TUESDAY, Aug. 21, 2018 — Healthy people with a low risk of cardiovascular disease may still need to keep a close eye on their cholesterol, according to new research.
A study, published recently in the journal Circulation, found that otherwise healthy people with high LDL cholesterol levels are at higher risk of dying from cardiovascular disease than those with lower LDL.
Often called “bad cholesterol,” LDL contributes to fatty buildups in arteries, which increases the risk for heart attacks, strokes and peripheral artery disease.
“Even if you have a low 10-year risk, that doesn’t eliminate the long-term risks of having high cholesterol levels and significantly poorer cardiovascular health,” said Dr. Shuaib Abdullah, the study’s lead author.
Researchers looked at data from 36,375 patients in the Cooper Center Longitudinal Study. Participants had no history of cardiovascular disease or diabetes and were deemed to have a low 10-year risk of developing cardiovascular disease.
After following the participants for about 27 years starting in their 30s or 40s, the researchers found that people with LDL levels of 160 or higher had a 70 percent to 90 percent higher risk of dying from cardiovascular disease compared to people with LDL below 100.
“There’s controversy within the medical community about what the LDL cutoff level should be, when patients should be treated, and if they should be treated at all,” said Abdullah, an assistant professor of internal medicine at UT Southwestern Medical Center in Dallas. “But this study shows a marked increase in death from cardiovascular disease and coronary heart disease at the 160 level.”
An estimated 28.5 million Americans have total cholesterol levels of 240 or higher, which roughly corresponds to an LDL level of 160 or higher, according to the study.
Abdullah said the study serves as a reminder that all adults should get regular cholesterol tests no matter how old they are. “A lot of patients with high cholesterol don’t know it until they have a heart attack,” he said.
Guidelines recommend people have their cholesterol checked every four to six years starting at age 20.
The study also showed an increased risk for people with non-HDL cholesterol readings above 160. Non-HDL levels are a person’s total cholesterol minus their HDL, the “good” type of cholesterol that helps the body get rid of some of the harmful LDL. Abdullah said past studies have shown non-HDL levels might be a better marker for cardiovascular risk than LDL in patients with additional risk factors.
Dr. Christie Ballantyne, who was not involved in the new research but coauthored an accompanying editorial, said the study provides “more important information for the patient-doctor decision-making process.”
“A study like this helps doctors say, ‘Your risk has increased and there are things we can do to treat that risk, whether it’s lifestyle modifications or using medications like statins,’ ” said Ballantyne, chief of cardiology and cardiovascular research at Baylor College of Medicine in Houston.
Ballantyne said the new research shows that even healthy people should be following recommendations for ideal cardiovascular health, such as not smoking, managing blood pressure and staying physically active.
“Most cardiovascular disease is preventable, especially if we get patients and health care providers the right information so they can make the best decisions,” he said.
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Is It Really That Bad to Eat Non-Organic Produce?
Yes, they are bad, but it’s way more important to include a wide variety of fruits and vegetables in your diet than to avoid them because of pesticide concerns. Here’s a tip: If you thoroughly wash your produce with cold water and throw away the outer leaves of leafy vegetables (like romaine), you will remove most of the pesticide residue.
If you’re still worried about ingesting chemicals, buy organic varieties of the produce on the Environmental Working Group’s “Dirty Dozen” list, which highlights the conventionally grown foods that tend to have the most pesticide contamination, like strawberries, spinach, apples, and tomatoes. Load up on more foods from their “Clean Fifteen” list too, like avocados (yes!), broccoli, kiwis, and mangoes. You can find both lists on their website. As a general rule, fruits that you eat after removing the outer covering—like bananas—are less prone to pesticide contamination. And whatever you do, focus more on getting as many fruits and veggies into your diet as possible: Organic or not, these types of foods are associated with countless important health benefits, like a decreased risk of cancer, heart disease, and overall mortality.
Health’s medical editor, Roshini Rajapaksa, MD, is an associate professor of medicine at the NYU School of Medicine and a cofounder of TULA Skincare.
6 Things This Nutritionist Wishes She Knew About Food Years Ago
I’ve been a practicing dietitian for more than two decades, which is a l-o-n-g time. Over the years, I’ve had the opportunity to work with so many wonderful clients with nutrition-related concerns, including pregnant women, children, amateur and professional athletes, overweight and obese adults, and the elderly.
I’ve learned so much during the years, and while new guidelines and recommendations will come and go, there are six core principles I wish I had realized years ago–and they apply to everyone.
Healthy food isn't all-you-can-eat food
Studies show that people will subconsciously eat more food if they believe it’s healthy. More often than not, clients I see struggling with their weight have high-quality diets. Their food journals reveal they’re eating lots of fruits and veggies, lean protein, healthy fats, and quality carbs.
So what gives? They eat too much–period. With today’s oversized portions, it’s easy to overeat without realizing it. And even the healthiest foods can contribute to weight gain if you're taking in too many calories daily. If you can relate, perfect your portions by paying more attention to how much you’re eating compared to what’s recommended.
Think progress, not perfection
Healthy eating is a lifelong journey, so it’s important to have a plan to navigate the bumps and detours that you will eventually encounter in the road. As a dietitian, I can attest that everyone slips up on their diet and fitness routines at some point. If you overdo it on pizza or ice cream every now and again, don’t freak. It’s going to be okay; life happens!
Those who eat well and maintain a healthy weight for life are most likely to get back on track after they’ve had a setback. They don’t give in or give up, they move on. Heart disease or type 2 diabetes won’t develop from what you ate on a specific day, week, or month; these and other conditions progress from the cumulative effects of behaviors like unhealthy eating, lack of exercise, tobacco use, and more. Take a big-picture look at eating, with the ultimate goal of living the longest and healthiest life that you can.
Use mental tricks to keep you on track
Did you know you make more than 200 food-related decisions every day? If you leave those choices up to chance, you’ll deplete your daily willpower—and you’ll be more likely to overeat. But if you have a plan for what and when you’re going to eat, you will limit the number of times you tap into your willpower reserve.
New weight-loss research is focusing on removing many food-related decisions or making healthier options the easiest choice, so your willpower stays strong all day long. To do this, researchers recommend the following: Get adequate sleep (without enough Zz’s, your willpower is weakened, and you’ll be more likely to make less nutritious decisions), and keep your kitchen tidy (store the healthiest foods front-and-center so you’re reminded how convenient they are to eat).
Eat lower on the food chain
Eating low on the food chain means eating more plant-based foods. According to the Centers for Disease Control and Prevention (CDC), around 90% of Americans don’t meet the daily recommended servings for fruits and veggies, which is 1.5 to 2 cups of fruit and 2 to 3 cups of veggies a day. A plant-forward menu will naturally have plenty of filling fiber and a range of vitamins and nutrients, plus it keeps calories, sugar, and saturated fat in check. No matter what type of eating plan you follow, strive to fill half your plate with produce for all (or most) of your meals.
A well-stocked pantry, with plenty of canned produce like tomatoes and beans, can help ensure that you hit those targets. Canned produce has similar—and sometimes even more!—nutritional value than fresh varieties.
Supplements aren't cure-alls
It’s estimated that more than half of all Americans take at least one dietary supplement to improve their health. However, according to the National Institutes of Health Office of Dietary Supplements, there’s not always sufficient evidence that supplements improve health–and in some cases, supplements may increase risk for disease.
Throughout my career, I’ve seen a lot of "must-have" supplements that claim to increase energy, burn off belly fat, keep your brain sharp, or fend off (or even cure) any number of chronic conditions. Since manufacturers don’t have to prove that dietary supplements work before they are sold, there’s no guarantee they’ll be effective.
If you fit one of these specific cases, you may benefit from a certain supplement. Otherwise, focus on eating a plant-rich, balanced diet based on the foundation of wholesome, real foods that provide a complex matrix of nutrients.
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Eat quality carbs, not low-carb
If you eat according to what’s trending on your social feeds, you might be avoiding carbs at all cost. However, what I’ve learned through the years is that low-carb diets are hard to follow long-term, and eating quality carbs is better than cutting them out. (The body needs a minimum daily amount of carbohydrates to fuel your muscles and brain, after all.)
However, the types of carbs in, say, soda or cookies are metabolically different than the carbs in beans or brown rice. Enjoy wholesome carbohydrates present in real foods like fruits, veggies, whole grains, and legumes to help you maintain a healthy weight and live longer.
Two bitten by rabid raccoon that was living in Kennebunkport home
A Kennebunkport woman and a game warden were bitten last week by an injured rabid raccoon that the resident had illegally taken into her house.
Game warden Eric Blanchard was bitten as he tried to remove the wild animal from a house in town. The woman had taken in the injured animal illegally and could face charges, according to officials.
It was the first confirmed case of rabies in Kennebunkport this year, police said. Blanchard and the woman are both undergoing treatment for rabies.
“This is kind of a worst-case scenario,” said Cpl. John MacDonald of the Maine Warden Service. “It’s a real reminder that this is the reason why it’s not a safe thing to do.”
MacDonald said it is not uncommon for people to take in wild animals, but said they should not do so because it is both illegal and dangerous.
“People have an instinct to want to take care of animals. Most people understand the risk involved with taking a wild animal into their home,” he said. “They think they’re doing the animal a favor, but wild animals can be very dangerous and unpredictable, especially one prone to rabies.”
Blanchard, the 2017 game warden of the year, was wearing a thick, rabies glove similar to ones used to handle raptors with talons when the raccoon tried to bite through the thumb. Blanchard did not believe the raccoon had broken through his skin, but was advised to go through treatment for rabies exposure as a precaution, MacDonald said.
MacDonald said the Warden Service would not make Blanchard available to speak to a reporter about the incident.
In Maine, it is illegal to keep wildlife in captivity without a proper permit, MacDonald said. Permits and licenses are issued to people who regularly come into contact with wild animals, including wildlife rehabilitators and people who relocate nuisance animals. Possessing wildlife without a permit is a Class E crime punishable with a minimum fine of $50 per day the animal was in a person’s possession.
MacDonald said he is not yet releasing the name of the woman because it is likely she will face charges.
Police said in a Facebook post that wild animals should be left alone outside. Local police or the Maine Warden Service should be contacted when wild animals appear injured or have become a nuisance.
“In no circumstances do we tell people to take (wild animals) into their homes or even touch them,” MacDonald said.
The attack in Kennebunkport follows a number of high-profile rabies incidents this year in Brunswick, where seven people have been bitten by rabid animals.
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