A few weeks ago, I posted some thoughts on why I don't believe that reducing cholesterol is the magic bullet that will prevent or cure heart disease. For starters, cardiovascular problems just aren't that simple, and on top of that, most cholesterol is completely harmless.
There is, however, one form of cholesterol that always requires aggressive treatment. It's called lipoprotein(a), or Lp(a), and it's one of the most dangerous heart risk factors.
Lp(a) is a subtype of LDL cholesterol that is highly inflammatory and thrombotic, which means it causes the blood to thicken and clot. Everyone has some Lp(a) in their blood stream--but when it increases abnormally, Lp(a) can raise your risk of having a heart attack up to 25 times.
Finding out if you have high Lp(a) is relatively simple. Just ask your doctor for one of the new-generation blood lipid tests that measure your cholesterol subtypes. There are two of them on the market, one called the Lipoprotein Particle Profile, or LPP, and another called the Vertical Auto Profile, or VAP. I prefer the LPP because I think the measurements are more precise, but both will tell you how much Lp(a) is circulating in your blood. As a general rule, you want your score to be less than 10 mg/dL.
Unfortunately, treating high Lp(a) is a little bit more complicated. One challenge is that there are no drugs with the ability to reduce it. Another is its genetic nature. High Lp(a) is often hereditary and is not the result of a poor diet or lack of exercise--which means you can't cure the problem through lifestyle changes, either.
That leaves just one genuinely good option, and that's to use natural therapies that offset the toxic effects of Lp(a) in the blood. Since Lp(a) causes inflammation and thickening of the blood, you want to look for products that have the opposite effect. I like fish oil (1-2 g daily) and nattokinase (50-100 mg daily). Fish oil is a natural blood thinner and has been shown to reduce inflammation, while nattokinase helps break down fibrin in the blood--one of the components that lead to clots. I also like high doses of vitamin C (1-2 g daily) for its antioxidant effects, as well as niacin (500 mg), which helps lower blood pressure.
Another option that I like is delta tocotrienol. Tocotrienol compounds occur naturally in plants and protect the carotenoids in plants from degradation. New research shows that delta tocotrienol is an effective means for reducing cholesterol overall, and it may be effective specifically on Lp(a). I recommend 100 mg daily.
Though it's somehwat less effective than targeted nutritional supplementation, you can also attack Lp(a) through a heart-healthy, cholesterol lowering diet. The PAMM eating plan (Pan Asian Modified Mediterranean) is a good place to start. It emphasizes healthy fats such as olive oil, along with whole grains, beans, legumes, nuts, fresh fruits and vegetables, and very small servings of meat (preferrably fresh, wild fish--not farm raised). This will help keep your ratio of HDL cholesterol to LDL cholesterol in proper balance, and the fresh fruits and legumes--such as chickpeas and lentils--indirectly help to reduce Lp(a) by lowering insulin levels.
Finally, there are certain people for whom an Lp(a) test is an absolute must. The first group includes anyone with a family history of heart disease. Lp(a)'s tendency to run in families means that these folks, above everyone else, need to find out if their levels are in the normal range. The test is alo essential if you're a postmenopausal woman or you have diabetes, because we know that Lp(a) increases in both of those groups. Women, it is hypothesized, experience elevated levels due to falling estrogen levels. This may be why the incidence of heart disease quadruples among menopausal women.
Of course, I urge the rest of you to have your Lp(a) level tested, too. The best way to prevent cardiovascular problems is to know your risk factors--and act accordingly.
For more information on healthy heart nutrition and cholesterol lowering diets, visit www.drsinatra.com.
There is, however, one form of cholesterol that always requires aggressive treatment. It's called lipoprotein(a), or Lp(a), and it's one of the most dangerous heart risk factors.
Lp(a) is a subtype of LDL cholesterol that is highly inflammatory and thrombotic, which means it causes the blood to thicken and clot. Everyone has some Lp(a) in their blood stream--but when it increases abnormally, Lp(a) can raise your risk of having a heart attack up to 25 times.
Finding out if you have high Lp(a) is relatively simple. Just ask your doctor for one of the new-generation blood lipid tests that measure your cholesterol subtypes. There are two of them on the market, one called the Lipoprotein Particle Profile, or LPP, and another called the Vertical Auto Profile, or VAP. I prefer the LPP because I think the measurements are more precise, but both will tell you how much Lp(a) is circulating in your blood. As a general rule, you want your score to be less than 10 mg/dL.
Unfortunately, treating high Lp(a) is a little bit more complicated. One challenge is that there are no drugs with the ability to reduce it. Another is its genetic nature. High Lp(a) is often hereditary and is not the result of a poor diet or lack of exercise--which means you can't cure the problem through lifestyle changes, either.
That leaves just one genuinely good option, and that's to use natural therapies that offset the toxic effects of Lp(a) in the blood. Since Lp(a) causes inflammation and thickening of the blood, you want to look for products that have the opposite effect. I like fish oil (1-2 g daily) and nattokinase (50-100 mg daily). Fish oil is a natural blood thinner and has been shown to reduce inflammation, while nattokinase helps break down fibrin in the blood--one of the components that lead to clots. I also like high doses of vitamin C (1-2 g daily) for its antioxidant effects, as well as niacin (500 mg), which helps lower blood pressure.
Another option that I like is delta tocotrienol. Tocotrienol compounds occur naturally in plants and protect the carotenoids in plants from degradation. New research shows that delta tocotrienol is an effective means for reducing cholesterol overall, and it may be effective specifically on Lp(a). I recommend 100 mg daily.
Though it's somehwat less effective than targeted nutritional supplementation, you can also attack Lp(a) through a heart-healthy, cholesterol lowering diet. The PAMM eating plan (Pan Asian Modified Mediterranean) is a good place to start. It emphasizes healthy fats such as olive oil, along with whole grains, beans, legumes, nuts, fresh fruits and vegetables, and very small servings of meat (preferrably fresh, wild fish--not farm raised). This will help keep your ratio of HDL cholesterol to LDL cholesterol in proper balance, and the fresh fruits and legumes--such as chickpeas and lentils--indirectly help to reduce Lp(a) by lowering insulin levels.
Finally, there are certain people for whom an Lp(a) test is an absolute must. The first group includes anyone with a family history of heart disease. Lp(a)'s tendency to run in families means that these folks, above everyone else, need to find out if their levels are in the normal range. The test is alo essential if you're a postmenopausal woman or you have diabetes, because we know that Lp(a) increases in both of those groups. Women, it is hypothesized, experience elevated levels due to falling estrogen levels. This may be why the incidence of heart disease quadruples among menopausal women.
Of course, I urge the rest of you to have your Lp(a) level tested, too. The best way to prevent cardiovascular problems is to know your risk factors--and act accordingly.
For more information on healthy heart nutrition and cholesterol lowering diets, visit www.drsinatra.com.
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