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Roundup: Bad Cholesterol, Low Carb Diets and EpiPens

Otherwise Healthy People with High LDL Cholesterol Vulnerable to Heart Disease

Healthy adults with an overall low risk of cardiovascular disease may still need to keep a close eye on their cholesterol, especially low-density lipoprotein or the “bad” LDL cholesterol, according to new research.

A new study published in the journal Circulation [1] indicates that people with high levels of LDL cholesterol early in life may experience an increased lifetime risk of death related to cardiovascular disease. LDL cholesterol can increase heart disease risk at high levels because it’s a major contributor to lipid buildup in the arteries, which control the blood flow to and from the heart.

Researchers reviewed data on 36,375 patients in the Cooper Center Longitudinal Study [2]. Participants had no history of cardiovascular disease or diabetes and had been given a low 10-year risk of developing cardiovascular disease. The participants were monitored over about 27 years starting in their 30s or 40s. The researchers found that those with LDL levels of 160 or higher had a 70 percent to 90 percent higher risk of dying from cardiovascular disease, compared to participants with LDL below 100.

LDL cholesterol levels ideally should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no other health issues — but may be an issue for those with other heart disease risk factors.

“Our study demonstrates that having a low 10-year estimated cardiovascular disease risk does not eliminate the risk posed by elevated LDL over the course of a lifetime,” says lead study author Shuaib Abdullah, M.D., from the University of Texas Southwestern Medical Center in Dallas.

People with high LDL levels should adopt lifestyle interventions, such as diet and exercise, “to achieve LDLs levels as low as possible, preferably under 100,” Dr. Abdullah advises.

Limiting saturated fat intake in the diet, maintaining a healthy weight, not smoking and increasing aerobic exercise are the lifestyle habits that can help reduce LDL readings and maintain them at healthy levels.

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Animal-Based Low-Carb Diets May Lead to Early Death, Study Claims

People who consume low-carb diets that replace carbohydrates with proteins and fats from plant sources are linked to a lower risk of early death, compared to those that replace carbohydrates with proteins and fats from animal sources, a new study [6] claims.

Researchers analyzed data from more than 15,400 middle-aged U.S. adults who participated in the Atherosclerosis Risk in Communities Study [7]. The data was self-reported, meaning that the information collected is dependent on the subject’s memory. The dietary patterns researchers found were compared against additional studies that included 432,000 people in more than 20 countries.

Diets were measured for consumption of carbohydrates only twice during the 25-year study period, at the start of the study and again six years later.

Researchers concluded that people who ate a moderate amount of carbohydrates lived four years longer than those with low-carbohydrate diets, and one year longer than those who ate high amounts of carbohydrates. Low-carb diets were defined as less than 40 percent of calories from carbohydrates and high-carb diets were more than 70 percent of calories.

“Low-carb diets that replace carbohydrates with protein or fat are gaining widespread popularity as a health and weight loss strategy,” says Sara Seidelmann, M.D., clinical and research fellow in cardiovascular medicine from Brigham and Women’s Hospital, Boston, who led the research. “However, our data suggests that animal-based low carbohydrate diets, which are prevalent in North America and Europe, might be associated with shorter overall life span and should be discouraged.”

Instead, she adds, “exchanging carbohydrates for more plant-based fats and proteins might actually promote healthy aging in the long term.”

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Responding to U.S. Shortage, FDA Extends Expiration Dates of Some EpiPens

There is a shortage of EpiPens in the United States and the U.S. Food and Drug Administration (FDA) is responding by approving the extension of the expiration dates of certain lots of the life-saving allergy drug. The extension is for four months.

The FDA’s action [10] applies to the 0.3 mg dose of EpiPen and its authorized generic version, with current expiration dates between April and December 2018, according to a statement from Pfizer, which manufactures the EpiPen for Mylan. The extension doesn’t apply to EpiPen Jr., which is used for children weighing between 33 pounds and 66 pounds and provides half the dose of epinephrine.

EpiPens usually expire after 20 months, according to the FDA. The agency states that “this change beyond the approved 20-month shelf life is based on stability data provided by Mylan and reviewed by the FDA.” The FDA’s move comes as children across the nation return to school, a time of year during which demand for EpiPens surges.

“The FDA continues to work closely with Mylan on EpiPen production and supply, and also has been in contact with the other manufacturers of epinephrine auto-injectors,” the agency said in a statement.

These products with the now-extended expiration dates, which already have been dispensed to patients, “should have been — and should continue to be — stored as labeled,” the FDA states.

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