Yesterday I had the pleasure of speaking with leading cardiologist Dr. Carl Lavie to discuss how to maintain a healthy cholesterol level, how to lower high cholesterol with supplements such as niacin, how to choose the right niacin supplement and much more.
Candace Rose: What advice would you give people who want to maintain their cholesterol within a healthy range?
Dr. Carl Lavie: "Well, certainly one needs to know not just the total cholesterol. But they need to know the bad which is the LDL (which you want to be as low as possible) or the good (the HDL) which you want to be as high as possible. Certainly diet is very important to help cholesterol. You need to be lowering saturated fat cholesterol and the trans fatty acids in the diet. Most people also eating way too much carbohydrates, especially simple sugars that are leading to weight gain. Weight's very important because the overweight and obesity epidemic is contributing not just to cholesterol abnormalities but also to heart disease. And we can't forget about exercise, which exercise is needed to raise good cholesterol (the HDL) but also, for many aspects of cardiovascular health.
But there are a number of supplements that clinicians recommend frequently to help maintain a healthy cholesterol, like omega-3 fatty acids. The fish oils have tremendous preventative effects; but also physicians often recommend niacin products and especially they want niacin products that contain nicotinic acid because it's the nicotinic acid that is the part of the niacin that helps maintain a good healthy cholesterol. If the niacin doesn't contain nicotinic acid- if it's a flush-free niacin for example which is inositol, well there's not flushing but this is not very beneficial for maintaining a good healthy cholesterol. You need the nicotinic acid, which is the active ingredient in a product- for example Slo-Niacin by Upsher-Smith, which has been around for well over 20 years with good quality control. And this uses a unique polygel control release delivery system that slowly gets the nicotinic acid in the body, and this helps minimize or markedly reduce the flushing, but at the same time gets the good nicotinic acid in the body to help maintain a good healthy cholesterol."
Candace Rose: What are some of the differences among niacin dietary supplements?
Dr. Carl Lavie: "Well one, many niacins do not even contain nicotinic acid and these are flush-free niacins and this sounds good and attractive, but it's inositol that is not nicotinic acid and it really does not have the good effects on maintaining a healthy cholesterol. Of course you can get nicotinic acid by prescription, but within the dietary supplements many of the nicotinic acid preparations are immediate release. Well, this has good effects on maintaining the good cholesterol, yet it causes a tremendous amount of flushing that most people don't tolerate. The nice thing about a product like Slo-Niacin by Upsher-Smith it is the nicotinic acid that you want, but it's a controlled release delivery system that delivers its slowly and therefore markedly minimizes the effect of flushing and make of course the supplement more tolerable."
Candace Rose: Is it possible to get enough niacin through diet?
Dr. Carl Lavie: "Well, niacin is a B vitamin but you wouldn't be able to get niacin in the amount that is used to maintain good cholesterol by diet alone. You really need 500 milligrams or more and if you're in fact taking a supplement like niacin at that dose you should do so under the guidance of a physician or a health care provider. And again, many clinicians recommend nicotinic acid products even in some patients who are taking statin medications who still haven't achieved ideal cholesterol values."
Candace Rose: Do you have any additional tips or information you'd like to share?
Dr. Carl Lavie: "Well, the main thing for people to remember is there's a lot that they can do themselves, especially with diet, weight loss and exercise. Exercise is extremely important because not only is it important for cholesterol, but it's important for overall cardiovascular health. Fitness is one of the biggest factors that promote health and it's not just cardiovascular health, even there's evidence that high fitness is associated with lower risk of breast cancer and colorectal cancers. And probably one of the strongest predictors of survival is cardiorespiratory fitness which you get by regular physical activity and exercise training."
Candace Rose: Earlier you mentioned saturated fats, and we've been hearing a lot about coconut oil lately and how it can improve cholesterol levels and heart health. What are your thoughts on incorporating it into your diet?
Dr. Carl Lavie: "Well, I think in general, eating coconut is fine and coconut is healthy (it's a vegetable). I don't think there's that much evidence that one should be actually supplementing with coconut oil, I think that that's misleading. I think again, if somebody's eating the coconut itself that would be a very healthy thing, but I think using coconut oil as a supplement right now based on current evidence would be a mistake."
Candace Rose: Thank you, Dr. Lavie. Where can we go for more information?
Dr. Lavie: "Well, certainly always a great source of information is the American Heart Association websites, but you can also get some good information about this particular nicotinic acid preparation Slo-Niacin by going to Slo-Niacin.com to get information about this particular nicotinic acid dietary supplement as well as some good information about maintaining healthy cholesterol in general."
Slo-Niacin website. Slo-Niacin.com