Cholesterol and lipids Archive

For years, experts recommended low-fat diets as a way to lower cholesterol and heart disease risk. Today, we know that low-fat isn't the way to go after all. A healthy diet includes plenty of "good-for-you" fats — and limits the unhealthy ones.  Current dietary guidelines recommend that you get 20% to 35% of your daily calories from fat. Even more may be fine, if you follow these simple guidelines.

Favor the "good" fats.

The best sources of healthy fats are oily, cold-water fish, such as salmon and tuna; plant sources such as avocados and nuts; and vegetable oils, such as olive, canola, soybean, and cottonseed oils. These fats promote heart health because they lower cholesterol levels — and they may even fight chronic inflammation, which may contribute to heart disease. It's okay to get up to 35% of your daily calories from fat — as long as most of it comes from sources like these.

Regularly eating whole grains can help you lower “bad” cholesterol, triglycerides, and blood pressure. A diet rich in whole grains also “is associated with a lower risk of developing cardiovascular disease, type 2 diabetes, metabolic syndrome, and certain types of cancer,” says Dr. Qi Sun, an associate professor at Harvard Medical School.

In a study published in JAMA Internal Medicine, Sun and colleagues reported that eating whole grains may even extend your life. Sun used the diet information of more than 100,000 men and women whose health was followed for more than 20 years. The study found that those who regularly ate whole grains had a 9% lower overall death rate and a 15% lower death rate from heart disease.

The "nocebo effect" may explain why some people believe they can't tolerate statins.

For more than 20 years, cholesterol-lowering statin drugs have been a mainstay for preventing and treating heart disease. But up to half of people prescribed these drugs are no longer taking them within a year or two. The reasons vary, but some people experience what they believe to be statin-related side effects — most often muscle pain. Others avoid statins altogether because of worries over side effects.

"Far too any people think they cannot tolerate statins when they actually can," explains Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women's Hospital. To be clear, muscle problems are a known side effect of statins. However, serious muscle-related complications are extremely rare (see "What is rhabdomyolysis?"). And when people experience the more common — but less worrisome — muscle-related symptoms, those issues usually resolve with a lower statin dose or a change to a different statin, Dr. Plutzky says.

Healthy older adults ages 75 and older might not benefit from the drugs to protect against cardiovascular disease.

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Cardiovascular disease is the leading cause of death for people ages 75 and over. The cholesterol-lowering statin drugs can help protect against heart attack or stroke, both for people who have already had one and those who are at high risk for one of these events.

But what if you are in this older age bracket and have no history of cardiovascular problems? Do you really need one of these cholesterol-lowering drugs to protect yourself from future heart attacks and strokes?

Research we're watching

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Having high levels of "bad" LDL cholesterol may put you at higher risk of dying from cardiovascular disease — even you are otherwise considered at low risk. A study published online August 16 by the journal Circulation came to this conclusion by looking at data from more than 36,000 patients who had no history of cardiovascular disease or diabetes and were classified as low risk for developing cardiovascular disease over the next 10 years.

Researchers tracked participants for approximately 27 years and found that people who had LDL levels of 160 or higher were 70% to 90% more likely than those with LDL cholesterol levels below 100 to die from cardiovascular disease during the course of the study.

Research we're watching

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About one in 10 people has eczema, a chronic inflammatory condition that leaves skin dry and itchy. People with more severe forms may experience a scaly rash or skin that cracks and oozes. These people may also be at greater risk for heart attack and stroke, according to a study in the May 23 issue of The BMJ.

For the study, researchers analyzed data from more than 385,000 adults with eczema, which was classified as mild, moderate, or severe. Each was matched with up to five people of similar age and sex who didn't have eczema.

Studies have shown that alcohol can have a good or bad impact depending on how much you drink.

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Should you enjoy that glass of wine with dinner? Is it okay to relax with a cold beer? When it comes to your heart health, the answer is not clear. The existing research is quite conflicting — some studies say alcohol improves heart health, while others imply the reverse.

So, what's the truth?

"It comes down to moderation," says Dr. J. Michael Gaziano, a preventive cardiologist with Harvard-affiliated Brigham and Women's Hospital's Division of Aging and VA Boston. "A safe amount — about one drink per day — may support a healthy heart and lower your risk of heart disease, while too much can be damaging."

By lowering your blood LDL ("bad") cholesterol level, even if it is normal, you help reduce your chances of having a heart attack. It's especially important if the LDL level is above 130 milligrams per deciliter. For every 10% drop in your cholesterol level, your heart attack risk potentially falls by 20% to 30%.

There are several steps you can take to lower your cholesterol level, like losing weight if needed, being more active, and choosing healthy foods. Here are three simple steps toward a healthier, cholesterol-lowering diet:

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Peppers, which belong to the genus Capsicum, come in a variety of colors, shapes, sizes, and flavors. Bell peppers (available in green, yellow, orange, red, and even purple) make a nice addition to a salad or plate of crudités. Supermarkets carry bags of assorted mini bell peppers that are convenient both for snacking and using in recipes.

While sweet bell peppers are crunchy and mild, hot peppers — such as jalapeños, serranos, and habaneros — provide a tongue-tingling punch of heat. They contain varying amounts of the phytochemicals responsible for the spiciness in hot peppers.

Research we're watching

About four in 1,000 adults in this country are born with a genetic condition marked by abnormally high cholesterol levels, known as familial hypercholesterolemia (FH). Their "bad" LDL cholesterol can be two to three times as high as the common target LDL value of 100 milligrams per deciliter (mg/dL) or lower for healthy people. But only about half of people with FH are getting proper treatment for the disease, according to a report in the May 22 issue of Circulation.

For the study, researchers analyzed health surveys done between 1999 and 2014 with nearly 42,500 adults in the United States. Although more than 80% of people with FH or severely high cholesterol were aware of their condition, only half were taking cholesterol-lowering statins. And among those who were, only one-third were taking optimal doses of the drugs.