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Cholesterol

"Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both: -- Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol. High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease. -- High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol. HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease."

Highlighted Article

"Niacin therapy, currently the most effective means for raising HDL levels, should be initiated in patients with isolated low HDL (HDL <40 mg/dL, LDL and non-HDL at or below National Cholesterol Education Program (NCEP) targets based on global cardiovascular risk evaluation). Patients who have both low HDL and elevated LDL should receive a statin or statin-niacin combination therapy, and patients with concomitant low HDL and elevated TGs should receive a fibrate initially, with a statin, niacin, or ezetimibe added thereafter as needed to help attain NCEP lipoprotein targets."

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Cholesterol - Lipids - Hyperlipidemia

Risk Reduction

NEWS:

Exercise May Boost 'Good' Cholesterol: Longer Workouts May Be Better Than Brief Exercise Sessions "Chalk up another health benefit of aerobic exercise -- it may boost HDL ("good") cholesterol levels. But brief bouts of exercise may not be enough. It may take at least two hours per week of aerobic exercise such as walking, biking, or swimming -- preferably in sessions lasting for more than half an hour -- to get the HDL benefit. That's according to a new research review published in the Archives of Internal Medicine."

Whole-Grain Oats Cut Cholesterol

ARTICLES:

4 Tips for Lower Cholesterol Fast

Cholesterol: The best foods to lower your cholesterol and protect your heart

Cholesterol-lowering supplements: Another way to reduce cholesterol

Exercise To Lower Cholesterol "One way exercise can help lower cholesterol is by helping you lose -- or maintain -- weight. Being overweight tends to increase the amount of low-density lipoprotein (LDL) in your blood, the kind of lipoprotein that’s been linked to heart disease."

Foods for Cholesterol

HDL cholesterol: How to boost your 'good' cholesterol

What foods lower cholesterol?

JOURNAL ARTICLES:

Caloric restrictions affect some factors involved in age-related hypercholesterolemia. (J Cell Biochem. 2007)

Carbohydrate intake and HDL in a multiethnic population. (Am J Clin Nutr. 2007) "CONCLUSIONS: Differences in HDL and triacylglycerols observed in different ethnic groups may be due in part to carbohydrate intake. Reducing the frequency of intake of sugar-containing soft drinks, juices, and snacks may be beneficial."

Effect of Aerobic Exercise Training on Serum Levels of High-Density Lipoprotein Cholesterol (Arch Intern Med. 2007) "Conclusions Regular aerobic exercise modestly increases HDL-C level. There appears to exist a minimum exercise volume for a significant increase in HDL-C level. Exercise duration per session was the most important element of an exercise prescription. Exercise was more effective in subjects with initially high total cholesterol levels or low body mass index."

Endurance exercise training raises high-density lipoprotein cholesterol and lowers small low-density lipoprotein and very low-density lipoprotein independent of body fat phenotypes in older men and women. (Metabolism. 2007) "These results show that 24 weeks of endurance exercise training induced favorable changes in plasma lipoprotein and lipid profiles independent of diet and baseline or change in body fat."

High-Density Lipoprotein as a Therapeutic Target (JAMA. 2007) "Conclusions At present there is modest evidence to support aggressively increasing HDL-C levels in addition to what is achieved by lifestyle modification alone. Ongoing clinical trials that target specific pathways in HDL metabolism may help expand cardiovascular treatment options."

Interaction of exercise training and n-3 fatty acid supplementation on postprandial lipemia. (Appl Physiol Nutr Metab. 2007) "These results suggest that n-3 FA supplementation reduced PPL in sedentary subjects. Exercise training has no interference or additive effects with n-3 FA supplementation in attenuating PPL, but combined treatments may be additive in raising high-density lipoprotein cholesterol."

Low-calorie cranberry juice supplementation reduces plasma oxidized LDL and cell adhesion molecule concentrations in men. (Br J Nutr. 2007)

Niacin in cardiovascular prevention: mechanisms, efficacy, and safety. Hyperlipidaemia and cardiovascular disease (Current Opinion in Lipidology. 2007) "Although niacin induces insulin resistance, deterioration of glycemic control in diabetes is usually minor, and there is no evidence of increased incidence of new onset diabetes. Hepatic toxicity is common with higher doses of sustained-release niacin but rare with immediate-release and extended-release niacin at doses up to 2000 mg/day. … Summary: Recently developed understanding of the mechanisms, efficacy, and safety of niacin, along with progress in reducing the chief side effect of flushing, should enhance the use of this valuable agent for cardiovascular prevention."

[Niacin in therapy] (Postepy Hig Med Dosw (Online). 2007) "Niacin (nicotinic acid and nicotinamide) is a vitamin used as a source of the NAD+ and NADP+ coenzymes required for many metabolic processes. Its low dietary levels induce the development of pellagra. Niacin has been used for decades in the treatment of patients with disturbed lipid and lipoprotein metabolism, this being the main cause of atherosclerotic changes in cardiovascular diseases. It is still the most efficacious drug in terms of its ability to increase HDL cholesterol content accompanied by a decrease in all atherogenic lipoproteins (VLDL, LDL, and L(a)) as well as fatty acids and triglycerides. Niacin also increases adiponectin level, which might result in additional atheroprotection. There are studies confirming the beneficial action of niacin against migraine and hyperphosphatemia associated with renal failure, ethanol-induced neurodegeneration, and loss of beta-cell function in type 1 diabetes. … In view of these observations, niacin therapy must be accompanied by control of the choice of niacin preparation and its dose in order to eliminate or at least limit its side effects."

Present-day uses of niacin: effects on lipid and non-lipid parameters. (Expert Opin Pharmacother. 2007) "Raising HDL-C levels with lifestyle changes and pharmacologic interventions appear to reduce the risk of coronary artery disease beyond that of lowering LDL-C alone. Niacin has a substantial HDL-C raising effect, and also may beneficially alter total cholesterol, LDL-C and triglyceride levels. Niacin also exhibits antioxidant, anti-inflammatory and other beneficial effects on atherosclerosis. Niacin is safe and effective to use in women, in patients with diabetes mellitus and/or metabolic syndrome, and when used in combination with statins."

[Regular aerobic physical activity improves the lipid profile in persons with excessive body weight] (Vnitr Lek. 2007)

Synergistic effects of phenolics and carotenoids on human low-density lipoprotein oxidation. (Mol Nutr Food Res. 2007) "However, enrichment of LDL with the carotenoids lutein or lycopene did not result in an alleviation of LDL oxidation. Since there is an agreement that not one antioxidant alone can lead to health benefits but the combination, as found for example in fruits and vegetables, is the active principle, we tested whether the combination of a phenolic compound (i. e. rutin) and carotenoids (i.e. lutein or lycopene) leads to synergistic effects. Both combinations were shown to exert supra-additive protection of LDL towards oxidation, which is most likely due to different allocation of the antioxidants in the LDL-particle and to different mechanisms of antioxidant action."

Therapies for raising high-density lipoprotein cholesterol. (Intern Med. 2007)

Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation. (Br J Nutr. 2007) "In conclusion, a high dietary intake of tomato products had atheroprotective effects, it significantly reduced LDL cholesterol levels, and increased LDL resistance to oxidation in healthy normocholesterolaemic adults."

Which lifestyle interventions effectively lower LDL cholesterol? (J Fam Pract. 2007)

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