To avoid a heart attack, more and more research is finding that your #1 strategy is getting your LDL (bad) cholesterol not just down, but way down. Striving for LDL levels of 100 and below is good, but dropping to 80 and lower may be even better.
LDL levels of 81
The latest research, published in the Journal of the American Medical Association (JAMA), involved 8,800 European patients. All had previously suffered heart attacks. The trial found that those who reduced their LDL levels to an average 81 with high-dose statins significantly reduced their risk of major coronary events like heart attacks and strokes at the 4.8 year follow-up compared to patients who reduced their LDL to 104 on usual-dose statin therapy.(1)
“Lower is better.”
In a JAMA editorial accompanying the study, Christopher P. Cannon, MD, of Brigham and Women’s Hospital and Harvard Medical School wrote that aggressive LDL lowering is the ideal – “lower is better.”
The JAMA study’s findings echo those of another large 4,162-patient study, published in the New England Journal of Medicine in 2004. It concluded that LDL cholesterol levels of 62 were even better than levels of 95 at preventing death, heart attacks, and other cardiovascular-related problems in people with heart disease.(2)
Drugs’ negative effects
In both studies, mega-doses of statins (a doubling and tripling of regular doses) drove LDL levels way down. But in both studies, mega-doses also caused problems. Suffering from adverse side effects like muscle pain, memory loss, and elevated liver enzymes, patients on the high doses stopped taking their medications at twice the rate of patients on regular doses.
Muscle pain, also called myopathy, occurs in 2% to 11% of people treated with statins, recently reported investigators at the University of Wisconsin Hospital and Clinics in Madison, and although the pain usually subsides once the statin is discontinued, it can take several months to do so. Like previous studies, the Wisconsin scientists also found that the negative side effects of statins increased as dosages increased.(3)
Medication-free alternatives
“That’s why drug-free alternatives like the Pritikin Program are so important,” advises Dr. William McCarthy, UCLA School of Public Health and member of the Pritikin Scientific Advisory Board.
“For people who cannot tolerate maximum doses of statins, or for those wanting to minimize their dependence on drugs, the Pritikin Program of diet and exercise – or a combination of low-dose statins plus the Pritikin Program – offers a much safer option for lowering LDL cholesterol to levels significantly below 100.”
In research on more than 4,500 men and women following the Pritikin Program, LDL levels plummeted 23%, and in just three weeks.(4)
39% drop in LDL
And in a study by UCLA scientists in conjunction with the Pritikin Foundation, men and women doubled their reductions in cholesterol, averaging a 39% drop, when they supplemented regular-dose statin therapy with the diet-and-exercise lifestyle of the Pritikin Program.(5)
7 Dietary/Lifestyle Tips
To dramatically lower your LDL cholesterol levels without resorting to high doses of statins (and maybe even eliminating the need for statins altogether), the doctors and dietitians at the Pritikin Longevity Center & Spa recommend these 7 dietary/lifestyle tips, listed in order of importance:
1. Avoid all foods with trans fats. Limit your intake of foods with saturated fats and cholesterol (no more than 3½ ounces of seafood, poultry, or lean meat daily).
The leading heart-health institutions in America, including the American Heart Association and the National Cholesterol Education Program, state that diets high in trans fats, saturated fats, and cholesterol raise blood cholesterol levels and lead to clogged, inflamed arteries, or atherosclerosis. Atherosclerosis is the #1 killer of Americans, and the primary cause of most heart attacks and strokes. Steer clear of these fats:
- Trans fats (such as margarine, vegetable shortening, and partially hydrogenated oils)
- Saturated fats (such as butter, palm oil, coconut oil, meat fats, and milk fats)
- Cholesterol (found ONLY in animal products such as meat and cheese, not plants)
2. Eat a lot more fiber-rich foods (especially soluble fiber from foods like beans, oats, barley, fruits, and vegetables).
A wealth of data from countries worldwide have found that populations with the lowest rates of heart disease follow a diet very high in natural, fiber-rich foods and low in fats. Some of the most compelling research, from Cornell University, tracked the eating habits of more than 6,500 people of China. It found that the traditional Chinese diet, high in unrefined, fiber-filled carbohydrates (77% of calories) and low in fat (about 15% of calories), was linked with very low levels of cholesterol and cardiovascular-related diseases.(6)
Foods plentiful in fiber have always been an important part of the Pritikin Program. Aim for a minimum of 35 to 50 grams of total fiber daily. Soluble fiber has proven particularly good at lowering cholesterol. Excellent sources include oats, oat bran, barley, peas, yams, sweet potatoes and other potatoes, as well as legumes or beans, such as pinto beans, black beans, and garbanzo beans. Vegetables rich in soluble fiber include carrots, beets, okra, and eggplant. Good fruit sources are berries.
3. Eat vegetable proteins (such as beans) in place of lean meat, poultry, and cow’s milk.
ALL beans, including pinto beans, black beans, lentils, red beans, and soy beans, are full of nutritional riches – and are a very healthy, protein-packed alternative to meat or poultry. Beans help lower total cholesterol, LDL cholesterol, blood sugar, and insulin levels, and may even lower cancer risk.
Think beans are boring? Oh, we beg to differ! Think ethnic, think spicy -- Middle Eastern hummus with roasted red peppers, Mediterranean minestrone, Southwestern black bean soup, curried lentils from India, Italian stew with spinach and cannelinni beans, Japanese edamame appetizers, and so much more.
When choosing products made from soy beans, stick to low-fat versions, like low-fat soymilk or 1% fat tofu, especially if you’re trying to lose weight.
4. Lose as much excess weight as possible.
Losing excess weight is beneficial for all sorts of reasons, from lowering LDL cholesterol to preventing diseases epidemic in industrialized, Western societies, including type 2 diabetes, high blood pressure, heart attacks, strokes, and many types of cancer.
The evidence in support of a fiber-rich diet to control weight is so strong that in their Dietary Guidelines for Americans, 2005, the nation’s top nutrition experts recommended that Americans choose whole grains over refined grains and increase their intake of fruits and vegetables to about 9 servings daily.
Fiber-rich, water-rich foods like fruits and vegetables are ideal for keeping the pounds off, the experts explained, because they are high-volume, filling, and satisfying without being high in calories.
5. Eat nuts and seeds in place of lean meat and poultry. (Just 1 to 2 ounces daily, or you’ll have trouble succeeding at Tip #4).
Nuts and seeds have been proven to modestly lower LDL cholesterol levels. To avoid blood-pressure-raising salt, choose raw or dry roasted, unsalted varieties. To avoid gaining weight, don’t eat more than 1 to 2 ounces daily since nuts and seeds are dense with calories (averaging about 175 calories per ounce). Also, don’t add them to the calories you’re already eating; rather, substitute them for other high-calorie, high-protein foods, like lean meat and poultry.
NOTE: The above steps contain the key food groups that have cholesterol-lowering properties. The supplements described in Tips 6 and 7 may provide additional LDL lowering.
6. Take plant sterol supplements.
Sterols are naturally occurring substances found in plants. A daily intake of 1 to 2 grams of plant sterols has been shown to lower LDL cholesterol levels.(7) Your best choice is supplements, such as Cholest-Off, because they do not have the calories, sugar, trans fats, and/or salt of many foods enriched with plant sterols.
7. Take psyllium.
Psyllium husks are seed grains sold as a soluble fiber supplement and laxative. Metamucil is the best known brand, but psyllium is also available in less expensive store brands. Studies have shown that 9 to 10 grams daily of psyllium, the equivalent of about 3 teaspoons daily of Sugar-Free Metamucil, reduced LDL levels.(8)
“If your LDL is still too high after trying these 7 nutrition-based approaches, talk to your doctor about cholesterol-lowering medications like niacin and statins, but give these 7 tips your best shot,” encourages Dr. Jay Kenney, Nutrition Research Specialist at the Pritikin Longevity Center. “The right diet can be powerfully beneficial – and there are no adverse side effects.”
1. JAMA, 2005; 294: 2437.
2. New England Journal of Medicine, 2004; 350: 15.
3. Archives of Internal Medicine, 2005; 165: 2671.
4. Archives of Internal Medicine, 1991; 151: 1389.
5. American Journal of Cardiology, 1997; 79: 1112
6. T. Colin Campbell, PhD, The China Study: Startling Implications For Diet,
Weight Loss and Long-Term Health, Benbella Books: 2005
7. British Medical Journal, 2000; 320: 861.
8. J Nutrition, 1997; 127: 1973.
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marilyn cassidy
said:
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what to do now? I eat only low cholesteral foods, salmon (broiled at least 2x a week, but mostly tofu and veggie recipies. My HDL and LDL do not reflect this. ( 205 and 89 ) . I cannot tolerate statins because of intense muscle aches. My doctor has just started me on Zetia instead of statins. Is this my genes catching up with me? My entire family died from heart realted problems. I am 76 y.o. and exercise by walking 3-4 miles every day - seven days with my dog. |
