On Tuesday, November 12th, the American Heart Association and the American College of Cardiology jointly published prevention guidelines. The guidelines focus on the treatment of blood cholesterol to reduce heart disease, lifestyle management to reduce heart disease, overweight/obesity management, and cardiovascular risk assessment. These new guidelines call for a focus on risk factors and not just cholesterol levels.
Up until now, the focus has been on “bad” cholesterol — LDL cholesterol — levels and the need to keep LDL cholesterol below 100 mg/dL. Instead of using LDL cholesterol levels to determine if cholesterol lowering statin drugs should be prescribed, the new guidelines look at risk factors.
Here are four questions used to assess risk:
Base on the new guidelines, if your answer was “yes”, to any of the above four questions, you should be prescribed a statin medication. If you answered “no” to all, then lifestyle and behavior modification should be adequate to manage high cholesterol.
How do you know if your 10-year risk of a ASCVD event is greater than 7.5%? Continue reading
It’s very easy to let media hype influence eating choices. A new study comes out telling you this or that food increases your risk of having a heart attack and that food is off the menu. It’s hard to remember that the media is trying to get your attention. They need you to keep reading or watching whatever information they share. So, they are going to take a study (whether it is a solid study or not) and sensationalize it to keep your interest. Doesn’t mean the whole story is going to be fully shared.
This puts you at a disadvantage because you may not have the background to determine if the information shared is valid or not. How do you know if the study was peer reviewed? How do you know if the results have a statistical significance? How do you know if the study was funded by a company with a conflict of interest that caused results to be skewed in the direction they wanted? There are many factors to consider when determining the validity of study results.
Yes, you need to be aware of new research being conducted, but don’t let the TV, newspaper, magazine, etc. be the final determinant on what is a healthy food choice and what is not.
Here are a few foods that have been impacted by such media hype:
Maintaining a healthy weight does not mean you are free from heart disease risk. New research indicated body fat percent plays a role.
Data published in the American Journal of Cardiology online August 29th, reviewed over 1500 older adults with a normal body mass index (BMI). BMI is a measure of how your weight relates to your height. Here is a link to calculate your BMI. Researchers found one in five men and close to one in three women had unhealthy high body fat percentages. A high body fat percentage was defined as above 25 percent for men and above 35 percent for women.
The study found that women with high body fat percentages were at 57% higher risk of dying from a heart-related cause versus women with a healthy body fat. Men with excess body fat were also found to be at greater risk. Those with high levels of body fat were more likely to live with high blood pressure and metabolic syndrome. Metabolic syndrome is a combination of conditions that when they occur together they increase risk for heart disease and diabetes.
In order to promote heart health, many times weight loss is required. With over two-thirds of the US adult population being overweight or obese, this is almost a given…even though there are exceptions. When you think about weight loss I think “diet” is the first thing that comes to mind. Plus, in some ways it is more appealing. It somehow equates to quick results. However, you do have another option – lifestyle changes.
Lifestyle changes are more effective long term than “going on a diet”. Let’s compare these two options.
Diet
There are many diet options.
Low-carb
Low-fat
High protein
Vegetarian
Blood type diet
The Zone Diet
South Beach Diet
Weight Watchers
Raw Food Diet
Jenny Craig
Dean Ornish Diet
Mediterranean Diet
Atkins Diet
…and the list goes on. Which one is right for? All the diet options are more likely to cause confusion as you determine which one is best. Plus, the word “diet” implies a short term fix. You’re not going to stay on a diet forever, right? This means after the diet ends, most people regain the weight and you are right back to square one.
For long term success, lifestyle changes are shown to have more lasting results.

Consuming a low cholesterol diet is not necessarily the best treatment plan for lowering cholesterol levels and reducing your risk for heart disease.
Why? Well, it depends on which of your total cholesterol particles is elevated. For example, if LDL cholesterol is high, it’s best to focus on reducing your intake of saturated fat. If triglycerides are elevated you want to reduce your sugar and alcohol intake for the most impact. Knowing which of your cholesterol particles is elevated will allow you to implement a more effective treatment plan.
Then you also have the other component – inflammation. Cholesterol by itself does not necessarily lead to heart disease. It’s a process that begins with inflammation resulting in the oxidation of cholesterol particles. So, you also want to incorporate a diet rich in “anti-inflammatory foods”.
How to Follow an Anti-Inflammatory Diet
Continue reading
First of all, your cholesterol levels are not the final determinant of your heart attack or heart disease risk. Other factors besides cholesterol play a role, such as inflammation which causes cholesterol to oxidize and then lead to heart concerns. That being said, you don’t just want to ignore cholesterol levels. They are a good measure to assess risk and determine if further investigation is needed to determine appropriate treatment.
Norwegian researchers reported middle-age men with high cholesterol levels to be at increased risk for a first heart attack when compared to women with high cholesterol levels.
This study, published in the September issue of Epidemiology, included more than 40,000 participants under the age of 60 years-old. They found men with high cholesterol to have three times the risk for a heart attack versus women.
The reason for this increased wasn’t identified by the researchers, but speculation that it may be connected to the protective effects of hormones, such as estrogen. That is why this study had an age limit of 60 years-old. After the age of 60, the protective benefits women may receive from hormones is eliminated as menopause begins.