We use a lot of niacin in the Track Your Plaque program.
Niacin:
--Increases HDL and shifts HDL towards the large, protective fraction
--Reduces small LDL --In fact, niacin is the best treatment we have to reduce small LDL after wheat elimination and carbohydrate reduction.
--Reduces fasting and postprandial (after-eating) triglycerides
--Reduces heart attack risk by 20-28%--even as a sole agent.
But . . . niacin also triggers higher blood sugar because it partially blocks the effects of insulin (insulin "resistance").
While the net effect of niacin remains positive, the provocation of insulin resistance is not such a good thing. Can it be minimized or eliminated?
Yes, through exercise. Here's one interesting observation in obese (BMI 34.0), sedentary men given placebo, exercise, niacin (1500 mg Niaspan, once per day), or niacin + exercise:
From Plaisance et al 2008.
Blood was drawn following a high-fat meal challenge. (Yes, a high-fat challenge, not a carbohydrate challenge. In this study, there were only 17 grams carbohydrates in the test meal, but 100 grams fat. More on this in future.) Exercise consisted of walking for 50 minutes at a moderate pace one hour prior to the meal challenge.
You can see from the graph that exercise partially corrected the increased insulin level provoked by niacin.
Judging from this and other studies, exercise can help minimize the insulin-blocking effects of niacin. It doesn't take much, just moderate exercise for at least 30 minutes.
Adequate sleep can also help, since sleep deprivation is a potent trigger for insulin resistance, only worsened in the presence of niacin. Vitamin D supplementation to achieve desirable blood levels (which I define as 60-70 ng/ml) is also an effective means to minimize this effect.