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Lipids: Sometimes Ignored as Player in Cardiovascular Disease
Advanced lipid testing can be useful in predicting cardiac risk, but tests are often underutilized.
The medical world is eagerly awaiting the likely approval this summer of two new cholesterol-lowering drugs, known as PCSK9 inhibitors. But at a cost of $7,000 to $12,000 a year, they won't be for everyone.
Lipid management is a complex issue. Peter Jones, MD, a Houston, TX, internist who specializes in lipidology, offers advice to primary care physicians trying to sort out competing treatment guidelines.
Dietary trans fatty acids have had their heyday and are fading from the American food landscape. Once ubiquitous in margarine, snack food, packaged baked goods, and fried fast food, they have been associated with adverse effects on lipid profiles, metabolic function, insulin resistance, inflammation, and cardiac and general health.
In previous studies, regular breakfast consumption has been correlated with lower BMI and improved cardiometabolic risk profile. Furthermore, evidence suggests that low-energy density, high-fiber, and high-carbohydrate foods may be more satiating when compared to their alternatives.
Epidemiological studies have provided conflicting evidence regarding the impact of dietary cholesterol and egg consumption on heart disease risk in patients with type 2 diabetes mellitus (T2DM). Also controversial is the idea that dietary cholesterol may contribute to the very development of T2DM by altering glucose metabolism. Given the significant influence of diet on diabetes management, the lack of conclusive evidence on this subject emphasizes the need for further study.
The Paleolithic (grain-free) diet is gathering steam among dieters and health conscious individuals alike. Proponents consume only items that, hypothetically, cavemen would have had access to. They claim that modern man can't metabolize comparatively new types of food, and our reliance on processed foods has increased rates of obesity, heart disease, and diabetes.

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