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Omega-3 Fatty Acids (Fish Oil, Flaxseed Oil) for Heart Health continued...

She advises taking 1 to 4 grams of fish oil daily -- containing 240 milligrams of DHA (docosahexaenoic acid) and 360 milligrams of EPA (eicosapentaenoic acid) per gram. However, the prescribed dosage will vary depending on the patient's blood samples. "With very high triglycerides, we might use higher doses," she says. High doses of omega-3 supplements -- over 3 grams daily -- may increase the risk of bleeding and should be done only under a doctor’s care.

If you're taking a statin drug to lower your cholesterol, fish oil provides added heart benefits, Guarneri says. A large Japanese study showed 19% fewer heart-related events (like heart attack) in adults taking a fish oil supplement plus a statin drug, compared with those taking only a statin.

Taking fish oil plus a magnesium supplement is also a good combination -- decreasing blood pressure and preventing heart rhythm problems, Guarneri adds. Look for glycinated magnesium, which is more easily absorbed.

She's not as big on flaxseed oil because results are not so dependable, Guarneri says. "Flaxseed oil has to be converted in the body, and conversion will vary from person to person depending on age and metabolism. But flax is soluble fiber and can lower LDL by 8% to 18% with doses of 40 to 50 grams per day."

Plant Sterols for Heart Health

Plant sterols are derived from plant-based foods and are used to enrich margarines and other foods. Many human and animal studies have found that plant sterol-enriched products lower total cholesterol and LDL cholesterol. Plant sterols do not affect triglycerides or HDL levels, however.

"Plant sterols block cholesterol absorption and lower LDL by 10%, Guarneri says. "They also work synergistically with statins and can be more effective than doubling the statin dose." Taking a statin plus plant sterol supplement can reduce LDL by 20%.

Numerous studies have shown that eating more plant sterol-enriched foods lowers total and LDL cholesterol. In a study of 194 adults with moderately high cholesterol, each consumed 2 servings of low-fat milk that was plant sterol-enriched. By the third week, their LDL cholesterol was reduced by 9.5%; by week six, LDL was 7.8% reduced.  

Although some margarine and other specialized foods are made with plant sterols, Guarneri recommends powdered plant sterols because she says it’s easier to make sure you’re getting the recommended 2 grams per day.

Niacin for Heart Health

Also known as vitamin B-3 or nicotinic acid, niacin is a well-accepted treatment for high cholesterol. "Niacin is one of my favorites," Guarneri says. "It is tried and true in raising HDL and lowering triglycerides." She prescribes from 500 milligrams to 2 grams daily, depending on the patient's blood levels.

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