Research - Cholesterol
Consortia of bioactives in supercritical carbon dioxide extracts of mustard and small cardamom seeds lower serum cholesterol levels in rats: new leads for hypocholesterolaemic supplements from spices
Soumi Chakraborty (a1), Kaninika Paul (a1), Priyanka Mallick (a2), Shrabani Pradhan (a3)
Melatonin-rich and 1,8-cineole-rich extracts have been successfully obtained from yellow mustard (YM) and small cardamom (SC) seeds, respectively, employing green technology of supercritical CO2 (SC-CO2) extraction. Chemical profiling confirmed the presence of melatonin and 1,8-cineole and co-extractants in the respective extracts. Electron paramagnetic resonance spectroscopy attested strong antioxidant activities of the extracts foregoing pan-assay interference compounds involved in spectroscopic analysis. These extracts also exhibited synergistic efficacies greater than unity confirming antioxidant synergy among the co-extracted bioactives therein. To ascertain hypocholesterolaemic efficacies, these extracts were co-administered orally with Triton X (at the pre-optimised dose of 175 mg/kg body weight (BW)) to Wistar albino rats at doses of 550, 175 and 55 mg/kg BW. Serum total cholesterol levels in the rats were monitored on days 3, 7, 15 and 21. On day 21, total cholesterol level reduced appreciably by 49·44 % in rats treated with YM seed extract and by 48·95 % in rats treated with SC seed extract, comparable with atorvastatin-administered rats (51·09 %). Either extract demonstrated inhibitory effects on hepatic 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase activity. A molecular docking exercise identified specific compounds in the extracts which possessed binding affinities comparable with therapeutically used HMG-CoA reductase inhibitors. In silico and in vivo studies concertedly concluded that the consortium of bioactive components in the extracts cannot be considered as invalid metabolic panaceas and therefore these ‘green’ extracts could be safely subjected to clinical studies as preventive biotherapeutics for hypercholesterolaemia. These extracts could be consumed per se as hypocholesterolaemic supplements or could be ingredients of new spice-based therapeutic foods.
Source : Journal of Nutritional Science
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Efficacy and Tolerability of a Nutraceutical Combination (Red Yeast Rice, Policosanols, and Berberine) in Patients with Low-Moderate Risk Hypercholesterolemia: A Double-Blind, Placebo-Controlled Study
BackgroundStatins are at the forefront of strategies to manage hypercholesterolemia. However 10% to 15% of patients are intolerant to any statin drugs, even at low daily doses and almost one-third of statin users discontinue therapy within 1 year. Some nutraceuticals are prescribed as lipid-lowering substances, but doubts remain about their efficacy and tolerability.
We aimed to investigate the efficacy and the safety of a nutraceutical combination consisting mainly of 200 mg red yeast rice extract (equivalent to 3 mg monacolins), 500 mg berberine, and 10 mg policosanols (MBP-NC) in patients with low-moderate risk hypercholesterolemia.
In this single centre, randomized, double-blind, placebo-controlled study 60 consecutive outpatients (29 men and 31 women; age range = 18–60 years), with newly diagnosed primary hypercholesterolemia not previously treated, after a run-in period of 3 weeks on a stable hypolipidic diet, were randomized to receive a pill of MBP-NC (n = 30) or placebo (n = 30) once a day after dinner, in addition to the hypolipidic diet. The efficacy and the tolerability of the proposed nutraceutical treatment were fully assessed after 4, 12, and 24 weeks of treatment.
In the MBP-NC group both total cholesterol and LDL-C already showed a significant reduction at Week 4 (–30.3% ± 33.9% and –29.4% ± 35.3%, respectively) that remained substantially unchanged at Week 12 (–26.7% ± 33.1% and –25.6% ± 31.5%, respectively) and at Week 24 (–24.6% ± 32.1% and –23.7% ± 32.6%, respectively). The between-groups differences were significant at all time points for both total cholesterol and LDL-C. There were no significant changes in HDL-C, fasting glucose, and triglyceride serum levels in either group. MBP-NC was also safe and well tolerated.
In patients with low- to moderate-risk hypercholesterolemia a nutraceutical combination in association with a hypolipidic diet significantly reduced total cholesterol and LDL-C levels and may favor the reaching the recommended cholesterol targets.
Source : Current Therapeutic Research
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The Serum Lipid Lowering Effect of Rugosa Rose Petal Extract Rich in Polyphenols in Adults with High Serum Triglyceride
Takashi YAMAGISHI1,2, Keiji TAKANO1,3, Sumio KONDO41
Harunire Bio Institute Ltd.2 Kitami Institute of Technology3 DRC Ltd.4 Medical Corporation Kenshou-kai Fukushima Health Care Center
Objective: Hypertriglyceridemia or elevated serum triglyceride (TG) is a leading risk factor for developing atherosclerotic cardio-vascular diseases. This clinical study was designed to test the potential of polyphenol-rich extract from Rosa rugosa petals (PE) for improving hypertriglyceridemia and other types of dyslipidemia.
Methods: An open-label clinical study was conducted on 19 male and female adult subjects with elevated serum TG (120–399mg/dL), who were intervened the study diet containing (in a daily dose) 200mg of PE once daily for sss4 weeks. The serum levels of TG and cholesterols were measured at baseline and week-4. The efficacy was evaluated by comparing the measurements at these two time points.
Results: A significant decrease (P<0.05) in serum TG, as well as in serum total cholesterol and non HDL-cholesterol, and a marginal-ly significant decrease (P=0.070) in serum LDL-cholesterol were observed, while serum HDL-cholesterol was virtually not changed. The study diet was well tolerated without any untoward side effect
.Conclusions: The PE-containing diet appears to have benefits in improving hypertriglyceridemia and hypercholesterolemia
Source : Japanese Journal of Complementary and Alternative Medicine
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The protective effect of the Cornus mas fruits (cornelian cherry) on hypertriglyceridemia and atherosclerosis through PPAR[alpha] activation in hypercholesterolemic rabbits.
Cornelian cherry (Cornus mas L.) fruits have been used in traditional cuisine and in folk medicine in various countries. This study was conducted to evaluate the constituents and impact of cornelian cherry (C. mas L.) fruits lyophilisate on lipid levels, PPAR[alpha] protein expression, atheromatous changes in the aorta, oxidoredox state, and proinflammatory cytokines in hypercholesterolemic rabbits. The HPLC-MS method was used for determining active constituents in cornelian cherry. In a subsequent in vivo study the protective effect of the cornelian cherry on diet-induced hyperlipidemia was studied using a rabbit model fed 1% cholesterol. Cornelian cherry (100 mg/kg b.w.) or simvastatin (5 mg/kg b.w.) were administered orally for 60 days. Two iridoids--loganic acid and cornuside--and five anthocyanins were identified as the main constituents of the cornelian cherry. The administering of the cornelian cherry led to a 44% significant decrease in serum triglyceride levels, as well as prevented development of atheromatous changes in the thoracic aorta. Cornelian cherry significantly increased PPAR[alpha] protein expression in the liver, indicating that its hypolipidemic effect may stem from enhanced fatty acid catabolism. Simvastatin treatment did not affect PPAR-[alpha] expression. Moreover, the cornelian cherry had a significant protective effect on diet- induced oxidative stress in the liver, as well as restored upregulated proinflammatory cytokines serum levels. In conclusion, we have shown loganic acid to be the main iridoid constituent in the European cultivar of the cornelian cherry, and proven that the cornelian cherry could have protective effects on diet-induced hypertriglicerydemia and atherosclerosis through enhanced PPAR[alpha] protein expression and via regulating oxidative stress and inflammation.
Source : International Journal of Phytotherapy and Phytopharmacology via Free Library
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Drinking Deep Seawater Decreases Serum Total and Low-DensityLipoprotein–Cholesterol in Hypercholesterolemic Subjects
Zhao-Yang Fu,1Feili Lo Yang,1Hsin-Wen Hsu,2and Yi-Fa Lu1
1Department of Nutritional Science, Fu-Jen Catholic University, Hsinchuang, New Taipei City, Taiwan.
2Department of Family Medicine, Cardinal Tien Hospital, Yung Ho Branch, Yung Ho, New Taipei City, Taiwan.
Drinking deep seawater (DSW) with high levels of magnesium (Mg) decreased serum lipids in animal studies.Therefore the effects of drinking DSW on blood lipids and its antioxidant capacity in hypercholesterolemic subjects were investigated. DSW was first prepared by a process of filtration and reverse osmosis, and then the concentrated DSW with highlevels of Mg was diluted as drinking DSW. Forty-two hypercholesterolemic volunteers were randomly divided into three groups: reverse osmotic (RO) water, DSW (Mg: 395mg/L, hardness 1410ppm), and magnesium-chloride fortified (MCF)water (Mg: 386mg/L, hardness 1430ppm). The subjects drank 1050mL of water daily for 6 weeks, and blood samples were collected and analyzed on weeks 0, 3, and 6. Drinking DSW caused a decrease in blood total cholesterol levels and this effect was progressively enhanced with time. Serum low-density lipoprotein–cholesterol (LDL-C) was also decreased by DSW.Further, total cholesterol levels of subjects in the DSW group were significantly lower than those in the MCF water or RO water groups. Compared with week 0, the DSW group had higher blood Mg level on weeks 3 and 6, but the Mg levels were within the normal range in all three groups. DSW consumption also lowered thiobarbituric acid-reactive substances (TBARS)values in serum. In conclusion, DSW was apparently effective in reducing blood total cholesterol and LDL-C, and also indecreasing lipid peroxidation in hypercholesterolemic subjects.
Source : Journal of Medicinal Foods
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A Review and Update of Red Yeast Rice
Megan E. Musselman, PharmD, BCPS1, Rebecca S. Pettit, PharmD, MBA, BCPS2, and Karrie L. Derenski, PharmD, BCNSP, CNSC3
Dyslipidemia is a growing concern causing significant morbidity and mortality. High cholesterol levels increase the risk of individuals
developing heart disease, stroke, and other disease states. Dietary modification is the initial approach for treatment, but
many patients require statins (3-hydroxy-3-methylglutaryl co-enzyme A reductase inhibitors) to reduce cardiovascular risk.
Unfortunately, a number of patients cannot tolerate statins, leading to practitioners searching for alternative regimens. One alternative that has been extensively studied is red yeast rice (Monascus purpureus), a dietary supplement. In patients with dyslipidemia, red yeast rice was efficacious and safe for short-term use (<16 weeks). Red yeast rice has also been studied head to head with statins and was shown to be noninferior in reducing cholesterol levels and cardiovascular risk. Because of the positive clinical effects seen in dyslipidemia, researchers have begun to study its use in other disease states.
Source : Journal of Evidence-Based Complementary & Alternative Medicine
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Probiotic Lactobacillus rhamnosus GG and Aloe vera gel improve lipid profiles in hypercholesterolemic rats.
Kumar M, Rakesh S, Nagpal R, Hemalatha R, Ramakrishna A, Sudarshan V, Ramagoni R, Shujauddin M, Verma V, Kumar A, Tiwari A, Singh B, Kumar R.
Source : Department of Microbiology and Immunology, National Institute of Nutrition, Hyderabad, India.
OBJECTIVE: The effects of Lactobacillus rhamnosus GG (LGG) and Aloe vera (AV) gel on lipid profiles in rats with induced hypercholesterolemia were studied.
METHODS: Five treatment groups of rats (n = 7) were the fed experimental diets: a normal control diet, a hypercholesterolemic diet (HD), HD + LGG, HD + AV gel, and HD + LGG + AV gel.
RESULTS: Supplementation with LGG decreased serum total cholesterol by 32%; however, in combination with AV, the decrease was 43%. The decreases in triacylglycerol levels in the HD + LGG, HD + AV, and HD + LGG + AV groups were 41%, 23% and 45%, respectively. High-density lipoprotein increased by 12% in the HD + LGG + AV group, whereas very low-density and low-density lipoprotein values decreased by 45% and 30%, respectively. The atherogenic index in the HD + LGG + AV group decreased to 2.45 from 4.77 in the HD + LGG group. Furthermore, fecal Lactobacillus species counts increased significantly when LGG was fed in combination with the AV gel. The oral administration of LGG fermented milk alone or in combination with the AV gel increased cholesterol synthesis (3-hydroxy-3-methylglutaryl coenzyme A reductase expression) and absorption (low-density lipoprotein receptor expression), whereas cholesterol 7α-hydroxylase mRNA expression levels were lower in the HD + LGG and HD + LGG + AV groups compared with the control HD group.
CONCLUSION: The combination of LGG and AV gel may have a therapeutic potential to decrease cholesterol levels and the risk of cardiovascular diseases.
Source : Nutrition. 2012 Dec 31. pii: S0899-9007(12)00362-0. doi: 10.1016/j.nut.2012.09.006
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High cholesterol linked to dementia with stroke
Having high serum levels may increase risk of dementia with stroke in elderly people, according to a study in the Journal of American Medical Association.
The study led by Joan T. Moroney, MD, MRCPI and colleagues found levels of low density lipoprotein (LDL) cholesterol were significantly correlated with an increased risk of dementia with stroke.
For the study, Moroney et al. followed a total of 1,111 nondemented participants with a mean age of 75 years for an average 2.1 years. Total srum cholesterol, low-density lipoprotein cholesterol, high density lipoportein cholesterol, lipoproteins(a) and apolipoprotein E genotype were determined at baseline.
During the follow-up, 286 participants developed dementia, 61 were diagnosed with dementia with stroke, and 225 with probable Alzheimer's disease.
Participants in the highest quartile of LDL cholesterol were found to be three times as likely as those in the lowest quartile of LDL cholesterol to be diagnosed with dementia with stroke after adjustment for vascular risk factors and demographic factors.
And serum levels of LDL corrected for lipoprotein(a) were even more significantly associated with risk of dementia with stroke. Participants in the highest quartile of lipoprotein(a)–corrected LDL cholesterol were four times as likely as those in the lowest quartile to develop dementia with stroke after adjustment for confounders.
Serum levels of lipid or lipoprotein levels were not associated with the development of Alzheimer disease in the study population.
The researchers concluded "Elevated levels of LDL cholesterol were associated with the risk of dementia with stroke in elderly patients. Further study is needed to determine whether treatment of elevated LDL cholesterol levels will reduce the risk of dementia with stroke."
Statins can lower cholesterol, but can also cause side effects. Red yeast rice is a safe alternative, which is as effectively as statins at lowering cholesterol.
Source : Food Consumer
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Mexican traditional medicine lowers bad cholesterol, dissolve gallstones
Statins and red yeast rice are equally effective at lowering cholesterol. Black radish could be the third most effective cholesterol lowering agent, a traditional medicine that has been used in Mexico to prevent or treat gallstones and lower cholesterol and triglycerides levels, a new study suggests in Journal of Biomedicine and Biotechnology.
I.G. Castro-Torres of Facultad de Química Farmacéutica Biológica, Universidad Veracruzana, Xalapa, Veracruz, Mexico and colleagues conducted the study and found using the juice extracted from a type of black radish (Raphanus sativus L. var. niger) for days eliminated cholesterol gallstones and decreased serum levels of cholesterol and triglycerides in female mice.
For the study, female C57BL/6 mice were fed a lithogenic diet, a gallstone diet that consists often of fat, cholesterol and cholic acid, to induce cholesterol disorders. Some of the mice on the diet were then treated with the black radish juice and then histopathological properties of the gallbladder and liver, and serum cholesterol levels, high density lipoprotein (HDL) cholesterol and triglycerides levels were measured.
Mice on the lethogenic diet developed cholesterol gallstones; increased serum cholesterol and triglycerides levels, and decreased HDL; also gallbladder wall thickness increased significantly, accompanied by epithelial hyperplasia and increased liver weight.
These mice received treatment with black radish juice for merely six days and had cholesterol gallstones removed significantly from the gallbladder; and also had cholesterol and triglycerides levels decreased. Additionally, the black radish juice treatment boosted levels of HDL cholesterol, which is considered a beneficial cholesterol.
However, the traditional medicine did not reverse epithelial hyperplasia and granulocyte infiltration and liver tissue continued to show vacuolar degeneration.
The researchers concluded "The juice of black radish root has properties for treatment of cholesterol gallstones and for decreasing serum lipids levels; therefore, we confirm in a preclinical study the utility that people give it in traditional medicine."
Source : foodconsumer.org
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Natural Niacin Beats Prescription Zetia for Cholesterol
A study published in the New England Journal of Medicine concluded that niacin, also known as vitamin B3, is better for reducing cholesterol and preventing heart disease than Merck & Co., Inc.'s prescription medication Zetia.
Researchers found that over a 14 month period niacin was significantly more effective at reducing artery plaque than ezetimibe, the active ingredient in Zetia. In addition, niacin was found more effective than Zetia at decreasing the number of heart attacks.
Zetia is a medication used in conjunction with statins to try to further lower levels of the so-called bad LDL cholesterol in the blood. It claims to work by blocking the absorption of cholesterol in the digestive track. Annual sales of the drug in 2010 were $2 billion.
The study was halted early because the niacin group was doing better. In fact, the researchers concluded that the more LDL cholesterol was reduced in the Zetia group, the greater was the progression of their atherosclerosis. In addition, there were significantly more major cardiovascular events among patients using Zetia than among those in the niacin group.
The lead author of the study questioned whether Zetia was effective at all and concluded that "prudent clinical practice currently favors the avoidance of ezetimibe" until further clinical studies are conducted.
What is niacin? Niacin is a water soluble B vitamin also known as "nicotinic acid" used by the body to convert carbohydrates, fats and protein into energy. It also contributes to keeping the nervous system, digestive system, skin, hair and eyes healthy.
Niacin has been used for over 50 years as an effective method for raising the levels of good HDL cholesterol in the blood and is also known to help reduce bad LDL cholesterol and triglycerides.
What foods contain niacin? Niacin is widely available in the food supply. The principal food sources of niacin include:
• Dairy products
• Lean meats
• Nutritional yeast
• Wheat germ
• Whole grains
Most people get sufficient niacin in their daily diets. Minimum requirements are 14-16 milligrams per day to prevent pellagra, a disease characterized by diarrhea, dementia and dermatitis. If left untreated it can lead to death.
Pellagra was widespread when people ate a diet heavy in corn rather than other whole grains since corn is very low in niacin. Native Americans traditionally cooked corn with lime because lime improves niacin absorption in the body, thus preventing the disease.
The optimum daily amount of niacin has not been set but a typical multi-vitamin will contain 20 milligrams, and many B complex vitamin supplements will contain as much as 200 milligrams.
Niacin for cholesterol control The idea that there are "bad" and "good" blood lipids that contribute to heart disease is known as the "lipid hypothesis," or "cholesterol myth." The hypothesis is subject to much criticism and has been challenged often.
Nevertheless, most doctors continue to use cholesterol numbers to determine treatment. For treating high cholesterol, prescription doses of niacin are typically used only under a doctor's supervision.
Source : Green Med Info
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DHA Helps Make Healthier Cholesterol
Many studies associate DHA intake with a reduction in cardiovascular disease, even though DHA is not considered a nutrient that typically lowers cholesterol. A new study in Eskimos proves that DHA intake influences the quality of cholesterol you have, regardless of whether or not you are overweight.
When you get a basic lab test that shows your LDL, HDL, and total cholesterol, it does not show what kind of condition your cholesterol is in. We are learning more and more that quality, both in terms of LDL and HDL, makes a huge difference to the potential for cardiovascular risk. For example, only damaged LDL cholesterol becomes plaque, regardless of the amount of LDL in your blood. Thus, a person with low LDL can readily be making plaque if free radicals or toxins are damaging the LDL they do have.
Cholesterol testing will undoubtedly improve in the next decade or so as we learn more and more about the nature of cholesterol quality, both for LDL and HDL. Some insight into cholesterol quality can be obtained by measuring the size of cholesterol particles. For example, if VLDL (very low density lipoprotein) particles are larger they have a higher tendency to contribute to disease, whereas if HDL particles are larger in size they tend to be of better quality.
In the new study researchers were able to show that DHA intake was linked to healthier cholesterol particles, thus providing novel insights into one way DHA helps reduce cardiovascular disease risk. The intake of this omega-3 essential fatty acid was linked to having fewer VLDL particles, plus the VLDL was smaller in size. DHA contributed to a higher number of HDL (good cholesterol) and the HDL particles were larger.
You need cholesterol, both LDL and HDL, to carry on many important functions in your body. This study means that DHA contributes to having LDL and HDL that is more metabolically fit and less likely to cause health problems.
Source : Wellness Resources
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Why Women Should Stop Their Cholesterol Lowering Medication
by Dr. Mark Hyman, Guest Writer
Originally published on Dr. Mark Hyman's web site, January 2012
If you are a post-menopausal women with high cholesterol, your doctor will almost certainly recommend cholesterol lowering medication or statins. And it just might kill you. A new study in the Archives of Internal Medicine found that statins increase the risk of getting diabetes by 71 percent in post-menopausal women. Since diabetes is a major cause of heart disease, this study calls into question current recommendations and guidelines from most professional medical associations and physicians. The recommendation for women to take statins to prevent heart attacks (called primary prevention) may do more harm than good.
Take it if you already have had one, but beware if your doctor recommends it for you if have never had a heart attack.
This current study adds to an increasing body of literature questioning the benefits of statins, while highlighting their potential risks.
New Study Shows 48 Percent Risk of Diabetes in Women Who Take Statins This study examined the data from the large government sponsored study called the Women's Health Initiative, the same study that disabused us of the idea that Premarin prevented heart attacks in postmenopausal women.
In fact, based on this randomized controlled trial, estrogen replacement therapy, once considered the gold standard of medical care for the prevention of heart disease, was relegated to the trash bin of history joining medicine's many other fallen heroes including DES, Thalidomide, Vioxx, Avandia, and more.
In this new study researchers reviewed the effect of statin prescriptions in a group of 153,840 women without diabetes and with an average age of 63.2 years. About 7 percent of women reported taking statin medication between 1993 and 1996. Today there are many, many more women taking statin medications, thus many more are at risk from harm from statins.
During the 3-year period of the study, 10,242 new cases were reported – a whopping 71 percent increase in risk from women who didn't take statins. This association stayed strong at a 48 percent increased risk of getting diabetes, even after taking into account age, race/ethnicity, and weight or body mass index. These increases in disease risk were consistent for all statins on the market.
This effect also occurred in those with and without heart disease. Surprisingly disease risk was worse in thin women. Minority women were also disproportionately affected. The risk of diabetes was 49 percent for white women, 57 percent for Hispanic women, and 78 percent for Asian women.
But in a typical "my mind's made up, don't confuse me with the facts" statement by the medical establishment, the researchers said we should not change our guidelines for statin use for the primary prevention of heart disease.
In a large meta-analysis published in the Lancet last year, scientists found that statins increased the risk of diabetes by 9 percent. If current guidelines were followed for those who should take statins, and people actually took them (thank God only 50 percent of prescriptions are ever filled by patients), there would be 3 million more diabetics in America. Oops.
Other studies have recently called into question the belief that high cholesterol levels increase your risk of heart disease as you get older. For those over 85 it turns out having high cholesterol will protect you from dying from a heart attack, and, in fact, from death from any cause.
Low Cholesterol May Kill You A recent study showed that in healthy older persons, high cholesterol levels were associated with lower non-cardiovascular-related mortality. This is extremely concerning because millions of prescriptions are written every day to lower cholesterol in the older population, yet no association has been found between higher cholesterol and heart disease deaths for those aged 55 to 84; and for those over 85, the association seems to be inverse – higher cholesterol predicts lower risk of death from heart disease.
The pharmaceutical industry, medical associations, and academic researchers whose budgets are provided by grants from the pharmaceutical industry continue to preach the wonders of statins, but studies like these should have us look good and hard at our current practices. Are we doing more harm than good?
Cardiologists recommend putting statins in the water and giving them out at fast food restaurants and having them available over the counter. They believe in driving cholesterol as low as possible. Statin prescriptions are handed out with religious fervor, but do they work to prevent heart attacks and death if you haven't had a heart attack already?
Bottom line: NO! If you want to learn why this is true, read on.
Statins Don't Work to Prevent First Heart Attacks Recently, the Cochrane Group did a review of all the major statin studies by an international group of independent scientists. The review failed to show benefit in using statins to prevent heart attacks and death. In addition, many other studies support this and point out the frequent and significant side effects that come with taking these drugs. [i] If scientists found that drinking two glasses of water in the morning prevented heart attacks, even if the evidence was weak, we would jump on board. Big up side, no down side.
But this is not the case with statins. These drugs frequently cause muscle damage, muscle cramps, muscle weakness, muscle aches, exercise intolerance [ii] (even in the absence of pain and elevated CPK – a muscle enzyme), sexual dysfunction, liver and nerve damage and other problems in 10-15 percent of patients who take them. [iii] They can also cause significant cellular, muscle, and nerve injury as well as cell death in the ABSENCE of symptoms. [iv]
There is no lack of research calling into question the benefits of statins. Unfortunately, that research doesn't get the benefit of billions of dollars of marketing and advertising that statins do. One big trial was touted as proving statins work to prevent heart attacks, but the devil is in the details.
It was the JUPITER [v] trial that showed that lowering LDL (or bad cholesterol) without a reduction in inflammation (measured by C-reactive protein) didn't prevent heart attacks or death. [vi] Statins happen to reduce inflammation so the study has been touted as proof of the effectiveness of these medications. Mind you it wasn't lowering the cholesterol that helped (which is the intended purpose of statins), but the fact that they lower inflammation. What is ignored by people who use this study to "prove" that statins work is the fact that there are so many better ways to lower inflammation than taking these drugs.
Yet other studies have shown no proven benefit for statins in healthy women [vii] with high cholesterol or in anyone over 69 years old. [viii] Some studies even show that aggressive lowering of cholesterol can cause MORE heart disease. The ENHANCE trial showed that aggressive cholesterol treatment with two medications (Zocor and Zetia) lowered cholesterol much more than one drug alone, but led to more arterial plaque and no fewer heart attacks. [ix]
Other research calls into question our focus on LDL or the bad cholesterol. We focus on it because we have good drugs to lower it, but it may not be the real problem. The real problem is low HDL that is caused by insulin resistance (diabesity).
In fact studies show that if you lower the bad (LDL) cholesterol in people with low HDL (good cholesterol) that is a marker of diabesity – the continuum of obesity, prediabetes and diabetes – there's no benefit. [x]
Most people simply ignore the fact that 50-75 percent of people who have heart attacks have normal cholesterol. [xi] The Honolulu Heart Study showed older patients with lower cholesterol have higher risks of death than those with higher cholesterol. [xii]
Some patients with multiple risk factors, or who have had previous heart attacks do benefit, but when you look closely the results are underwhelming. It's all in how you spin the numbers. For high-risk males (those who are overweight and have high blood pressure, diabetes, and/or a family history of heart attacks) and are younger than 69 there is some evidence of benefit, but one hundred men would need to be treated to prevent just one heart attack.
That means that 99/100 men who take the drug receive no benefit. Drug ads say the risk is reduced by 33 percent. Sounds good, but that just means the risk of getting a heart attack goes down from 3 percent to 2 percent.
Despite the extensive data showing that statins are a questionable therapy at best, they are still the number one selling drug in the US. What isn't so well known is that 75 percent of statin prescriptions are written for people who will receive no proven benefit. The cost of these prescriptions? Over $20 billion a year.
Yet somehow the 2004 National Cholesterol Education Program guidelines expanded the previous guidelines to recommend that even more people without heart disease take statins (from 13 million to 40 million) [xiii] What are we thinking?
Why would respected scientists go against the overwhelming research that statins don't prevent heart disease in people who haven't already had a heart attack?
You can find the answer if you follow the money. Eight of the nine experts on the panel who developed these guidelines had financial ties to the drug industry. Thirty-four other non-industry affiliated experts sent a petition to protest the recommendations to the National Institutes of Health saying the evidence was weak.
What Should Women Do? It is time to push the sacred cow of statins overboard.
But first let me say this. If you have had a heart attack, or have heart disease, the evidence shows they do in fact help protect against a second heart attack, so keep taking them.
However, you should be aware that most prescriptions for statins are given to healthy people whose cholesterol is a little high. For these folks the risk clearly outweighs the benefit.
The editorial that accompanies the recent study on women taking cholesterol-lowering medication that I opened this article with was quite clear. Dr. Kirsten Johansen from the University of California, San Francisco said that the increased risk of diabetes in women without heart disease has "important implications for the balance of risk and benefit of statins in the setting of primary prevention in which previous meta-analyses show no benefit on all-cause mortality."
In plain English, she said that we shouldn't be using statin drugs for women without heart disease because:
- The evidence shows they don't work to prevent heart attacks if you never had one.
- They significantly increase the risk of diabetes.
Remember what you put at the end of your fork is more powerful than anything you will ever find at the bottom of a pill bottle.
My new book The Blood Sugar Solution, which comes out at the end of February, gives exact details on what you should put at the end of your fork to prevent and reverse diabesity. It provides a comprehensive solution to the health problems facing our nation today.
Source : Foundation of Alternative and Integrative Medicine
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Diets containing barley significantly reduce lipids in mildly hypercholesterolemic men and women
Background: Barley has high amounts of soluble fiber but is not extensively consumed in the US diet.
Objective: This study investigated whether consumption of barley would reduce cardiovascular disease risk factors comparably with that of other sources of soluble fiber.
Design: Mildly hypercholesterolemic subjects (9 postmenopausal women, 9 premenopausal women, and 7 men) consumed controlled American Heart Association Step 1 diets for 17 wk. After a 2-wk adaptation period, whole-grain foods containing 0, 3, or 6 g -Beta glucan/d from barley were included in the Step 1 diet menus. Diets were consumed for 5 wk each and were fed in a Latin-square design. Fasting blood samples were collected twice weekly.
Results: Total cholesterol was significantly lower when the diet contained 3 or 6 g Beta-glucan/d from barley than when it contained no Beta-glucan; the greatest change occurred in the men and postmenopausal women. HDL and triacylglycerol concentrations did not differ with the 3 amounts of dietary Beta-glucan. Large LDL and small
VLDL fractions and mean LDL particle size significantly decreased whenwhole grains were incorporated into the 3 diets. Large LDL and large and intermediate HDL fractions were significantly higher, mean LDL particle size was significantly greater, and intermediate VLDL fractions were significantly lower in the postmenopausal women than in the other 2 groups.Agroup-by-diet interaction effect was observed on LDL fractions and small LDL particle size.
Conclusion: The addition of barley to a healthy diet maybe effective in lowering total and LDL cholesterol in both men and women.
Source : Am J Clin Nutr 2004;80:1185–93.
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The Effects of Barley-Derived Soluble Fiber on Serum Lipids
Purpose - We wanted to determine the association between consumption of barley and changes in plasma lipids in healthy and hypercholesterolemic men and women.
Methods- A systematic literature search was conducted from the earliest possible date through January 2008. Trials were included in the analysis if they were randomized controlled trials of barley that reported effi cacy data on at least 1 lipid endpoint. A DerSimonian and Laird random-effects model was used in calculating the weighted mean difference (WMD) and its 95% confidence interval (CI). Statistical heterogeneity was addressed using the I2 statistic. Visual inspection of funnel plots, Egger’s weighted regression statistics, and the trim and fill method
were used to assess for publication bias.
Results We found 8 trials (n = 391 patients) of 4 to 12 weeks’ duration evaluating the lipid-reducing effects of barley. The use of barley significantly lowered total cholesterol (weighted mean difference [WMD], –13.38 mg/dL; 95% CI,
–18.46 to –8.31 mg/dL), low-density lipoprotein (LDL) cholesterol (WMD, –10.02 mg/dL; 95% CI, –14.03 to –6.00 mg/dL) and triglycerides (WMD, –11.83 mg/dL; 95% CI, –20.12 to –3.55 mg/dL) but did not appear to signifi cantly alter highdensity lipoprotein (HDL) cholesterol (P = .07).
Conclusion Barley-derived β-glucan appears to beneficially affect total cholesterol, LDL-cholesterol, and triglycerides, but not HDL-cholesterol.
Source : 1University of Connecticut School of Pharmacy, Storrs, Connecticut. 2Department of Drug Information at Hartford Hospital, Hartford, Connecticut
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Dose effects of dietary phytosterols on cholesterol metabolism: a controlled feeding study
- Susan B Racette, Xiaobo Lin, Michael Lefevre, Catherine Anderson Spearie, Marlene M Most, Lina Ma, and Richard E Ostlund Jr
Objective: We evaluated the effects of 3 phytosterol intakes on whole-body cholesterol metabolism.
Design: In this placebo-controlled, crossover feeding trial, 18 adults received a phytosterol-deficient diet (50 mg phytosterols/2000 kcal) plus beverages supplemented with 0, 400, or 2000 mg phytosterols/d for 4 wk each, in random order. All meals were prepared in a metabolic kitchen; breakfast and dinner on weekdays were eaten on site. Primary outcomes were fecal cholesterol excretion and intestinal cholesterol absorption measured with stable-isotope tracers and serum lipoprotein concentrations.
Results: Phytosterol intakes (diet plus supplements) averaged 59, 459, and 2059 mg/d during the 3 diet periods. Relative to the 59-mg diet, the 459- and 2059-mg phytosterol intakes significantly (P < 0.01) increased total fecal cholesterol excretion (36 ± 6% and 74 ± 10%, respectively) and biliary cholesterol excretion (38 ± 7% and 77 ± 12%, respectively) and reduced percentage intestinal cholesterol absorption (−10 ± 1% and −25 ± 3%, respectively). Serum LDL cholesterol declined significantly only with the highest phytosterol dose (−8.9 ± 2.3%); a trend was observed with the 459-mg/d dose (−5.0 ± 2.1%; P = 0.077).
Conclusions: Dietary phytosterols in moderate and high doses favorably alter whole-body cholesterol metabolism in a dose-dependent manner. A moderate phytosterol intake (459 mg/d) can be obtained in a healthy diet without supplementation.
Source : The American Journal of Clinical Nutrition
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NB Dietary phytosterols, are cholesterol-like compounds that are found mostly in vegetable oils, nuts and legumes