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Episode 2540:
Discover how to manage high cholesterol levels effectively when traditional methods fall short. This insightful discussion unpacks the complexities of cholesterol, its bodily functions, and advanced medication options like Praluent and Repatha, aimed at reducing LDL levels. Learn about impactful lifestyle changes, from diet tweaks to exercise tips, that could enhance medication efficacy and provide substantial health benefits.
Quotes to ponder:
"Cholesterol isn't just about what we eat; our bodies produce it too because we need some cholesterol floating around in our bloodstream."
"The liver makes cholesterol on its own. This is because we need some cholesterol floating around in the bloodstream."
"If our cholesterol levels get too high, it increases the risk of blockages in the arteries."
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[00:01:01] That's WonderfulPistachios.com. It's another Q&A edition of Optimal Health Daily, episode 2540
[00:01:09] and I'm Dr. Neil Malek. Hey there, happy Friday and welcome to another Q&A edition
[00:01:14] of Optimal Health Daily where I answer your health questions related to fitness, diet and
[00:01:20] and lots more. You send in the questions and I answer them for you. Now if you do send in a
[00:01:25] question, we'll physically mail you a copy of our hardcover workbook as long as you're in the US
[00:01:30] and we have some left. If you're outside of the US, we'll email you a digital version.
[00:01:36] Now I'll tell you how to send in a question at the end of the show but for now,
[00:01:40] let's hear today's audio question as we optimize your life.
[00:01:50] I really enjoy your podcast. I wanted to ask you if you have any opinion on the medications
[00:02:00] and the sister medication for high HDL, I'm sorry, high LBLs without my ability to take
[00:02:12] statins of any kind and diet and exercise have not really worked. Thanks.
[00:02:19] Thank you so much for taking the time to send in your question, listener.
[00:02:22] I'm so sorry to hear that up until this point diet and exercise haven't helped reduce your
[00:02:27] cholesterol levels. Let me first talk about how these types of medications may help lower
[00:02:33] cholesterol levels. Well actually, let me first talk about where cholesterol comes from
[00:02:38] and why we should care about it. Cholesterol can come from the foods we eat but the body
[00:02:43] makes it on its own too. The liver specifically makes cholesterol on its own. This is because
[00:02:50] we need cholesterol floating around in the bloodstream. Cholesterol helps the body transport
[00:02:55] fat throughout the body. When it comes to foods, cholesterol can be found in any product that
[00:03:02] basically came from an animal. If the animal had a liver, since the liver makes cholesterol,
[00:03:07] then it's going to have some cholesterol in it. So having cholesterol in the body and
[00:03:12] in the blood isn't a bad thing. The problem is having too much of it. This is because if
[00:03:17] our cholesterol levels get too high, then it increases the risk of that cholesterol forming
[00:03:22] blockages in the arteries. Now the medications you asked about in your question, Prolum and
[00:03:29] Rapatha help decrease a specific type of cholesterol. This type of cholesterol is called
[00:03:35] LDL. You'll hear LDL often referred to as bad cholesterol or if it helps you think of it
[00:03:42] as lousy or lethal cholesterol. So certain medications tell the liver to stop making so
[00:03:50] much of this LDL or lousier lethal cholesterol. Now they don't stop the production of this
[00:03:55] cholesterol completely, it just tells the liver to chill out for a while. Over time, it's the
[00:04:00] hope that this will decrease the amount of this lousy lethal cholesterol floating around
[00:04:05] in the bloodstream. This is because too much of this lethal lousy cholesterol, again, tends
[00:04:10] to form blockages in the arteries. So if these medications decrease this lousy lethal cholesterol
[00:04:17] from floating around in the bloodstream, this means there's less of a chance of future disease
[00:04:23] risk like heart attack or stroke. Now the reported side effects to both of these medications,
[00:04:28] Prolum and Rapatha are minor. Of course though, for some, the side effects can be pretty
[00:04:34] awful. It really just depends on the person. But if a doctor prescribes these medications
[00:04:39] and there are no reported side effects or minimal side effects, then the doctor believes that the
[00:04:44] benefits of taking these medications outweigh any risks. But the medications do tend to work
[00:04:50] even better when we include lifestyle changes. If blood cholesterol is really well managed,
[00:04:56] the dosage or frequency of these medications can actually be reduced. Most health professionals
[00:05:02] agree that diet, exercise, weight management, stress management and not smoking can help reduce
[00:05:08] blood cholesterol levels. In fact, several studies have found that these lifestyle changes
[00:05:13] can actually work better than the medications themselves. But based on your question,
[00:05:18] OHD listener, it sounds like you've tried some of these lifestyle behaviors and unfortunately they
[00:05:23] don't seem to be working. But let me describe some of these lifestyle behaviors more specifically
[00:05:28] just in case you haven't tried them. First, simple sugars. So when it comes to changes to our
[00:05:35] diets, one of the best things we can do is to lower our intake of simple sugars. Simple
[00:05:41] sugars are those that are found in candy, soda, white flour, baked goods, you know all
[00:05:47] the things we really like. Now this doesn't mean these foods need to be completely eliminated
[00:05:52] from the diet. But even a small reduction can help when it comes to some things we want to
[00:05:58] increase in our diet like fiber that can actually help remove LDL cholesterol from the
[00:06:05] bloodstream. So increasing our dietary fiber intake to around 28 grams per day can help remove
[00:06:11] that lousy or lethal cholesterol from the blood. Next, fish. I would say it's important
[00:06:18] to eat fish at least twice a week. Specifically consume responsibly caught cold water fatty fish.
[00:06:25] These tend to be high in a specific type of fatty acid called omega-3 fatty acids which
[00:06:31] help keep our arteries healthy. An easy mnemonic device I like to use to help clients remember
[00:06:37] which fish are high in omega-3 is to follow a SMASHED diet. S-M-A-S-H-T where S stands for
[00:06:47] salmon, M mackerel, A anchovies, the other S sardines, H halibut or herring and T trout.
[00:06:58] Each of these fish are good sources of omega-3 fatty acids. Now if you don't like fish and
[00:07:03] want to take an omega-3 supplement instead, definitely consult your doctor or dietitian first
[00:07:08] and also you don't need to take those so-called mega doses of these supplements either.
[00:07:14] Next, alcohol. A number of well-designed studies have found that consuming alcohol
[00:07:19] in moderation can significantly reduce the likelihood of cardiovascular disease which
[00:07:25] includes heart attack and stroke. Now what does moderation actually mean? For those identified as
[00:07:31] male at birth, that means no more than two drinks per day. For those identified as female at birth,
[00:07:38] that means no more than one drink per day. Now most of these studies were performed with red
[00:07:43] wine so that's the form I would recommend as long as your doctor is okay with it.
[00:07:48] There are of course those individuals that should not consume alcohol like those with
[00:07:53] a history of addiction and possibly those with a family history of addiction,
[00:07:57] those that are pregnant, those with diabetes and those that are underage of course just to name
[00:08:03] a few. Now my last diet tip is to eat plenty of dark green, red and orange veggies. These will
[00:08:10] provide a number of heart healthy vitamins and minerals to help the body heal. Now what about
[00:08:16] exercise? Starting with a walking and stretching program is often recommended. Staying active
[00:08:22] keeps your bad lousy lethal LDL cholesterol levels down which will again help prevent that blockage
[00:08:29] forming in the arteries. Stretching has actually been found to keep the arteries nice and
[00:08:34] flexible which is what we want. Now before beginning any exercise program, yes you know
[00:08:40] what I'm going to say, check with your doctor first. If they give the all clear,
[00:08:45] have your doctor specify the type of exercise you should be doing, the intensity you should
[00:08:51] be doing it at and the frequency meaning how often should you be exercising. Several studies
[00:08:57] have found that high intensity exercise is safe and effective for most people and high
[00:09:02] intensity exercise may be better at improving blood cholesterol levels than lower intensity
[00:09:08] exercise but again definitely get medical clearance first and depending on the situation
[00:09:14] some weight loss may help too. Even a five to ten percent reduction in body weight,
[00:09:20] especially for those that are in the overweight or obese categories according to their body mass
[00:09:24] index, can help lower blood cholesterol levels. Now this weight loss again isn't for everyone,
[00:09:31] it's really for those that may carry a little extra weight and this weight loss doesn't need
[00:09:36] to happen fast. No more than one to two pounds of weight loss per week is considered safe
[00:09:41] by most health organizations. I should add that to start to see any actual changes
[00:09:46] to blood cholesterol levels these recommendations, these behaviors need to be followed for at least
[00:09:53] six weeks and for some it may even take twice as long, 12 weeks before seeing any results.
[00:10:00] So please keep in mind time, patience and consistency are needed.
[00:10:10] Thank you again so much for taking the time to send in your audio question OHD listener.
[00:10:15] Answering your questions is my favorite part of the show and if you want to send in a question
[00:10:19] remember you'll get a physical copy of our workbook mailed to you if you're in the US
[00:10:24] and as long as we still have copies available. You can email your question to health at
[00:10:29] OLDpodcast.com or if you want your voice played on the show come by OLDpodcast.com
[00:10:36] slash ask. You can record your question straight from your computer's microphone,
[00:10:41] you can even play back your message and do retakes before sending it in or you can call
[00:10:46] in your question. The number is 161-ILOVE-OHD that's 161-4568-3643. Thank you so much again
[00:10:59] for sending in your questions and that'll do it for another Q&A edition of Optimal Health Daily.
[00:11:04] Thank you so much for listening every day and all the way through. I hope you have a great
[00:11:08] start to your weekend and I'll see you back here tomorrow where your optimal life awaits.