Cholesterol Archive

High-dose niacin (vitamin B₃) is no longer recommended to improve cholesterol and triglyceride levels. Different forms of niacin, such as niacinamide (nicotinamide), are sold as supplements; the potential benefits and risks remain unclear.

According to a 2024 review, the ketogenic (keto) diet—which is high in fat and protein and low in carbohydrates—doesn't meet standards for a healthy diet and may not be safe for some people with heart disease.

Up to 30% of Americans have above-normal levels of triglycerides, which many studies have linked to a higher risk of heart disease. Lifestyle changes that can lower triglycerides include losing weight if needed; avoiding simple carbohydrates, sweets, and alcohol; cutting back on saturated fats; and doing regular exercise. For people whose levels remain high (especially those at risk for heart disease), medications such as fibrates or icosapent ethyl (Vascepa) may be helpful.

Large studies have not found evidence of higher rates of heart attacks, strokes, or other cardiovascular diseases in people who eat up to one egg per day.

Metabolic syndrome is a constellation of interrelated health conditions that significantly increases the risk for heart attacks, strokes, diabetes, and more. A diagnosis requires at least three of the following risk factors: obesity, high blood sugar, high triglycerides, low HDL (good) cholesterol, or high blood pressure. Metabolic syndrome can be reversed if it's recognized. Losing weight is central to reducing many of its features. Lowering elevated blood pressure, blood sugar, and cholesterol levels also plays a major role in reducing the risk for heart disease and stroke.

For people older than 75 who have heart disease already, or who are at increased risk of developing heart disease, there now is solid evidence that statins remain effective at lowering cholesterol and, more important, in reducing the risk of new or recurrent heart disease. For people older than 75 who have not been diagnosed with heart disease and are not at increased risk for developing it, the value of statins still is uncertain.

The portfolio diet, which emphasizes foods rich in fiber and healthy fats, helps lower LDL cholesterol. A 2023 study suggests that the more closely people follow the diet, the lower their risk of cardiovascular disease. The diet discourages foods from animal sources and features foods from five main categories, including (1) plant protein such as legumes; (2) nuts and seeds; (3) foods rich in viscous fibers such as oatmeal, eggplant, and berries; (4) plant sterols such as phytosterol-enriched margarine; and (5) monounsaturated fats such as olive and canola oils.

Skin tags are fleshy, soft growths that tend to develop on the neck, under the arms, or around the groin. People who develop many skin tags should see their doctor, since they may be associated with diabetes or metabolic syndrome. Skin tags can be removed using various methods.

People who get most of their recommended weekly physical activity over one or two days may lower their heart disease risk just as much as those who are active more regularly throughout the week. Evidence also suggests there's no particular benefit to exercising at certain times of the day, including with respect to mealtimes. So people should be physically active whenever they find it to be most convenient.