By Amy Tousman
Special to The Advertiser
February is Heart Month, so this is a good time to determine if you are at risk for heart disease and learn how to decrease your chances of having a heart attack.
Some things that increase your risk include: elevated cholesterol; abnormal amounts of blood fats such as HDL (high-density lipoprotein), LDL (low-density lipoprotein) and triglycerides; high blood pressure; diabetes; family history of heart disease; and being over the age of 50. Blood levels of certain proteins, as well as the hormone estrogen, may also determine risk.
There are as many products on the market to help improve your odds of preventing heart problems as there are causes of heart disease. In addition to a healthy diet and exercise plan, nutraceuticals may be of use. Nutraceuticals are food products and supplements that act like medications in the body. Let’s take a look at some of these products.
Food products
Soluble fiber, found in oats, beans, fruits and psyllium products, is a safe addition to the diets of those wanting to decrease their cholesterol. In the case of psyllium, consuming 10 grams daily can lower cholesterol by 5 percent and LDL (bad cholesterol) by 9 percent. Cereals such as Bran Buds and the laxative Metamucil contain psyllium.
Substances called plant esters are also useful. They help block cholesterol absorption in the body. They are included in margarine-like spreads such as Benecol and Take Control. They are also available in gel capsules. Studies show plant esters can help lower cholesterol by 10 to 14 percent.
Herbs
Those fighting Dracula with garlic were on to something. Garlic can be useful for helping to decrease cholesterol levels by 10 to 15 percent. Raw garlic is especially helpful. If eating raw garlic daily does not sound appealing, there are capsules available.
Not all capsules are effective, though, so you need to check the label for the following characteristics: The dose should be standardized to an allicin yield of 5,000 micrograms or more. This means it contains a certain amount of the cholesterol-fighting ingredient in garlic. It should also be enteric-coated to protect the active ingredients from being broken down too soon by stomach acids. An important note: If you take blood thinners such as Coumadin, you should not use garlic supplements.
Guggulipid is an herb that comes from a tree sap in India. It lowers LDL levels by increasing their elimination in the liver. It is safe for most people, but should not be used by those on blood-pressure medications.
Cholestin is a supplement containing red yeast powder. It can help lower cholesterol by 25 to 40 points. It contains the same active ingredient as Mevacor, a cholesterol-lowering drug. Although it is somewhat milder than Mevacor, it can have the same potential side effects. One of these is possible liver damage in some people, so those taking it should have their liver enzymes monitored regularly. Patients who want to use Cholestin should also check with their physicians first.
Vitamins
Vitamins C and E are beneficial due to their antioxidant qualities. Although these vitamins are available in food, some researchers feel supplements are warranted for those who are at high risk for heart attacks.
Vitamin C is found in many fruits and vegetables, such as oranges, papaya, mango, strawberries, broccoli and tomatoes. Vitamin E is found in avocados, nuts and vegetable oils.
Since vitamin E is found in foods with a high fat content, people on low-fat diets may not eat the amount of vitamin E needed for heart disease prevention. I would recommend a 200-400 IU (international unit) supplement for high-risk patients.
The B-vitamins folic acid, B6 and B12 offer another shield in the battle against heart disease. They help keep homocysteine levels low. Too much homocysteine in the blood is a strong predictor of heart disease.
Folic acid is found in orange juice, dark leafy green vegetables and peanuts. Vitamin B6 is found in bananas, tuna and nuts. Vitamin B12 is found in meats, fish, poultry and dairy products. Those at high risk may want to take a multivitamin containing these vitamins.
Although nutraceuticals may be useful tools in the fight against heart disease, they work best in conjunction with a healthy diet and exercise regimen. For those who need something even more powerful in their fight, cholesterol-lowering medications are available.
Amy Tousman is a registered dietitian at Straub Clinic & Hospital Inc. and a member of the Hawai‘i Dietetic Association.
Hawai‘i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send comments to: Prescriptions, ‘Ohana Section, The Hono-lulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com or fax 535-8170. This column is not intended as medical advice; you should consult your doctor.
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