A BASIC OUTLINE: How to Lower LDL and Triglycerides with Supplements and Food

This entire page is in outline form with a brief listing of major supplements that lower LDL, triglycerides, and raise HDL:

Diet:  (Eliminate hidden sugar – eat plants): plant sterols, almonds, viscous fibers, nutrient dense plants. AVOID processed food, sugar, packaged food, flour, pasta, bread, milk, dairy, and gluten.

The Graph below: a PLANT-BASED DIET lowered cholesterol 33% – based on the best selling book, Eat to Live, by Joel Fuhrman, MD

A PLANT-BASED, NUTRIENT DENSE DIET is more powerful than drugs and other diets.

Nutrition: Foods and “Designer Foods”

  • Policosanol (all studies have been from China or Cuba, and may have been manipulated, so policosanol is not a 1st line supplement)
  • Red Yeast Rice
  • Plant -Sterols
  • Soluble fibers: psyllium, guar gum, B-glucan
  • Omega 3s and Krill Oil
  • Flax (ground only – not the oil): decrease TC and LDL 5-15%
  • Green tea (EGCG)
  • Rice bran oil (tocotrienols)
  • Nuts: walnuts, almonds, macadamia
  • Grape products
  • Wine and alcohol (U-shaped curve – bad at high doses)
  • Citrus: orange, grapefruit, pomegranate
  • Barley
  • Blueberries
  • Coriander seeds
  • Blue green algae
  • Monounsaturated fats: olives, guacamole
  • Sesame: 40 grams / day decreased LDL-C by 9%; inhibits intestinal absorption; decreased HMG-CoA Reductase

Nutraceuticals

  • Tocotrienols: gamma and delta: decrease Lp(a) 17%, decreases LDL 24%, HDL no change, Blood Glucose decreases; effects plateau at dose of 200mg of gamma/delta or 100 mg of the desmethylated derivatives taken at night at least 12 hours after any tocopherols; with evening meal to increase absorption
  • Niacin
  • Pantethine
  • Vit C
  • CoQ10
  • Chromium
  • Probiotics and prebiotics
  • Isoflavones and flavonoids
  • Carotenoids

Herbals:

  • Choleretics: silymarin (milk thistle), globe artichoke (decreases cholesterol 18%), dandelion root, black radish root, beet leaf tops
  • Garlic
  • Ginkgo
  • Curcumin
  • Yam extract (increase HDL)
  • Guggulipid ( studies have been + and -)

Proven endpoints with hard clinical evidence for:

  • Niacin
  • Fish oils
  • ALA
  • Fiber

Pantethine vs. Pantothenic Acid

  • Pantethine: 28 clinical trials in humans with 648 patients
  • Pantethine lowers TC 10%, LDL 20% and ApoB 27%
  • Increased HDL 9%
  • Lowers Triglycerides by 33% (takes 9 months for these changes)
  • Dose 300mg TID (3 x / day)
  • Peak effect in 4 months: may take 6-8 months

Gugulipids:

  • Resin of mukul myrrh tree
  • Dose: 50-75 mg / day
  • Randomized CCT in JAMA: 103 patients: 8 weeks:
    • increased LDL! 4-5%
    • No change in HDL, TC, TG, VLDL
    • Decreased Lp(a)
    • Decreased CRP
    • Not recommended at this time

Probiotics:

  • In 4-8 weeks: Total Cholesterol decreased 9%, LDL 8%, Triglycerides 10%

Conclusions: many supplements have a beneficial effect on cholesterol, LDL, HDL, and triglycerides

  • Best Clinical Evidence for lipid lowering
    • Niacin
    • Omega 3
    • Rice bran oil (tocotrienols)
    • Gamma / Delta tocotrienols
    • Pantethine
    • Red Yeast Rice
    • Plant Sterols
    • Soluble Fibers
    • Monounsaturated / Polyunsaturated Fats / Nuts
    • Soy
    • Sesame
  • Best Clinical Data for Cardiovascular Event Reduction
    • Niacin
    • Omega 3 fatty acids
    • Fiber
    • Vitamin D
    • Vitamin K2 – MK7
  • Best Clinical Evidence for Lowering the Markers and Numbers:
    • Niacin
    • Omega 3 fats
    • Red yeast rice
    • Plant sterols
  • Inhibition of the oxidation of LDL (the 1st step in the formation of arterial disease)
    • Niacin
    • EGCG (green tea)
    • Pantethine
    • Resveratrol
    • Seanol (Ecklonia cava)
    • Garlic
    • Policosanol
    • CoQ10
    • Vitamin E
    • Oleic acid (MUFA)
    • Polyphenols
    • Curcumin
  • The Following Lower LDL
    • Niacin
    • Red yeast rice
    • Plant sterols
    • Soy
    • EGCG
    • Omega 3s
    • Flax seeds
    • Sesame
    • Tocotrienols (gamma and delta)
    • Rice bran oil (phytosterols)
    • Gugulipid??
    • Garlic
    • Policosanol??
  • The Following Convert Dense Type B LDL, to Large Type A LDL (Note: large fluffy LDL do not cause disease like the small dense LDL)
    • Niacin
    • Omega 3s
    • Plant sterols
    • Water soluble fiber: psyllium
    • Reduce TG (triglycerides) to below 75%
    • Reduce refined carbohydrates
  • Reduce Intestinal Absorbtion of Cholesterol
    • Plant sterols
    • Soy
    • EGCG
    • Flax seed (fiber)
    • Sesame
    • Fiber
  • Inhibit HMG-CoA Reductase
    • Pantethine
    • Gamma / Delta tocotrienols
    • Red yeast rice
    • Sesame
  • Lower Lp(a): Lp(a) is a nastly LDL-like particle that can increases blood clots and heart attacks
    • Niacin
    • NAC
    • Tocotrienols
    • Gugulipid?
    • Omega 3s: DHA > EPA
    • ASA
    • Estrogen
    • ETOH
  • Lower TG (triglycerides)
    • Niacin
    • Red yeast rice
    • Soy
    • Omega 3s
    • Pantethine
    • Fiber
    • Garlic
    • Gugulipid?
    • Policosanol?
  • Increase HDL 2 and/or Convert HDL 3 to HDL 2 (the large fluffy HDL2 is very protective against heart disease)
    • Niacin
    • Omega 3s
    • Pantethine
    • Soy
    • Garlic
    • Policosanol?
    • ETOH – alcohol – U-shaped curve
    • Exercise
    • Weight loss: increase lean muscle
    • Stop smoking
    • Reduce Total Fats and Saturated Fats

A Nutritionally Based Cardiologist’s Favorite Approach to Heart Disease

by Decker Weiss, NMD (completed a cardiology residency at Arizona Heart, and believes most heart attacks are preventable)

As a naturopathic physician, I integrate nutrition into every patient treatment plan.

Unfortunately, this integration is challenged by the dissemination of false nutritional information, which tends to make patients confuse toxins for food. For example, white flour and white sugar are devoid of nutrition and almost all effects are dangerous and negative.

People think fat causes heart attacks.  While it is true that TRANS-FATS and inflammatory OMEGA-6 fats cause heart disease, it is MAINLY THE MASSIVE AMOUNT OF SUGAR , JUNK-SUGAR, AND PROCESSED FOOD that has caused an EXPLOSION of disease in the U.S.

When these toxic foods are part of your daily diet, you are in danger of developing heart disease, diabetes, and chronic inflammation—all serious, deadly, yet completely preventable conditions. I advise my patients to remove these toxins and add nutrition.

Sadly, this won’t happen any time soon, especially considering the United States Department of Agriculture (USDA) has been promoting poor nutrition since 1991 in the form of the Food Guide Pyramid. It recommends six to 11 servings of white rice, bread, potatoes, and pasta—the very foods I tell my patients to avoid! Plus, it doesn’t differentiate between the more healthful flours and sugars (i.e., whole wheat and honey) from the disease-causing variety.

Fats are treated similarly, with no distinction made between trans and saturated fats, which should be removed. Healthy fats, such as fresh olive and high-DHA, clean-sourced and tested fish oils, should be added.

As an alternative to the USDA pyramid, I suggest the following revisions to create the Heart Disease Prevention Pyramid. Weight control and daily exercise would form the foundation. To build a truly healthy heart, we must keep our weight down and our exercise levels high.

Also on my pyramid, I would place naturally stable fish oil, which is loaded with omega-3 essential fatty acids (EFAs)—nutrients vital to heart health. Research has proven that the omega-3 EFAs in fish oil do the following:

  • Lower blood pressure—Uncontrolled blood pressure can lead to stroke, heart attack or failure, or kidney failure.
  • Lower triglycerides—Triglycerides are the most common fats found in food. High triglycerides indicate a high risk for heart attacks.
  • Slow atherosclerosis (the growth of harmful plaque on artery walls)—Rapidly growing or unstable plaques can rupture. The body responds with chronic inflammation, which can lead to blood clots, and can cause heart attacks and strokes.

It’s absolutely critical, however, that the fish oil supplement you buy be free of contaminants and guaranteed fresh!

Supplements should contain no detectable toxins, such as dioxins, DDT, PCBs, or heavy metals, such as mercury and lead. Be sure to ask the manufacturer to provide documentation of purity in their product.

Next, I’d place fresh garlic and its beneficial compound allicin on the pyramid. Research has proven that allicin can:

  • Prevent heart attacks and strokes
  • Inhibit atherosclerosis
  • Reduce blood triglycerides
  • Reduce “bad” LDL cholesterol
  • Raise “good” HDL cholesterol
  • Lower blood pressure

The most effective supplements are made from enteric-coated fresh garlic and provide a total allicin potential of 4,000 micrograms (mcg).

Another level of my pyramid would emphasize CoQ10. This natural nutrient is present in every nucleated cell in our body.And unless disease stricken or artificially depleted by drugs, heart cells are loaded with CoQ10.

“Statin” drugs, such as simvistatin (Zocor) and atorvistatin (Lipitor®), are powerful medications prescribed to lower cholesterol. However, one harmful side effect statin drugs share is that they deprive heart cells of CoQ10. While some physicians are aware of this and tell their patients to take between 100 mg to 400 mg of CoQ10 each day, most are not.

Unfortunately, as the use of statins has risen in the U.S., so have instances of congestive heart failure. And, since heart attacks tend to occur when CoQ10 levels are low in the heart cells, it begs the question, “If we are trying to prevent heart attacks with the statins, could they be causing some as well?”

Not all CoQ10 is created equal, however. The key is quality manufacturing. You need to take a CoQ10 that’s been used in research conducted by prestigious universities.

THE BEST COQ10 MUST BE:

1. Easily digested for better absorption

2. Able to permeate the mitochondria of the cell

3. Proven effective in studies

4. Safe and free of impurities

My pyramid also contains pantethine and plant sterols.

Backed by many years of scientific research and clinical study, pantethine and plant sterols are nature’s answer to dangerous prescription cholesterol-lowering medications.

Pantethine is found in foods such as liver, salmon, and yeast, and has been known for years to lower cholesterol in blood. Studies show that pantethine inhibits several enzymes in the liver and blocks the activity of one co-enzyme involved in cholesterol synthesis, called HMG-CoA, by about 50 percent; thus significantly lowering cholesterol production.

Then, to compensate for the lowered cholesterol production, the liver pulls the LDL cholesterol out of the blood. Studies show on average, pantethine can lower total cholesterol by 16 percent, LDL cholesterol levels by 14 percent, serum triglycerides by 38 percent, and can raise HDL cholesterol by 10 percent.

Plant sterols are the fats of plants and are found in nuts, vegetable oils, corn, and rice. Because plant sterols “look” like cholesterol, they can act as a stand-in for it, blocking its absorption. Here’s how:

The liver receives about 800 mg of cholesterol every day from intestinal absorption. Cholesterol is absorbed from the intestines through receptor sites, from which it is then absorbed into the bloodstream. Because plant sterols look like cholesterol, they fit perfectly into these receptors. The actual cholesterol, which is being blocked from absorption, remains in our intestines where it is eventually excreted.

While both plant sterols and pantethine are found naturally in foods, we need to take a concentrated combination of pantethine and plant sterols in just the right ratio to lower cholesterol. The key here is not just to isolate LDLs, but improve the numbers for LDLs, HDLs, and triglycerides. With pantethine and plant sterols, we are not challenging the liver, but bringing it into balance naturally.

I do not think heart disease is reversible using only conventional physicians and methods. I have been reversing it for years, but the process usually includes the reduction of medication, adding exercise, making a few simple changes in diet (avoiding white foods), and taking the following supplements outlined in my Heart Disease Prevention Pyramid:

  • Naturally stable fish oil
  • Enteric-coated fresh garlic extract
  • CoQ10 formulated for optimal absorption
  • Concentrated pantethine and plant sterols

I believe most heart disease is preventable and reversible using natural medicine and approaches.