Statins are widely prescribed to reduce levels of LDL, the “bad cholesterol,” a vital goal in stemming and preventing cardiovascular disease. But they don’t work for everybody, often for inexplicable reasons. Researchers now think some of the blame rests with gut bacteria, that influential yet mysterious group that occupies our bowels and outnumbers our cells 10 to one. In a study published this month in PLoS One, researchers took blood samples from 944 study participants prior to and after six weeks of treatment with a statin called simvastatin. They measured the levels of various bile acids, many of which are produced by gut bacteria and help metabolize fat by acting like detergents, allowing cholesterol to be dissolved and transported in the blood. The researchers found that people whose LDL levels dropped the most had significant quantities of three bile acids produced by a particular type of gut bacteria. Those who responded least to the statins had significantly higher levels of five different bile acids from different gut flora. The researchers hypothesize that bile acids present in the non-responders compete with simvastatin for transporters that ferry both chemicals to the liver, where the drug has its effect.
Researchers recently went to an Amish community in Pennsylvania with an odd request: Will you drink milkshakes for the sake of science? In a study about cardiovascular health and genetics that had more than 800 Amish people slurping high-fat shakes, researchers discovered that about five percent of their subjects had a genetic mutation that defends the heart against the effects of a high-fat diet—specifically, breaking down triglycerides, those fats that clog arteries like hair in your bathroom drain [Newsweek].
In the study, published in Science [subscription required], Amish men and women agreed to drink a rich milkshake that was made mostly of heavy cream. Over the next six hours, a group of investigators took samples of their blood, determining how much fat was churning through their bloodstreams. Most of the study participants responded as expected — their levels of triglycerides, a common form of fat in the blood, rose steadily for three to four hours and then declined. But about 5 percent had an extraordinary reaction: their triglyceride levels started out low and hardly budged [The New York Times].
In yet another warning signal of the toll that childhood obesity will take on health and health care budgets, a small study has shown that overweight kids as young as 10 years old have the thickened arteries of 45-year-olds. Researchers say the findings raise the possibility that these kids could develop serious heart disease in their 20s or 30s. “There’s a saying that ‘you’re as old as your arteries,’ meaning that the state of your arteries is more important than your actual age in the evolution of heart disease and stroke,” said [lead researcher] Dr Geetha Raghuveer [Telegraph].
The findings, while preliminary, should serve as a serious alarm bell in the United States, where about one-third of children are overweight and almost one-fifth are obese. Many parents think that “baby fat” will melt away as kids get older. But research increasingly shows that fat kids become fat adults, with higher risks for many health problems. “Obesity is not benign in children and adolescents,” said Dr. Robert Eckel, a former heart association president [AP].
The cholesterol-lowering drugs known as statins are already one of the most commonly prescribed medications, taken by 15 million Americans in an attempt to ward off heart disease. Now, a new study suggests that the drugs may also reduce the risk of Alzheimer’s and dementia by 50 percent.
While the provocative finding offers hope that the cholesterol-reducing drugs might help against Alzheimer’s disease and other forms of dementia, scientists say this study is unlikely to be the last word on the topic. Indeed, it may just fuel an already lively debate over statins’ potential effect on dementia. Some research has hinted at benefits, while other studies, particularly in people with clear signs of Alzheimer’s disease, show no effect from the drugs [Science News].
California is striking a blow against obesity and heart disease: On Friday, Governor Arnold Schwarzenegger signed a bill outlawing the use of trans fats in all restaurants and bakeries. The bill creates the first state-wide ban of trans fats, but follows the path set out by cities like New York City and Philadelphia, which have already evicted the substance from restaurants within city limits.
Trans fats are created by pumping hydrogen into liquid oil at high temperature, a process called partial hydrogenation. The process results in an inexpensive fat that prolongs the shelf life and appearance of packaged foods and that, many fast-food restaurants say, helps make cooked food crisp and flavorful [The New York Times]. The artificial fats have been shown to increase levels of “bad” cholesterol and decrease levels of “good” cholesterol, and are therefore linked to heart disease.
The day after the American Academy of Pediatrics recommended prescribing cholesterol-lowering drugs to some 8-year-olds, howls of protest arose from many doctors and parents. While the academy maintains that prescription drugs could help cope with the rising tide of childhood obesity and could prevent children from developing heart disease later in life, many observers say the guidelines send the wrong messages to families.
Some doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines. “To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen [The New York Times]. Childhood obesity expert David Ludwig adds: “My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective” [The New York Times].
The American Academy of Pediatrics has issued new guidelines that call for testing at-risk children’s cholesterol levels from the age of 2, and advise giving some children cholesterol-lowering drugs from the age of 8 in hopes of preventing heart disease later in life. Writing in the journal Pediatrics, doctors say that the recommendations have taken on “a new urgency, given the current epidemic of childhood obesity.”
The new guidelines are likely to stir the controversy over prescribing long-term medications to children, especially for treating symptoms related to obesity, which can also be treated with diet and exercise. But proponents say there is growing evidence that the first signs of heart disease show up in childhood, and with 30 percent of the nation’s children overweight or obese, many doctors fear that a rash of early heart attacks and diabetes is on the horizon as these children grow up [The New York Times].
The “good” cholesterol that is found in olive oil and avocados has been portrayed as a good fairy lately based on its association with healthy hearts, but a new study may give people another reason to chow down on guacamole. A broad study of people in their 50s and 60s revealed that low levels of good cholesterol are linked to poor memory, which may be an early indicator of dementia and Alzheimer’s.
The results, reported in a journal [subscription required] published by the American Heart Association, showed that 60-year-olds with low levels of good cholesterol were 53 percent more likely to have memory problems. However, other researchers point out that the study did not prove causation, and said the study did not yet support larger diet trials aiming to boost levels [BBC News].