Perhaps you’ve seen the series of commercials for Lipitor (atorvastatin) while watching your favorite TV programs. Lipitor is a cholesterol-lowering medication, according to the October 2009 edition of the AARP Bulletin, a turnover of over $ 5.88 billion were in 2008 alone. Needless to say, that buys a lot of advertising time. One of the main points in this “heart to heart” ads is that these drugs can be ‘bad’ (LDL) cholesterol by 39% -60%. The implication is that lowering LDL cholesterol may help reduce the risk of heart attacks and strokes. But there is a growing body of evidence suggests that another measure of cardiovascular health to the fore when assessing heart attack risk.
Way back in 1992, scientists at a “Health consensus conference” organized by the National Institutes of Health to discuss the possibility that high triglycerides and low HDL cholesterol may be an important factor in promoting heart disease. At that time there was only suggestive data to support this theory. The conclusion of this meeting was that patients should be urged to diet, exercise, smoking cessation and weight loss use “to TG (triglyceride) levels and / or raise HDL”. Since then, several large studies in both men and women reinforces the connection between the “triglyceride-to-high-density lipoprotein cholesterol ratio” (TG / HDL). (1)
- A study in the November 2009 issue of American Journal of Cardiology examined the link between high triglycerides / low HDL-cholesterol and the first time a heart attack in a group of 2288 middle-aged men. The authors concluded that “the TG / HDL ratio, a high predictive value of a first coronary even regardless of BMI (body mass index).” Another study conducted on 1,824 men found that younger people with the least desirable TG / HDL ratios were 75% more likely to suffer from coronary heart disease. This particular study followed participants for an average of 6.5 years. (2,3)
- The TG / HDL ratio appears to be a reliable marker of cardiovascular health in women. Recent research from the University of Alabama at Birmingham studied 544 middle-aged women who have never had a heart attack or heart-related surgery. In the course of approximately 6 years, the female participants were monitored through blood tests, coronary angiography and standard physical exams. There were a total of 33 deaths and 83 “cardiovascular events” during the test period. The strongest association was found between health markers and cardiovascular risk was the triglyceride / HDL ratio. The researchers found that a high TG / HDL ratio was responsible for a 95% increased risk of mortality and a 54% increase in cardiovascular events. An Italian study in 2005 found a “fourfold risk of death” in older women with the same combination of high triglycerides and low HDL cholesterol. (4,5)
The American Heart Association defines low HDL-cholesterol below 40 mg / dl for men and 50 mg / dL in women. An HDL level of 60 mg / dL or higher is mentioned as a possible protection against heart disease. The AHA points keeping triglycerides below 150 mg / dL mark. (6)
Based on this information, I’ve searched through the scientific literature for a number of natural options in the above TG / HDL ratio can improve finding. While doing this, I came across some research on a relatively obscure supplement that seems to benefit the heart in multiple ways.
Astaxanthin is a reddish pigments (carotenoids), which possesses powerful antioxidant properties. If you have eaten wild salmon, then you have consumed astaxanthin. It is the carotenoid that gives salmon its distinctive color. From a supplement standpoint astaxanthin is generally derived from an algae known as Haematococcus pluvialis (shown above) or krill oil.
A study appearing in the Oct. 14 issue of the journal Atherosclerosis effects of different doses of astaxanthin tested for HDL cholesterol. 61 “non-obese persons” with normal triglycerides and different ages (25-60 years) participated in this experiment 12 weeks. The subjects were divided and given 0 mg, 6 mg, 12 mg or 18 mg astaxanthin per day. The 12 mg dose showed the most effective way, both lowering triglycerides and elevating HDL levels. The researchers also found an increase in serum adiponectin, a hormone that helps the body maintain healthy blood sugar and lipid levels. Previous studies in animals and humans substantiate lipid effect. (7,8,9)
But there is much more to the story than just astaxanthin HDL cholesterol. Other research indicates that this valuable pigment can prevent lipid peroxidation in humans, the risk of arterial plaque accumulation may decrease. A study currently underway examining the effect on arterial stiffness in high-risk patients. In addition, astaxanthin reduces systemic inflammation that the progression of heart disease can promote. Finally, it seems to be free of serious side effects, with several human studies to support the positive safety profile. (10,11,12,13,14,15)
Effects of 4 mg astaxanthin on cardiovascular health
(A) Systolic blood pressure (B) Diastolic pressure (C) Triglycerides (D) Blood Glucose
Source: J Clin Nutr Biochem. 2009 May-44 (3): 280-284. (Link)
When it comes to high triglycerides, lifestyle changes are probably the best way to tackle the problem. Recent studies indicate that cutting back on most sweeteners is a good start. The December 2009 issue of the journal Physiology and behavior determined that feeding rats agave syrup, fructose and high fructose corn syrup significantly increased their triglyceride levels. This effect was not clear when the same rats were given the natural non-caloric sweetener stevia. Similar findings are embodied in people who are fed experimental diets rich in crystalline fructose. The message is clear: reduce your calorie sweeteners and processed foods that contain them and your cardiovascular system will thank you for. (16,17)
Some people have significantly elevated triglycerides. If you are one of them, there are two additional techniques that can dramatically improve your situation. A recent study conducted at the University of Connecticut, Storrs discovered that a diet low in carbohydrates (20-25% carbohydrates, 50-55% fat and 25-30% protein) triglyceride levels decreased by 39% in a group of 39 men and women for 12 weeks. A separate study published in August 2009 showed that in the short term (10 days) exposure to a “Paleolithic, hunter-gathering type diet” (with fruit, nuts, meat and vegetables only) caused “large significant reductions in total cholesterol , low-density lipoproteins (LDL) and triglycerides. ” (18,19)
Another powerful tool that can decrease triglyceride concentrations are found at your local drugstore or almost any pharmacy. High potency fish oil concentrates are available over-the-counter and through your doctor prescribed path. A recent medical research indicates that 4 grams of fish-based omega-3 fatty acids (total 1,395 mg EPA and DHA 1125) “can effectively TG (triglycerides) levels decrease to 45%, and is generally well tolerated. ” The recipe fish variety is usually much more expensive unless your insurance covers part of the cost. (20,21)
If a third-line approach is needed, try focusing on dietary fiber in your meal plan or this as a supplement. Some preliminary data suggest that adding fiber to a healthy diet can lower TGS. The advantage of this strategy is that, in general, fibers, is
thought also to lower LDL-cholesterol and may reduce the inflammatory substances, such as C-reactive protein which can also contribute to poor cardiovascular health. (22,23)
Finally, I would add that remain physically active is almost always a good idea if you’re worried about your heart or any aspect of your health. There is much evidence that supports this link. So 30 minutes of brisk walking can offset some of the adverse effects of occasionally eating too much sugar. 6 months worth of Kung Fu training can reduce long-term blood sugar levels (HbA1c), total cholesterol and triglycerides. As little as 8 weeks of high-intensity interval training is effective in improving the TG / HDL ratio. There really are many natural and safe options for improving heart health. I’m not saying that prescription drugs such as Lipitor does not have a place in medicine. There may be instances where a cardiologist truly believes she is the best option. However, today’s column presents an alternative to what you will likely be prescribed. If you mention your doctor that you want to try something different first, he would be willing to support your decision. At least that option should exist. It is your body. (24,25,26)