Pistachios may help curb less-than-ideal levels of LDL "bad" cholesterol, a new study shows published in The American Journal of Clinical Nutrition shows.
Nuts are already
known to be good for your heart when eaten in moderation as part of a
low-fat diet. Since 2003, the FDA has allowed almonds, hazelnuts,
pecans, pistachios, walnuts, and peanuts to make a qualified health
claim to that effect.
The new study, published in The American Journal of Clinical Nutrition,
is only about pistachios. Almonds and walnuts have been featured in
most of the previous nut studies, so the researchers, who included
Pennsylvania State University graduate student Sarah Gebauer and
Distinguished Professor Penny Kris-Etherton, PhD, put pistachios in the
The key question: Would one or two daily servings of pistachios pack a punch against LDL cholesterol?
Pistachio Cholesterol Lowering Study
pistachio study included 28 adults whose LDL cholesterol level was
higher than the optimal range. Their average LDL level was in
"borderline high" range when the study started.
Apart from their cholesterol levels, participants were healthy. None was taking cholesterol-lowering drugs.
First, participants spent two weeks on a standard American diet rich in full-fat cheese, oil, and butter and lacking pistachios.
came a month on a low-fat diet without pistachios, another month on a
healthy diet that included one daily serving of pistachios, and a third
month eating a similar diet with two daily servings of pistachios, with
two-week breaks between each type of diet.
all their food, packaged into appropriate serving sizes, from the
researchers. And they stuck to their assigned diets pretty well, the
Average LDL levels
fell when participants ate pistachios — not enough to get their LDL
levels into the optimal range, but enough to get it out of the
"borderline high" category.
LDL cholesterol level dropped
by 9% during the month that participants ate a daily serving of
pistachios and by 12% when they had two daily servings of pistachios.
for the low-fat diet, it didn't trim LDL cholesterol. That surprised
the researchers. What happened? The researchers aren't sure, but they
note that the low-fat diet was lower in polyunsaturated fats (which
include heart-healthy omega-3 fatty acids) and higher in carbohydrates
than the pistachio diets.
Pistachios didn't affect levels of HDL cholesterol, which is often called "good" cholesterol.
The study was funded in part by the California Pistachio Commission.
SOURCES: Gebauer, S. The American Journal of Clinical Nutrition, Sept. 1,
2008; vol 88: pp 651-659. WebMD Medical News: "FDA OK's Nutty Heart Health Claim."
Cholesterol is a type of fat (lipid) found in foods from animal sources. The body
(the liver) also produces about 1,000 milligrams of cholesterol a day. Because
cholesterol can't travel alone through the bloodstream, it has to combine with
certain proteins so that they are able to be transported to different parts of
the body. When this happens, the cholesterol and protein form what is called a
The two most
important types of lipoproteins are high-density lipoproteins (or HDL) and
low-density lipoproteins (or LDL). You've probably heard people call LDL
cholesterol "bad cholesterol" and HDL cholesterol "good
cholesterol" because of their very different effects on the body. Most
cholesterol is LDL cholesterol, and this is the kind that's most likely to clog
the blood vessels, keeping blood from flowing through the body the way it
should. Only about one third to one fourth of the total amount of cholesterol
is HDL cholesterol. HDL cholesterol carries cholesterol back to the liver,
where it can be processed and sent out of the body; therefore HDL is often
referred to as "good cholesterol".
HDL levels between 40
and 60 mg/dL are considered "normal." HDL levels greater than 60
mg/dL may actually protect people from heart disease.
HDL levels below 40 mg/dL
result in an increased risk of coronary artery disease, even in people whose
total cholesterol and LDL cholesterol levels are normal. Bottom line, the
medical community has known for years that when it comes to HDL levels, the
higher the better.
When you have too much cholesterol, it
can be dangerous to your health. When LDL cholesterol levels are high,
cholesterol is deposited on the walls of arteries and forms a hard substance
called plaque. Over time, plaque causes the arteries to become narrower,
decreasing blood flow and causing a condition called atherosclerosis or
hardening of the arteries. When
atherosclerosis affects the coronary arteries (the blood vessels that supply
the muscles of the heart), the condition is called coronary artery disease,
which puts a person at risk for having a heart attack. When atherosclerosis
affects the blood vessels that supply the brain, the condition is called
cerebral vascular disease, which puts a person at risk of having a stroke.
may also block blood flow to other vital organs, including the kidneys and
intestines. This is why it's so important to start paying attention to
cholesterol levels as a teen - you can delay or prevent serious health problems
in the future. Based on the biggest cholesterol study to date (Lancet 2007), if
you lower cholesterol even by about 4 mg/dL at age 40-49, you reduce the risk
of a fatal heart attack by half; at age 50-69, by a third; and at age 70-89, by
a sixth. This applies to both men and women. This is quite significant
considering that heart disease is one of the leading causes of death in the U.S
and throughout the developed world.
lowering cholesterol is important in reducing the risk to heart disease it is
just one part of an important health management plan to reduce risks to heart
disease. Eating a healthy diet, exercising daily, managing stress, maintaining
your ideal weight, and restraining from smoking are also equally important when
managing your risks for heart disease. All of these factors can have a huge positive
impact on health.
are many things that can cause high LDL levels. The most common factors
Heredity - If cholesterol problems or heart disease
run in your family, you are at a higher risk for having problems.
Diet - Avoid foods that are high in cholesterol, saturated fat, and trans fat, all of
which increase cholesterol levels and your risk of developing heart disease.
Bodyweight - Excess weight has been linked with high
Physical activity - Exercise tends to increase HDL levels,
which lowers your chance of developing heart disease.
Age - The risk of high cholesterol increases as you get
You don't have to settle for prescription medications with life-long dependency
and undesirable side effects to lower cholesterol levels. There are many
preventative measures you can take and natural ways to lower cholesterol. Many
ways are simple, yet still very effective. Some very simple yet effective
approaches for lowering your cholesterol levels include:
- Improve Your Diet. The first step to lowering cholesterol should
be an effort to improve your diet. This means each and every day making
sure you get at least 5 to 7 servings of the freshest possible fruits and
- Learn to
Read Food Labels. Choosing foods wisely is one significant way to lower cholesterol without
prescription drugs. By making a practice of reading and understanding food
labels, you can make more informed choices for your low cholesterol diet. If a
food product contains cholesterol it will list the number of milligrams per
serving and the percent of your daily total. Note, for whole, fresh foods such
as fresh eggs the seller doesn't have to list nutritional facts, therefore it
is important to find a good resource that gives the nutritional breakdown of
- Avoid Foods With Saturated Fats. The fact is that cholesterol is mostly
produced by the body and only about ¼ of the cholesterol in the blood comes
from foods. However, someone trying to lower cholesterol intake will have
difficulty in two ways when they consume foods high in saturated fats (which
includes trans fats).Trans fats, also called trans fatty acids, raise overall
blood cholesterol. Trans fat is the worst of all fats, far more damaging to
cholesterol levels than even saturated fats. Not only do they raise the low
density lipoprotein (LDL), which is the bad cholesterol, but it also lowers the
good cholesterol, known as high density lipoprotein (HDL). By lowering your
intake of trans fats, you can lower your blood cholesterol significantly. Foods
that contain the highest amounts of trans fats are the typical junk foods: snack
crackers, fast food, fried foods that are commercially prepared, etc.
- Start Exercising. The benefits of
exercise in lowering cholesterol cannot be overemphasized. To see some of the
evidence behind the positive effects of exercise in reducing cholesterol see
this link: http://www.ncbi.nlm.nih.gov/pubmed/18645633
- Reduce Stress. Stress can make reducing cholesterol difficult
because of the physiological process stress initiates. When you feel emotional
stress, the body initiates a hormone to fight the stress called cortisol.
Cortisol triggers the release of fat into the bloodstream creating extra fuel
for the body. Fat in the blood stream equals higher cholesterol levels
including the Low Density Lipoprotein (LDL), which is the bad type of
cholesterol that causes plaque to build up in the arteries. This process also
causes many people to crave foods high in saturated fat. The greater intake of
fatty foods means higher cholesterol entering the body through food sources -
in addition to the cholesterol naturally created by the body. Since stress can
raise LDL cholesterol, controlling stress can reduce cholesterol. A good health
plan for anyone, especially those trying to reduce cholesterol, is to therefore
control the stress and the automatic responses it triggers. Ways to do this is
to be mindful and aware of how stress can make you crave certain types of foods
you can more consciously avoid the foods. Another way to combat stress is to
head it off at the past and work into your daily routine ways to combat stress.
Ways may include exercising, adding hobbies that make you feel more relaxed
(meditation, yoga), getting a massage, etc.
- Start a natural Supplementation Program. Natural supplements
like, lecithin, policosanol (a natural substance derived from sugar cane
alcohols, primarily octacosanol) and Omega 3 fatty acid (found in most
varieties of fish) can help significantly lower cholesterol. These supplements
have been studied extensively and show great promise for people who want to
lower cholesterol as quickly and effectively as prescription drugs, but without
the side effects.
- Add Fiber to your Diet. Soluble fiber been shown to significantly
lower cholesterol and help prevent the heart disease that can result from high
cholesterol levels. Soluble fiber actually washes away the bad cholesterol that
clings to the inner walls of the arteries. You can increase the amount of
soluble fiber in your diet through supplementation or by adding certain foods
that contain soluble fiber such as oat bran (which contains Psyllium), and
certain fresh fruits and vegetables are a great source of soluble fiber. Apples
and carrots, for instance contain generous amounts of pectin. Adding a few
servings a day or better yet, following the recommended 5 servings of fruits
and vegetables daily, will help in lowering cholesterol. Psyllium, you can also
take a supplement. Pysllium comes in capsules or granules that can be dissolved
in water or juice. Also consider eating your fruits and veggies in the rawest
form for increased amounts of fiber.
Another simple change that is easy to make is to switch from white bread
to a whole grain, high fiber bread. Not only will it help in lowering
cholesterol, but also this type of bread will help you feel full longer.
Feeling full helps you maintain a healthy weight, which is another key
ingredient in lowering cholesterol.
- Increase Your Water Intake. Water is good for
your overall health. Increasing your
water intake can also help cleanse the body.
There are many natural supplements that have shown promise with lowering
cholesterol levels. If most of your excess cholesterol is made by your body, B
vitamins such as vitamin B3 (niacin) and pantethine have evidence to support
- Niacin (AKA Nicotinic Acid, B3). Niacin is also
another popular natural agent used to lower LDL cholesterol and increase HDL. Well-designed
studies have found that niacin lowers LDL cholesterol by approximately 10%,
lowers triglycerides by 25%, and raises "good" HDL cholesterol by 15%
to 30%. Niacin also appears to significantly lower levels for another risk
factor for atherosclerosis, lipoprotein Note, Niacin can increase the effect of high
blood pressure medication or cause nausea, indigestion, gas, diarrhea, gout,
and worsen peptic ulcers, or trigger gout, liver inflammation, and high blood
sugar. It can also cause skin flushing or hot flashes, which is caused by
widening of blood vessels. Although high doses of niacin showed promise in
combination with drugs to lower cholesterol (called "satins"), there are
concerns that combining them could result in a potentially fatal condition
called rhabdomyolysis, therefore they shouldn't be combined unless under the
close supervision of a physician.
- Pantethine. Pantethine is the biologically active
form of pantothenic acid (Vitamin B-5) and the fundamental component of
Coenzyme A. Pantethine participates in the metabolism of carbohydrates, amino
acids, fatty acids and dozens of other important chemical reactions. Pantethine
has been used for the past 30 years in Japan, where it is approved as a
pharmaceutical agent for the purpose of increasing HDL-C. In the US, pantethine is sold as a supplement
without a prescription in the United States. Pantethine works by slowing
production of cholesterol in the liver and boosting the rate at which your
metabolism uses fats. It significantly reduces levels of TC and LDL-C while
raising HDL-C. It is the most effective natural product against serum TG
levels. Pantethine is not known to cause significant side effects, has no known
drug interactions, and may be the best choice for diabetics. It has not been
known to cause birth defects.
If you think most of your excess blood cholesterol is from the diet, there are
additional natural alternatives that may also help lower your LDL and increase
- Plant Sterols/Stanols. If you think most of your excess blood
cholesterol is from the diet, plant sterols (such as beta-sitosterol and
sitostanol) and/or stanols can help prevent the absorption of dietary
cholesterol. These naturally-occurring substances found in certain plants.
Stanols are also found as dietary supplements or are added to margarine, orange
juice, and dressings have been given an FDA nod for their use in decreasing
heart disease risk. Studies have found that stanols significantly reduced total
cholesterol and LDL cholesterol, but had no significant effect on HDL
cholesterol or triglycerides. Stanols and sterols appear to enhance the effects
of other methods to lower cholesterol. In studies, people taking the statin
drugs to lower cholesterol had an additional improvement in their cholesterol
levels with stanols/sterols.
- Soluble Fiber. Soluble fiber also reduces
LDL cholesterol by reducing cholesterol absorption in the intestines. Soluble
fiber binds with cholesterol so that it is excreted. Five to 10 grams a day of
soluble fiber has been found to decrease LDL cholesterol by approximately 5%. Soluble
fiber can be found as a dietary supplement, such as psyllium powder, or in
foods such as: oats, rye, barley, legumes (peas, beans), certain fruits (e.g., apples,
prunes, and berries), certain vegetables (e.g., carrots, broccoli, yams, etc.).
There are other supplements such as guggulipids, artichoke extract (Cynara
scolymnus), policosanol, red yeast rice, Coq, and garlic - but the evidence is
- Guggulipids. Guggulipids is a natural ingredient derived
from the mixture of plant chemicals (ketonic steroids) from the gum resin of commiphora
mukul, called guggulipid, and is an approved treatment of hyperlipidemia (high
cholesterol) in India. It has been a mainstay of traditional Indian herbal medicine
(Ayurveda) approaches in preventing high cholesterol and atherosclerosis. It is
believed that guggul helps reduce high cholesterol, because it lowers harmful
LDL (low-density lipoproteins) while elevating the beneficial HDL (high-density
lipoproteins). Studies have also shown that LDL oxidation, which is the main
cause of plaque build in the arteries, can be prevented or at least decreased
by the antioxidant activity of guggul. Guggul also has anti-inflammatory
activity and reduces the levels of C-reactive protein. It helps prevent blood
platelet aggregation and breaks up blood clots. Therefore there are practioners
that believe that guggul can be used not only to lower bad cholesterol but can
be used as a preventative against heart disease and stroke.
- Policosanol. Policosanol is a
natural substance derived from sugar cane alcohols, primarily octacosanol. Millions of people needing to lower
cholesterol in other countries have been using policosanol for years. It has
just recently been introduced into U.S. markets. People are turning to this
natural substance because of concerns over the safety statin drugs. There are
limited studies indicating that those taking policosanol can expect up to a 25%
reduction in LDL cholesterol.
- Artichoke leaf extract. Artichoke leaf extract may work by limiting
the synthesis of cholesterol in the body. Artichokes also contain a compound
called cynarin, believed to increase bile production in the liver and speed the
flow of bile from the gallbladder, both of which may increase cholesterol
excretion. A double-blind, placebo-controlled German study found that 1,800 mg
of artichoke extract per day for six weeks significantly lowered total
cholesterol by 18.5% compared to 8.6% in the placebo group and lowered LDL
cholesterol by 22.9% compared with 6% in the placebo group. The ratio of LDL to
HDL decreased by 20% in the artichoke group compared with 7% in the placebo
group. There were no adverse effects associated with artichoke use. Larger clinical trials over longer periods are
- Red Yeast Rice. Red yeast rice also
has been used in China for over 1,000 years for medicinal purposes, most
notably for improving blood circulation and for alleviating indigestion and
diarrhea. Recently, red yeast rice has been developed by Chinese and American
scientists as a product to lower blood lipids, including cholesterol and
triglycerides. Although small scale studies using pharmaceutical-grade red rice
yeast have demonstrated efficacy and safety, it is no longer legal to sell
supplements containing red yeast rice in the United States. The main reasons
the Food and Drug Administration (FDA) removed red yeast rice from the market
in the United States were because there is
concern that patients who take statin drugs when combined with red yeast rice
products may increase their risk of muscle or kidney injury. The FDA also considers
the products containing red yeast rice to be new, unapproved drugs for which
marketing violates the Federal Food, Drug, and Cosmetic Act.
- Coenzyme Q10. Coenzyme Q10 is a
fat-soluble nutrient also known as CoQ10, or ubiquinine primarily found in the
mitochondria. The mitochondria are small bodies within cells that produce
energy for the body. CoQ10 provides energy to the cells, stabilizes cell
membranes and acts as an antioxidant (a substance
that reduces damage that results from oxygen, such as is caused by free
radicals). As for lowering cholesterol there are some reports that this
supplement may have some benefit in ischemic heart disease, which occurs when there
are already blockages in the coronary arteries. This claim is not yet
proven. Co Q 10 has no effect on lowering cholesterol.
- Garlic. While some individual studies have shown
that garlic can be effective in reducing "bad" cholesterol (LDLs),
the overall body of evidence is inconclusive. A recent study conducted in 2007,
appears to shed serious doubt on the reality behind garlic's reputation in this
area. The researchers tested raw garlic and two different garlic supplements on
nearly 200 adults with moderately high levels of LDL ("bad")
cholesterol. After six months, the patients showed no improvements in their
average cholesterol or other blood fats (lipids), no matter what kind of garlic
they had consumed. SOURCES: Gardner, C.
Archives of Internal Medicine, Feb. 26, 2007; vol 167: pp 346-353. Charlson, M.
Archives of Internal Medicine, Feb. 26, 2007; vol 167: pp 325-326. National
Heart, Lung, and Blood Institute: "How is High Blood Cholesterol
Diagnosed?" News release, Stanford University Medical Center. Haru
Amagase, PhD, director, research and development, Wakunaga of America.
There are also several things that you can do to raise your HDL or "good cholesterol."
Most evidence supports the use of niacin to increase HDL - up to 35%. The
beneficial effect is dose dependent. Niacin can cause flushing which people
don't like - in these cases, it makes sense to start at a low dose and slowly
build up. If people end up taking large doses of niacin, it is important that
they ask their doctor about checking for liver enzymes because liver injury is
a potential side effect at high doses. There is evidence supporting the use of
exercise, red wine, polyphenols in berries in increasing HDL too.
changes in lifestyle can have a positive impact on raising HDL levels:
Start on a Mediterranean
A Mediterranean diet emphasizes mono unsaturated fats (e.g., canola oil,
avocado oil, or olive oil) over saturated fats, emphasizes the consumption of
fish over meat, includes heart healthy oils, and emphasizes moderate
consumption of alcohol. This approach has shown to increase HDL cholesterol
levels without increasing the total cholesterol, and lowers the risk for heart
Removing trans fatty
acids from the diet.
Trans fatty acids are currently present in many of your favorite prepared foods
-- anything in which the nutrition label reads "partially hydrogenated
vegetable oils" -- so eliminating them from the diet is not a trivial
task. But trans fatty acids not only increase LDL cholesterol levels, they also
reduce HDL cholesterol levels. Removing them from your diet will almost
certainly result in a measurable increase in HDL levels.
Reducing fat in the
Limiting intake of dietary fat to 30-35% of total calories can lower
Weight loss. Obesity results not
only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you
are overweight, reducing your weight should increase your HDL levels. This is
especially important if your excess weight is stored in your abdominal area;
your weight-to-hip ratio is particularly important in determining whether you
ought to concentrate on weight loss.
Smoking cessation. If you smoke, giving
up tobacco will result in an increase in HDL levels. Within 30 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. Quitting smoking does a body good!! So, QUIT TODAY!!!
exercise. Consistent moderate physical activity can help raise high-density
lipoprotein (HDL) cholesterol, the "good" cholesterol. With your
doctor's OK, work up to 30 to 60 minutes of exercise a day. Exercising does not have to be in a gym. Take a
brisk daily walk. Play tennis. play with your kids or your dog in your yard. just get up and move!!
- Drink wine.
One drink of alcohol a day or less yields higher HDL-C levels, more so in women
than men. HDL transports cholesterol to the liver and cholesterol is known to
have a protective effect on the cell membrane. It is likely that this reflects
the liver's need for more cholesterol to protect itself from the alcohol.
Adding soluble fiber
Soluble fibers found in oats, fruits, vegetables, and legumes, can result in
both a reduction in LDL cholesterol and increase HDL cholesterol.
to the diet.
The antioxidant qualities of vitamin E with beta carotene can raise the good or
HDL cholesterol levels, cleansing the body of free radicals. Green tea can be
consumed each day also because of the antioxidant properties in the tea.
In addition to lowering LDL cholesterol and raising HDL, green tea can also
regulate blood sugar and reduce high blood pressure.