Heart disease is the No. 1 killer of Americans. However, having high cholesterol levels doesn’t always lead to heart disease, a South Florida cardiac specialist has discovered.
Dr. Jonathan Fialkow , deputy director of clinical cardiology at Baptist Health Miami Cardiac & Vascular Institute, said a study of 80 people on the low-carbohydrate ketogenic (KETO) diet for nearly five years found that high levels of low-density lipoprotein cholesterol, LDL-C (often referred to as bad cholesterol), didn’t always lead to coronary plaque buildup or heart disease.
“This is because they (participants on the KETO diet) are metabolically healthy,” Fialkow said. “This shows that high LDLs might not be the risk for heart disease we thought it would be.”
This study, published in the American College of Cardiology Journal , compared 80 people with an average age of 55 on low-carb/ high-protein and fat diets with 80 people enrolled in a Miami heart study and not on a special diet.
“They had the same level of disease risk,” Fialkow said. “The study found no increased progression in either group.”
Researchers concluded there was no association between cholesterol levels and plaque burden in either group. So, as long as people do not consume lots of sugar and carbohydrates, they may not be at risk for heart disease, even if they have high cholesterol.
The results could influence how doctors approach cholesterol management in patients, Fiaklow said. Doctors should not ignore high levels of LDL (bad cholesterol) when treating patients, but they now know other factors should be considered before prescribing medications. “Patient risk assessment should be personalized and precise,” Fialkow said. “The pushback comes from generations who believe fat is bad and cholesterol is bad, but that is not substantiated by evidence,” he said. “The results challenge the conventional wisdom of these markers being predictors of heart disease.”
Researchers note that lipid-lowering medications, including statins, have been effective in reducing heart attacks in high-risk populations. However, they highlighted that most of the clinical trials involving treatments included patients mostly considered “metabolically unhealthy.”
Fialkow said he had a significant role in the Miami heart study and supplied the data to UCLA researchers who conducted the KETO study. “I keep the data clean and partner with academics,” he said.
As a South Florida cardiac specialist, Fialkow said anyone with high cholesterol or a genetic predisposition to heart disease should work with a doctor “early in the trajectory of a chronic disease” to develop a personalized approach to prevention.
A flu shot you can give yourself
If you want a flu vaccine, you will soon be able to get one without going to a health provider. The FDA has just approved FluMist to be self-administered or caregiver-administered by anyone 18 or older. FluMist, the first at-home flu vaccine, is the same nasal spray vaccine you previously could receive only from a health provider.
The Food and Drug Administration initially approved FluMist in 2003 for use in individuals 5 through 49 years of age, and in 2007 for children 2 through 5.
FluMist’s most commonly reported side effects are fever over 100°F in children 2 through 6 years of age, runny nose and nasal congestion in individuals 2 through 49 years of age, and a sore throat in adults 18 through 49 years of age.
Anyone interested in self-administering FluMist still will need a prescription. However, the vaccine manufacturer plans to make FluMist available through a third-party online pharmacy. You will need to complete a screening and eligibility assessment. The pharmacy will write the prescription and ship the vaccine to the address provided. The FDA said a caregiver should administer FluMist to individuals 2 through 17.
FluMist’s manufacturer anticipates home delivery will be available for the 2025–2026 flu season.
Miami student is the new face of Macy’s youth mental health campaign
Adison Schwartz, a University of Miami freshman, has been tapped by Macy’s to be the face of its national campaign to raise funds and bring attention to youth mental health.
Schwartz, 18, gained the attention of Macy’s as the founder of You Are Enough, a nonprofit organization that works to eliminate mental health stigma and remind young people they do not have to face challenges alone. You Are Enough’s key initiative is the creation of wellness centers in schools staffed by trauma interventionists. Schwartz said she started her organization as a coping mechanism for her anxiety. Her organization aims to create safe spaces within all schools where students can relax, recharge, and reset without fear of stigma. “Everyone deserves to get the support they need to thrive.”
Schwartz is on the youth advisory board of The Jed Foundation and spoke at its annual fundraising gala in Delray Beach. This is Macy’s third year teaming up with The Jed Foundation (JED) and the National Alliance on Mental Illness (NAMI) for its youth mental health campaign. Over the past two years, Macy’s has raised more than $3.3 million for JED and NAMI in support of this cause.
“My connection to this is through my family,” Schwarz told the South Florida Sun Sentinel. “My grandma died by suicide. I founded my organization in her honor.”
Schwartz has appeared in social media posts and participated in a video to raise awareness for seeking mental health support. “When more people talk about mental health, the less of a stigma there will be,” she said.
Delray Beach study looks at Vitamin B1 for Alzheimer’s prevention
The Delray Beach and Stuart locations of Brain Matters Research have launched an Alzheimer’s disease clinical study for participants who have mild cognitive impairment or early Alzheimer’s disease. The BenfoTeam study is funded by the National Institutes of Health’s National Institute on Aging and is enrolling participants at 50 sites in the U.S.
For this phase 2 study, researchers will examine the effects of benfotiamine, a synthetic version of thiamine or vitamin B1, on cognitive function and potential improvement in daily routine activities.
“In the U.S., nearly seven million people are living with Alzheimer’s disease, and it is the fifth leading cause of death in people over 65,” said Dr. Paayal Patel, neurologist and principal investigator at Brain Matters Research. “We are urgently in need of new treatment options for people living with this devastating disease. We know that the brain needs thiamine and that people with Alzheimer’s disease have a thiamine deficiency in the brain.”
Patel said benfotiamine is readily accessible, scientifically compelling, and cost-effective. “That’s a trifecta for a potential Alzheimer’s disease therapy,” he said.
To enroll, participants must be between ages 50 and 89 and have mild memory problems or mild dementia due to Alzheimer’s disease. For more information about participating in the study at Brain Matters Research, call 561-374-8461 (Delray Beach location) or 772-223-7880 (Stuart location) or visit benfoteam.org .
Holy Cross Health now offers a new treatment for atrial fibrillation
Earlier this month, the cardiology team at Holy Cross Health in Fort Lauderdale performed its first procedure with the newly approved FARAPULSE Pulsed Field Ablation (PFA) System to treat a patient with atrial fibrillation, the most common type of heart arrhythmia. An estimated 38 million people globally have atrial fibrillation.
“Instead of using cold or heat energy, the FARAPULSE PFA System uses short bursts of high energy targeting the heart tissue, which will lead to a normal rhythm,” said Adrienne Wolfson, executive director of nursing administration at Holy Cross Health. “It’s safer and faster than conventional ablations.”
In a 12-month randomized clinical trial, researchers found the FARAPULSE PFA System to be as safe and effective as conventional thermal ablation. It also had benefits. For example, the procedure could be performed quicker, the risks associated with thermal ablation were minimized, and physicians’ learning curves for operating the equipment were shorter.
“This new technology gives us the ability to increase our procedure volume in a safer, more efficient way,” said Dani Echarte, nurse manager of the Holy Cross Health Heart and Vascular Program. “We are excited to be able to accommodate our patients and the community by using PFA, which is currently only offered in selective hospital systems.”
How to save money on prescription drugs
Last month, the South Florida Sun Sentinel asked readers for their methods for saving money on prescription medications. Consumers, doctors, and pharmacists contributed tips for lowering costs as drug prices soar. An article with the results included ideas such as shopping around, using coupons and turning to online pharmacies.
South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com .
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