FDA Considering Statin Use for Those With Normal Cholesterol

MONDAY, Dec. 19, 2009 (Health.com) — Should people who dont have high cholesterol take a cholesterol-lowering statin? Maybe, according to the U.S. Food and Drug Administration (FDA), which is considering an advisory panels recent recommendation to do just that.

If the FDA adopts the panel’s recommendation–the agency isn’t required to do so, but typically does in such cases–it would mark the first time that a statin was approved for heart-disease-free people with healthy cholesterol levels but other risk factors, including high levels of C-reactive protein (CRP), a marker of inflammation.

It would also mean that roughly 6 million new patients would be eligible to take a statin–in this case, Crestor (rosuvastatin).

The recommendation “changes medical practice dramatically [and] will work its way into the guidelines,” says Steven E. Nissen, MD, the chairman of cardiovascular medicine at the Cleveland Clinic.

Cardiologists are divided over the expanded use of the drug. Some say it will help fight heart disease; others are concerned about the data used by the panel and the potential side effects of statins. Adding to the debate is a new study, published this week in The Lancet, that calls into question the strength of the connection between CRP and heart disease.

The panel’s decision was based almost entirely on the Jupiter trial, a study funded by Crestors maker, AstraZeneca, that compared a daily dose of Crestor to placebo in nearly 18,000 people who fit the description used by the panel (and who would not be eligible for a statin under the current guidelines).

“There was a 44% reduction in death, heart attack, and stroke among people taking Crestor,” says Dr. Nissen. “The benefit was very large and happened very quickly.”

“I dont think the new labeling recommendation is really controversial,” he adds. “The decision was very straightforward and among the people who treat lipids, this is a no-brainer.”

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17 Ways to Burn More Calories All Day

Looking to zap more calories? Here are 17 stealth ways to crank up your potential.

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by Jenna Autuori-Dedic

From Health magazine

If you can get to the gym every day and blast off 500 calories, then that’s awesome–but if you follow up a morning workout by sitting at a desk for 8 hours, then you may not be too pleased with how long it takes you to start noticing weight falling off. Luckily, there are stealth ways you can turn up your calorie burn all day long. Lose more weight in less time with these expert tips.

Next: Rise and sweat

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20 Foods You Should Always Have in Your Kitchen

Cooking healthy meals and choosing smart snacks is easy when you keep your pantry stocked with these healthy staples.

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by Jessica Migala

A well-stocked kitchen allows you to throw together a fast, flavorful meal after a long day. And, when you wake up and have to dash out the door for work, it pays to have grab-and-go breakfast and snack options on hand. We tapped registered dietitians, personal chefs, and bloggers for their must-have foods to always keep in their kitchens. (And yes, they’re all good for you, too.) Some you probably already have, while others you’ll want to add to your list.

Next: Extra-virgin olive oil

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The Top 5 Cholesterol Myths

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American men rank 83rd in the world in average total cholesterol.

(ISTOCKPHOTO)

Even if you think you know everything there is to know about cholesterol, there may be a few more surprises in store. Check out these common myths about high cholesterol; find out whos most likely to have it, what types of food can cause it, and why–sometimes–cholesterol isnt a bad word.

Myth 1: Americans have the highest cholesterol in the world

One of the world’s enduring stereotypes is the fat American with cholesterol-clogged arteries who is a Big Mac or two away from a heart attack. As a nation, we could certainly use some slimming down, but when it comes to cholesterol levels we are solidly middle-of-the-road.

The Cholesterol-Inflammation Connection

Inflammation is cholesterol’s partner in crime  Read more

According to 2005 World Health Organization statistics, American men rank 83rd in the world in average total cholesterol, and American women rank 81st; in both cases, the average number is 197 mg/dL, just below the Borderline-High Risk category. That is very respectable compared to the top-ranked countries: In Colombia the average cholesterol among men is a dangerous 244, while the women in Israel, Libya, Norway, and Uruguay are locked in a four-way tie at 232.

Myth 2: Eggs are evil

It’s true that eggs have a lot of dietary cholesterol–upwards of 200 mg, which is more than two-thirds of the American Heart Association’s recommended limit of 300 mg a day. But dietary cholesterol isn’t nearly as dangerous as was once thought. Only some of the cholesterol in food ends up as cholesterol in your bloodstream, and if your dietary cholesterol intake rises, your body compensates by producing less cholesterol of its own.

While you don’t want to overdo it, eating an egg or two a few times a week isn’t dangerous. In fact, eggs are an excellent source of protein and contain unsaturated fat, a so-called good fat.

http://www.health.com/health/condition-article/0,,20259746,00.html

12 Superfoods for Stress Relief

Get smart about stress-eating. Skip the chips and fill up on these potentially anxiety-reducing foods.

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by Lindsay Funston

When work deadlines begin piling up and your social calendar is booked, the last thing you want to hear is to steer clear of the vending machine. Who has time for healthy eating? But when it comes to combating stress levels, what you eat may actually help relieve your tension. Indeed, some foods may help stabilize blood sugar or, better yet, your emotional response. Here, 12 foods to reach for when you’ve just about had enough.

Next: Green leafy vegetables

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12 Superfoods for Stress Relief

Get smart about stress-eating. Skip the chips and fill up on these potentially anxiety-reducing foods.

superfoods-stress-relief

Credit: Getty Images

by Lindsay Funston

When work deadlines begin piling up and your social calendar is booked, the last thing you want to hear is to steer clear of the vending machine. Who has time for healthy eating? But when it comes to combating stress levels, what you eat may actually help relieve your tension. Indeed, some foods may help stabilize blood sugar or, better yet, your emotional response. Here, 12 foods to reach for when you’ve just about had enough.

Next: Green leafy vegetables

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Running With Your Dog: 17 Dos and Don’ts

Health, safety, and behavioral tips for logging miles with your four-legged fitness partner.

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by Amanda MacMillan

Your dog may be the ultimate exercise partner. Think about it: dogs are always eager to spend more time with you, they have plenty of excess energy to burn, and temptation to skip a scheduled sweat session melts away when your furry friend stands at the front door, leash in mouth, ready to log a few miles with you.

Before you hit the pavement, though, you’ll need to train your pooch to run with you. Here’s how to make your run enjoyable and rewarding for both you and your best (furry) friend.

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Menopause Causes Cholesterol Jump, Study Shows

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FRIDAY, Dec. 11, 2009 (Health.com) — Doctors have known for years that a woman’s risk of developing heart disease rises after menopause, but they weren’t exactly sure why. It wasn’t clear whether the increased risk is due to the hormonal changes associated with menopause, to aging itself, or to some combination of the two.

Now, we have at least part of the answer: A new study shows beyond a doubt that menopause, not the natural aging process, is responsible for a sharp increase in cholesterol levels.

This seems to be true of all women, regardless of ethnicity, according to the study, which will be published next week in the Journal of the American College of Cardiology.

“As they approach menopause, many, many women show a very striking increase in cholesterol levels, which in turn increases risk for later heart disease,” says the lead author of the study, Karen A. Matthews, PhD, a professor of psychiatry and epidemiology at the University of Pittsburgh.

Over a 10-year period, Matthews and her colleagues followed 1,054 U.S. women as they went through menopause. Each year the researchers tested study participants for cholesterol, blood pressure, and other heart disease risk factors such as blood glucose and insulin.

In nearly every woman, the study found, cholesterol levels jumped around the time of menopause. (Menopause usually occurs around age 50 but can happen naturally as early as 40 and as late as 60.)

In the two-year window surrounding their final menstrual period, the women’s average LDL, or bad cholesterol, rose by about 10.5 points, or about 9%. The average total cholesterol level also increased substantially, by about 6.5%.

Other risk factors, such as insulin and systolic blood pressure (the top number in a blood pressure reading), also rose during the study, but they did so at a steady rate, suggesting that the increases–unlike those for cholesterol–were related to aging, not menopause. Of all the risk factors measured in the study, the changes in cholesterol were the most dramatic.

The jumps in cholesterol reported in the study could definitely have an impact on a womans health, says Vera Bittner, MD, a professor of medicine at the University of Alabama at Birmingham, who wrote an editorial accompanying Matthewss study.

“The changes don’t look large, but given that the typical woman lives several decades after menopause, any adverse change becomes cumulative over time,” says Dr. Bittner. “If somebody had cholesterol levels at the lower ranges of normal, the small change may not make a difference. But if somebody’s risk factors were already borderline in several categories, this increase may tip them over the edge and put them in a risk category where treatment may be beneficial.”

In a first, the study did not find any measurable differences in the impact of menopause on cholesterol across ethnic groups.

Experts have been unsure how ethnicity may affect the link between menopause and cardiovascular risk, because most research to date has been conducted in Caucasian women. Matthews and her colleagues were able to explore the role of ethnicity because their research is part of the larger Study of Womens Health Across the Nation (SWAN), which includes substantial numbers of African-American, Hispanic, and Asian-American women.

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Fats You Can—and Should—Eat

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It’s just not fair: Fat got a bad rap decades ago because scientists assumed, based on the misinterpretation of a couple of large studies, that eating foods containing fat would lead directly to obesity and heart disease. Fatty foods were made out to be our sole dietary vice, responsible for raising our cholesterol levels, clogging our arteries, and causing us to get, well, fat.

And that made a kind of intuitive sense–why wouldn’t the fat you consume wind up as the fat you see on your butt and thighs? But “the low-fat diet backfired,” says Frank Hu, MD, professor of nutrition and epidemiology at the Harvard School of Public Health. “America’s obesity epidemic skyrocketed even while our fat intake went down.” So experts are getting off the “fat is evil” bandwagon these days–and we should, too.

The upside of eating fat

Like carbohydrates and protein, fat is an essential nutrient. This means that your body requires it for key functions, such as absorbing the fat-soluble vitamins A, D, E, and K. “Fat is also an important energy source and is vital for keeping your skin and hair healthy and smooth,” says Bonnie Taub-Dix, RD, author of Read It Before You Eat It.

Even more surprising: Research is revealing that eating the right fats can actually lower your risk of diabetes, heart disease, and obesity, and improve your cholesterol levels. That’s because all fats are not created equal, Dr. Hu points out. It’s not the total amount of fat in your diet that affects how much you weigh or whether you’re at risk for heart disease, according to rigorous studies from the past decade. What matters is the type of fats you choose (and, when it comes to dropping pounds, the total number of calories you eat). Here’s a breakdown.

Good fats

Monounsaturated fatty acids (MUFAs)

Found in plant foods like nuts, avocados, olive oil, and canola oil, and in poultry

MUFAs can actually lower cholesterol levels, and, in doing so, your risk of heart disease. In fact, a Journal of the American Medical Association study showed that replacing a carb-rich diet with one high in monounsaturated fats can do both, and reduce blood pressure, too.

Polyunsaturated fatty acids (PUFAs)

Found in fatty fish such as salmon and mackerel, and corn and soybean oils

Like MUFAs, PUFAs have been shown to improve cholesterol levels and reduce heart disease risk. One type is the omega-3 fatty acid, which is plentiful in some kinds of fish–not to be confused with omega-6 fatty acids, found in meats, corn oil, and soybean oil. Some research finds that Americans eat about 20 times more omega-6 than omega-3; we should be aiming to get closer to four times as much. To do so, Dr. Hu says, sub in fish for meat when you can.

Ok-in-moderation fat

Saturated fat

Found in meat and dairy products such as cheese, butter, and milk

We’ve been warned for decades to eat less saturated fat–after all, it raises “bad” (LDL) cholesterol levels, and thus, it was assumed, ups your risk of heart attack and stroke. Lately, though, research has begun to vindicate it. For instance, a 2010 American Journal of Clinical Nutrition review of 21 studies was unable to find a link between saturated fat consumption and heart disease or stroke. Some types have been entirely exonerated: “Stearic acid, found in dark chocolate, is clearly non-harmful,” says David L. Katz, MD, director of the Yale University Prevention Research Center. The same may be true of lauric acid, a type of saturated fat abundant in coconut oil, but there’s not enough evidence to say for sure, Dr. Katz says.

While some experts, like Dr. Katz, say there’s no downside to cutting out saturated fats, others believe keeping them in the mix helps us avoid getting too many bad-for-you refined carbohydrates instead. Bottom line: You don’t need to ban them. Just make sure most of your fat intake is unsaturated, eat red meat only once or twice a week, and use olive oil instead of butter when possible.

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