‘Good’ Cholesterol Alone May Not Cut Heart Disease Risk

The long-standing advice about “good” vs. “bad” cholesterol has become a little more complicated.

According to some recent studies, we’re learning that good cholesterol alone has little ability to lower the risk of heart disease, and more is not necessarily better.

Instead, avoiding “bad” cholesterol while favoring “good” is only effective when combined with an overall healthy lifestyle that includes exercise and not smoking.

As most people know by now, bad cholesterol (low-density lipo­protein, or LDL) deposits excess cholesterol in your arteries, where it can build up into plaque, increasing the likelihood of heart disease and blood clots. Good cholesterol (high-density lipo­protein, or HDL) carries surplus cholesterol back to your liver so that it can be excreted.

To prevent heart disease, we’ve been told to keep our bad cholesterol level down and our good cholesterol level up—with 45 milligrams per deciliter usually offered as a good target.

Sounds pretty straightforward, right? But the picture is more complicated than it once seemed.

Here’s what you need to know about the current thinking, along with some healthy-heart guidelines that are unlikely to change even if our understanding of cholesterol does.

The New Evidence on HDL

The first clue that the role of good cholesterol was more complicated than previously thought emerged when scientists tried to develop medications to raise HDL levels.

The drugs they tested—niacin and cholesteryl ester transfer protein inhibitors—boosted HDL in the blood but failed to reduce cardiovascular-disease risk.

Those results surprised doctors. We know that certain lifestyle changes, such as exercising more and quitting smoking, drive HDL levels up and heart-disease risk down.

But increasing HDL levels arti­fi­cially, without behavioral changes, doesn’t reduce risk at all. “It turns out that HDL is not a very good therapeutic target,” says Dennis Ko, M.D., a cardiologist and senior scientist at the Institute for Clinical Evaluative Sciences in Ontario, Canada.

What’s more, Ko’s own research suggests that above a certain threshold, more HDL could increase health risks.

His team looked at 631,762 people and found that those with an HDL level greater than 70 mg/dL (in men) or 90 mg/dL (in women) were more likely to die—for reasons ­unrelated to cardiovascular disease.

Getting Good Cholesterol Up

As researchers work to figure out what these findings mean in the quest to keep hearts healthy, your doctors might still use your HDL level (in conjunction with measurements of LDL and total cholesterol) to help predict your cardiovascular-disease risk.

Our experts say that a very low HDL level can be a sign of trouble, but that the only meaningful way to raise it is through lifestyle changes.

“There is no evidence for a benefit from any HDL-raising drug,” says Steven Nissen, M.D., a cardiologist with the Cleveland Clinic. “It’s still important to pay attention to the numbers, but the main focus should be on making healthy choices.”

In other words, whether your HDL is low, high, or somewhere in the middle, the prescription for a healthy heart will be the same: Don’t smoke, drink alcohol only in moderation, exercise regularly, and stay away from trans fats, which are found in fried foods, baked goods, and other items made with partially hydrogenated oils.

As Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser, notes, “Everyone agrees with the pursuit of a healthy lifestyle.”

Bringing Bad Cholesterol Down

In 2016, the U.S. Preventive Services Task Force recommended that a vastly larger group think about taking statin medications, which lower LDL cholesterol.

If you’re 40 to 75 and have diabetes, or high cholesterol or blood pressure, or you smoke, you’re now advised to have a doctor estimate your chance of a major cardiovascular event within 10 years. If chances are 10 percent or greater, the task force suggests a statin. For a risk of 7.5 to 10 percent, it suggests that you consider one.

Our current advice is that for those whose 10-year risk is lower than 10 percent, diet and lifestyle changes should be the first steps. They could lower your risk enough that you are no longer a candidate for a statin, which has well-­established adverse effects.

Source: Consumer Reports

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Video: The Oldest Restaurant in the World

Botín Restaurant has kept the flame burning for the past 293 years … literally.

Ever since the doors opened in 1725, the oven has been sizzling continuously, never to be extinguished.

According to deputy manager Luis Javier Sànchez Alvarez, the oven is the crown jewel of the restaurant and the fundamental element of their most popular dish, the roast suckling pig. The recipes used today have been passed down from generation to generation, keeping the legacy of these traditional dishes alive.

With the honor of being the oldest restaurant in the world, Alvarez hopes to keep the doors open for centuries to come.

Watch video at You Tube (2:21 minutes) . . . .

The Surprising Anti-Aging Benefits of Fiber


Enlarge image . . . . .

Sally Wadyka wrote . . . . . .

Fiber gets a lot of well-deserved credit for keeping the digestive system in good working order—but it does plenty more. In fact, it’s a major player in so many of your body’s systems that getting enough can actually help keep you youthful. For example, older people who ate fiber-rich diets were 80 percent more likely to live longer and stay healthier than those who didn’t, according to a recent study in the Journals of Gerontology.

The trouble is, few Americans consume the amount they should. For people age 51 and older, government guidelines recommend at least 28 grams per day for men and 22 grams for women. But the Department of Agriculture says adults in this age group average just about 16 grams per day.

What Is Fiber Anyway?

Fiber is a carbohydrate found in plant foods: beans, fruit, grains, nuts, and vegetables. Technically, it isn’t a nutrient because it isn’t broken down and absorbed. But that’s what makes it so beneficial.

There are several types of fiber, but they all fall into two broad categories: soluble and insoluble.

Soluble fiber is soft and dissolves in water, forming a gel-like substance. It bulks up your stool, making it easier to pass. Sources include beans, oats, sweet potatoes, and the flesh of some fruit.

Insoluble fiber is found in whole grains, vegetables, and fruit skin. “This kind of fiber promotes contractions of the digestive tract that move food and waste through the body,” says Lindsay Malone, R.D., a dietitian at the Cleveland Clinic Center for Functional Medicine.

Many plant foods contain both, so by eating a variety, you’ll cover all your bases.

How It Keeps You Young

The study mentioned earlier followed over 1,600 healthy adults for 10 years. Those who had “aged successfully” after a decade (meaning they were free of cancer, heart disease, and diabetes, and had good overall cognitive, physical, and cardiovascular function) consumed an average of 29 grams of fiber per day. How is it that this simple substance can have such a powerful effect on health and longevity? It turns out there are many ways that fiber works its anti-aging magic.

Cutting cholesterol. Soluble fiber binds to bile acids, substances produced by the liver that aid in digestion and fat absorption, and it helps your body excrete them. “The body then needs to produce more bile acids, and it pulls cholesterol from the blood to do it,” says JoAnn E. Manson, M.D., chief of the division of preventive medicine at Brigham and Women’s Hospital. A 2016 Cochrane Review of 23 studies found that increasing fiber led to a 7.7 mg/dL reduction in total cholesterol and a 5.4 mg/dL drop in LDL (“bad”) cholesterol.

Protecting against diabetes. A study published in 2009 in Diabetes Care found that people who got less than 20 grams of fiber per day had about a 50 percent greater risk of developing type 2 diabetes than those who got 31 grams or more per day. “Eating a food that’s high in fiber slows the absorption of carbohydrates into your bloodstream,” Manson says, “so blood sugar levels rise more slowly and the pancreas has more time to react and produce insulin.”

Controlling weight. Fiber adds bulk, so you feel full faster and stay full longer. And many high-fiber foods are low in calories.

Lowering colorectal cancer risk. A recent report by the World Cancer Research Fund International/American Institute for Cancer Research found that eating 90 grams of fiber-rich whole grains daily could lower colorectal cancer risk by 17 percent.

Reducing inflammation. Chronic inflammation has been linked to many diseases, such as arthritis, certain cancers, and even Alzheimer’s. “Many studies have shown that increased insoluble fiber intake leads to reduced inflammation,” says Qi Sun, M.D., Sc.D., an assistant professor in the department of nutrition at the Harvard T. H. Chan School of Public Health. This may be because other beneficial components of whole grains, such as polyphenols and magnesium, also have anti-inflammatory properties.

Protecting joints. If fiber can reduce inflammation, it stands to reason that it may help reduce the risk of arthritis. And a recent study, published in the Annals of the Rheumatic Diseases, offers some proof. Researchers evaluated two groups of people and found that in one group, those whose daily fiber intake averaged 20 grams had a 30 percent lower risk of knee osteoarthritis than people who ate about 8 grams. In the other group, those who averaged about 25 grams of fiber per day had a 61 percent lower risk compared with those who consumed about 14 grams.

Boosting good bacteria in the gut. “Fiber doesn’t digest, it ferments,” Malone says. “By the time it reaches the colon, the fermented material supplies food to help those good bacteria multiply and thrive.” A healthy supply of good bacteria can have far-reaching health effects, such as strengthening the immune system and helping to control inflammation.

Natural or Not?

Beta glucan, cellulose, chicory root, inulin, pectin, psyllium, and xanthan gum are types of fiber that are added to some packaged foods. The Food and Drug Administration is reviewing of some of those ingredients to determine whether to allow manufacturers to continue to count them as part of a product’s total fiber content.

The question is whether there’s enough evidence to prove they have the same physiological benefits as natural fiber, says Joanne Slavin, Ph.D., a professor of food science at the University of Minnesota. “The advantage of adding fiber into foods and beverages is to increase fiber without increasing calories,” she says. But critics worry that this practice may make something that’s essentially junk food appear to be healthy because the label touts its fiber content. “Foods that are naturally high in fiber are some of the healthiest foods,” Manson says. “You’re not going to get the same health effects from eating highly processed foods with a sprinkling of added fiber.”

Tips for Boosting Fiber Intake

Getting fiber from foods naturally rich in it is your best bet. “Using a supplement as a replacement means missing out on all the other benefits of fruits, vegetables, and whole grains,” Manson says.

And getting more fiber doesn’t limit you to eating only prunes and wheat bran. Some top sources include avocados (9 grams in one medium fruit), green peas (9 grams per cup), raspberries (8 grams per cup), sweet potatoes (6 grams in one large potato), and pears (5.5 grams per medium fruit).

People often cite gas and bloating as reasons for not adding more fiber-rich foods to their diets. That concern is warranted. “You don’t want to go from 5 grams a day to 30 all at once,” Manson says. “There are enzymes that need to be cultivated so that the intestines are ready to handle the increased load.”

So up your fiber intake gradually, spread it across meals, and be sure to drink more water simultaneously. “Fiber in the presence of fluid adds bulk and softens stool,” Malone says. Without enough water, fiber can actually be constipating. It’s also worth experimenting with a variety of high-fiber foods to find which ones your digestive system tolerates best.

Source: Consumer Reports

New Year Cup Cakes of Starbuck Korea

Celebrating the Year of the Dog

Sushi Set to Celebrate the Cat’s Day on February 22 in Japan

Cat Face and Paws Kazari Roll Sushi and Three Inari Sushi

Each set (若廣の肉球助六セット) is sold by Ecute Nippori (エキュート日暮里) for 580 yen (tax included).