The American Heart Association (AHA) and the American College of Cardiology (ACC) recently updated their cholesterol guidelines to reduce the risk of cardiovascular diseases (Stone, November 12, 2013). This is the first major change in these national guidelines since 2004.
The previous guidelines focused on achieving ideal numbers for total serum cholesterol as well as HDL, LDL, and triglyceride levels. However, the AHA and ACC are now shying away from the numerical goals for cholesterol and instead are focusing on a person’s “risk category.” There are only two risk categories. The high-risk group includes people with diabetes, a history of a heart attack, or extremely high levels of LDL. They recommend prescription intervention with statin-type drugs for all people in this group. Among people in the lower risk category, statin-type drugs are still recommended for those with a 7.5% risk of heart attack or stroke within the next 10 years. This risk is determined by a new risk calculator which takes into account age, blood pressure, total cholesterol, HDL, age, race, and status as a diabetic or smoker. People should discuss their health with their general care practitioner to evaluate their risk for developing cardiovascular diseases.
While statins have shown marked success in helping many people improve undesirable cholesterol levels, they also may bring with them side effects that are less than desirable: memory loss, mental confusion, high blood sugar, and muscle pain. Other common, but less severe side effects may include a headache, insomnia, flushing, fatigue, dizziness, nausea, gastrointestinal distress, or skin rash.
Lower Cholesterol with Easy Diet Changes
balanced healthful diet should not have the largest portion of the meal or most commonly eaten foods be steak and eggs. The foods that should make up the lion’s share of your diet are vegetables, fruit, whole grains, nuts, seeds and legumes. These foods are high in soluble fiber, which has been shown to reduce cholesterol. (2)
The recommendation is 25-30 grams of fiber per day. If you incorporate fiber at every meal and with snacks, then you will have no problem meeting recommendations. An example of a days worth of fiber would be: ½ cup oatmeal, 1 medium apple with skin, 2 plain rye crackers, ½ cup kidney beans, ½ avocado, 1 ounce almonds, ¼ cup whole grain pasta noodles.
The main source of protein in your diet should be all types of seafood and then poultry, eggs, milk and yogurt. Lastly include red meat and sweets in small portions. When considering fats, focus on increasing the amount of mono-unsaturated fats like olive, canola, sesame and peanut oil.
I have just described the popular Mediterranean diet. My hope is that you now have an idea of how you could incorporate some it’s components. The reason for my hope is that this diet showed to reduce mortality from cardiovascular disease by 9% in meta-analysis. (3)
For those who would prefer to steer clear of prescription statins, supplements may be a good alternative.
Red yeast rice
This contains a natural statin, mevastatin, (Monacolin K) shown effective at improving cholesterol and triglyceride levels in several research studies. Red yeast rice contains much less Monacolin K than prescription statin drugs. However, the Monacolin K in red yeast rice works synergistically with other compounds in the extract to produce a greater effect on cholesterol levels than with Monacolin K alone. Mild and occasional side effects have been reported by some people taking red yeast rice, which include heartburn, gas, and dizziness. (A7 Health Notes, 2013)
Garlic has shown promise in research at improving cholesterol levels, lowering triglycerides, and lowering blood pressure. (A7 Health Notes, 2013) For those not interested in consuming raw cloves of garlic daily, capsules of standardized extracts are available.
Guggul comes from the yellow resin of the Mukul Myrrh tree, native to India. This resin has been used medicinally as a part of the Ayurvedic Medicine tradition for thousands of years. Recent research has shown Guggul to be helpful in lowering blood cholesterol and triglyceride levels.
When making dietary and lifestyle changes such as including supplements to support heart health remember to maintain the right perspective and focus on what you can do and what you can have instead of what you cannot.
- 2015–2020 Dietary Guidelines for Americans. N.p., n.d. Web. 01 June 2017.
- Glore SR, Van Treeck D, Knehans AW, Guild M. Soluble fiber and serum lipids: a literature review. J Am Dietet Assoc1994;94:425-36.
- Sofi, F., et al. “Adherence to Mediterranean diet and health status: meta-analysis.” BMJ. 2008:337:a1344.
- A7 Health Notes. (2013). Garlic. Retrieved from Aisle 7: http://web.aisle7.net/api/1.0/us/assets/nutritional-supplement/garlic/uses?apikey=91797caf0e114e47b47009576575f611
- A7 Health Notes. (2013). Red Yeast Rice. Retrieved from Aisle 7: http://web.aisle7.net/api/1.0/us/assets/nutritional-supplement/red-yeast-rice/uses?apikey=91797caf0e114e47b47009576575f611
- Stone, N. J. (November 12, 2013). 2013 ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardkovascular Risk in Adults: A Report of the Amercian College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation: Journal of the American Heart Association, online.