 March 1999 -- Nutrition Notes
By: Andrea Platzman
According to the American Heart Association (AHA), one in five Americans suffers from some form of vascular disease in which blood vessels - especially those leading to the heart, brain and legs - harden and become stiff. This disease, arteriosclerosis, is most commonly seen in the form of atherosclerosis, in which plaque builds up on arterial walls. This can clog arteries and restrict blood flow, eventually leading to a heart attack.
Cholesterol, a fatty substance found in animal tissues, meats, dairy products, egg yolks and some oils, has been implicated in many heart problems, but it has gotten a bad rap according to Ronald Hoffman, M.D., director of the Hoffman Center, New York. "In my opinion, it is a critical ingredient for the production of sex and stress hormones and well as contributing to manufacture of bile for the breakdown of fat in the intestines. I look at homocysteine levels to determine my course of treatment."
More than 200 studies have firmly established elevated homocysteine as a major independent risk factor and predictor not just for heart attacks, but for strokes, leg blood clots and general systemic artery damage. Without adequate vitamins - particularly B12, B6 and folic acid - to fuel the enzymatic action, homocysteine levels begin to elevate.
The ratio between low-density lipoprotein (LDL, or "bad" cholesterol) and high-density lipoprotein (HDL, or "good" cholesterol) levels is more significant than an elevated cholesterol level.
Many compounds can influence cholesterol levels, but it is critical to research potential drug/supplement interactions, since many can be fatal. "Supplements can have side effects; for example, if someone is taking anticoagulant therapy, taking vitamin E or gingko biloba may be a dangerous combination," states Riska Platt, M.S., R.D., spokesperson for AHA.
Rhubarb-stalk fiber may also be effective in reducing cholesterol levels. Studies have found that consuming 27 grams of the powdered form each day could lower total cholesterol levels by 8% and LDL cholesterol by 9%. Psyllium, another fiber, has been shown to prevent cholesterol absorption as well as increase fecal bulk.
High doses - 1,000 to 3,000 mg - of nicotinic acid, a vitamin B complex also known as niacin, have been shown to lower cholesterol levels. This compound exerts dual benefits by lowering LDL while increasing HDL. However, at these high levels, it can cause serious side effects - activating peptic ulcers, impairing glucose tolerance, and damaging the liver as well as the usual flushing and fatigue. Although the time-release form of nicotinic acid is less likely to cause flushing, it can damage the liver and raise blood glucose to dangerous levels, prompting the American Medical Association to advise against its use.
"This cholesterol-lowering has been found even in people who are already eating the recommended low-saturated-fat, low-cholesterol diet," observes Cater.
To date, cholesterol claims on foods are limited to certain fibers such as oats and psyllium. Current regulations allow health-claim statements such as "soluble fiber from whole oats (or psyllium seed husks), as part of a diet low in saturated fat and cholesterol, may reduce risk of coronary heart disease."
Currently proposed FDA labeling regulations state that a health claim of "lowers cholesterol" cannot be put on dietary supplements, since people might believe that this statement equates to treating cardiovascular disease. "All these products are designed for preventive health maintenance and could save a lot of money in healthcare costs, but the FDA does have a challenge to the way products are labeled," says Cardellina.
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Cholesterol Considerations
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