The Statin Alternative By Leigh Erin Connealy, M.D.

High cholesterol, a major risk factor for cardiovascular disease, affects nearly 26% of all adults and an additional 100 million Americans are considered borderline high.  Considering these statistics, it’s entirely possible that you or a loved one is living with this potentially dangerous health problem.  In 2001 Americans filled over 57 million prescriptions for the cholesterol-lowering drug, Lipitor, making it one of the highest prescribed pharmaceuticals in history.  But is this medication necessary to lower high cholesterol or are you needlessly subjecting yourself to the drugs’ potentially debilitating, and sometimes even life-threatening, side effects?  It’s true that statin medications do lower cholesterol levels, but there is a much healthier proven option: healthy eating habits and exercise! 

Cholesterol is a wax-like substance found in both your bloodstream and every cell in your body.  Proper levels of cholesterol are vital to your health as it’s necessary for producing cell membranes and several important hormones including the male and female sex hormones and the adrenal hormones.  Too much cholesterol however, can cause cardiovascular disease and result in heart attack or stroke.

Cholesterol is produced by the liver but also comes from animal products such as meat, poultry, fish, eggs, butter, cheese and whole milk.  As a matter of fact, the liver creates all of the cholesterol that the body requires and any cholesterol derived from food is considered excess. 

Cholesterol, like other fats, doesn’t dissolve in your bloodstream and needs to be transported to and from cells by special carriers called lipoproteins.  There are two types of lipoproteins: low density lipoproteins (LDL) and high density lipoproteins (HDL).  LDL is known as the “bad” cholesterol because it builds up in the bloodstream, clogging arteries and increasing risk for heart attack and stroke.  HDL, on the other hand, is considered the “good” cholesterol because it mops up the LDL cholesterol and transports it to the liver to be excreted from the body.  For this reason, it is important to have low levels of LDL and high levels of HDL.  An LDL score of 100 mg/dL or less is considered optimal, while anything higher is cause for concern.  An HDL score of 40 or higher is desirable since lower levels are linked to higher incidence of cardiovascular disease.  Total blood cholesterol is the most common measurement of cholesterol and the number that you normally receive as your test result.  A total blood cholesterol level of 200 mg/dL or lower is ideal.  A higher total blood cholesterol level indicates an elevated risk for cardiovascular disease.

Adults with high cholesterol are often offered statin medications as a first line of defense in lowering both their cholesterol level and their risk of heart attack and stroke.  Statin drugs work by blocking the production of cholesterol in the liver, thereby lowering the levels of cholesterol in the bloodstream.  Unfortunately, blocking the production of cholesterol interferes with the production of hormones and vitamin D, which can result in a loss of sex drive, feelings of fatigue and poor bone density.  Additionally, common side effects of statin medications include memory loss, muscle soreness and deterioration, upset stomach, gas, bloating and abdominal pain.

A recent study in the American Journal of Clinical Nutrition found that adding foods like tofu, almonds, fibers, plant sterols and soy products into your daily eating plan can lower total cholesterol more effectively than statin medications.  The most effective cholesterol lowering fibers can be found in oat bran, barley, flax seed, apples, citrus fruits, lentils and beans.  Plant sterols can be found in small amounts in foods such as whole grains, vegetables, fruits and vegetable oils and to a larger degree in spreads such as Smart Balance and Benecol.  Combining a dietary intake of these foods along with lowering your intake of saturated fats is the most effective way to lower your total cholesterol.  Additionally, stay away from partially hydrogenated and hydrogenated fats (such as margarine and shortening), which are sources of trans fatty acids known to increase LDL (“bad” cholesterol) and lower HDL (“good” cholesterol). 

Research has also shown that taking a daily essential fatty acid supplement (such as flax seed oil or fish oil) can help to lower cholesterol and protect the heart.  The fatty acid not only decreases the rate at which the liver produces LDL cholesterol but it also has an anti-inflammatory effect in the body, decreases the growth of plaque in the arteries and aids in thinning the blood.

If your HDL cholesterol level is low you can help increase it by losing weight or maintaining a healthy weight, quitting smoking and being physically active for at least 30 to 60 minutes a day on most or all days of the week.  Researchers have also found that supplementing with niacin (vitamin B3) is highly effective at increasing HDL levels while lowering LDL levels and preventing atherosclerosis.

Make an appointment today to have your cholesterol levels checked.  HDL levels of 40 mg/dL or lower, LDL levels of 130 mg/dL or higher or a total blood cholesterol level higher than 200 mg/dL all indicate an elevated risk for heart disease.  Should you have high cholesterol, discuss with your doctor your options and only consider statins as a last resort.  Dietary changes and exercise can prove to be more effective than medication and can have a positive and lasting impact on your overall health, without the negative side effects!

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