LDL cholesterol Archives - Amazing Health Advances

Fortified Eggs Did Not Raise Cholesterol in Modest-Sized Cardiology Study

The AHA! Team — Wed, 18 Sep 2024 09:04:44 +0000

Duke Health – Further study needed to investigate secondary findings. DURHAM, NC – There are often conflicting headlines about whether certain foods are good or bad for you, and the news about eggs has been especially confusing. Search the topic online and you’ll find a wealth of articles spanning back decades. A study presented at the American College of Cardiology’s Annual Scientific Session and led by researchers at Duke, offers new evidence on fortified eggs, which are eggs enriched with various vitamins or nutrients. In a modest-sized randomized trial, researchers found that fortified eggs did not have a negative impact on bad cholesterol (LDL cholesterol) or good cholesterol (HDL cholesterol) over the course of the four-month study. The study was sponsored by Eggland’s Best The study was sponsored by Eggland’s Best, a company that makes and sells fortified eggs. It also provided the eggs used in the research. The study had 140 participants, all people aged 50 or older, who had experienced at least one cardiac event in the past or had risk factors for cardiovascular disease such as diabetes. Researchers randomized participants into two groups, asking half to eat two or fewer eggs per week for four months. The other half were provided with fortified eggs and asked to eat 12 per week for the same period of time. While no significant changes in bad or good cholesterol were found, a secondary finding hinted there could be some benefit associated with fortified egg consumption for older patients and patients with diabetes. That secondary finding was not statistically significant due to the number of study participants, but senior researcher, Robert Mentz, M.D., associate professor in the Department of Medicine at the Duke University School of Medicine, said it’s an interesting signal that the researchers would like to investigate in future work. “If we can explore this area further, in a larger study, specifically focusing on the type of patients who appear to have potentially experienced some benefit, and over a longer period of time, we could see if it is possible for fortified eggs to improve cholesterol,” Mentz said. The study’s first author, Nina Nouhravesh, M.D., a cardiology fellow at the Duke Clinical Research Institute, said the study can be viewed as a pilot study. “While it was modest in size, it did include a broadly generalized population,” Nouravesh said. “The average age of participants was 66 years, half were women, and more than 25% identified as Black.” Mentz said the enrollment was representative of the community, especially for a study aimed at cardiology patients. He said he would like to move forward with a larger study assessing clinical outcomes, particularly when considering the topic of equity and food access. “There are disparities around access to food,” Mentz said. “Individuals who are the most socially disadvantaged (and likely have more instances of high blood pressure and diabetes), often have less access to healthy foods. Often what we hear described in the community is access to fresh fruits and vegetables. Those are really time-limited foods that may go bad quickly. Fortified eggs can be safely stored in the refrigerator for longer periods of time. Investigating potential health benefits of an easily accessible and less time-limited food is something we should be doing.” “I think we are in this exciting time where people think of food as medicine,” Mentz said. “Some foods are fortified and nutritionally optimized before they’re disseminated, similar to medications, so it’s exciting to use the same rigor that’s applied in medication trials to food science.” In addition to Mentz and Nouhravesh, study authors include Josephine Harrington, Laura H. Aberle, Cynthia L. Green, Kathleen Voss, Dave Holdsworth, Kurt Misialek, Bartel T. Slaugh, Mandee Wieand, William S. Yancy and Neha Pagidipati. To read the original article click here.

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Eating Walnuts Daily Lowered Bad Cholesterol and May Reduce Cardiovascular Disease Risk

AHA Publisher — Wed, 01 Sep 2021 07:00:47 +0000

American Heart Association (AHA) via Newswise – Eating about ½ cup of walnuts every day for two years modestly lowered levels of low-density lipoprotein (LDL) cholesterol, known as “bad cholesterol,” and reduced the number of total LDL particles and small LDL particles in healthy, older adults, according to new research published today in the American Heart Association’s flagship journal Circulation. Walnuts are a rich source of omega-3 fatty acids (alpha-linolenic acid), which have been shown to have a beneficial effect on cardiovascular health. “Prior studies have shown that nuts in general, and walnuts in particular, are associated with lower rates of heart disease and stroke. One of the reasons is that they lower LDL-cholesterol levels, and now we have another reason: they improve the quality of LDL particles,” said study co-author Emilio Ros, M.D., Ph.D., director of the Lipid Clinic at the Endocrinology and Nutrition Service of the Hospital Clínic of Barcelona in Spain. “LDL particles come in various sizes. Research has shown that small, dense LDL particles are more often associated with atherosclerosis, the plaque or fatty deposits that build up in the arteries. Our study goes beyond LDL cholesterol levels to get a complete picture of all of the lipoproteins and the impact of eating walnuts daily on their potential to improve cardiovascular risk.” In a sub-study of the Walnuts and Healthy Aging study, a large, two-year randomized controlled trial examining whether walnuts contribute to healthy aging, researchers evaluated if regular walnut consumption, regardless of a person’s diet or where they live, has beneficial effects on lipoproteins. This study was conducted from May 2012 to May 2016 and involved 708 participants between the ages of 63 and 79 (68% women) who were healthy, independent-living adults residing in Barcelona, Spain, and Loma Linda, California. Participants were randomly divided into two groups: active intervention and control. Those allocated to the intervention group added about a half cup of walnuts to their usual daily diet, while participants in the control group abstained from eating any walnuts. After two years, participants’ cholesterol levels were tested, and the concentration and size of lipoproteins were analyzed by nuclear magnetic resonance spectroscopy. This advanced test enables physicians to more accurately identify lipoprotein features known to relate to the risk of cardiovascular disease. The two-year study had a 90% retention rate (632 participants completed the study). Complete lipoprotein analyses were available in 628. Among key findings of all study participants: At 2 years, participants in the walnut group had lower LDL cholesterol levels – by an average of 4.3 mg/dL, and total cholesterol was lowered by an average of 8.5 mg/dL. Daily consumption of walnuts reduced the number of total LDL particles by 4.3% and small LDL particles by 6.1%. These changes in LDL particle concentration and composition are associated with a lower risk of cardiovascular disease. Intermediate Density Lipoprotein (IDL) cholesterol also decreased. It is known that IDL cholesterol is a precursor to LDL and refers to a density between that of low-density and very-low-density lipoproteins. In the last decade, IDL cholesterol has emerged as a relevant lipid cardiovascular risk factor independent of LDL cholesterol. LDL cholesterol changes among the walnut group differed by sex; in men, LDL cholesterol fell by 7.9% and in women by 2.6%. “While this is not a tremendous decrease in LDL cholesterol, it’s important to note that at the start of the study all our participants were quite healthy, free of major non-communicable diseases. However, as expected in an elderly population, close to 50% of participants were being treated for both high blood pressure and hypercholesterolemia. Thanks in part to statin treatment in 32%, the average cholesterol levels of all the people in our study were normal,” Ros said. “For individuals with high blood cholesterol levels, the LDL cholesterol reduction after a nut-enriched diet may be much greater.” “Eating a handful of walnuts every day is a simple way to promote cardiovascular health. Many people are worried about unwanted weight gain when they include nuts in their diet,” Ros said. “Our study found that the healthy fats in walnuts did not cause participants to gain weight.” The major limitation of this investigation is that both participants and researchers knew who was and was not eating walnuts. However, the study did involve two very different populations with distinct diets. “The outcomes were similar in both groups, so we can safely apply the results of this study to other populations,” Ros said. More research is also needed to clarify the different LDL results in men and women. According to the American Heart Association, walnuts are especially high in omega-3 fatty acids, the same heart-healthy fat found in oily fish. A serving size is a small handful or 1.5 ounces of whole nuts or 2 tablespoons of nut butter. To read the original article click here.

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Coconut Oil and the Boost in HDL “Good” Cholesterol

AHA Publisher — Wed, 03 Feb 2021 08:00:44 +0000

Michael Greger M.D. FACLM via NutritionFacts – The effects of coconut oil were compared to butter and tallow. Even if virgin coconut oil and other saturated fats raise LDL “bad” cholesterol, isn’t that countered by the increase in HDL “good” cholesterol? According to “the experience and wisdom of 200 of the country’s leading experts in cardiovascular diseases,” in a report representing 29 national medical organizations, including the American Heart Association and the American College of Cardiology, we’ve known for nearly half a century that “coconut oil is one of the most potent agents for elevating [blood] serum cholesterol level.” As I discuss in my video Coconut Oil and the Boost in HDL “Good” Cholesterol, studies showing coconut oil elevates cholesterol date back to 1955, when it was first shown experimentally that switching someone from coconut oil to soybean oil could drop cholesterol from around 200 down to 150, as you can see at 0:39 in my video. Coconut oil can significantly raise cholesterol levels within hours of consumption. In fact, a significant increase in blood cholesterol was found within hours of eating a slice of cake made from either coconut oil (or cod liver oil for that matter), but not from the same cake made from flaxseed oil. As you can see at 1:10 in my video, coconut oil may even be worse than tallow, or beef fat, but it isnot as bad as butter. An interventional trial was published in March 2017: a month-long randomized, controlled, crossover study looking at the impact of two tablespoons per day of virgin coconut oil. The result? Coconut oil elevated cholesterol about 14 percent over the control, which was consistent with seven other interventional trials published to date in a 2016 review. Hold on. Saturated fats can make HDL, the so-called good cholesterol, go up, so what’s the problem? The problem is that it doesn’t seem to help. Having a high blood HDL level is “no longer regarded as protective.” What? Wait a second. Higher HDL levels are clearly associated with lower risk of heart disease, as you can see at 2:01 in my video. In fact, HDL levels “are among the most consistent and robust predictors of CVD [cardiovascular disease] risk.” Ah, but there are two types of risk factors: causal and non-causal. Association does not mean causation—that is, just because two things are tightly linked, it doesn’t mean one causes the other. Let me give you an example, which you can see at 2:30 in my video. I bet that the number of ashtrays someone owns is an excellent predictor of lung cancer risk and that study after study would show that link. But, that does not mean that if you intervene and lower the number of ashtrays someone has, their lung cancer risk will drop, because it’s not the ashtrays that are causing the cancer, but the smoking. The ashtrays are just a marker of smoking, an indicator of smoking, as opposed to playing a causal role in the disease. So, just like having a high number of running shoes and gym shorts might predict a lower risk of heart attack, having a high HDL also predicts a lower risk of heart attack. But, raising HDL, just like raising the number of gym shorts, wouldn’t necessarily affect disease risk. How do you differentiate between causal and non-causal risk factors? You put them to the test. The reason we know LDL cholesterol truly is bad is because people who were just born with genetically low LDL cholesterol end up having a low risk of heart disease. And, if you intervene and actively lower people’s LDL through diet or drugs, their heart disease risk drops—but not so with HDL. People who live their whole lives with high HDL levels don’t appear to have a lower risk of heart attack, and if you give people a drug that increases their HDL, it doesn’t help. That’s why we used to give people high-dose niacin—to raise their HDL. But, it’s “time to face facts.” The “lack of benefit of raising the HDL cholesterol level with the use of niacin…seriously undermine[s] the hypothesis that HDL cholesterol is a causal risk factor.” In simple terms: “High HDL may not protect the heart.” We should concentrate on lowering LDL. So, specifically, as this relates to coconut oil, the increase in HDL “is of uncertain clinical relevance,” but the increase in LDL you get from eating coconut oil “would be expected to have an adverse effect” on atherosclerotic cardiovascular disease risk. But, what about the MCTs, the medium-chain triglycerides? Proponents of coconut oil, who lament “that ‘coconut oil causes heart disease’ has created this bad image of [their] national exports,” assert that the medium-chain triglycerides, the shorter saturated fats found in coconut oil, aren’t as bad as the longer-chain saturated fats in meat and dairy. And, what about that study that purported to show low rates of heart disease among Pacific Islanders who ate large amounts of coconuts? I cover both of those topics in my video What About Coconuts, Coconut Milk, and Coconut Oil MCTs?. To read the original article click here. For more articles from Dr. Greger click here.

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Proof that Lifelong Cholesterol Reduction Prevents Heart Disease

AHA Publisher — Sat, 07 Mar 2020 08:00:08 +0000

Michael Greger M.D. FACLM via Nutrition Facts – “It is well accepted that coronary atherosclerosis is a chronic progressive disease that begins early in life and slowly progresses over several decades” before symptoms arise. However, the average age in cholesterol-lowering drug trials is 63; therefore, people have already been exposed to a lifetime of circulating LDL cholesterol. It’s no wonder pharmaceutical therapies typically reduce cardiovascular disease risk by only 20 to 30 percent. We know LDL, the so-called bad cholesterol, plays “a central role” in the “initiation, development, and progression” of our number-one killer. In fact, more than 100 prospective studies involving more than a million people have demonstrated that those with higher LDL levels are at higher risk. “It seems reasonable to assume, therefore, that if lowering LCL-C [cholesterol] levels beginning later in life can slow the progression of advanced atherosclerotic plaques…then keeping LDL-C levels low, beginning much earlier in life” might prevent our arteries from getting clogged in the first place. A reasonable assumption, certainly—but let’s not just assume. “It would be…unethical to set up a controlled clinical trial in which young adults with elevated serum cholesterol levels were treated or not treated over their lifetime”—just as we couldn’t ethically set up a study in which half the young adults are made to start smoking to see if smoking really does cause lung cancer. That’s where observational studies come in. We can follow people who already smoke and compare their disease rates to those who don’t. It was around 40 years ago when the president of the American Heart Association tried to argue we should all stop smoking even though there were no randomized controlled trials. You can see a copy of the “Presidential Address” entitled “The Case for Prevention of Coronary Heart Disease” to the AHA’s 47th Scientific Sessions at 1:34 in my video. Those who smoke have a higher risk of heart attack, and the more we smoke the higher the risk. After we stop smoking, our risk drops. The same can be said for high cholesterol. Young men 18 through 39 years of age were followed for up to 34 years, and their cholesterol levels, even when they were young, predicted long-term risk of heart disease and death. Men in their 20s and 30s who have a total cholesterol just under 200 have a “substantially longer estimated life expectancy”—around 4 to 9 years longer—than those with levels over 240. “Evidence from observational studies, however, [is] vulnerable to confounding” factors. Eating a diet that is plant-based enough to lower cholesterol below average, for example, may add years to our lives regardless of what our cholesterol actually is. Ideally, we’d have a long-term, randomized, controlled trial. Nature may have actually set one up for us. Each of us, at conception, gets a random assortment of genes from our mother and our father, and some of those genes may affect our cholesterol levels. Just like there are rare genetic mutations that result in unusually high cholesterol levels, there are rare genetic mutations that lead to unusually low cholesterol levels, “provid[ing] an ideal system in which to assess the consequences of low LDL cholesterol levels independently of other factors that may modify disease progression,” such as confounding diet and lifestyle factors. Starting at 3:14 in my video, you can see what I mean. About 1 in 40 African Americans have a mutation that drops their LDL cholesterol from around 130 down toward more optimal levels. Now, this group didn’t eat healthy to get achieve that drop. It’s just in their genes. More than half had high blood pressure and there were a lot of smokers and diabetics in the group, yet those with genetically low LDL levels still had a significant reduction in the incidence of coronary heart disease even in the presence of all those other risk factors. How significant? How much less heart disease? A remarkable 88 percent of heart disease was simply gone. The astounding finding was that the risk of heart disease in these individuals was reduced by more than 80 percent, whereas the same 20- to 40-point decrease in LDL from drugs only reduces risk around 30 percent. Makes sense, though, because the folks with the mutation had low levels their entire life. They didn’t simply start taking a pill when they were 60. “The magnitude of the effect of long-term exposure to lower LDL-C [cholesterol] concentrations observed in each of these studies represents a threefold greater reduction in the risk of CHD,” or coronary heart disease, compared to drug treatment started later in life. (As an aside, for all of my fellow research nerds, check out that p value shown in my video at the 4:30 mark. You’d have to do arourd a quintillion studies to get that kind of result by chance!) “Therefore, a primary prevention strategy that promotes keeping LDL [cholesterol] levels as low as possible, beginning as early in life as possible, and sustaining those low levels of LDL [cholesterol] throughout the whole of one’s lifetime has the potential to dramatically reduce the risk of CHD,” coronary heart disease. This article has been modified. To read the original article click here. For more articles from Dr. Greger click here.

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