For Cholesterol Control, Experts Urge More Than Meds
TUESDAY, Dec. 28 -- Advances in medical science have made it easier than ever to lower dangerous cholesterol levels.
A class of cholesterol-lowering drugs known as statins have proven particularly effective, reducing the risk for heart-related death by as much as 40 percent in people who have already suffered a heart attack, said Dr. Vincent Bufalino, president and chief executive of Midwest Heart Specialists and a spokesman for the American Heart Association.
"People have said we need them in the drinking water because they are just so effective in lowering cholesterol," Bufalino said.
But he and other doctors warn that when it comes to controlling cholesterol and enjoying overall health, nothing beats lifestyle changes, such as a heart-friendly diet and regular exercise.
"Once we became a fast-food generation, it's just too easy to order it at the first window, pick it up at the second window and eat it on the way to soccer," Bufalino said. "We need to get you to change now or you're going to end up as one of these statistics."
Folks with high cholesterol often are overweight, and if they deal with their cholesterol through medication only, they leave themselves open to such other chronic health problems as diabetes, high blood pressure and arthritis, said Alice Lichtenstein, director and senior scientist at the Cardiovascular Nutrition Laboratory of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Medford, Mass.
The thought of controlling cholesterol solely through medication is "an unfortunate point of view," Lichtenstein said. "There are a lot of other factors, especially when it comes to body weight, that the medications won't help. The idea that 'I'll just take medications' isn't a very healthy option, especially for the long term."
That point of view seems to be bolstered by new evidence that using cholesterol-lowering drugs won't necessarily help a person who hopes to avoid heart disease.
British researchers who pooled and re-analyzed data from 11 cardiovascular studies found that taking statins did not reduce cardiac deaths among people who had not developed heart disease.
The finding has been questioned, however, by some medical experts, who note that the research did find an overall reduction in cholesterol levels linked to statin use. "I have to tell you that belies a lot of the other science," Bufalino said of the study.
High cholesterol is strongly connected to cardiovascular disease, which is the leading cause of death in the United States, according to the American Heart Association. Nearly 2,300 Americans die of cardiovascular disease each day -- an average of one death every 38 seconds.
Cholesterol, which is a waxy substance, occurs naturally in the human body. In fact, the body produces about 75 percent of the cholesterol needed to perform important tasks, which include building cell walls, creating hormones, processing vitamin D and producing bile acids that digest fats, according to the U.S. National Institutes of Health. The other 25 percent of a person's cholesterol is ingested in foods that are eaten.
But many people's diets include the wrong type of cholesterol. They eat foods loaded with saturated fats or trans fats, which increase levels of low-density lipoprotein (LDL) cholesterol in the bloodstream.
LDL, the so-called "bad" cholesterol, forms plaques on the sides of artery walls, narrowing the arteries and forcing the heart to work harder to pump blood. Saturated fats are found in most animal products, and trans fats are found in processed foods that contain hydrogenated oils.
But other foods are rich in "good" cholesterol: high-density lipoprotein (HDL) cholesterol. It acts as the bloodstream's garbage truck by rounding up and hauling off some of the bad cholesterol.
These days, it's easier than ever to choose foods that contain lots of good cholesterol and little to no bad cholesterol, Lichtenstein said.
There are lots of healthy choices, including low-fat or nonfat dairy products, lean cuts of meat, poultry, fish, vegetables and grains, she said.
And for people who want to buy a processed food, the Nutrition Facts label on every product explicitly states the amount of fat it contains.
"From a consumer's perspective, it's easier than ever to restrict saturated fat and trans fatty acids," she said. "It's just a matter of doing it."
People also can lower their cholesterol by eating foods that contain lots of dietary fiber. Soluble fiber has been found to draw cholesterol out of the bloodstream, Bufalino said. Such foods, including oatmeal and whole-grain bread, are an important part of a cholesterol-fighting diet.
But beating cholesterol takes additional steps as well. Because high cholesterol is closely linked to being overweight or obese, losing pounds is critical -- as is keeping them off. And that means exercising as well as eating right.
Exercising as little as 30 minutes every day can reduce a person's risk for heart disease, according to the American Heart Association. Even more exercise can help achieve greater weight loss.
The important thing is to remain dedicated to your own health, Bufalino said.
"People can be good with it for a while, but it's hard to stay disciplined all the time," he said. "We don't need folks to be perfect. If you can be good 80 to 90 percent of the time, that's great. That's all we need from people."
The American Heart Association has more on cholesterol.
For more on the effects of high cholesterol, read about one woman's story.
Posted: December 2010
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