Cholesterol Solutions Today:The Good & The Bad

I recently wrote about high blood pressure and its associated health problems. Today, I’d like to focus on salt because it is a major contributor to high blood pressure and because many people either don’t understand it or are misinformed about it.
Around the world, and in the U.S., excess salt intake and increasing rates of high blood pressure go hand in hand. High blood pressure in turn leads to cardiovascular disease and to premature death from heart attack and stroke. The evidence linking salt intake with high blood pressure is overwhelming and definitive. Americans consume too much salt and the amount they consume is increasing. Between 1970 and 2000, the amount of salt we consume went up 55 percent and the prevalence of high blood pressure went up 50 percent. On average, we each consume at least twice the recommended amount of salt per day (with some people easily getting 3 or 4 times that amount).
Salt comes in many forms, but chemically it is all the same. It consists of two elements: sodium and chloride and it is the sodium that you should be concerned about. Whether it is sea salt, kosher salt, table salt or any of the various new gourmet salts, they are all sodium chloride. When you look at a food label you should look for the word sodium. The recommended daily allowance for sodium is 2400 mg or less. The food label will tell you how many milligrams (mg) of sodium are contained in each serving, and it will also tell you how much of the total daily allowance that represents. So, for example, if a serving contained 240 mg of sodium that one serving would provide 10 percent (240/2400) of your daily amount.
It has been estimated that our sodium intake breaks down as follows: 5 percent is added in cooking, 6 percent is added at the table, 12 percent occurs naturally in the foods we eat, and, most importantly, a whopping 77 percent comes from processed and restaurant foods. That means that even if you are very strict about the salt you add at the table and while you’re cooking, you’ll probably not make a dent in the total amount of salt you eat if you use a lot of processed/packaged foods and/or if you eat many restaurant type foods. Here’s a list of foods that typically contain the most sodium:
• Cured or smoked meats- such as bacon, ham, salami
• Canned meats
• Processed meats- such as hot dogs, lunch meats, bologna
• Condiments- such as ketchup, soy sauce, mustard and tartar sauce
• Packaged snack foods- such as chips, pretzels, popcorn and crackers
• Canned vegetables and soups
• Many dairy products- such as cheese and buttermilk
• Pickles
• Prepared foods- such as sauces (like tomato sauce), gravy and spice mixes
• Frozen, boxed or prepared entrees
• Many baked goods
• Breakfast cereals
Essentially, anything you buy in the supermarket that isn’t fresh will have a lot of salt in it. Start looking at the nutrition labels. You may be in for a shock!
You may have read the last paragraph and thought “Wait a minute, if everything in the supermarket has too much salt, that’s a real problem!” And you’d be 100 percent right. The salt content of processed and restaurant foods is a huge public health problem that needs to be addressed on a national level. According to an article in the September 26, 2007 issue of the Journal of the American Medical Association, “Finland, the United Kingdom, Ireland, Australia, and New Zealand are ahead of the United States in addressing dietary sodium intake.” Moreover, the article states that “a 50% reduction in sodium intake would lower [blood pressure], resulting in a 20% lower prevalence of [high blood pressure] and a reduction in mortality [from] coronary heart disease, stroke, and death from all causes. One estimate suggests that these changes could prevent at least 150,000 deaths annually in the United States.”
More information about salt can be found at the Web site of the Center for Science in the Public Interest, at the NIH Web site and at the American Heart Association Web site. (Source: Dr. Z’s Medical Report)

Get your child’s cholesterol checked! That is what they are suggesting now. Researchers are urging parents to have their children’s cholesterol checked as early as 15 months.
Researchers at Barts and the London Queen Mary’s School of Medicine and Dentistry found that screening was most effective if done between the ages of 1 and 9. They said the screening at this age detected 88 percent of affected individuals.
Once an “affected” child is identified, the parents would then be screened. This could ultimately help in the medical prevention and treatment of the child and the adult. Killing 2 birds with 1 stone! I am all for it.
There is blood work done routinely in children of this age anyway, might as well add a cholesterol panel to the blood work as well! Doesn’t hurt anything. What do you think? Would you screen your child for cholesterol?
via Science Daily

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Today I read something that blew me away! While Myriad is hammering away on NYC TV to get your BRCA test. 10-15% of all breast cancer patients have BRCA mutations in either 1 or 2. These tests cost over 3000 USD a piece, even worse, there are very few clinical changes that result from positivity of either mutation.The stat that hit me like a punch in the nose was “80 per cent of women in the US between 18 and 44 don’t know their cholesterol level” I couldn’t believe it! This according to a recent survey by the Society for Women’s Health Research (SWHR). This non-profit agency “encourages the study of sex differences between women and men that affect the prevention, diagnosis and treatment of disease”. This is what I find funny. A patented gene test can have a multi-million dollar ad campaign, but women’s heart health gets barely a whisper. Despite heart disease being a much bigger killer in women. If you thought carrier status for breast cancer was a big deal. Having an elevated cholesterol is the closest thing to having a heart attack. Even worse, there are some simple preventative things you can do for cholesterol and it doesn’t include surgery or medications.So while we all bask in the glory of The Personal Genome Project and 23andMe, we need to get a grip. Just because you can get your genome sequenced, doesn’t mean it will tell you your cholesterol level. Clinical acumen is what is required for personalized medicine, not technology alone.The Sherpa says: According to this study “More than half of the women 18-44 surveyed were concerned about cholesterol, but the vast majority weren’t aware of their personal cholesterol level and one-quarter did not even know how cholesterol is tested” Why? Because we don’t have Quest lab reps stopping by your PMDs office telling you that you MUST test women’s cholesterol. That means asking your physician to check your cholesterol is up to you! (Source: Gene Sherpas: Personalized Medicine and You)

In the first installment of this two part series on dietary fat, I reviewed the differences between good fats and bad fats, where they come from and how to tell them apart. Today I’ll talk about fat in the diet, what to eat, how much is ok and how to make positive changes regarding the food you eat.
According to the USDA Dietary Guidelines, the recommended total fat intake for adults is between 20 and 35 percent of calories, with less than ten percent of calories coming from saturated fat, and cholesterol less than 300 mg/day. Got that? I didn’t think so. And even if you could remember these guidelines you’d still have to count your calories every day and, in addition, track fats as a percentage of those calories. That’s a tall order.
Here’s a better way. Eat as little fat as possible. Why? First of all, as I mentioned last time, every gram of fat (regardless of whether it’s good, bad or indifferent) equates to nine calories, more than twice as much as either a gram of protein (four) or carbohydrate (also four). Second, the odds are that when you do eat fat it will be bad (saturated and/or trans) and we learned last time that bad fats raise bad (LDL) cholesterol, which raises your risk of cardiovascular disease.
How do you reduce fat in your diet? Through awareness and thinking. That’s right, you can think about the foods you buy and the foods you eat! I don’t mean to sound all high and mighty, but it’s pretty obvious that the vast majority of Americans don’t think at all about what or how much they eat.
But let’s get back to awareness. If you want to reduce fat in your diet, you’ll need to think about how much meat, dairy and processed/packaged foods you eat. These are the major high-fat content foods. Those and foods that are fried. And of course eggs, which are high in cholesterol. How many times a day do you eat meat? And how many of those meat servings are especially high in fat (bacon, sausage, prime beef, poultry skin, etc)? Can you cut back on or cut out some of that meat? Or choose low-fat meats like “loin” or “round” or skinless chicken breasts?
Can you choose low-fat or non-fat dairy products? And/or cut back on full-fat ice cream? How about butter? Butter is pure fat (63 percent bad fat) and cholesterol. You can easily substitute a low or no fat margarine for spreading and liquid vegetable oil for cooking. I’m astonished at the amount of butter served at most restaurants. Whenever I get a huge scoop of butter on my food I ask for a small dish in which to put it. Of course, if I were thinking I’d have asked them to hold the butter, but it’s always easier to give advice than to follow it!
Where else is fat lurking besides in meat and dairy products? In most baked goods. So limit the amount of bakery products you eat, including doughnuts, pies, cakes and cookies. Look instead for fat-free or low-fat varieties of crackers, snack chips, cookies and cakes. But baked isn’t always bad. For example, instead of fried snacks, like chips, you can choose baked snacks, which have far less fat.
You can make significant changes in your fat consumption by eating less meat, less dairy and fewer eggs, high-fat processed/packaged and/or bakery products. Instead eat more fresh fruits and vegetables, salads, whole grains, beans, nuts and fish. There’s a wealth of information and other specific nutrition tips at the American Heart Association’s website.
Good luck and good eating! (Source: Dr. Z’s Medical Report)

Everyone knows that eating too much fat is bad for your health, but just as many people know that fats are just plain confusing. There are good fats and bad fats and different types of each. Fats come from both animals and plants - and then there’s cholesterol. No wonder some people just throw up their hands and give up. But it’s not impossible to get a basic understanding of fat. Just keep reading and you’ll be well on your way.
One thing that all fats have in common is the number of calories they produce inside your body; namely, nine per gram of fat eaten. To put that into context, a gram of protein equates to four calories and a gram of carbohydrate is also four. That is the sum total of everything you need to know about calories: fats = 9, protein = 4 and carbohydrate = 4 (calories per gram eaten). But please note well that every gram of fat provides more than twice the number of calories as does either protein or carbohydrate. So as an aside, you can readily see that cutting back fat is more beneficial on a gram per gram basis than cutting back other foods.
Fats come in two major types: bad and good. And each type has two subtypes. Bad fats are saturated and trans, which tend to be solid at room temperature (think of butter and lard), and good fats are mono-unsaturated and poly-unsaturated, which tend to be liquid at room temperature (think of vegetable oils). So if you can actually see the fat, like when you’re shopping, it’s easy to tell bad (solid) from good (liquid). The problem is you can’t always see it, which is why you have to read the label.
First let’s talk a bit about cholesterol, which also comes in bad and good types. We can eat cholesterol – it only comes from animal-derived foods like meat, dairy products and eggs – but even if you are a strict vegan (there’s no cholesterol in plants), your body naturally makes the cholesterol it needs. Bad cholesterol (LDL) is associated with heart and artery disease (heart attack, stroke, atherosclerosis, hardening of the arteries). Good cholesterol (HDL) actually takes cholesterol away from your arteries and takes it to the liver for digestion and removal.
Bad fats (saturated and trans) raise the levels of bad cholesterol. Moreover, bad fat-containing foods also tend to be high in cholesterol (so you get a double whammy: you eat cholesterol and the bad fats raise your cholesterol). Trans fats also lower good cholesterol. Good fats (mono and poly-unsaturated) don’t raise bad cholesterol and, when eaten in moderation, actually are beneficial.
What foods contain the bad saturated and trans fats? Saturated fats most often come from animal sources: meat and dairy products (these also contain cholesterol). Some vegetable oils, like palm and coconut) contain saturated fats (they don’t contain cholesterol). These oils are an exception to the rule noted above that visibly liquid fats are always good. Saturated fats can also be added to processed foods such as cakes, cookies, pies, chips, butter and salad dressings (including mayonnaise). Please also remember that ice cream is a dairy product containing lots of saturated fat.
Trans fats are almost always man-made. They are sometimes listed on food labels as hydrogenated and partially hydrogenated vegetable oil (they actually take good fat and make it bad!). Because trans fats are both bad and hidden (they’re man-made and added to processed foods so you can’t see them), there’s been much effort recently to get rid of them. The types of foods most likely to contain trans fats are cakes, cookies, crackers, pies, margarine, French fries, fried foods, chips, shortening, cereal and candy.
Examples of foods high in monounsaturated fats include vegetable oils such as olive oil, canola oil, peanut oil, sunflower oil and sesame oil. Other sources include avocados, peanut butter, and many nuts and seeds. Foods high in polyunsaturated fat include a number of vegetable oils, including soybean oil, corn oil and safflower oil, as well as fatty fish such as salmon, mackerel, herring and trout. Other sources include some nuts and seeds. The omega-3 and 6 fatty acids are polyunsaturated oils and are the ones contained in the fatty fish just mentioned.
In summary, bad fats are saturated fats (that may also contain cholesterol) and trans fats, both of which raise bad cholesterol. Saturated fats tend to be solid at room temperature and are easy to see when in their solid form, but can also be hidden in many processed foods. Good fats are unsaturated (mono and poly), tend to be liquid at room temperature, and tend to be found in vegetables (including nuts and seeds) and in some fish.
Next time, we’ll take a look at fats in the diet, how much of the different types of fats should you eat and how to figure it all out.
There’s lots of great information on fats and diet at the American Heart Association’s Web site. (Source: Dr. Z’s Medical Report)

Filed under: Family history, PreventionEarlier this year, my great-aunt passed away suddenly from an unknown heart condition. Her doctor recommended that all of her siblings, children, and nieces and nephews be screened for heart problems as well, flagging them at a higher risk for developing cardiovascular disease. Thankfully, no problems were uncovered, but they are now aware of the higher risk associated with having heart disease in our family.Scottish researchers believe that if family members of those with known heart disease were singled out as high-risk and their risk factors gotten under control, up to 40% of early deaths from cardiac events could be prevented. Even so, this type of flagging system is rarely used, even though it is common procedure among families with genetic cancers. So if someone in your family has had some form of heart disease or heart attack, be sure that you know your risks. Talk to your doctor and tackle any problems that increase your chances of developing cardiovascular disease, such as high cholesterol and high blood pressure, and protect your heart for the long haul.Read | Permalink | Email this | Linking Blogs | Comments (Source: The Cardio Blog)

Filed under: Diet, Prevention, NutritionIt turns out that there’s some truth to the old adage that An Apple a Day Keeps the Doctor Away. According to a study published in a recent issue of American Journal of Clinical Nutrition, women who eat apples regularly have a decreased risk of dying from coronary heart disease and cardiovascular disease.
What if you don’t like apples? Try pears — or even red wine. This same study revealed that consuming either of these will have the same preventative effects as eating apples. The researchers attribute these heart-healthy benefits to compounds known as flavonoids, which help reduce bad (LDL) cholesterol (Note: Flavanoids are not to be confused with the Noid — who in the 80s was known to ruin the occasional pizza).
Flavonoids are also known for their antioxidant activity, meaning that they protect against free radical damage. For a more comprehensive look at how flavonoids, found in such foods as apples and pears, can better your health, click HERE. As for how they measure up against this guy on the right, however, I think there is still much research to be done.Read | Permalink | Email this | Linking Blogs | Comments (Source: The Cardio Blog)

Filed under: Diet, American Heart AssociationEven one fatty feast can cause your body to stop protecting itself from cardiovascular disease, a recent study showed, at least temporarily. When study participants were given a high-fat meal — the equivalent of a double cheeseburger, large fry, and a chocolate shake — their HDL (or good) cholesterol lost the ability to protect their arteries from inflammation. But when participants ate the same meal, this time prepared with polyunsaturated fat, the ability of HDL to prevent inflammation actually improved.Researchers say this study points out the importance of avoiding saturated fats as much as possible. In fact, they say that a maximum of 10% of your calories should come from saturated fats, and the AHA takes that one step further and recommends no more than 7%. That means that if you typically eat 2,000 calories a day, you should eat no more than 14 to 20 grams of saturated fat. Here’s more about good fats and bad fats from the AHA.Read | Permalink | Email this | Linking Blogs | Comments (Source: The Cardio Blog)