Archive for the ‘lifestyle’ Category

Four Main Factors Causing High Cholesterol

Monday, October 27th, 2008

Besides diet, other causes of high cholesterol are lifestyle, gender and the heritage of the individual.

For some, even maintaining cholesterol at the right levels and being fit and thin will still not prevent the development of high levels of bad cholesterol. Due to heart risk factors besides diet, some people require a very aggressive approach which includes cholesterol lowing medication.

Lifestyle issues and high cholesterol:

* When we opt for convenience in eating over nutrition, we are setting ourselves up for problems. Eating fast foods and convenience foods results in eating too many fats and salts, which can raise our bad cholesterol levels. In addition, a more sedentary lifestyle also contributes to unhealthy levels of cholesterol.

* A visit to a nutritionist or dietician can help us all better understand eating for the right reasons and for optimal health. It is never too late to start on this path.

* Regular exercise will effectively lower cholesterol and will maintain your body strength to function best. Just 20 minutes of aerobic exercise, including walking, each day will lower cholesterol. Exercise does not have to be a large time or money commitment. Simple activities that get you moving and that you enjoy enough to repeat are almost always adequate.

Diet:

* An important consideration in eating is choosing lower fat.

* Buy cooking oils that are unsaturated. Use low fat cooking sprays to replace heavy oils whenever possible. Reduce your overall use of oils even further by using cooking techniques that require little or no oil.

Age and Gender:

*Cholesterol levels increase with age. Women generally have a lower level than men from age 50 to 55. Once a woman starts menopause, the cholesterol level starts to increase.

* While there is not much that you can do about your age, you can make sure that age does not threaten your heart health by sticking to a healthy lifestyle and diet and by getting your cholesterol levels monitored.

Heritage:

* Genetics play a key role in a person’s health and this includes the amount of cholesterol you might have.

* Find out if your family battles with high levels of cholesterol and then bring this to your doctor?s attention right away. If you have a family history of heart disease and high cholesterol levels, work harder and start earlier in adopting a healthy lifestyle and eating plan.

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To Manage Your Cholesterol, Know Your Lipid Levels

Saturday, June 28th, 2008

Are you confused about cholesterol?

Wondering which numbers need to go up and which numbers need to go down? If so, you’re not alone. According to the American Heart Association, an estimated 80 million Americans have high levels of LDL “bad” cholesterol, over 44 million have low levels of HDL “good” cholesterol and over 28 million have high levels of triglycerides . Also, 42 million Americans suffer from a disorder called mixed dyslipidemia meaning their levels of triglycerides are high, LDL cholesterol is moderately high and HDL cholesterol is low.

Considering these staggering statistics, chances are you or a loved one may have unhealthy cholesterol levels.

“Despite treatment advances, heart disease is still the leading cause of death in this country,” says Jerome D. Cohen, M.D., of the National Lipid Association. “Because unhealthy cholesterol levels can lead to this devastating disease we need to do a better job educating people about risk factors and what they can do to minimize them.”

It is important to work with your doctor to set healthy goals and measure all cholesterol levels including LDL, HDL and triglycerides.

LDL, HDL and triglycerides are all independent risk factors for heart disease. The risk of developing heart disease doubles when triglyceride levels are above 200. When triglycerides are above 200 and HDL cholesterol is below 40, a person is at four times the risk.

To help lower your risk of heart disease, start by getting your cholesterol levels checked.

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How to Lower Your Cholesterol

Wednesday, April 9th, 2008

Heart disease is the UK’s biggest cause of death - and having high cholesterol puts you at significant risk. But as there are no obvious symptoms, a heart attack is often the first warning sign of the condition.

Don’t let this happen to you. Take our quick cholesterol quiz to identify whether you may have the condition - and how to slash your risk…

1. How old are you?

a) Under 24 (-1)
b) 25-44 (0)
c) 45-65 (+1)
d) Over 65 (+2)

Why it matters: Cholesterol increases with age. Only 26 per cent of men and 31 per cent of women under 25 have high cholesterol, but by the age of 50 those figures shoot up to 81 per cent of men and 79 per cent of women. “We don’t exercise as much as we get older and we tend to eat more fat,” explains Ellen Mason, cardiac nurse at the British Heart Foundation.

Whatever your age simple lifestyle changes can turn things round fast. Just adding a handful of walnuts a day to your diet can slash levels of harmful LDL cholesterol by 10 per cent in up to six months, while eating 100g of beans daily can reduce it by 20 per cent in three weeks.

2. Do your relatives have high cholesterol? Or have any close male relatives had a heart attack before 50, or any female ones before the age of 55?

a) Yes (+2)
b) No (0)
c) I have no idea (+1)

Why it matters: “Family history is definitely a risk factor for cholesterol,” says Dr Robert Finnie, a trustee for the cholesterol charity Heart UK.

“If a sibling or parent has high cholesterol you have a 50 per cent greater chance of having it yourself.” The reason is that genes can determine how your body makes and processes cholesterol. If, for example, you inherit an under-performing version of a gene called APOE-4, you won’t transport cholesterol out of your body as well as other people.

Fortunately, gene behaviour can be changed. According to Dr Jack Challam, author of Feed Your Genes Right (Wiley Books), healthy levels of vitamin E in the diet help boost APOE-4 activity. Consider taking a supplement.

3. Which of these sounds most like your exercise regime?

a) I don’t do any (+2)
b) I do my 10,000 steps throughout the day (+1)
c) I exercise for 20 minutes at least three times a week (0)
d) I exercise for more than 20 minutes at least three times a week (-1)

Why it matters: “Exercise triggers the release of enzymes that break down the harmful LDL form of cholesterol that collects in your arteries,” says Dr Marie Murphy, head of the School of Exercise Sciences at the University of Ulster. Any movement triggers this enzyme release - in Dr Murphy’s trials simply walking up stairs for two minutes up to eight times a day slashed LDL levels by seven per cent in eight weeks. But longer sessions of formal exercise create a greater effect.

Aim to do a 40-minute workout three to four times a week.

4. Which of these do you eat more than three times a week?

a) Red or processed meats (+1)
b) Butter, cheese, full fat milk (+1)
c) Cakes, biscuits, chocolate, crisps (+1)
d) Deep-fried foods (+1)

Why it matters: All of these are high in saturated fat. “This is basically the raw material your body needs to make cholesterol,” says nutritionist Dale Pinnock (www.dalepinnock.com).

Cut your intake of saturated fat and cholesterol levels fall.

A us study has shown that every one per cent of saturated fat you drop from your diet cuts your cholesterol by one per cent, too.

To cut down, limit all of the above and opt for low-fat versions. Grill, bake or steam foods and use heart-healthy sunflower or olive oil for frying.

5. How stressful is your life?

a) Very, I get stressed easily and it happens a lot (+2)
b) Very, but I do lots of relaxation/ exercise to fight it (+1)
c) I usually cope well with stress (0)

Why it matters: Dr Andrew Steptoe, at University College London, found that levels of “bad cholesterol” are three times higher in people who are stressed than those who remain cool under pressure. “Blood fats, including cholesterol, are released during stress as, in past times, we needed them to fuel our ability to flee the thing causing us stress. Today we tend not to run away from stresses so the fats are not used up and remain in our blood,” he says. Controlling stress is therefore important for controlling cholesterol levels.

6. How many of these do you have more than four times a week - tea, wholegrains, oats, beans, soy, olives, seeds, Benecol, nuts, apples?

a) None (+2)
b) 1-2 (0)
c) Over 2 (-1)

Why it matters: “These foods can all actively lower levels of cholesterol in your body,” says Dale Pinnock. High-fibre foods such as oats, wholegrains and beans absorb cholesterol in the intestine helping you pass it out of the system. Healthy fats in nuts, seeds and olives speed up how fast your liver breaks it down. Try to include one to two servings of cholesterol lowering foods every day.

7. How much coffee do you drink a day

a) Fewer than four cups (0)
b) Over four cups of espresso or cafetiere coffee (+1)
c) Over four cups of any other type (0)

Why it matters:
“Cafestol, an oil in coffee beans, activates an enzyme that inhibits cholesterol breakdown,” says Professor David Moore, of Baylor College of Medicine in Texas. Drinking five cups of high-cafestol coffee - espresso or that made in a cafetiere - can raise cholesterol by up to eight per cent in four weeks. Fortunately for coffee lovers a sensible intake of under four cups a day won’t cause major issues.

8. Measure the area around your tummy. Is it over 37ins (men) or 32ins (women?

a) Yes (+1)
b) No (0)

Why it matters: The more you weigh, the higher your cholesterol is likely to be.

Denise Armstrong, at Heart Research UK, says: “People who are overweight tend to eat higher fat diets and do less exercise.”

Changing these things will reduce weight - and cholesterol.

9. How much alcohol do you drink a day?

a) Nothing (+1)
b) Up to two units a day for women, up to three for men (0)
c) More than two units a day (women) or three for men (+1)

Why it matters: Moderate alcohol intake actually boosts levels of healthy HDL cholesterol. Excess alcohol doesn’t raise cholesterol, but it does increase the amount of harmful fats called triglycerides which damage the arteries.

10. Do you smoke?

a) No (0)
b) Yes (+1)

Why it matters: Smoking doesn’t increase cholesterol but it also raises triglycerides in your body.

WHAT THE SCORES MEANS

Under 3: You are living a low-cholesterol lifestyle so chances are your levels are within the normal range. Keep it up.

4-10: You may have health issues. Ask your GP for a cholesterol test, or try a home test (Superdrug’s Self-Check Test is £9.99).

More than 11: You are at high risk of high cholesterol. See your GP for a test rather than trying a home one. If levels are very high, you may need a course of cholesterol-lowering drugs - as well as making lifestyle changes.

I got a wake-up call before it was too late

Sarah Wade, 34, lives in East London. She’s single and works for a design agency. She says:

“I was registering with a new GP so I asked him to give me an MOT.”

“Although I’d lost an uncle to heart disease and my mum has high cholesterol, I was still shocked when he said my levels were high, bordering on very high. I thought cholesterol only affected overweight people and at 9st I certainly wasn’t that.”

My doctor explained some simple changes I could make to lower it. Now, one Sunday a month, I cook loads of pasta, lean meat and oily fish dishes (the omega 3 fats help lower cholesterol) and freeze them in batches. I work long hours and used to rely on ready-meals and takeaways, which are packed with saturated fats, but now I have my own healthy ready-meals.

“I eat more fruit and veg and have replaced squashes with fresh juice, especially pomegranate juice, which is good at lowering cholesterol. I eat more fibre and take psyllium husk supplements, a natural source of dietary fibre. I also run three times a week and have reduced my alcohol intake.”

“Thankfully my cholesterol is now normal. I’m just grateful I had a wake-up call before it was too late.”

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Heart Disease Myths Busted

Friday, February 8th, 2008

Six Common Myths You Should Know To Protect Your Heart

February is National Heart Month, a time to raise awareness about heart disease, which remains the leading cause of death for American men and women.

Ask yourself if you’re taking care of your heart, and do not be fooled by these common myths.

Myth 1
If I exercise and maintain a healthy lifestyle, I will not get heart disease. — False

Eating healthy and exercising is a great start, but does not guarantee health.

Risk of heart disease increases with several uncontrollable factors: You are more at risk if you are a man, if you are older and if you have a genetic history of diabetes, high cholesterol or high blood pressure.

It is important to follow up with your doctor at least once a year to test your blood pressure and cholesterol levels, even in your 20s.

If you are predisposed to high blood pressure or high cholesterol, you may need to take medication to prevent heart disease.

Myth 2
I won’t have to worry about heart disease until I’m much older. — False

Coronary artery disease can start to develop in our teenage years, and many of the bad habits we develop as young adults persist as we get older.

Children who are obese, have high blood pressure and a family history of heart disease are at higher risk.

Although rare, some children (usually due to genetic differences) can have unusually high cholesterol and thus an increased risk for heart disease.

Myth 3
A little bit of alcohol is good for the heart. — True

Recent studies show a small amount of alcohol every day, such as one glass of wine or a little bit more, can actually be beneficial for the heart.

There is debate as to what type of alcohol is best. There are benefits associated with red wine, but other types may be beneficial as well.

Too much alcohol can pose problems though. Binge drinking on weekends, for example, can be very damaging to the heart. Alcohol in large amounts has a toxic effect on the heart muscle cells, and can lead to heart failure.

Myth 4
If I have two scrambled eggs for breakfast, I’ve already exceeded my daily recommended cholesterol intake. — True.

A typical egg yolk has about 200 to 250 milligrams of cholesterol (of course, there is no cholesterol in egg whites). The recommended daily cholesterol intake, according to the American Heart Association, is 300 milligrams a day.

If you eat two egg yolks for breakfast, you are likely exceeding your daily recommended intake by more than one-third.

Even after eating just one egg yolk in the morning, it’s likely you will need to restrict other animal fats from your diet for the rest of the day to keep within recommended levels.

Myth 5
My blood pressure can never be too low. — False

In general, high blood pressure — a risk factor for heart disease — is so persistent that just getting blood pressure to normal levels doesn’t happen very often.

For most people, low blood pressure is a healthy thing. However, in rare cases, when a person is ill or on blood-pressure-lowering medication, she can get truly low blood pressure, which can lead to fatigue, fainting and kidney dysfunction.

Myth 6
I’ll know I’m having a heart attack because my chest and arm(s) will hurt. — False

Although 60 percent to 90 percent of heart attacks have the common symptoms (chest pain, arm pain, etc.), 25 percent of heart attacks have either no signs or atypical signs associated with the incident. So-called “silent” heart attacks are more common in diabetics.

On average, about half of women will have traditional chest pain, and the other half show atypical symptoms such as headaches, nausea, fatigue and stomach upset.

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Why Does Cholesterol Cause Heart Disease?

Thursday, February 7th, 2008

It may surprise you that cardiovascular disease is the number one killer of Jamaicans. Most of us hear that high cholesterol causes cardiovascular disease, but understanding cholesterol’s role in disease of the heart and blood vessels helps individuals work with their physician in choosing effective treatment.

Atherosclerosis means ‘artery hardening’ from deposits of macrophages (cells that usually help the body fight infections), fat, cholesterol, calcium, and fibrous tissue that build up in the artery lining. This build-up is known as a plaque or lesion, gradual accumulation of which leads to blockage of blood flow in arteries. Obstruction of arteries feeding the heart can lead to heart attack.

How does cholesterol cause lesions? Essentially, excess blood cholesterol deposits in artery lining and induces signals that attract macrophages to the site of cholesterol deposits. The macrophages engorge cholesterol, die and become the core of the lesion. Before dying, macrophages attract muscle cells to invade and disrupt the structure of the artery’s lining. The muscle proliferates causing the lesion to grow and bulge into the artery’s interior, making blood flow increasingly tight.

Harmful or beneficial

In truth, however, it is the protein transporting cholesterol in blood that determines whether cholesterol is harmful or beneficial. Cholesterol transported by bulky low-density lipoprotein (LDL) is what macrophages consume thereby causing lesions, whereas, smaller high-density lipoprotein inhibits atherosclerosis by transporting cholesterol out of macrophages.

Research shows numerous factors determine why some people develop atherosclerosis while others do not. Family history of naturally high cholesterol, diabetes mellitus or high blood pressure are linked to greater risk of developing atherosclerosis. These studies indicate as many as 50 per cent of patients have a genetic pre-determinant for developing the disease in the other 50 per cent or more of atherosclerosis patients, environmental risk factors, such as diets high in saturated fats and cholesterol, smoking, low physical activity and excess waistline fat, are some of the causes for atherosclerosis onset.

A compounding fact is that genetic and environmental risk factors combine to more than just an additive extent in inducing heart disease.

How each risk factor contributes to atherosclerosis varies, but one consistent player in the grand scheme is cholesterol. It is no surprise then that current drug therapies aim to lower cholesterol. Two types of prescribed drugs are statins like Lipitor, which stimulate the liver to remove LDL from the blood; and those that prevent the stomach from absorbing cholesterol, like Zetia. Since these drugs reduce cholesterol, their best candidates are patients with family history of high cholesterol who, with a low cholesterol diet, still cannot reduce their blood cholesterol enough efficient at inhibiting atherosclerosis, and therefore heart failure, the medications’ side effects of muscle pain and weakness, as well as treatment cost, are notable.

Lifestyle changes

For individuals without genetic predisposition who begin to develop atherosclerosis, there is strong argument for lifestyle changes. The Heart Foundation of Jamaica recommends a combination of physical activity, healthy weight, and nutrient-rich diets low in animal fats. These choices are sometimes enough to inhibit atherosclerosis in several ways, like lowering blood pressure and cholesterol - the benefits of which are indisputable, even in combination with cholesterol medication.

Ultimately, by staying informed so we know the right questions to ask our doctor, and with regular check-ups, we can take control of our well-being. Following these simple steps, it is within our power to change the statistics by reducing occurrence of cardiovascular disease, Jamaica’s number one killer.

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Cholesterol is NOT the Critical Cause of Heart Disease

Monday, February 4th, 2008

Cholesterol is not the major culprit in heart disease or any disease. If it becomes oxidized it can irritate/inflame tissues in which it is lodged in, such as the endothelium (lining of the arteries). This would be one of numerous causes of chronic inflammation that can injure the lining of arteries. However, many good fats are easily oxidized such as omega-3 fatty acids, but it does not mean that you should avoid it at all costs.

Common sense would indicate that we should avoid the oxidation (rancidity) of cholesterol and fatty acids and not get rid of important life-giving molecules. Using the same conventional medical thinking that is being used for cholesterol would lead one to believe that doctors should reduce the risk of Alzheimer’s disease by taking out everybody’s brain.

In fact, cholesterol is being transported to tissues as part of an inflammatory response that is there to repair damage.

The fixation on cholesterol as a major cause of heart disease defies the last 15 years of science and deflects from real causes such as the damage (via glycation) that sugars such as glucose and fructose inflict on tissues, including the lining of arteries, causing chronic inflammation and resultant plaque.

Insulin & Leptin Resistance

Hundreds of excellent scientific articles have linked insulin resistance and more recently leptin resistance to cardiovascular disease much more strongly than cholesterol, and they are in fact at least partially responsible for cholesterol abnormalities. For instance, insulin and leptin resistance result in “small dense” LDL particles and a greater number of particles.

This is much more important than the total cholesterol number. Because of particle size shift to small and dense, the total LDL cholesterol could still be low even though the number of particles and the density of the particles is greater. Small, dense LDL particles can squeeze between the cells lining the inside of the arteries, the “gap junction” of the endothelium, where they can get struck and potentially oxidize, turn rancid, and cause inflammation of the lining of the arteries and plaque formation.

Importantly, many solid scientific studies have shown a mechanistic, causal effect of elevated insulin and leptin on heart and vascular disease, whereas almost all studies with cholesterol misleadingly only show an association. Association does not imply cause. For instance, something else may be causing lipid abnormalities such as elevated cholesterol and triglycerides, and also causing heart disease.

This “something else” is improper insulin and leptin signaling. Similarly, sugar does not cause diabetes; sugar is just listening to orders. Improper insulin and leptin signaling is the cause of diabetes. Likewise, cholesterol does not cause heart disease, but improper metabolic signals including improper signals to cholesterol (causing it to oxidize) and perhaps to the liver that manufactures the cholesterol, will cause heart and vascular disease and hypertension.

Removing cholesterol will do nothing to improve the underlying problems, the real roots of chronic disease, which will always have to do with improper communication, and the generals of metabolic communication are insulin and leptin. They are really what must be treated to reverse heart disease, diabetes, osteoporosis, obesity, and to some extent aging itself.

Cholesterol; Wrongly Accused?

Before we can begin to talk about the real cause and effective treatment for heart and blood vessel disease, we must first look at what is known, or I should say what we think we know. The first thing that comes to mind when one hears about heart disease is almost always cholesterol. Cholesterol and heart disease has been almost synonymous for the last half-century. Cholesterol has been portrayed as the Darth Vader to our arteries and our heart.

The latest recommendation given by a so-called panel of “experts” recommends that a person’s cholesterol be as low as possible, in fact to a level so low they say it cannot be achieved by diet, exercise, or any known lifestyle modification. Therefore, they say cholesterol-lowering drugs; particularly the so-called “statins” need to be given to anyone at high risk of heart disease. Since heart disease is the number one killer in this country that would include most adults and even many children. The fact that this might add to the $26 billion in sales of statin drugs last year I’m sure played no role in their recommendations.

Or did it?

Expert Conflict of Interests

Major consumer groups think so. They found out that eight of the nine “experts” that made the recommendations were on the payroll of pharmaceutical companies that manufacture those drugs. Major scientific organizations have chastised medical journals for allowing the pharmaceutical industry to publish misleading results and half-truths. There is a major push under way to force the pharmaceutical industry (and others) to publish results of all of their studies, and not just the ones that appear positive. The studies that showed negative results would be forced to be published also.

It could be that lowering cholesterol might not be as healthy as we are being told. More and more studies are coming out showing just how unhealthy lowering cholesterol might be, particularly by the use of statin drugs. In particular, statin drugs have been shown to be harmful to muscles causing considerable damage. A common symptom of this damage is muscular aches and pains that many patients experience on cholesterol-lowering drugs, however most do not realize that these drugs are to blame.

Hmm…isn’t the heart a muscle?

Statin Drugs Actually Increase Heart Disease

Indeed, low cholesterol levels have been shown to worsen patients with congestive heart failure, a life-threatening condition where the heart becomes too weak to effectively pump blood. Statin drugs have been shown to also cause nerve damage and to greatly impair memory. One reason that statin drugs have these various serious side effects is that they work by inhibiting a vital enzyme that manufactures cholesterol in the liver. However, the same enzyme is used to manufacture coenzyme Q10, which is a biochemical needed to transfer energy from food to our cells to be used for the work of staying alive and healthy.

Statin drugs are known to inhibit our very important production of coenzyme Q10. Importantly, while many cardiologists insist that lowering cholesterol is correlated with a reduction in the risk of heart attacks; few can say that there is a reduction in the risk of mortality (death). That has been much harder to show. In other words it has never been conclusively shown that lowering cholesterol saves lives. In fact, several large studies have shown that lowering cholesterol into the range currently recommended is correlated with an increased risk of dying, especially of cancer.

No Such Thing as Good and Bad Cholesterol

Because the correlation of total cholesterol with heart disease is so weak, many years ago a stronger correlation was sought. It was found that there is so-called “good cholesterol” called HDL, and that the so-called “bad cholesterol” was LDL. HDL stands for high-density lipoprotein, and LDL stands for low-density lipoprotein. Notice please that LDL and HDL are lipoproteins — fats combined with proteins. There is only one cholesterol. There is no such thing as a good or a bad cholesterol. Cholesterol is just cholesterol. It combines with other fats and proteins to be carried through the bloodstream, since fat and our watery blood do not mix very well.

Fatty substances therefore must be shuttled to and from our tissues and cells using proteins. LDL and HDL are forms of proteins and are far from being just cholesterol. In fact we now know there are many types of these fat and protein particles. LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation. Thus, you might say that there is “good LDL” and “bad LDL.” Also, some HDL particles are better than others. Knowing just your total cholesterol tells you very little. Even knowing your LDL and HDL levels do not tell you very much.

A mistake that is rarely made in the hard-core sciences such as physics seems to be frequently made in medicine. This is confusing correlation with cause. There may be a weak correlation of elevated cholesterol with heart attacks, however this does not mean it is the cholesterol that caused the heart attack. Certainly gray hair is correlated with getting older; however one could hardly say that the gray hair caused one to get old. Using hair dye to reduce the gray hair would not really make you any younger. Neither it appears would just lowering your cholesterol.

Perhaps something else is causing both the gray hair and aging. Even if elevated cholesterol were significant and heart disease (which I question) perhaps something else is causing the elevated cholesterol and also causing the heart disease.

Let’s look little more at cholesterol or, as Paul Harvey was fond of saying, “the rest of the story.” First and foremost, cholesterol is a vital component of every cell membrane on Earth. In other words, there is no life on Earth they can live without cholesterol. That will automatically tell you that, in of itself, it cannot be evil. In fact it is one of our best friends. We would not be here without it. No wonder lowering cholesterol too much increases one’s risk of dying. Cholesterol also is a precursor to all of the steroid hormones. You cannot make estrogen, testosterone, cortisone, and a host of other vital hormones without cholesterol.

Cholesterol Is The Hero, Not The Villain.

It was determined many years ago that the majority of cholesterol in your bloodstream comes from what your liver is manufacturing and distributing. The amount of cholesterol that one eats plays little role in determining your cholesterol levels. It is also known that HDL shuttles cholesterol away from tissues, and away from your arteries, back to your liver. That is why HDL is called the “good cholesterol;” because it is supposedly taking cholesterol away from your arteries. But let’s think about that.

* Why does your liver make sure that you have plenty of cholesterol?
* Why is HDL taking cholesterol back to your liver?
* Why not take it right to your kidneys, or your intestines to get rid of it?

It is taking it back to your liver so that your liver can recycle it; put it back into other particles to be taken to tissues and cells that need it. Your body is trying to make and conserve the cholesterol for the precise reason that it is so important, indeed vital, for health.

One function of cholesterol is to keep your cell membranes from falling apart. As such, you might consider cholesterol your cells “superglue.” It is a necessary ingredient in any sort of cellular repair. The coronary disease associated with heart attacks is now known to be caused from damage to the lining of those arteries. That damage causes inflammation. The coronary disease that causes heart attacks is now considered to be caused mostly from chronic inflammation.

What Is Inflammation?

Think of what happens if you were to cut your hand. Within a fraction of a second, chemicals are released by the damaged tissue to initiate the process known as inflammation. Inflammation will allow that little cut to heal, and indeed to keep you from dying. The cut blood vessels constrict to keep you from bleeding too much. Blood becomes “thicker” so that it can clot. Cells and chemicals from the immune system are alerted to come to the area to keep intruders such as viruses and bacteria from invading the cut. Other cells are told to multiply to repair the damage so that you can heal. When the repair is completed, you have lived to be careless another day, though you may have a small scar to show for your troubles.

We now know that similar events take place within the lining of our arteries. When damage occurs to the lining of our arteries (or even elsewhere) chemicals are released to initiate the process of inflammation. Arteries constrict, blood becomes more prone to clot, white blood cells are called to the area to gobble up damaged debris, and cells adjacent to those damaged are told to multiply. Ultimately, scars form, however inside our arteries we call it plaque. And the constriction of our arteries and the “thickening” of our blood further predisposes us to high blood pressure and heart attacks.

So Where Might Cholesterol Fit Into All Of This?

When damage is occurring and inflammation is being initiated, chemicals are being released so that that damage can be repaired. One could speculate that to replace damaged, old and worn-out cells the liver needs to be notified to either recycle or manufacture cholesterol since no cell, human or otherwise, can be made without it. In this case, cholesterol is being manufactured and distributed in your bloodstream to help you repair damaged tissue and in fact to keep you alive.

If excessive damage is occurring such that it is necessary to distribute extra cholesterol through the bloodstream, it would not seem very wise to merely lower the cholesterol and forget about why it is there in the first place. It would seem much smarter to reduce the extra need for the cholesterol — the excessive damage that is occurring, the reason for the chronic inflammation.

So Why Take Cholesterol-Lowering Drugs?

The pharmaceutical companies thought that you might think that. They went back to the drawing board. They did more “research” and found (coincidentally) that statin drugs had anti-inflammatory effects. Therefore we’re currently being told to stay on our cholesterol-lowering drugs because now they work by reducing inflammation and perhaps not even by reducing cholesterol, and in fact perhaps in spite of it. Aspirin reduces inflammation for a lot less money. So does vitamin E, and fish oil, and dietary changes without the dangers of drugs and having many other benefits instead.

What About Triglycerides?

Triglycerides are just medical terminology for fat. A person with high triglycerides has a lot of fat in the bloodstream. Triglycerides are generally measured when a person has fasted overnight. High fasting triglycerides are either from manufacturing too much, or using (burning) too little. In other words, what high triglycerides are telling you is that you are making too much fat and you are unable to burn it. This indeed is a major problem. The inability to burn fat underlies virtually all of the chronic diseases of aging, and in fact may contribute to the rate of aging itself.

As such, one might think that the control all fat burning and storage might be very important in heart disease, and the other diseases of aging such as diabetes, obesity, osteoporosis, and even cancer. Indeed, this appears to very much be the case. The two hormones that to a major extent control our ability to burn and store fat, insulin and leptin, appear to play a major role in all of the chronic diseases of aging. I would call them the most important hormones, indeed chemicals in the entire body. But that is a story for next time.

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Adding Lipitor Early Provided a Significant Reduction in Heart Attacks

Sunday, February 3rd, 2008

The early addition of Lipitor(R) (atorvastatin calcium) Tablets to effective blood pressure lowering treatment maintained a significant 36 per cent reduction in the relative risk of fatal or non-fatal heart attacks over five years, according to a new analysis.

This was a post-hoc analysis (designed and completed following theclosure of the trial) of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) follow-up period. A majority of patients who were treated with Lipitor or placebo during a three-year study went on to receive Lipitor during two years of post-study follow up. At the start of the study, patients had high blood pressure and additional cardiovascular risk factors but no coronary heart disease.

ASCOT-LLA is one of the first studies to explore the benefit of controlling more than one cardiovascular risk factor at a time.
“These important results show that starting early initiation of Lipitor with an effective blood pressure lowering drug regimen may have significant clinical implications for reducing the risk of heart attacks,” said Professor Peter Sever, study principal investigator, professor of clinical pharmacology and therapeutics, International Center for Circulatory Health at London’s Imperial College. “It is vital that physicians use the right combination of treatments from the start to maximize the reduction in the risk of heart attacks and coronary heart disease death.”

The results were published online in the European Heart Journal: “Patients with high blood pressure and other risk factors for cardiovascular disease are usually treated with blood pressure lowering medications first,” said Professor Bryan Williams, professor of medicine, University Hospitals NHS Trust, Leicester, United Kingdom, and chairman of the British Hypertension Society Guidelines working party.

“It is important to note, however, that many people with high bloodpressure are also at sufficient risk of cardiovascular disease to benefit from statin therapy,” he said. “Even if patients are prescribed statins in this context, they are generally only treated with statins after lifestyle modifications have failed.”

“This study highlights the importance of initiating medical treatment for both blood pressure and cholesterol as soon as possible, and raises questions about medical guidelines that do not focus on early intensive treatment of multiple risk factors, notably blood pressure and cholesterol, in patients with moderate cardiac risk,” he said.

Pfizer offers physicians and patients the option of Lipitor or a combination medication known as Caduet(R) (amlodipine besylate/atorvastatin calcium) that includes Lipitor and Norvasc(R) (amlodipine besylate).

ABOUT THE STUDY

The ASCOT study was one of the largest hypertension trials ever conducted with 19,342 patients in Europe. It compared the calcium channel blocker anti-hypertensive Norvasc based regimen versus a beta-blocker based regimen in reducing cardiac events in patients with high blood pressure and additional cardiovascular risk factors but without coronary heart disease.

Patients in ASCOT-LLA had normal to mildly elevated cholesterol levels (n=10,000), were not candidates for lipid-lowering treatment at the time of the study initiation, and received Lipitor 10 mg or placebo at the outset of the trial.

The ASCOT-LLA part of the trial was expected to last five years, but was stopped early after three years due to a highly significant 36 per cent lower risk of death from heart disease and non-fatal heart attack in patients treated with Lipitor versus patients taking placebo.

At the end of the follow-up period, LDL-C levels were similar in both groups as a result of Lipitor treatment and the average blood pressure level was significantly reduced from 164/95 mmHg to 137/78 mmHg with the blood pressure lowering therapy.

Funded by Pfizer, ASCOT was an investigator-led trial coordinated by an independent steering committee.

ABOUT LIPITOR

Lipitor is the most extensively studied and most prescribed cholesterol-lowering therapy in the world, with nearly 144 million patient-years of experience. Lipitor is supported by an extensive clinical trial program involving more than 400 ongoing and completed trials with more than 80,000 patients.

Lipitor is a prescription drug indicated to lower LDL cholesterol and other fats in the blood (such as triglycerides) when response to diet and other lifestyle measures alone have been inadequate, in both adults and pediatric patients (boys and postmenarchal girls, 10 to 17 years of age, with heterozygous familial hypercholesterolemia). Lipitor is also indicated to reduce the risk of myocardial infarction in adult hypertensive patients without clinically evident coronary heart disease, but with at least three additional risk factors (such as 55 years and older, smoking and type 2 diabetes) for coronary heart disease.

Lipitor is also indicated to reduce the risk of myocardial infarction and stroke in adult patients with type 2 diabetes mellitus and hypertension without clinically evident coronary heart disease, but with other risk factors such as age (55 years and older) retinopathy, albuminuria or smoking.

In addition, Lipitor is indicated to reduce the risk of myocardial infarction in patients with clinically evident coronary heart disease.

Lipitor is generally well-tolerated. Adverse reactions have usually been mild and transient. The most common adverse events were gastrointestinal complaints, headache, pain, muscle pain and fatigue.

ABOUT CADUET

Caduet is a prescription drug that combines two medicines, Lipitor (atorvastatin calcium) and Norvasc (amlodipine besylate), which have been extensively studied in clinical trials. It is a single-pill therapy that reduces global cardiovascular risk in hypertensive patients with risk factors for cardiovascular disease such as smoking, physical inactivity, being overweight, high blood pressure and diabetes.

Norvasc is a prescription drug indicated in the treatment of mild to moderate essential hypertension. Norvasc is also indicated for the management of chronic stable angina (effort-associated angina) in patients who remain symptomatic despite adequate dose of beta blockers and/or organic nitrates or who cannot tolerate those agents.

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Keeping Cholesterol Down

Thursday, January 31st, 2008

There’s new scrutiny of  statins, which are the most popular prescription drug ever that’s been marketed as a cholesterol-lowering medication.

As Businessweek reports: “The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program, 40 million Americans should be taking them. Some researchers have even suggested-half-jokingly-that the medications should be put in the water supply, like fluoride for teeth.”

This week, CBS News partnered with Businessweek, which reported today that statins don’t necessarily help patients in the way they are thought to. Read our partner story from Businessweek here.

While it is possible that it is in your best interest to use cholesterol-lowering medication, medical experts suggest ways to lower your cholesterol without drugs - making simple lifestyle changes.

The American Heart Association’s Web gives simple recommendations in a checklist for lowering cholesterol. It suggests taking simple measures: exercising regularly, eating a heart-healthy diet and making certain lifestyle choices, such as avoiding tobacco smoking.

Eating healthy

The American Heart Association offers some information on cholesterol, your body and your diet.

Some of your cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol - including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.

The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.

At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.

Eat at least 25 to 30 grams of dietary fiber each day - preferably from whole grains, fruits, vegetables and legumes. To combat high blood pressure and for overall cardiovascular health, also limit sodium to 2,300 mg or less per day.

But a heart-healthy diet isn’t just about what you shouldn’t eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.

But can a bowl of cereal help prevent a heart attack? The Mayo Clinic suggests the best foods to lower your cholesterol and protect your heart. A partial list from the Mayo Clinic is below.

Oatmeal

Oatmeal contains soluble fiber, which reduces your “bad” cholesterol. Soluble fiber is also found in such foods as kidney beans, brussels sprouts, apples, pears, psyllium, barley and prunes.

Walnuts and almonds

Studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.

Fish including omega-3 fatty acids

Studies in the 1970s showed that Greenland Eskimos had a lower rate of heart disease than did other individuals living in Greenland at the same time. Analysis of dietary differences between the groups showed that the Eskimos ate less saturated fat and more omega-3 fatty acids found in fish and whale and seal meat. Research since that time has supported the heart-healthy benefits of eating fish. If you can’t dine with the Eskimos, other good sources of omega-3 fatty acids include flaxseed, walnuts, canola oil and soybean oil.

Soy

Long thought to have cholesterol-lowering effects, a recent meta-analysis by the American Heart Association’s Nutrition Committee showed soy protein actually has very little impact on reducing cholesterol levels. In January 2006, the American Heart Association issued a statement saying the cardiovascular health benefits of soy protein are minimal at best. No benefit was seen on HDL, triglycerides, or blood pressure and even with a large intake of soy, only a small impact on LDL was seen.

Stay away from smoke

The American Heart Association advises the following:
Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control. Cigarette smoking is so widespread and significant as a risk factor that the Surgeon General has called it “the leading preventable cause of disease and deaths in the United States.”

Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery.

Keep up physical activity

Physical inactivity is a major risk factor for heart disease, according to The American Heart Association, which recommends getting at least 30 minutes of physical activity, preferably every day but at least more days than not.

You don’t need to get your minutes all at once - it’s fine to break up your activity into 10-minute sessions or 15-minute sessions. For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you’ve been inactive.

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Obesity, Cholesterol and Health

Wednesday, January 30th, 2008

Kids overweight by age 2

One of Dublin’s busiest hospitals reports treating kids for weight problems as young as age 2 and says immediate action needs to be taken to stop childhood obesity. Doctors say they’re seeing more overweight kids and that people don’t understand that having a chunky child isn’t just a cosmetic issue that they’ll grow out of…

Does low cholesterol matter?

Following the report earlier this week that the cholesterol-lowering drug Zetia didn’t actually lower the amount of plaque in the body, some cardiologists are saying the idea that lowering cholesterol is the key to good heart health is too simplistic. Even though these drugs are the biggest sellers in the country, heart disease is still the leading killer, and drugs have been approved that lower cholesterol without proving that they also lower the number of heart attacks patients have. Reports that drugs lower cholesterol but don’t lower risk factors for heart attacks mean the two might not be as linked as some people think…

Starbucks takes organic milk off the menu

Starbucks has announced it will be eliminating organic milk from its shops next month because they are now using non-organic milk made without growth hormones. Starbucks says it offered organic milk at a higher price for those customers who said they wanted hormone-free milk, and now that all their milk is hormone free they no longer need to offer the option, since orders for organic milk have always been “very low”…

Modified carrot provides more calcium

Scientists at Baylor College of Medicine in Texas have developed a carrot that gives people more calcium than conventional carrots and could help ward off osteoporosis. The carrot allows for absorption of 41 percent more calcium than is retained from traditional carrots, and researchers say it could be helpful for those who don’t tolerate milk products to get more calcium. More research into the safety of the veggies is needed before they’ll hit the shelves…

Quiznos has released two small Sammies that are under 200 calories each. The $2 sandwiches are served on flatbread and the options are balsamic chicken and black angus. (Incidentally, Quiznos has finally revealed some nutritional information, so these lighter sandwiches might be a way of cleaning up their act.) But beware if you’re not ordering one of the lower-calorie sandwiches and you choose the meal deal, which includes two sandwiches, chips and a drink. Your calories will add up fast…

Use a laundromat? You must be fat

Finally, an interesting ad campaign has shown up in New York City laundromats this week. Tiny T-shirts found in dryers around the city suggest that the people who find them ought to “shrink a few sizes.” The campaign is being run by the Ad Council and the U.S. Department of Health and Human Services and directs people to the Small Step website. I wonder what gave them the idea that people who don’t have washers in their homes are fatter than people who do?

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5 Ways to Conquer Cholesterol

Tuesday, January 29th, 2008

Without the right kinds of cholesterol, your body could have problems tackling many tasks, including digesting certain foods.

Take a look at these quick facts to make sure you’re on the good side of the cholesterol battle.

1. Stay in shape.
“Exercise is the best thing you can do,” said Dr. Cynthia Williams, St. Francis Hospital & Health Centers. “Walking is great, but it’s got to be 30 minutes of continuous walking.” The key here is making sure anything you do is aerobic exercise, Williams said. She also points out that someone who says they walk all day at work might not actually be exercising.

2. Know the numbers.
When you’re tracking your cholesterol levels, LDL is something you don’t want to see a lot of, said Amanda Scott, a health educator with Health & Nutrition Technology in Carmel. “This is the cholesterol that carries fatty buildups to your heart and artery walls,” she said. The best way to fix this is to watch your diet. Better eating will help reduce your weight, taking some of the LDL with it. The goal is to get the LDL number under 130 for most people, or under 100 if you have diabetes, Scott said.

3. Shop right.
At the grocery, take time to find the right foods. “Cholesterol is found in animal products only,” Scott said. “Limiting high-fat animal products helps. And try a low-fat or skim milk.” Other items to consider are soluble fiber products, including oats, beans, peas, bran, barley, citrus, strawberries, apple, Brussels sprouts, broccoli and carrots. These reduce LDL by attaching to cholesterol and being excreted through the bowels.

4. Mind your medicine.
Medical experts stress the importance of healthy living and good eating as key factors in the cholesterol battle. But both take time and might not be an option for some patients. “If someone’s had a heart attack, I may not give them the time to exercise to lower cholesterol,” Williams said. “I’ll be more aggressive.” Usually, that’s the key indicator for when medicine will be used to treat cholesterol issues. At the same time, some medicines can have negative effects of their own, so get all of your questions answered before moving forward.

5. Check it out.
Keeping an eye on your cholesterol levels isn’t a full-time job. A simple blood test is all it takes, and that typically needs to be done just once every five years if you have a clean bill of health. Williams and Scott agreed that when patients have diabetes or heart ailments, it’s a good idea to increase the frequency to every year or two.

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