Earlier studies have suggested that high-density lipoprotein (HDL) cholesterol is associated with several health benefits, such as promoting heart health. But, according to a recent study, high levels of HDL cholesterol could be linked to a greater risk of dementia.
The study, which was led by Monash University in Melbourne, involved thousands of volunteers from Australia and the United States. The study ran for more than six years and the findings were published in the journal Lancet Regional Health Western Pacific.
Cholesterol is a lipid or a waxy type of fat. It is produced by the liver, but people can also receive cholesterol by consuming it from food products from animals, and the ingested cholesterol is then transported throughout the body by blood.
There are two primary types of cholesterol: High-density lipoprotein (HDL) and low-density lipoprotein (LDL).
Very low-density lipoproteins are a third type of cholesterol that carry triglycerides or the fat the body stores up and uses for energy between meals.
LDL is called bad cholesterol because it can build up on the walls of blood vessels, which then narrow the passageways. If a blood clot forms and gets stuck in one of these narrowed passageways, it can trigger a heart attack or a stroke.
HDL is often called good cholesterol because it absorbs other types of cholesterol and carries them away from arteries and back to the liver, which then eliminates it from the body. Additionally, HDL cholesterol is called “good” cholesterol because it can remove other types of cholesterol from the bloodstream.
HDL: Good or bad for overall health?
While conducting the study, scientists recorded 850 incidences of dementia in 18,668 participants. The research team discovered that volunteers with high HDL cholesterol of more than 80 milligrams per deciliter had a 27 percent greater risk of dementia.
They also reported that there was a 42 percent increase in dementia risk for volunteers older than 75.
High HDL cholesterol was linked to an increased risk of all-cause dementia in both middle-aged and older individuals.
“The association appears strongest in those 75 years and above,” explained the researchers.
Even considering different variables such as country, age, sex, daily exercise, education, alcohol consumption and weight change over time, the researchers advised that the link between high HDL cholesterol and dementia remained “significant.” (Related: Study: Life’s Essential 8 could help you live healthier longer.)
Monira Hussain, a senior research fellow at Monash University’s School of Public Health and Preventive Medicine, said the study findings can be used to help improve understanding of dementia, but more research is needed.
Hussain said while it has been confirmed that HDL cholesterol has a crucial role in cardiovascular health, the study suggests that continued research can help shed more light on the “role of very high HDL cholesterol in the context of brain health.”
Hussain added that it is worth considering very high HDL cholesterol levels in prediction algorithms for dementia risk.
Researchers recruited a larger cohort for the HDL/dementia risk study
For the study, the research team recruited 16,703 Australians older than 70 years, along with 2,411 people older than 65 years from the United States.
The volunteers examined during the research had no physical disability, cardiovascular disease, dementia, or life-threatening illness at the time of recruitment for the study. They were also “cognitively healthy.”
According to the scientists, while several studies have indicated a connection between HDL cholesterol and adverse health events, evidence regarding its connection to dementia remains unknown.
The researchers said an analysis of a medical database examining the link between high HDL cholesterol and dementia revealed that there was only one study from Denmark that established a link.
“Only one study of cohorts from Denmark was identified which suggested that high HDL-C is associated with dementia in people aged 47–68 years,” said the scientists.
Because early-onset dementia may have a different pathophysiology than late-onset dementia, the researchers advised that it is important to extend these results to well-characterized prospective studies of older individuals who are cognitively intact at the study onset.
The data analysis was conducted between October 2022 and January 2023, before publishing the study.
The scientists said their study is the “most comprehensive study” to report high HDL cholesterol and the risk of dementia in the elderly.
High-density lipoprotein cholesterol (HDL-C), the “good cholesterol,” transports cholesterol from the arteries to the liver for elimination. Previous studies have demonstrated an association between higher HDL-C and lower cardiovascular (CV) risk. Epidemiologic studies reported CV disease (CVD) reductions of around 2%-3% for every unit rise in HDL-C level. However, a recently published prospective, multicenter, cohort study found that very high levels of HDL-C (> 80 mg/dL [> 2.069 mmol/L]) were associated with adverse outcomes in patients with coronary heart disease (CHD), suggesting that hyperalphalipoproteinemia (HALP) can negatively affect CV mortality.
Here are five things about the role of HDL-C and the potential negative impact of HALP on CV health.
1. HDL-C is essential for lipid homeostasis.
HDL-C comprises various particles that differ in size, density, electrophoretic mobility, and apolipoprotein (Apo) content. ApoA-I and ApoA-II, the two major HDL-C apolipoproteins, are essential for normal HDL-C biosynthesis. ApoA-I constitutes about 70% of HDL-C protein while ApoA-II constitutes about 20%. The multiple proteins and lipids that comprise HDL-C not only assist in lipid metabolism but also play a role in acute-phase response, complement regulation, and proteinase inhibition. HDL-C plays an integral role in reverse cholesterol transport by removing excess cholesterol from peripheral vessels and transporting it back to the liver for elimination. It also has important anti-inflammatory, cytoprotective, antithrombotic, and antioxidative functions, inhibits the expression of adhesion molecules in endothelial cells, and increases the production of the atheroprotective signaling molecule nitric oxide.
2. Several factors can impair HDL-C functionality.
In addition to ApoA-I and ApoA-II, HDL-C comprises several other proteins, including ApoC-III, ApoC-II, ApoC-I, ApoL, APOE, lecithin-cholesterol acyltransferase, Apo-J, platelet-activating factor acetylhydrolase, and serum paraoxonase-1. An acute-phase response (eg, to infection, inflammation, trauma) can alter plasma proteins in HDL-C, converting HDL-C from an anti-inflammatory to a proinflammatory particle. A study on human smooth muscle and aortic endothelial cells found that HDL-C levels of patients before cardiac surgery inhibited the low-density lipoprotein (LDL)-induced increase in monocyte transmigration. However, HDL-C levels obtained 2-3 days after surgery did not inhibit monocyte transmigration but rather increased it up to 1.8-fold. Further, glycation and protein carbamylation may impair HDL-C function and reduce its antiatherogenic effects.
Ethnicity and dietary patterns can also affect HDL-C functionality. For example, a study by Woudberg and colleagues found higher HDL-C antioxidant functionality and increased protection against CHD — irrespective of lower circulating HDL-C levels and higher obesity — in Black South African women as compared with White women. Regarding dietary habits, saturated fat intake has been shown to reduce the anti-inflammatory properties of HDL-C and impair arterial endothelial function.
3. Understanding HDL-C levels can be effective in assessment of CVD risk.
Most studies have shown that reducing LDL-C with statin monotherapy and/or with ezetimibe can lower the number of CV events and that HDL-C plays an important, beneficial role in CV morbidity and mortality. A study by Ko and associates reported increased risk for death in patients with low HDL-C (< 40 mg/dL [< 1.0344 mmol/L] in men and < 50 mg/dL [< 1.293 mmol/L] in women) or very high HDL-C levels (> 80-90 mg/dL [> 2.069-2.3274 mmol/L]) compared with patients with moderate HDL-C levels. While other studies showed that HDL-C levels higher than around 60 mg/dL (1.5516 mmol/L) did not further improve CVD prognosis, other trials, including EPIC and IDEAL, found that while low HDL-C is a predictor of increased CVD risk, very high HDL-C may also lead to adverse outcomes.
4. Several factors are associated with high HDL-C levels.
Factors contributing to HALP include genetic mutations in cholesteryl ester transfer protein (CETP), hepatic lipase, endothelial lipase, and scavenger receptor class B type I (SR-B1). Cholesteryl ester transfer protein is associated with the transportation of triglyceride from very low-density lipoproteins (VLDLs)/chylomicrons to HDL-C and (LDL-C along with cholesteryl esters from HDL-C to VLDLs/chylomicrons. In Japan, which has the highest prevalence of primary HALP, studies found CETP deficiency of around 60% and 31% among patients with high and very high levels of HDL-C, respectively.
Some clinical trials over the past few decades have focused on deficiency in hepatic lipase, a heparan-sulfate proteoglycan-bound lipolytic enzyme associated with HDL-C and triglyceride metabolism that can increase HDL-C size and affect HDL-C function in the reverse cholesterol transport process, in turn increasing the risk for premature CVD. Endothelial lipase is mainly associated with HDL-C phospholipid hydrolysis and can negatively affect HDL-C metabolism. In addition, studies show that SR-B1, a receptor for HDL-C that regulates the uptake of cholesterol esters by HDL-C, increased atherosclerosis and plasma HDL-C levels and impaired liver cholesterol transfer in SR-B1 knockout mice.
5. The focus of lipid studies has shifted to further evaluate the CV risks associated with very high HDL-C.
Very high HDL-C levels may result in abnormally large dysfunctional HDL-C particles that have the potential to become trapped in the arterial intima, promoting deposition of cholesterol and increasing CVD risk. More studies need to be carried out to confirm such findings. Some clinical trials over the past few decades have focused on targeting HDL-C to reduce CVD risk. These studies mostly used niacin, statins, fibrates, and other drugs to increase HDL-C levels. Most of these clinical trials (HATS, AIM-HIGH, ARBITER-2, HPS2-THRIVE, CLAS, and CDP) found that increasing HDL-C had no significant impact on CV events or outcomes, although studies on naturally occurring high HDL-C are yet to be done. A few trials that evaluate cardioprotection based on improving HDL-C functions or increasing specific HDL-C subclasses are underway. Targeting HDL-C function and quality can be an effective strategy to understand mechanisms related to CV protection, which in turn can lead to the development of newer therapies to prevent CVD.
Could researchers develop a vaccine to lower bad cholesterol?
Could the future bring a vaccine against bad cholesterol? Image credit: Milena Milani/Stocksy.
All people need some cholesterol, but having too high cholesterol levels can be dangerous, particularly to areas of cardiovascular health.
Research is ongoing to find new ways to help people keep cholesterol within a healthy range.
Data from a recent study on animals found a vaccine that may be effective at lowering cholesterol.
Future research is required before this data can be applied in clinical practice with humans.
Cholesterol levels outside a healthy range can be dangerous for heart health, but what options exist for lowering cholesterol?
Most often, people can manage cholesterol levels by changing components of their lifestyle or taking certain medications. However, the options for assistance with cholesterol management may be expanding.
A study published in npj vaccinesTrusted Source examined the effectiveness of a cholesterol-lowering vaccine.
The study looked at mouse and nonhuman primate models, and found that a bivalent vaccine effectively lowered cholesterol levels.
The results point to promising research and the potential development of another way to help people keep cholesterol in a healthy range.
Study author Dr. Bryce Chackerian, Regent’s professor of molecular genetics and microbiology at the University of New Mexico School of Medicine, explained the reasoning behind the research to Medical News Today.
“The common medications to treat elevated cholesterol are statins,” he told us. “However, statins don’t work for everyone, and some patients on statins experience side effects.”
“Recently, a new class of medication, called PCSK9 inhibitors, have been approved to lower cholesterol. PCSK9 inhibitors are very effective at lowering cholesterol, but unfortunately they are also very expensive, which has limited their use. We were interested in developing a lower-cost vaccine-based approach for inhibiting PCSK9. The idea behind this approach is that the vaccine induces antibodies against PCSK9, which then lower cholesterol levels.”
– Dr. Bryce Chackerian
The research notes that the body removes low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, via the low-density lipoprotein receptor (LDL-R).
The protein PCSK9 helps inhibit this process, thus leading to higher levels of LDL cholesterol in the bloodstream. There are a few ways to inhibit PCSK9 — one potential way is through a vaccine.
The study explored the efficacy of these potential vaccines in monkeys and mice. The researchers looked at the effectiveness of two PCSK9 vaccines: single and bivalent.
They found that single and bivalent vaccines lowered cholesterol levels among mice. However, the single vaccine type did not lower LDL cholesterol to a statistically significant level.
Among monkeys, researchers were able to carefully measure cholesterol levels over time to help test vaccine efficacy. They also tested how the vaccines worked in combination with statins.
They found that the bivalent vaccine was effective in lowering LDL cholesterol. However, the single vaccine was not effective on its own and had to be combined with statins to be effective.
Dr. Chackerian, Ph.D. explained: “In our study, we identified a vaccine that dramatically lowers cholesterol in two different animal species. In monkeys, for example, vaccination led to a 30% reduction in LDL cholesterol levels, without requiring statins. Importantly, the vaccine also had long-lasting effects on cholesterol levels, meaning that it is likely that patients would not need frequent injections.”
Is this anti-cholesterol vaccination regime likely to be effective in humans? First of all, the researchers note that their study focused on animals, so more research is required before doctors could use the vaccine in clinical practice with human patients.
The researchers also noted that the average baseline of LDL cholesterol in the monkeys was normal, which might have limited how much LDL was lowered.
It is also not entirely clear why the bivalent vaccine was more effective in the monkeys, so this is another area for researchers to explore.
The research also included a small number of monkeys, meaning future studies could include larger sample groups. More research is needed to determine the vaccine’s long-term effectiveness and the potential need for boosters.
Furthermore, the study authors note that the experimental vaccine in their study was less effective than other cholesterol-lowering methods. Nevertheless, they point out that even lowering cholesterol by a small amount can play a crucial role in decreasing cardiovascular events.
Dr. Richard Wright, a board-certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the current research, commented on the findings, offering the following words of caution:
“Unfortunately, there are insufficient data to show how long, or even if, this type of vaccine would lower the LDL in humans. The larger issue is the magnitude of benefit: no vaccination has been shown to be as effective as current therapies, and in this current study, the magnitude of LDL reduction is less than what is achievable with current inexpensive statin drugs and far less than obtained with administration of exogenous monoclonal antibodies or RNA therapeutics.”
Still, if research moves forward in this area, it could be highly beneficial for individuals at a higher risk for problems from high cholesterol. And it could be potentially used in combination with other therapies.
Dr. Cheng-Han Chen, board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, also not involed in the study, noted that “[t]he potential clinical benefit of such a vaccine would be tremendous.”
“Current PCSK9 inhibitors in clinical use, while extremely efficacious, are very expensive. In addition, these therapeutics require routine administration. A vaccine-based targeting of PCSK9 could potentially provide long-lasting lowering of LDL levels with a longer duration of effect. This would lower health care costs for the system while improving cardiovascular outcomes,” he added.
There is also cholesterol in certain foods. The two main types of cholesterol are LDL cholesterol and high-density lipoproteins (HDL) cholesterol.
LDL cholesterolTrusted Source is sometimes called “bad” cholesterol because when levels of it in the body get too high, it can increase the risk of heart attack and stroke.
Certain lifestyle choicesTrusted Source can increase the risk of high cholesterol, such as eating a diet high in saturated fat, not exercising regularly, and smoking.
People can make lifestyle and dietary changes to help lower their cholesterol levels. They can also take medications like statins to help reduce cholesterol levels.
But even with these interventions, cholesterol can still be a challenge to keep in a healthy range. This is why it is crucial that researchers continue to explore potential new ways to manage cholesterol levels.
Cholesterol levels vary by age, weight, and sex. They typically increase over time, and people over 20 should check their cholesterol levels every 5 years.
In this article, we look at how doctors measure cholesterol and the healthy levels at different stages of life. We also look at ways of lowering cholesterol and maintaining acceptable levels.
If there is too much LDL or “bad” cholesterol in the bloodstream, it can build up in blood vessels, forming fatty deposits called plaques.These plaques can lead toTrusted Source other problems, including heart attacks and strokes.
Total and LDL cholesterol levels should be low. But having more HDL or “good,” cholesterol in the blood may reduce the risk of a heart attack or stroke.
Doctors can measure HDL, LDL, and total cholesterol levels. The results may also show levels of all non-HDL fats that can raise the risk of heart disease.
Cholesterol levels tend to increase with age. Taking steps to reach or maintain healthy levels earlier in life may prevent them from becoming dangerously high over time. Years of unmanaged cholesterol levels can be challenging to treat.
Children should have at least one cholesterol test at age 9–11 and another one at age 17–21. However, children with risk factors for high cholesterol may need more frequent checks.
Typically, males tend to have higher levels throughout their lives than females. A male’s cholesterol levels increase with age, and a female’s cholesterol levels rise after menopause.
The table below shows healthy levels of cholesterol by age, according to the National Institutes of Health (NIH). Doctors measure cholesterol in milligrams per deciliter (mg/dl).
For adults aged 20 and over, the following levels are significant:
Type of cholesterol
Acceptable
Near optimal
Borderline high
High
Very high
Total cholesterol
below 200 mg/dl
n/a
200–239 mg/dl
240 mg/dl or above
n/a
LDL
below 100 mg/dl
100–129 mg/dl
130–159 mg/dl
160–189 mg/dl
190 mg/dl or over
For HDL cholesterol, higher levels are linked to a reduced risk of heart disease:
Type of cholesterol
Acceptable
Borderline low
Risk of heart disease
HDL
60 mg/dl and above
40–59 mg/dl
below 40 mg/dl
Aging aside, any changes in cholesterol levels usually stem from health conditions and lifestyle factors. Below, we describe healthy and unhealthy ranges in more detail.
Cholesterol levels for adults
A doctor may classify a person’s levels as high or low, borderline, or healthy.
Ideally, LDL cholesterol levels should be less than 100 mg/dl. Doctors may not express concern about levels of 100–129 mg/dl for people with no health issues, but they may suggest treatment at this stage for people with heart disease or its risk factors.
Cholesterol levels for children
According to the American Academy of Pediatrics, the following measures apply for children and adolescents aged 19 and below:
The CDCTrusted Source point outs that some health conditions and lifestyle factors can raise cholesterol levels. It says that type 2 diabetes, for example, raises LDL cholesterol levels, as does familial hypercholesterolemia.
The CDC also states that having a diet high in saturated fats and getting low levels of exercise may contribute to high cholesterol levels.
In addition, it acknowledges that having family members with high cholesterol increases a person’s risk.
The NIH recommends consulting a healthcare professional before starting a new exercise plan. Overall, current guidelines advise people to aim for at least 150 minutesTrusted Source per week of moderate-intensity exercise as well as muscle-strengthening exercise 2 days per week.
Having a healthy diet and getting plenty of exercise can also bring down high cholesterol levels in children.
Generally, the earlier a person starts making these changes, the better for their cholesterol levels, as cholesterol builds up over time.
High cholesterol at any age increases the risk of heart disease, heart attack, and stroke. These risks only increase over time.
Drug therapies to treat high cholesterol
When lifestyle changes alone cannot bring down high cholesterol, doctors may recommend medications. The CDCTrusted Source reports that the following drugs and supplements can help:
Statins:Statins keep the liver from producing cholesterol and are the most common medication for high cholesterol.
Bile acid sequestrants: These drugs reduce the amount of fat that the body absorbs from food.
Cholesterol absorption inhibitors: These drugs lower levels of fats called triglycerides in the blood and reduce the amount of cholesterol absorbed from food.
Some vitamins and supplements: These, such as niacin, stop the liver from removing HDL and lower levels of triglycerides.
Omega-3 fatty acids: These raise HDL levels and lower triglyceride levels.
Before the age of 18, a doctor should check a child’s cholesterol levels at least twiceTrusted Source. If the child’s family has a history of heart disease, overweight, or certain other health conditions, doctors may recommend checking levels more often.
A healthcare professional should check cholesterol levels in adults aged 20 or older every 4–6 years.
The doctor may recommend treatment if:
The results show high or borderline high levels of total and LDL cholesterol.
Here are some questions people often ask about cholesterol levels.
What is a healthy cholesterol level by age?
For children and teens, borderline high total cholesterol levels are 170–199 mg/dl and borderline high LDL levels are 100–129 mg/dl. For adults aged 20 and over, borderline high total cholesterol levels are 200–239 mg/dl and borderline high LDL levels are 130–159 mg/dl. Over this is very high.
What cholesterol level is considered high?
If total cholesterol levels are 240 mg/dl or above, a doctor will consider this very high, while 200–239 mg/dl is borderline high. Very high levels of LDL are 190 mg/dl and above. HDL cholesterol levels of 40 mg/dl or less are very low and a major risk factor for heart disease.
What reduces cholesterol quickly?
Dietary measures, weight management, and exercise can all help lower cholesterol levels. A doctor may prescribe medication if the person has other cardiovascular risk factors or if their levels are very high or do not respond to lifestyle measures.
Cholesterol levels outside a healthy range can be dangerous for heart health, but what options exist for lowering cholesterol?
Most often, people can manage cholesterol levels by changing components of their lifestyle or taking certain medications. However, the options for assistance with cholesterol management may be expanding.
A study published in npj vaccinesTrusted Source examined the effectiveness of a cholesterol-lowering vaccine.
The study looked at mouse and nonhuman primate models, and found that a bivalent vaccine effectively lowered cholesterol levels.
The results point to promising research and the potential development of another way to help people keep cholesterol in a healthy range.
Study author Dr. Bryce Chackerian, Regent’s professor of molecular genetics and microbiology at the University of New Mexico School of Medicine, explained the reasoning behind the research to Medical News Today.
“The common medications to treat elevated cholesterol are statins,” he told us. “However, statins don’t work for everyone, and some patients on statins experience side effects.”
“Recently, a new class of medication, called PCSK9 inhibitors, have been approved to lower cholesterol. PCSK9 inhibitors are very effective at lowering cholesterol, but unfortunately they are also very expensive, which has limited their use. We were interested in developing a lower-cost vaccine-based approach for inhibiting PCSK9. The idea behind this approach is that the vaccine induces antibodies against PCSK9, which then lower cholesterol levels.”
– Dr. Bryce Chackerian
The research notes that the body removes low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol, via the low-density lipoprotein receptor (LDL-R).
The protein PCSK9 helps inhibit this process, thus leading to higher levels of LDL cholesterol in the bloodstream. There are a few ways to inhibit PCSK9 — one potential way is through a vaccine.
The study explored the efficacy of these potential vaccines in monkeys and mice. The researchers looked at the effectiveness of two PCSK9 vaccines: single and bivalent.
They found that single and bivalent vaccines lowered cholesterol levels among mice. However, the single vaccine type did not lower LDL cholesterol to a statistically significant level.
Among monkeys, researchers were able to carefully measure cholesterol levels over time to help test vaccine efficacy. They also tested how the vaccines worked in combination with statins.
They found that the bivalent vaccine was effective in lowering LDL cholesterol. However, the single vaccine was not effective on its own and had to be combined with statins to be effective.
Dr. Chackerian, Ph.D. explained: “In our study, we identified a vaccine that dramatically lowers cholesterol in two different animal species. In monkeys, for example, vaccination led to a 30% reduction in LDL cholesterol levels, without requiring statins. Importantly, the vaccine also had long-lasting effects on cholesterol levels, meaning that it is likely that patients would not need frequent injections.”
Is this anti-cholesterol vaccination regime likely to be effective in humans? First of all, the researchers note that their study focused on animals, so more research is required before doctors could use the vaccine in clinical practice with human patients.
The researchers also noted that the average baseline of LDL cholesterol in the monkeys was normal, which might have limited how much LDL was lowered.
It is also not entirely clear why the bivalent vaccine was more effective in the monkeys, so this is another area for researchers to explore.
The research also included a small number of monkeys, meaning future studies could include larger sample groups. More research is needed to determine the vaccine’s long-term effectiveness and the potential need for boosters.
Furthermore, the study authors note that the experimental vaccine in their study was less effective than other cholesterol-lowering methods. Nevertheless, they point out that even lowering cholesterol by a small amount can play a crucial role in decreasing cardiovascular events.
Dr. Richard Wright, a board-certified cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the current research, commented on the findings, offering the following words of caution:
“Unfortunately, there are insufficient data to show how long, or even if, this type of vaccine would lower the LDL in humans. The larger issue is the magnitude of benefit: no vaccination has been shown to be as effective as current therapies, and in this current study, the magnitude of LDL reduction is less than what is achievable with current inexpensive statin drugs and far less than obtained with administration of exogenous monoclonal antibodies or RNA therapeutics.”
Still, if research moves forward in this area, it could be highly beneficial for individuals at a higher risk for problems from high cholesterol. And it could be potentially used in combination with other therapies.
Dr. Cheng-Han Chen, board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, also not involed in the study, noted that “[t]he potential clinical benefit of such a vaccine would be tremendous.”
“Current PCSK9 inhibitors in clinical use, while extremely efficacious, are very expensive. In addition, these therapeutics require routine administration. A vaccine-based targeting of PCSK9 could potentially provide long-lasting lowering of LDL levels with a longer duration of effect. This would lower health care costs for the system while improving cardiovascular outcomes,” he added.
There is also cholesterol in certain foods. The two main types of cholesterol are LDL cholesterol and high-density lipoproteins (HDL) cholesterol.
LDL cholesterolTrusted Source is sometimes called “bad” cholesterol because when levels of it in the body get too high, it can increase the risk of heart attack and stroke.
Certain lifestyle choicesTrusted Source can increase the risk of high cholesterol, such as eating a diet high in saturated fat, not exercising regularly, and smoking.
People can make lifestyle and dietary changes to help lower their cholesterol levels. They can also take medications like statins to help reduce cholesterol levels.
But even with these interventions, cholesterol can still be a challenge to keep in a healthy range. This is why it is crucial that researchers continue to explore potential new ways to manage cholesterol levels.
Higher HDL levels may be associated with increased fracture risk for older adults independent of other risk factors, according to a post hoc analysis of the ASPREE study.
“Our findings add to growing evidence of unfavorable impacts linked to high HDL levels,” Sultana Monira Hussain, MBBS, PhD, MPH, a senior research fellow at Monash University School of Public Health and Preventive Medicine in Melbourne, Victoria, Australia, told Healio. “It shows that HDL, commonly known as ‘good cholesterol,’ in high levels is not as good as we previously thought. Rather, it is associated with several adverse outcomes such as fractures.”
Higher HDL levels may be associated with increased fracture risk for older adults independent of other risk factors. Source: Adobe Stock
ASPREE fracture data
Sultana Monira Hussain
Hussain and colleagues analyzed data from adults participating in the ASPREE study and the ASPREE-Fracture substudy. Participants from Australia (n = 16,703) were aged 70 years or older; participants from the U.S. (n = 2,411) were aged 65 years or older; all were free of CVD, dementia, physical disability and chronic illness at baseline. The ASPREE-Fracture substudy collected data on fractures reported after randomization from Australian participants. Researchers assessed HDL and traumatic and minimal trauma fractures, confirmed by medical imaging and adjudicated by an expert review panel.
The findings were published in JAMA Cardiology.
Among 16,262 participants who had a plasma HDL measurement at baseline (55% women), 1,659 experienced at least one fracture during a median of 4 years.
In a fully adjusted model, each one standard deviation increment in HDL level was associated with a 14% higher risk for fractures (HR = 1.14; 95% CI, 1.08-1.2). Results persisted in analyses stratified by sex and limited to only minimal trauma fractures and participants not taking osteoporosis medications. Researchers did not observe an association between non-HDL levels and fractures.
“HDL particles are complexes of lipids and apolipoproteins with diverse structures and biological activities,” Hussain told Healio. “Having high levels of HDL does not mean that the HDL particles are functional. Therefore, in the future, researchers should aim to examine the role of other aspects of HDL structure and functionality in the pathogenesis of chronic diseases in older populations.”
Data leave ‘unanswered questions’
John T. Wilkins
In a related editorial, John T. Wilkins, MD, MS, assistant professor of medicine (cardiology)/preventive medicine at Northwestern University Feinberg School of Medicine, and Anand Rohatgi, MD, MSCS, professor of medicine at University of Texas Southwestern Medical Center, noted that the study demonstrated significant associations between HDL level and fracture risk; however, models were not adjusted for detailed measures of exercise or physical activity, triglycerides or any other lipids, including other HDL compositional measures such as HDL particle concentration or apolipoprotein A-I levels.
“There was no assessment of whether HDL cholesterol improved discrimination reclassification, or any other validated measures of risk prediction performance,” Wilkins and Rohatgi wrote. “Taken together, this study alone leaves several unanswered questions as to whether high HDL cholesterol could be a useful biomarker to detect fracture risk.”
Wilkins and Rohatgi wrote that extreme high HDL may reflect dysfunctional biology, rare adverse genetic variants, some component of heavy alcohol use, and/or a unique metabolic substrate in specific populations.
“With respect to fracture risk, future questions include whether HDL particle concentration or functional measures confer similar or differential risk information, whether these associations vary by sex, Black race, diabetes and kidney function status, and whether therapies that decrease fracture risk have an effect on lipoprotein metabolism, independent of consequent changes in lifestyle,” they wrote.
In adults with CAD, those with HDL of 80 mg/dL or greater are nearly twice as likely to die of any cause compared with those with HDL between 40 mg/dL and 60 mg/dL, according to an analysis of two large biobank databases.
In an analysis of data from nearly 20,000 patients, researchers also found the higher risk for all-cause and CV death associated with very high HDL, typically considered protective, was independent of traditional CV risk factors and alcohol use.
Quyyumi is professor of medicine, director of the Emory Clinical Cardiovascular Research Institute and the Bruce Logue Chair for Cardiovascular Research at Emory University School of Medicine.
“Very high HDL levels are associated with increased risk for adverse outcomes, not lower risk, as previously thought,” Arshed A. Quyyumi, MD, FRCP, professor of medicine, director of the Emory Clinical Cardiovascular Research Institute and the Bruce Logue Chair for Cardiovascular Research at Emory University School of Medicine, told Healio. “This is true not only in the general population but also in people with known coronary artery disease. The higher risk with very high HDL levels is particularly seen in men, although women also have higher risk at very high HDL levels.”
Prospective biobank data
In a prospective study, Quyyumi and colleagues analyzed data from patients with confirmed CAD and high HDL, defined as at least 80 mg/dL, using UK Biobank (2006-present; n = 14,478; mean age, 62 years; 76.2% men) and Emory Cardiovascular Biobank (2003-present; n = 5,467; mean age, 64 years; 66.4% men) data. Patients without confirmed CAD were excluded. The primary outcome was all-cause death; secondary outcome was CV death.
The findings were published in JAMA Cardiology.
During a median follow-up of 8.9 years in the UK Biobank and 6.7 years in the Emory Cardiovascular Biobank, researchers observed a U-shaped association between HDL level, all-cause death and CV death, with higher risk among patients with low and very high HDL vs. patients with midrange values.
For the UK Biobank analysis, compared with patients with an HDL between 40 mg/dL and 60 mg/dL, patients with an HDL of at least 80 mg/dL were nearly twice as likely to die of any cause during follow-up, with a HR of 1.96 (95% CI, 1.42-2.71; P < .001) and 71% more likely to die of CV causes, with an HR of 1.71 (95% CI, 1.09-2.68; P = .02). Results persisted after adjustment for other CV risk factors, including hypertension, diabetes and smoking.
Findings were similar for patients in the Emory Cardiovascular Biobank, with findings for the UK Biobank persisting after further adjustment for genetic risk score.
In sensitivity analyses, all-cause death risk among patients from the UK Biobank with very high HDL was greater among men (HR = 2.63; 95% CI, 1.75-3.95; P < .001) compared with women (HR = 1.39; 95% CI, 0.82-2.35; P = .23).
“Physicians have to be cognizant of the fact that, at levels of HDL above 80 mg/dL, they must be more aggressive with risk reduction and not believe that that the patient is at ‘low risk’ because of high levels of ‘good cholesterol,’” Quyyumi told Healio. “We need to understand what the mechanisms underlying this increased risk are. What are the functional changes in HDL that lead to this higher risk?”
Very high HDL as ‘red flag’
Sadiya S. Khan
Gregg C. Fonarow
In a related editorial, Sadiya S. Khan, MD, MSc, assistant professor of preventive medicine (epidemiology) and medicine (cardiology) at Northwestern University Feinberg School of Medicine, and Gregg C. Fonarow, MD, FACC, FAHA, FHFSA, director of the Ahmanson-UCLA Cardiomyopathy Center, co-director of the UCLA Preventive Cardiology Program, co-chief of the division of cardiology at UCLA and the Eliot Corday Chair in Cardiovascular Medicine and Science, wrote that emerging data from healthy populations suggest a “paradoxical association” may be present, with higher mortality observed among people with very high HDL.
“Although the present findings may be related to residual confounding, high HDL-C levels should not automatically be assumed to be protective,” Khan and Fonarow wrote. “Clinicians should use HDL-C levels as a surrogate marker with very low and very high levels as a red flag to target for more intensive primary and secondary prevention, as the maxim for HDL-C as ‘good’ cholesterol only holds for HDL-C levels of 80 mg/dL or less.”
Previous analyses have suggested very high HDL may be a risk factor for all-cause death. As Healio previously reported, patients with HDL levels greater than 60 mg/dL in the Emory Cardiovascular Biobank had a nearly 50% increased risk for all-cause mortality, CV mortality and MI compared with those with HDL levels of 41 mg/dL to 60 mg/dL.
HDL is commonly referred to as the “good” cholesterol. LDL, mistakenly, is known as the bad cholesterol. But that is all pharmaceutical company propaganda. The human body manufactures both HDL and LDL for a purpose. No mistakes are made, only responses to poor nutrition and chemicals.
HDL stands for high-density lipoprotein. Since HDL contains a large proportion of protein versus fat, it gravitates toward the bottom of a centrifuge easily, compared to the less dense, low-density lipoprotein (LDL).
On the surface of the HDL particle is a protein called Apo A. It helps with HDL structure and function, much like Apo B assists LDL particles. Studies show the more Apo A, the lower the risk of cardiovascular disease.
The HDL particle is made in the liver and performs many functions in the body. The original shape of the HDL as it leaves the liver is like a disc. As the LDL travels around the body, it picks up excess cholesterol and eventually takes on a spherical shape.
HDL acts as a scavenger and picks up cholesterol from around the body AND also delivers cholesterol to the hormone producing organs such as the ovaries, testes, and adrenal glands.
The HDL exchanges its triglycerides with cholesterol from foam cells in coronary plaque! Foam cells are inflammatory cells that are at the forefront of coronary disease.
But the main benefit of HDL is likely how it combats oxidation and inflammation. A protein carried by HDL is called PON-1. This is an enzyme that destroys oxidized (damaged) lipids. The more PON-1, the lower the heart disease risk.
HDL also inhibits platelets, therefore keeps the blood thin. Additionally, HDL maintains the health of the endothelium, the cells that line blood vessels.
Eventually, old HDL is picked up by the liver and re-processed.
Testing for HDL
Here is what we know. The more HDL the better. A multitude of studies confirm that HDL-C, HDL particle number, and HDL particle size all assist in our risk assessment. In short, the more HDL, the lower the risk of heart attacks, strokes, and dying. The bigger, fluffier HDL’s also link to a lower risk of cardiac events.
But all HDL does not function the same. And at the forefront of technology is the ability to determine how well HDL is doing its job.
It appears that the best number to identify cardiovascular risk is the Apo B to Apo A ratio. The lower, the better.
Raising HDL numbers
Here are some proven suggestions to raise the HDL number:
· Quite simply, eat Paleo. Seafood, saturated fat, and low carbohydrate intake have all been shown to raise HDL
· Mild/moderate alcohol intake (not recommended by me)
Niacin- vitamin B3
Niacin has been extensively studied and is the best available method to raise HDL. But just because the HDL number goes up, it does not necessarily decrease heart attacks, strokes, or extend life. Many drugs have tried and failed in this endeavor.
But niacin seems to hold true. The form that works is called nicotinic acid. Flush-free niacin does not work.
The Coronary Drug Project provides the best evidence that niacin works. 15 years after the study was concluded, the group who received niacin lowered their heart attack risk by 11%.
In addition, the SIHDSPS found a benefit to niacin AND gemfibrozil to reduce cardiac events in people who already had suffered a previous heart attack. Total mortality was reduced by 26%. Since gemfibrozil by itself does not have much benefit, we can assume that niacin provided the event reduction.
A 2011 study found niacin, combined with a statin and another drug, laropiprant, did not decrease events, and actually trended toward more strokes. Again, this trial was with statins and a second study drug, hence I do not think this is applicable to a holistically treated patient.
Niacin also appears to lower LDL, increase LDL particle size, and lower triglycerides.
When you think of macadamia nuts, Hawaii might come to mind, but this nut is actually native to the continent Down Under, which explains why the fruit is also known as the Australian or Queensland Nut. From theProteacea family of plants, evergreen macadamia trees can reach 40 feet in horizontal as well as vertical spread.
These are some of the most sought-after nuts in the world, so they can be expensive. This has driven up commercial production in other balmy areas like South Africa and Central America where the trees thrive if there’s sufficient water. Introduced in Hawaii in 1881 and soon afterward in California, Hawaii is now the world’s largest exporter. A 10-year-old macadamia tree might produce up to 50 pounds and increase indefinitely.
Besides being a food source, the husks are composted for mulch or for fertilizer, and in Japan, the oil is used in the cosmetic industry to make soaps, shampoos, and sunscreens. The remainder can be used in animal feed.
Macadamias are a tough nut to crack, as the saying goes. Containing at least 72 percent oil, they’re encased in a leathery, green husk that splits open as the nut matures. Harvest comes when they fall from the tree, which is when the husk is removed and the nuts are dried. The shell can then be removed using a nutcracker. A handful of these nuts makes a crunchy snack, but they’re also great in cookies, breads and pastries, fruit salads, and garden salads.
Health Benefits of Macadamia Nuts
As a natural, whole food, macadamia nuts, specifically, contain antioxidants, vitamins, and minerals with significant health-boosting potential. They contain high amounts of vitamin B1 and magnesium, and just one serving nets 58 percent of what you need in manganese and 23 percent of the recommended daily value of thiamin.
Raw nuts contain a number of nutrients along with a healthy amount of monounsaturated fat.Macadamias, with their own unique nutritional profile, are relatively low in carbs and protein (containing two percent per one-ounce serving), high in oleic acid and omega-9 monounsaturated fatty acid, the same fatty acid found in olive oil. In fact, of the 21 grams of fat found in macadamia nuts, only three grams are saturated fat.
There’s sometimes a disconnect in the understanding of which foods contain good fats (HDL) and which have the bad kind (LDL). According to the American Heart Association: 1
LDL cholesterol is considered the ‘bad’ cholesterol because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. This condition is known as atherosclerosis. If a (blood) clot forms and blocks a narrowed artery, heart attack or stroke can result. Another condition called peripheral artery disease can develop when plaque buildup narrows an artery supplying blood to the legs.
HDL cholesterol is considered ‘good’ cholesterol because it helps remove LDL cholesterol from the arteries. Experts believe HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it is broken down and passed from the body. One-fourth to one-third of blood cholesterol is carried by HDL. A healthy level of HDL cholesterol may also protect against heart attack and stroke, while low levels of HDL cholesterol have been shown to increase the risk of heart disease.”
When choosing fats that you should and should not eat, it’s important to note that it’s the type of fat that matters, not the amount. Not all saturated fatty acids are the same. If you eliminate them all, you’ll suffer serious health consequences. Healthy saturated fats are found in animal products like butter, cheese, whole milk, ice cream, and fatty meats. They’re also found in some tropical plants and vegetable oils such as coconut oil, palm, and palm kernel oil.
Then you have trans fats, which form when vegetable oil hardens, a process called hydrogenation. This can raise your LDL and lower HDL, which is not good for your health, especially your heart. Trans fats have a direct link to heart disease, type 2 diabetes, and even Alzheimer’s Disease. In fact, Mayo Clinic names nuts as one of the five foods that can protect your heart health by lowering your cholesterol. Just make sure they’re not coated with sugar or salt and that you keep the serving size to around 1.5 ounces.
Peanuts excluded, raw nuts like macadamias have been proven to help trim waistlines rather than pack on pounds. A review of 31 clinical and university trials showed that when people included extra nuts or nuts in their diets or substituted for other foods, over five weeks, they lost rather than gained about 1.4 pounds and half an inch from their waists. Although that may seem to be a small amount, over time it makes a difference.
So, if you’re watching your weight, a handful of nuts like macadamias or almonds is a much a better snack choice than a bran muffin. With about 60 percent monounsaturated fat oleic acid – the same amount as in olives – they provide the highest amount of healthy fat while being on the low end of the carb spectrum.
Macadamia Nut Nutrition Facts
Serving size: One oz. (28 grams) whole macadamia nuts
Amt. Per Serving
Calories
203
Carbohydrates
4 g
Sugar
1 g
Fiber
2.4 g
Protein
2 g
Sodium
1 mg
Studies Done on Macadamia Nuts
Clinical trials and studies demonstrated that the fatty acid profile of macadamia nuts beneficially affect serum lipids/lipoproteins, resulting in a lowered risk of cardiovascular disease.2
Additionally, a Journal of the American College of Nutritionstudy found that people who ate nuts benefitted in other ways, including:
Lower systolic blood pressure
Less likelihood of having two of the risk factors for metabolic syndrome: high blood pressure and low HDL (good) cholesterol (for nut consumers)
Less likelihood of having four risk factors for metabolic syndrome: abdominal obesity, high blood pressure, high fasting glucose, and a lower prevalence of metabolic syndrom
Another reason why nuts are beneficial is that many of them, such as walnuts, hazelnuts, pecans, Brazil nuts, almonds, cashews and peanuts, contain the amino acid l-arginine, which offers multiple vascular benefits to people with coronary heart disease. Nut consumption is also associated with a reduced incidence of diabetes in women, gallstones in both men and women, and beneficial effects on oxidative stress, inflammation, and vascular reactivity.3
It’s also important to note that macadamia nuts are toxic for dogs and can cause weakness, vomiting, loss of coordination, tremors, and hyperthermia.4
Healthy Macadamia Nut Recipe: Raw Macadamia Fudge
Ingredients:
1 cup raw macadamia nuts or 1/2 cup macadamia nut butter
Macadamia trees were named by the director of Australia’s Royal Botanical Gardens, Baron Ferdinand von Mueller, to honor his friend and colleague, chemist Dr. John MacAdam. Ironically, MacAdam died onboard ship while en route to taste the nut that was named for him.
Summary
One of the healthiest nuts, raw or otherwise, macadamia nuts originated in Australia, with the highest production coming from Hawaii. Today, they’re grown in a number of continents with moderate sun and plenty of water. Like many other nuts, they have a high “fat” content, but it’s the good fat – HDL, not LDL – that your body needs, to fight heart disease and lower your stroke risk. Other healthy nutrients in macadamia nuts include the amino acid l-arginine, vitamin B1, and magnesium, and they’re an excellent source of manganese and thiamin while being low in carbohydrates. Try them roughly chopped in a green salad.
Lifestyle changes can help reduce cholesterol, keep you off cholesterol-lowering medications or enhance the effect of your medications. Here are five lifestyle changes to get you started.
High cholesterol increases your risk of heart disease and heart attacks. You can reduce cholesterol with medications, but if you’d rather make lifestyle changes to reduce cholesterol, you can try these five healthy lifestyle changes. If you’re already taking medications, these changes can also improve their cholesterol-lowering effect.
1. Lose weight
Carrying some extra pounds — even just a few — contributes to high cholesterol. Losing as little as 5 to 10 percent of your body weight can help significantly reduce cholesterol levels.
Start by taking an honest, thorough look at your eating habits and daily routine. Consider your challenges to weight loss and ways to overcome them.
If you eat when you’re bored or frustrated, take a walk instead. If you pick up fast food for lunch every day, pack something healthier from home. If you’re sitting in front of the television, try munching on carrot sticks instead of potato chips as you watch. Take time and enjoy rather than “devouring” your food. Don’t eat mindlessly.
And look for ways to incorporate more activity into your daily routine, such as using the stairs instead of taking the elevator. Take stock of what you currently eat and your physical activity level and slowly work in changes.
2. Eat heart-healthy foods
Even if you have years of unhealthy eating under your belt, making a few changes in your diet can reduce cholesterol and improve your heart health.
Choose healthier fats. Saturated fats, found in red meat and dairy products, raise your total cholesterol and low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. As a general rule, you should get less than 7 percent of your daily calories from saturated fat. Instead, choose leaner cuts of meat, low-fat dairy and monounsaturated fats — found in olive, peanut and canola oils — for a healthier option.
Eliminate trans fats. Trans fat can be found in fried foods and many commercial baked products, such as cookies, crackers and snack cakes. But don’t rely on packages that are labeled “trans fat-free.” In the United States, if a food contains less than 0.5 grams of trans fat per serving, it can be labeled “trans fat-free.” Even though those amounts seem small, they can add up quickly if you eat a lot of foods that have a small amount of trans fat in them. Instead, read the ingredients list. You can tell if a food has trans fat in it if it contains partially hydrogenated oil.
Limit the cholesterol in your food. Aim for no more than 300 milligrams (mg) of cholesterol a day — less than 200 mg if you have heart disease or diabetes. The most concentrated sources of cholesterol include organ meats, egg yolks and whole milk products. Use lean cuts of meat, egg substitutes and skim milk instead.
Select whole grains. Various nutrients found in whole grains promote heart health. Choose whole-grain breads, whole-wheat pasta, whole-wheat flour and brown rice.
Stock up on fruits and vegetables. Fruits and vegetables are rich in dietary fiber, which can help lower cholesterol. Snack on seasonal fruits. Experiment with veggie-based casseroles, soups and stir-fries. If you prefer dried fruit to fresh fruit, limit yourself to no more than a handful (about an ounce or two). Dried fruit tends to have more calories than does fresh fruit.
Eat foods rich in omega-3 fatty acids. Omega-3 fatty acids can help lower your LDL (“bad”) cholesterol. Some types of fish — such as salmon, mackerel and herring — are rich in omega-3 fatty acids. Other good sources of omega-3 fatty acids include walnuts, almonds and ground flaxseeds.
3. Exercise on most days of the week
Whether you’re overweight or not, exercise can reduce cholesterol. Better yet, moderate physical activity can help raise high-density lipoprotein (HDL) cholesterol, the “good” cholesterol. With your doctor’s OK, work up to at least 30 minutes of exercise a day. Remember that adding physical activity, even in 10-minute intervals several times a day, can help you begin to lose weight. Just be sure that you can keep up the changes you decide to make. Consider:
Taking a brisk daily walk during your lunch hour
Riding your bike to work
Swimming laps
Playing a favorite sport
To stay motivated, find an exercise buddy or join an exercise group. And remember, any activity is helpful. Even taking the stairs instead of the elevator or doing a few situps while watching television can make a difference.
4. Quit smoking
If you smoke, stop. Quitting may improve your HDL cholesterol level. And the benefits don’t end there. Just 20 minutes after quitting, your blood pressure decreases. Within 24 hours, your risk of a heart attack decreases. Within one year, your risk of heart disease is half that of a smoker. Within 15 years, your risk of heart disease is similar to someone who never smoked.
5. Drink alcohol only in moderation
Moderate use of alcohol has been linked with higher levels of HDL cholesterol — but the benefits aren’t strong enough to recommend alcohol for anyone who doesn’t already drink. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. Drinking too much alcohol can lead to serious health problems, including high blood pressure, heart failure and stroke.
If lifestyle changes aren’t enough …
Sometimes healthy lifestyle changes aren’t enough to lower cholesterol levels. Make sure the changes you choose to make are ones that you can continue, and don’t be disappointed if you don’t see results immediately. If your doctor recommends medication to help lower your cholesterol, take it as prescribed, but continue your lifestyle changes.
Once found only in health food stores, organic food is now a regular feature at most supermarkets. And that’s created a bit of a dilemma in the produce aisle. On one hand, you have a conventionally grown apple. On the other, you have one that’s organic. Both apples are firm, shiny and red. Both provide vitamins and fiber, and both are free of fat, sodium and cholesterol. Which should you choose?
Conventionally grown produce generally costs less, but is organic food safer or more nutritious? Get the facts before you shop.
Conventional vs. organic farming
The word “organic” refers to the way farmers grow and process agricultural products, such as fruits, vegetables, grains, dairy products and meat. Organic farming practices are designed to encourage soil and water conservation and reduce pollution. Farmers who grow organic produce and meat don’t use conventional methods to fertilize, control weeds or prevent livestock disease. For example, rather than using chemical weedkillers, organic farmers may conduct more sophisticated crop rotations and spread mulch or manure to keep weeds at bay.
Here are some key differences between conventional farming and organic farming:
Conventional
Organic
Apply chemical fertilizers to promote plant growth.
Apply natural fertilizers, such as manure or compost, to feed soil and plants.
Spray synthetic insecticides to reduce pests and disease.
Spray pesticides from natural sources; use beneficial insects and birds, mating disruption or traps to reduce pests and disease.
Use synthetic herbicides to manage weeds.
Use environmentally-generated plant-killing compounds; rotate crops, till, hand weed or mulch to manage weeds.
Give animals antibiotics, growth hormones and medications to prevent disease and spur growth.
Give animals organic feed and allow them access to the outdoors. Use preventive measures — such as rotational grazing, a balanced diet and clean housing — to help minimize disease.
Organic or not? Check the label
The U.S. Department of Agriculture (USDA) has established an organic certification program that requires all organic foods to meet strict government standards. These standards regulate how such foods are grown, handled and processed.
Any product labeled as organic must be USDA certified. Only producers who sell less than $5,000 a year in organic foods are exempt from this certification; however, they’re still required to follow the USDA’s standards for organic foods.
If a food bears a USDA Organic label, it means it’s produced and processed according to the USDA standards. The seal is voluntary, but many organic producers use it.
Products that are completely organic — such as fruits, vegetables, eggs or other single-ingredient foods — are labeled 100 percent organic and can carry the USDA seal.
Foods that have more than one ingredient, such as breakfast cereal, can use the USDA organic seal plus the following wording, depending on the number of organic ingredients:
100 percent organic. To use this phrase, products must be either completely organic or made of all organic ingredients.
Organic. Products must be at least 95 percent organic to use this term.
Products that contain at least 70 percent organic ingredients may say “made with organic ingredients” on the label, but may not use the seal. Foods containing less than 70 percent organic ingredients can’t use the seal or the word “organic” on their product labels. They can include the organic items in their ingredient list, however.
Do ‘organic’ and ‘natural’ mean the same thing?
No, “natural” and “organic” are not interchangeable terms. You may see “natural” and other terms such as “all natural,” “free-range” or “hormone-free” on food labels. These descriptions must be truthful, but don’t confuse them with the term “organic.” Only foods that are grown and processed according to USDA organic standards can be labeled organic.
Organic food: Is it more nutritious?
The answer isn’t yet clear. A recent study examined the past 50 years’ worth of scientific articles about the nutrient content of organic and conventional foods. The researchers concluded that organically and conventionally produced foodstuffs are comparable in their nutrient content. Research in this area is ongoing.
Organic food: Other considerations
Many factors influence the decision to choose organic food. Some people choose organic food because they prefer the taste. Yet others opt for organic because of concerns such as:
Pesticides. Conventional growers use pesticides to protect their crops from molds, insects and diseases. When farmers spray pesticides, this can leave residue on produce. Some people buy organic food to limit their exposure to these residues. According to the USDA, organic produce carries significantly fewer pesticide residues than does conventional produce. However, residues on most products — both organic and nonorganic — don’t exceed government safety thresholds.
Food additives. Organic regulations ban or severely restrict the use of food additives, processing aids (substances used during processing, but not added directly to food) and fortifying agents commonly used in nonorganic foods, including preservatives, artificial sweeteners, colorings and flavorings, and monosodium glutamate.
Environment. Some people buy organic food for environmental reasons. Organic farming practices are designed to benefit the environment by reducing pollution and conserving water and soil quality.
Are there downsides to buying organic?
One common concern with organic food is cost. Organic foods typically cost more than do their conventional counterparts. Higher prices are due, in part, to more expensive farming practices.
Because organic fruits and vegetables aren’t treated with waxes or preservatives, they may spoil faster. Also, some organic produce may look less than perfect — odd shapes, varying colors or smaller sizes. However, organic foods must meet the same quality and safety standards as those of conventional foods.
Food safety tips
Whether you go totally organic or opt to mix conventional and organic foods, be sure to keep these tips in mind:
Select a variety of foods from a variety of sources. This will give you a better mix of nutrients and reduce your likelihood of exposure to a single pesticide.
Buy fruits and vegetables in season when possible. To get the freshest produce, ask your grocer what day new produce arrives. Or check your local farmers market.
Read food labels carefully. Just because a product says it’s organic or contains organic ingredients doesn’t necessarily mean it’s a healthier alternative. Some organic products may still be high in sugar, salt, fat or calories.
Wash and scrub fresh fruits and vegetables thoroughly under running water. Washing helps remove dirt, bacteria and traces of chemicals from the surface of fruits and vegetables. Not all pesticide residues can be removed by washing, though. You can also peel fruits and vegetables, but peeling can mean losing some fiber and nutrients.
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