One Day MD | Evidence-Based Wellness

A comprehensive analysis merging clinical trials on high-dose fermented soy enzyme therapy, statin head-to-head comparisons, and plaque regression mechanisms. Atherosclerosis remains the leading cause of cardiovascular events worldwide. While statins focus primarily on lowering low-density lipoprotein (LDL) cholesterol, groundbreaking clinical research reveals that nattokinase —a fibrinolytic enzyme derived from traditional Japanese nattō —acts directly on the structural matrix of established arterial plaque. Credit: Oasis Medical Institute 1. The Head-to-Head Clinical Trial (Ren et al., 2017) In a 26-week randomized controlled study, 82 patients with carotid atherosclerosis received either Nattokinase (6,000 FU/day) or Simvastatin (20 mg/day). Key outcomes included: Carotid Plaque Reduction: Nattokinase achieved a 36.6% reduction in plaque area vs. 11.5% in the statin group. HDL Elevation: Nattokinase significantly increased benefici...

By Dr. Frank Yap, MD | Medically reviewed by the One Day MD Editorial Team | Originally published January 26, 2026 | Fully updated September 2026 for the new 2026 ACC/AHA dyslipidemia guideline Quick Answer Saturated fat's relationship to heart disease is more nuanced than decades of "avoid it" messaging suggested — large meta-analyses of cohort studies have found no consistent independent link between total saturated fat intake and cardiovascular mortality, but randomized trials show that replacing it with polyunsaturated fat (not refined carbohydrates) does lower cardiovascular events. Industrial trans fat remains unambiguously harmful, with no safe level of intake. The newly released 2026 ACC/AHA dyslipidemia guideline (published in Circulation , March 2026) restored specific numeric LDL-C targets (roughly <100 / <70 / <55 mg/dL depending on your risk category), added universal one-time Lp(a) screening, and — notably — downgraded routine LDL particle...

Why does LDL cholesterol sometimes rise dramatically on a ketogenic diet while triglycerides fall and HDL cholesterol rises? This is one of the most intriguing and controversial lipid responses associated with very-low-carbohydrate diets. For many people, a ketogenic diet produces a relatively modest change in LDL cholesterol. But a subset—particularly some lean individuals—can experience a much larger increase, occasionally reaching LDL-C levels above 300, 400, or even 500 mg/dL. At the same time, triglycerides may fall dramatically and HDL-C may rise. LDL-C ↑↑↑ Triglycerides ↓↓↓ HDL-C ↑ This combination is commonly referred to in the research literature as the Lean Mass Hyper-Responder (LMHR) phenotype. The phenomenon is important because it challenges the assumption that LDL and triglycerides must always move together. It also raises a difficult clinical question: what does dramatically elevated LDL mean when the individual otherwise appears metabolically healthy?...