Beans are heart healthy, but take it easy at first

Question: I keep hearing that beans are good for you. But don't they cause inflammation, and shouldn't you avoid that? — Anonymous

Answer: Beans might cause a little "inflation" in your intestines if you're not used to eating fiber. But inflammation? Quite the opposite, probably because of that very fiber. A high-fiber diet reduces levels of an inflammatory red flag — C-reactive protein, or CRP — in your blood. Elevated CRP may be a risk factor for heart attack and stroke.

It's possible that fiber helps prevent serious damage to the cardiovascular system caused by rogue molecules called free radicals. One study found that eating 30 grams of fiber a day could slash CRP levels by 18 percent.

One cup of black beans brings you more than half that (19.4 g) while delivering just 190 calories. But if you haven't been eating fiber, don't pile on all 30 grams at once, or you'll produce enough gas to clear out any elevator pretty quickly. Start with 1-2 grams, and gradually increase it.

The product Beano also can deflate the chances of gas from beans; soaking dried beans ahead of time is useful as well, and it won't affect the fiber benefits.

Question: My husband's doctor cut back his Lipitor from 80 mg to 40 mg a day. My husband worries about his liver because the doctor doesn't check it very often, but he's afraid to quit taking the drug because he already has had two heart attacks. What should he do? — Effie, Flemingsburg, Ky.

Answer: If your husband already has had two heart attacks, his doctor is obviously trying to prevent a third. But the fact that the doc cut the dosage and isn't ordering liver function tests twice a year suggests it's time for a chat.

Many studies have looked at how well Lipitor — a cholesterol-lowering "statin" drug, available generically as atorvastatin — can prevent heart attacks and strokes, especially after a first one. In general, the highest dose (80 mg) prevents subsequent heart attacks, and at least one multicenter study has found that that dose can halt heart disease in its tracks. However, statins, which stop cholesterol production in the liver, sometimes can have the serious side effects of muscle and liver damage. While these are rare, the higher the dose, the higher the risks. This is one sticky medical conundrum. Do you slash the dose to reduce the threat of side effects and possibly reduce heart attack protection, too, or is the danger of another heart attack high enough to go full speed ahead?