For years doctors have been telling us that higher levels of HDL “good” cholesterol will help protect us from heart disease. Even though it’s widely accepted that more HDL cholesterol is beneficial, it’s never been more than a theory. And new research casts doubt on whether HDL cholesterol actually does lower the risk of heart disease.
Bad news for big pharma?
Millions of people take statin drugs like Crestor, Lipitor, Pravachol, and Zocor to lower LDL “bad” cholesterol. Strong evidence exists that high LDL levels increase heart attack risk. But no research supports giving medication to raise HDL cholesterol levels. Even so, drug companies are developing and testing drugs that raise HDL, although recent trials have failed.
New research from Harvard Medical School seems to refute the idea that raising HDL lowers risk of heart attack and stroke. The study, published online in “The Lancet,” expands on earlier research that identified a gene variant found in about 2.6 percent of the population associated with higher HDL levels. People with the gene variant have HDL levels about six points higher, on average, than people without it.
Genetic evidence is clear
If HDL does indeed reduce the risk of heart disease, then those who make more of it naturally should be at lower risk for heart disease. However, when the researchers looked for the gene variant in about 21,000 people who had suffered heart attacks and 95,000 people who hadn’t, they saw no evidence that people with the gene variant were less susceptible to heart attacks.
No cause and effect found
The study’s authors said their findings don’t question well-documented research showing that higher HDL levels are associated with lower heart attack risk. But no cause and effect relationship exists for higher HDL alone. Instead, higher HDL levels may be an indicator something else is going on that lowers the risk. It could be as simple as a healthier lifestyle, given that low HDL tracks with obesity, smoking, lack of exercise and insulin resistance.
Statins vs. diet and exercise
The study probably won’t change current heart disease treatments, which focus on using statin drugs to lower LDL cholesterol. But in the meantime, raising HDL cholesterol naturally certainly couldn’t hurt, because plenty of exercise is the best way to do that, even though it may not have a direct impact on heart attack risk.
Research does support lowering cholesterol levels overall. And changing your diet is still more effective and affordable than statin drugs:
- Avoid saturated fats such as butter and transfats in hard margarines and processed baked goods. Cook with olive oil and dip your toast in it.
- Limit fatty meats, processed meats, egg yolks and organ meats like liver and kidney. Go with skinless chicken or turkey, lean beef, veal, pork, lamb, and fish. Try meatless main dishes, like beans, peas, pasta, or rice.
- Limit your meat, poultry, and fish to no more than two servings about the size of a deck of playing cards a day.
- Limit dairy with more than 1 percent milk fat, including cream, most cheeses, and nondairy coffee creamers or whipped toppings.
- Avoid fast food. When you eat out, choose broiled sandwiches or chicken without skin, salads with low-fat dressing, and foods that aren’t fried. Ask your server to hold the cheese and mayo.