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Холестеролът – факти и начини за справяне с проблема Какво е холестеролът?Повечето от нас мислят, че холестеролът идва от мазните храни, но преобладаващото количество от това лепкаво вещество се произвежда в тялото ни. Черният дроб синтезира 75% от холестерола в кръвта. Останалите 25% са от храната. В нормални пропорции холестеролът е полезен и играе важна роля в метаболизма на клетките. За жалост, у все повече хора нивата на холестерол далеч превишават нормата, а това е свързано с увеличен риск от инфаркт, инсулт и всичките им последствия. „Лошият“ холестеролПовечето холестерол в кръвта се пренася от белтъци, наречени липопротеини с ниска плътност или LDL. Това е така нареченият „лош“ холестерол, който се свързва с едни други вещества и запушва артериите. Приемът на големи количества наситени мазнини, като лой, мас и масло, както и трансмазнини обикновено увеличава нивата на LDL холестерола. За повечето хора нива под 3 mmol/L се считат за нормални, но хора със сърдечни заболявания или с висок наследствен риск, трябва да се целят и по-надолу (под 2,5 mmol/L). „Добрият“ холестеролДо една трета от холестерола в кръвта се пренася от липопротеини с висока плътност или HDL. Наричат го „добър“ холестерол, тъй като премахва отлаганията от „лош“ холестерол и предотвратява натрупването му в кръвоносните съдове. Колкото повече е HDL холестерола, толкова по-добре. Хората с недостиг на „добър“ холестерол са по-предразположени към сърдечносъдови заболявания. Консумацията на здравословни мазнини като зехтин и рибено масло може да увеличи нивата на HDL холестерола в кръвта. ТриглицеридитеОрганизмът превръща излишните калории от захар и алкохол в триглицериди – вид мазнини, които циркулират с кръвта и се отлагат в мастни клетки, разположени на различни места из тялото. Хората с наднормено тегло и застоял начин на живот, пушачите, любителите на алкохола и тестените храни имат повече триглицериди от останалите. Нива на триглицериди над 2 mmol/L и нагоре, предразполага към развитие на метаболитен синдром, който е пряк предвестник на диабета и сърдечносъдовите заболявания. Общият холестеролСборът от LDL, HDL и VLDL (липопротеините с много ниска плътност) се нарича общ холестерол. VLDL е предшественик на „лошия“ холестерол LDL. Като цяло, общ холестерол, който не надвишава 5,2 mmol/L, се счита за нормален, според Европейската асоциация по атеросклероза. Хората с по-високи стойности са по-застрашени от сърдечносъдови усложнения. Съотношението между „добрия“ и „лошия“ холестеролТо се изчислява, като се раздели общия холестерол на HDL холестерола. Например, 5,5 mmol/L общ холестерол, разделени на 2,0 mmol/L HDL холестерол дава съотношение 2,75 към 1. Това е добре, тъй като препоръчителното съотношение е от 4 към 1 надолу. Колкото е по-ниско, толкова по-добре. Показателят дава представа за сърдечносъдовия риск, но няма особена стойност при избора на лечение. То се определя въз основа на стойностите на HDL, LDL и общия холестерол. Признаци за увеличен холестеролУвеличаването на холестерола е безсимптомно, но пораженията, които нанася, са реални. Тъй наречените ксантоми – мастни образувания във вид на бледо жълти подутини по кожата, са единствената външна проява на излишния холестерол, но те се срещат относително рядко. Основната и далеч по-опасна подривна дейност на холестерола се върши скрито – във вътрешността на артериите ни. Натрупаните там мастни отлагания са причина за тежки сърдечносъдови инциденти и усложнения. Колкото до ксантомите, те обикновено намаляват при нормализиране на холестерола в организма ни. Холестеролът и наследствените факториХолестеролът попада в кръвта по два начина – да бъде произведен от организма и да се внесе чрез храната. И двата източника могат да причинят неестествено повишени стойности. Някои хора са генетично предразположени да произвеждат повече холестерол. Това е много лош късмет, тъй като се налага цял живот да внимават какво ядат и да приемат лекарства. Късметлиите са унаследили способността да оползотворяват по-пълноценно холестерола, внесен с храненето и не се налага да внимават чак толкова. При повечето хора, които имат увеличени нива на холестерол, това се дължи не само на неправилно хранене, а и на наследственост. Освен приема на храни с мазнини, допълнителни фактори, които допринасят за високи нива на холестерола са наднорменото тегло и напредването на възрастта. Влиянието на полаДо настъпването на менопаузата жените обикновено имат по-нисък общ холестерол от мъжете на същата възраст. Хормонът, който предпазва и подмладява жените се нарича естроген. Той намалява „лошия“ холестерол и увеличава „добрия“. За жалост, естрогенът не е в състояние да компенсира вредите от неправилното хранене и нездравословния начин на живот, а пък след менопаузата неговото количество намалява и рисковете от сърдечно – съдови заболявания при мъжете и жените се изравняват. Холестеролът в детска възрастИма научни данни, които показват, че холестеролът започва да запушва артериите съвсем отрано, въпреки че последиците се проявяват известно закъснение. Препоръчително е децата също да се изследват за търсене на наднормен холестерол и при необходимост да се пристъпи към диетичен режим, промени в начина на живот и евентуално лечение. Холестеролът и еректилната дисфункцияВисокият холестерол води до нарушаване на кръвоснабдяването в тазовата област както на жените, така и на мъжете. Кръвният ток е затруднен по целия път от сърцето до половите органи и еректилната дисфункция обикновено е ранен предупредителен симптом за сърдечносъдово заболяване. Поддържането на нормални холестеролови нива помага за възстановяването на еректилната функция и се постига чрез здравословен живот с повече движение, подходяща храна и поддържане на теглото в нормални граници. Изследване за висок холестеролНикой – дори и стройните и подвижни хора – не е застрахован от висок холестерол, тъй като последната и решаваща дума имат наследствените фактори. Поддържането на нормални холестеролови нива е полезно не само за сърцето, но и за мозъка ни. Високият холестерол е причина както за масивни, така и за микроинсулти, които в повечето случаи остават незабелязани. За жалост, тези макар и малки съдови инциденти влошават паметта и ограничават нашите умствени възможности. Ето защо е важно да следим нивото на холестерола в кръвта и, започвайки от 20-годишна възраст редовно да се изследваме. В случай, че в семейството има сърдечно болни и съществува наследствен риск, вниманието трябва да е допълнително повишено. Изследването става посредством кръвен тест, известен като „липиден профил“. С него се определят нивата на различните видове холестерол и триглицериди в кръвта. Препоръката е кръвта да се вземе след изтичане на 9 - 12 часа от последното хранене. Приемът на алкохол през последните 48 часа може да повлияе стойностите в липидния профил. Някои специалисти препоръчват поне два дни пълно въздържание преди изследването. Обаче, ако 48 часовата алкохолна пауза преди изследването е в състояние да ви откаже извършването на профилактични тестове, по-добре не се измъчвайте и си пийте. Така поне ще видите каква е реалната ситуация с липидния профил. Как да се справим с холестерола?Здравословното хранене е основно средство за намаляване на холестерола. Това е първият начин. Лекарствата са все повече, все по-ефикасни, но идват на следващ етап, когато ефектът от промяната в начина на живот и хранене не е достатъчен. Зърнените храни, рекламирани като здравословни, дължат това си свойство на растителните влакнини (фибри). Разтворимите влакнини, съдържащи се в много храни намаляват нивата на LDL, „лошия“ холестерол. Добри източници на растителни влакнини са пълнозърнестите храни и пълнозърнестите тестени продукти, овесените ядки, пресните и сушени плодове и зеленчуците, например боба. Диетичните фибри могат да извлекат от храносмилателната система голяма част от приетия холестерол, но не е ли по-добре да не внасяме нещо излишно, което да се чудим как да изнесем след това. Богатите на холестерол храни като яйца, раци и скариди вече не са изцяло забранени. Те съдържат и полезни вещества, които помагат за това холестеролът да не се отлага по съдовете. Изследванията показват, че при повечето хора приемът на холестерол с храната влияе съвсем слабо на холестерола в кръвта. Има, разбира се, и хора, при които едно-две яйца могат да повишават нивата на холестерола главоломно. Това е резултат от унаследен лош късмет. Приемливото дневно количество холестерол за здрави хора е 300 мг, а хората от рискови групи трябва да консумират под 200 мг дневно. Жълтъкът на едно яйце съдържа около 170 -190 мг холестерол в зависимост от големината. Една-единствена лъжичка сладолед съдържа цели 11 грама наситени мазнини – далеч повече, отколкото едно яйце или пържола. Изобщо, изкуствено създадените храни съдържат най-много опасни съставки. Холестерол и алкохолИзненадващо, алкохолът също увеличава „добрия“ холестерол, но пиенето надали е най-подходящото „лечение“. Не само червеното вино, но и всички видове алкохол увеличават нивата на HDL холестерола. Лошото е, че алкохолът увеличава и триглицеридите, а те си носят своя риск. Освен това алкохолът увеличава резистентността на съдовете и повишава артериалното налягане, така по обходни пътища бавно, но сигурно разрушава здравето ни. Важна е мярката. Приемът на алкохол не трябва да надхвърля две чашки дневно за мъжете и една за дамите. Трансмазнините са най-коварни Трансмазнините намаляват „добрия“ и увеличават „лошия“ холестерол, поради което вредата от тях е двойна.Наситените мазнини и трансмазнините се крият в огромен брой сладкарски продукти, пържени храни (чипс, пържени картофи, понички…и много други вкусотии), трансмазнини има в маргарина, както и в печива и бисквити от всевъзможен род. Четете какво съдържат храните, които купувате и после ядете вие и семейството ви. В Европа всички производители са длъжни да изпишат съставките на продукта. Правят го, макар че постоянно се опитват да завоалират вредните съставки чрез кодове и сложни термини или да ги напишат с толкова малък шрифт, че да ви трябва микроскоп. Следете за надписи като „частично хидрогенирани растителни масла“, което е едно от наименованията на тези широкоразпространени, но крайно опасни продукти на хранителната индустрия. Оръжия срещу холестерола: полезни мазниниПрепоръката е мазнините да не надвишават 35% от дневния прием на калории. Има полезни и вредни мазнини. Наситените мазнини – тези от животински произход и тропическите растителни масла – увеличават нивата на LDL холестерола. Полезни са ненаситените мазнини, които, включени в състава на балансирана и здравословна диета успешно намаляват нивата на LDL. Яжте риба поне два пъти седмично. Намаляване на холестерола чрез протеиниМесото и пълномасленото мляко са отличен източник на белтъчини, но ако не са подбрани добре могат да съдържат и много холестерол. Важно е да си набавяте достатъчно протеини, но бъдете претенциозни и избирайте месо без видима мазнина. Лошото е, че хич не е вкусно. Набавяйте протеини от други източници като соя, например във вид на тофу, или от риба, която е отличен избор във всяко отношение. Някои тлъсти риби като сьомгата са богати на омега-3 мастни киселини – верен съюзник в борбата срещу „лошия“ и наднормен холестерол. Поне два пъти седмично слагайте риба на трапезата си. Намаляване на холестерола чрез отслабванеАко сте с наднормено тегло, обмислете варианти за отслабване. Нормализирането на теглото води до намаляване на триглицеридите, „лошия“ и общия холестерол. Раздялата с макар и едва няколко излишни килограма е също добре дошла: свалянето на всеки три килограма покачва с един пункт стойностите на „добрия“ холестерол. Непрекъснато се натрупват научни данни, подкрепящи хипотезата, че нисковъглехидратната диета намалява холестерола по-успешно от нискомаслената. Двегодишно американско изследване е показало, че хората, консумиращи нисковъглехидратни храни имат значително по-висок HDL, тоест „добър“ холестерол в сравнение с онези, които ограничават мазнините в менюто си. Така че, намалете хляба, макароните и кифлите! Намалете холестерола чрез движениеАко сте здрав, но водите заседнал живот, заниманията с аеробни упражнения могат да увеличат „добрия“ холестерол с 5% още след първите два месеца. Редовните физически натоварвания намаляват и „лошия“ холестерол. Изберете спорт, който да ускорява пулса – например тичане, плуване или бързо ходене, и го практикувайте поне половин час дневно през повечето дни от седмицата. „Дозата“ може и да е разделена на части – две разходки от по 15 минути са толкова полезни, колкото и едно 30-минутно занимание. Аеробните упражнения имат и друга полза – периферните кръвоносни съдове, тези които захранват мускулите, се разширяват. Така може да коригирате повишеното кръвно налягане, което работи в комбина с объркания липиден профил за да ви докара инфаркт или инсулт. Откажете тютюнопушенетоАко имате повишен наследствен риск от сърдечно-съдови заболявания или наследствена дислипидемия и пушите, значи сте самоубиец. За останалите хора отказът от цигарите е труден, но си струва. Една от множеството здравословни ползи от подобно решение е и 10% намаляване на холестерола в кръвта. Стратегиите за спиране на тютюнопушенето са различни и понякога помагат, когато се прилагат заедно. Поговорете със специалист. Лечение с хранителни добавки и билкиИма хранителни добавки, които спомагат за подобряване нивата на холестерола. След тях са лененото и рибено масло и растителните стероли като бета-ситостерола. Един витамин от групата В – ниацинът, също увеличава „добрия“ и намалява „лошия“ холестерол. Ниацинът, съдържащ се в обикновените мултивитаминни препарати не върши работа, има си специални лекарства с рецепта. Има изследвания, които показват, че консумацията на чесън снижава нивата на общия холестерол в кръвта. Но чесънът има странични ефекти и взаимодейства с някои медикаменти. Други растения и растителни продукти, които спомагат за намаляване на холестерола са: - семената от сминдух (чимен); - екстрактът от листа на артишок; - белият равнец; - босилекът. Медикаментозното лечение има и нежелани реакции, но те се оправдават от постигнатата и доказана в множество клинични проучвания ефективност по отношение намаляване нивата на холестерола и триглицеридите и удължаване на живота на хората със сърдечно-съдови заболявания.
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Reasons For Cholesterol Lower Your Cholesterol Guide Is it possible to lower your cholesterol without harmful drugs? Thats the claim made by the e-book Beat Cholesterol in 30 Days by Scott Davis. Through this e-book you can learn the all-natural secrets that he used to lower his cholesterol 100 points in less than a month. Some of Davis' suggestions are lesser-known herbal remedies for high cholesterol: the most ubiquitous, of course, is the author's suggestion to buy red yeast rice. Red yeast rice is in fact a natural source of monocolin K, known in medical circles as lovastatin. In fact, the prescription version of lovastatin is nothing more than a concentrate of monocolin K. Davis' ability to collect such an astounding array of oftentimes obscure information and arrange it in a way that is easy for people of all ages to follow and apply to their lives immediately is itself quite an achievement. More here... Natural Cholesterol Guide Summary Contents: EBook Author: Scott Davis Official Website: blueheronhealthnews.com My Natural Cholesterol Guide Review The writer presents a well detailed summery of the major headings. As a professional in this field, I must say that the points shared in this book are precise. As a whole, this ebook contains everything you need to know about this subject. I would recommend it as a guide for beginners as well as experts and everyone in between. What Is the Difference Between Fat Oils and Triglycerides Fats and oils are terms commonly used to refer to food sources of triglycerides. Often fat and oil are considered to be different based on appearance fat is solid at room temperature and oil is liquid. However, they are really two of the same thing, generally speaking. They are both collections of triglycerides. For simplicity, we will use fat to include all sources of triglycerides. Exercise Training Effects on Triglycerides One of the more extensive reviews of the effects of exercise on lipids and lipoproteins was conducted by Durstine and Haskell.36 First, in analyzing several cross-sectional studies comparing inactive controls to either endurance athletes, runners, crosscountry skiers, tennis players, or individuals with longer treadmill test times, they concluded that generally active individuals have lower triglyceride concentrations. With regard to exercise-training studies, they reported that training also generally reduced the triglyceride levels if the baselines were elevated. They also found that the degree of reduction in triglycerides was related to both the baseline amount of triglyceride elevation and to the volume of exercise training, but that in women, these findings were not as consistent. In a more recent meta-analysis of fifty-one studies, of which twenty-eight were randomized controlled trials, Leon and Sanchez37 reported an overall 3.7 percent average decrease in triglycerides (P <... How Are Triglycerides and Cholesterol Absorbed Absorbing lipids into the body requires special consideration. Since the blood is water-based, how can these water-insoluble substances circulate Cells lining the wall of the small intestine reassemble triglycerides and package them up along with cholesterol into shuttles called chylomi-crons. Chylomicrons can leave these cells and enter the lymphatic circulation before enter the blood. Chylomicrons are very large and are unable to squeeze through the entry holes to the blood stream. Instead they drain into the larger openings to the lymphatic circulation. Within minutes, chylomicrons will circulate to a duct in the chest that gives them access to the blood (Figure 5.7). Once in the blood, a chylomicron will circulate for about a half hour, delivering its lipid bounty to tissue throughout the body. Triglycerides and Fatty Acids Triglycerides (TG), or triacylglycerols, make up by far the largest proportion of dietary lipids consumed by humans. A TG is composed of three FAs esterified to a glycerol molecule in one of three stereochemically distinct bonding positions sn-1, sn-2, and sn-3. Variation in the type of FA and their bonding pattern to glycerol further increases the heterogeneity of TG composition. For most dietary oils, approximately 90 of the TG mass consists of FA. These FA are generally unbranched hydrocarbon chains with an even number of carbons, ranging from 4 to 26 carbon atoms. Smaller quantities of longer-chain FA have also been identified in mammalian tissues and thus may exist in human diets (4). Very long-chain fatty acids (VLCFA) predominate in the brain and specialized tissues, such as retina and spermatozoa (5). Adipose tissue contains FA of varying lengths. Reducing Elevated Cholesterol or Triglycerides This is a special formulation of the basic vitamin niacin that avoids the flushing of conventional niacin and has fewer serious side effects. It has been used in Europe for the past thirty years to lower cholesterol. Inositol is related to the B group of vitamins and is used to improve nerve function in diabetics. Because of its role in cell-membrane function, it has also shown beneficial effects for depression and general neurological function. The dose is 500 mg taken three times a day with meals. Like guggulipid, full effectiveness will take four to five months. Human studies have shown that by twenty-six weeks LDL cholesterol was lowered 23 percent and HDL cholesterol was elevated 33 percent. This equals or exceeds that of prescription drugs, and has a much better margin of safety. Vitamin C has been shown to lower total cholesterol and triglycerides, and increase HDL. For each 1 percent rise in HDL the risk of heart attack drops by 4 percent. This extract has shown a capacity to... Are Certain Types of Fiber Good for Lowering Blood Cholesterol Levels Additionally, there is evidence to suggest that the short-chain fatty acids (acetic, butyric, propionic, and valeric acids) and lactate produced in the colon by bacterial breakdown of soluble dietary fibers may reduce cholesterol formation in the liver. Thus, soluble fibers can inhibit cholesterol absorption from the digestive tract as well as cholesterol production in the liver. These two factors may lead to reductions in the level of cholesterol in blood this will be explored more thoroughly in Chapter 13. Wont eating eggs raise my cholesterol levels In most people, cholesterol levels are regulated internally and not affected by your diet. Others must watch what they eat to prevent increases in bad cholesterol levels. If your cholesterol is already high, you can choose to eat the white part of the egg only, which is pure protein - it contains no fat whatsoever. Or, you can use a new egg product called Omega-3 eggs. Producers achieve this by feeding the chickens foods that contain high amounts of Omega-3 like flaxseeds and algae. Omega-3 is a good fat that has been proven to help increase your good cholesterol levels (HDL), and lower bad cholesterol level (LDL). Blood vs Dietary Cholesterol Confused about cholesterol You're not alone Actually, the term itself refers to two different types. Blood, or serum, cholesterol circulates in the bloodstream. Dietary cholesterol comes from food. While many factors affect blood cholesterol levels, the cholesterol that circulates in your body comes from two sources Cholesterol also comes from foods and beverages of animal origin eggs, meat, poultry, fish, and dairy foods. Animals produce cholesterol, but plants don't. A diet high in cholesterol is one factor that elevates blood cholesterol levels for some people. That's why the Dietary Guidelines advise Consume less than 300 . what tropical oils are And how they stack up for nutrition Tropical oils (coconut, palm, palm kernel) come from the fruit or nuts of the tropical plants they're named for. In processed foods they impart qualities similar to partially hydrogenated oils. There's debate, however, about their impact on blood cholesterol levels. While tropical oils contain... How Do Unsaturated Fatty Acids Affect Cholesterol Levels In fact, if they are used to replace saturated fatty acids in the diet, total cholesterol will probably be lowered. This is especially true for people whose blood cholesterol levels were elevated well above recommended levels. This is one reason why populations consuming higher fat intakes, with less of the fat via saturated fat sources, enjoy lower rates of heart disease. Your HDL Cholesterol Level HDL cholesterol is the good type in fact, it's the only good kind of cholesterol. Some folks are genetically blessed with high HDL readings, a lucky inherited gene which significantly reduces the risk for heart disease. Other folks have to work at elevating their numbers. Smoking, being overweight, and being sedentary can all result in lower HDL cholesterol. If you learn that you have low HDL cholesterol, you can help raise it by not smoking, by losing weight or maintaining a healthy weight, adding monounsaturated fat to your diet (olives, nuts and avocado), and by being physically active for at least 30-60 minutes a day. Desirable HDL cholesterol levels are 40 mg dL or higher. People with high blood triglycerides usually have lower HDL cholesterol and a higher risk of heart attack and, indirectly, of stroke. Furthermore, many people with high triglycerides have underlying diseases or genetic disorders. If this applies to you, the main therapy is to change your lifestyle by... What Foods Provide Us with Triglycerides and Cholesterol As displayed in Table 5.3, fats and oils, and thus triglycerides, are present in both animals and plants. Oil is a natural component of many plant tissues including leaves, stem, roots, kernels, nuts, and seeds. Common edible oils include sunflower, safflower, corn, olive, coconut, canola, and palm oil. Contrarily, butter is made from the fat in milk, while lard is hog fat, and tallow is the fat of cattle or sheep. Other animal flesh will contain fat, including poultry and their eggs. Dont Be A Saturated Fathead Charles Glueck, MD, medical director of the Cholesterol Center of Jewish Hospital in Cincinnati, OH demonstrated in a dramatic 1994 study that high levels of triglycerides, high cholesterol, and low HDL (the good cholesterol) were the sole causative factors in mild to serious depression. So for the next 54 weeks, they ate a diet very low in fat (10-15 of total calories consumed) and took triglyceride-lowering medication. As triglycerides fell, depressive symptoms disappeared. After 54 weeks, 91 of the patients were rated normal. The most significant reduction in triglycerides and depression occurred in the first six weeks of treatment. Obviously, not all psychological or psychiatric disorders are attributable to triglycerides and saturated fats, notes Dr. Glueck. Glueck recommends that anyone with a psychiatric problem or who is suffering from depression should have his her cholesterol and triglycerides tested. Cholesterol Metabolism Cholesterol is either obtained from the diet or synthesized in a variety of tissues, including the liver, adrenal cortex, skin, intestine, testes, and aorta. High dietary cholesterol suppresses synthesis in the liver but not in other tissues. Carbohydrate is converted to triglyceride utilizing glycerol phosphate and acetyl CoA obtained from glycolysis. Ketogenic amino acids, which are metabolized to acetyl CoA, may be used for synthesis of triglycerides. The fatty acids cannot fully prevent protein breakdown, because only the glycerol portion of the triglycerides can contribute to gluconeogenesis. Glycerol is only 5 percent of the triglyceride carbon. Blood Lipids and Lipid Transport Lipids are insoluble (does not dissolve) in water but are soluble (dissolves) in alcohol and other solvents. When dietary fats are digested and absorbed into the small intestine, they eventually re-form into triglycerides, which are then packaged into lipoproteins. Dietary fats, including cholesterol, are absorbed from the small intestines and transported into the liver by lipoproteins called chylomicrons. Chylomicrons are large droplets of lipids with a thin shell of phospholipids, cholesterol, and protein. Once chylomicrons enter the bloodstream, an enzyme called lipoprotein lipase breaks down the triglycerides into fatty acid and glycerol. After a 12- to 14-hour fast, chylomicrons are absent from the bloodstream. Thus, individuals who are having a lipid profile done should fast overnight to ensure that chylomicrons have been cleared. The liver removes the chylomicron fragments, and the cholesterol is repackaged for transport in the blood in very low-density lipoproteins (VLDLs),... Chemistry And Structure Fats and lipids are defined as a class of compounds soluble in organic solvents, including acetone, ether, and chloroform. These compounds vary considerably in size and polarity, ranging from hydrophobic triglycerides (TGs) and sterol esters to more water-soluble phospholipids (PL) and cardiolipins. Dietary lipids also include cholesterol (CH) and phytosterols. Unlike other macronutrients, the non-water miscibility of lipids necessitates that these compounds receive specialized processing during digestion, absorption, transport, storage, and utilization. This specialization in metabolic handling distinguishes dietary lipids and their metabolites from other macronutrients. Table Atp Iii Criteria Women Triglycerides HDL cholesterol diagnostic purposes, it is not clear that it has much predictive capacity, thus limiting its clinical utility. Most consider metabolic syndrome to be a prediabetic state, as the various components of the condition are invariably associated with some degree of insulin resistance. However, there are relatively little to no definitive data on the conversion rate of individuals with metabolic syndrome to frank diabetes. Also, although the ATP III guidelines provide a useful working definition, it is clear that the five diagnostic criteria are not independent. For example, low-serum HDL cholesterol and high-serum triglycerides tend to track together in individuals. This makes the current scoring mechanism (i.e., the need to have three of the five diagnostic criteria) seem somewhat artificial and negatively impacts its predictive utility. There are other, less obvious issues with the current definition. The ATP III and WHO (Tables 4.1 and 4.2) include... Does Fat Play a Structural Role in Our Body Our cell membranes contain molecules, called phospholipids, that seem to have structural similarities to triglycerides (see Figure 5.1). Like triglycerides, phospholipids contain a glycerol backbone to which fatty acids are attached. However, phospholipids contain only two fatty acids, not three as in triglycerides. The third fatty acid is replaced by phosphate combined with another molecule, such as choline, serine or inostiol. This Your Health Empty Calories Lipids are insoluble in water, and thus they are difficult to carry in the blood. They are categorized into triglycerides, phospholipids, and steroids. The principal dietary lipids in the body are cholesterol and triglycerides. Phospholipids are mostly tied up in cell membranes and do not play a significant role in energy metabolism. Triglycerides, which are made in the liver to store excess energy from carbohydrates, make up a major portion of adipose tissue. This tissue provides the body with insulation to keep warm and cushions joints and organs for protection. Triglycerides are composed of three-carbon glycerol molecules with three fatty acids attached, one to each of the three carbons. What Other Dietary Factors Influence the Development of Heart Disease Are associated with a lower incidence of the disease. Fruits and vegetables probably exert a beneficial effect in several ways. First, they can replace fat- or cholesterol-rich foods and also provide more essential nutrients compared with less nutrient-dense foods. Second, fruits, vegetables, and whole grains are sources of health-promoting factors called nutraceuti-cals which will be discussed next. In addition, smoking has a negative impact by introducing numerous free-radical compounds as well as possibly raising blood pressure. On the other hand, regular exercise can promote cardiovascular health by improving circulation, increasing HDLs, and lowering triglycerides and improving body weight composition and glucose tolerance. What Tests Will I Need While the numbers do not directly relate to heart-attack risk, it can indicate the presence of a problem. Total cholesterol is a combination of LDL, HDL, and VLDL cholesterol levels. While this study is suggestive, there are many other factors involved as well, such as dietary differences in the two groups, exercise levels, and overall healthier lifestyle of the lower cholesterol group. LDL Cholesterol Levels HDL Cholesterol Levels In the lay press, HDL cholesterol is known as good cholesterol. Its function is to remove cholesterol from the tissues and blood stream, but it should be recognized that even oxidized HDL can contribute to atherosclerosis. Fortunately, it is more difficult to oxidize than LDL. Higher levels of HDL appear to be protective. Triglycerides These are esterified fatty oils. High levels of triglycerides also act as an independent risk factor separate from all other factors. Some studies have shown that triglyceride levels are a good measure of the severity of... Understanding Your Blood Test Optimal Cardiac Numbers We hear lots of numbers being tossed around when it comes to cardiovascular health. And without a clear understanding of each category, this information can be downright overwhelming. Key players include the cholesterol ratio, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, homocysteine, and your blood pressure score. Your HDL cholesterol, on the other hand, should not be too low. In fact, a low HDL cholesterol puts you at high risk for heart disease. HDL cholesterol that is less than 40 mg dL is considered low. Typically, a woman's HDL cholesterol ranges from 50-60 mg dL and a man's ranges from 40-50 mg dL. Triglyceride level is yet another reading. You want your triglyceride level to be under 150 mg dL, since high triglycerides can contribute to heart disease. If your triglyceride level is 150-199 mg dL, you are borderline-high, if it's 200-499 mg dL, it is high, and a reading of 500 mg dL is considered eoctremely high. The American Heart Association recommends... Fat Function Metabolism and Storage Fats are metabolized primarily in the small intestines because the enzymes of the stomach cannot break down fat molecules due to their hy-drophobicity. In the small intestines, fat molecules stimulate the release of cholecystokinin (CCK), a small-intestine hormone, into the bloodstream. The CCK in the blood triggers the pancreas to release digestive enzymes that can break down lipids. The gallbladder is also stimulated to secrete bile into the small intestines. Bile acids coat the fat molecules, which results in the formation of small fat globules, which are called micelles. The coating prevents the small fat globules from fusing together to form larger fat molecules, and therefore the small fat globules are more easily absorbed. The pancreatic enzymes can also break down triglycerides into monoglycerides and fatty acids. Once this occurs, the broken-down fat molecules are able to diffuse into the intestinal cells, in which they are converted back to triglycerides, and finally into... Specific aspects of fat needs Most fats are triglycerides, which consist of three fatty acids linked or bonded to one glycerol molecule. Glycerol is actually a small carbohydrate, but when it is linked to fatty acids the glyceride product is classified as a fat. So, monoglycerides, diglycerides, and triglycerides are all considered fat molecules. Lipid is another broader term used to include the fats or triglycerides, cholesterol, phospholipids, and many other fat-soluble molecules in foods or synthesized in our bodies. The 35 or so of energy provided by dietary fat refers only to the triglycerides found in our foods. High-performing athletes typically consume 20 to 25 fat, but they make certain that they get enough unsaturated fats because these fats, especially the omega-3 fatty acids, are generally thought to support immune function and keep athletes from catching common colds and nagging infections. Should You Have Your Childs Cholesterol Level Checked It's not routinely recommended for all children. The American Heart Association advises screening for children with a family history of risk factors blood-related parents, grandparents, aunts, and uncles with high cholesterol levels, high triglyceride levels, or cardiovascular disease before age fifty-five for men and age sixty-five for women. If your child has a higher than normal blood cholesterol level, don't panic. High cholesterol levels among children don't necessarily predict high levels in adulthood. But when children come from high-risk families, it's prudent to check with a doctor and work with a registered dietitian to bring the levels down good advice for the whole family For cardiovascular health, young people, ages two through nineteen years, should maintain acceptable blood cholesterol levels HDL levels should be greater than or equal to 35 mg dL triglycerides should be less than or equal to 50 mg dL. Compelling research suggests that fatty buildup in arteries... Exercise Training Effects on Insulin Sensitivity The metabolic syndrome is conceptually the same as the insulin-resistance syndrome, and the names are essentially interchangeable. That some prefer the term insulin-resistance syndrome is due to the common understanding that an observable decrease in insulin sensitivity is the first detectable aberration in course toward metabolic syndrome. In fact, some deterioration in insulin sensitivity is generally observed prior to elevations in triglycerides levels, decreases in HDL-C concentrations, which in turn precede deterioration in fasting glucose, and glucose-tolerance measures, and perhaps even before clinically significant increases in body weight, body-mass index, and waist circumference are apparent. In fact, as a reflection of this understanding, the WHO includes a resting measure of insulin resistance in its definition of metabolic syndrome (Table 4.2). Which Enzymes Digest Fat and Cholesterol Although a triglyceride-digesting enzyme called lingual lipase is present in saliva, the job of digesting triglycerides is mostly handled by another lipase enzyme delivered by the pancreas. Pancreatic lipase detaches two fatty acids from glycerol, which results in a monoglyceride and two fatty Can Different Kinds of Fatty Acids Be Part of the Same Triglyceride Molecule There are probably no definite rules as to the selection of fatty acids that make up a triglyceride molecule. One triglyceride molecule may be composed of one saturated, one monounsaturated, and one polyunsaturated fatty acid, all of the same or varying lengths. However, the types of fatty acids found within triglyceride molecules will depend on the plant or the animal source. For instance, the triglycerides in olive oil largely contain the MUFA oleic acid (18 1 ra-9) (about 82 percent), while about two-thirds of the fatty acids in butter are SFAs of varying length. The Top Fitness Foods to Stock Your Cabinets With Making Smart Choices Starts at the Grocery Store Alright, so let's start with the fridge. Each week, I try to make sure I'm loaded up with lots of varieties of fresh vegetables. During the growing season, I only get local produce, but obviously in winter, I have to resort to the produce at the grocery store. Most of the time, I make sure I have plenty of vegetables like zucchini, onions, asparagus, fresh mushrooms, spinach, broccoli, red peppers, etc. to use in my morning eggs. I also like to dice up some lean chicken or turkey sausage into the eggs, along with some swiss, jack, or goat cheeses. Coconut milk is another staple in my fridge. I like to use it to mix in with smoothies, oatmeal, or yogurt for a rich, creamy taste. Not only does coconut milk add a rich, creamy taste to lots of dishes, but it's also full of healthy saturated fats. Yeah, you heard me I said healthy saturated fats Healthy saturated fats like medium chain triglycerides, specifically an MCT called lauric acid. If the idea of healthy saturated fats is foreign... Effects of Amino Acid Supply on the Secretion of Milk Acids or intravenous infusion of amino acids, has variable effects on the secretion of milk fat. However, it is well known that supplements of methionine often increase the yield and concentration of milk fat and this occurs when the methionine is added to the diet, in rumen-protected form (Overton et al., 1996) or as methionine hydroxy analogue (MHA) (Huber et al., 1984), or infused postrumi-nally (Varvikko et al., 1999) or intravenously (Chamberlain and Thomas, 1982). It has been suggested that the effects of methionine on the secretion of milk fat might be linked to a stimulation of the synthesis of lipoproteins and hence increased transport of triglycerides to the udder (Pullen et al., 1989). Importance of Body Protein Mass in Homeostasis The human body has the capacity to store carbohydrate in the form of muscle and liver glycogen, and to store fat as triglycerides in adipose and muscle tissue. However, there is no comparable storage pool for protein. Yet, under conditions of energy or protein deficit, proteins that serve a variety of functions must be catabolized.5 When needed, the body can utilize skeletal muscle protein as a somewhat dispensable protein and energy reserve. With an inadequate supply of protein, AAs can be mobilized from muscle protein catabolism and used to synthesize proteins more essential to survival than skeletal muscle. Similarly, with an inadequate supply of carbohydrate, AAs from protein catabolism are used as substrate for gluconeogenesis to maintain an adequate supply of blood glucose. Effects on physical performance Training, the phospholipid fatty acid contents of oleic acid and DHA were higher in the trained than the untrained leg, and the ratio of ro-6 to ro-3 was lower in the trained than in the untrained leg.95 The beneficial effect of exercise on lipoproteins and subfractions has been reported previously. The ro-3 fatty acid role in physiological metabolism includes an amelioration of lipid profiles, specifically triglycerides and cholesterol fractions, and increased fluidity in membranes, of which similar effects have been attributed to regular aerobic exercise.97 It has been indicated that a single session of aerobic exercise has shown effects on triglyceride concentrations similar to those shown by ro-3 supplementation.98 Brilla and Landerholm97 assessed the effect of aerobic exercise for 1 hour three times a week (mean range VO2 max post-exercise 35.6 to 49.5 ml kg1 min1), and fish oil supplementation (4 g day of ro-3 fatty acids) on serum lipids and aerobic fitness on healthy sedentary... Linking the energy contributions of fats and proteins The provision of adequate fat, i.e., triglycerides (TGs), is important for exercising individuals to meet their energy needs and to provide EFAs, i.e., both omega-6 and omega-3 FAs. With the typical fat intake of 35 of total energy, however, it is almost impossible to consume enough of the omega-3 FAs. Therefore, the optimal balance between omega-3 FAs and omega-6 FAs cannot be achieved without a supplement, e.g., fish oil rich in omega-3 FAs. The energy from fat is sufficient, but not the specific omega-3 FAs. Adipose Tissuetriacylglycerol Fatty acids are stored in the body as triacylglycerols (triglyceride) in fat cells which make up the adipose tissue. Fat is also stored in muscle tissue in the form of triglyceride, present in small intramuscular fat droplets. After a meal, fat is absorbed and circulates in the blood as triglycerides in the form of circulating lipid particles (HDL, VLDL, LDL, chylomicrons) or as free fatty acids bound to albumin, called non-esterified fatty acids (NEFA). As with glycogen, the synthesis of fat or its degradation depend on the concentration of the 'building blocks', in this case fatty acids. This concentration is determined mainly by uptake of free fatty acids in and from triacylglycerols and their rate of utilization for energy metabolism. Cardiovascular Disease Besides the acute danger faced when eating meals high in MSG another less obvious danger exists. Recent studies have found that animals exposed to MSG soon after birth show markedly elevated levels of triglycerides and the very low-density lipoproteins (VLDL) that persist throughout life.245 The values were higher in males than females, ft is now accepted that elevated serum oxidized lipids are associated with an increased risk of heart attack and stroke. High insulin levels combined with hyperinsulinemia, high triglycerides, and hypertension are all symptoms of a newly described disorder called Metabolic Syndrome, a condition that constitutes major risk factors for atherosclerosis, heart attacks, and strokes. So we see that, if the same effects found in test animals also occur in humans, a diet high in MSG-containing foods and snacks would greatly increase the likelihood of a child developing early-onset diabetes and cardiovascular disease exactly what we are seeing today. What Foods Contain Trans Fatty Acids Trans fatty acids can be found in many fat sources although its prevalence is very low. Bovine (cows, steer, oxen, etc) food sources are probably the greatest natural contributors of trans fatty acids to the human diet. For instance, beef, butter, and milk triglycerides may contain 2 to 8 percent of their fatty acids as trans fatty acids. Interestingly, cattle are not solely responsible for generating this trans fatty acid content. It is actually the bacteria in their unique stomachs that produce the trans fatty acid. These fatty acids are then absorbed by the cow and make their way into the tissues and milk of these animals. What Is the Composition of Our Body What Kind of Stuff Are We Made of When we step on a scale, it registers the total weight or mass of our body. However, this is just a general measurement and does not really provide us with an accurate assessment of the individual contributions made by the different types of substances to our weight. Said another way, the scale is not sensitive to body composition. In the first chapter we recognized that the elements carbon, hydrogen, oxygen, and nitrogen make up greater than 90 percent of our body weight. We also acknowledged that these elements are components of the major types of molecules in our body. These molecules are by and large water, protein, fat (triglycerides), and carbohydrate, as well as variations and combinations of the latter three molecule types. Meanwhile, minerals make up most of our remaining body weight. Table 8.1 presents examples of body compositions of what are deemed to be average adults. Survey Of The Digestive Process And Components Protein fragments, and triglycerides. The final breakdown of the ingested food, including disaccharides, occurs at the surface of the columnar cells lining the tube, and is then absorbed into the lining cells. Nearly all the absorption of nutrients occurs in the small intestine. When nutrients leave the digestive tract, they go either to the body's tissues or to the liver. The liver is an accessory organ to the digestive tract that regulates much of what goes out to the body through the bloodstream. A specific description of this part of the process can be found in Chapter 5. Diabetes Complications Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS) are serious diabetic emergencies and the most frequent cause of mortality. Both DKA and HHS result from an insulin deficiency and an increase in counter-regulatory hormones (a.k.a. hyperglycemia). Hyper-glycemia leads to glycosuria (glucose in the urine), increased urine output, and dehydration. Because the glucose is excreted in the urine, the body becomes starved for energy. At this point, the body either continues to excrete glucose in the urine making the hyperglycemia worse (HHS), or the body begins to break down triglycerides causing the release of ketones (by-products of fat breakdown) into the urine and bloodstream (DKA). The mortality rate of patients with DKA is less than 5 percent while the mortality rate of HHS patients is about 15 percent. Infection (urinary tract infections and pneumonia account for 30 to 50 percent of cases), omission of insulin, and increased amounts of counter-regulatory hormones... Components of Physical Fitness The relative proportion of fat-free mass to fat mass in the body. Fat-free mass is composed of muscle, bone, organs, and water, whereas fat is the underlying adipose tissue. Excessive fat is a good predictor of health problems because it is associated with cardiovascular disease, high cholesterol, and high blood pressure. Higher proportions of fat-free mass indicate an increase in muscle, and thus an increased ability to adapt to everyday stress. cholesterol), low-density lipoprotein cholesterol (LDL-C, the bad cho-triglyceride a type of fat lesterol), and triglycerides (TRG, storage form of energy), which reduce Bloodglucose Regulation Blood-glucose regulation is achieved by an intricate balance among many factors, including nutritional status, endocrine and neural mechanisms, and physical activity. However, for the purpose of this discussion, we will just focus on the different biochemical processes of glucose utilization and synthesis in the tissues, which maintain normal blood glucose. In the fed state, blood glucose is kept normal by increased utilization of glucose and storage as glycogen. Glucose produced by the catabolism of amino acids not used for protein synthesis is also stored as glycogen. Fatty acids not resynthesized into triglycerides for storage as lipids are oxidized and, by so doing, generate substrates also used for de novo glucose synthesis (gluconeo-genesis) and storage as glycogen. In the postabsorptive state, normal blood glucose is maintained by a combination of gluconeogenesis and glycogenolysis. During short-term fasting, blood glucose is primarily maintained by hepatic glycogen breakdown.... Metabolic Syndrome And Exercise In the Heritage Family Study, of the 105 subjects who had the ATP III definition of metabolic syndrome (waist circumference, fasting, triglycerides, HDL-C and glucose, and blood pressure), nearly one third (30.5 percent, 32 of the 105) were no longer defined as having metabolic syndrome after the exercise-training program of 20 weeks. This was a highly physiologically, clinically, and statistically significant effect. It is particularly impressive, given that the exercise stimulus was of a fairly modest weekly amount (likely very similar total amount of exercise as approximately 30 min of moderate-intensity exercise six days per week) and was of a relatively modest training duration. In Figure 4.1, the prevalence of individual risk factors and the prevalence of metabolic syndrome is shown with both before and after prevalence rates. Of the five risk factors, all except the prevalence of low HDL-C were significantly decreased with exercise training. In individuals with a clustering of... Body mass Tbw Bm Fm residual Overview FM, although often treated as a singular component of body composition, is heterogeneous. Fat, or more appropriately lipid, is physiologically divided into essential and nonessential lipids. Essential lipids are vital components of cells and are basic for a variety of physiologic functions they constitute about 10 of total lipids in the body. The remaining lipids, 90 of total body lipids, are nonessential. They are triglycerides, which provide a storage form of available energy and perhaps thermal insulation 2 . The small amount of essential lipids in the body usually are not considered in estimates of body composition Use in Prevention and Therapy Vitamin C increases breakdown and excretion of cholesterol and protects cholesterol in the body from oxidation (oxidation of cholesterol increases its athe-rogenicity). It can lower blood cholesterol and triglycerides, while raising HDL cholesterol. Large doses decrease platelet aggregation and may reduce risk of blood clots in the legs and Cholesterol and heart disease Cholesterol levels alone are not the entire story. Many people with high cholesterol levels live to a ripe old age, but others with low total cholesterol levels develop heart disease. Worse yet, recent research indicates that low cholesterol levels may increase the risk of stroke. In other words, cholesterol is only one of several risk factors for heart disease. Here are some more Even if you allow yourself to indulge in (a few) high-cholesterol ice cream cones and burgers every day of the year, your cholesterol level may still be naturally lower in the summer than in winter. The basis for this intriguing culinary conclusion is the 2004 University of Massachusetts SEASONS (Seasonal Variation in Blood Lipids) Study of 517 healthy men and women ages 20 to 70. The volunteers started out with an average cholesterol level of 213 mg dl (women) to 222 mg dl (men). A series of five blood tests during the one-year study showed an average drop of 4 points in the summer for men and 5.4 points... Ergogenic benefits Performance The effects of three levels of fat on performance and metabolism were evaluated by Horvath et al.67 A low-fat diet (16 of total kcal) and a medium-fat diet (31 of total kcal) were compared by feeding the diets to 12 males and 13 females for approximately 30 days. Six males and 6 females completed a second phase of the trial by increasing their fat consumption to a high-fat diet (44 of total kcal) for approximately another 30 days. Protein percentages in the diet remained about the same as percent fat increased and carbohydrate (CHO) percentage decreased. CHO was never below 250 g day for the females and 325 g day for the males. Body weight or percent body fat was not affected by the different diets. Additionally, VO2max, expiratory gas exchange, maximum heart rates, peak power and average power, plasma lactate, pyruvate, and triglycerides were not affected by the different diets.68 1 Fats, Oils, Fatty Acids, Triglycerides Chemical Structure, ScientificPsychic website, 2006.61 Dietary Interventions That May Reduce Illness and Death A further systematic review examined the effects of omega-3 fats in diabetics.15 Unfortunately, no studies or large subgroups of published studies assess the effects of omega-3 fats on disease endpoints in diabetics. There is no evidence of detrimental effects of cardioprotective doses of omega-3 fats on glycemic control or LDL cholesterol levels (higher levels of supplementation have been used to reduce triglyceride levels the smaller cardioprotective doses mentioned above may well save lives of diabetics but do not alter triglycerides significantly). More evidence would be useful to clarify this issue. Market acceptance of nutrigenomics Another key factor is the development of standards for utilization of information and associations from research in nutrigenomics. A view that is often repeated in the popular press is that 'the science isn't there yet' or 'it's too early', so establishing criteria for how much research is required before commercializing a genetic test would help the industry. Consider the case of the MTHFR gene, described above. Searching PubMed for the search string 'MTHFR and polymorphisms and folic acid' delivers 679 records for publications from 2000 to 2007. Is further research required On the other hand, a PubMed search for literature on the APOA5 genetic variations, which have been associated with elevated triglycerides, delivered 70 records for 'APOA5 and polymorphisms'. When searching for a specific nutritional association, the term 'dietary fats' was added to the APOA5 search string and the number of records dropped to 3. A key factor for industries in this field is the determination of how... Making Insulin Receptors Work Chromium deficiency is linked to impaired glucose metabolism, impaired glucose clearance, a decrease in the number of insulin receptors, and a reduction in binding of glucose to those receptors. In addition, we see lowered HDL (the good cholesterol) levels, and an increase in total cholesterol and triglycerides all factors that increase atherosclerosis. There is good evidence that chromium supplementation improves carbohydrate metabolism in diabetics.415 It is especially effective when there is a significant deficiency of the mineral. One of the more useful plants is Gymnema sylvestre (Gumar) which stimulates insulin secretion and lowers cholesterol and triglycerides with minimal side effects. A test on twenty-two type II diabetics found 400 mg per day to be superior to prescription medications for long-term blood-sugar stabilization and an overall sense of well-being.420 The Metabolic Syndrome Many of these loci have also been linked to individual components of the metabolic syndrome. For example, chromosome 2p has been linked to serum triglycerides, systolic blood pressure, obesity, body fat percentage, and HDL (111-113), while chromosome 7q has been linked to systolic blood pressure, triglyceride-HDL-C ratio, fasting glucose, insulin, and insulin resistance (114-116). Fatty acid binding protein 2 (FABP2) and apolipoprotein C-III (APOC3) polymorphisms have been directly associated with increased risk for dyslipidemia and the metabolic syndrome in Asian-Indians (132). Other examples include a number of lipid-sensitive transcription factors (nuclear receptor subfamily 1, member 4 (FXR), nuclear receptor subfamily 1, member 3 (LXR-a), retinoid X receptor a (RXR-a), PPAR-a, PPAR- , peroxisome proliferator-activated receptor (PGC1-a), PCG1-fi, sterol regulatory element binding transcription factor 1 (SREBP-1c)) that have been implicated in the development of dyslipidemia, one... Essential Basic Supplementation Numerous studies have shown that garlic lowers total cholesterol as well as LDL cholesterol and raises HDL cholesterol. In addition, it will lower triglycerides, thin the blood, and act as an antibacterial. And, as we have seen before, it is one of the few supplements that can actually reverse atherosclerosis. You should take two capsules twice a day with a meal. Selenium-enhanced garlic is even better. Lipid Differences Between Omnivores And Vegetarian Or Vegans The dominance of unsaturated fat to saturated fat of the vegetarian diet lowers total cholesterol and LDL-C levels. The saturated fatty acids (SFA) lauric (C12 O), myristic (C14 O), and palmitic (C16 O) are very hypercho-lesterolemic. Palmitic acid is the dominant fatty acid synthesized in the human body from excess calories that are converted to fat.42 Thus, the elderly vegetarian on a plant protein diet does not synthesize large amounts of palmitic acid. The SFA, stearic acid (C18 O), has no effect on blood lipoproteins and is considered neutral, with moderate amounts of dietary carbohydrate.43 Of all the added dietary fats, the most hypercholesterolemic are palm-kernel, coconut, and palm oils, and butter. SFA raise LDL-C by decreasing LDL receptor synthesis and activity. All fatty acids will lower fasting triglycerides if they replace carbohydrates in the diet.44 The most significant way to lower LDL-C and raise HDL is to replace carbohydrate with linoleic acid (C18 2), the... Diseasespecific Guidelines Coronary Heart Disease (CHD) is the major cause of death in industrialized and emerging nations and is the most common and serious form of cardiovascular disease. Elevated blood lipids and related disorders of lipoprotein metabolism are implicated in the progression of atherosclerosis and subsequent obstruction of coronary blood vessels and development of atherosclerotic heart disease. Atherosclerosis is infrequently hereditary in origin and there is an extensive body of epidemiologic, laboratory, and clinical evidence of an association between diet and the incidence of CHD. Recent clinical trials provide evidence that reducing serum cholesterol levels through diet, drugs, or both decreases the incidence of CHD. Although much attention has been focused on the effect of dietary fat and cholesterol on blood lipids, diet may influence other steps in the pathogenic sequence leading to atherosclerosis or to a cardiac event. For example, dietary factors may influence the propensity toward... Strength of evidence While vitamin E intake appears to have no relationship to risk of CVD, there is convincing evidence that myristic and palmitic acids, trans fatty acids, high sodium intake, overweight and high alcohol intake contribute to an increase in risk. A ''probable'' level of evidence demonstrates a decreased risk for a-linolenic acid, oleic acid, NSP, wholegrain cereals, nuts (unsalted), folate, plant sterols and stanols, and no relationship for stearic acid. There is a probable increase in risk from dietary cholesterol and unfiltered boiled coffee. Possible associations for reduced risk include intake of flavonoids and consumption of soy products, while possible associations for increased risk include fats rich in lauric acid, p-carotene supplements and impaired fetal nutrition. The evidence supporting these conclusions is summarized below. Fatty acids and dietary cholesterol When substituted for saturated fatty acids in metabolic studies, both monounsaturated fatty acids and... Design Of Treatment For Type Diabetes Based On Nutrient Interactions Metformin hydrochloride, a biguanide, is currently the only clinically available antidiabetic oral agent whose mechanism of action involves suppression of hepatic-glucose release through inhibition of gluconeogenesis and glycogenolysis, albeit other metabolic parameters may also be affected (21, 30, 31). For instance, it has been shown that metformin enhances insulin sensitivity at the muscle by promoting glucose transport and glycogen synthesis. It may also enhance peripheral glucose utilization by suppression of FFA release and oxidation (21). Body-weight reduction, as well as significant decreases in plasma levels of LDL cholesterol, triglycerides, and FFA, have also been reported in patients treated with metformin (21, 31). Based on these metabolic actions of metformin treatment, its use has actually been recommended as a possible strategy to prevent type 2 diabetes in individuals at high risk for developing the disease (32). The PPAR-a agonist group of drugs include those... Fruits And Vegetables A Population Studies Reductase, the rate-limiting enzyme in cholesterol synthesis. Cholesterol synthesis is suppressed and LDL receptor activity is augmented by the carotenoids te-carotene and lycopene, similar to that seen with the drug fluvastatin. When lycopene supplements (60 mg day) were given to men for a 3-month period, a 14 reduction in their LDL cholesterol levels occurred.44 Therefore, lycopene may be useful for decreasing the risk of coronary heart disease. The regular use of red wine is suggested for lowering the risk of heart disease. Two possible mechanisms explain this effect. First, alcohol raises HDL cholesterol levels.58 Second, wine inhibits the formation of blood clots. Since purple grape juice and dealcoholized red wine inhibit platelet aggregation, it is clearly not an effect of alcohol, but appears to be related to the flavonoid pigments in the grape juice or wine.59,60 Dealcoholized red wines and red grape juice inhibit platelet aggregation by blocking thromboxane B2 synthesis in... What Drugs Are Prescribed to Reduce Blood Cholesterol The drugs commonly prescribed to treat hypercholesterolemia include those that either decrease cholesterol synthesis in the liver, decrease VLDL production, or decrease dietary cholesterol absorption. Drugs such as lovostatin are known to reduce the manufacturing of cholesterol by the liver, although the benefits of this medication may also include increased LDL removal from the blood. Cholestyramine or colestipol will bind cholesterol in the digestive tract and render it unavailable for absorption. Gram doses of nicotinic acid, a form of niacin, seem to decrease the production of VLDL in the liver. It is believed that nicotinic acid impedes fat mobilization from the fat cells, which ultimately decreases fatty acids returning to the liver. If fewer fatty acids are in the liver, then less VLDL will be made. Are There Medical and Social Concerns with Childhood Obesity Overweight children are fraught with many of the same concerns as adults. Socially, overweight and obese kids are subject to teasing and other negative peer interactions leaving them prone to feeling isolated. Medically, the incidence of Type 2 diabetes mellitus in overweight children continues to climb along with the diagnosis of hypercholesterolemia and hypertension. Sadly, about 40 percent of obese children and 70 percent of obese adolescents maintain their obese status into adulthood. In addition, obese children who achieve a healthier weight before becoming adults are more prone to obesity during adulthood than children who never were obese. This is a huge concern as we are all aware of the low success rates of weight reduction and maintenance in adults. Central Europeans and Russians Diets of A health gap separates Central and Eastern Europe from the United States, Canada, Japan, and the Western part of Europe. This East-West gap in health started during the 1960s. Almost half of this gap was due to cardiovascular disease (CVD) mortality differentials. There has been a marked increase of CVD in Central and Eastern Europe, which is only partially explainable by the high prevalence of the three traditional CVD risk factors (hypercholesterolemia, hypertension, and smoking) in these countries. There is an extreme nonhomogeneity of the former Soviet bloc, and the data from each country must be analyzed individually. The aim here is to present the latest available data, which show the health status of various regions of postcommunist Europe. All data used are taken from the World Health Organization (WHO) Health for All Database (as updated in June 2003). The last available data from most countries are from the year 2002. hypercholesterolemia high levels of cholesterol in the... Consequences of Long Term Undernutrition among Homeless Children Hypercholesterolemia high levels of cholesterol in the blood Homeless adults also suffer several medical problems due to undernutrition. Common problems include anemia, dental problems, gastric ulcers, other gastrointestinal complaints, cardiovascular disease, hypertension, hypercholesterolemia, acute and chronic infectious diseases, diabetes, and malnutrition. Biliopancreatic Diversion Short- and long-term weight loss and weight maintenance has been excellent. Loss of excess body weight has been 74 percent and 78 percent at 2 and 14 years, respectively. Other beneficial effects include significant improvement of the hypoventilation and obstructive sleep apnea syndromes, hypertension, venous stasis disease, hypercholesterolemia, glucose intolerance, and adult-onset diabetes mellitus following the procedure. Marceau and associates51 in Canada reported results in 465 patients undergoing BPD-DS. Mean percentage excess weight loss at 51 months follow-up was 73 percent, or an average of 101.2 pounds per patient. Only 4 percent of patients with diabetes mellitus, 42 percent with hypertension, and 49 percent with obstructive sleep apnea or hypoventilation syndromes still required medical treatment for these obesity-related conditions. When Marceau51 compared the 457 patients undergoing BPD-DS to 233 previous patients undergoing BPD, revision rates were lower and... DeStress with strength training More and more research concludes that strength training helps reduce anxiety. Your body's response to stress is to release chemicals to prepare your body for it, like adrenaline, norepinephrine, and cortisol. Also called the fight or flight response. Being anxious about the holidays, your job, getting fit, or money also produces the stress response. But you still have those chemicals floating around in your bloodstream. Being sedentary and anxious is where stress wreaks havoc on your health - heart disease, high cholesterol, hypertension, and aging. Lifting against a resistance is a great way to burn up those lingering stress hormones and help you feel better. If Youre Dealing with High Lipid Levels However, it takes effort and commitment, changes in your eating and lifestyle, and perhaps medication. Here's what you need to do. If you have diabetes and risk factors that affect LDLs (see page 543), you may need more aggressive treatment for high LDL and total cholesterol levels. Other heart-disease-related problems may require other dietary changes get advice from your doctor or a registered dietitian. If you have high cholesterol, especially high LDLs, give your heart some TLC Therapeutic Lifestyle Changes with guidance from the National Heart, Lung, and Blood Institute a cholesterol-lowering eating plan, weight management, and physical activity advice. Eating for TLC. If you're among the many Americans with high or borderline high total blood cholesterol or LDL cholesterol levels, a few changes in your food choices and lifestyle may bring your numbers down . and boost your HDLs. Even if your levels are normal, these guidelines make sense. Can Coenzyme Q Ubiquinone Be Helpful in Preventing Heart Attacks Coenzyme Q10 (CoQ10) is found in a variety of plants and animals, and better food sources include meats (especially organ meats such as heart and liver), sardines, mackerel, soybean oil, and peanuts. The research involving CoQ10 is difficult to assess for several reasons. Often the studies are short, not long term, or the CoQ10 is provided in addition to other drugs. CoQ10 acting as an antioxidant can be yet another protective factor against free-radical activity and thus heart disease development. Furthermore, some researchers believe that CoQ10 may decrease damage to heart muscle after it has been deprived of oxygen for a brief period of time. In this situation, when oxygen floods back into the deprived cells, there is an increased opportunity for free-radical production. Further still, many researchers have determined that the use of statin drugs for high cholesterol levels may compromise CoQ10 status in cells making CoQ10 supplementation along with statin drug use good practice. Vitamin D The Sunshine Vitamin On the other hand, vitamin D is fat soluble, so taking large supplemental doses can be dangerous. Some of the toxic effects involve drowsiness, diarrhea, loss of appetite, headaches, high blood pressure, high cholesterol, fragile bones, and calcium deposits throughout your body (including your heart, kidneys, and blood vessels). If you are taking supplements, make sure you're not getting much more than the recommended amount for your age category you'll notice that folks over 50 need more. Also, note that the adequate intake (AI) for vitamin D is given in micrograms on the chart the vitamin D in food and supplements is usually measured in international units (IU)-The conversion is one microgram 40 international units (IU). Weight Cyclingthe YoYo Problem Have you gained and lost the same 10, 20, or even 30 pounds over and over again The cycle of repeatedly losing and regaining weight can make weight management more difficult in the long run. Lost weight that repeatedly comes back may lead to feelings of frustration, failure, and poor self-esteem. According to some studies, weight cycling may even increase the risk for ongoing health problems such as high blood pressure, high cholesterol, and gallbladder disease. Have You Ever Wondered what stearic acid is It's another saturated fat, found in animal products and some plant foods, under scientific study. Research suggests that its effect may be neutral, neither raising nor lowering blood cholesterol levels. For now, there's not enough evidence to offer advice-but enough to suggest that even saturated fats work in different ways. One third of the saturated fat in beef is stearic acid. for American adults saturated fat intake is 4 to 5 times higher. Still, it's wise to be prudent, especially if you have high cholesterol levels already. You don't need trans fats for normal health. As the Dietary Guidelines advise Keep trans fatty acid consumption as low as possible. And at the same time, consume a healthful eating plan you can't eliminate trans fats completely. Characterized soy proteins enables mechanism of action research One of the major benefits of working with well-defined and characterized soy proteins is likely to be the elucidation of a credible and testable mechanism of action of the protein's cholesterol-lowering activity. One mechanism that could account for the cholesterol-lowering properties of hydrolyzed soy protein is bile acid binding. Support for this mechanism comes from studies showing a two-threefold increase in fecal bile acid excretion in young women consuming 4 of their total energy as an undigested fraction of soy hydrolysate (Wang et al., 1995). This mechanism is further supported by animal studies showing increases in fecal bile acid excretion in rats consuming soy protein hydrolysates (Iwami et al., 1986 Sugano et al., 1988 Ogawa et al., 1992 Higaki et al., 2006). Of note, the increases in fecal bile acid excretion were dose-dependent (Sugano et al., 1988) and observed whether the rats were maintained on normal or cholesterol-supplemented diets (Sugano et al., 1988 Ogawa et... Chronic Infection as a Cause of Atherosclerosis Initial attempts did produce mild atherosclerotic lesions, but overall, the results were not very impressive. Dr. Muhlestein then wondered if there could be an interplay between high cholesterol levels and the infection. He repeated the experiment using rabbits, this time feeding the animals a diet high in cholesterol before infecting them with the organism. The combination produced significantly accelerated atherosclerosis. It should be noted that these animals were infected in the same way that humans would be, by entry of the bacteria into the body through the nose. Oatmeal for Heart Health Research suggests that eating a bowlful of oatmeal (1 1 2 cups cooked) each day can help people attain lower cholesterol levels, especially when eaten as part of a low-fat diet, and especially when the person has elevated cholesterol levels to begin with (Expert Panel 2001). In a six-week study of healthy adults who ate oatmeal for breakfast, cholesterol dropped 10 points (Katz et al. 2005). Of course, a low-fat diet is as important as Folic Acid Plus B and B Red rice yeast (cholestin) is currently being investigated as a way to lower cholesterol. With an ingredient called monacolin K that inhibits the production of cholesterol, red rice yeast looks promising as a food-based method of lowering LDL plaque. Red rice yeast also contains plant sterols, which may contribute to its cholesterol-reducing effects. Why this works You dont really exercise with them All the things you want from exercise but don't yet have - a better body, lower cholesterol, low blood pressure, more people showering you with compliments of how wonderful you look - will come only from pushing yourself just a little harder. Put a Whole in Your Diet When cooked into a tasty hot cereal or eaten raw as in muesli, oatmeal makes a wonderful breakfast that helps lower cholesterol and protect against heart disease. Some people even keep microwaveable packets of instant oatmeal in their desk drawers for cozy afternoon snacks. Oatmeal (instant and regular) is a whole-grain food with slow-to-digest carbohydrate that offers sustained energy and is perfect for a preexercise snack. Coronary heart disease CHD In conclusion, the apparent benefits of vitamin E in individuals with existing coronary disease were not consistent with the proposed role of antioxidants to prevent initiation or block propagation of lesions (HOPE, 2000). However, Steinberg hypothesised that unlike agents that lower cholesterol or blood pressure which have an immediate benefit, antioxidants may have to be used for more than 5 years to have demonstrable benefits, since the primary mechanism of these agents may be in the prevention of new lesions (Stephens et al, 1996). Further work on the possible effects of vitamin E on the clinical aspects of cardiovascular disease is needed. At present possibly the best advice to give is to recommend a balanced diet with emphasis on antioxidant-rich fruits, vegetables and whole grains. Plant Sterols or Stanols You may know them as Take Control and Benecol. Whatever name they go by, these new margarine-like spreads may turn out to be promising weapons in the war against elevated total and LDL cholesterol levels. Plant sterol esters or stanol esters are natural substances found in wood pulp, leaves, nuts, vegetable oils, corn, rice, and some other plants. Now there is some evidence that the spreads (and salad dressings) made with plant sterols or stanols can actually reduce cholesterol absorption, and decrease the LDL cholesterol levels. For people trying to lose weight, light versions of these spreads are also available. How Important Are Blood Lipids in Determining the Risk of Heart Disease and Stroke LDLs are a major player in the development of atherosclerosis. Because elevations in LDL-cholesterol are associated with increased risk of heart disease and stroke, it is often deemed the bad cholesterol. Although it may not be this simple, higher LDL-cholesterol levels means that there are more LDLs in the blood, which in turn means more LDLs that can participate in atherosclerosis. On the other hand, HDL-cholesterol seems to decreases the risk of heart disease and it is often referred to as the good cholesterol. Researchers believe that the virtuous nature of HDLs is due to their ability to gather some of the cholesterol associated with atherosclerotic plaque. This could slow the progression of atherosclerosis. In addition, HDLs carry antioxidants which can reduce LDL oxidation. A blood lipid profile can help to assess an individual's risk. Among the several telling indicators are elevated total and LDL-cholesterol levels, reduced HDL-cholesterol levels, and elevated ratios of total... Have You Ever Wondered 112 Treating hypothyroidism with medication-thyroid hormone-also helps reduce high LDL cholesterol levels associated with this condition. Untreated, hypo-thyroidism can damage the cardiovascular system permanently. Cholesterol-lowering, butterlike spreads, juice, and yogurt (with plant stanol or sterol esters) for more LDL-lowering benefits. Weight Management. Maintain or improve your weight. The more excess body fat you have, the greater your risk for heart disease. If you're overweight, losing weight can help you lower LDL cholesterol, especially important if you have high triglycerides and or low HDL cholesterol, and carry excess abdominal fat. Those who carry a spare tire around their abdomen have a higher cardiac risk than those with extra padding around their hips and thighs. See chapter 2, Your Healthy Weight. It helps boost your HDLs and lower your LDLs and triglycerides, helps reduce blood pressure, helps your body control stress, and helps reduce excess body weight as you burn... How Does Linoleic Acid Omega PUFA Impact Heart Disease When saturated fat is replaced in the diet with polyunsaturated fat, total and LDL-cholesterol levels are reduced, particularly in people with elevated levels. In fact, linoleic acid, an omega-6 fatty acid, is likely to be the most potent fatty acid when it comes to lowering blood cholesterol levels in this manner. By lowering total and LDL cholesterol, heart disease risk is lowered. Linoleic acid can be found in safflower, sunflower, corn, soybean, and canola oils. So replacing animal fat with plant fat (oil) could be helpful in preventing heart disease. However, one important consideration is that the level of omega-6 fatty acids should be in a healthy ratio with omega-3 fatty acids as explained below. Nuts Seeds And Oils While 73 to 95 of the calories in nuts come from fat, they are low in saturated fat. On average, nuts contain about 60 of their calories from monounsaturated fat, which facilitates a reduction in blood total- and LDL cholesterol levels, without lowering the HDL cholesterol levels. A number of clinical trials have demonstrated the effectiveness of diets that contain either almonds, pecans, peanuts, hazelnuts, macadamia nuts, pistachios, or walnuts to significantly lower blood cholesterol levels.122-129 Human feeding trials that incorporated these nuts into the diet produced significant reductions in LDL cholesterol levels ranging from an 8 decrease with macadamia nuts to a 16 decrease with walnuts. Except for the studies with almonds and pistachios, all of the clinical trials involved normocho-lesterolemic subjects. Only in the case of the pistachio study did HDL cholesterol levels increase (up 12 ).129 In an analysis of the nut-feeding studies, Kris-Etherton reports that the... Studies Relating Very Low Meat Intake To Longevity A group of 5000 non-vegetarians were identified using a method whereby investigators asked the vegetarians to identify friends and relatives of similar lifestyle and social class but who ate meat. These 11,000 subjects completed a food frequency questionnaire at baseline (1980-1984) with items on meat intake and were then enrolled in a 12-year follow-up. In a validation sub-study, conducted 2-4 years after baseline, it was found that the non-meat-eaters had significantly lower total cholesterol and LDL cholesterol levels. Thorogood et al.90 reported the relation between very low meat intake and all-cause mortality in this study population. Can Fiber Impact Heart Disease Prevention Dietary fiber, especially soluble fiber found in oats, barley, and legumes (for example, beans, peas and lentils), and psyllium can have a positive impact on blood cholesterol levels. The relationship between fiber (namely beta-glucans) from these food sources and cholesterol lowering Soluble fibers from these sources influence blood cholesterol levels by interacting with cholesterol digestive tract and decreasing its absorption. These fibers may also undergo breakdown by bacteria in the colon and the byproducts have been noted to potentially reduce cholesterol production in the liver. Eat More Good Fat and Reduce Your Intake of Bad Fats Now, the bad way to go about adding fat to your diet is to simply eat any type of food that has fat in it. This is not the best approach simply because most high fat foods contain saturated fat and trans-fat. Saturated fat is the artery clogging fat that raises your cholesterol levels and can give you heart disease later down the road. Trans-fat is a mutant fat that is even worse for you than saturated fat Monounsaturated fats are easily found in olive oil and avocadoes. They are known to help lower bad cholesterol levels, and raise good cholesterol levels. Olive oil is an easy to find, inexpensive oil that can be easily added to your diet. Antioxidantsyour Ace Against Oxygen Rebels Another lipoprotein which may result from excess or oxidized fat has been labeled lipoprotein-a. This fat globule has an enormous tendency to stick inside the walls of weakened vessels. A reevaluation of the Framingham heart study indicated a risk for heart disease from lipoprotein-a which was ten times greater than for high levels of LDL (bad cholesterol). *85 Be prepared it may be that LDLs, now lumped together under the term bad cholesterol, will one day be broken into sub-categories ranging from better to worse with these more recently discovered lipoproteins among them. They may become a part of standard blood lipid testing. With these renegade toxic radicals one thing leads to another, impairing the system at every step along the way. Treating Abnormal Blood Lipids The National Cholesterol Education Program, the American College of Cardiology, and the American Heart Association recommend diet and lifestyle modification as the first line of defense against abnormal blood lipids. These recommendations include a diet low in total fat, saturated fat, and cholesterol a diet high in fiber weight loss or weight management increased physical activity smoking cessation increased intake of plant sterols (e.g., margarines and salad dressings made with soybean sterols) and daily use of a low-dose aspirin. Drug therapy may be required for high-risk individuals. Cholesterol-lowering drugs works to lower LDL by reducing cholesterol synthesis and by binding bile acids in the small intestines. However, there are possible side effects to these drugs that patients should be aware of. SEE also Arteriosclerosis Atherosclerosis Cardiovascular Diseases Fats. Personalized Medicine Nutrigenomics offers a personalized medicine, using nutrient, dietary, and lifestyle interventions to mitigate adverse biochemical pathways. Here is an example of a nutrigenomic intervention that allows the practitioner to restore a muscle-building environment Some statin medications used to treat heritably elevated cholesterol may deplete mitochondrial enzyme function and coenzyme Q10, which results in mitochondrial energy uncoupling, oxidative stress and subsequent cell death.38,39 The use of coenzyme Q10 supplements has been suggested to improve mitochondrial function in muscle and reduce myopathic pain in patients who have adverse response to statins.40-43 This intervention utilizes coenzyme Q10 as a conditionally essential nutrient to replete a critical biomolecule necessary for proper mitochondrial function. This is an example of personalizing the nutrient intake for the specific gene-environment relationship of the patient. What Information Can We Derive from a Blood Cholesterol Test The fractions of total cholesterol are the amount of cholesterol found in each type or class of lipoproteins. Thus LDL-cholesterol is the cholesterol only found in LDL. And likewise HDL-cholesterol is the cholesterol found only in HDL. With regard to heart attacks and strokes, having a total cholesterol level greater than 200 milligrams per 100 milliliters of blood and elevated LDL- and low HDL-cholesterol levels increase the risk (Table 5.6 has a sample lipid profile). Do Trans Fatty Acids Increase the Risk of Heart Disease Trans fatty acids are naturally found in low percentages in most animal fats, including milk and dairy products. These fatty acids are made by bacteria in the stomachs of cows and other grazing animals, by converting cis unsaturated fatty acids in grass and leaves to trans (see Chapter 5). Furthermore, when vegetable oils are hydrogenated, some of the points of unsaturation are converted from a cis to a trans design. It does appear that trans fatty acids impact blood lipids in many people by raising total and LDL-cholesterol when compared with oils containing unsaturated fatty acids. In addition, HDL-cholesterol levels may also be reduced. Thus the important message is that trans fatty acids can have an unhealthy effect similar to saturated fatty acids. Thus, one of the most potent ways to lower your total and LDL cholesterol is to limit saturated fat and trans fatty acid levels in your diet. Rice for Medical Therapy and Prevention Rice has been the mainstay of treatment for a number of conditions, particularly for hypertension at a time when few effective drug therapies were available. In the 1940s, Walter Kempner developed a treatment for mild, and even malignant, hypertension at Duke University. His hypothesis was that a low-protein diet, free of salt, would be an effective treatment. He devised the rice diet, which consisted of rice, fruits, and vegetables. This treatment had good results the blood pressure of his patients fell, and even malignant hypertension was partially reversed. In addition, blood cholesterol levels also fell. Since this was a cholesterol-free and low-fat diet, it was one of the first to document a cholesterol-lowering effect from diet. Systematic Review Evidence Self-help resources, in terms of reducing total serum cholesterol in adults. The reviewers electronically searched the Cochrane Library, MEDLINE, EMBASE, CINAHL, Human Nutrition, the Science Citation Index, and the Social Sciences Index. They also hand-searched conference proceedings and contacted experts to find all of the randomised controlled trials through 1999. Randomised controlled trials that compared the effects of dieticians' advice on serum cholesterol levels with the effects of advice by other health professionals or self-help packages were selected. Decisions on inclusion were duplicated by two independent reviewers and disagreements were resolved by discussion or by a third reviewer. Two reviewers independently extracted the data from included studies and assessed trial quality. Patient follow-up of at least 80 in both groups was achieved for four studies only, but blinded and reliable assessment of blood cholesterol was done for all studies. Most studies ensured that... Diet nutrition and the prevention of chronic diseases through the life course There has been great interest in the possible effect of high-cholesterol feeding in early life. Reiser et al. (49) proposed the hypothesis that high-cholesterol feeding in early life may serve to regulate cholesterol and lipoprotein metabolism in later life. Animal data in support of this hypothesis are limited, but the idea of a possible metabolic imprinting served to trigger several retrospective and prospective studies in which cholesterol and lipoprotein metabolism in infants fed human milk were compared with those fed formula. Studies in suckling rats have suggested that the presence of cholesterol in the early diet may serve to define a metabolic pattern for lipoproteins and plasma cholesterol that could be of benefit later in life. The study by Mott, Lewis & McGill (50) on differential diets in infant baboons, however, provided evidence to the contrary in terms of benefit. Nevertheless, the observation of modified responses of adult cholesterol production rates, bile... How Do Omega Fatty Acids Impact Heart Disease Omega-3 PUFAs, such as linolenic acid and DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) can have a favorable impact, lowering the risk of cardiovascular disease. However, since omega-3 fatty acids have not been shown to lower blood cholesterol levels in a consistent manner in research studies, the cardioprotective effects must extend beyond that mechanism. For instance, omega-3 fatty acid intake is associated with How Does Food Cholesterol Impact the Development of Heart Disease One of the earliest recommendations for reducing blood cholesterol levels was to follow a low cholesterol diet. However, it soon became apparent that blood cholesterol levels are influenced more by how much saturated fat is eaten rather than cholesterol. Cholesterol is derived from animal How Does Olive Oil and Oleic Acid Impact Heart Disease Much interest in MUFA, namely oleic acid, was generated when studies of heart disease in various populations around the world revealed that certain Mediterranean countries enjoyed a relatively lower incidence of heart disease despite eating a diet that would be considered rich in fat. Further evaluation revealed that these people ingested much of their fat in the form of olive oil, which has a high percentage (77 percent) of the MUFA oleic acid. This resulted in several research studies which determined that when oleic acid replaced palmitic acid in a diet, blood cholesterol levels were lowered by decreasing the amount of LDL-cholesterol in the blood. Researchers also determined that while this significantly impacted heart disease risk it didn't explain all of the cardioprotective Olive oil doesn't raise cholesterol levels and contains antioxidants that can protect arteries. Can Garlic Help Prevent Heart Disease Garlic has sulfur-containing substances including allicin and its breakdown products diallyl sulfides, which are purported to have medicinal properties. There are several reasons to believe that garlic can play a role in preventing heart disease. First, garlic-derived compounds lessens the activity of the key enzyme in cholesterol formation. However, garlic supplementation has not consistently been shown to lower blood cholesterol levels. Researchers have determined that garlic might be an inhibitor of blood clot formation, which is a principal cause of heart attacks, as well as having anti-inflammatory and antioxidant properties. Considered together there is strong reason to believe that garlic can play a contributing role in promoting a healthy cardiovascular system. Dont Be Fooled by Misleading Labels How does saturated fat work its way into the cholesterol picture This artery-clogging culprit can also raise blood cholesterol levels. Just imagine how harmful the high-fat animal foods such as marbled red meats and whole milk dairy products can be they contain both saturated fat and cholesterol. How Can Plant Sterols Help Lower Heart Disease Risk Sitosterol, stigmasterol, campesterol, and sitostanol can lower blood cholesterol levels. Phytosterols appear to block the absorption of cholesterol in the digestive tract, which in turn lowers the level of total and LDL cholesterol in the blood. As these sterols are found in plant oils (especially unrefined oils), this may help explain some of the cholesterol-reducing properties of those oils. Phytosterols are also found in nuts, seeds, whole grains, and legumes. Commercially available spreads such as Take Control and Benecol are produced with phytosterols to be used by people trying to lower their cholesterol. Cholesterol Homeostasis Since cholesterol is also supplied by foods, interactions between exogenous supply and endogenous synthesis are of great significance. Plasma cholesterol levels, which have been established as an independent pathogenetic risk factor, are used as a parameter. In the case of low cholesterol intake, which can only be achieved by a strict dietary regimen, the contribution of food cholesterol to total cholesterol metabolism is minor (B). Assuming 55 absorption, the cholesterol supplied by foods makes up only 10-15 of the cholesterol used in a day. In this case, plasma cholesterol levels and LDL receptors (responsible for cellular uptake) remain in a steady-state. The body can react to the commonly occurring increase in the supply from foods in two ways compensate for the increased supply by reducing endogenous synthesis while maintaining a constant number of LDL surface receptors, or fail to compensate. In the latter case, the result is an increased cholesterol influx into the cells with... Eggs and Heart Health Eggs have gotten a bad rap when it comes to healthy eating. Medical experts have told us that eating eggs is bad because a single egg has 210 milligrams of cholesterol. This just about hits the American Heart Association's recommended limit of 300 milligrams per day. But more recent studies suggest that egg cholesterol may have little effect on many people's blood cholesterol levels, especially in combination with an overall low-saturated-fat diet (Katz et al. 2005 Kritchevsky and Kritchevsky 2000). In fact, an estimated 85 percent of Americans can eat a high-cholesterol diet with no elevation of blood cholesterol. Among 49 healthy men and women who ate two eggs daily for six weeks, blood cholesterol levels remained stable (Katz et al. 2005). Too Much of a Good Thing High-fat eating, especially high saturated fat and excessive trans fats, is linked to higher blood cholesterol levels and so a greater chance for heart disease. There's more reason for caution eating a high-fat diet also increases the risk for obesity, and a diet high in saturated fat, for colon and prostate cancers. Regulatory hurdles for nutrigenomics A very real challenge for parties interested in bringing nutrigenomics to the marketplace is open communication and education of regulators who have been accustomed to more direct medical diagnostic applications for genetics, such as testing for cystic fibrosis or Huntington's chorea. Moving regulators and health care professionals from an expectation of a particular genetic result leading to a particular health outcome, as is the case with single gene disease diagnostics, to the more nuanced applications in nutrigenomics, where there is a significant dietary or environmental component that contributes to an expected outcome, has already proven to be a challenge for industry members. The challenges of moving from the deterministic 'gene equals disease equals diagnosis' model, coupled with the fact that the science of nutrigenomics is relatively young, with many of the studies based on the tracking of biomarkers, such as cholesterol levels, DNA adduct levels and homocysteine levels,... The priorities for nutritional enhancement For the developed world The only plant-derived food product on the market where nutritional health benefits are claimed (as opposed to implied) is the enrichment of margarines with plant sterol and stanol esters for the reduction in plasma cholesterol levels (Fig. Experiments with plant stanol esters were shown to lower serum cholesterol consistently by about 10-15 and LDL-cholesterol by about 20 in patients with high serum cholesterol levels as well as in normal individuals.16, 17 Similar effects have been seen with plant sterol esters but at least 1 g day of plant sterols need to be consumed.18 Consequently, they require extraction and addition to foods. The ideal situation would be for sufficient sterols to be present in our diets to ensure that plasma cholesterol levels are kept reasonably low without the need to buy a specific functional food, and that they would be in a fat-soluble form for effective uptake. The evidence favours, in increasing order of preference, the use of More Products Lower Your Cholesterol In Just 33 Days Discover secrets, myths, truths, lies and strategies for dealing effectively with cholesterol, now and forever! Uncover techniques, remedies and alternative for lowering your cholesterol quickly and significantly in just ONE MONTH! Find insights into the screenings, meanings and numbers involved in lowering cholesterol and the implications, consideration it has for your lifestyle and future!