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Cholesterol

Starting Strong: Why Doctors Should Begin with High-Dose Statins to Save Lives

Potent statins are the best-proven weapon against heart disease, especially when paired with lifestyle changes. Most people aren’t active enough—and many are underdiagnosed—so starting treatment strong is key.

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Starting Strong: Why Doctors Should Begin with High-Dose Statins to Save Lives

There is broad consensus among medical professionals that lowering LDL (low-density lipoprotein) cholesterol levels provides significant benefits in treating and preventing cardiovascular disease. Often referred to as “bad” cholesterol, elevated levels of LDL can clog arteries and increase the risk of heart attacks and strokes.

Researchers from Florida Atlantic University’s Schmidt College of Medicine have published an invited editorial in Trends in Cardiovascular Medicine, urging cardiologists to achieve lower LDL cholesterol levels beginning with the highest doses of potent statins, such as rosuvastatin and atorvastatin. The authors emphasize that high-potency statins should be the primary pharmacologic treatment for cardiovascular disease, alongside therapeutic lifestyle changes.

Therapeutic lifestyle changes, including avoidance or cessation of smoking, healthy body weight and blood pressure, regular physical activity, and restricted alcohol consumption, are proven to be effective in treating and preventing cardiovascular diseases. However, despite these benefits, approximately 40% of adults in the United States have metabolic syndrome, a constellation of risk factors that significantly increases their cardiovascular risk.

The authors also highlight the importance of physical activity, noting that only about 21% of Americans meet the minimum daily requirement. They emphasize that meaningful increases in physical activity are possible at any age, including among older adults.

Based on the robust totality of randomized trial data and meta-analyses, the authors conclude that statins, particularly rosuvastatin and atorvastatin, have the strongest and most consistent body of evidence supporting their prescription in treatment and prevention for both men and women, including older adults.

The authors recommend starting therapy with the highest dose of these agents and titrating down if necessary. They also highlight the benefits of statins and aspirin being additive or potentially synergistic. Most secondary prevention patients should be prescribed aspirin; however, individual clinical judgments are necessary in primary prevention, and aspirin should be considered after statins.

“Practicing cardiologists may wish to consider that all adjunctive drug therapies to therapeutic lifestyle changes should be added only after achieving maximal doses of statins,” said Charles H. Hennekens, M.D., FACC, senior and corresponding author. “Further, statins have the largest and most persuasive body of evidence of any pharmacological adjunctive therapy in treatment and prevention of cardiovascular disease.”

The researchers offer cautious views on adjunctive therapies such as ezetimibe and evolocumab, which tend to be used more widely than optimal. They suggest that these therapies may be more appropriately reserved for select high-risk patients who have not achieved LDL goals with statins alone.

The authors also discuss the role of omega-3 fatty acids, noting that earlier trials were positive but later tended to show no net benefit. They opine that this may have been due to widespread statin use and suggest that icosapent ethyl was the only omega-3 fatty acid to demonstrate significant added benefits when added to evidence-based doses of high potency statins.

Hennekens reflected on the enduring relevance of Benjamin Franklin’s 1736 observation, “An ounce of prevention is worth a pound of cure.” The authors conclude that starting with high-dose statins can save lives and emphasize the importance of prevention in cardiovascular disease management.

Cholesterol

Grapes Earn Superfood Status: A Scientific Case for Boosting Brain, Heart, and Gut Health

Fresh grapes contain a potent mix of over 1,600 compounds that benefit heart, brain, skin, and gut health. New evidence suggests they deserve official superfood recognition, with benefits even at the genetic level.

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Grapes have long been enjoyed for their sweet taste and refreshing crunch, but recent research has solidified their position as a true “superfood.” A groundbreaking study published in the Journal of Agriculture and Food Chemistry presents a compelling case for why fresh grapes deserve superfood status. Led by renowned resveratrol researcher John M. Pezzuto, Ph.D., this article delves into the scientific evidence supporting grapes’ exceptional health benefits.

The term “superfood” is often used loosely, but what exactly constitutes a superfood? Typically, these foods are rich in natural plant compounds that have been shown to provide health benefits. Mainstream superfoods like berries and leafy greens are commonly associated with a Mediterranean Diet, which emphasizes whole, nutrient-dense foods. Pezzuto’s article sheds light on the broader topic of superfoods and makes a strong scientific case for grapes.

One of the most significant advantages of grapes is their staggering diversity of compounds – over 1,600 have been identified! This includes antioxidants, polyphenols like flavonoids, anthocyanidins, catechins, phenolic acids, and resveratrol. These compounds work synergistically to promote health benefits through antioxidant activity and influencing cellular processes. It’s essential to note that the whole grape, with its unique matrix of compounds, is responsible for these biological effects – not just a single component.

A wealth of scientific literature has been devoted to exploring grapes’ impact on various aspects of human health. The evidence suggests that:

* Grapes have cardiovascular benefits by promoting relaxation of blood vessels and healthy circulation while modulating cholesterol levels.
* Clinical trials demonstrate grapes’ support for brain health, including maintaining healthy brain metabolism and beneficial impacts on cognition.
* Skincare benefits from grapes include enhanced resistance to UV radiation and DNA damage in skin cells.
* Gut health is positively influenced by grape consumption, with modulation of the gut microbiome and increased diversity in the gut.
* Eye health also stands to benefit, with retinal impact via increase in macular pigment optical density.

In the realm of nutrigenomics – the study of foods on gene expression in the body – grape consumption has been shown to positively alter gene expression in relevant body systems. Pezzuto suggests that these activities at the genetic level are likely driving forces behind grapes’ health benefits.

The California Table Grape Commission’s president, Ian LeMay, emphasizes Dr. Pezzuto’s findings: “Based on the science, grapes are indeed a superfood and should be recognized as such.” He encourages using this nomenclature in association with grapes to promote awareness of their exceptional health benefits.

Whether enjoyed for their nutritional value or simply as a healthy snack, consuming fresh grapes is undoubtedly a win-win situation.

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Cholesterol

Twice as Effective: The Surprising Benefits of Minimally Processed Foods for Weight Loss

People eating minimally processed foods lost twice as much weight as those on ultra-processed diets, even though both diets were nutritionally balanced and participants could eat freely. This real-world, long-term study revealed that food processing itself—not just nutrients—plays a significant role in shaping body weight and health outcomes.

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The latest clinical trial from UCL and UCLH has shed light on a surprising secret for losing weight: choosing minimally processed foods. When given nutritionally matched diets, participants lost twice as much weight eating minimally processed foods compared to ultra-processed foods. This groundbreaking study is the first interventional research comparing ultra-processed food (UPF) and minimally processed food (MPF) diets in real-world conditions.

The trial involved 55 adults who were split into two groups. One group started with an eight-week diet of MPF, such as homemade spaghetti Bolognese or overnight oats, followed by a four-week ‘washout’ period and then switched to a diet of UPF, like breakfast oat bars or ready meals. The other group completed the diets in the opposite order. After eight weeks on each diet, both groups lost weight, but with significantly greater weight loss (2.06% reduction) on the MPF diet compared to the UPF diet (1.05% reduction).

The researchers found that this difference corresponded to an estimated calorie deficit of 290 kilocalories (kcal) per day on the MPF diet, compared to 120 kcal per day on the UPF diet. This suggests that choosing minimally processed foods may be more effective for losing weight when following recommended dietary guidelines.

The study also showed that participants experienced greater improvements in craving control and ability to resist cravings on the MPF diet. Despite the greater weight loss on the MPF diet, which might have led to stronger cravings, participants reported a two-fold greater improvement in overall craving control, a four-fold greater improvement in craving control for savory food, and an almost two-fold greater improvement in resisting whichever food they most craved.

Professor Chris van Tulleken emphasized the importance of ultra-processing in driving health outcomes, beyond the role of nutrients like fat, salt, and sugar. He underlined the need to shift policy focus away from individual responsibility and on to environmental drivers of obesity, such as multinational food companies shaping unhealthy food environments.

The researchers caution that longer studies would be needed to investigate secondary health markers properly in relation to changes in weight and fat mass. However, their findings suggest that sticking to nutritional guidelines by moderating overall energy intake, limiting salt, sugar, and saturated fat, and prioritizing high-fiber foods like fruits, vegetables, pulses, and nuts may offer additional benefits for body weight, body composition, and overall health.

This research was supported by the National Institute for Health and Care Research UCLH Biomedical Research Centre and the Rosetrees Trust.

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Cholesterol

The Pistachio Paradox: How Swapping Bedtime Snacks Can Rewire Your Gut and Help Prevent Diabetes

A new study reveals that swapping a typical nighttime carbohydrate snack for pistachios may beneficially alter gut bacteria in people with prediabetes. Conducted by Penn State researchers, the 12-week clinical trial found that pistachio consumption increased beneficial gut microbes like Roseburia and reduced harmful ones such as Blautia hydrogenotrophica. These microbiome changes could potentially support metabolic health and slow the progression to Type 2 diabetes. While more research is needed to confirm health outcomes, this study positions pistachios as a promising late-night snack with microbiome-boosting potential.

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The Pistachio Paradox: How Swapping Bedtime Snacks Can Rewire Your Gut and Help Prevent Diabetes

A third of people in the United States live with prediabetes, a condition that often progresses to Type 2 diabetes. While dietary interventions have shown promise, effective strategies remain limited. A recent study by researchers at Penn State has shed new light on how nighttime pistachio consumption can reshape the gut microbiome and potentially prevent diabetes.

Researchers led by Kristina Petersen, associate professor of nutritional sciences, found that replacing a traditional carbohydrate-based bedtime snack with pistachios can significantly alter the gut bacterial landscape in adults with prediabetes. The study, published in the journal Current Developments in Nutrition, demonstrated that consuming about two ounces of pistachios each night for 12 weeks resulted in distinct stool microbial community profiles compared to those who consumed the recommended 15 to 30 grams of a carbohydrate snack.

Specifically, researchers observed increased abundance of “good” bacteria like Roseburia and members of the Lachnospiraceae family, which produce beneficial short-chain fatty acids like butyrate. Butyrate serves as a primary energy source for colon cells, helps maintain the gut barrier, and supports anti-inflammatory processes.

Pistachio consumption also led to reductions in bacterial groups linked to less favorable metabolic outcomes, such as Blautia hydrogenotrophica and Eubacterium flavonifractor. The study’s design, a randomized crossover clinical trial, allowed researchers to better understand how specific foods like pistachios can influence the gut microbiome.

While the study demonstrated shifts in gut bacteria, it remains unclear whether these changes directly translate to improvements in health. Researchers hope to explore this question further in future research.

This study has significant implications for people working to improve their metabolic health. By incorporating pistachios into one’s bedtime snack routine, individuals may be able to reshape their gut microbiome and potentially prevent the progression of prediabetes to Type 2 diabetes.

The study was funded by the American Pistachio Growers, Penn State’s Clinical and Translational Science Institute through the National Center for Advancing Translational Sciences of the National Institutes of Health, and additional support from Juniata College and the U.S. National Science Foundation.

At a time when federal funding cuts threaten research progress, studies like this one demonstrate the importance of continued investment in scientific inquiry that can improve the lives of people across the country and around the world.

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