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Heart disease is the leading cause of death in the U.S.

A group of physicians at Johns Hopkins Medicine and the American Heart Association have released updated guidelines on managing cholesterol to minimize the risk of heart attack, stroke, and death. The new guidelines advocate for more aggressive treatment with statin therapy and getting LDL cholesterol counts, commonly referred to as “bad cholesterol” to your target level –- in general, less than 100mg/dL; for those with risk factors, less than 70mg/dL.

What is cholesterol?

Cholesterol is a type of fat found in blood and cells. It travels in bundles called lipoproteins. Cholesterol itself isn’t bad — the body needs it to make hormones, vitamin D and digestive fluids, and it helps organs function properly. But having too much cholesterol can be a problem.

There are two forms of cholesterol:

– LDL (low-density lipoprotein): “bad,” unhealthy cholesterol. It builds up in arteries forming plaques, which can block the flow of oxygen-carrying blood to major organs including the heart, and has been shown to be associated with cardiovascular events including heart attacks and stroke. LDL levels are influenced by the food you eat, genetics, liver function and other factors.

– HDL (high-density lipoprotein): “good,” healthy cholesterol. It takes extra cholesterol out of arteries and delivers it to the liver, removing it from the body.

How do I know if I need to lower my cholesterol?

There are three tests to talk about with your doctor:

– Non-fasting blood test to measure LDL cholesterol

– Coronary artery calcium score

– Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator — an equation to calculate the 10-year future risk of a heart attack

Based on these tests, your doctor will decide if you should be on a statin.

What can I do to lower my cholesterol?

Lifestyle changes including exercise, a healthy diet, and quitting smoking can prevent 80 percent of heart disease. Diet has been shown to be vitally important and effective in preventing heart attacks and reducing the risk of subsequent cardiovascular events in those who have already had a heart attack. Plant-based and Mediterranean diets are effective but you must find a diet that works for you. However, lifestyle changes may not be enough; you may need to take a statin to lower your LDL further.

What are statins?

Statins prevent heart attacks by lowering LDL and reducing inflammation, among other mechanisms. They can be used to prevent a heart attack or stroke before it occurs, or prevent a second heart attack or stroke.

What are the side effects of statins?

The risk of serious side effects range from one in 500 to one in 1,000, which is considered very low. Muscle aches are a possible side effect, but are not considered serious. An increase in the dose of statins is not associated with an increase in side effects.

What is the bottom line of the new recommendations?

Talk to your doctor about what LDL level is right for you, and use the highest dose of statin tolerated to get to that target LDL level. And, as always, continue with lifestyle modifications, including exercise, a healthy diet, and quitting smoking.

 

With approximately 40 million adults across the United States experiencing anxiety each year, scientists and researchers have dedicated their careers to trying to better understand this condition. 

Despite this work, we are still somewhat unclear on what actually causes this condition to occur.

Characterized by feelings of nervousness and restlessness, increased heart rate,hyperventilation, sweating, trembling, difficulty concentrating and uncontrolled worry, it has the ability to impact every area of one’s life. 

There are many theories regarding the root cause of the condition, including genetics, brain chemistry, environmental factors or other medical factors and/or disease, however, nothing has been proven definitively. 

Instead, the scientific community continues to explore these leads further in the hope of an answer.

One small study out of Japan may provide an important insight into the connection between nutritional deficiencies and mental health, revealing that 

   “ low levels of vitamin B6 and iron may actually trigger the chemical changes in the brain responsible for panic attacks, hyperventilation and other forms of anxiety.”

The research team analyzed the nutritional levels of 21 participants with varying levels of anxiety, panic attacks, and hyperventilation episodes. 

While some experienced minor attacks, manageable at home, others were severe enough to result in emergency room visits. 

They tested these participants for a number of different nutritional deficiencies or abnormalities in the hope of identifying a pattern.

 At the same time, they ran a similar set of tests on a control group of 20 people, comparing the two.

The data showed that those who were experiencing anxiety were found to have lower levels of B6 and Iron than those in the healthy group. 

Why is this important? 

One of the most accepted theories regarding the development of anxiety is that it is caused by a chemical imbalance in the brain, with serotonin seen as a key player. 

This is due to the fact that serotonin is one of the ‘happiness hormones’, responsible for triggering the reward and pleasure centers of the brain.

Serotonin is synthesized from the amino acid tryptophan, and both iron and vitamin B6 play an important role in this process. 

Therefore, an absence of these nutrients can, ultimately cause a decrease of serotonin levels. 

In fact, many of today’s antidepressant drugs work on this same theory, by boosting serotonin levels in order to regulate mental health.

The study’s authors wrote, 

   “These results suggest that low serum concentrations of vitamin B6 and iron are involved in PA (panic attacks) and HVA (hyperventilation).” 

Further studies are needed to clarify the mechanisms involved in such differences.

It seems like simple, obvious advice: Eat your vegetables, get some exercise, and take your vitamins.

Decades of research have failed to find any substantial evidence that vitamins and supplements do any significant good. 

In fact, recent studies skew in the opposite direction, having found that certain vitamins may be bad for you. 

Several have been linked with an increase in certain cancers, for example, while others have been tied to a rise in the risk of kidney stones.

And a large new study out Wednesday suggested that, despite this growing knowledge, Americans’ pill-popping habits have stayed basically the same over the last decade.

Here are the vitamins and supplements you should take — and the ones you should avoid:

For decades, it was assumed that multivitamins were critical to overall health. 

Vitamin C to boost your immune system,

vitamin A to protect your vision, 

vitamin B to keep you energized.

Not only do you already get these ingredients from the food you eat, but studies suggest that consuming them in excess can actually cause harm. 

Vitamin D: ✅Take it — It helps keep your bones strong and it’s hard to get from food.

Vitamin D isn’t present in most of the foods we eat, but it’s a critical ingredient that keeps our bones strong by helping us absorb calcium. 

Getting sunlight helps our bodies produce it as well, but it can be tough to get enough in the winter. 

Several recent study reviews have found that people who took vitamin D supplements daily lived longer, on average, than those who didn’t.

Antioxidants: ❎Skip them — an excess of these has been linked to an increased risk of certain cancers, and you can eat berries instead.

Vitamins A, C, and E are antioxidants found in plentiful form in many fruits — especially berries — and veggies, and they’ve been touted for their alleged ability to protect against cancer.

But studies suggest that when taken in excess, antioxidants can actually be harmful. 

Vitamin C: ❎Skip it — it probably won’t help you get over your cold, and you can eat citrus fruits instead.

The vitamin C hype — which started with a suggestion from chemist Linus Pauling made in the 1970s and has peaked with Airborne and Emergen-C — is just that: hype. 

Study after study has shown that vitamin C does little to nothing to prevent the common cold. 

Plus, megadoses of 2,000 milligrams or more can raise your risk of painful kidney stones.

So get your vitamin C from your food instead. Strawberries are packed with the nutrient.

Vitamin B3: ❎Skip it and eat salmon, tuna, or beets instead.

For years, vitamin B3 was promoted to treat everything from Alzheimer’s to heart disease. 

But recent studies have called for an end to the overprescription of the nutrient.

A large 2014 study of more than 25,000 people with heart disease found that putting people on long-acting doses of vitamin B3 to raise their levels of “good,” or HDL, cholesterol didn’t reduce the incidence of heart attacks, strokes, or deaths.

Plus, people in the study who took the B3 supplements were more likely than those taking a placebo to develop infections, liver problems, and internal bleeding.

Probiotics: ❎Skip them — the science isn’t yet advanced enough to prove they have a significant benefit, and you can eat yogurt instead

Probiotics — pricey bacterial supplements that can cost upward of $1 per pill but are found naturally in smaller amounts in yogurt and other fermented foods — have become a big business, with a market of roughly $23.1 billion in 2012.

The idea behind them is simple: Support the trillions of bacteria blossoming in our gut, which we know play a crucial role in regulating our health.

But putting that idea into actual practice has been a bit more complicated. 

So far, the effects of probiotics have been all over the map. 

Sometimes they help, sometimes they don’t. So rather than shelling out for a pill that promises to be a cure-all, snack on a parfait.

Zinc: ✅Take it — it’s one of the only ingredients linked to shortening a cold.

Unlike vitamin C, which studies have found likely does nothing to prevent or treat the common cold, zinc may actually be worth it. 

The mineral seems to interfere with the replication of rhinoviruses, the bugs that cause the common cold.

In a 2011 review of studies of people who’d recently gotten sick, researchers looked at those who’d started taking zinc and compared them with those who’d just taken a placebo. 

The ones on the zinc had shorter colds and less severe symptoms.

Vitamin E: ❎Skip it — an excess has been linked to an increased risk of certain cancers, and you can eat spinach instead.

The antioxidant vitamin E was popularized for its alleged ability to protect against cancer. But a large 2011 study of close to 36,000 men found that the risk of prostate cancer actually increased among the men taking vitamin E compared to the men taking a placebo.

And a 2005 study linked high doses of vitamin E with an overall higher risk of death. 

So if you’re looking for more vitamin E, make yourself a fresh spinach salad and skip the pill. Dark greens like spinach are rich with this stuff.

Folic acid B12: ✅Take it if you’re pregnant or if you might want to get pregnant.

Folic acid is a B vitamin our bodies use to make new cells. 

The National Institutes of Health recommended that women who are currently pregnant or who want to get pregnant take 400 micrograms of folic acid daily, because their bodies demand more of this key nutrient when they’re carrying a growing fetus.

Additionally, several large studies have linked folic acid supplementation before and during pregnancy with decreased rates of neural-tube defects, serious and life-threatening birth defects of the baby’s brain, spine, or spinal cord.