Steak not Statins
1/25/07
On the demise of a new superdrug that was meant to raise HDL, the New York Times was blunt: Wall Street and Big Pharma stocks may have winced, but 'An effective HDL booster already exists. It is niacin, the ordinary B vitamin.'
Niacin, or vitamin B3, raises HDL, reduces LDL (that's what the super-drugs, statins, do - but at some risk), and reduces triglycerides. Like all the B vitamins, B3 is water-soluble, which means it cannot be stored in the body; it's flushed out when you pee. That means you need to consume B vitamins every day. That's easy: you can get niacin from milk, cheese, meat, fish, and eggs. Legumes and enriched breads and cereals also contain some.
As the excitement (and disappointment) over the potential HDL-booster indicates, it's now clear, after much misinformation over 30 years, that HDL should be high. On the virtues of HDL, the National Cholesterol Education Program is clear: the 'higher the better.'
Thus an HDL-booster is what Big Pharma hopes will be the next super-cardio drug, to go with the hugely profitable class of statin drugs, which stop your liver from making LDL.
LDL, of course, is the lipoprotein that carries cholesterol from the liver, where it's made, to body tissues like arteries. It is considered by the conventional cardiology wisdom to be 'bad.'  This is an unfortunate oversimplification of the role of cholesterol in the healthy body.  For example, a 2005 study (cited in Real Food) found that in older people, 'high' LDL means a longer life. LDL, I was amazed to learn (in a college nutrition text book, not a Big Pharma pamphlet) is a repair molecule. LDL doesn't damage your arteries - it rushes to repair already damaged arteries.
(And what damages arteries? Homocysteine, a protein that attacks arteries when your diet is deficient in B vitamins. For a lucid and simple account of this proven theory, see The Heart Revolution by Dr. Kilmer McCully.)
Don't wait for the next drug. You don't need to pay Big Pharma to raise your HDL. Exercise, weight loss, fish oil, red wine, and natural saturated fats such as butter and coconut oil - yes, butter and coconut oil - raise HDL. Have a steak, with a pat of butter if it's grass-fed and thus lean - and take your medicine that way.
By the way, what happened to the new drug meant to raise HDL? In trials, it increased heart problems and death rates. Happily, the system worked and this drug won't be sold. But it does make you wish the FDA had more money to oversee large, independent drug trials - and that medical journalists were more aggressive about how they report on fluffy pharma PR.