Dec
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A new year brings new hopes for healthier lifestyles, tighter waistlines and lighter diets. Each year I review some simple resolutions and fun advice for staying heart healthy for the holidays and throughout the new year — this year, I chose 12 tips for 2012:
- Start right: Begin each day with a good breakfast, including dairy, fiber and fruit. Choose items such as whole grain toast, low or fat-free milk, bananas, pears and high-fiber oatmeal with nuts and berries.
- Walk this way: Walk at lunch with coworkers, before or after work with your pets, join in team sports or find an outlet that gets your heart pumping for at least 30 minutes a day. Take the stairs, park further away, buy a push lawn mower and enjoy the great outdoors.
- Cholesterol management: Get an expanded test that tells you and your doctor about the dangerous cholesterol — directly measured LDL, non-HDL, apoB and subparticles — that can hurt your arteries. The Vertical Auto Profile (VAP) lipid test from Atherotech is one such test.
- Fiber is your friend: Read the nutrition label on foods so you know what you’re eating and to better manage your cholesterol, fiber and other nutrients. Women should try to eat at least 21 to 25 grams of fiber a day, while men should aim for 30 to 38 grams a day.
- Glucose in moderation: Too much sugar and starch contribute to diabetes. Get tested for diabetes with a blood glucose test, and cut back on pasta, potatoes, sodas, ice cream and fast food.
- Red red wine: Did you know the 1984 hit “Red Red Wine” from pop-reggae band UB40 was originally written and first recorded by Neil Diamond in 1967? Did you know that red wine and dark beer contain more flavonoids (protective antioxidants) than other alcoholic beverages? You can have up to 1 ounce of undiluted alcohol daily, the equivalent of two 4-ounce glasses of wine, a 12-ounce bottle of beer or two shots of spirits.
- Dark dark chocolate: Cocoa and chocolate products have the highest concentration of flavonoids among commonly consumed foods. Dark chocolate with high cocoa content is best for heart healthy benefit.
- Think Mediterranean: Even if you can’t vacation here, you can eat as if you are. This diet is high in fiber, “earth-healthy” carbs, whole grains, beans, fruits, veggies, eggs, nuts, cheese, olive oil, avocadoes and fish.
- All things in moderation: Red meat is OK when eaten in moderation — once per week. When it comes to fish and poultry, feel free to invite them to dinner at least twice a week.
- Healthy lifestyle: Lead a healthy lifestyle, which means no smoking, seeing your clinician every year for a physical and expanded cholesterol test, and laughing often. Spend time with friends, kids and grandkids.
- Don’t stress out: Blood pressure (hypertension) can lead to blockages, blood clots and hardened, weakened arteries and is a major risk factor for heart disease. Getting your blood pressure checked out is a great way to better understand your heart disease risk to stay heart healthy all year long.
- Enjoy life: Use your imagination to enjoy life and get the most out of each and every day. Have fun, do what you love and do what makes you happy.
Wishing all my readers happy holidays and a new year full of good health!



Dear Dr. Cobble,
My results from a recent lipoprotein test was disturbing. I am ApoE Genotype 3/4. LDL-C is 199. HDL-C is 54. TGL is 74. ApoB is 149. LDL-P is 2793. ApoA-1 is 132. Lp (A) is 22. MPO is 1379. Glucose is 98. Insulin is 4.9. CRP is .05. Homocysteine is 9. Recent CTA showed calcium rating of 0 and one unremarkable area of soft plaque. I am in the 30% for a female the age of 62. I cardio exercise 4-5 days a week, practice yoga, eat a healthy diet, take 2 grams of fish oil, 100 grams of ubiquinol, 250 mg of resveratrol, 400 mg of magnesium, probiotics, and food enzymes. I cannot take statin drugs. What do you make of the results of my lipid panel which contradicts the outcome of my CTA? Do you have any recommendations regarding other supplements other than niacin to reduce my small particle lipoproteins? I have two siblings who died of a cardiac arrest at the age of 47. Needless to say, I am gravely concerned with the lipid panel results. Do you have any research I can read that would give me more information for remedial action? Thank you for your time, Nancy
By: Nancy April 5, 2012Nancy,
With an LDLp that high I would presume your NHDLc is 250 mg/dL or higher. LDLc over 190 mg/dL should be a consideration for LDLc reduction therapy. It is rare that I can’t find a “statin” that someone cannot tolerate. That being said niacin, ezetimibe and colesevelam can also lower LDLc individually or in combination. I don’t consider any areas of soft plaque “unremarkable”‘ and would not call your CTA normal. Yes, you don’t have significant stenosis, but elevated MPO and/or LpPLA2 would make me quite concerned with your lipid levels in light of your family history. You likely have FH (familial hypercholesetrolemia) and I would hope you have a clinician in your area which can find adequate treatment to target such.
Also, if you have two NCEP risk factors (female age 55, premature family history athero event primary male < 55 of primary female < 65), you are considered at moderate risk and guidelines would recommend LDLc be under 130 mg/dL.
All the best. MC
By: Mike Cobble, MD April 9, 2012