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Research we're watching

Don't want to skip breakfast before your cholesterol test? You probably don't need to. A study published online May 28 by JAMA Internal Medicine adds to the evidence that fasting isn't necessary before this common blood test, often referred to as a lipid profile.

For the study, nearly 8,300 people at risk for heart disease had fasting and nonfasting lipid profile tests done at least four weeks apart. (Fasting means they had nothing to eat or drink except water for at least eight hours before the test.) The differences in their total, LDL, and HDL cholesterol values were negligible. Triglyceride levels were modestly higher in the nonfasting samples.

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In the journals

Eating large amounts of red meat can raise LDL (bad) cholesterol levels, but new research suggests you should curb your intake of white meat, too. The findings were published online June 4, 2019, by The American Journal of Clinical Nutrition.

Researchers randomly assigned 113 healthy adults, ages 21 to 65, to follow a four-week diet with high levels of either red meat, white meat (chicken and turkey), or plant-based protein (such as nuts, whole grains, soy products, and legumes). Afterward, LDL levels in the high-red-meat diet group rose, as predicted, but the researchers found that high levels of poultry had the same effect on LDL levels as red meat.

There are several things you can do to prevent or minimize the aches and pains that might accompany statin use.

If you're not taking a statin now, you may well be soon. These medications are commonly prescribed to lower "bad" LDL cholesterol and have been shown to reduce the risk of heart attack, stroke, and death. They are routinely recommended for people who have cardiovascular disease and for many people ages 40 to 75 who don't have cardiovascular disease but have at least one risk factor (high blood pressure, high cholesterol, diabetes, or smoking) and a 7.5% or greater risk of a stroke or heart attack in the next decade. Moreover, recent research indicates that they may benefit high risk individuals over age 75 as well.

Muscle pain and other statin side effects

Taking a statin may give you some assurance that you're doing all you can to avoid heart attack and stroke, but you may also experience side effects. Reported side effects include an increased chance of developing diabetes 鈥� which is largely restricted to people who are already at risk for diabetes, and who can be monitored with glucose or hemoglobin A1c tests. Statin use has also been associated with difficulties with memory and reasoning, although there is no clear evidence that the drugs were responsible. In very rare cases, statins may cause liver problems or a potentially life-threatening breakdown in muscle cells.

Research we're watching

Got a high cholesterol reading? You may have a higher risk for a dangerous eye condition called glaucoma, according to a recent study published online May 2 by JAMA Ophthalmology. The condition, characterized by pressure in the eye that can damage the optic nerve, can lead to vision loss.

The study looked at 866 cases of primary open-angle glaucoma, the most common type of glaucoma, among more than 136,000 study participants who were followed for 15 or more years. Participants provided researchers with updates on statin use and cholesterol levels every other year throughout the study period. After analyzing the information, study authors found that for every 20-point increase in total cholesterol there was a 7% increase in glaucoma risk. But the use of cholesterol-lowering statin drugs seemed to reduce risk. People who used statins for five years or longer had a 21% lower risk of developing glaucoma.

News briefs

Vitamins and supplements won't help stave off dementia, but a healthy lifestyle might, suggest new guidelines released May 19, 2019, by the World Health Organization (WHO). The WHO warns that the number of new dementia cases around the world 鈥� currently 10 million per year 鈥� is set to triple by 2050. While there's no cure for any kind of dementia (such as Alzheimer's disease and vascular dementia), the WHO says it may be possible to delay the onset of the disease or slow its progression. The key: managing modifiable risks, such as chronic disease and unhealthy habits. The guidelines recommend that you keep your weight, cholesterol, blood pressure, and blood sugar under control; get lots of exercise; and eat a Mediterranean-style diet (which emphasizes olive oil, fruits, vegetables, nuts, and fish; minimizes red meats and processed meats; and includes a moderate amount of cheese and wine). The WHO also advises that you don't smoke and you avoid harmful use of alcohol (no more than one drink per day for women, no more than two drinks for men). But don't count on supplements to help you stave off dementia. The WHO says there's no evidence that vitamin B, vitamin E, multivitamins, or fish oil supplements help reduce the risk for dementia. The agency recommends against using supplements as a means to ward off cognitive decline.

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In the journals

Another way to lower LDL (bad) cholesterol levels? Eat more soy protein, suggests a study published online April 22, 2019, by The Journal of Nutrition.

Researchers examined 43 trials to evaluate the effect soy had on LDL levels. (High LDL levels can lead to a buildup of cholesterol in arteries and increase a person's risk of cardiovascular disease.)

This noninvasive test can predict plaque in the heart's arteries. But it is useful only in certain situations.

Imagine a 57-year-old man (let's call him Bill) who's in pretty good health 鈥� a nonsmoker who eats right and exercises regularly. He takes two drugs to treat high blood pressure. Even though his LDL (bad) cholesterol isn't all that high, his primary care doctor suggests that Bill consider taking a statin to lower his risk of a heart attack.

Bill is a little hesitant to add another drug to his daily regimen, so his doctor tells him about a test that may help with the decision: a coronary artery calcium scan. This noninvasive test, which can reveal dangerous plaque in the heart's arteries, has been available for more than a decade. But calcium scans (as they're often called) are now recognized in official guidelines and are being used far more often than in the past, says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital.

Q.听I keep reading that peanut butter is a healthy food. But it contains saturated fat and has more sodium than potassium. That doesn't sound healthy to me. Is peanut butter good for you?

A.听The presence of saturated fat doesn't automatically kick a food into the "unhealthy" camp. Olive oil, wheat germ, and even tofu 鈥� all "healthy" foods 鈥� have some saturated fat. It's the whole package of nutrients, not just one or two, that determines how good a particular food is for health.

Advice about eating eggs has evolved over the years. Should you go easy on this popular protein source?

Over the years, eggs have taken a bit of a beating, starting in the late 1960s. That's when the American Heart Association advised people to cut back on cholesterol in their diets and to eat no more than three whole eggs a week.

Decades later, eggs got a break after studies suggested that for most people, an egg a day was A-OK for heart health. But a recent report cracked down on eggs once again, suggesting that we return to the yolk-rationed days of yore (see "No yolk: Eggs linked to slightly higher risk of heart disease").

Recent research reignited interest in inflammation, a major player in heart disease.

A buildup of cholesterol-rich plaque inside arteries 鈥� known as atherosclerosis 鈥� is the root cause of most heart attacks and strokes. Researchers have long recognized that chronic inflammation sparks this artery-damaging process (see "Understanding inflammation"). Now, they're zeroing in on better ways to tackle that aspect of the problem.

Addressing inflammation is vital. Even when people take steps to lower their risks for heart disease, such as reducing their cholesterol and blood pressure, they may still face life-threatening cardiovascular events.