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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 Overview 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. 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 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. Cholesterol metabolism The average North American diet provides approximately 300 to 500 mg of cholesterol per day,13 ingested as either free cholesterol or cholesteryl esters. A feedback system exists in which cholesterol synthesis decreases as the ingestion of dietary cholesterol is increased. Endogenous supplies originating from newly synthesized cholesterol, bile, and intestinal mucosal epithelium are about 1000 to 1600 mg day.14 Synthesis of cholesterol is a multistep process regulated by 3-hydroxy-3-methylglu-taryl-CoA (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol biosynthesis. When an increase in dietary cholesterol occurs, a reduction in hepatic cholesterol synthesis is observed, while synthesis in peripheral tissues may not be altered.15 In this way, hepatic synthesis is the primary regulator of cholesterol balance in the body, despite the human liver accounting for only 10 of whole-body synthesis.16 In hamsters fed a diet containing 2 cholesterol (wt wt), cholesterol feeding induced... 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... 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... 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. 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 Compelling research suggests that fatty buildup in arteries begins in childhood and is more likely with higher blood cholesterol levels. For that reason, the American... 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). 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. 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. 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. 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. 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. This extract has shown a capacity to lower cholesterol and contains high levels of luteolin, a powerful anticancer and antioxidant flavonoid. Do not take if you have gallbladder disease. There are no... 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. 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. 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. Lifestyle Changes. Diet, weight management, and physical activity aren't the only ways to lower blood cholesterol levels. Lifestyle changes in support of TLC also can reduce... 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. 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... 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... 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. 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. 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... 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. Design Of Treatment For Type Diabetes Based On Nutrient Interactions The PPAR-a agonist group of drugs include those synthetic, therapeutic agents that are molecular targets for fibrates, such as gemfibrozil, bezafibrate, clofibrate, and fenfofibrate, which are used to treat dyslipidemia and cardiovascular disease. PPAR-a promotes fatty-acid transport across cell membranes and converts them into a metabolic form that precedes their subsequent metabolism. These drugs are gaining popularity in combination treatment with the statins (23). 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. 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 Cholesterol in the blood and tissues is derived from two sources diet and endogenous synthesis. Dairy... 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 Cholesterol Biosynthesis Due to the significance of hypercholes-terolemia for the pathogenesis of various diseases, regulation of cholesterol biosynthesis is the focus of intense research. Transcriptional control of a diversity of enzymes involved in this biosynthesis is of particular interest. Expression can be triggered by various stimuli, e.g., cholesterol levels, expression of LDL receptors, or, more generally, by dietary composition. Additionally, these different factors may interact with one another. Meat Palaeolithic diets and health Studies have shown that Australian Aborigines have shown significant health improvements, including a reduction in blood cholesterol levels, after returning to their natural diets, where there is a high reliance on animal foods (O'Dea, 1991). Research of macronutrient proportions in the diet of hunter-gatherer populations shows a clear relationship between high protein content and the evolution of insulin resistance, which offered a survival and reproductive advantage (BrandMiller and Colagiuri, 1994). However, the advent of agriculture saw the rise of a diet higher in carbohydrate this has meant that people were unprepared for the high glycaemic load which in turn is responsible for the current incidence of non-insulin dependent diabetes mellitus (Brand-Miller and Colagiuri, 1994). However, we must also remember that humans are not carnivores and thus we cannot exist on protein intakes above 35 energy for extended periods of time. 'A clear role for lean red meat in a healthy balanced... Drinks With or without Caffeine Over the years many studies have explored the connection between caffeine and health. No scientific evidence has been found to link caffeine intake to any health risks, including cancer (pancreatic, breast, or other types), fibrocystic breast disease (benign fibrous lumps), cardiovascular disease, blood cholesterol levels, ulcers, inflammatory bowel disease, infertility, birth defects, or osteoporosis. Dietary Interventions That May Alter Risk Factors While dietary advice has a role to play in normalizing abnormal serum lipids in people with cardiovascular disease, aspects of diet that clearly protect against death and disease should be given greater emphasis than lipid reduction in this group. Dietary changes are likely to result in reductions of total cholesterol of about 5 ,25-27 while statin trials reduce total cholesterol by 18 to 28 therefore, lipid lowering medication is more effective than dietary advice.25 Metabolic ward studies suggest that replacing 60 of saturated fats by other fats and avoiding 60 of dietary cholesterol would reduce serum total cholesterol by 0.8 mmol L (about 13 ), but it appears difficult to maintain this in a normal lifestyle.25 Replacing saturated fats with unsaturated fats leads to improved lipid levels28 and a reduction in cardiovascular events, but it is not clear whether polyunsaturated or monounsaturated fats are more cardioprotective.29 Daily use of realistic levels of soluble fiber (found in... Thiamin Riboflavin and Niacin Toxicity is not a problem except in the case of niacin. Nicotinic acid, a form of niacin, is often prescribed by physicians to lower elevated blood cholesterol levels. Unfortunately, it has some undesirable side effects. Starting at doses of 100 milligrams, typical symptoms include flushing, tingling, itching, rashes, hives, nausea, diarrhea, and abdominal discomfort. Flushing of the face, neck, and chest lasts for about 20 minutes after a person takes a large dose. More serious side effects of large doses include liver damage and high blood sugar levels. Vitamins and Vascular Disease These three vitamins are cofactors in the metabolism of methionine. If one or more of these vitamins is deficient, blood and tissue levels of homocysteine will rise. Several recent studies have shown that even modest elevation of homocysteine, even within the normal range, can significantly increase the risk of a heart attack, stroke, or peripheral vascular disease.381 Smoking, obesity, inactivity and stress can all increase homocysteine levels. Homocysteine is an independent risk factor, possibly having more importance than cholesterol levels. 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... 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. Soy Foods and Heart Health At one time, soy was believed to lower the bad LDL cholesterol and increase the good HDL cholesterol. This shift would offer protection against heart disease. The current research suggests that soy and substances in soy called isoflavones do not protect against heart disease. Yet, soy products can still be beneficial because of their high content of polyunsaturated fat, fiber, vitamins, and minerals (Sacks et al. 2006). Soy foods are also low in saturated fat, so when you choose soy foods for dinner, you forgo prime rib and other artery-clogging choices. 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. The American Heart Association recommends that you limit your dietary cholesterol to less than 200 mg a day consume 25-35 percent of your total calories from fat (with less than 7-10 percent of total calories coming from saturated fat). What Are Lipoproteins and What Do They Do Water-insoluble substances such as fat, cholesterol, and other nutrients throughout the body in circulation. They are in effect lipid-laden submarines. Since the cholesterol in the blood is found aboard lipoproteins, total blood cholesterol is the sum of the cholesterol being carried in the different types of lipoproteins. A clinical laboratory is able to determine the quantity of cholesterol in each lipoprotein class (for example, HDL-cholesterol or LDL-cholesterol). 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... Heavy Alcohol Consumption For most adults, occasional moderate alcohol drinking (one to two drinks per day) is not harmful, and may have health benefits. Moderate alcohol drinking can increase the HDL-cholesterol level in the blood, decrease risk of blood clots, and reduce risk of heart attack.1 However, regular heavy drinking (more than three to four drinks per day) is a health hazard. (A drink is considered a 180-ml glass of wine, 360-ml glass of beer, or 30-45 ml of spirits.) Heavy drinking increases risk of high blood pressure, stroke, liver disease, im Use in Prevention and Therapy Vitamin B6 has multiple beneficial actions in the prevention and treatment of coronary heart disease and peripheral vascular disease. It reduces the tendency for platelets to clump together, lowers LDL cholesterol and raises HDL cholesterol, and reduces levels of blood homocysteine.8,9 Deaths from Other Vascular Diseases Seventy-four deaths from CHD other than acute MI were identified during follow-up (41 per 100,000 person-years). In contrast to the inverse relationship with acute MI mortality, neither fish and shellfish nor marine n-3 fatty acid intake was associated with mortality from other forms of CHD (Table 2.2 and Table 2.3). Adjustment for known cardiovascular disease risk factors or the ratio of serum total to HDL cholesterol did not materially change these associations. 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. Soy Protein as a Cholesterol Lowering Nutrient The evidence-based review by the AHRQ concluded that, for the soy products used in the evidence-based analysis, the consumption of these products yielded a significant net reduction of low density lipoprotein (LDL) cholesterol (-5 mg dl, 95 confidence interval CI -8to -3 mg dl) (Balk et al., 2005). There was, however, considerable variability in the cholesterol-lowering response. Using the nutrigenomic model of Figure 2.2, a key question to ask relates to the nature of the soy protein used in the various studies. As it turns out, many different sources of soy protein were used in these studies and they were consumed in a variety of TABLE 2.1 Nutrient bioactive information provided in the AHRQ evidence-based review of soy protein studies of cholesterol reduction Taking medicine changing your appetite Some examples of appetite uppers are certain antidepressants (mood elevators), antihistamines (allergy pills), diuretics (drugs that make you urinate more frequently), steroids (drugs that fight inflammation), and tranquilizers (calming drugs). Appetite reducers include some antibiotics, anti-cancer drugs, anti-seizure drugs, blood pressure medications, and cholesterol-lowering drugs. Developing nutritionallyenhanced cerealbased foods Current status Arguably, however, the key growth area has been fibre-enriched products. These products may be enriched with cereal-based dietary fibre or fibre derived from other plants, for example psyllium. As discussed in more detail elsewhere in this book, dietary fibre has been shown, or is thought to be, beneficial in managing the risk of a number of diseases. From classical times (British Nutrition Foundation, 1990) the beneficial effects of cereal fibre and in particular insoluble fibre on colonic function have been known. More recent work, such as the meta-studies of Ripsin et al (1992) have demonstrated that soluble fibres may have beneficial blood cholesterol lowering effects, particularly when eaten as part of a reduced fat diet. Critical evaluation of present knowledge Modulation of intestinal and systemic immune responses. Reduction and protection of radiotherapy-associated intestinal dysfunction. Prevention of intestinal cancers Intestinal microflora effects, immunomodulation effects, competitive exclusion, cholesterol lowering Worksheet Determine Your Maximum Fat Limit Cholesterol is made in the liver, is an essential part of body cells, serves as a building block for some hormones (e.g., testosterone and estrogen), and it is required to digest fats. Cholesterol is also consumed in the diet by eating animal products. High intakes of dietary cholesterol and saturated fats are associated with an increased risk for heart disease. The American Heart Association recommends that daily cholesterol intakes should not exceed 300 milligrams (mg.). Red meats and egg yolks are examples of cholesterol rich foods that should be consumed in moderation. Inhibition of cholesterol absorption or synthesis Plant sterols (such as -sitosterol, which differs from cholesterol in the structure of the side-chain) and stanols (which differ from sterols in having a saturated B-ring see Figure 4.13) inhibit the absorption of cholesterol from the small intestine. As discussed in section 4.3.2.1, in addition to about 500 mg of dietary cholesterol, about 2 g of cholesterol is secreted each day in the bile. Almost all of this is normally reabsorbed any inhibition of cholesterol absorption is therefore likely to have a more marked hypocholesterolaemic effect than might be expected simply by considering the dietary intake. A number of products, such as margarine, yoghurts and cream, that contain plant sterols and or stanol esters have been marketed. Squalene, which is the last non-cyclic intermediate in cholesterol synthesis. Almost uniquely among foods, olive oil is rich in squalene. Studies of the effects of fatty acids on plasma cholesterol in the 1950s and 1960s showed a cholesterol-raising effect... Cooking Oils for Heart Health Cooking with olive and canola oil is far more healthful than using butter, stick margarine, bacon grease, lard, salt pork, and animal fat, which are all solid at room temperature. If you use a significant amount of margarine, you may want to use Take Control, a margarine with sterols, a substance that interferes with the absorption of dietary cholesterol. Two tablespoons a day (to equate to 2 grams of plant sterol per day) can contribute to lower LDL (bad) cholesterol by 10 percent or more. Well Equippedfor Healthful Cooking An egg separator helps you easily separate the yolks from the whites. That's important when you're cutting back on dietary cholesterol. Using an egg separator has a food safety benefit, too. Compared to the technique of transferring the yolk back and forth between the two shell halves, using an egg separator reduces the chance of transferring bacteria from the outside of the shell to the uncooked egg. Klaus KA Witte and Andrew L Clark Zinc is a powerful site-specific antioxidant.39 Deficiency leads to elevated oxi-dative stress and cholesterol levels in rats.40,41 A combination of zinc deficiency and ethanol can lead to contractile dysfunction in pre-ischemic conditions in the rat Copper is absorbed through active processes from the stomach and duodenum. Excretion occurs mainly via the gastrointestinal tract. Deficiency is rare but has been seen in patients receiving total parenteral nutrition (TPN) and premature infants. Copper is also a powerful antioxidant and is involved in the acute phase reaction. As such it is involved in the regulation of oxidative free radicals and deficiency increases lipoprotein peroxidation.44 Copper-deficient cardiomyopathy has been described in patients on TPN.45 This may be due to decreased cytochrome C oxidase activity46 that causes a reduction in mitochondrial activity. Experimental copper deficiency in rats leads to increased risk of myocyte oxidative damage47 and long-term copper... Intestinal microflora physiology and functions In ruminant species, propionate is a major glucose precursor but this is not an important role in hindgut fermenting species such as man. Propionate is largely cleared by the liver and has not been shown consistently to have significant effects on carbohydrate metabolism in human subjects. In vitro, propionate inhibits uptake of acetate into the cholesterol synthesis pathway, and in both rats and pigs propionate supplementation of the diet reduces cholesterol levels in blood. In human feeding studies of propionate only one out of three currently reported shows any change in blood cholesterol levels (Venter et al. 1989 Todesco et al. 1991 Stephen, 1994). Strengthening the Heart Muscle Cholesterol-lowering drugs all deplete CoQIO. This is because the enzyme that generates cholesterol, HMG CoA reductase, is also responsible for the production of CoQIO. The Cholestyramine drugs (Questran, LoCHOLEST and Prevalite) also lower beta-carotene, folic acid, and vitamins A, D, E, and K by inhibiting absorption. The drug, Colestid, inhibits absorption of beta-carotene, folic acid, and vitamins A, D, and E. (Source Natural Medicines Comprehensive Database, 2001). Foods Nutrients Vegetarianism and Coronary Heart Disease It is likely that the reduction in CHD among vegetarians is, at least partly, due to a lower serum cholesterol concentration caused by a lower dietary intake of saturated fat and cholesterol. Unfortunately, none of the five prospective studies of mortality in vegetarians has complete information on serum cholesterol concentrations in all subjects, therefore, it is currently impossible to investigate whether the difference in CHD between vegetarians and non-vegetarians can be statistically explained by the difference in cholesterol levels. Some data are available, however, on the relationships of various foods to CHD within the cohort studies of vegetarians. Meat intake was strongly positively associated with CHD among male Seventh-Day Adventists in the two large prospective studies in California.49,77 There was also a positive, but weaker, association with meat intake among women in the earlier study,77 but not in the more recent study.49 Eggs, but not dairy products, were also... Eating to Stay Healthy for the Long Few people fully appreciate the power of food in the prevention and treatment of the so-called diseases of aging, which are, in reality, diseases of inactivity and poor nutrition. In this day and age where people are taking all sorts of medications to lower cholesterol, blood sugar, and blood pressure and to deal with other health concerns, we forget that, just as the wrong foods can be powerfully bad for your health, the right foods can be powerfully health protective. By eating wisely, you are investing in your good health and top performance alternatively, you can eat poorly and end up with your poor health controlling you and your life. Saturated Fats vs Unsaturated Fats Monounsaturated fat (monos) and polyunsaturated fats (polys) are considered the good fats. At the other end of the fat spectrum are saturated and trans fats, known to increase the risk for atherosclerosis and heart disease. When monos or polys are substituted for saturated fats or trans fats in the diet, they can lower total blood cholesterol and triglycerides (fats in the blood) and raise healthy, high-density lipoprotein cholesterol (HDL, the good cholesterol) levels in the blood. They also improve insulin sensitivity and help regulate blood pressure. Saturated fats and trans fats, on the other hand, are the bad fats. These fatty acids raise blood cholesterol levels and markers of inflammation, and are linked to excess belly fat. Excess saturated fat is associated with increased risk for heart disease, diabetes, and certain cancers. Interactions with other nutrients and drugs Omega-3 fatty acids lower triglyceride concentrations and may have a synergistc effect with the triglyceride-lowering effects of agents such as niacin, fibrates such as gemfibrozil, or resins such as cholestyramine. However, ro-3 fatty acids may work against the low-density lipoprotein (LDL) cholesterol-lowering properties of statin drugs.49 Methylmethoxyisoflavone Methoxyisoflavone A Hungarian company called Chinoin in the 70s originally studied Methoxy. The company has a patent on methoxy and lists its many effects on metabolism, including increased protein synthesis, increase lean mass, reduced body fat, promoted endurance, lowered cholesterol levels and an improvement in the body's ability to use oxygen. Faecal bulking index and wheat bran equivalents Originated from the physiological concept of dietary fibre as roughage - plant cell wall material not digested by human enzymes in the gut, and responsible for stool bulk.76 The plant cell wall still remains central to most definitions of dietary fibre and corresponding methods of analysis,77 although, the definition is being extended to include added non-digestible polysaccharides and oligosaccharides that have beneficial effects.78,79 But 'beneficial effects' specified as part of the definition of dietary fibre include blood cholesterol-lowering and blood glucose-lowering effects, and are not confined to those associated with faecal bulking, so the definition has become too broad to be useful. In fact, dietary fibre analysis has never been congruent with the original physiological concept of dietary fibre as faecal bulking 'roughage', because it measures materials resistant to digestion by foregut proteases and amylases, while faecal bulk depends also on resistance to hind gut... The Effect Of A Vegetarian Diet On Performance Nineteen long-term (mean of 46 years) vegetarian and 12 non-vegetarian, healthy, physically active elderly women (mean age of 71 years) were compared on a variety of hematological, anthropometric, and metabolic factors.30 Although the vegetarian subjects had significantly lower blood glucose and cholesterol levels, no differences between groups were found for submaximal and maximal cardiorespiratory and electrocardio-graphic parameters measured during graded treadmill testing. The authors Animal product intake was measured and related to VO2max in a group of 80 women who varied widely in age, body mass, maximal aerobic power, and meat intake (1.1 to 31.6 meat exchanges per day).33 Maximal aerobic power was not related to meat intake, an animal product index, or dietary cholesterol. Multiple regression analysis, using models to control for age and body composition, failed to alter these findings. Protein Differences Between Omnivores And Vegetarians Or Vegans Additional advantages from the decrease or elimination of animal protein for the elderly can be seen in the lower serum lipid levels of vegetarians or vegans. The type of dietary protein, animal or plant, is the primary factor in the effect of proteins on serum cholesterol levels. Thus, the amino acid composition of the protein is a controlling factor for serum cholesterol levels.19 Sixteen references in this cited paper indicate that the lysine arginine ratio in proteins explains the effect of proteins on the level of serum cholesterol and, in turn, atherogenesis.19 Figure 11.1 shows the relationship between animal and vegetable protein on serum cholesterol levels. Soy protein from the soybean is a plant protein source that has been successfully used in long-term studies to decrease the level of serum cholesterol in hypercholesterolemic subjects. A high saturated fat intake however, can mask the soy protein effect.20 As the level of cholesterol in serum is decreased, the plasma... Functional Nutrition Stanol and Sterol Based Ingredients New cholesterol-lowering spreads contain unique, functional ingredients plant stanol esters or plant sterol esters. Stanols and sterols are naturally present in small amounts in vegetables and plant oils. In fact, the average person consumes about 250 milligrams of plant stanols and sterols daily from many plant-based foods, not enough to lower blood cholesterol. Naturally occurring plant stanols and sterols, however, can be modified and added to fat-containing foods. For example, butterlike spreads with plant sterol or stanol esters are promoted for their ability to lower LDL blood cholesterol by up to 14 percent they don't affect HDLs. For a significant cholesterol-lowering effect, the health claim states that you need to consume two servings of a spread that contains plant stanol or sterol esters daily-with meals-as part of an eating plan that's low in saturated fat and cholesterol. Read the package label for the serving size. These spreads offer cholesterol-lowering benefits to... Strengths and Weaknesses of Study As with any observational epidemiological study, the inverse association between fish shellfish consumption and fatal MI could have been due, at least in part, to residual confounding. High consumption of fish and shellfish may be a marker of a healthy lifestyle. We examined the association between dietary fish shellfish consumption and MI mortality with adjustments for various indices of diet and other lifestyle factors, and no substantial changes were observed. The inverse fish-MI association remained after further adjustment for the ratio of baseline serum total to HDL cholesterols. Actually, in this population, fish intake was higher in subjects with histories of diabetes and hypertension conditions that are established risk factors for CHD. As expected, adjustment for these two medical conditions in multivariate analyses led to a stronger inverse fish-MI association. Fiber and your heart The continuing saga of oat bran Recently, scientists at the Medical School of Northwestern University, funded by Quaker Oats, enlisted 208 healthy volunteers whose normal cholesterol readings averaged about 200 mg dl for a study involving oat bran. The volunteers' total cholesterol levels decreased an average of 9.3 percent with a low-fat, low-cholesterol diet supplemented by 2 ounces of oats or oat bran every day. About one-third of the cholesterol reduction was credited to the oats. Today scientists know that although a little oat bran can't hurt, the link between oats and cholesterol levels is no cure-all. By the way, the soluble pectin in apples and the soluble beta-glucans (gums) in beans and peas also lower cholesterol levels. The insoluble fiber in wheat bran does not. 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!