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A vitamin used to lower cholesterol may have the paradoxical side effect of increasing heart disease risk, a study has found.
Niacin, also known as vitamin B3, is essential for various bodily functions and is sometimes added to fortified foods.
However, researchers at the Cleveland Clinic have now found that surplus niacin increases the circulation of a byproduct called 4PY.
High circulating levels of 4PY have been linked to heart attacks, strokes, and other adverse cardiovascular events in large-scale clinical studies.
Researchers also showed that it directly causes inflammation in blood vessels.
Niacin used to be prescribed to increase HDL cholesterol – the “good” cholesterol that helps remove LDL, the “bad” cholesterol, from the bloodstream.
However, ultimately, niacin was shown to be less effective than other cholesterol-lowering drugs.
Dr. Stanley Hazen, who led the research, says: “For decades, the United States and more than 50 countries have mandated niacin fortification in staple foods such as flour, grains and oats to prevent nutritional deficiency-related diseases. Have given.
“Given these findings, it can be discussed whether the mandate to fortify flour and grains with niacin can be continued in the US.”
Meanwhile, over-the-counter supplements made from forms of niacin claim to improve aging, blood fats, skin health, brain function and more.
These can be purchased online and from health food stores for as little as 3p per tablet.
The study, published in Nature Medicine, found that one in four of the researchers' patients had high levels of 4PY, suggesting they had consumed too much niacin.
Dr. Hazen says: “The effects of niacin have always been somewhat contradictory.
“Despite niacin's reduction in cholesterol, the clinical benefits based on the degree of LDL reduction have always been less than anticipated.
“This led to the idea that excess niacin produces unexplained adverse effects that partially offset the LDL-lowering benefits.
“We believe our findings help explain this paradox. It shows why it is so important to investigate residual cardiovascular risk; we learn much more than we set out to find.”
The NHS says most people get enough niacin in their daily diet from good sources including meat, fish, eggs and wheat flour.
There are two forms of niacin: nicotinic acid and nicotinamide.
The NHS says: “Taking high doses of nicotinic acid supplements can cause reddening of the skin. Taking high doses for a long time can cause liver damage.”
“There is not enough evidence to know what effects taking high daily doses of nicotinamide supplements may have.”
It therefore recommends limiting the dose to 17 mg nicotinic acid or 500 mg nicotinamide per day.
how to reduce cholesterol
There are many ways to lower your cholesterol.
High levels of cholesterol can deposit in artery walls and reduce blood flow to the heart.
This increases the risk of blood clots forming around the body and coronary heart disease.
According to the NHS website, high levels can be caused by:
- Narrowing of the arteries (atherosclerosis)
- heart attack
- the strokes
- Transient ischemic attack (TIA) – often referred to as a “mini stroke”
- Peripheral Arterial Disease (PAD)
High cholesterol is mainly caused by eating fatty foods, not getting enough exercise, being overweight, smoking and drinking alcohol. So, to lower your cholesterol:
- Maintain a healthy diet that is low in fatty foods. Reduce your intake of meat pies, sausages, butter, ghee, cream, hard cheeses, cakes and biscuits and foods containing coconut oil. Instead, eat more oily fish, brown rice, nuts and seeds. Also increase the intake of fruits and vegetables.
- give up smoking. You can get help from your GP or the NHS Stop Smoking Service.
- Do regular exercise. Aim to get at least 150 minutes of exercise per week by walking, swimming or cycling. It is also recommended to do strength training twice per week.
- Reduce alcohol consumption. Guidelines say alcohol should be limited to 14 units per week. If you are having difficulty reducing your alcohol intake, ask your doctor for help.
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