Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Lipoprotein A, also known as Lp(a), is an independent, genetic, and causal factor for cardiovascular disease and heart attacks. At any level of LDL cholesterol, your risk of heart attacks and strokes is two to three-fold higher when Lp(a)is elevated. With a high enough level, atherosclerosis continues to progress, even if you get your LDL cholesterol way down, which may help explain why so many people continue to have heart attacks and strokes even under treatment for high cholesterol. So, it’s suggested that doctors check lipoprotein A levels in a patient who has suffered such an event if it can’t otherwise be easily explained. What’s the point of checking it, though, if there’s not much we can do about it? To date, no drug to reduce circulating Lp(a) levels has ever been approved for clinical use.
Some researchers blame our lack of knowledge on the fact that Lp(a)is not found in typical lab animals, like rats and mice. It’s only found two places in nature: primates…and hedgehogs. How strange is that? No wonder Lp(a)is an enigmatic protein that has mystiﬁed medical scientists ever since it was first discovered a half century ago. But, who needs mice when you have men? The level in our bloodstream is primarily determined by genetics, and for the longest time, Lp(a)was not thought to be much inﬂuenced by things such as diet. Given its similarity to LDL, though, one might assume a healthy lifestyle would help. However, the evidence has been lacking––but maybe that’s because they have not yet tried a plant-based diet.
We’ve known for years that the trans fats found in meat and dairy are just as bad as the industrially-produced trans fat found in partially-hydrogenated oil junk food when it came to raising LDL cholesterol. When it comes to lipoprotein A, the meat and dairy trans fat appears to be even worse. Just cutting out meat––putting people on a lacto-ovo-vegetarian diet––does not appear to help, but put people on a whole food plant-based diet packed with a dozen servings of fruits and vegetables a day, and within four weeks, Lipoprotein A levels dropped 16%. Of course, in those 30 days, they also lost 15 pounds. But weight loss does not appear to affect Lp(a)levels; so, you figure, it must have been due to the diet.
If you’re already eating a healthy plant-based diet, and your Lp(a)levels are still too high, are there any particular foods that can help? Like for cholesterol, even if the average total cholesterol of those eating strictly plant-based may be right on target at less than 150, with an LDL right on target at under 70, there’s a bell curve, with plus or minus 30 falling immediately on both sides. Enter, the “Portfolio Diet,” which is not just plant-based but adds specific cholesterol-lowing foods if that’s not enough. So, like nuts and beans, oatmeal, and berries to drag cholesterol down even further. What about LP(a)?
Nuts have been put to the test. Two and a half ounces of almonds every day dropped levels, but only about 8%. But that’s better than the other studies on nuts that found no effect at all, no effect at all, and… no effect at all. Ah, nuts.
There is one plant, though, that appears to drop Lp(a)levels 20%, enough to take people exceeding the U.S. cut-off down to a more optimum level. And that plant is a fruit: Emblica officinalis, otherwise known as amla––Indian gooseberries. A randomized, double-blind placebo-controlled study asking smokers before and after about their cough, their shortness of breath, loss of appetite and feelings of impending doom, palpitations, sleep deprivation, irritability, heart burn and tiredness, as well as objective measurements from their blood count, cholesterol, DNA damage, to antioxidant status and lung function, and…the amla extract they used showed a significant improvement compared to placebo in all the parameters tested, with no reports of side effects. That’s unbelievable! No, really, that’s unbelievable. And indeed, it’s completely not true.
Yes, subjective complaints got better in the amla group, but they got better in the placebo group too, with arbitrary scoring systems and no statistical analysis whatsoever. And of the two dozen objective measures, only half could be said to reach any kind of even before-and-after statistical significance, and only three were significant enough to account for the fact that if you measure two dozen things, a few things might pop up as positive, if only by chance. Any time you see this kind of spin in the abstract, which is sometimes the only part of a study people read, you suspect some kind of conflict of interest, but there were no conflicts of interest declared… But that’s bullshit, as the study was funded by the very company selling those amla supplements. *sigh*
Anyways, one of those three significant findings was the LP(a); so, it might be worth a try. I mean, in the context of a plant-based diet, which in addition to the weight loss, can dramatically improve blood pressures even as people cut down on their blood pressure medications, plus a 25-point drop in LDL bad cholesterol, plus a 30% drop in C-reactive protein, and significant reductions in other inflammatory markers for a systemic, cardio-protective effect, all thanks to this single dietary approach.
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