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Section 1: Cholesterol and its value for health
Cholesterol, the fat-like substance necessary for the normal functioning of the body plays an important role in the construction of cell membranes, the synthesis of hormones (for example, estrogen, testosterone, cortisol) and the production of vitamin D. However, with an excess of cholesterol in the blood, especially low-density lipoproteins (LDL), the risk of cardiovascular development increases. diseases such as atherosclerosis, myocardial infarction and stroke.
Cholesterol is transferred in the blood with two main types of lipoproteins: LDL and high density lipoproteins (HDL). LDL, often called “poor” cholesterol, delivers cholesterol from the liver to the cells of the body. If the LDL level is too high, cholesterol can accumulate on the walls of the arteries, forming plaques, narrowing the lumen of blood vessels and limiting blood flow. HDL, on the contrary, removes cholesterol from the arteries and transports it back to the liver to remove it from the body, so it is called “good” cholesterol.
Triglycerides, a different type of fat in the blood, also play a role in the health of the cardiovascular system. A high level of triglycerides, especially in combination with a high level of LDL and a low level of HDL, increases the risk of heart disease.
Factors affecting cholesterol levels:
- Diet: The use of products with a high content of saturated and trans fats increases the level of LDL. Products rich in cholesterol can also affect its level in the blood, although to a lesser extent than saturated and trans fats.
- Weight: Excess weight and obesity are associated with a higher level of LDL, triglycerides and low levels of HDL.
- Physical activity: Low physical activity helps to increase LDL levels and reduce LDP levels.
- Age: With age, cholesterol, as a rule, increases.
- Floor: In men, the level of LDL is usually higher than in women, before menopause.
- Genetics: A genetic predisposition can play a significant role in determining the level of cholesterol.
- Diseases: Some diseases, such as diabetes mellitus, hypothyroidism (reduced thyroid function) and liver disease, can affect cholesterol.
- Smoking: Smoking reduces the level of HDL and increases the level of LDL.
Regular monitoring of cholesterol, especially after 40 years, is important for maintaining the health of the cardiovascular system. A blood test, including the determination of general cholesterol, LDL, HDL and triglycerides, allows you to evaluate the risk of heart disease and timely take measures to normalize the level of cholesterol.
Section 2: Vitamins and additives to reduce cholesterol: review
Despite the fact that a change in lifestyle, including a diet and physical activity, is a cornerstone in a decrease in cholesterol, some vitamins and additives can serve as an effective addition to these measures. It is important to note that before taking any additives, you need to consult a doctor, especially if you have any diseases or you take medications. The doctor will be able to evaluate your individual needs and risks and give appropriate recommendations.
Some vitamins and additives with a potential cholesteroling effect include:
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Niacin (Vitamin B3): Niacin, also known as nicotinic acid, is group B vitamin, which can reduce the level of LDL and triglycerides, as well as increase the level of HDL. Niacin affects the metabolism of lipids, reducing the production of LDL and triglycerides in the liver. It can also increase the speed of LDL removal from blood flow. Effective doses of niacin for reducing cholesterol are usually much higher than the recommended daily norm and require medical control due to potential side effects, such as redness of the skin, itching, nausea, vomiting and, in rare cases, damage to the liver. There are various forms of niacin, including nicotinic acid (immediate release), niacinamide (which does not have a cholesteroling effect) and niacin of prolonged action. The form of immediate release often causes more side effects than the form of prolonged action.
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Red yeast rice: Red yeast rice is a product of rice fermentation with yeast Monascus. It contains Monacoline K, which is chemically identical to lovastatin, a drug from a group of statins used to reduce cholesterol. Monacolin inhibits the HMG-COA enzyme reductase, which plays a key role in the synthesis of cholesterol in the liver. Red yeast rice can effectively reduce the level of LDL, but its use requires caution due to potential side effects similar to those that are observed when taking statins, including muscles (myalgia), increasing the level of liver enzymes and, in rare cases, rabdomyolysis (destruction of muscle tissue). The concentration of Monacolin K in various products of red yeast rice can vary significantly, which complicates the standardization of dosage and efficiency. It is important to purchase red yeast rice from reliable manufacturers in order to minimize the risk of contamination by citrinin, toxic substance produced by some strains Monascus.
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Omega-3 fatty acids: Omega-3 fatty acids, especially eicopascentenic acid (EPC) and non-zahexaenic acid (DHG) contained in fish oil and some plant sources (for example, flax seed, chia, walnuts), have many beneficial properties for health, including reducing triglycerides, increasing the level of LPVP and improving the function endothelium (internal lining of blood vessels). Omega-3 fatty acids affect lipid metabolism, reducing the production of triglycerides in the liver and increasing their splitting. They also have anti-inflammatory properties that can help reduce the risk of cardiovascular diseases. The recommended dose of omega-3 fatty acids to reduce the level of triglycerides is usually 2-4 grams per day. Possible side effects include fish belching, nausea and blood thinning. People taking anticoagulants should be careful when taking high doses of omega-3 fatty acids.
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Plant Stanols and sterols: Plant Stanolas and stero are compounds that are structurally similar to cholesterol and are contained in small quantities in vegetable oils, nuts, seeds and whole cereals. They block the absorption of cholesterol in the intestines, thereby reducing the level of LDL in the blood. Plant stanolars and sterols are added to some foods, such as margarine, yogurt and juices. An effective dose of plant Stanols and sterols for reducing cholesterol levels is usually 2-3 grams per day. They are usually well tolerated, but in some cases minor gastrointestinal disorders can cause.
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Soluble fiber: The soluble fiber contained in oats, barley, legumes, fruits (apples, pears, citrus fruits) and vegetables forms gel -like mass in the intestines, which binds to cholesterol and prevents its absorption. It also helps to remove cholesterol with bile. An increase in the consumption of soluble fiber can reduce the level of LDL. The recommended dose of soluble fiber is 5-10 grams per day. It is important to gradually increase the consumption of fiber in order to avoid discomfort in the abdomen and gas formation.
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Coenzim Q10 (COQ10): Coenzyme Q10 is an antioxidant that plays an important role in the production of energy in cells. Some studies show that statins, drugs to reduce cholesterol can reduce the COQ10 level in the body. Therefore, some doctors recommend taking COQ10 as an additive to patients taking statins to reduce side effects, such as muscle pain. However, additional studies are needed to confirm the effectiveness of COQ10 to reduce muscle pain caused by statins.
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Garlic: Garlic is a popular ingredient in cooking and traditional medicine. Some studies show that garlic can reduce cholesterol and blood pressure. However, the research results are ambiguous, and additional studies are needed to confirm the effectiveness of garlic to reduce cholesterol.
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Arginine: Arginine is an amino acid that can help improve blood flow and reduce blood pressure. Some studies show that Arginine can have a positive effect on cholesterol, but additional studies are needed to confirm these results.
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Vitamin C and vitamin E: Although vitamin C and vitamin E are powerful antioxidants, their effectiveness in reducing cholesterol levels is not proven convincingly. Some studies show that they can help protect LDLs from oxidation, which is an important step in the development of atherosclerosis. However, additional studies are needed to determine their role in reducing the level of cholesterol.
Section 3: Niacin (vitamin B3) in detail
Niacin, also known as vitamin B3 or nicotinic acid, is a water -soluble vitamin that plays an important role in energy metabolism, DNA synthesis and cell recovery. It is available in two main forms: nicotinic acid and niacinamide (nicotinamide). Nicotinic acid is a form that has a cholesteroling effect, while niacinamide does not have a significant effect on cholesterol.
The mechanism of action:
Niacin affects the metabolism of lipids in several ways:
- Reducing the production of LDL and triglycerides: Niacin inhibits the Aciltrazferase-2 (DGAT2) diglceride enzyme in the liver, which is involved in the synthesis of triglycerides. A decrease in the synthesis of triglycerides leads to a decrease in LDL production.
- Improving the level of HDL: Niacin increases the level of apolipoprotein AI (APOA-I), the main protein as part of HDL. An increase in the level of APOA-I helps to increase the level of HDL.
- Decrease in the level of lipoprotein (a) [Lp(a)]: Lipoprotein (a) is genetically determined lipoprotein, which is associated with an increased risk of cardiovascular disease. Niacin can reduce the level of LP (A), which is a unique advantage compared to statins.
Efficiency:
Clinical studies have shown that niacin can effectively reduce the LDL level by 10-25%, reduce the level of triglycerides by 20-50%and increase the level of HDL by 15-35%. However, to achieve these effects, high doses of niacin are needed, usually 1-3 grams per day.
Side effects:
Reception of niacin in high doses is often accompanied by side effects that can limit its use. The most common side effects include:
- Redness of the skin (flashing): This is the most common side effect of niacin, characterized by a sensation of heat, redness and itching of the skin, especially on the face, neck and upper body. Flashing is caused by the release of prostaglandins. Reception of aspirin or ibuprofen 30 minutes before taking niacin can reduce this effect. The intake of niacin also helps during meals.
- Nausea, vomiting and diarrhea: Niacin can cause gastrointestinal disorders, such as nausea, vomiting and diarrhea. Reception of niacin during eating can reduce these symptoms.
- Improving the level of liver enzymes: Niacin can cause an increase in the level of liver enzymes, which indicates damage to the liver. Regular monitoring of the liver function is necessary when taking niacin in high doses.
- Improving blood sugar: Niacin can increase blood sugar, so patients with diabetes should be careful when taking it.
- Improving uric acid levels: Niacin can increase the level of uric acid, which can lead to the development of gout from predisposed persons.
- Arrhythmia: In rare cases, niacin can cause arrhythmia.
Niacin’s forms:
There are various forms of niacin, characterized by the rate of release and the risk of side effects:
- Nicotinic acid of immediate release: This form of niacin causes the most pronounced flaming, but usually cheaper than other forms.
- Niacin of prolonged action: This form of niacin is released more slowly, which can reduce the flashing, but increases the risk of liver damage.
- Niacin with slow release: This form of niacin has an intermediate risk of flange and liver damage.
Contraindications:
Niacin contraindicated in:
- Liver diseases
- Active stomach ulcer
- Heavy gout
- Pregnancy and breastfeeding
Section 4: Red yeast rice in detail
Red yeast rice (KDR) is a product of rice fermentation with yeast Monascus. In traditional Chinese medicine, it has been used for centuries. The KDR contains a number of compounds known as Monacolins that have cholesteroling effects. The most important Monacolin is Monacolin K, which is chemically identical to Lovastatin, a drug from a group of statins.
The mechanism of action:
Monacolin K, contained in the KDR, inhibits the HMG-COA enzyme reductase, which is a key enzyme in the synthesis of cholesterol in the liver. Inhibition of this enzyme leads to a decrease in cholesterol production, which, in turn, reduces the level of LDL in the blood.
Efficiency:
Clinical studies have shown that KDR can effectively reduce the level of LDL. The meta-analysis of several studies showed that KDR can reduce the level of LDL by 10-20%. The effectiveness of KDR depends on the concentration of Monacolin K in the product.
Side effects:
KDR can cause side effects similar to those observed when taking statins, since Monacoline K is the same compound as lovastatin. The most common side effects include:
- Muscle pain (myalgia): This is the most common side effect of KDR. Muscle pain can vary from slight discomfort to severe pain that makes it difficult to move.
- Improving the level of liver enzymes: KDR can cause an increase in the level of liver enzymes, which indicates damage to the liver. Regular monitoring of the liver function is necessary when taking KDR.
- Rabdomiolysis: In rare cases, KDR can cause rabdomyolysis, a serious condition characterized by the destruction of muscle tissue, which can lead to renal failure.
- Gastrointestinal disorders: KDR can cause gastrointestinal disorders, such as nausea, vomiting, diarrhea and constipation.
Security and quality control:
It is important to note that KDR is a food supplement, not a drug, so it is not subject to the same strict quality control as drugs. The concentration of Monacolin K in various products of the KDR can vary significantly, which complicates the standardization of dosage and efficiency. In addition, some products of KDR can be polluted by citrinin, toxic substance produced by some strains Monascus.
To ensure the safety and efficiency of KDR, it should be purchased from reliable manufacturers who test products for the maintenance of Monacolin K and Citrinin. It is also recommended to consult a doctor before taking KDR, especially if you have any diseases or you take medicines.
Interactions:
KDR can interact with some medicines, including:
- Statins: taking KDR, along with statins, can increase the risk of side effects, such as muscle pain and rabdomyolysis.
- Hemfibrosil: taking KDR along with hemfibrozil can increase the risk of rabdomyolysis.
- Anticoagulants: KDR can enhance the effect of anticoagulants, increasing the risk of bleeding.
Contraindications:
CDR contraindicated in:
- Liver diseases
- Pregnancy and breastfeeding
- Accepts Statinov or Gemfibrosila
Section 5: omega-3 fatty acids in detail
Omega-3 fatty acids is a group of polyunsaturated fatty acids that are necessary for human health. The most important omega-3 fatty acids are eicopascentaenoic acid (EPK) and preshaseic acid (DGC), which are found in fish oil, and alpha-linolenic acid (Alc), which is contained in some plant sources, such as linen seeds, chia and walnuts.
The mechanism of action:
Omega-3 fatty acids affect lipid metabolism in several ways:
- Reducing the production of triglycerides: Omega-3 fatty acids reduce the production of triglycerides in the liver.
- Increase in the splitting of triglycerides: Omega-3 fatty acids increase the splitting of triglycerides in the blood.
- Improving the function of the endothelium: Omega-3 fatty acids improve the function of endothelium, internal lining of blood vessels.
Efficiency:
Clinical studies have shown that omega-3 fatty acids can effectively reduce the level of triglycerides. Doses of EPK and DHK from 2 to 4 grams per day can reduce the level of triglycerides by 25-50%. Omega-3 fatty acids can also slightly increase the level of HDLs and reduce LDL levels in some people.
Side effects:
Omega-3 fatty acids are usually well tolerated. The most common side effects include:
- Fish belching: This is the most common side effect of fish oil.
- Nausea: Omega-3 fatty acids can cause nausea.
- Diarrhea: Omega-3 fatty acids can cause diarrhea.
- Blood thinning: Omega-3 fatty acids have an anticoagulant effect, so people who take anticoagulants should be cautioned when taking high doses of omega-3 fatty acids.
Sources of omega-3 fatty acids:
- Fish oil: Fish oil is a rich source of EPK and DGK.
- Flaxseed, chia and walnuts: These plant sources contain Alk, which can be transformed into EPC and DGC in the body, but the effectiveness of this transformation is limited.
Selecting the Omega-3 additive:
When choosing an Omega-3 additive, it is important to consider the following factors to consider:
- EPC and DGK concentration: Choose additives with a high concentration of EPK and DGK.
- Purity: Choose additives tested for the content of heavy metals and other pollutants.
- Form: Omega-3 fatty acids are available in various forms, including soft gelatin capsules, liquid fish oil and etherified esters.
Interactions:
Omega-3 fatty acids can interact with some drugs, including:
- Anticoagulants: omega-3 fatty acids can enhance the effect of anticoagulants, increasing the risk of bleeding.
Contraindications:
Omega-3 fatty acids are contraindicated in:
- Allergies to fish
Section 6: Plant Stanols and Sterols in detail
Plant Stanols and sterols are compounds that are structurally similar to cholesterol and are contained in small quantities in vegetable oils, nuts, seeds and whole cereals. They are also known as phytosterols.
The mechanism of action:
Plant Stanolas and stero blocks the absorption of cholesterol in the intestines. They compete with cholesterol for absorption in the intestines, reducing the amount of cholesterol that enters the bloodstream.
Efficiency:
Clinical studies have shown that plant Stanolas and sterolas can effectively reduce LDL levels. Doses of 2-3 grams per day can reduce the level of LDL by 6-15%.
Side effects:
Plant Stanolas and stero are usually tolerated well. In some cases, they can cause minor gastrointestinal disorders, such as gas formation and bloating.
Sources of plant Stanols and sterols:
- Enriched products: Plant Stanolas and sterols are added to some foods, such as margarine, yogurt, juices and flakes.
- Natural sources: Vegetable oils, nuts, seeds and whole cereals contain plant Stanolas and sterola in small quantities.
Recommendations for use:
To achieve the maximum effect, plant Stanolas and stero should be consumed during meals so that they can compete with cholesterol for absorption in the intestines.
Interactions:
Plant Stanolas and sterols do not interact with most drugs.
Contraindications:
Plant Stanolas and sterola do not have known contraindications.
Section 7: Soluble fiber in detail
Soluble fiber is a type of dietary fiber, which dissolves in water, forming a gel -like mass in the intestines.
The mechanism of action:
Soluble fiber reduces cholesterol levels in several ways:
- Binding with cholesterol: Soluble fiber binds to cholesterol in the intestines, preventing its absorption.
- Deriving cholesterol with bile: Soluble fiber helps to remove cholesterol with bile.
- Reducing reabsorption of bile acids: Soluble fiber reduces the reabsorption of bile acids in the intestines, which forces the liver to use more cholesterol for the production of new bile acids.
Efficiency:
Clinical studies have shown that an increase in the consumption of soluble fiber can reduce the level of LDL. The dose of 5-10 grams of soluble fiber per day can reduce the level of LDL by 3-5%.
Sources of soluble fiber:
- Oats and barley: Oats and barley are rich sources of beta-glucan, such as soluble fiber, which is especially effective for reducing cholesterol.
- Legumes: Beans, lentils and peas are good sources of soluble fiber.
- Fruits: Apples, pears, citrus fruits and berries contain soluble fiber.
- Vegetables: Carrots, broccoli and Brussels cabbage contain soluble fiber.
Recommendations for use:
It is important to gradually increase the consumption of fiber in order to avoid discomfort in the abdomen and gas formation. It is also necessary to drink enough water so that fiber can work effectively.
Side effects:
An increase in fiber consumption can cause gas formation, bloating and constipation, especially if the increase occurs too quickly.
Interactions:
Fiber can slow down the absorption of some drugs, so it is recommended to take medicines an hour before or two hours after consuming products rich in fiber.
Contraindications:
Fiber does not have known contraindications.
Section 8: Coenzym Q10 (CoQ10) details
Coenzym Q10 (COQ10), also known as Kilikhinon, is a fat -soluble antioxidant that plays an important role in the production of energy in cells. It is necessary for the functioning of mitochondria, “power plants” of cells. COQ10 also protects cells from damage by free radicals.
The mechanism of action:
COQ10 is involved in the process of transferring electrons in mitochondria, which is necessary for the production of adenosine triphosphate (ATP), the main form of energy used by cells.
The role in taking statins:
Statins, drugs for reducing cholesterol, inhibit the HMG-COA enzyme reductase, which is necessary not only for cholesterol synthesis, but also for the synthesis of COQ10. Some studies show that statins can reduce the COQ10 level in the body. It is believed that a decrease in the level of COQ10 can contribute to the development of muscle pain, a side effect, often associated with statins.
Efficiency for reducing muscle pain caused by statins:
Some studies show that the COQ10 reception can help reduce muscle pain caused by statins as an additive. However, the research results are ambiguous, and additional studies are needed to confirm the effectiveness of COQ10 for this purpose.
Side effects:
CoQ10 is usually well tolerated. The most common side effects include:
- Nausea
- Diarrhea
- Abdominal pain
- Headache
Forms COQ10:
COQ10 is available in two forms: Kilikhinon and Kilikhinol. KOLIKHINOL is a restored form of COQ10 and is considered more bio -accessful than Kilikhinon.
Choosing the COQ10 additive:
When choosing a COQ10 additive, it is important to consider the following factors to consider:
- Form: Kilikhinol is considered more bioavailable than Kilikhinon.
- Dosage: The recommended dose of COQ10 varies depending on the purpose of the reception. To reduce muscle pain caused by statins, a dose of 100-200 mg per day is usually recommended.
- Quality: Choose additives from reliable manufacturers that test products for cleanliness and potency.
Interactions:
COQ10 can interact with some drugs, including:
- Anticoagulants: COQ10 can reduce the effectiveness of anticoagulants such as warfarin.
Contraindications:
COQ10 does not have known contraindications.
Section 9: Garlic in detail
Garlic (Allium sativum) is a widely used culinary seasoning and a medicinal plant that has been used for centuries in traditional medicine to treat various diseases.
The mechanism of action:
It is believed that garlic has a cholesteroling effect due to the content of allicine, the main biologically active compound formed during grinding or cutting garlic. Allicine, in turn, breaks up into other sulfur -containing compounds that can affect lipid metabolism.
Efficiency:
Some studies show that garlic can reduce cholesterol and blood pressure. However, the research results are ambiguous, and additional studies are needed to confirm the effectiveness of garlic for these purposes. The meta analysis of several studies showed that garlic can reduce the level of total cholesterol and LDL by a small value.
Forms of garlic:
Garlic is available in various forms, including:
- Fresh garlic
- Dried garlic
- Garlic powder
- Garlic extract
- Garlic oil
- Destroyed garlic extract
Side effects:
Garlic is usually well tolerated. The most common side effects include:
- Unpleasant odor
- The unpleasant smell of the body
- Heartburn
- Gas formation
- Diarrhea
Interactions:
Garlic can interact with some drugs, including:
- Anticoagulants: garlic can enhance the effect of anticoagulants, increasing the risk of bleeding.
Contraindications:
Garlic is contraindicated in:
- Garlic allergies
- Blood coagulation disorders
- Before the operation (you should stop taking garlic a few days before the operation)
Section 10: Arginine in detail
Arginine is a half -replaced amino acid that plays an important role in various physiological processes, including protein synthesis, immune function, wound healing and regulation of blood pressure.
The mechanism of action:
Arginine is the predecessor of nitrogen oxide (No), which is a powerful vasodilator that expands blood vessels and improves blood flow. No also plays a role in the regulation of cholesterol levels and preventing the formation of plaques in the arteries.
Efficiency:
Some studies show that Arginine can have a positive effect on cholesterol, but additional studies are needed to confirm these results. Some studies have shown that Arginine can reduce LDL levels and increase the level of HDLs, as well as improve the function of the endothelium.
Arginine sources:
Arginine is contained in various foods, including:
- Meat
- Bird
- Fish
- Dairy products
- Nuts and seeds
- Legumes
Side effects:
Arginine is usually well tolerated. The most common side effects include:
- Nausea
- Diarrhea
- Abdominal pain
- Bloating
Interactions:
Arginine can interact with some drugs, including:
- Antihypertensive drugs: Arginine can enhance the effect of antihypertensive drugs, which can lead to a decrease in blood pressure.
- Nitrates: Arginine can enhance the effect of nitrates, which can lead to a decrease in blood pressure.
Contraindications:
Arginine contraindicated in:
- Herpes (Arginine can contribute to the relapse of herpes)
- Recent myocardial infarction
Section 11: Vitamin C and vitamin E detail
Vitamin C (ascorbic acid) and vitamin E (tocopherol) are powerful antioxidants that protect the cells from damage to free radicals.
The mechanism of action:
Free radicals are unstable molecules