To Your Health

A. One would think that after decades of research on cholesterol there would be little controversy about the subject. Just the opposite is true. Assumptions regarding the connection of elevated cholesterol to increased risk of heart attack, which seemed so reasonable just a few years ago, are being questioned and in some cases discarded. Additional research is still needed to determine just what is good and bad about cholesterol. For instance, according to research recently published in the Journal of the American Geriatrics Society (April 2004), increases in cholesterol, even low density or "bad" cholesterol, may be beneficial in some older adults.

Cholesterol-lowering drugs, mostly "statins," are among the most commonly used medicines, taken daily by tens of millions of Americans in hopes of keeping their blood vessels clear and reducing their risk of heart attack. Recent news that statins may reduce risk of cancer supports the notion that statins may actually work as anti-inflammatory agents rather than by affecting cholesterol. Still, all have various mild to serious side effects that range from nerve damage to death from heart attack, so that about half of those who start taking the drugs will eventually quit. Many are seeking alternatives that are less expensive and more "natural," as well as safer.

Lifestyle changes that include regular exercise, quitting smoking, and improving your diet may be boring but are at the top of the list when it comes to natural care. Exactly how to improve your diet may require some professional assistance, since we each have differing nutrient requirements, but a little research will serve you well.

Niacin is a B-complex vitamin that lowers cholesterol when used at high doses, and is often prescribed in addition to "statin" drugs even by nonalternative doctors. This combination can decrease cholesterol more than statins can alone and appears to raise levels of beneficial cholesterol, or HDL. Using aspirin a couple of times a week can minimize the uncomfortable "flush" that comes from taking high-dose niacin.

Soluble fiber is very effective for lowering cholesterol. The best way to get fiber is to eat your vegetables, but fiber supplements are available and effective. Fiber binds cholesterol in the intestine, making it more difficult to absorb. Also, fiber binds bile acids that are then excreted, and when the liver needs to replace the bile acids that went out with the fiber, it pulls cholesterol from the bloodstream to make more bile acids. The other benefits of increased fiber on your entire digestive system, such as encouraging the growth of friendly intestinal bacteria, make this a very attractive option.

Plant stanols can be found in small quantities in foods such as grains and olive oil. The amount supplied by the average American diet has no detectable effect on serum cholesterol levels, but when concentrated to provide about 1.5 grams per day, stanols can reduce the absorption of cholesterol from the digestive tract. Benecol margarine, developed in Finland and available now in the U.S., contains stanol esters.

Red yeast rice contains a natural form of a statin drug, although the FDA is trying to remove it from the market because it is not yet a standardized preparation.

The good news is that there are several alternatives to prescription medication for lowering cholesterol if you need to, and that high cholesterol alone is not a death sentence.