Wood Street Clinic Blog

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DASH diet reduced heart failure risk 'by almost half' in people under 75

Sticking to a plant-rich diet that can reduce high blood pressure may also lower the risk of heart failure in people under the age of 75.
example of DASH diet with salad and salmon
The DASH diet is rich in fruit, vegetables, and fish, as well as poultry and nuts.

This was the conclusion of a study that a team at Wake Forest School of Medicine in Winston-Salem, NC, led to assess the impact of the Dietary Approaches to Stop Hypertension (DASH) eating plan on heart failure.

They report their findings in a paper that now features in the American Journal of Preventive Medicine.

According to figures from the Centers for Disease Control and Prevention (CDC), there are around 5.7 million adults with heart failure in the United States.

The condition arises when the heart continues to beat but cannot pump blood as well as it should.

The result is that organs and tissues do not get the oxygen and nutrients they need to function properly and remain healthy.

"Heart failure is a frequent cause of hospitalization in older adults and is associated with substantial healthcare costs, so identifying modifiable risk factors [for] heart failure is an important public health goal," says lead study author Dr. Claudia L. Campos, an associate professor of general internal medicine at Wake Forest School of Medicine.

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DASH eating plan can lower blood pressure

The DASH eating plan is high in fruits, vegetables, and whole grains, as well as beans, nuts, low-fat or fat-free dairy, poultry, fish, and vegetable oils.

It is low in saturated fats, full-fat dairy, fatty and red meats, salt, sugary drinks, sweets, and tropical oils such as those from coconut and palm.

Some previous studies have shown that the DASH diet can lower blood pressure and low-density lipoprotein, or "bad," cholesterol.

The National Institutes of Health (NIH) promote DASH as part of a "heart-healthy lifestyle" that includes exercising, maintaining a healthy weight, not drinking too much alcohol, managing stress, not smoking, and sleeping well.

Although much of it is similar to the Mediterranean diet, DASH differs in that it emphasizes low-fat dairy and completely excludes alcohol.

The new investigation follows another that also reported that a plant-based diet could cut the risk of heart failure. However, that study focused on people who were aged 45, on average, while the new one examined older adults.

The researchers analyzed records from The Multi-Ethnic Study of Atherosclerosis (MESA), which enrolled men and women at six clinics in different universities across the U.S.

DASH effective for those under 75

The participants were aged 45–84 when they joined in 2000–2002. None had any cardiovascular diseases at that time. MESA tracked them from that point, noting any incidences of cardiovascular health conditions, including heart failure.

The analysis used data covering 13 years of follow-up on 4,478 participants. Dietary data came from the participants' responses to 120-item questionnaires on consumption frequency and amounts of various foods and drinks.

The researchers grouped the participants into five sets, each comprising 20% of the cohort, and ranked them according to how closely their eating pattern matched that of DASH. They then examined the incidence of heart failure across the sets of participants.

The results showed that for all the participants, sticking to the DASH eating plan seemed to have little significant effect on heart failure risk. However, when they took out participants aged 75 and over, the researchers saw a pattern.

The rate of heart failure was 40% lower in people under 75 who most closely followed the DASH eating plan, compared with those who followed it the least.

Dr. Campos says that their findings establish a basis for further studies to explore whether adopting the DASH eating plan could effectively prevent heart failure.

"This research showed that following the DASH diet can reduce the risk of developing heart failure by almost half, which is better than any medicine."

Dr. Claudia L. Campos

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5 causes of cold intolerance

People with cold intolerance frequently feel cold when other people are comfortable or even warm. Cold intolerance may only occur in certain parts of the body, such as the hands or feet.

Some people naturally tend to feel colder than others, without any discernible cause. However, cold intolerance can also be a symptom of an underlying medical condition.

In this article, learn about a range of possible reasons for cold intolerance. We also describe when to see a doctor.

Causes of cold intolerance There are many reasons why a person might feel cold all the time, including: 1. Hypothyroidism Woman wrapped up in a blanket wondering why am i always cold
Symptoms of hypothyroidism can include fatigue, depression, and feeling cold.

Cold intolerance is a well known symptom of hypothyroidism.

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones. These hormones help regulate metabolism and temperature.

When the thyroid is not producing enough thyroid hormones, the body's processes tend to slow down.

Symptoms of hypothyroidism include:

A doctor can diagnose hypothyroidism with a simple blood test. Treatment often consists of thyroid hormone replacement.

2. Raynaud's disease

Raynaud's disease affects the arteries in the fingers, toes, or both. These arteries become narrow, which reduces blood flow.

During these episodes, the fingers and toes can turn blue or white. As blood flow returns, the fingers and toes can become red and feel numb or painful.

Cold temperatures and stress can trigger episodes of Raynaud's. Treatment involves avoiding triggers if possible and, for some people, medication or surgery.

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3. Anemia

Anemia occurs when a person does not have enough red blood cells circulating and carrying oxygen throughout the body. Symptoms of anemia, including feeling cold, result from a relative lack of oxygen.

Other symptoms can include:

feeling cold in the hands or feet weakness or fatigue dizziness or lightheadedness trouble breathing an increased heart rate headache pale skin

There are several kinds of anemia. Types that may make a person feel cold include:

Iron-deficiency anemia

Iron-deficiency anemia is the most common type of anemia. It typically occurs due to blood loss but can also result from poor iron absorption.

People who are pregnant or menstruating are at risk of iron-deficiency anemia.

Vitamin-deficiency anemia

Anemia can also result from nutritional deficiency. Low levels of vitamin B-12 and folic acid can lead to anemia, usually from inadequate dietary intake.

4. Anorexia nervosa

Anorexia nervosa, or just "anorexia," is an eating disorder characterized by weight loss or inadequate weight gain and a distorted body image.

People with anorexia may intensely restrict their food intake, exercise excessively, or purge with laxatives or by vomiting.

Anorexia can cause a person to experience cold intolerance due to inadequate body fat.

Other symptoms of anorexia can include:

weight loss stomach problems, such as constipation or cramping trouble concentrating dizziness or fainting the lack of a period in menstruating women dry, brittle hair or nails weakness poor wound healing intense fear of becoming overweight restricting certain foods or categories of food being secretive about food intake fear of eating in public social isolation

Treatment of anorexia nervosa often involves a multidisciplinary team of doctors, nurses, and nutritionists. A person may benefit from talk therapy in addition to medication and a nutrition plan.

5. Peripheral artery disease

Peripheral artery disease occurs when plaque builds up in the arteries that carry blood to the rest of the body. Another name for this buildup is atherosclerosis.

The accumulation of plaque in the arteries makes them narrower, which means that it is more difficult for blood to flow through them.

Peripheral artery disease often causes decreased blood flow to the extremities, creating a feeling of coldness, numbness, tingling, or pain in the hands, feet, or both. In severe cases, peripheral artery disease can lead to tissue death.

Treatment for peripheral artery disease often includes lifestyle changes, such as exercising and quitting smoking. Some people also need surgery.

Thank you for supporting Medical News Today Do women feel colder than men? Man and woman outside in the cold
Women may feel colder than men, according to research. Research suggests that women may feel colder or have a higher preferred temperature than men. The authors of a 2015 study reported that the preferred room temperature for men is 22°C (71.6°F), while for women it is 3°C higher, at 25°C (77°F). One possible reason for a more significant cold intolerance in females is that they often have a lower resting metabolic rate than men, which means that a female body may use less energy when at rest. A higher metabolic rate can keep the body warmer, while a low metabolic rate may keep someone feeling cold. When to see a doctor If cold intolerance is a new symptom or a person's tolerance for cold is diminishing, it is best to see a doctor. The doctor will ask for a detailed history of symptoms and conduct a physical exam. Depending on the exam results, the doctor may order additional testing, such as blood tests to check hormone levels or blood counts to determine if there is an underlying medical cause. Thank you for supporting Medical News Today Summary Some people tend to feel colder than others; this is not usually an indication of any health issue. However, if a person is experiencing new or worsening cold intolerance, it might be a sign of an underlying condition. Anyone concerned about cold intolerance or anyone who experiences additional symptoms should see a doctor for an evaluation.
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What to know about the Whole30 diet

The Whole30 diet is a 30-day program that aims to remove certain groups of foods, which it claims may harm a person's health. Most people should be able to tolerate the diet, though some people may want to avoid it for several reasons.

Unlike many other diets, the Whole30 diet does not focus solely on weight loss or calorie counting, so it may not be right for people who are only looking to lose weight. Instead, the restrictions include groups of foods that a person can or cannot eat.

The end goal of the Whole30 diet is to reset the body and allow the person to then slowly add foods back into their diet and check for adverse reactions.

Definition People making a fruit salad in kitchen using berries and apples for whole30 diet
The whole30 diet involves eating only certain food groups.

The Whole30 diet is a 30-day program created in 2009.

The basis for the program is to deal with underlying health issues in the body by removing certain groups of foods, which the creators of the diet believe are harmful.

The Whole30 website itself states that the diet helps to cut out food groups that it claims are:

inflammatory gut-disrupting psychologically unhealthy hormone unbalancing

According to the Whole30 program, these potentially harmful food groups include:

dairy sugar grains legumes

By cutting out all of these foods for 30 consecutive days, proponents of the diet believe the body can heal from the underlying issues these foods may cause. In this regard, the diet would act as a reset button.

While not everyone will feel some negative effects of eating each of these food types, the diet eliminates them all at once to allow an individual to find a new baseline, working their way back up from there to establish a suitable permanent diet.

Thank you for supporting Medical News Today Safety and effectiveness There are no current studies on the effects of the Whole30 program itself, so there may be no way to say for sure whether it works or not. Also, the end goal of the diet is not concrete, so success may be hard to quantify. While the Whole30 diet is not primarily a weight loss program, the Whole30 website claims that over 95% of participants lose weight and improve their overall body composition. Additional benefits the program claims people experience include: more energy sharper mental focus better sleep clearer skin improved mood increased athletic performance reduced cravings for unhealthful foods The website also claims that thousands of testimonials from clients state that the diet helps with conditions that include: This evidence from testimonials is anecdotal, which does not support the idea that the diet will help improve these conditions for everyone. As the diet focuses more on the elimination of food groups rather than individual components, it would be difficult to quantify success or failure with the diet. With that said, the Whole30 diet does eliminate most sources of dietary carbohydrates, such as refined grains and sugars. As such it is technically a low-carb diet, though it does allow for some sources of carbohydrates, such as potatoes. Low-carb diets have research behind them and may help people lose weight and reduce their risk of cardiovascular issues. A study in the journal Annals of Internal Medicine compares low-carbohydrate diets and low-fat diets for their effect on weight loss and cardiovascular risk. Researchers found that when they checked at 3, 6, and 12 months, people who followed a low-carb diet lost more weight than people who followed a low-fat diet. The quantity of harmful fats that may increase the risk of cardiovascular disease also went down. Importantly, this study followed up with people after a minimum of 3 months, which is much longer than the 30-day program of the Whole30 diet. On the other hand, a review in the journal PLoS One notes that low-carbohydrate eating may produce similar results as other weight loss diets, and does not appear to have any particular benefit over other forms of dieting. Again, this is with longer-term diets. The researchers also note that in the long term, dietary guidelines should be sustainable and easy to manage. A heavy restriction diet such as the Whole30 diet is not going to be easily sustainable without careful management, so people who use the program should have a good exit strategy and modified diet afterward. Foods to avoid Bottles of syrup on wooden tray
A person following the Whole30 diet should avoid most sugars, including syrups. Unlike other diets that focus on only one aspect of nutrition, such as low-fat diets or calorie counting, the Whole30 diet concerns itself with entire food groups that it sees as problematic. The Whole30 diet sets out strict guidelines for what participants may eat during the program. Participants have to avoid the following foods: Sugars, including natural or alternative sweeteners, such as: Dairy, including all products made from cow, sheep, or goat's milk, such as: Grains in all forms, including: Legumes and beans of all types, including: Soy in all forms, such as: edamame soy sauce miso tempeh tofu soy protein soy lecithin soy oil Other things to avoid are: alcohol in any form added ingredients, including monosodium glutamate (MSG), sulfites, and carrageenan baked goods and junk foods, including everything from pancakes and waffles to chips and ice cream To follow the Whole30 diet correctly, a person can have no cheat days during these 30 days and may not allow these foods into their diet under any circumstances. Anyone who does slip up or has a cheat day would have to repeat the process from day 1. Foods to eat Instead of these foods, the Whole30 diet suggests filling up the person's food intake with other fresh, whole foods, including: high quantities of vegetables moderate amounts of meat, seafood, and eggs plenty of natural, healthy fats some fruits nuts and seeds such as almonds and cashews all herbs, spices, and seasonings coffee, tea, and herbal teas There are also some exceptions to the food groups that the diet eliminates. These include: ghee or clarified butter — the only dairy product allowed on the program green beans, snow peas, and sugar snap peas — the only legumes the program permits iodized table salt all forms of vinegar except malt vinegar fruit juice These foods may technically be problematic foods, but the diet allows for their use. Should I try the Whole30 diet? A person outside having almond nuts as a snack.
A person following the Whole30 diet may want to prepare on-the-go snacks in advance. The Whole30 diet is not a simple diet plan that a person can ease into over long periods. It is more of a 30-day commitment. Because of this, it may not be right for everyone. The diet itself is very restrictive. Additionally, if a person slips up once or has a cheat meal, they have to start their 30 days over again. This alone is a hurdle, as it takes a lot of self-discipline to complete these 30 days. In addition, undertaking the diet can take a lot of time. Because the diet eliminates entire groups of foods, it may take a lot of time to plan and prepare meals for the 30 days. Eating out at most restaurants is not an easy option, given the strict nature of the diet. On-the-go snacks that may class as junk foods are also off limits. This may mean that a person who wants to try the Whole30 diet will need a lot of time to cook and prepare their meals and snacks ahead of time. People who are not ready to commit time to their diet may want to try other methods, such as simple calorie counting. Thank you for supporting Medical News Today Takeaway While the Whole30 program may help some people lose weight, it is not the main focus of the diet. The main aim is to give the body a reset, allowing it to recover from the effects of foods the program's creators believe are harmful. In that regard, the weight-loss benefits of the diet would be secondary to the reset it provides the body. The person would then slowly integrate these potentially problematic foods back into their diet one at a time to check for any reactions. It is important to note that the Whole30 diet is extremely restrictive and is not a long-term diet. After the 30 days are up, it is essential to transition to a more balanced, healthful long-term diet than the Whole30 diet.
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How do you prevent type 2 diabetes?

There are steps that people can take to significantly reduce their risk of developing type 2 diabetes. Maintaining a healthy weight, eating well, and exercising often are three very effective preventative measures.

According to the American Diabetes Association (ADA), over 9% of the population of the United States are living with diabetes. In 2015, the number of people living with prediabetes was over 84 million.

Since diabetes is a growing health concern, many people want to learn about ways to prevent it.

There are two types of diabetes: type 1 and type 2. It is not possible to prevent type 1 diabetes. However, there are several steps a person can take to significantly reduce their risk of developing type 2 diabetes.

In this article, learn which steps to take to help prevent type 2 diabetes from developing.

How to prevent type 2 diabetes There are three ways a person can help prevent type 2 diabetes: Maintaining a healthy weight Man eating noodles in restaurant smiling and happy preventing type 2 diabetes
Eating a balanced diet can help with maintaining a healthy weight.

One of the most important steps a person can take to help prevent the onset of type 2 diabetes is to reach or maintain a healthy weight.

The National Institute of Diabetes and Digestive and Kidney Diseases suggest that if a person who is overweight loses about 5–7% of their body weight, they can lower their chances of developing type 2 diabetes.

According to the ADA, being overweight can increase a person's risk of:

If a person who is overweight reduces their total weight by just 10–15 pounds, they may reduce their risk of developing these conditions significantly.

However, effectively controlling weight can be challenging. Results are often slow to come and require changes to physical activity as well as eating habits.

Some strategies a person can try to help reach and maintain a healthy weight include:

joining a support group keeping a food journal eating smaller portions drinking plenty of water making a meal plan joining a gym, running club, or yoga class spending less time sitting during the day getting enough sleep

People who want to lose weight should consider talking to their doctor about safe and effective methods.

Eating a balanced diet

Maintaining a balanced diet can help reduce the risk of developing type 2 diabetes. It is a crucial part of reaching and maintaining a healthy weight.

Eating a balanced diet does not mean simply cutting calories. Eating a balanced diet involves eating foods rich in vitamins, minerals, fiber, protein, and good fats.

It also means avoiding or cutting back on foods with added sugars and sodium.

Some of the best foods to include in a preventative diet include:

green, leafy vegetables beans non-starchy vegetables fresh or frozen fruits lean proteins, such as fish and tofu nuts and seeds oatmeal and whole grains

Foods to avoid include:

sugary beverages, including energy drinks, sodas, and juices processed meats, such as bacon packaged snacks sweets and desserts

It is a good idea to start with small steps and changes. For example, somebody who regularly drinks soda can try replacing it with sparkling water and lime. Another example is replacing white grains and pasta with whole-grain versions.

Also, try reducing meal sizes and drinking water a few minutes before eating meals. This can help reduce the amount of calories a person consumes at meal times.

Exercising regularly

Regular exercise can help reduce the risk of developing type 2 diabetes.
Regular exercise can help reduce the risk of developing type 2 diabetes.

An essential part of reaching and maintaining a healthy weight is exercising regularly. This has a range of health benefits, including:

improving blood flow reducing the risk of heart disease improving stamina reducing weight providing stress relief improving flexibility

There are several types of exercise a person can try to help prevent the development of type 2 diabetes. These include:

aerobic exercise, such as walking, cycling, swimming, or running strength training using weights or bands stretching exercises, such as yoga or Pilates

A person can also incorporate more movement into their day by using a standing desk, parking farther away from the workplace, and using active transport.

According to the ADA, a person should aim to move or stretch every 30 minutes during the day.

Also, for maximum benefit, a person should aim to do at least 30 minutes of an aerobic activity once per day for 5 days of the week.

People should always speak with a doctor before starting an exercise regime for the first time to discuss safety and risks.

Thank you for supporting Medical News Today Risk factors Risk factors that a person can reduce include their cholesterol levels and weight. Having higher levels of bad cholesterol and excess weight both increase the risk of developing type 2 diabetes. People can reduce some, but not all, of their risk factors for type 2 diabetes. Risk factors that a person cannot change include: Age: Older people have a higher risk of developing diabetes than young people. Race: American Indians, African Americans, Native Hawaiians, Mexican Americans, Pacific Islanders, and Asian Americans are at a higher risk of diabetes. Family history: Having a close family member, such as a sibling or parent, with type 2 diabetes increases a person's risk. Gestational diabetes: Women who develop gestational diabetes during pregnancy are at greater risk of type 2 diabetes. Early signs of diabetes Increased thirst is a potential early signs of type 2 diabetes.
Increased thirst is a potential early sign of type 2 diabetes. There are several potential early warning signs that a person may experience that indicate they have diabetes. These include: increased thirst a frequent need to urinate feeling of constant hunger blurred vision fatigue developing darker patches of skin itchiness numbness or tingling in hands or feet cuts that heal slowly When to see a doctor As people age, they should see their family doctor for annual checkups. The doctor will usually order blood work to check for factors such as blood sugar levels, cholesterol, and other health warning signs. At annual checkups, a person can ask their doctor about strategies that help prevent diabetes, especially if they have a family history of the condition. If a person experiences any signs or symptoms of diabetes, it is best to speak to a doctor. This is because diagnosing diabetes early can help keep symptoms under control. Summary Type 2 diabetes is a growing concern for many people. Although there are some risk factors that people cannot change, such as age and family medical history, there are several steps they can take to reduce their likelihood of developing the condition. Maintaining a healthy weight, eating a balanced diet, and exercising regularly can all help reduce the risk of developing type 2 diabetes.
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Natural ways to lower cholesterol

Cholesterol is a waxy, fat-like substance that the liver produces. It is also present in animal-based foods. Cholesterol supports many essential bodily functions, but high levels can lead to health issues.

According to the National Heart, Lung, and Blood Institute (NHLBI), unhealthful lifestyle choices are the leading cause of high cholesterol. However, genetics, certain medical conditions, and medications can also contribute to high cholesterol.

Having high cholesterol does not cause symptoms, but it can increase the risk of heart disease and stroke. Doctors can prescribe statins to help lower a person's cholesterol levels, but these medications can cause side effects, such as headaches, muscle cramps, and nausea.

In this article, we explore some natural ways to lower cholesterol without medication. We also discuss what cholesterol is and why high levels can be harmful.

Avoid trans fats girl eating fried breakfast
Eating fried food can raise a person's LDL cholesterol.

Trans unsaturated fatty acids, which people commonly refer to as trans fats, are unsaturated vegetable fats that have undergone an industrial process called hydrogenation, which makes them solid at room temperature. Food manufacturers use trans fats because they are relatively inexpensive and long-lasting.

Sources of trans fats include:

margarine vegetable shortening partially hydrogenated vegetable oils fried foods certain processed and prepackaged foods

Bacteria in the stomachs of cows, sheep, and goats produce natural trans fats. Cheese, milk, and other dairy products may contain modest amounts of natural trans fats.

According to the American Heart Association (AHA), consuming trans fats can negatively affect a person's health in two different ways:

they can raise blood levels of low-density lipoprotein (LDL) cholesterol, or "bad cholesterol" they can reduce blood levels of high-density lipoprotein (HDL) cholesterol, or "good cholesterol"

LDL cholesterol can accumulate in the arteries and increase the risk of heart disease, heart attack, and stroke. HDL cholesterol helps remove LDL cholesterol from the bloodstream.

According to a 2019 review, low levels of HDL cholesterol are common in people with type 2 diabetes, which increases their risk of heart disease. The authors suggest that treatment should focus on lowering LDL cholesterol levels to reduce this risk.

In a 2017 study, researchers used cell cultures to show that a trans fat called elaidic acid had toxic effects in neuron-like cells. Elaidic acid led to cell death and increased markers of oxidative stress.

Thank you for supporting Medical News Today Consume fewer saturated fats Saturated fats generally stay solid at room temperature whereas unsaturated fats are usually liquid. Dietary sources of saturated fats include: red meat pork chicken with the skin on butter cheese and other dairy products cooking oils, such as palm oil and coconut oil The AHA recommend that saturated fat should only represent about 5–6% of a person's daily calorie intake. A diet high in saturated fats may raise a person's LDL cholesterol levels. Excess LDL cholesterol can accumulate and form hard deposits in the arteries, which may lead to a condition called atherosclerosis. A 2018 study examined how different dietary fats affected blood levels of cholesterol. The 4-week study involved 96 healthy adults who consumed 50 grams (g) daily of either: extra virgin coconut oil butter extra virgin olive oil Coconut oil and butter predominately contain saturated fat, whereas olive oil contains mostly monounsaturated fat. According to the results, the participants who consumed butter had significantly higher levels of LDL cholesterol than those in the coconut oil and olive oil groups. The study also showed that different types of saturated fat can vary in their effects on cholesterol levels. For example, coconut oil significantly increased the participants' levels of HDL cholesterol whereas butter significantly raised LDL cholesterol levels. However, a 2015 systematic review did not find a direct association between saturated fat intake and risk of death, coronary heart disease, cardiovascular disease, stroke, or type 2 diabetes. Consume more monounsaturated fats Vegetables, nuts, and fish are rich in monounsaturated fats. These fats take the form of liquids at room temperature. Good sources of monounsaturated fats include: avocados nuts, such as almonds, peanuts, and Brazil nuts seeds vegetable oils, such as olive, peanut, sesame, and sunflower oils In a 2019 study involving 119 adults with a high waist circumference, consuming a diet high in a monounsaturated fat called oleic acid resulted in lower LDL and total cholesterol levels than a diet that was higher in saturated fats and lower in monounsaturated fats. Oleic acid had no effect on the levels of triglycerides or HDL cholesterol in the blood of the participants. Eat more polyunsaturated fats lower cholesterol naturally by eating salmon and avocado
Eating foods rich in polyunsaturated fats can reduce LDL cholesterol. Polyunsaturated fats include omega-3 and omega-6 fatty acids. Consuming these fats in moderation can reduce LDL cholesterol without affecting HDL cholesterol levels. Dietary sources of polyunsaturated fats include: walnuts fish, such as salmon, tuna, and trout plant oils, such as soybean, corn, and sunflower oils A 2017 review found evidence suggesting that diets rich in polyunsaturated fats from fish oil may prevent some mechanisms of arrhythmia, which is an irregular heartbeat, and promote overall heart health. It is important to balance the intake of omega-6 fatty acids with that of omega-3 fatty acids. Consuming too many omega-6 fatty acids may cause adverse health effects. In a 2018 study, mice that consumed a diet high in omega-6 fatty acids had low-grade chronic inflammation that was due to oxidative stress. Eat more soluble fiber Soluble fiber absorbs water to create a thick, gel-like paste in a person's digestive tract. Soluble fiber not only supports digestive health but also lowers levels of LDL cholesterol and promotes overall heart health. A 2017 study investigated the benefits of a high-fiber diet in 69 Asian Indians with higher-than-normal cholesterol levels. The participants who consumed 70 g per day of soluble fiber had lower total cholesterol and LDL cholesterol levels than those who ate their usual diet. Foods rich in soluble fiber include: vegetables fruits whole grains, such as oatmeal and brown rice legumes beans Soluble fiber lowers LDL cholesterol levels but does not affect HDL cholesterol or triglyceride levels. Consuming too much soluble fiber can lead to constipation, bloating, and stomach pain. People should try to increase their soluble fiber intake gradually over time. Thank you for supporting Medical News Today Exercise regularly group of men jogging
Regularly exercising can help lower bad cholesterol. Studies show that regular exercise can help lower bad cholesterol levels and raise good cholesterol levels. For example, the results of a 2019 study involving 425 older adults showed that moderate and vigorous physical activity lowered blood pressure, reduced blood sugar levels, and increased HDL cholesterol levels. In a 2015 study involving 40 adult women, participants who followed a 12-week resistance training program had reduced total cholesterol and increased HDL cholesterol levels compared with those who did not follow the program. The Department of Health and Human Services recommend that adults do at least 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic physical activity a week for substantial health benefits. A person can spread this activity throughout the week. People new to exercise may want to start with lower intensity activities and gradually build the intensity of their workouts. Performing high-intensity exercises without proper training or supervision can lead to injuries. People can incorporate regular exercise into their lives by walking, jogging, cycling, or doing resistance exercises with light weights. People with cardiovascular disease or other heart problems should consult a doctor before participating in intense physical activities. What is cholesterol? Cholesterol is a fat-like substance that is present in every cell in the body. Although having too much cholesterol can increase the risk of adverse health effects, the body needs cholesterol to build cell membranes and to produce: The liver naturally produces all of the cholesterol that the body needs. However, certain foods contain cholesterol, and other foods can trigger the liver to produce more cholesterol. High levels of LDL cholesterol can lead to fatty deposits building up on the walls of arteries, which increases a person's risk of heart disease, heart attack, and stroke. HDL cholesterol collects LDL cholesterol and other fats from the arteries and transports them back to the liver. The liver disposes of excess cholesterol by converting it into a digestive fluid called bile. Although people should aim to have more HDL cholesterol than LDL cholesterol, the NHLBI recommend that adults keep their blood levels of total cholesterol below 200 milligrams per deciliter. Thank you for supporting Medical News Today Summary Cholesterol supports many essential bodily functions, such as cell membrane formation and hormone production. However, having high levels of LDL cholesterol can increase a person's risk of heart disease, heart attack, and stroke. People can naturally lower their cholesterol levels through dietary and lifestyle changes. Replacing trans fats with monounsaturated and polyunsaturated fats can help lower levels of LDL cholesterol and raise levels of HDL cholesterol. Other ways to naturally lower cholesterol include eating more soluble fiber and exercising regularly.
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Cancer treatments: Patients need to know heart risks

Recent research on the health risks that people undergoing cancer treatment face warns that there is a lack of awareness about the risks that some of these therapies can pose to heart health.
doctor speaking to patients
Not enough cancer patients are aware of the potential adverse effects of cancer treatment on their heart.

Investigators from Flinders University in Adelaide, Australia have found that many people who receive chemotherapy or radiotherapy for cancer risk their heart health by having these treatments.

At the same time, the new research shows that most of these people have limited or no knowledge about the cardiovascular risks because their doctors never tell them.

The authors recently presented their findings at EuroHeartCare 2019, a congress of the European Society of Cardiology, which took place at the start of May in Milan, Italy.

"Depending on the type of chemotherapy and radiotherapy, between 1% and 25% [of] cancer patients may develop heart failure due to cancer treatment," warns study author Prof. Robyn Clark.

"Risk," she adds, "also depends on cardiovascular risk factors, such as smoking and obesity. Better monitoring of the heart and intervention before, during, and after treatment can prevent or lessen the impact of this cardiotoxicity."

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Cancer patients unaware of risks

The study authors explain that people who experience heart problems following cancer treatment may not do so immediately.

In fact, according to research investigating heart failure risk in people who have undergone cancer treatment, therapy-related heart failure can develop up to 20 years after the treatment has concluded.

In the current study, the researchers looked at the medical records of 46 people who had received cancer treatment at one of three hospitals between 1979 and 2015. All of these people had cardiotoxicity (damage to the heart muscle), and the research team selected them at random.

The investigators found that of these 46 patients, only 11% had received a referral to a specialized cardiologist before beginning chemotherapy, and medical professionals had only referred 48% of them to a heart failure clinic following their treatment.

Prof. Clark and colleagues also note that among the individuals whose records they studied, about 40% were overweight or had obesity, 41% had smoked or were still smoking, 24% used alcohol regularly, 48% had high blood pressure, and 26% lived with diabetes.

Patients miss crucial self-care information

The researchers then looked at the provision of care received by subsets of cancer patients during two different periods: 1994–2011 and 2012–2015. They selected these dates so that they could look at the effect of the publication of the European Society for Medical Oncology's Clinical Practice Guidelines, which appeared for the first time in 2012.

When they compared the provision of care in the two periods, the investigators found that the rate of appropriate heart care did actually increase.

The percentage of people who received a referral to a cardiologist before starting chemotherapy went from 0% to 23%, while the percentage of patients receiving a baseline echocardiogram — a scan that allows doctors to assess heart function — rose from 57% to 77%.

Moreover, the researchers went on to interview 11 cancer patients, of whom seven also belonged to the randomly selected group of 46 people whose medical records the investigators initially analyzed.

None of these individuals were aware of their heart health needs, and while more than half of the interviewees reported developing more healthful eating habits following their diagnosis, none of them had a solid understanding of what a balanced diet should entail.

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Doctors should issue more referrals

Based on all of these findings, the study authors stress the importance of monitoring heart health in people about to undergo cancer treatment and adjusting care to meet each person's needs.

"Monitoring the heart throughout the cancer journey can ensure it is protected. Cardiotoxicity can occur even in people without cardiovascular risk factors since drugs like anthracyclines and trastuzumab are toxic to the heart, so it is an innocent bystander."

Prof. Robyn Clark

Prof. Clark and team also note that doctors should explicitly tell cancer patients about the risks that their recommended cancer treatments carry and advise them on the best ways to minimize heart risks — for instance, by working to improve relevant lifestyle factors, such as physical activity and diet.

However, if a cancer patient does develop heart failure, they can still access helpful therapies as long as doctors keep a close eye on the condition, says Prof. Clark.

The researchers explain that healthcare professionals can identify cardiotoxicity either by using echocardiograms or cardiac imaging or by looking for specific biomarkers. People who may develop or already have heart failure could receive angiotensin converting enzyme inhibitors or beta-blockers as a treatment.

At the same time, people whose cancer treatments are damaging their heart health could benefit from modified cancer therapies that minimize this harm, if their doctors closely monitor any cardiovascular developments.

"For cancer patients who do develop heart failure, there are clinics that will improve their quality of life, but our study shows many are not referred," Prof. Clark points out.

"Telephone calls to support and monitor those with cancer and heart failure would reduce the burden of hospital appointments, which patients said was a priority," she emphasizes.

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Using coal as a potent antioxidant

Researchers may have found a way to prevent certain medical conditions from overwhelming the body's natural antioxidant system.
Pile of coal
Could coal form the basis of hi-tech antioxidants?

Traumatic events, such as brain injuries, strokes, and heart attacks affect millions of people each year and can be fatal. The World Health Organization (WHO) lists stroke as the world's second biggest killer.

All of these conditions involve oxidative stress, which is a bodily imbalance between the levels of free radicals and antioxidants.

In the case of traumatic brain injuries, the number of free radicals increases, resulting in tissue damage and, potentially, organ dysfunction. This imbalance can also lead to the lasting effects of heart attack and stroke.

Antioxidant therapy is one way to combat oxidative stress. Researchers are still studying its efficacy, but many consider it to be a promising treatment. However, natural antioxidants, such as the enzyme superoxide dismutase, tend to be overrun by free radicals called reactive oxygen species (ROS).

Finding an artificial antioxidant might help the body's natural antioxidants overpower ROS — a new study reports on a surprising source.

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Coal's potential

The answer is coal, according to scientists at Rice University in Houston, TX, the Texas A&M Health Science Center, and the McGovern Medical School at The University of Texas Health Science Center.

This antioxidant derives from graphene quantum dots (GQDs) that the scientists first extracted from common coal in 2013. These quantum dots are tiny semiconductor particles that scientists can manipulate in certain ways. The newest development shows that these dots might help to keep oxidative stress at bay.

The chemists had previously found that adding polyethylene glycol (PEG) to hydrophilic clusters could reduce oxidative stress. One nanoparticle canceled out thousands of ROS molecules.

But coal could provide a much cheaper and more convenient solution. The scientists found that adding PEG to coal-derived quantum dots was equally effective. The team recently published their findings in the ACS Applied Material & Interfaces journal.

Future benefits

The scientists tested the coal dots on live cells taken from rodents. They showed that a number of different concentrations seemed to reduce ROS activity.

They saw a positive effect even when they administered the quantum dots 15 minutes after adding hydrogen peroxide to the samples. Hydrogen peroxide is a chemical that induces oxidative stress.

The researchers extracted quantum dots from both bituminous and anthracite coal. The former are smaller, and the team found them to be less effective as an antioxidant. Anthracite dots, on the other hand, could preserve more cells even at lower concentrations.

But in a living organism, "the smaller ones are more effective," notes Rice University chemist James Tour. "The larger ones likely have trouble accessing the brain as well."

Although scientists will have to do more research into antioxidant therapy, Tour believes his new work will be hugely beneficial in the future.

"Replacing our earlier nanoparticles with coal-derived quantum dots makes it much simpler and less expensive to produce these potentially therapeutic materials," he says. "It opens the door to more readily accessible therapies."

"Working on this project has been quite the eye-opening experience. It has been fascinating to synthesize, characterize, and then test these nanoparticles in vivo and see them work."

Co-lead author Kimberly Mendoza

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Type 2 diabetes: Intensive hypertension therapy may lower death risk

According to a new study, intensive treatment for high blood pressure may reduce the risk of death from any cause, including cardiovascular disease, in people with type 2 diabetes.
close up of a person taking their blood sugar test
New research suggests that intensive blood pressure treatment may help those with type 2 diabetes.

Diabetes is one of the most common and costly chronic conditions in the United States. Over 100 million people in the U.S. have diabetes or prediabetes, according to the 2017 report compiled by the Centers for Disease Control and Prevention (CDC).

Diabetes is a disease that affects how the body processes glucose. Type 2 diabetes, which is the most common form of the disease, reduces the production of insulin, a hormone that regulates blood sugar levels. When this occurs, blood sugar levels rise, increasing the risk of heart disease.

Hypertension, or high blood pressure, also increases the risk of cardiovascular disease. According to the National Institutes of Health (NIH), blood pressure is "the force of blood pushing against the walls of [the] arteries as the heart pumps blood." Hypertension happens when "this force against the artery walls is too high."

Doctors measure blood pressure in millimeters of mercury (mmHg). The first number, or the systolic pressure, refers to the pressure in the blood vessels when the heart beats. The second number measures the diastolic blood pressure, which is the pressure in the blood vessels when the heart rests between beats.

Doctors define "prehypertension" as 120–139 mm Hg for systolic pressure and between 80–89 mmHg for diastolic pressure. They consider a pressure of 140/90 mmHg as high.

According to the CDC, about 75 million people in the U.S. have high blood pressure, but only about half of them have the condition under control.

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Link between diabetes and hypertension

Many people with diabetes also have high blood pressure. Studies found that at least 1 in 3 people with diabetes also have hypertension.

Diabetes and high blood pressure make for a deadly combination because one condition makes the other worse. Diabetes may increase blood pressure by reducing the blood vessels' ability to stretch, increasing the fluid in the body, and affecting how the body manages insulin.

According to the American Heart Association (AHA), nearly 70% of people age 65 or older with diabetes die from cardiovascular disease, and 16% die of stroke. In addition, people with diabetes are up to four times more likely to die from heart disease than those without diabetes.

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Looking for the best blood-pressure targets

Now, a new study, which appears in the AHA's journal Hypertension, found that people with type 2 diabetes who received intensive treatment to keep blood pressure levels at or below 130/80 mmHg experienced fewer heart attacks, strokes, and had a lower risk of death from any cause.

"Our findings demonstrate a benefit of more intensive therapy aiming for blood pressure thresholds at 130/80 [mmHg] or below and should help resolve some ongoing confusion over the best blood pressure targets for people with diabetes," says the study's senior investigator J. Bill McEvoy, a professor of preventive cardiology at the National University of Ireland in Galway.

The 2017 AHA blood pressure guidelines recommended intensive treatment for people with diabetes and hypertension to help reduce their blood pressure. The new study revealed that blood pressure levels of 130/80 mm/Hg may benefit people regardless of cardiovascular risk.

"Patients, including those with diabetes, with blood pressure levels above 130/80 on two consecutive checks should discuss with their physicians whether they need [a] change in treatment to get to a lower number."

Prof. McEvoy

Benefits of intensive hypertension therapy

The researchers analyzed the outcomes of about 11,000 people with type 2 diabetes. The researchers clinically followed the study participants over 4 years across multiple clinical centers and locations.

The scientists examined people with type 2 diabetes and high blood pressure, who had different levels of cardiovascular risk, and who received intensive treatment. They then compared them with people with the same conditions who received a placebo.

Previous findings had suggested that hypertension treatment was effective, but researchers did not know whether this benefit also applied to people with diabetes and blood pressure below 140/90 mmHg.

The new study looked at rates of overall death from any cause and found that all people benefited from intensive treatment, regardless of cardiovascular risk.

More than 800 deaths and over 950 major vascular events — including heart attacks, strokes, diabetic kidney disease, and diabetic eye disease — occurred during the study period.

The people who received intensive blood pressure treatment experienced 9% fewer events and 14% fewer deaths than the people who took a placebo.

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Stress, insomnia may triple death risk for those with hypertension

A stressful work environment coupled with a lack of sleep can result in a threefold-higher risk of cardiovascular death in people with hypertension.
man looking tired in front of their computer
Having both a stressful job and difficulty sleeping may dramatically increase a person's risk of cardiovascular death.

Recent research looked at how stress and insomnia affected the health of employees who have hypertension, and the news was sobering.

The researchers found that in comparison with their peers who slept well and did not experience work-related stress, hypertensive employees with stress and insomnia were three times more likely to die from cardiovascular disease.

Researchers analyzed data from nearly 2,000 employees whose ages ranged from 25 to 65 years. These workers had high blood pressure, but, at the time of the study, they did not have cardiovascular disease or diabetes.

Although those with either job-related stress or insomnia did have an increased risk of cardiovascular death, the risk was higher when people had both of these factors present in their everyday lives.

The authors published their findings in the European Journal of Preventive Cardiology.

"These are insidious problems," notes Prof. Karl-Heinz Ladwig of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich.

"The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave."

Prof. Karl-Heinz Ladwig

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Hypertension is a major risk factor for many

Researchers define hypertension as high blood pressure in the arteries.

According to the American Heart Association (AHA), normal blood pressure readings for adults sit below 120/80 millimeters of mercury (mm Hg), while people with hypertension have either a systolic pressure (upper number) of 130 mm Hg or higher or a diastolic pressure (lower number) of 80 mm Hg or above.

High blood pressure is a widespread problem in the United States, with the AHA estimating that close to 103 million adults have hypertension.

This number equates to almost half of all adults in the U.S., and experts note that the death rate stemming from hypertension is increasing. In fact, it rose by nearly 11% from 2005 to 2015.

Many factors can increase a person's risk of heart disease, some of which are uncontrollable, such as increasing age, biological sex, and heredity.

However, other factors — such as smoking habits, high blood cholesterol, high blood pressure, physical inactivity, and being overweight — are modifiable.

High blood pressure is a significant risk factor for heart disease because when blood pressure becomes elevated, the heart has to work harder to pump blood around the body.

This extra work thickens the muscles of the heart, and it can also harden or damage artery walls. As a result, less oxygen makes its way to the body's organs, and the heart becomes damaged over time due to its increased workload.

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How stress relates to sleep, heart health

Stress is another factor that can contribute to heart disease.

In the current study, the researchers defined a stressful job as one that places high demands on the employee without giving them much control over what they have to do and achieve each day.

They also noted that most of the people with sleep issues had problems staying asleep, while others had trouble falling asleep.

"Maintaining sleep is the most common problem in people with stressful jobs," says Prof. Ladwig. "They wake up at 4 o'clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues."

Hypertension on its own is a major risk factor for heart disease, but pairing it with both insomnia and work-related stress compounds the potential problems.

Prof. Ladwig says that it would be a good idea for employers to offer stress management and sleep treatment in the workplace, while doctors should discuss sleep and job stress with people who have hypertension and may have a higher risk of issues with their cardiovascular health.

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Obesity: Could fat cell differences predict diabetes risk?

Differences in the cells that store fat in the body could explain why some people are more prone to obesity-related conditions, such as type 2 diabetes.
Pink fat cells
This colored scanning electron micrograph shows fat cells in bone marrow tissue.

Scientists at the University of Melbourne, in Australia, led an investigation that examined human white fat cells from samples that volunteers had donated.

The samples came from white fat tissues in different parts of the body.

White fat cells are the cells that store energy in fat molecules called triglycerides.

The human body has reservoirs of regenerative cells, called adipose progenitor cells (APCs), which mature into white fat cells.

Using tools that assessed genes, proteins, and metabolism, the study is the first to identify three distinct subtypes of APCs.

In a recent Cell Reports paper, the authors explain how the APC subtypes differ in the ways that they deal with energy and hormones.

The findings suggest that the makeup and distribution of white fat in the body, in terms of the APC subtypes, could predict a person's risk of developing type 2 diabetes and other metabolic diseases.

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The first APC subtype matures into fat cells that discharge lots of fat molecules into the bloodstream, while the second type leads to cells that burn energy fast. The third subtype has a more "neutral" profile and behaves more like scientists might expect a fat cell to behave, if rather more slowly.

Senior study author Prof. Matthew J. Watt, who heads the physiology department in the School of Biomedical Sciences at the University of Melbourne, suggests that the first subtype could be one that promotes fat deposits on organs and in other parts of the body. This could happen in people of healthy weight as well as in those who are overweight.

He suggests that the second APC subtype could be one that stops people from gaining weight.

Need for better understanding of fat cells

The World Health Organization (WHO) declare that the worldwide prevalence of obesity "has nearly tripled since 1975."

In the United States, figures from the Centers for Disease Control and Prevention (CDC) reveal that 40% of adults, amounting to some 93.3 million people, had obesity in 2015–2016.

Obesity-related health conditions such as heart disease and type 2 diabetes account for a large number of preventable early deaths.

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In their study paper, Prof. Watt and his colleagues note that obesity and dysfunction of fat tissues are "inextricably linked to the development of metabolic diseases, such as dyslipidemia and type 2 diabetes."

Given the rising tide of worldwide obesity, "There remains intense interest," they write, in furthering knowledge of how fat cells develop and how their energy and hormone mechanisms work, especially in relation to overeating.

When they examined the fat tissue samples, the researchers found all three APC subtypes in all the samples. There was no part of the body in which white fat tissue did not have all three.

However, they did find that the distribution of the subtypes differed among individuals: Some subtypes were more abundant, while others were less so.

Prof. Watt remarks that this could mean that the makeup of people's APC subtypes in their white fat tissues could be a factor in their metabolic health.

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Switching on the fast-burners to lose weight?

He imagines, for example, that future weight loss treatments could involve switching off the fat-releasing APCs and switching on the fast-burners.

Drugs that do this could potentially help to prevent obesity-related conditions and offer less invasive alternatives to surgery.

However, Prof. Watt cautions that there is still a lot of work to do, and it could be 10 years or more before such treatments become available.

Further studies should, for example, confirm whether having more or less of certain APC subtypes actually raises or lowers risk of specific metabolic diseases.

They then need to find out whether increasing or decreasing certain cell types can affect disease outcomes.

Even if treatments that alter APCs become available, Prof. Watt predicts that people will likely still need to adopt healthful lifestyles, reduce food consumption, and increase physical activity.

"The discovery is important because it tells us that not all fat cells are the same and that by understanding the fat subtypes in a human, we might be able to predict their future metabolic health."

Prof. Matthew J. Watt

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Atherosclerosis: Research reveals new mechanism and therapeutic target

New research offers fresh insights into how a type of immune cell can destabilize the fatty deposits, or plaques, that form in arteries during atherosclerosis.
illustration of a heart on black background
Healthy arteries keep the heart healthy. A new study may help prevent atherosclerosis — a disease that affects our blood vessels.

Atherosclerosis is a persistent, inflammatory condition in which plaques build up inside arteries, causing them to narrow and restrict blood flow.

When an atherosclerotic plaque bursts or breaks, it can trigger a heart attack or stroke.

Neutrophils are an abundant type of leukocyte (white blood cell) that defend against infection by attacking microbes. They also serve "many roles in inflammation."

The new international study reveals that neutrophils can aggravate atherosclerosis by triggering a previously unknown type of cell death that destabilizes arterial plaques.

A recent Nature paper describes how neutrophils can induce a series of molecular events that also kills the smooth muscle cells that help to retain the plaques in the artery wall.

"Every inflammatory reaction," says co-corresponding study author Prof. Oliver Söhnlein, who is the director of the Institute for Cardiovascular Prevention at the Ludwig Maximilian University (LMU) of Munich in Germany, "results in some collateral damage, because neutrophils also attack healthy cells."

He and his colleagues have also designed and made a "tailored peptide" that could potentially target and block the cell-death process.

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Atherosclerosis and its consequences

Arteries are vessels that supply the heart and other parts of the body with oxygen- and nutrient-rich blood, which cells need to function and live.

Atherosclerosis develops when various materials, such as cholesterol, fat, and cellular waste, deposit in the tissue lining the arteries. The deposits, or plaques, build up slowly over time causing the arteries to narrow and harden.

When arteries narrow, they impede blood flow and restrict the supply of oxygen and nutrients to cells. Depending on where it occurs, the restricted blood flow can result in heart disease, angina, carotid artery disease, peripheral artery disease, and chronic kidney disease.

The plaques themselves are also a risk. They can rupture, or pieces can break off, causing blockages. In addition, blockages can arise from blood clots that stick to the inner walls of narrowed arteries.

If the blockage is in an artery that supplies blood to the brain or the heart, it can result in a stroke or heart attack. Blockages in arteries that supply the legs can lead to tissue death, or gangrene.

According to statistics that the American Heart Association publish online, cardiovascular conditions, such as heart attack and stroke, were the primary cause of 840,678 deaths in 2016 in the United States.

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Neutrophils help plaques become unstable

Another feature of atherosclerosis is that it triggers signals that prompt the immune system to send neutrophils and other immune cells through the bloodstream to the plaques.

When they reach a plaque site, the immune cells slip between the endothelial tissue cells of the artery lining. At the same time, they release chemicals that signal to the immune system to send even more immune cells.

This can set up a cycle that turns the initial inflammation response into persistent, or chronic, inflammation. Once the inflammation becomes chronic, it raises the risk that the plaque will grow, rupture, and cause a blockage.

Using mouse models of atherosclerosis to investigate what goes on at cell level, the researchers discovered that neutrophils can play a particularly destructive role in destabilizing plaques.

"They bind to the smooth muscle cells that underlie the vessel wall, and are activated," Prof. Söhnlein explains.

Once active, the neutrophils release "chromosomal DNA and its associated histones, which are highly charged and [toxic to cells]," he continues, adding: "Free histones kill nearby cells – in the case of atherosclerosis, smooth muscle cells."

Histones are proteins that help to package DNA tightly inside chromosomes.

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Peptide could block toxic histones

The histones kill the smooth muscle cells by causing pores to form in their walls. This allows extracellular fluids to seep through the pores into the cells, causing them to burst.

Because smooth muscle cells help to retain the plaques in the artery wall, their destruction causes the fatty deposits to become unstable and more likely to rupture and break.

In another part of the study, the team used molecular modeling to design a small protein molecule, or peptide, that could block the toxic effect of the free histones.

The authors suggest that the "histone-inhibitory peptide" could disrupt the histones by binding to them so that they cannot create pores in the cell membranes.

Prof. Söhnlein says that the synthetic peptide could have a similar effect on other conditions that involve chronic inflammation, such as chronic bowel inflammation and arthritis.

He and his co-authors conclude:

"Our data identify a form of cell death found at the core of chronic vascular disease that is instigated by leukocytes and can be targeted therapeutically."
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'A Viagra-like drug could reverse heart failure'

New research in sheep shows that a drug that doctors usually prescribe for the treatment of erectile dysfunction can also treat heart failure.
man taking pills
A drug that treats erectile dysfunction could also reverse heart failure, according to an animal study.

In people with heart failure, the heart muscle becomes unable to pump out blood efficiently, meaning that some organs may not receive the amount of oxygen that they need to function properly.

The Centers for Disease Control and Prevention (CDC) note that 5.7 million adults in the United States have heart failure and that approximately half of the people with this condition die within about 5 years of receiving their diagnosis.

Moreover, research that Cardiac Failure Review published in 2017 argued that there is a "global pandemic" of heart failure, with this condition affecting an estimated 26 million people worldwide.

Such numbers suggest that finding new ways to treat heart failure is a priority for specialists who study this condition.

Recently, Prof. Andrew Trafford led a team of researchers from the University of Manchester in the United Kingdom who found that a drug that doctors typically use to treat erectile dysfunction could also treat systolic heart failure, in which the heart's left ventricle loses the ability to contract as normal.

The findings of the new study, which the researchers conducted in sheep, appeared today in the journal Scientific Reports.

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Tadalafil brings significant improvements

Prof. Trafford and team decided to focus on tadalafil, which is available under the brand name Cialis among others. This drug falls under the same category as sildenafil, which people commonly refer to by the brand name Viagra.

"We do have limited evidence from human trials and epidemiological studies that show tadalafil can be effective in treating heart failure," Prof. Trafford says.

The researchers studied the effects of the drug in sheep, whose hearts are very similar to those of humans. The team treated the sheep with tadalafil once they had developed heart failure symptoms that were serious enough to require intervention.

Prof. Trafford and colleagues induced heart failure in the animals through the use of a pacemaker, and when they treated them with tadalafil, they gave them doses consistent with what a human patient would usually receive for erectile dysfunction.

After just 3 weeks of tadalafil treatment, the researchers began to notice improvements in the animals that received this drug.

The drug improved the heart's contraction and almost completely restored its ability to respond to epinephrine. It is a lack of response to this hormone that causes breathlessness in heart failure.

Although so far, the researchers have only tested the effects of this drug in sheep, Prof. Trafford maintains that humans are likely to experience the same benefits.

"This study provides further confirmation, adds mechanistic details, and demonstrates that tadalafil could now be a possible therapy for heart failure," the researcher notes, adding, "It's entirely possible that some patients taking it for erectile dysfunction have also unwittingly enjoyed a protective effect on their heart."

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'We need safe and effective new treatments'

So, why does this drug have a therapeutic effect on heart failure? The scientists explain that tadalafil helps treat erectile dysfunction by acting on a particular enzyme called phosphodiesterase 5. This enzyme plays a key role in determining how different types of tissue interact with hormones, including epinephrine.

In the case of heart failure, the research team notes, tadalafil allows the heart to start responding to epinephrine once more, which means that the heart muscle regains its ability to pump out blood effectively.

These findings are promising because, as Prof. Trafford says, tadalafil "is a widely used and very safe drug with minimal side effects," but the researcher nevertheless cautions against self-prescription.

"[W]e would not advise the public to treat themselves with the drug, and [they] should always [speak] to their doctor if they have any concerns or questions," Prof. Trafford emphasizes.

"Tadalafil is only suitable as a treatment for systolic heart failure — when the heart is not able to pump properly — and there may be interactions with other drugs patients are taking," he warns.

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Prof. Metin Avkiran, who is Associate Medical Director at the British Heart Foundation, which funded the current study, expresses hope that these findings might lead to a better treatment that could not only reduce the symptoms of heart failure but also potentially reverse the condition entirely.

"We need safe and effective new treatments for heart failure [...]. The evidence from this study — that a Viagra-like drug could reverse heart failure — should encourage further research in humans to determine if such drugs may help to save and improve lives."

Prof. Metin Avkiran

"Viagra-type drugs were initially developed as potential treatments for heart disease before they were found to have unexpected benefits in the treatment of erectile dysfunction," Prof. Avkiran notes.

"We seem to have gone full circle," he continues, "with findings from recent studies suggesting that they may be effective in the treatment of some forms of heart disease — in this case, heart failure."

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Blood test may predict cardiovascular disease

New research suggests that a simple blood test, which doctors currently use to diagnose heart attacks, may be useful in predicting the risk of cardiovascular disease.
scientist looking at blood sample
New research suggests a simple blood test could accurately predict who will go on to develop cardiovascular disease.

According to the latest statistics from the American Heart Association (AHA), almost half of the people living in the United States have some form of cardiovascular disease.

In fact, according to 2016 figures, 121.5 million U.S. adults, or 48 percent of the entire population, have cardiovascular disease (CVD), which is a cluster of conditions that includes hypertension. Doctors often call hypertension the "silent killer" because it does not show any visible symptoms until it is too late.

The same AHA report predicts that by 2035, over 130 million adults will have a form of CVD that could bring costs in the U.S. to 1.1 trillion dollars.

Currently, heart disease is the top leading cause of death in the U.S., while stroke is the fifth.

But what if there was a blood test that could accurately predict whether a person will have heart disease or a stroke?

New research suggests that such a test may already exist. By detecting the blood levels of specific proteins that heart muscles release when they are injured, scientists may be able to predict a person's risk of eventually developing CVD.

Dr. Christie Ballantyne, who is the cardiology chief at Baylor College of Medicine in Houston, TX, and his team, detail this idea in a new study that appears in the AHA journal Circulation.

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Troponins are proteins that signal heart muscle damage, and in the new research, Dr. Ballantyne and his colleagues wanted to see if detecting troponin in the blood of healthy middle-aged adults or seniors could predict CVD risk.

Dr. Ballantyne and colleagues analyzed a group of 8,121 people aged 54–74 who participated in the "Atherosclerosis Risk in Communities" study. None of the participants had a history of cardiovascular disease.

The scientists identified troponin levels in 85% of the participants and applied Cox proportional hazards models to examine the links between these levels and cardiovascular disease.

Namely, they studied correlations with coronary heart disease, myocardial infarction, ischemic stroke, atherosclerotic cardiovascular disease, heart failure hospitalization, global cardiovascular disease, and all-cause mortality.

The research found that high levels of troponin correlated strongly with "increased global CVD incidence in the general population independent of traditional risk factors."

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High-sensitivity troponin tests, therefore, proved to be an accurate way of predicting CVD risk, especially when combined with a standard method of calculating a person's 10-year cardiovascular risk.

"What we're finding out is that these tests can be used in the general population to give us information as to who is most likely to have a future problem, whether it be a heart attack, stroke, or heart failure," says Dr. Ballantyne.

"If you can treat someone much earlier, before {they] have symptoms, you will be far more effective in preventing events," continues the researcher, who adds, "Our major problem is that we do too little too late."

"If the first time you find out that you're at risk for heart failure is when you actually start getting short of breath and you end up in the hospital, you probably have advanced heart disease already, and it is going to be harder to treat than if that person took steps years earlier."

Dr. C. Ballantyne

Instead, knowing the risk in advance can prompt people to take preventive measures, such as exercising more and watching their blood pressure.

However, the scientists explain that although doctors currently use troponin tests to diagnose a heart attack, they do not yet accept them as a tool for predicting risk. Scientists need to do more research before using these tests to evaluate risk.

"Research in this area is leading us toward individualized care more and more, so we can better predict who's at risk for developing adverse cardiovascular outcomes," comments Dr. Rebecca Vigen, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, who did not participate in the research.

"This study is a step in the direction of personalizing care," Dr. Vigen says.

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What to know about vitamin K-2

Vitamin K is an essential vitamin that supports blood clotting and healthy bones. It occurs in two forms, K-1 and K-2.

Vitamin K-1 is the primary form, and it mainly comes from leafy green vegetables. Vitamin K-2 occurs in animal proteins and fermented foods. The bacteria in the human gut also produce small quantities of K-2.

In this article, we discuss vitamin K-2, its functions, and how it differs from K-1. We also describe dietary sources, health benefits, the recommended daily intake, deficiency symptoms, and supplements.

What is it? Sauerkraut, which contains vitamin K-2
Sauerkraut is a good dietary source of vitamin K-2.

Vitamin K refers to a family of fat-soluble vitamins that the body needs to produce a protein called prothrombin, which promotes blood clotting and regulates bone metabolism.

The vitamin comes in two main forms:

Vitamin K-1, or phylloquinone, occurs naturally in dark leafy green vegetables and is the main dietary source of vitamin K. Vitamin K-2, or menaquinone, is present in small quantities in organ meats and fermented foods. Gut bacteria also produce vitamin K-2. Functions The body needs both types of vitamin K to produce prothrombin, a protein that plays crucial roles in blood clotting, bone metabolism, and heart health. Vitamin K also helps facilitate energy production in the mitochondria of cells. Vitamin K-1 is primarily involved in blood coagulation. K-2 may have a more diverse range of functions in the body. In a long-term study involving 36,629 participants, researchers observed an association between high intakes of vitamin K-2 and a reduced risk of developing peripheral arterial disease (PAD), particularly in people with high blood pressure. However, the authors concluded that K-1 had no effect on PAD risk. Vitamin K has antioxidant properties. It protects cellular membranes from damage due to excess free radicals, in a process known as peroxidation. Blood thinning medication, such as warfarin, can lower the antioxidative potential of vitamin K. Thank you for supporting Medical News Today K-1 vs. K-2 Vitamins K-1 and K-2 have different chemical structures. Both types have a phytyl side chain, but K-2 also has isoprenoid side chains. K-2 has several subtypes, called menaquinones (MKs), which scientists have numbered MK-4 through MK-13, based on the length of their side chains. K-1 is the primary form of the vitamin, and it is mainly present in leafy green vegetables. However, the body has difficulty absorbing vitamin K-1 from plants. According to a 2019 review, research suggests that the body absorbs 10 times more vitamin K-2, in the form of MK-7, than vitamin K-1. Vitamin K is fat-soluble, so eating dietary fats, such as butter or plant oils, may enhance the body's absorption of vitamin K-1 from plants. Bacteria in the gut can synthesize vitamin K-1 into vitamin K-2. Also, fermented foods, meat, and dairy products contain modest amounts of vitamin K-2. The body stores vitamins K-1 and K-2 differently. K-1 accumulates in the liver, heart, and pancreas. K-2 occurs in high concentrations in the brain and kidneys. Best dietary sources Leafy greens which contain vitamin K-2
Leafy green vegetables contain vitamin K-1. Several foods are rich in vitamin K-1, and vitamin K-2 is much less common. Bacteria in the gut can convert some K-1 into K-2. Fermented foods are a good source of vitamin K-2. Also, because it is fat-soluble, organ meats and high-fat dairy products contain fairly substantial quantities of vitamin K-2. Conversely, lean meats, such as poultry, are not good sources of K-2. Dietary sources of vitamin K-1 include: dark leafy green vegetables, such as spinach, kale, and collards lettuce turnips broccoli carrots vegetable oils blueberries grapes Dietary sources of vitamin K-2 include: natto, a traditional Japanese dish of fermented soybeans sauerkraut dairy products, especially hard cheeses liver and other organ meats beef pork egg yolks chicken fatty fish, such as salmon Health benefits of vitamin K-2 In addition to its crucial role in blood clotting and wound healing, vitamin K-2 has a number of other health benefits. We discuss some of these below. Heart health Vitamin K-2 may lower the risk of cardiovascular damage and improve overall heart health. According to a 2015 review article, K-2 activates a protein that prevents calcium deposits from forming in the walls of blood vessels. The author cited findings suggesting that a diet high in natural vitamin K2 may decrease the risk of coronary heart disease. Bone health Vitamin K-2 promotes healthy bone mineral density by carboxylating osteocalcin, a protein that binds calcium to bones. A 2019 study investigated the effects of taking MK-4 supplements in 29 postmenopausal females who had experienced hip or vertebral compression fractures. The researchers concluded that taking 5 milligrams of an MK-4 supplement daily reduced the levels of undercarboxylated osteocalcin to that "typical of healthy, premenopausal women." A 2017 study from Japan examined whether vitamin K-2 enhances the effects of standard medication for osteoporosis in adult females aged 65 or older. According to the results, vitamin K-2 did not appear to enhance the effects of the osteoporosis medication. Anxiety and depression High blood glucose levels may increase a person's risk of developing depression, anxiety, and cognitive impairment. A 2016 study investigated the effects of vitamin K-2 in rats with metabolic syndrome, high blood glucose levels and symptoms of anxiety, depression, and memory deficit. After 10 weeks, treatment with vitamin K had normalized blood glucose and reduced symptoms of anxiety and depression. However, it did not improve memory deficit in the rats. Cancer Vitamin K-2 has antioxidant properties that may help protect against cancer. In addition, findings suggest that K-2 may suppress genetic processes that lead to tumor growth. According to a 2018 study, vitamin K-2 that scientists had modified with a sialic acid-cholesterol conjugate significantly suppressed tumor growth in mouse cells. A 2019 study suggests that K-2 significantly reduces the activity of hypoxia-inducible factor 1-alpha (HIF-1A) in hepatocellular carcinoma cells. HIF-1A is an important target for cancer drug therapy. Thank you for supporting Medical News Today Recommend daily intake The Office of Dietary Supplements (ODS) recommend a daily intake of 120 micrograms (mcg) of vitamin K for adult males and 90 mcg for adult females. There is no specific recommendation for vitamin K-2. Deficiency symptoms According to the ODS, vitamin K deficiency affects very few adults in the United States. Newborns and people with certain gastrointestinal disorders, such as celiac disease and ulcerative colitis, have a higher risk of vitamin K deficiency. A severe deficiency increases the time it takes for the blood to clot, making a person more prone to bruising and bleeding and increasing the risk of hemorrhage. A deficiency of the vitamin can also reduce bone mineralization, which can lead to osteoporosis. Certain medications can affect vitamin K levels in the body. For example, long courses of antibiotics can kill the gut bacteria that produce vitamin K. Some cholesterol-lowering medications can also interfere with the body's ability to absorb vitamin K. Blood thinners, such as warfarin, can interact dangerously with the vitamin. It is important for people taking these medications to consume the same amount of dietary vitamin K each day and to speak to a doctor before taking supplements or making dietary changes. Supplements woman takes supplements
Many multivitamins contain vitamin K. While the ODS report that vitamin K deficiency is very rare and that most people are getting enough of the vitamin from their diet, anyone at risk of a deficiency may wish to consider dietary supplements. Many multivitamins contain both forms of vitamin K. A person can also purchase vitamin K as a standalone supplement or in combination with specific nutrients, such as vitamin D, calcium, or magnesium. The types of vitamin K commonly available in dietary supplements include: vitamin K-1, as either phylloquinone or a synthetic form called phytonadione vitamin K-2, as either MK-4 or MK-7 The concentrations of K-1 and K-2 vary, depending on the supplement. Always check the nutrition label before purchasing supplements. Vitamin K can interact with some drugs, especially blood thinners, so it is important for people taking prescription medications to speak to their doctor before using a dietary supplement. A variety of vitamin K supplements are available to purchase online. Thank you for supporting Medical News Today Summary There are two main forms of vitamin K: vitamin K-1 and vitamin K-2. K-1 primarily occurs in leafy green vegetables, and it is the main dietary source of vitamin K. However, the body absorbs K-2 more readily, particularly the K-2 subtype MK-7. Good sources of vitamin K-2 include fermented foods, organ meats, and dairy products. Fermented soybeans, such as natto, are an especially rich source of vitamin K-2. Bacteria that live in the human gut also produce small quantities of K-2. Both forms of vitamin K are essential for blood clotting and bone health. However, vitamin K-2 may also protect against certain forms of cancer and heart disease. Vitamin K deficiency is very rare and most people get enough of this vitamin from their diet. Some gastrointestinal conditions can increase the risk of a deficiency. However, people with these conditions should speak to their doctor before taking a dietary supplement. People currently taking blood thinners, such as warfarin, should not take vitamin K supplements without seeking medical advice first. Sudden changes in vitamin K levels can impact the anticoagulant effects of warfarin and lead to dangerous complications. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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What is the best time to take statins and why?

Statins are cholesterol-lowering drugs. Some statins work best in the evening while others work just as well in the morning. The best time to take statins depends on the specific drug.

Statins are a type of prescription medication that can lower a person's risk of heart disease. They do this primarily by reducing a person's low-density lipoprotein (LDL) cholesterol.

There are several different types of statin on the market, which the body may process differently. People may need to take some statins at specific times of the day to get the most benefit from them.

In this article, we look at the effects of statins at different times of the day and discuss the best times to take certain types. We also cover side effects and how a person can choose the right statin to suit their needs.

What do statins do? Senior man in bed taking prescription medication statin pills and drinking water
Statins can help manage cholesterol levels.

Statins are also called lipid-lowering medications or HMG-CoA reductase inhibitors. They reduce the levels of LDL cholesterol in the blood.

LDL cholesterol, which people sometimes refer to as bad cholesterol, can build up in the arteries and form plaque. This plaque can block blood flow in the arteries, leading to heart attack and stroke.

Statins block an enzyme in the liver that makes cholesterol, which reduces the risk of plaque buildup. Statins may also help the body remove cholesterol that has started to accumulate in the arteries.

Conversely, high-density lipoprotein (HDL), or good, cholesterol can reduce the risk of heart attack and stroke. Doctors consider HDL cholesterol to be beneficial because it can transport other forms of cholesterol from the blood to the liver, which helps the body get rid of bad cholesterol.

Studies have shown that statins are effective in improving a person's cholesterol levels:

A large-scale 2017 study found that statins can reduce the risk of heart disease by 27 percent by decreasing LDL levels. The authors of a 2010 meta-analysis concluded that statins might raise HDL levels, which can further protect a person from heart disease. In a 2015 study paper, researchers reported that the effects of statins vary depending on a person's genetic risk factor. These drugs reduced the risk of heart disease by 13 percent in people at low risk, 29 percent in those at medium risk, and 48 percent in the participants whose risk was high. Thank you for supporting Medical News Today Best time to take different statins It is important that a person taking statins follows the advice of their prescribing doctor regarding the time of day to take them. The recommended time, which is something that a person should discuss with their doctor, will vary depending on the type of statin. Short-acting statins A systematic review found that short-acting statins worked best when people took them in the evening. The people who took these statins toward the end of the day had lower total cholesterol and LDL cholesterol levels compared with the people who took them in the morning. Another review came to the same conclusion. Short-acting statins work better at night because the liver enzyme that produces cholesterol is more active at this time. Most short-acting statins have a half-life of 6 hours. A medication's half-life is the time that it takes for the body to process and remove half of the medication. Short-acting statins include: lovastatin (Mevacor) fluvastatin (the standard-release tablet) pravastatin (Pravachol) simvastatin (Zocor) Long-acting statins It takes longer for the body to process long-acting statins, which may have a half-life of up to 19 hours. The two reviews above noted that long-acting statins worked equally well whether a person took them in the morning or the evening. Therefore, people taking long-acting statins can choose which time of the day best suits them. The authors recommend that people using long-acting statins take them at a time of day that is easy for them to remember. It is important to be consistent with the timing of doses, so if a person prefers to take statins in the morning, they should take them in the morning every day. Long-acting statins include: People who are taking statins may need to take them indefinitely. In many cases, when a person stops taking statins, their cholesterol levels increase again. People should not stop taking statins without a doctor's approval. Some people might be able to stop taking statins or reduce their dosage if they significantly lower their risk of heart disease. A person may do this by losing a significant amount of weight, quitting smoking, or making other major lifestyle changes that improve their health. Even in these cases though, a person should talk to a doctor before they stop taking statins or any other medications. Which statin is right for me? A person can discuss the types of statins with a doctor to choose the best one.
A person can discuss the different types of statins with a doctor. Statins come in a range of types and dosages. A person can discuss with their doctor which type of statin may work best for them. The doctor's recommendation will depend on many factors, including the person's: current cholesterol levels other risk factors for heart disease other medical conditions, such as diabetes family history of heart disease other medications If a person has an increased risk of heart disease, their doctor may prescribe a higher dosage or a long-acting statin. Conversely, a person with less risk of heart disease may start on a lower dosage or a short-acting statin. Recent evidence suggests that many people can benefit from taking statins, even if they do not have high blood cholesterol levels. The American Heart Association say that statins can benefit people who have an average risk of heart disease, especially when they take them in combination with medications to lower blood pressure. Thank you for supporting Medical News Today Side effects of statins Statins do not cause serious side effects for most people. According to the American College of Cardiology, as many as 90 percent of people taking statins do not experience bothersome side effects. For those who do experience side effects, these may include: The Food and Drug Administration (FDA) state that the risk of these side effects is small and that the benefits of statins usually outweigh this risk. Some reports have warned that statins can cause severe memory loss, but an investigation found inconsistent evidence of this side effect. Another review states that there is evidence to suggest that statins do not affect memory. In rare cases, a person taking statins may have serious side effects, such as liver damage or an allergic reaction. The following side effects require immediate medical attention: fever upper abdominal pain yellow skin or eyes dark-colored urine unusual bleeding or bruising extreme fatigue rash, hives, or itching swelling of the face, lips, tongue, eyes, or throat difficulty speaking How to stay healthy when taking statins Regular exercise can help lower the risk of heart disease.
Regular exercise can help lower the risk of heart disease. Statins can interact with some medications. People who take statins will need to make their doctor aware of any medicines, vitamins, herbs, or other supplements that they take to help prevent dangerous interactions. Statins may also interact with grapefruit and grapefruit juice. Therefore, it is important to avoid eating grapefruit or drinking grapefruit juice while taking statins unless a doctor says it is safe. People who have a higher risk of heart disease can work with a doctor or nutritionist to modify their diet. In many cases, a medical professional is likely to advise the person to eat a diet that is low in cholesterol and saturated fat, free of trans fats, and rich in fruits and vegetables. In addition, a person may need to increase their weekly exercise and work toward a healthy weight. In this way, they can further lower their risk of heart disease. Smoking is a significant risk factor for heart disease. A doctor may advise a person to get help with quitting if they do smoke. Whether or not they are taking statins, people can help keep their cholesterol in check by maintaining a healthy weight, exercising regularly, and eating a healthful diet that contains plenty of fruits and vegetables. Thank you for supporting Medical News Today Summary Doctors have been prescribing statins for more than 30 years, and these medications are generally safe and effective with a low risk of serious side effects. Short-acting statins are most effective when a person takes them at night, but a person can take long-acting statins at any time of the day. The most important point to remember is to take them every day, ideally at the same time. As with any medication, a person should take it according to their prescription. They should also tell a doctor if they notice any side effects.
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Patterns of antibiotic use may predict cardiovascular risk

A new study that analyzed the health information of thousands of women found that prolonged antibiotic use is correlated with a higher risk of experiencing a cardiovascular event.
woman taking medicine
Women may wish to consider limiting their use of antibiotics to prevent cardiovascular issues.

Scientists at Tulane University in New Orleans, LA, Harvard Medical School and Harvard T. H. Chan School of Public Health in Boston, MA, and Fudan University in Shanghai, China investigated how antibiotic use is linked to women's risk of experiencing cardiovascular problems.

They were interested in the link between antibiotics and cardiovascular health because, they explain, antibiotics can have an important impact on gut microbiota, which, in turn, can affect various other aspects of health.

"Antibiotic use is the most critical factor in altering the balance of microorganisms in the gut," says study co-author Prof. Lu Qi.

"Previous studies have shown a link between alterations in the microbiotic environment of the gut and inflammation and narrowing of the blood vessels, stroke, and heart disease," he adds.

The study — the findings of which appear in the European Heart Journal — analyzes information the scientists collected from a cohort of 36,429 women enrolled in the Nurses' Health Study.

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Specifically, the researchers examined data from 2004–2012; at the beginning of this period, all the women in the cohort were 60 or older.

All the participants reported how often they used antibiotics and other relevant information during three periods of their lives: ages 20–39, ages 40–59, and ages 60 and over.

Based on the antibiotic use patterns that the women reported, the scientists split them into four groups:

those who had never used antibiotics those who took antibiotics for fewer than 15 consecutive days at a time those who used antibiotics for between 15 days and 2 months those who took antibiotics for over 2 months
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'A cumulative effect' of antibiotic use?

Over a follow-up period of almost 8 years, on average, 1,056 participants developed cardiovascular problems.

Throughout this period, the women continued to offer information about their antibiotic use every couple of years.

The scientists analyzed the data they took throughout this time, adjusting the results for potentially confounding factors. These included age, race, dietary choices, lifestyle habits, medical conditions, and overall drug use.

Women who took antibiotics for very long periods of time (for 2 months or longer) at age 60 or over had a 32% higher risk of experiencing cardiovascular disease compared with those who had never taken antibiotics.

Those who took antibiotics for 2 months or longer at ages 40–59 were 28% more likely to develop cardiovascular problems than women who did not take antibiotics at that age. However, the team found no correlation between prolonged antibiotic use at ages 20–39 and cardiovascular risk.

"By investigating the duration of antibiotic use in various stages of adulthood," points out first study author Yoriko Heianza, Ph.D., "we have found an association between long-term use in middle age and later life and an increased risk of stroke and heart disease during the following 8 years."

"As these women grew older they were more likely to need more antibiotics, and sometimes for longer periods of time, which suggests a cumulative effect may be the reason for the stronger link in older age between antibiotic use and cardiovascular disease."

Yoriko Heianza, Ph.D.

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'The shorter time of use, the better'

The researchers also note that some of the most common reasons women cited for their antibiotic use included infections — respiratory and pertaining to the urinary tract — and oral health conditions.

Though this is the largest prospective study to date that has looked at the correlation between the use of antibiotics for long periods of time and cardiovascular risk, the research was not without its limitations.

For example, the researchers admit that the main problem they faced in this study was the fact that the participants self-reported their use of antibiotics, which tends to leave room for inaccuracies.

However, they also argue that the participants were likely to report fairly precise information, being healthcare professionals themselves.

The scientists are quite confident in their findings, but they explain that the study was observational and cannot, as yet, speak to cause and effect.

"This is an observational study," notes Prof. Qi, "and so it cannot show that antibiotics cause heart disease and stroke, only that there is a link between them."

"It's possible that women who reported more antibiotic use might be sicker in other ways that we were unable to measure, or there may be other factors that could affect the results that we have not been able [to] take account of," he goes on.

Despite these points, Prof. Qi concludes: "Our study suggests that antibiotics should be used only when they are absolutely needed. Considering the potentially cumulative adverse effects, the shorter time of antibiotic use the better."

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Innovative patch may reduce muscle damage after a heart attack

A recent study in rats shows that an innovative patch prevented the stretching of the heart muscle common after a heart attack.
heart illustration with stethoscope
An innovative new patch limits heart muscle damage after a heart attack.

A heart attack occurs when the blood flow that provides the heart muscle with oxygen is significantly reduced or blocked.

The heart muscle is injured in the process, and the amount of damage usually depends on the size of the area supplied by the blocked artery.

It can take about 8 weeks for the heart muscle to heal. Despite the damage, the rest of the heart has to keep on pumping blood.

Scar tissue may form in the injured area and have an impact on the amount of blood that the heart is able to pump.

Most people who survive a heart attack have some degree of coronary artery disease. This occurs when arteries become hardened and narrowed. Usually, survivors have to make crucial lifestyle changes and may have to take medication to prevent a future heart attack.

According to the Centers for Disease Control and Prevention (CDC), more than 700,000 people in the United States have a heart attack every year. Of these, more than 500,000 experience their first heart attack and about 200,000 have already had one.

Signs of a heart attack include chest pain and shortness of breath. Half of U.S. individuals have at least one of the following risk factors: high blood pressure, high cholesterol, or smoking.

Diabetes, obesity, physical inactivity, and excessive alcohol use also increase the risk of a heart attack.

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Testing a new type of adhesive heart patch

Scientists at Brown University in Providence, RI, Fudan University in Shanghai, China, and Soochow University in Suzhou, China have collaborated to create and test a new type of adhesive heart patch on rats.

The study was an interdisciplinary effort among researchers in computer modeling and mechanics, material scientists, and cardiology. The scientists published their findings in the journal Nature Biomedical Engineering.

The scientists created this adhesive patch using a water-based hydrogel material and developed it using computer simulations. The patch can sit directly on the heart, and the results of the study show that it may help limit the muscle damage that often occurs after a heart attack.

"The idea here," explains study co-author Prof. Huajian Gao, from Brown University, "is to provide mechanical support for damaged tissue, which hopefully gives it a chance to heal."

Prof. Gao goes on to say that past studies had shown that mechanical patches could be effective, but no research had attempted to identify the "optimum mechanical properties." Getting those properties right is crucial to ensuring that the patch can work properly.

"If the material is too hard or stiff," he adds, "then you could confine the movement of the heart so that it can't expand to the volume it needs to. But, if the material is too soft, then it won't provide enough support. So, we needed some mechanical principles to guide us."

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Creating right mechanical properties is key

The researchers developed a computer model focused on two key components, one of which was the expanding and contracting of the heart and the impact the patch had on these functions.

The other was to model the injuries that occur after a heart attack. In this way, the team could look at how much mechanical support would be necessary to limit the damage.

Following the results of the computer model, the researchers — led by Prof. Lei Yang, of Soochow University — created a hydrogel material using food-sourced starch. This material is inexpensive, easy to make, and viscoelastic, which means that "it combines fluid and solid properties."

The study in rats showed that this new type of adhesive patch was effective in reducing muscle damage after a heart attack.

"[It] maintained a better cardiac output and thus greatly reduced the overload of those remaining cardiomyocytes and adverse cardiac remodeling," says study co-author Ning Sun, a cardiology researcher at Fudan University.

Their research found that the patch can reduce cell death, the accumulation of scar tissue, and oxidative stress. The researchers believe that more testing is required, but the results are promising.

"It remains to be seen if it will work in humans, but it's very promising."

Prof. Huajian Gao

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Is this chest pain from GERD or a heart attack?

Chest pain can be a sign that a person is having a heart attack. However, chest pain is also a common symptom of other, less serious conditions, such as gastroesophageal reflux disease.

Doctors refer to pain from heart attacks and other conditions that affect the cardiovascular system as cardiac chest pain. Pain that does not come from the cardiovascular system is called noncardiac chest pain.

Gastroesophageal reflux disease (GERD) can cause heartburn, which is a common type of noncardiac chest pain.

While heart attacks are a life-threatening medical emergency, heartburn is not. Therefore, being able to recognize the difference between cardiac and noncardiac chest pain is essential.

In this article, we discuss the symptoms of GERD and heart attacks along with the differences between cardiac and noncardiac chest pain. We also cover other causes of both types of chest pain.

Is it GERD? Person holding hands over chest in pain because of gerd or heart attack
Many conditions can cause chest pain, including acid reflux.

Acid reflux occurs when acid from the stomach leaks up into the food pipe, or esophagus. One of the most common symptoms of acid reflux is heartburn, which is a painful burning sensation in the center of the chest just behind the breastbone, or sternum.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, a person who experiences acid reflux more than twice a week for a few weeks may have GERD. Close to 20 percent of people in the United States have GERD.

Other symptoms of acid reflux and GERD can include:

People with persistent symptoms of acid reflux or GERD should see a doctor.

Thank you for supporting Medical News Today Is it a heart attack? Heart attacks occur when the blood supply to the heart muscles becomes completely blocked. If a person does not receive immediate treatment, part of the heart muscle can die. A common symptom of a heart attack is pain or discomfort that typically occurs in the center or left side of the chest. This pain may come and go, and its severity can range from mild to severe. It can also sometimes feel like heartburn or indigestion. However, not everyone who has a heart attack experiences chest pain. The symptoms of a heart attack can vary considerably from person to person, and they may come on slowly or very suddenly. Other symptoms of a heart attack might include: intense pressure or tightness in the center of the chest a feeling of heaviness or weakness in one or both arms pain, numbness, or a tingling sensation in the arms, neck, jaw, lips, or stomach difficulty breathing or shortness of breath nausea and vomiting dizziness or lightheadedness fatigue breaking out in a cold sweat Anyone who suspects that they or someone else is having a heart attack should immediately call 911 or go to the emergency room. Cardiac vs. noncardiac chest pain A person experiencing recurring or severe chest pain should speak to a doctor.
A person experiencing recurring or severe chest pain should speak to a doctor. When trying to distinguish between cardiac and noncardiac chest pain, a person needs to consider the following three factors: the location of the pain how the pain feels the accompanying symptoms We discuss each of these in more detail below: Location of chest pain Both cardiac and noncardiac chest pain can occur in the center of the chest behind the breastbone. However, cardiac chest pain can spread across the chest and even affect other parts of the body, such as the: arms back shoulders neck or throat jaw teeth Noncardiac chest pain, such as heartburn, tends to remain localized, meaning that it does not spread to other areas. Heartburn typically develops behind or underneath the breastbone. How the pain feels Some of the words that people use to describe cardiac chest pain are: pressure squeezing heaviness fullness tightening aching burning In contrast, noncardiac chest pain tends to feel like an intense stabbing or burning sensation just beneath the surface of the skin. Coughing, breathing, or moving can affect the intensity of noncardiac chest pain, while the severity of cardiac chest pain usually remains stable, even when resting. Accompanying symptoms The symptoms accompanying chest pain can be an important indication of whether it is cardiac or noncardiac. The symptoms that can occur along with cardiac chest pain may include: shortness of breath irregular heartbeat dizziness or lightheadedness numbness pain or discomfort in other parts of the body, such as the arms, neck, jaw, shoulders, and back Symptoms that indicate that the chest pain is from heartburn or GERD can include: Thank you for supporting Medical News Today Other causes of cardiac chest pain Causes of cardiac chest pain can include: Angina Coronary artery disease (CAD), also called ischemic heart disease or coronary heart disease, occurs when fatty deposits build up in the arteries that supply blood to the heart muscle. Over time, these deposits can restrict blood flow, which can cause a type of chest pain called angina. CAD can also lead to heart attacks and heart failure. People often describe angina as a feeling of pressure, squeezing, burning, or tightness behind the breastbone. This pain can spread to other parts of the body, including the arms, jaw, neck, and shoulders. Angina often occurs during physical activity, and stress can also bring it on. If the pain continues after rest, this can be a sign of a heart attack. People who are unsure whether they are experiencing angina or a heart attack should call 911 immediately or go to the emergency room. Myocarditis Myocarditis is a rare form of cardiovascular disease that causes inflammation of the heart muscle. This inflammation can lead to chest pain, heart failure, or sudden death. According to the National Organization for Rare Disorders, myocarditis commonly develops without an identifiable cause. However, doctors often diagnose people with myocarditis following a viral or bacterial infection. Myocarditis produces symptoms similar to those of other heart conditions, such as chest tightness and fatigue. Leaning forward can help relieve chest pain resulting from myocarditis. Other symptoms of myocarditis include: slow heart rate irregular heartbeat dizziness or lightheadedness loss of consciousness Hypertrophic cardiomyopathy Hypertrophic cardiomyopathy (HCM) is a thickening of the muscle wall in the heart. People can inherit genes from their parents that increase their risk of developing HCM. However, HCM can also occur as a result of high blood pressure, diabetes, or thyroid disease. The symptoms of HCM include: chest pain that often results from exercise shortness of breath fainting fluttering heartbeat or heart palpitations Pulmonary hypertension Pulmonary hypertension refers to high blood pressure in the arteries that supply the lungs. Common symptoms include shortness of breath and chest pain, which may occur or worsen with physical activity. Over time, symptoms may become more frequent as the disease progresses. People with pulmonary hypertension may also experience: fatigue and weakness fainting, lightheadedness, or dizziness irregular heartbeat a dry cough that may bring up blood swelling of the legs or feet that results from fluid buildup Other causes of noncardiac chest pain Causes of noncardiac chest pain can include: Pneumonia Pneumonia can cause shortness of breath and chest pain.
Pneumonia can cause shortness of breath and chest pain. Pneumonia is a chest infection that causes the tiny air sacs inside the lungs to become inflamed and fill with fluid. A common symptom of pneumonia is chest pain that typically worsens when a person inhales deeply or coughs. The chest pain can range from mild to severe. Other symptoms of pneumonia can include: Peptic ulcer A peptic ulcer is an open sore in the lining of the stomach or small intestine. Bacterial infections and long-term use of nonsteroidal anti-inflammatory drugs can lead to peptic ulcers. Peptic ulcers can cause a painful burning sensation that starts in the abdomen and extends to the chest. This pain can come and go and may get better when a person eats or takes an antacid. Other symptoms of peptic ulcers can include: bloating belching nausea and vomiting dark stools unexplained weight loss loss of appetite lightheadedness However, not everyone with peptic ulcers experiences symptoms. Costochondritis Costochondritis is an inflammation of the cartilage around the breastbone. This inflammation can cause tenderness and sharp chest pain that may feel similar to the pain of a heart attack. The pain from costochondritis usually affects the left side of the chest, but it can sometimes affect both sides. Deep breathing, coughing, and physical activity may make the pain worse. Possible causes of costochondritis include severe coughing, chest injuries, infections, and overexertion. Esophageal spasms Involuntary spasms or contractions of the food pipe can cause intense chest pain. These spasms can come on suddenly and sometimes last for several hours. Other symptoms of esophageal spasms may include: intense pain or tightness in the chest feeling as though something has become stuck in the throat stomach contents coming up the food pipe difficulty swallowing It is not always clear why esophageal spasms occur, but risk factors include GERD, anxiety, and high blood pressure. Panic attack A panic attack refers to a sudden attack of intense anxiety and fear. These attacks can last for between a few minutes and several hours, and a person may feel as though they are having a heart attack. Symptoms of a panic attack can include: chest pain pounding, rapid, or irregular heartbeat trembling or shaking shortness of breath a sensation of choking or suffocating nausea dizziness or lightheadedness numbness sweating feelings of doom, loss of control, or unreality A person may have a panic attack in response to a stressful event, but an attack can also occur unexpectedly. Recurrent panic attacks are a symptom of panic disorder. Thank you for supporting Medical News Today Summary Heartburn is a symptom of acid reflux and GERD that causes a painful burning sensation in the center of the chest. This sensation can sometimes feel similar to the chest pain that people experience during a heart attack or attacks of angina. A heart attack is a medical emergency, so being able to tell the difference between heartburn and cardiac chest pain is crucial. If chest pain spreads to other areas of the body, such as the arms or jaw, or occurs alongside symptoms such as shortness of breath and a feeling of tightness in the chest, it might be a sign of a heart attack. If chest pain lasts for more than a few minutes, call 911 immediately. A person who suspects that they or someone else is having a heart attack should immediately call 911 or go straight to the emergency room. It is also advisable to see a doctor about any unexplained chest pain, even if it goes away on its own.
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Plant-based diet cuts heart failure risk by over 40 percent

New research finds that sticking to a diet rich in fruits, vegetables, and fish can slash heart failure risk by 41 percent. By contrast, a diet rich in fats, fried foods, processed meat, and sugary drinks can raise the risk of this condition.
male hands eating tomato salad
Adding more vegetables to our plate could keep heart failure at bay.

Heart failure occurs when the heart cannot supply enough blood and oxygen to the main organs in the body.

The condition affects about 5.7 million people in the United States and approximately 26 million people worldwide.

Some experts predict that heart failure will become more and more prevalent worldwide, which has led them to refer to it as a "global pandemic."

However, emerging evidence suggests that a diet consisting mainly of fruits and vegetables can prevent cardiovascular disease. Now, a new study strengthens this idea.

Dr. Kyla Lara, a cardiology fellow at the Mayo Clinic in Rochester, MN, and her colleagues, have examined the associations between five major dietary patterns and the risk of heart failure among people without any known history of heart disease.

Dr. Lara and her team published the results of their study in the Journal of the American College of Cardiology.

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The effect of diets on heart failure

The researchers examined data available from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Namely, they looked at the dietary patterns among 16,068 black and white people who were 45 years old, on average.

The participants answered a 150-item survey, which included 107 food items. The researchers grouped the foods into five dietary patterns:

"convenience" diets, which consisted of meat-heavy dishes, pasta, pizza, and fast food "plant-based" diets, consisting mainly of vegetables, fruit, beans, and fish "Southern" diets, which comprised a significant amount of fried foods, processed meat, eggs, added fats, and sugary drinks "alcohol/salads" diets, which included lots of wine, liquor, beer, leafy greens, and salad dressing.

Dr. Lara and team followed the participants for 8.7 years on average, during which time, 363 people spent time in the hospital for heart failure for the first time.

Of these, 133 people had heart failure with preserved ejection fraction, and 157 had heart failure with reduced ejection fraction. The former refers to a form of heart failure in which the ejection fraction — a measure of how well the heart is pumping blood — is "normal," or "preserved."

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Plant-based diets slash heart failure risk

Overall, the researchers found that adhering to the Southern diet increased the risk of hospitalization due to heart failure by 72 percent.

But when the researchers adjusted for body mass index (BMI), "waist circumference, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation, and chronic kidney disease," this association became no longer statistically significant.

This could mean that the Southern diet raises heart failure risk by increasing obesity and abdominal fat, explain the researchers.

Importantly, the researchers found that the risk of heart failure hospitalizations was 41 percent lower among people who adhered to the plant-based diet.

Finally, the researchers found no statistically significant associations among heart failure risk and the other three dietary patterns.

"Adherence to a plant-based dietary pattern was inversely associated with incident [heart failure] risk, whereas the Southern dietary pattern was positively associated with incident [heart failure] risk," conclude the researchers, who also outline some strengths and limitations to their study.

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The researchers say that the socio-economically and demographically diverse study sample made the associations stronger. However, the study participants may have wrongly estimated their dietary intakes, which may have biased the results.

Also, the researchers examined the participants' diets only at the beginning of the study, and these dietary habits may have changed throughout the study period.

In a linked editorial, Dr. Dong Wang, a research fellow at the Harvard T.H. Chan School of Public Health in Boston, MA, comments on the significance of the findings, "This study represents an important step forward in establishing a robust evidence base for the dietary prevention of heart failure."

"The need for population-based preventive strategies for heart failure is critical [...] These findings support a population-based dietary strategy for lowering the risk of incident heart failure."

Dr. Kyla Lara

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Replacing red meat with plant protein reduces heart disease risk

A meta-analysis of trials comparing the health effects of red meat consumption with those of other diets found that substituting healthful plant protein for red meat helps lower the risk of cardiovascular disease.
Spelt, broccoli, savoy cabbage with chargrilled tofu with sriracha as plant protein
Eating plant proteins, such as tofu, may benefit cardiovascular health.

Many studies throughout the years have linked the consumption of red meat to cardiovascular disease and cancer, but the results have been inconsistent.

A 2015 study comparing the effects of plant protein and animal protein on the risk of cardiovascular disease found that the evidence was inconclusive.

Recent studies further investigated the link between red meat consumption and heart disease and found that red meat does not significantly increase the risk of cardiovascular disease when a person sticks to the recommended intake. Most of these studies focused on the potential harms of red meat, but they did not include an analysis of other specific diets.

Researchers from Harvard T.H. Chan School of Public Health in Boston, MA, and Purdue University in West Lafayette, IN, conducted the first meta-analysis of randomized controlled trials analyzing the effects of red meat by replacing it with other types of food. The results feature in the journal Circulation.

Red meat consumption in the United States

This new approach allowed researchers to examine a different side of the issue. Red meat consumption remains a very controversial topic, especially in the U.S., where the consumption of red meat per capita was more than 200 pounds in 2018, according to the U.S. Department of Agriculture.

Although red meat consumption in the U.S. is still high, chicken production and consumption have been increasing. The U.S. per capita beef consumption is down from its peak, but it is still remarkable — it is four times as high as the global average, according to the Organisation for Economic Co-operation and Development.

A recent survey showed that many people in the U.S. might be open to reducing their meat consumption in the future because they are becoming more aware of the associations that red meat has with nutritional and environmental health harms. The researchers suggested that education campaigns are necessary to accelerate the shift to a more sustainable diet.

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Asking 'Is red meat good or bad?' is useless

In this latest study, the researchers analyzed data from 36 randomized controlled trials, which included a total of 1,803 participants. The team looked at blood pressure and blood concentrations of cholesterol, triglycerides, and lipoproteins in people who ate diets with red meat. They then compared these values with those of people who ate more of other foods, such as chicken, fish, carbohydrates, legumes, soy, or nuts.

"Previous findings from randomized controlled trials evaluating the effects of red meat on cardiovascular disease risk factors have been inconsistent," says Marta Guasch-Ferré, lead author of the study and research scientist in the Department of Nutrition at the Harvard T.H. Chan School of Public Health.

"But, our new study, which makes specific comparisons between diets high in red meat versus diets high in other types of foods, shows that substituting red meat with high-quality protein sources lead to more favorable changes in cardiovascular risk factors."

The findings showed that there were no significant differences in total cholesterol, lipoproteins, or blood pressure between those who ate red meat and those who ate more of other types of food. However, diets high in red meat did cause an increase in triglyceride concentrations. Conversely, diets rich in high-quality plant protein lowered the levels of bad cholesterol.

"Asking 'Is red meat good or bad?' is useless," says Meir Stampfer, senior author of the study and professor of epidemiology and nutrition at Harvard T.H. Chan. "It has to be 'Compared to what?'"

"If you replace burgers with cookies or fries, you don't get healthier. But, if you replace red meat with healthy plant protein sources, like nuts and beans, you get a health benefit."

Prof. Meir Stampfer

The authors recommend that people follow healthful vegetarian and Mediterranean-style diets that provide plenty of high-quality plant protein because they offer excellent health benefits and promote environmental sustainability.

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