New measure trumps HDL levels in protecting against heart disease

A new study from researchers at the University of Pennsylvania School of Medicine shows that a different metric, a measure of HDL function called cholesterol efflux capacity, is more closely associated with protection against heart disease than HDL cholesterol levels themselves. Findings from the study could lead to new therapeutic interventions in the fight against heart disease.

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Nutritional Approaches for Reducing Cholesterol Levels – Part 2

In Part 1, the reasons why you should be concerned about cholesterol and what some of the recommended levels of total serum cholesterol were discussed. Here in Part 2, things that can affect your cholesterol levels and which of those things you can do something about and those you cannot do anything about; and things to consider in a cholesterol reduction plan are presented.

What Affects Your Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

o Diet. Saturated fat and cholesterol in the food you eat can make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.

o Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.

o Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol levels. It also helps you lose weight. Most health care professionals recommend that you try to be physically active for 30 minutes on most, if not all, days.

Things you cannot do anything about also can affect cholesterol levels. These include:

o Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.

o Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

You Can Reduce Your Cholesterol with a Cholesterol Reduction Plan

The main goal of a cholesterol reduction plan is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. There are two main ways to lower your cholesterol:

o Eating a cholesterol-reducing diet, being physically active and managing your weight. This is an effective method in reducing your LDL to your goal level.
The National Cholesterol Education Program (National Heart, Lung, and Blood Institute) recommends a cholesterol-reducing diet that is a low-saturated-fat, low-cholesterol eating plan that has less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. It recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Supplementing your diet with certain nutrients, such as vitamin C, can also help in reducing your cholesterol levels.
Losing weight, if you are overweight, can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

o If the lifestyle change of diet, physical activity and weight management are not effective in lowering your LDL to an acceptable level; your health care professional may prescribe cholesterol-lowering drugs, which are used in addition to your diet, exercise and weight management plan.

In Part 3, find out about nutritional options for reducing cholesterol levels.

Copyright 2006. Mary El-Baz. All rights reserved.

Author: Mary El-Baz, PhD
Article Source: EzineArticles.com
Provided by: WordPress plugin Guest Blogger

Take Control of Your Cholesterol

We’ve all heard of someone having “high cholesterol,” and your doctor may have even told you that yours is high. Most of us would agree that it’s a bad thing, but few really know what cholesterol is or how to combat unhealthy levels.

Cholesterol is a fat-like substance that your body actually needs a small amount of in order to function normally. However, if you have too much of it in your bloodstream, the extra amounts may be deposited in your coronary arteries where it can lead to the narrowing and blockages that cause the signs and symptoms of heart disease.

In some cases, certain prescription medication can cause elevated cholesterol levels, but for the most part, inherited risk factors, a sedentary lifestyle and an unhealthy diet are the main causes:

• Weight: Excess weight may modestly increase your LDL (bad) cholesterol level. If you are overweight and have a high LDL cholesterol level, losing weight may help you lower it. Weight loss especially helps to lower triglycerides and raise HDL (good) cholesterol levels.
• Physical activity/exercise: Regular physical activity may lower triglycerides and raise HDL cholesterol levels.
• Mental Stress: Several studies have shown that stress raises blood cholesterol levels over the long term. One way that stress may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating fatty foods. The saturated fat and cholesterol in these foods contribute to higher levels of blood cholesterol.
Not sure whether you are at risk? If your doctor doesn’t automatically test you, request a lipid panel or profile (i.e. cholesterol test) during your annual physical. Here are the general guidelines for interpreting the results:

Total Cholesterol
Below 200 mg/dL Desirable
200 – 239 mg/dL Borderline high
240 mg/dL High

LDL Cholesterol
Below 70 mg/dL Optimal for people at very high risk of heart disease
Below 100 mg/dL Optimal for people at risk of heart disease
100 – 129 mg/dL Near optimal
130 – 159 mg/dL Borderline high
160 – 189 mg/dL High
190 mg/dL and above Very high

HDL Cholesterol
Below 40 mg/dL Poor
40 – 59 mg/dL Better
60 mg/dL and above Best

Triglycerides
Below 150 mg/dL Desirable
150 – 199 mg/dL Borderline high
200 – 499 mg/dL High
500 or above Very high

In order to promote healthy cholesterol levels, follow these four steps:
1. Lose excess pounds
Excess weight contributes to high cholesterol. Losing even 5 to 10 pounds of excess weight can help lower total cholesterol levels. Start by taking an honest look at your eating habits and daily routine. Consider your challenges to weight loss — and ways to overcome them.

2. Eat heart-healthy foods
What you eat has a direct impact on your cholesterol level. In fact, researchers say a diet rich in fiber and other cholesterol-lowering foods may help lower cholesterol as much as medication for some people.

• Choose healthier fats. Saturated fat and trans fat raise your total cholesterol and LDL cholesterol. Get no more than 10 percent of your daily calories from saturated fat, and try to avoid trans fat completely. Monounsaturated fat – found in olive, peanut and canola oils – is a healthier option. Almonds and walnuts are other sources of healthy fat.

• Limit your cholesterol intake. Aim for no more than 300 milligrams (mg) of cholesterol a day — or less than 200 mg if you have heart disease. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat, egg substitutes and skim milk instead.

• Select whole grains. Various nutrients found in whole grains promote heart health. Choose whole-grain breads, whole-wheat pasta, whole-wheat flour and brown rice. Oatmeal and oat bran are other good choices.

• Stock up on fruits and vegetables. Fruits and vegetables are rich in dietary fiber, which can help lower cholesterol. Snack on seasonal fruits. Experiment with veggie-based casseroles, soups and stir-fries.

• Eat heart-healthy fish. Some types of fish — such as cod, tuna and halibut — have less total fat, saturated fat and cholesterol than do meat and poultry. Salmon, mackerel and herring are rich in omega-3 fatty acids, which help promote heart health.

• Drink alcohol only in moderation. In some studies, moderate use of alcohol has been linked with higher levels of HDL cholesterol — but the benefits aren’t strong enough to recommend alcohol for anyone who doesn’t drink already. If you choose to drink, do so in moderation. This means no more than one drink a day for women, and one to two drinks a day for men.

3. Exercise regularly
Regular exercise can help improve your cholesterol levels. With your doctor’s permission, work up to 30 to 60 minutes of exercise a day. Take a brisk daily walk. Ride your bike. Swim laps. To maintain your motivation, keep it fun. Find an exercise buddy, join an exercise group or hire a personal trainer.

4. Don’t smoke
If you smoke, stop. Quitting can improve your HDL cholesterol level. And the benefits don’t end there. Just 20 minutes after quitting, your blood pressure decreases. Within 24 hours, your risk of a heart attack decreases. Within one year, your risk of heart disease is half that of a smoker’s. Within 15 years, your risk of heart disease is similar to that of someone who’s never smoked.

Managing Your Cholesterol Naturally

Because of organizations like the American Heart Association (AHA), we’ve learned a lot about cholesterol and how it affects our health. Thanks to these educational organizations, we know that high cholesterol levels can increase our risk for heart attacks and strokes and, by lowering these levels; we reduce these risks as well as keep our hearts and blood vessels healthy. We also know that our cholesterol levels can be improved through exercise, diet, and weight loss.

Although we’ve learned a lot through these educational organizations, there are still a few misconceptions about cholesterol. One of these being that not all cholesterol is harmful. There are both “good” and “bad” forms of cholesterol and a good balance between the two is what is needed for a healthy heart. Because so much emphasis is placed on lowering “bad” cholesterol levels, not enough attention is paid to the benefit of raising “good” cholesterol levels (HDL). Research states that raising HDL levels can provide even greater protection against cardiovascular disease than just simply lowering “bad” cholesterol levels. By raising HDL levels by simply 1%, the risk of heart disease can be lowered by 2% in men and 3% in women. Many studies have shown that low HDL cholesterol levels are an independent risk factor in heart disease. This is extremely important because we’ve learned that despite efforts to change a person’s diet and exercise habits, some people’s cholesterol levels are still unhealthy.

Prescription drugs to lower cholesterol are now available and have been proven by multiple studies to be very successful. The statins’ effectiveness in reducing LDL (“bad”) cholesterol has produced highly significant reductions in heart attacks and strokes. Although these medications do lower cholesterol levels, their side effects must be considered. Statin drugs can cause liver irritation, reduce CoQ10 levels in the body, are associated with myopathy, and are even linked to a rare and sometimes fatal condition called rhabdomyolysis. These drugs also have a relatively small effect on good (HDL) cholesterol levels. Thankfully, there are safe and effective solutions available that can help you manage your cholesterol levels naturally. However, first we must review what we know about cholesterol and heart disease.

Cholesterol is a fat-like substance needed to help digest fats, strengthen cell membranes, make hormones and insulate nerves. Although it is found in every cell of the body, cholesterol is mainly made in the liver, as well as cells lining the small intestine. Even though our bodies make all the cholesterol we need, we also get cholesterol from the foods we eat, such as egg yolks and organ meats. All foods from animal sources contain cholesterol, while plant derived food, including peanut butter and avocado, contains no cholesterol at all.

Cholesterol is important to many functions of the body. However, too much cholesterol in the bloodstream is extremely dangerous. After blood cholesterol reaches high levels, it builds up on the artery walls, and thus increasing the risk for blood clots, heart attack, and stroke. If the cholesterol clogs any of the coronary arteries, the heart’s supply of oxygen and nutrients will diminish, resulting in coronary heart disease, angina, or even heart attack.

Because cholesterol and other fats can’t dissolve in the blood and thereby can’t travel on their own, they have to be transported to and from the cells by lipoproteins. The two major lipoproteins are low density lipoproteins (LDL or “bad cholesterol) and high density lipoproteins (HDL or “good cholesterol”) LDLs carry cholesterol throughout the body to the cells and cause artherosclerosis by clogging up our arteries with fat. On the other hand, HDL prevents the fat buildup by carrying it away from the arteries and to the liver where it can be eliminated. Although high levels of LDL are associated with cardiovascular disease, high HDL can drastically reduce your risk of heart disease. As a result, the AHA has established three guidelines to keep your heart healthy: HDL levels about 40 for men and above 50 for women, LDL levels between 100 and 159, and a total cholesterol (HDL and LDL) of under 200.

Triglycerides are fats used as fuel by the body and a source for metabolism. These levels can fluctuate easily but increased levels are almost always a sign of too much carbohydrate and sugar intake. High amounts of triglycerides make the blood less capable of transporting oxygen and are another factor for cardiovascular disease. Thankfully, the HDL and LDL blend mentioned earlier can safely and effectively lower triglyceride levels.

It has been shown that high levels of HDL cholesterol are inversely related to coronary artery disease risk. However, what people do not know is that there are different subtypes of HDl, including HDL-2 and HDL-3. HDL-3 is produced by the liver and intestines and is responsible for scooping up free cholesterol from the blood vessel walls. The cholesterol carried by HDL-3 is chemically modified, forming a larger-sized subtype, known as HDL-2, or “mature HDL.” HDL-2 transports cholesterol to the liver for processing and elimination, and its molecules are then recirculated in the blood stream. Research has shown that HDL-2 provides more heart-protection because it moves the cholesterol away from arterial walls, and holds a greater number of receptor sites which allows it to carry a larger amount of cholesterol to the liver.

Although many prescription medications have been developed to lower bad cholesterol, there are very few medications that target good cholesterol. Therefore, patients with naturally low HDL cholesterol, who can not alter these levels through diet and exercise, have limited medical options to reduce their risk of heart disease. Multiple nutrients have been clinically shown to favorably alter good cholesterol levels including: vitamins C, E, B6, B12, niacin, folic acid, magnesium and selenium, with protein-building amino acids, powerful antioxidants such as coenzyme Q10, alpha lipoic acid, N-acetyle cysteine, and policosanol, and extracts of hawthorn, garlic, grape seed, and soy isoflavones. Although this HDL-boosting combination does not result in a significant reduction in LDL, antioxidants found in this formulation can help stabilize LDL and prevent build up in the arterial wall.

This formula combines essential vitamins and minerals, at levels recommended by the American Heart Association. It contains amino acids, antioxidants, and botanicals that have all been used safely for years. No serious adverse effects have been found following supplementation and the combination is safe to use with statin drugs.

Plant sterols, found in nuts, vegetable oils, corn, and rice are structurally similar to cholesterol and are able to block its absorption. Each day the liver receives about 800 mg of cholesterol from intestinal absorption through receptor sites. After entering these channels, the cholesterol is absorbed into the bloodstream. Since plant sterols look similar to cholesterol, they fit perfectly into these receptor sites and block the absorption, which allows the cholesterol to remain in our intestines where it can eventually be excreted. A large amount of plant sterols reduces the amount of cholesterol transported from the intestinal tract to the liver. This cholesterol reduction causes a decrease in LDL levels.

Even if a person does not have high cholesterol levels, reducing bad and raising good cholesterol greatly reduces their risk for ever developing chronic heart disease. Due to side effects, physicians do not normally prescribe statin drugs to people without actual heart disease of high LDL cholesterol levels. Instead, they recommend dietary changes. The HDL-boosting combination and LDL-lowering pantethine and plant sterols blend can effectively help people with heart disease, uncontrolled cholesterol levels, high triglyceride levels, or people who just want to improve their heart health.