NMU – 207 Get Your LDL-Cholesterol into the Ideal Range to Prevent a Heart Attack

Nutrition/Natural Medicine Update No 207 (June 22, 2021)

with Dr. James Meschino

Topic: Get Your LDL-Cholesterol into the Ideal Range to Prevent a Heart Attack

Source: New England Journal of Medicine (2004); Cleveland Clinic (2019)

 
Recent studies have confirmed the recommendation I have made to patients over the last couple of decades, which entails doing everything possible to get your blood level of the bad cholesterol (LDL-cholesterol) into the ideal range to prevent a heart attack. According to the Cleveland Clinic, “everyone ages 20 and older should have their (blood) cholesterol checked at least every five years. The guidelines recommend you have a complete” lipoprotein profile” that measures total cholesterol, LDL cholesterol, high-density lipoprotein (HDL, the good cholesterol that may help prevent heart disease), and triglycerides, another type of fat in the bloodstream. The test should be performed after fasting (12 hours).” As they also state, “elevated low-density lipoprotein (LDL), the bad cholesterol, is a major cause of heart disease. LDL-cholesterol causes the build-up of fatty deposits within your arteries, reducing or blocking the flow of blood and oxygen your heart needs. This can lead to chest pain and heart attack…..and also causes problems such as stroke, kidney failure, and poor circulation.” We’ve known much of this for many years, but what is becoming increasingly clear is the ideal blood level of LDL-cholesterol to prevent heart attacks and other cardiovascular problems.

In high-risk patients, the LDL-cholesterol target has been adjusted down to 60 mg/dL or less (1.5 mmol/L) from the previous 70 mg/dL (1.8 mmol/L). The problem is that in medical circles the acceptable target LDL-cholesterol levels is listed as anything value less than 100 mg/dL (2.6 mmol/L) for patients without other risk factors for heart disease and for those who have not had a previous heart attack or stroke. To me, this recommendation makes no sense at all when you consider that cardiovascular is a leading cause of death in our society.

In my view, every adult should strive to get their LDL cholesterol down to 60 mg/dL (1.5 mmol/L) or lower as an important means to prevent blockages from forming in the coronary blood vessels in the heart and elsewhere in the body. I have made this a personal goal for myself over the years and have encouraged others to do the same. This is how you prevent plaque from building up in the artery wall in the first place. Now, we know that high LDL cholesterol is not the only risk factor for heart disease and stroke, but it is one of the very most important risk factors.

As such, I recommend that you know your LDL-cholesterol number. If its above 60 mg/d/L. or 1.5 mmol/L, then you should strongly consider becoming more aggressive in your lifestyle practices to lower your LDL cholesterol. This means eating less or no high-fat animal foods like beef, pork, and lamb, as well as any milk or yogurt containing more than 1% milkfat. It also means avoiding cheese, butter, cream, ice cream, whipped cream, sour cream, and other high-fat dairy products. It means avoiding mayonnaise, tahini sauce, cream sauces, and creamy salad dressings, as well as milk chocolate, coconut oil, palm oil, and most pastries, especially pie crusts and the icing on and layered into many cakes. You can also lower your LDL cholesterol by avoiding deep-fried foods and foods containing trans-fats. On the other hand, foods containing soluble fiber help to lower LDL-cholesterol, which include all types of beans and peas (including soybeans and soy products), oats and oat bran, as well as artichokes, ground flaxseeds, psyllium husk fiber, and fibrous fruits such as apples, pears, and plums.

If all these dietary practices don’t get your LDL-cholesterol into the ideal range (below 1.5 mmol/L), then speak to your doctor about taking a statin drug to help you accomplish this goal or consider taking a supplement of Red Yeast Rice, which is a natural source of the active compound used in some statin drugs to lower cholesterol. The natural agent is monacolin K, which, like statin drugs, blocks cholesterol synthesis in your body and possibly the absorption of cholesterol from the intestinal tract. If you use a Red Yeast Rice supplement you must ensure it is a standardized grade (for example 110 mg capsule standardized to 3% monascin and 1% ankaflavin).  However, whether you take a statin drug or Red Yeast Rice, it requires monitoring by your physician for potential side effects, including liver damage, the triggering of diabetes, memory loss and other issues. So, where possible get your LDL-cholesterol level into the ideal range through the prudent dietary strategies I’ve outlined, as well as remaining physically active.

I have included the references for this information in the text below.

References:

1. https://my.clevelandclinic.org/health/articles/16866-cholesterol-guidelines–heart-health

2. https://www.nejm.org/doi/full/10.1056/NEJMoa040583

Eat Smart, Live Well, Look Great

Dr. Meschino