you to address the risk factors that are causing your LDL cholesterol levels to rise above the optimum level. Avoid excess sugar by following an   organic Mediterranean-style diet rich in fish, DHA-fortified eggs, whole grains, fruits, and vegetables; keep your blood pressure in check by better managing stress; and lose weight by exercising every day. If you are a man, keep your waistline to less than 40 inches, and if you are a woman, to less than 36 inches (this helps prevent metabolic syndrome). When these fundamental issues are taken care of, not only will your cholesterol level fall, but you will reduce your risk for all age-related disease.

 

In my last blog entry, I promised some delicious recipes from the local farmer’s stand. One of my family’s absolute favorites—Eggplant Parmesan, is not only good for your LDL cholesterol levels (which I’ll get to in a minute)…it’s filled with amazing health benefits! 

Eggplant, a nightshade vegetable, is high in fiber, manganese, vitamin B1, copper, and potassium. It also contains nasunin, an anthocyanin antioxidant that protects your cell membranes from damage—and fortifies your immune system. 

Plus, eggplant’s main phenolic compound—cholorogenic acid—not only has viral and cancer fighting actions, it can lower your LDL cholesterol levels. But one caveat for folks with kidney and gallbladder problems is that eggplant may actually block your absorption of calcium if you’re not getting an adequate amount in your diet. 

When selecting an eggplant, we like the mid-sized ones for individual servings. They aren’t always easy to find though, and a full sized eggplant works just as well. (But avoid Japanese eggplants; there just isn’t enough “meat” inside to work with). Pick an eggplant that’s firm, heavy, shiny, and colorful, but not waxed. If your thumbprint springs back, it’s fresh!

Now, here’s something that might surprise you—not only is eggplant good for your LDL cholesterol levels, it can be cooked outside on the grill. In fact, Dr. Sinatra created an easy, delicious recipe called, “Eggplant Parm-on-the-Grill.” 

Here’s how to make it:

• Slice the washed eggplant in half horizontally, and place it on the grill, skin side down. By the way, be sure to use a stainless steel knife since carbon reacts with the phytonutrients in eggplant and causes them to turn black.  Depending on the size of the eggplant, your cooking time will vary, but allow about 7-12 minutes until the pulp inside softens.

• Use a fork to scratch and mash it in the skin, or scoop it out to mash (sorta like baking a twice-baked potato) and put it back in.
   
• Top the eggplant with pre-warmed spaghetti sauce (which is also good for your LDL cholesterol levels), and your favorite grated cheese. We dubbed this dish “Eggplant Parm,” but you can also use Romano, Pecorino, or Asiago cheeses. 
   
• Garnish with your choice of farmstand-fresh chopped basil, cilantro, or parsley. If you want more antioxidant support, the use all three!

 We like to enjoy our Eggplant Parm with a salad topped with broccoli florets—another good vegetable for your LDL cholesterol levels. The lycopene in the tomatoes and the sulphurophane in the broccoli also have a synergism that packs a one-two punch for squelching cancer. Then, add your favorite cool drink and enjoy!

Stay tuned…later in the week, I’ll be sharing another fast, easy farm stand favorite that’s also packed with good nutrition for your LDL cholesterol levels, and your heart!

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).