Heart of the Matter Health Article

Some studies, in fact, show dramatic health benefits, even though cholesterol levels may show only minor improvement. The famous Lyon Diet Heart study in 1999, for example, showed that patients following a Mediterranean-style diet for 46 months had a 50 to 70 percent lower risk of recurrent heart disease, including cardiac death and nonfatal heart attack. The easy-to-follow diet included more fruit and vegetables, more fish, more poultry, more bread, cereals, beans and nuts. It had less red meat and moderate use of eggs and poultry. Butter and cream were replaced with olive oil and a canola-oil margarine high in alpha-linolenic acid.

Most doctors, in fact, recommend the mainstream American Heart Association diet, which has many Mediterranean influences, in part because it represents simple changes that most people can make and maintain. Studies show that, on average, sticking to the AHA regimen reduces LDL by about 8 percent. The way individuals respond to changed diet varies widely, however.

Why isn’t clearly understood. "Obviously, someone who has been eating fast-food cheeseburgers every day for lunch and steaks for dinner is likely to get more dramatic results than someone who’s already following a pretty healthy diet," says Weiss. And then, of course, there are genetic differences, which can trump even the healthiest diet. Just out of college, Hilary Lundquist, 22, learned that her total cholesterol was 230, enough to be of concern to her physician. "I was flabbergasted," she says. "I’ve always eaten lots of fruits and veggies, whole grains, lean protein and soy, low- and nonfat dairy, even flax."

Every little bit helps

Ultimately, Lundquist, whose parents both have high cholesterol, may have to go on medication to control her cholesterol, joining millions of Americans. Fortunately, the latest drugs have been shown to lower not only cholesterol but also the risk of heart disease. And new drugs in the pipeline, researchers say, are likely to be even more effective. One currently awaiting FDA approval, for example, has been shown to dramatically increase HDL levels at the same time that it helps people lose weight—a promising combination.

Even the best medications, however, won’t replace the benefits of a healthy diet. One recent study showed that a 10-milligram dose of the statin drug simvastatin combined with 15 grams of soluble fiber a day had the same cholesterol-lowering power as a 20-milligram pill alone. "What that means is that we can often reduce the dose that people need by making a few changes in their diets," says family physician Daphne Miller, M.D., who also teaches nutrition at the University of California, San Francisco. "In other cases we can get them off the drugs entirely."

Thanks to statins, Steven Peterson has been able to keep his LDL cholesterol down. Thanks to a healthy diet, he’s also been able to stick with a relatively low dose of the medication—saving money and avoiding side effects. "We stopped cultivating broccoli sprouts in the kitchen, I’ll admit that," he says. "But it’s still whole grains for breakfast, skim milk, meat only now and then, lots of salads, vegetables, whole-grain breads, nuts or fruit for snacks." Lately he’s been considering switching to whole-wheat pasta and trying a new brand of yogurt enhanced with stanols. "The way I figure, every little bit helps."

Optimal Numbers for Most Individuals*

Total Cholesterol = Less than 200

Triglyceride (Less is better) = Below 150

LDL (Bad) Cholesterol (Less is better) = Below 100

HDL (Good) Cholesterol (More is better) = Above 60

*Risk factors vary. Check with your doctor for your targets.

Source: www.americanheart.org.

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