The Self-Cleaning Heart

You were born with immaculate arteries. Boost your HDL cholesterol and they can look like new once again

BY BILL GOTTLIEB, MARCH 10, 2004

 

The Fountain of Youth may be fiction, but there really is a magic gene pool in northern Italy. Thirty years ago, researchers discovered that, despite unhealthy cholesterol levels, 40 inhabitants of the village of Limone sul Garda were seemingly immune to heart disease. Turns out it wasn't the famed Mediterranean diet at work, but rather a variation of a protein in HDL cholesterol (the good kind) called ApoA-1 Milano. In less scientific terms, the villagers were born with self-cleaning arteries.



In about 3 years, you won't need to be a son of Limone sul Garda to enjoy the plaque-busting perks of ApoA-1 Milano. You'll probably be able to ask your doctor for a few shots of ETC-216, a synthetic form of HDL modeled after the Italian wonder protein. In a landmark study published in the Journal of the American Medical Association, Cleveland Clinic researchers found that emergency-room patients who received ETC-216 had an average reduction in arterial plaque of 4.2 percent. This may not sound like much, but according to Steven Nissen, M.D., the lead study author, "that level of reduction of arterial plaque--several weeks of treatment reversing several years' worth of accumulation--is extraordinary and unprecedented."



Think you can wait 3 years? You can't. A man with a low HDL-cholesterol level--40 milligrams per deciliter (mg/dl) or lower--can have as much as a three times greater risk of death from heart disease. So unless you're blessed with blood that consistently scores in the mid-40s or higher, you need to do something now. Make that several somethings. "The key to raising HDL levels with lifestyle changes is to do more than one thing," says Daniel J. Rader, M.D., director of the preventive cardiology and lipid clinic at the University of Pennsylvania school of medicine.



Our thinking exactly, which is why we've come up with these six strategies for making your HDL its level best.

Pop a milk pill, +7 percent

Strong bones, stronger heart. In a yearlong study published in the American Journal of Medicine, those people who took a daily 1,000-mg calcium supplement saw their HDL-cholesterol levels rise by 7 percent. "Calcium interferes with the absorption of fat from the diet and decreases fat mass in the body, both of which may help raise HDL," says Ian Reid, M.D., the lead researcher. Dairy products are an excellent source of calcium . . . except in this case. "Calcium is probably best ingested as a supplement, at least until there's more research on the HDL-increasing effects of calcium-rich foods," says Dr. Reid. Choose a brand that contains calcium citrate (not coral calcium) and 400 international units of vitamin D for maximum absorption.

Build killer quads, +19 percent

Scientists have always believed that you have to run, cycle, or do other aerobic acrobatics in order for exercise to boost HDL. But when Ohio University researchers studied the impact of weight training on older men, they discovered a surprising side effect: The men who did lower-body work--squats, leg extensions, leg presses--twice a week for 16 weeks raised their HDL levels by 19 percent. "If you add weight training to your exercise routine, you are going to increase your HDL," says Robert Staron, Ph.D., one of the study authors. For legs and HDL levels that are something to look at, follow the lead of the men in the study: Do three sets of six to eight repetitions of the half squat, leg extension, and leg press, resting no more than 2 minutes between sets. Use a weight that's about 85 percent of the amount you can lift just once.

Make a date with Mrs. Paul, +26 percent

Compared with omega-3-rich salmon, whitefish looks like the iceberg lettuce of seafood. However, when Canadian researchers recently compared a steady diet of the stuff with regular consumption of lean beef and chicken, they found that the fish-eating folks experienced a 26 percent increase in HDL2, a particularly protective form of HDL (see "Sizing Up Your HDL," in related articles on right). "Fish protein may increase insulin sensitivity, which in turn can elevate HDL2 cholesterol," says Helene Jacques, Ph.D., one of the study authors. Still, fish sticks aren't health food--unless they're baked, like Healthy Selects Sticks from Mrs. Paul's. Same goes for any other frozen fish: Always choose baked over battered.

Learn how to pronounce this word, +15 percent

"Policosanol" (poly-CO-sanol). This mixture of alcohols derived from sugarcane wax is the rare natural supplement that may actually live up to its hype. "At doses of 10 to 20 mg a day, it can increase HDL by up to 15 percent, which is incredible," says David Maron, M.D., a cardiologist at Vanderbilt University medical center. "I'm amazed it hasn't made more of a splash." One reason may be that most of that research has been done on a brand of policosanol not available in the United States. "A lot of the [U.S.] products don't use sugarcane," says Stephen Sinatra, M.D., an assistant professor of medicine at the University of Connecticut school of medicine. Instead, they use vegetable or bee waxes. Two domestic exceptions: Source Naturals and Nature's Life, both of which are sold at health-food stores.

Make your six-pack disappear, +12 percent

Not your abs, your Amstel lager. Researchers in the Netherlands found that men who drank 2 pints of beer a day increased their HDL levels by 7 percent after only 10 days, and by 12 percent after 3 weeks. "The exact way in which it affects HDL has never really been figured out, but the effect has been observed over and over again," says Norman Kaplan, M.D., a clinical professor of internal medicine at the University of Texas. What's more, says Dr. Kaplan, "beer contains components that reduce homocysteine levels in the blood [a risk factor for heart disease]." Of course, beer does have its limits, as should you--stop at two glasses a day, unless you're celebrating something special, like a triple-digit HDL score.

Munch on macadamias, +8 percent

This Hawaiian native will do even more to keep your heart pumping than getting lei'd by a babe in a grass skirt. In a study of 17 men with high cholesterol, Australian scientists found that when the men replaced 15 percent of their daily calorie intake with macadamia nuts--12 to 16 nuts a day--their HDL levels went up by 8 percent. "Since macadamia nuts contain the highest amount of monounsaturated fat of all nuts, this degree of HDL-raising effect may be unique to them," says Manohar Garg, Ph.D., the study author. And don't worry about your sodium intake; a dozen dry-roasted macadamias contains just 75 mg sodium, a third of what's coating an equivalent pile of peanuts.