Cholesterol Archive

The healthiest fats for cooking and using on food come from plants. Plant oils consist mostly of unsaturated fat, which in limited amounts is good for the heart. One can enjoy a wide variety of plant oils, such as avocado, canola, corn, flaxseed, grapeseed, olive, peanut, rice bran, safflower, soybean, sunflower, and walnut oils. But high heat can break down plant oil molecules and reduce health benefits. The most fragile plant oils include extra-virgin olive oil and nut oils, such as walnut oil.

In the journals

Can you be "fat and fit" — that is, overweight but still healthy because of regular exercise? There is no simple answer. But one study says that activity does not entirely reverse the effects weight has on heart health. The findings were published online Jan. 26, 2021, by the European Journal of Preventive Cardiology.

The study involved more than 527,000 adults, almost 70% of whom were men. People were placed into three groups based on their body mass index (BMI): normal, overweight, and obese. They also were grouped by activity level: regularly active (the minimum requirement from the World Health Organization, or WHO); insufficiently active (less than the WHO minimum, but some moderate to vigorous physical activity every week), and no exercise.

It takes a one-two punch to lower these risks for heart disease, heart attack, and stroke.

High cholesterol has long been known as a bad actor in heart health. Too much LDL (bad) cholesterol in your blood can lead to fatty deposits in your arteries and the formation of artery-narrowing plaque (atherosclerosis), heart attacks, and strokes.

But LDL doesn't act alone. Chronic inflammation — a persistent activation of the immune system — also fuels heart attack and stroke risks. That means you must address both high LDL levels and chronic inflammation to protect your health.

You need adequate amounts of good dietary fat.

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Low fat? No fat? Try more fat. Dietary fats are essential for maintaining good overall health, especially as you age. "Your body needs a regular intake of fat," says Vasanti Malik, a research scientist with the Department of Nutrition at Harvard's T.H. Chan School of Public Health. "Fat helps give your body energy, protects your organs, supports cell growth, keeps cholesterol and blood pressure under control, and helps your body absorb vital nutrients. When you focus too much on cutting out all fat, you can actually deprive your body of what it needs most."

Two types of fats

To understand the role fats play in a healthy diet, you have to look closer at the two types of dietary fats: saturated and unsaturated. (A third kind, trans fats, have been all but eliminated from U.S. foods.)

Research we're watching

Eating nuts even just a couple of times a week is linked to a lower risk of dying from heart disease, a new study suggests.

The study included 39,000 women who filled out dietary questionnaires at the start of the study and again about 10 years later. During the follow-up, which lasted an average of 19 years, nearly 1,000 of the women died of cardiovascular disease.

Research we're watching

Widely considered the healthiest diet for your heart, the Mediterranean diet is rich in plant-based foods and features only small amounts of meat and dairy products. But a variation that includes more green plant foods may be even better for you, a small study suggests.

The study included 294 sedentary, moderately obese people whom researchers randomly divided into three groups. Each received different dietary advice: a standard healthy diet, a low-calorie Mediterranean diet, or a "green" Mediterranean diet. Both Mediterranean diet groups included about a quarter-cup of walnuts daily, and poultry and fish replaced beef and lamb.

A novel study suggests that the "nocebo effect" could be why some people believe they cannot tolerate statins.

Are you hesitant to fill your statin prescription because you're worried the drug will cause muscle aches and other side effects? Although you're far from alone (see "A royal pain?"), the reality is that all drugs have side effects, and statins aren't worse than other drugs. And fears about statin side effects may be depriving people of a potentially lifesaving medication.

The nocebo effect — the flip side of the well-known placebo effect — occurs when people experience negative effects from a drug, placebo, or other treatment based on an expectation of harm. Because of the widespread belief that statins cause muscle aches, statins have been suspected of triggering a strong nocebo effect. A recent study confirmed this observation (see "A study to assess statin side effects").

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."

News briefs

A Mediterranean-style diet is rich in vegetables, legumes, fruits, whole grains, nuts, seeds, poultry, fish, and olive oil, and it's associated with lower risks for heart disease and diabetes. And a "greener" version of the eating style might be even more effective, according to a small, randomized study published online Nov. 23, 2020, by the journal Heart. Researchers — some from Harvard — recruited about 300 sedentary, middle-aged people (mostly men) with high cholesterol or abdominal obesity and divided them into three groups. One received guidance for exercise and a healthy diet; another received exercise guidance and was assigned to eat a calorie-restricted Mediterranean diet; and one group received exercise guidance and was assigned to eat a "greener" calorie-restricted Mediterranean diet with less animal-based and more plant-based proteins (including walnuts and a type of duckweed — an aquatic plant), plus lots of green tea. After six months, people on the "green" diet had lost more weight and inches around their middles, and had bigger drops in cholesterol, than people in the other two groups. "Green" dieters also had steeper declines in insulin resistance, inflammation markers, and diastolic blood pressure (the lower number in the measurement), compared with the other two groups.

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