Testing how well “good” cholesterol particles reduce inflammation may help predict who is at heightened risk to develop cardiovascular disease caused by narrowed arteries, according to research published today in the American Heart Association’s flagship journal Circulation.
The ability of HDL particles (commonly known as “good” cholesterol) to reduce inflammation in the cells that line blood vessels may help predict who is more likely to develop a heart attack or other serious heart-related event.
Gauging the anti-inflammatory capacity of HDL cholesterol may one day improve standard heart disease risk assessment.
The results may encourage greater attention to the function of HDL particles in addition to quantity of cholesterol within HDL in determining how to assess and reduce heart disease risk.
Assessing levels of high-density lipoprotein (HDL) cholesterol, known as “good cholesterol,” are already a standard part of formulas used to predict cardiovascular risk. A new test of the anti-inflammatory function of HDL seems to provide additional information that is independent of the quantity of HDL. If the results are confirmed in broader populations and a test developed for clinical use, adding anti-inflammatory capacity to risk scores may improve risk prediction and help people take steps to protect themselves against heart disease.
We cannot survive without cholesterol in our bodies. It is an essential part of cell walls, is used to make bile acids (which are critical in fat digestion), and is necessary for the production of vitamin D and a number of hormones according to Tufts Health & Nutrition Letter. But too much LDL cholesterol and not enough HDL cholesterol in the blood is associated with increased risk for heart attack and stroke. While the liver can produce all the cholesterol the human body needs, we also consume it in the form of animal-based foods like meat and dairy.
Question #1: What is cholesterol? Cholesterol is a lipid (fat), and, like other lipids, it does not mix with water. It therefore needs to be ‘packaged’ before it can move around the body in our (largely water-based) blood. These packages, called lipoproteins, vary in density, hence the now-familiar terms low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. Very low-density lipoprotein (VLDL) may be a less familiar term, but VLDL cholesterol is emerging as an important health measure.
Eat less; move more; live longer remains the mantra of this blog. Following is a super discussion of the relationship between body weight and heart health from Tufts Health & Nutrition Letter.
Excess body weight increases risk for cardiovascular disease (CVD), as well as type 2 diabetes, certain cancers, and many other illnesses. However, not everyone who is overweight or obese develops these illnesses; and simply having a “normal” body weight or body mass index (BMI)-a measure of body weight relative to height-is no guarantee of low risk. “The relationship between BMI and risk for CVD and death is complex,” says Edward Saltzman, MD, academic dean for education at Tufts’ Friedman School of Nutrition Science and Policy. “Elevated BMI does increase CVD risk, but risk is also impacted by things like body-fat percentage, waist circumference, age, duration of obesity, race, ethnicity, gender, and other genetic factors,” as well as lifestyle elements such as smoking and level of physical activity. Continue reading →
The most comprehensive analysis of its kind suggests that there is a strong link between non-HDL cholesterol levels and long-term risk for cardiovascular disease in people aged under 45 years, not just at older ages., according to The Lancet.
Study is the most comprehensive analysis of long-term risk for cardiovascular disease related to non-high-density lipoprotein (non-HDL) cholesterol – including almost 400,000 people from 19 countries who were followed for up to 43.5 years (median 13.5 years follow-up) between 1970 to 2013.
This longer-term evidence may be particularly important in people aged under 45 years.
Depending on cholesterol level and number of cardiovascular risk factors, men and women aged under 45 years have a 12-43% or 6-24% risk (respectively) of having fatal or non-fatal heart disease or stroke by the age of 75 years.
If non-HDL cholesterol levels were halved, women and men younger than 45 years with starting levels of non-HDL cholesterol between 3.7-4.8 mmol/liter and who had two additional cardiovascular risk factors could reduce their risk from around 16% to 4%, and from around 29% to 6%, respectively.
The observational and modelling study which used individual-level data from almost 400,000 people, published in The Lancet, extends existing research because it suggests that increasing levels of non-HDL cholesterol may predict long-term cardiovascular risk by the age of 75 years. Past risk estimates of this kind are based on 10-year follow-up data.
According to the researchers, bad cholesterol can refer to both oxidized low-density lipoprotein (LDL) and small, dense LDL particles.
In a randomized, controlled feeding study, the researchers found that eating one avocado a day was associated with lower levels of LDL (specifically small, dense LDL particles) and oxidized LDL in adults with overweight or obesity. Continue reading →
I count myself as one of those confused about whether and to what extent eggs are a healthy addition to my diet. Love the protein, not so thrilled with the fats… Here is what the Tufts Health & Nutrition Letter has to say about it.
There seems to be a lot of pro-plant based diet info coming out of late. The old ‘meat and potatoes’ diets we grew up on in the ’50’s are being viewed in some doubt. Attitudes change as we learn more about health benefits. While I don’t mean to equate smoking with eating meat, I remember when my first wife was pregnant with our daughter in the 1960’s she said she was going to quit smoking till the baby was born. I thought that seemed really extreme at the time. These days no sane mom-to-be would consider ‘lighting up.’
Vegetarian, especially vegan, diets are associated with better cardiovascular health, according to a new review published in the journal Progress in Cardiovascular Diseases.
Researchers with the Physicians Committee for Responsible Medicine looked at multiple clinical trials and observational studies and found strong and consistent evidence that plant-based dietary patterns can prevent and reverse atherosclerosis and decrease other markers of cardiovascular disease (CVD) risk, including blood pressure, blood lipids, and weight. Continue reading →
WHAT MADNESS IS THIS??? Sentenced to the sedentary penitentiary? By a medical man?
I am still the guy who wakes up in the morning looking forward to hopping on the bike and cranking up 10+ miles before breakfast. A flashback is in order.
Two weeks ago I had a big medical week. My annual physical and flu shot were due and I was having trouble chewing on one of my wisdom teeth. So, I had a doctor’s appointment and a dentist appointment in the same week. My normally robust good health keeps me out of doctors’ offices most weeks of the year.
So, I fasted in the morning, saw the doctor, had my blood drawn and left the hospital ravenous for food. So much for the doctor’s visit. My doctor was kind enough email me my blood work results that evening.
Guideline: < 170 mg/dl, Optimal (Not to be construed as a target for drug therapy.)
Guideline: < 100 mg/dl, Optimal (Not to be construed as a target for drug therapy.) > 499 mg/dl, Highly abnormal (Please review with your medical team.)
Guideline: > 50 mg/dl, Optimal (Not to be construed as a target for drug therapy.)
LDL CHOL (CALC)
Guideline: < 100 mg/dl, Optimal (Not to be construed as a target for drug therapy.) > 189mg/dl, Highly abnormal (Please review with your medical team.)
Guideline: < 120 mg/dl, Optimal (Not to be construed as a target for drug therapy.) > 219 mg/dl, Highly abnormal (Please review with your medical team.)
Herewith a wonderful write up on Metabolic Syndrome, a medical condition that sadly seems to be gaining in popularity. Dr. Jonathan gives a superb explanation of it and what you can do to avoid succumbing to it.
The diagnosis metabolic syndrome dates back to the 1950’s. It became more popular around the late 1970’s when the low fat diets first became popular. Today, it is a diagnosis used regularly to define an ever growing percentage of our population. We doctors make it sound like a “disease” requiring our intervention to overcome this life threatening syndrome. In reality, it is a state of dysfunction caused PRIMARILY by the consumer.
What is Metabolic Syndrome? It is a state of diminishing health based on an individual diagnosed with any three of the following five conditions:
elevated blood pressure (≥ 130/85mmHg)
elevated fasting blood sugar (≥100mg/dL)
excess body fat around the waste (abdominal obesity >35 inches in women and >40 inches in men)
HDL cholesterol ≤40 mg/dL for men or 50 mg/dL for women
elevated triglycerides (≥150 mg/dL)
In real numbers, these conditions exist in the United States population as follows:
I have mentioned previously about losing three family members to Alzheimer’s Disease and/or dementia. Hence, my own serious concern about these mental conditions. I remember my aunt whom Alzheimer’s took had very high cholesterol late in life and had been warned by her doctor that she needed to get her numbers down. So, this study from Medical News Today published several years ago had real meaning for me.
Project leader Bruce Reed, a professor of neurology at the University of California (UC) Davis, and associate director of its Alzheimer’s Disease Center, says:
“Our study shows that both higher levels of HDL – good – and lower levels of LDL – bad – cholesterol in the bloodstream are associated with lower levels of amyloid plaque deposits in the brain.”
“Nuts to you” used to be a way of putting someone down. But, according to Tufts, nuts might be a good way to get some of those pesky cholesterol levels down.
At least part of the proven cardiovascular benefits of eating nuts can be explained by their effects on cholesterol and other blood lipids, according to new Tufts research. The meta-analysis of 61 controlled intervention trials totaling 2,532 participants found that tree nut intake lowered total cholesterol, LDL cholesterol, triglycerides and lipoproteins (particles that transport fats through the body). The major determinant of cholesterol lowering appeared to be nut dose rather than nut type, so you can eat your favorite nuts without worrying about nutrient differences.
“This meta-analysis provides the most comprehensive estimates to date of the effects of tree nut intake on major cardiovascular disease risk factors,” says Dariush Mozaffarian, MD, DrPH, dean of Tufts’ Friedman School and editor-in-chief of the Health & Nutrition Letter, who was a co-author on the study.
Lead author Liana C. Del Gobbo, PhD, adds, “Accumulating evidence indicates that nut intake lowers risk of cardiovascular disease events. Our findings showing that nut intake significantly improves the lipid profile provide critical mechanistic evidence to support a causal link between nut intake and lowered cardiovascular disease risk.” Continue reading →
Don’t feel bad for harboring any confusion about just how healthy or unhealthy eggs are in your diet. There has been a lot of information and, it turns out, some misinformation about the little chicken nuggets over the years. So, to put it eggs-actly straight here is the latest from the Harvard T.H. Chan School of Public Health.
Long-vilified for their high cholesterol content by well-meaning doctors and scientists researching heart disease, eggs now seem to be making a bit of a comeback. So what changed?
While it’s true that just one egg yolk has 200 mg of cholesterol—making it one of the richest sources of dietary cholesterol—eggs also contain additional nutrients that may help lower the risk for heart disease. In addition, the moderate amount of fat in an egg, about 5 grams, is mostly monounsaturated and polyunsaturated fat. It’s also crucial to distinguish between dietary cholesterol and cholesterol in the blood, which are only weakly related. The focus on dietary cholesterol alone was de-emphasized as more attention was placed on the influence of saturated and trans fat on blood cholesterol. Accordingly, the Dietary Guidelines for Americans 2015 removed the prior recommendation to limit consumption of dietary cholesterol to 300 mg per day.
Before starting, let me clarify that the word ‘more’ in the header assumes you are eating little or no dark chocolate at present because here in the U.S. we primarily eat milk chocolate. How much? Good question. Some 71 percent of the chocolate we eat is milk chocolate. And, how much total?
The World Atlas of Chocolate puts the U.S. in 11th place worldwide in per capita chocolate consumption with a paltry 11.5 pounds per year. Switzerland is in first place with more than double that total.
As far as a definition of dark chocolate goes, the U.S. has no fixed percentage of cocoa content to define dark chocolate. In practice, however, it seems that 70 percent cocoa solids qualifies as dark chocolate.
But why eat more dark chocolate? Experience L!fe says, “Sure, chocolate’s exquisitely decadent. But its primary ingredient, cocoa, has triple the antioxidants of green tea, helps reduce…
A new Norwegian diet intervention study (FATFUNC), performed by researchers at the KG Jebsen center for diabetes research at the University of Bergen, raises questions regarding the validity of a diet hypothesis that has dominated for more than half a century: that dietary fat and particularly saturated fat is unhealthy for most people.
The researchers found strikingly similar health effects of diets based on either lowly processed carbohydrates or fats. In the randomized controlled trial, 38 men with abdominal obesity followed a dietary pattern high in either carbohydrates or fat, of which about half was saturated. Fat mass in the abdominal region, liver and heart was measured with accurate analyses, along with a number of key risk factors for cardiovascular disease.
“The very high intake of total and saturated fat did not increase the calculated risk of cardiovascular diseases,” says professor and cardiologist Ottar Nygård who contributed to the study. Continue reading →
Last Thursday, I posted Tips on fighting the flu. I thought it was a good time for these tips as we are entering flu season. Also, I had an appointment to get my own flu shot on the following day. Please check out that post as there is a lot of good information in it for you relevant to protecting yourself from the flu bugs eating away at your system. Also, Dr. Jonathan, who writes the blog All About Healthy Choices had some very informed ideas on fighting the flu which he offered in comments.
I know that there is a division of opinion about getting flu shots. I think flu shots, like politics, religion and labor unions are third rail conversational topics. Some people swear by flu shots (me) and some swear at them. The decision is yours, of course. I would offer anecdotally that I started getting them around 16 years ago when I was teaching journalism at Northwestern University. One of my students interviewed a senior citizen who said that she had been getting flu shots for 10 years and in that time she had not only not caught the flu, but she didn’t even catch a cold. That was good enough for me. I have been getting them ever since with similar results. Continue reading →
I am reblogging this analysis I wrote two years ago. At the time I thought it was good useful information for the general public. Now, It seems my doctor says that it applies to me.
I have just had my annual flu shot and pneumonia booster. In the course of my annual check up, I also had my blood work done.
As regular readers know I am 75 years old and in the best health of my entire life. I weigh around 155 pounds and have a resting heart rate below 50 beats per minute.
Here are my Cholesterol numbers: CHOLESTEROL182 Optimal (not to be construed as a target for drug therapy): <170 mg/dL TRIGLYCERIDE41 Optimal (not to be construed as a target for drug therapy): <100 mg/dL Highly Abnormal (please review with your medical team further): >499 mg/dL
HDL CHOLESTEROL77 Optimal (not to be construed as a target for drug therapy): >50 mg/dL LDL CHOL (CALC)97 Optimal (not to be construed as a target for drug therapy): < 100 mg/dL Highly Abnormal (please review with your medical team further): >189 mg/dL
Non-HDL Cholesterol105 Optimal (not to be construed as a target for drug therapy): <120 mg/dL Highly Abnormal (please review with your medical team further): >219 mg/dL
Despite my excellent physical condition and these good test results, my doctor recommended that I go on a statin drug, atorvastatin, to reduce my risk of heart attack or stroke.
POSTED OCT 9, 2015 To clarify:
My Doctor sent me the following:
… although your cholesterol numbers are quite good your overall risk for stroke and heart attacks is still quite high. I calculated your risk of having a stroke or heart attack in the next 10 years and it is 21.6%. I did this with the new American Heart Association Guidelines (AHA) and it is based on your age,sex, race, blood pressure, smoking status and hypertension as well as diabetes. We recommend starting cholesterol medications if the risk is above 7.5%. Even though you are doing everything right your overall risk is still high, as is the risk for most 75 year old males. Many physicians would recommend that your begin a cholesterol medication so I would have your consider taking atorvastatin.
For the record, I declined the recommendation saying that I felt more comfortable relying on my positive lifestyle.
Here is what I wrote back: Thanks very much for your prompt turnaround of my blood work. I also appreciate your considered recommendation regarding taking a statin prescription. At this time I am not comfortable with that. I understand the statistics, but I think those statistics include a lot of men who are not as healthy or health-conscious as I am. I think I would like to continue on with my current lifestyle of daily exercise and healthy eating and avoid the drugs. If I find a deterioration in my condition in the future, I will revisit this decision.
“Millions more Americans could end up taking cholesterol-lowering statin drugs under new recommendations released Tuesday that advocate a dramatic shift in the way doctors assess and treat cardiovascular risk,” according to the Washington Post.
“Roughly a quarter of Americans age 45 and older already take statins, which include familiar brands such as Lipitor and Zocor, to treat high cholesterol. But that number could grow sharply under far-reaching guidelines detailed by the American Heart Association and the American College of Cardiology.”
The leading cause of death for Americans is heart disease. About one in every four deaths in the United States, or about 600,000 annually, are attributed to heart disease, according to the Centers for Disease Control and Prevention.
Cholesterol helps your body build new cells, insulate nerves, and produce hormones. Normally, the liver makes all the cholesterol the body needs. But cholesterol also enters your body from food. Too…