At the end of 2014 Federal health officials reported that more Americans than ever are taking cholesterol-lowering medications. And according to the U.S. Centers for Disease Control and Prevention, the percentage of adults aged 40 and older taking drugs for high cholesterol rose from 20% to 28% between 2003 and 2012.
Why? Statins have a very impressive track record of lowering the “bad “cholesterol i.e. LDL, sometimes by as much as 50%. However…. what about the real goal? i.e. reduction in the risk for heart attacks?
Unfortunately those results are not impressive at all. What’s worse is that statins can have serious side effects. Most statin studies don’t show a reduction in mortality. More often than not, they’re used for primary prevention i.e. to lower LDL in those who haven’t been diagnosed with heart disease.
Barbara H. Roberts, MD, of the The Miriam Hospital talks about this in her book,The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs. She was interviewed by Bottom Line/Personal.
Dr Roberts poses the question…..Is LDL really the enemy?
“For decades, the public health message hasn’t changed. High cholesterol –particularly high levels of LDL cholesterol –leads to atherosclerosis, blood clots and heart attacks.
Yet many important studies, including the Framingham Heart Study, have shown that most patients who have had a heart attack have cholesterol levels that are nearly identical to those who haven’t. Also, many experts believe that HDL “good” cholesterol is a more important predictor of heart disease than LDL.”
She reports that statins can lower the risk for recurrent heart attack by a small amount in people who already have had one. In people who haven’t been diagnosed with cardiovascular disease, the use for statins reduced the risk for heart attacks and other cardiovascular events by a paltry 1% to 2%.
Serious Side Effects of Statins
Dr Roberts also addresses the side effects, some of which are serious…. like reducing blood levels of CoQ10, which is involved in energy production inside cells. Low CoQ10 has been linked to heart failure, hypertension, fatigue and “mental fog”.
The most common side effect of statin therapy is myalgia, or muscle pain.
The pain is usually mild, but the risk and the severity increases when taking higher doses.
Rhabdomyolysis is a severe form of statin-related muscle damage that can lead to kidney failure, which can be fatal.
She says that the side effects are an acceptable trade off when drugs truly save lives but she says this isn’t the case for the vast majority of patients who take statins.
She sites 2 exceptions:
- if you have high LDL and have had a heart attack….or
- if you have been diagnosed with cardiovascular disease (or diabetes if you are a man), a statin can make sense.
She also recommends statins to patients who have had familial hypercholesterolemia, sky-high cholesterol caused by a genetic abnormality.
“I advise most patients to work on their diets before resorting to statins. Dietary changes can increase HDL and reduce triglycerides, which is more important than reducing LDL, says Dr Barbara Roberts.
Dietary Changes for Lowing Cholesterol
Here’s the diet she recommends. It’s based on the Lyon Diet Heart study that showed conclusively that heart attack patients who followed a Mediterranean-type diet, greatly improved their odds of never having another heart attack. They were eating more whole grains, vegetables, fruit and fish, and less beef, lamb and pork, among other factors. They were compared to those who followed a “prudent” Western Diet.
They were 56% less likely to die from any cause…65% less likely to suffer cardiac death…and 70% less likely to have a heart attack.
She comments that you might assume patients in the Mediterranean diet group had lower LDL. But that was not the case. She tells us that their LDL was roughly the same as that of people in the control group, which is further proof that you don’t need to reduce LDL to improve cardiovascular risks.
Asked why the Mediterranean diet was so effective? She says that some credit goes to olive oil and fish and antioxidant-rich fruits and vegetables. The diet is also low in pro-inflammatory omega-6 fatty acids that we get from corn oil and other vegetable based oils. And also high in fiber.
Dr Robert’s other recommendations are:
- Extra virgin olive oil that are is rich in phytochemicals.
- Don’t worry about saturated fat, like, dairy fat, as its an effective way to increase HDL. It’s true that saturated fat raises LDL –but only the “fluffy” LDL particles that are largely benign.
- Seafood a few times a week, like salmon and tuna a few times a week. It reduces the risk for cardiovascular disease.
- Enjoy your wine.… no more than 2 drinks a day for men and 1 for women, has been shown to reduce the risk for heart disease. Red wine may be particularly helpful because it is high in antioxidants.
- Say ‘no’ to “white” foods because simple carbohydrates like white bread, white rice, white pasta and some breakfast cereals cause a surge of insulin, which in turn increases the risk for cardiovascular disease.
- Exercise … get at least 150 minutes of moderate-intensity exercise a week like brisk walking, biking, and swimming.
“People want some kind of magic powder to sprinkle on their food to lower cholesterol, but the best alternative treatment is weight loss and eating better, exercise, and quitting smoking, which will give you the best results and may allow a person to avoid medications entirely,” says Alice H. Lichtenstein, MD, professor of nutrition at Tufts University and spokeswoman for the American Heart Association.
Aside from lifestyle changes that include dietary changes and regular exercise, which supplements are helpful? Take a look at Good Gut Solution’s Cholesterol Care Category. There’s a great, selection of effective supplements.