Our expert is Richard L. Nemiroff, MD, Clinical Professor of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania.

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Very best,
Mitzi Perdue
Mperdue@liebertpub.com

EFFECTIVE LIPID CONTROL CAN INCREASE BOTH THE QUALITY AND LENGTH OF A WOMAN’S LIFE

Too many women with dyslipidemia are either never discovered or are undertreated. Often they don’t know they have a problem until after they’ve had an event. However, by finding and treating dyslipidemia, we can help prevent the inflammation that plays a role in numerous diseases including: cardiovascular disease; rheumatoid arthritis; osteoarthritis; fibromyalgia; and various GI diseases such as celiac disease or Crohn’s disease. Although this is unproven, better lipid control might also mean reducing the inflammation that could be implicated in some forms of dementia. By adding just a few minor tests (fasting lipid panel and LDL direct) to the usual testing and evaluations performed during well-women visits, we can find dyslipidemia at its earliest stages. When caught early, it can be treated relatively inexpensively and with very little risk.

THE MEDITERREAN DIET CAN HELP PREVENT DYSLIPIDEMIA

Nutrition is particularly important in controlling dyslipidemia. Omega-3 helps prevent or control dyslipidemia, and both freshwater fish and cold-water fish are good and reliable sources of omega-3. However, these fish are also high in calories so be careful not to overdo them. I also particularly recommend the Mediterranean diet which includes a lot of fish, fresh fruits and vegetables, and also olive oil. It’s interesting that when people who grew up consuming a Mediterranean diet move to the United States, and their diets move to a typical American diet, their cardiovascular risks increase along with their chances of being overweight.

For me, diet is so important that in my practice, I’m apt to send two or three patients a day for nutritional counseling.

EXERCISE CAN HAVE BOTH IMMEDIATE AND LONG TERM BENEFITS

Along with a good diet, exercise is crucial for slowing, preventing, or reversing dyslipidemia. If a patient can get her heart rate up to 90 beats per minute even for 10 or 15 minutes a day several times a week, almost right away she’ll be changing her serum level of triglycerides. She’ll decrease inflammation and she’ll be creating a less pervasive atherosclerotic environment. By the end of six months she’ll be looking at pretty good cardio vascular health.

AN INDOOR BICYCLE IS OFTEN A GOOD CHOICE FOR EXCERCISING

An individual who needs to exercise doesn’t necessarily need to join a gym. Rapid walking outside is good, but since she’s unlikely to want to go outdoors when it’s extremely hot or extremely cold or when it’s raining, having a stationery bicycle available can make consistent exercise more likely. In the case of an obese person, a stationery bicycle as opposed to a treadmill is preferable; the patient is less likely to get light-headed or fall from a stationary bicycle. If she’s not used to exercise, she could start at just 10 minutes a day, and then, over time when she’s able to do that much, have her keep increasing the number of minutes she exercises. A reasonable goal is 20 minutes of exercise four days a week.

OMEGA-3 CAN BE USEFUL FOR LOWERING INFLAMMATORY RESPONSES

While diet and exercise are both crucially important for preventing or improving dyslipidemia, omega-3 supplementation is a highly effective way to lower inflammatory responses throughout the body. However, I don’t recommend over-the-counter omega-3 supplements. I’ve tested almost all of them, and I view many of them as being marginal at best. In some cases the ingredients are inert, in other cases quality control is lacking, and in still others, once the seal on the bottle is broken, the contents are unstable and start deteriorating. For patients who need it, I recommend pure eicosapentaenoic acid (EPA), two 2-gram capsules a day.