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    Archive for the ‘LDL’ Category

    Numbers Game: Answer

    NutMealFlaxSeedStudies on flaxseed intake have shown that two tablespoons of ground flax a day for three months can lower LDL cholesterol by anywhere from 9 to 18 percent.

    Added bonus?  The lignans (specific plant compounds) in ground flax are highly anti-inflammatory.  Remember, inflammation at the cellular level is believed to be one of the chief causes behind a litany of degenerative diseases.

    Flaxseed offers a particular lignan known as SDG (secoisolariciresinol diglycoside, to be exact), which helps lower the levels of oxidative stress in blood vessels.  In laymen’s terms: SDG is a powerful tool against the development of atherosclerosis.

    Recent — and very promising! — studies appear to show that SDG also helps maintain steady blood glucose levels.

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    Numbers Game: Two Tablespoons A Day Keep Cholesterol at Bay

    flax_seed_mealStudies on flaxseed intake have shown that two tablespoons of ground flax a day for three months can lower LDL cholesterol by anywhere from ____ to ____ percent.

    a) 9 – 18
    b) 6 – 11
    c) 13 – 24
    d) 4 – 8

    Leave your guess in the “comments” section and come back on Thursday for the answer.

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    Numbers Game: Answer

    nurse taking blood pressureCardiovascular disease risk doubles for every 10-point increase in diastolic blood pressure (the bottom number) and every 20-point increase in systolic blood pressure (the top number).

    This serves as a perfect reminder of the domino effect of poor health.

    It also illustrates why maintaining a healthy weight is important.  It deeply frustrates me when people argue that weight gain should not be demonized, and that all body shapes should be accepted.

    I certainly back up that argument from a social and body-image standpoint.  No one should be made to feel inferior — by others as well as themselves — because of their waist size.  The fact that you’re ten or fifteen pounds overweight doesn’t negate the fact that you can be — and feel — sexy.

    From a health standpoint, however, getting rid of excess weight is crucial.

    Not only does excess weight increase cellular inflammation (THE most important factor behind the development of a number of degenerative diseases like cancer, heart disease, and Alzheimer’s disease), it also sets off a chain of symptoms and conditions.

    Excess weight increases blood pressure, lowers HDL cholesterol levels, and increase LDL cholesterol levels, thereby increasing cardiovascular disease risk.

    It also increases arthritis risk and puts excessive force on joints, often making exercise painful and difficult (thereby creating a powerful barrier against regular exercise).

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    You Ask, I Answer: Plant Stanols

    006347A few days ago I was reading a pamphlet on heart-healthy eating, which recommended eating 2 grams of plant stanols every day.

    What are they? What foods are they in?

    I’ve never heard of them before or seen them on a food label, so how do I know how many grams I’m eating?

    — Mike Appenbrink
    New York, NY

    Plant stanols are naturally-occurring compounds in fruits, vegetables, whole grains, legumes, nuts, and seeds.

    Stanols are closely linked to sterols; they both fall under the “phytosterol” umbrella (phytosterols have a similar molecular structure to cholesterol, and compete with it for absorption).

    Phytosterols have been clinically shown to lower LDL (unhealthy) cholesterol while keeping HDL (healthy) cholesterol levels steady, thereby improving our LDL:HDL ratio. Here’s the catch — in order to get those health benefits, you need to consume two grams of them a day. They are present in hundreds of plant-based foods, but in miniscule amounts.  You would need to eat an excessive amount of calories to consume two grams.

    Cue companies like Finland’s Raisio Group, which formulated Benecol, a proprietary (ka-ching!) blend of stanols that can now be found in handful of processed products — from margarines and corn chips to orange juice and cereal.

    So, yes, long-term daily intake of two grams of stanols can help reduce LDL cholesterol by an average of fifteen percent, but I don’t consider stanol/sterol-fortified margarines and milks a necessity in a heart-healthy diet.

    There are many other things you can do to improve blood lipid profiles: consume at least 25 grams of fiber a day, prioritize monounsaturated fats and omega-3 fatty acids, limit added sugars and refined flours, and avoid trans fats.

    Whole foods may contain negligible amounts of sterols, but they contain many heart-healthy phytonutrients.

    Something tells me the educational materials you read were written or sponsored by one of the big stanol companies. My advice? Eat real food — there are plenty of benefits to be reaped.

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    You Ask, I Answer: Amaranth

    Amaranth Grain crop 001A few days ago on Twitter you recommended we give alternative grains like amaranth a try.

    Can you tell me more about it?  How can it be prepared?

    — Will Reicks
    (Location withheld)

    Although amaranth can be eaten as a savory side dish, I prefer it as an alternative to oatmeal, especially since it has a porridge-like texture.

    I enjoy it topped with sliced bananas, chopped pecans, goji berries, and cacao nibs.

    Like quinoa and wild rice, amaranth falls into the “pseudo-grain” category, since it is technically a seed.

    Not only is it a completely safe food for those with gluten intolerances and wheat allergies — it also boasts a powerful nutritional profile.  One cup of cooked amaranth delivers:

    • 251 calories
    • 5 grams of fiber
    • 9 grams protein

    It is also an excellent source of iron, magnesium, manganese, and phosphorus, and delivers substantial amounts of calcium, copper, folate, selenium, vitamin B6, and zinc.

    Added bonus?  Amaranth contains exclusive phytonutrients that help lower LDL (bad) cholesterol as well as a powerful group of antioxidants called betalains that help reduce cellular inflammation and, consequently, the risk of different cancers.

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    You Ask, I Answer: Barley

    whole_barleyCan you tell me about the health benefits of barley?

    I just added some to my kale stew and really liked it, but I don’t know anything about it.

    — Susy (last name unknown)
    (Location unknown)

    Barley is a wonderful grain!

    You should know that there are two different varieties — hulled barley and pearled barley.

    Pearled barley is the most commonly consumed type.  While it is still nutritious, it is slightly more processed than hulled barley in that it loses its bran layer.

    Consequently, pearled barley cooks faster.

    If you can find hulled barley, I recommend you purchase that.

    However, even pearled barley is far superior to refined grains like white rice, couscous, or pastas made from white flours.

    After all, one cup of it (cooked) provides:

    • 6 grams of fiber
    • 6 grams of protein
    • 10% of a day’s worth of niacin, vitamin B6, and zinc
    • 20% of a day’s worth of manganese and selenium

    Meanwhile, one cup of cooked hulled barley adds up to:

    • 8 grams of fiber
    • 6 grams of protein
    • Higher amounts of niacin, riboflavin, thiamin, manganese, phosphorus, potassium and selenium

    One of the advantages of barley is that a significant percentage of its fibers are beta-glucans.

    Beta-glucans are a specific type of soluble fiber — also found in oatmeal, seaweed, and mushrooms — responsible for lowering LDL cholesterol (the higher your LDL cholesterol, the higher your risk for heart disease).

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    You Ask, I Answer: Nuts & Cholesterol

    nuts1240705690Are there any nuts that help lower cholesterol, or are they all bad?

    They are high in fat, right?

    — Greg (Last name withheld)
    Los Angeles, CA

    When it comes to lowering cholesterol with food, there are three particular nutrients to keep in mind:

    • Soluble fiber
    • Omega-3 fatty acids
    • Monounsaturated fats

    The above nutrients are ones you want to consume more of.  Ideally, you don’t want to simply add them to what you are already eating, but rather eat them in place of less-healthy foods (i.e.: refined carbohydrates, foods made with corn and cottonseed oil, etc.).

    In regards to your question: nuts are an absolutely wonderful food that I encourage everyone to have a serving of every single day.

    Almonds and Brazil nuts are the nuts with highest amounts of soluble fiber per ounce.  Walnuts, meanwhile, have more omega-3 fatty acids (in the form of Alpha-Linolenic Acid) than any other nut.  The monounsaturated fat category is dominated by peanuts.

    This is not to say other nuts are inferior; others have certain phytonutrients and compounds that have been shown to help lower cholesterol levels.

    While we’re discussing these three nutrients, check out this list of best sources (which includes some foods not mentioned above):

    • Soluble fiber: barley, figs, kidney beans, oat bran, oatmeal, pears, psyllium husk
    • Omega-3 fatty acids: chia seeds, hemp seeds, flaxseeds, halibut, sea vegetables, scallops, walnuts, wild-caught salmon
    • Monounsaturated fatty acids: almonds, avocado, macadamia nuts, peanuts olive oil

    Great news about soluble fiber — every gram of soluble fiber (when consumed in a consistent, daily basis) is linked to a 1 or 2 point reduction in total and LDL (“bad”) cholesterol.

    Above all, please undo the “fat is bad” mantra that has pervaded the American dietary landscape for the past two decades.  Omega-3 fatty acids and monounsaturated fats not only lower total and LDL cholesterol, they also increase HDL (“good”) cholesterol.

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    You Ask, I Answer: Health Benefits of Garlic

    garlic_bulbWhat health benefits do we get from eating garlic?

    Is it better to eat it raw (like in the pesto recipe you shared) or cook it?

    Do you need a certain amount of cloves to get the health benefits?

    — Whitney Bennett
    New York, NY

    The most solid evidence on daily and consistent garlic consumption is that it can:

    • Help reduce levels of LDL (“bad”) and total cholesterol
    • Slow down atherosclerosis (hardening of the arteries)
    • Discourage platelet aggregation (the grouping of platelets in the blood which ultimately forms clots)

    There doesn’t appear to be a difference whether garlic is consumed in a raw or cooked state.  For optimal results in terms of active compounds, though, fresh garlic should always be used (as opposed to pre-minced, jarred varieties).

    One garlic clove a day, once a day, provides the above-mentioned health benefits. An additional clove or two won’t pose any harm.

    I am not a fan of garlic supplements.  Firstly, since supplements are unregulated, you never know what you are truly getting.

    Number two — in the event that these supplements pack in high amounts of concentrated garlic, they may overly thin the blood.

    PS: If you take garlic supplements, you must stop taking them at least three weeks prior to any kind of surgery to prevent excessive bleeding.

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    You Ask, I Answer: Quorn

    I’ve seen Quorn products in supermarkets for a while in the same section as frozen veggie and soy burgers.

    Do you know anything about them?

    — Doris Kinley
    (city withheld), ME

    Quorn is a highly popular meat-free alternative in Great Britain that appears to finally be catching on with consumers on this side of the Atlantic.

    The main ingredient is a fermented mycroprotein (that means it’s fungus/mushroom-related) that provide tastes and textures similar to those of poultry.

    Quorn products are not a vegan alternative, though, as they are also concocted with egg protein.

    Like soy, this particular mycoprotein is a complete protein and a good source of polyunsaturated fat.

    Quorn also happens to be a decent source of fiber, and has been shown to help lower LDL cholesterol levels in some studies.

    Keep in mind, though, that your average quorn “chicken breast” contains roughly a quarter of a day’s worth of sodium.

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    You Ask, I Answer: Slivered Almonds

    Are slivered almonds as nutritious as whole almonds with the brown skin on them?

    — Gary Wington
    (Location withheld)

    Slivered almonds offer as much protein, manganese, selenium, fiber, and heart-healthy fat as their skinned counterparts.

    However, keep in mind that nutrition goes beyond the basic macro (protein, fat, and carbohydrates) and micronutrients (vitamins and minerals).

    Almond skins contain a high amount of flavonoids. Apart from having health benefits of their own, they help maximize the health benefits of the vitamin E present in actual almonds.

    This study from the June 2005 issue of the Journal of Nutrition, for instance, found that the flavonoids in almond skins work synergistically with vitamin E in almond “meat” to reduce LDL oxidation (one of the main factors behind the development of atherosclerosis).

    Another example of how a whole food is nutritionally superior to a slightly more processed counterpart.

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    You Ask, I Answer: Isolated Fibers

    I ran across a juice from Bolthouse Farms and was shocked when I saw that it packs in EIGHT grams of soluble fiber in one 8 fl oz serving!

    My eyes went to the ingredient list right away to see just what, if anything, was added to get that impressive number.

    What I found was dextrin, inulin, and xanthan gum all added and listed as “dietary fiber”.

    Are these treated by the body in the same manner as more “raw” food would be when it comes to the benefits the soluble fiber can provide?

    Are they mainly tossed in to get that impressive number and in reality not as effective for the body as soluble fiber from fruits or some other “raw” source?

    Other than that, what are you general thoughts on some Bolthouse Farms drinks?

    I still try to grab something that doesn’t have a bunch of sugar in it when I just feel like something refreshing to drink while watching a movie or something but as juice goes, does Bolthouse seem slightly above the others?

    — Andrew Carney
    Richland, WA

    You have to love those isolated fibers — food manufacturers certainly do!

    After all, how else would you manage to get eight grams of soluble fiber in 8 ounces of a drink that is nothing more than a medley of fiber-free, sugar-loaded juice concentrates?

    Although dextrin, inulin, and xanthan gum are real fibers that exist in nature, I am not a fan of consuming nutrients in isolated form.

    Food science research has demonstrated on several occassions that, for optimal performance, nutrients need to play off each other (and other phytochemicals in food.)

    This is precisely one reason why clinical trials involving vitamin E supplementation show different results than those in which vitamin E is consumed in the diet from food sources.

    Similarly, while oatmeal offers LDL-cholesterol lowering properties thanks to soluble fiber (in particular beta-glucan, which is not in this Bolthouse drink), it also offers manganese, selenium, and magnesium at the tune of 145 calories per cup.

    The drink you are asking about, meanwhile, packs in 350 calories’ worth of concentrated juices and then throws in fiber, vitamins, and minerals to provide a healthier image.

    The fact that one bottle contains 15 grams of soluble fiber is also worrying, as this can result in some very painful bloating for those unaccustomed to taking in such large amounts in one sitting.

    My verdict? You might as well be drinking Kool Aid, stirring in some Metamucil, and popping a Centrum.

    That being said, if you enjoy the drink and can afford the calories, enjoy it… as a sweet treat.

    On that note, one word of caution. When it comes to juice drinks, don’t hunt around for fiber, Omega-3’s, or added buzz-worthy nutrients.

    How come? I find that it is usually the drinks highest in calories and sugars that tack on these nutrients in order to trick consumers into thinking they are doing their health a favor.

    The best thing to look for when it comes to these beverages is a small bottle.

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    In The News: Is Fat Acceptance Acceptable?

    Yesterday’s New York Times Magazine ran a short piece on the “growing” fat-acceptance movement (although it’s been around for approximately three decades and has yet to catch on, but I digress.)

    “Fat-acceptance activists insist you can’t assume someone is unhealthy just because he’s fat, any more than you can assume someone is healthy just because he’s slim. “

    In fact, this movement firmly believes that “it is possible to be healthy no matter how fat you are.”

    No matter how fat? Really?

    So how do they explain, then, the countless research studies that have observed reductions in LDL (“bad”) cholesterol, type 2 diabetes risk, and blood pressure in overweight and obese individuals who lose weight, even just five pounds?

    Well, they point to a report published in The Archives of Internal Medicine this past August, which “reported that fully half of overweight adults and one-third of the obese had normal blood pressure, cholesterol, triglycerides and blood sugar — indicating a normal risk for heart disease and diabetes, conditions supposedly caused by being fat.”

    Too bad that study didn’t examine levels of C-reactive protein, a marker of inflammation.

    Remember, most diseases — especially cardiovascular ones — have cellular inflammation as a precursor.

    And guess one of the factors that increases C-reactive protein levels? Overweight and obesity!

    Additionally, one of those study’s co-authors was quoted as saying that “among people of healthy weight in the study, elevated blood pressure, cholesterol and other factors were more common for people with larger waists or potbellies” and that “among overweight and obese adults, those in the “healthy” category tended to have smaller waists than those with at least two risk factors.

    Need I say more?

    The problem with this entire “movement” is that it attempts to kill two very different birds (social acceptance of overweight/obese physiques and the health consequences of being overweight/obese) with one stone.

    It is one thing to denounce the media’s obsession on borderline unhealthy bodies, but how anyone can believe weight has nothing to do with health status is beyond me.

    All you have to do is speak to formerly obese people.

    Ask them how they feel walking up a flight of stairs now as opposed to when they were carrying an additional 60 or 70 pounds on them.

    Ask them how their lipid profiles have changed.

    Ask them, very simply, if they miss carrying that excess weight.

    Similarly, people who are extremely underweight (purposefully or not) are also at increased risk of mortality.

    I point that out to show that nutrition and weight management are not inherently “anti fat,” it’s just that with the obesity rate doubling in the past 30 years in this country, it is not surprising that most public health nutrition efforts are concentrated on that particular problem.

    Back to the Times article, I can’t help but roll my eyes at the mention of “a new book out this fall, Health at Every Size, by Linda Bacon, a nutritionist and physiologist at the University of California at Davis, which is less about dieting than a lifestyle change that emphasizes “intuitive eating”: listening to hunger signals, eating when you’re hungry, choosing nutritious food over junk.”

    What exactly is so revolutionary? The guidelines mentioned above are precisely the same ones advocated for permanent weight loss and increased health awareness by many Registered Dietitians.

    In fact, if any of you have ever been to a Registered Dietitian, you know the focus is on establishing healthy dietary patterns. It’s not about six packs, fitting into size 0 clothes, or looking like the cast of the new Beverly Hills 90210.

    To place the nutrition field on the same level as a celebrity diets segment on The Insider is preposterous and extremely reductive.

    I don’t see the damage in advocating for a healthy medium, where the end goal is to not be underweight or overweight.

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    You Ask, I Answer: Phytosterols

    Can you tell us more about this phytosterol fad I’m seeing lately in yogurt and multi-vitamins?

    What are phytosterols and why do we need them?

    Don’t we just get them from eating vegetables?

    Why would we need a supplement?

    — “gd”
    Via the blog

    Whereas cholesterol is a sterol (that is a steroid with an alcohol group attached, for any chemistry geeks out there) essential in maintaining cell structures in animals, phytosterols play the same role in plant foods.

    Not surprisingly, cholesterol is found only in animal products (meats and dairy) and phytosterols are exclusive to plant foods.

    The term “phytosterols” is actually an umbrella one that includes sterols (the three main ones being beta sitosterol, campesterol, and sitgmasterol) as well as stanols (naturally occurring plant compounds.)

    Clinical research has determined that 2 grams of phytosterols a day help reduce LDL (“bad” cholesterol) levels by as much as 20%.

    This is due to the fact that they compete with cholesterol for absorption in the digestive tract.

    There are a few caveats, though.

    Although phytosterols are present in plant foods (mainly nuts, seeds, and their respective oils), you need a LOT of calories to reach that 2 gram (2,000 milligram) goal.

    For instance, 2 tablespoons of peanut butter contain 55 – 60 milligrams, and an ounce of pistachios adds up to roughly 35 milligrams.

    And so came the development of functional foods (mainly yogurt drinks, like Promise Activ, and vegetable spreads) with high amounts of phytosterols added in.

    Advertisers were in hog heaven — now many of their products could be advertised as “cholesterol lowering.”

    However, phytosterols have only been proven effective in people with high cholesterol levels.

    In other words, I don’t see any reason why someone with a normal cholesterol profile would need to start consuming 2 grams of phytosterols a day.

    Additionally, even people who benefit from their consumption need to realize that this is another situation where more is not better, since phytosterols interfere with the absorption of fat-soluble vitamins (A, D, E, and K) and compounds like lycopene.

    Remember, too, that nutrition is really about a combination of nutrients and components — not just two or three.

    I lean more towards the “the healthier your overall diet, the more nutrition you are getting” camp than the “eat whatever you want and down supplements and multi-vitamins” one.

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    In The News: For A Healthy Heart, Watch Your Waist

    Tim Russert’s death last week was shocking on many levels.

    From a health standpoint, the NBC news anchor — who had been diagnosed with coronary artery disease — certainly didn’t appear to be a high-risk patient.

    He didn’t have any troubling symptoms and, as The New York Times reports, “he was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight.”

    Pay special attention to the last six words of that quote.

    As much as Mr. Russert was medicated and his LDL cholesterol was kept in check, the main risk factor here was, simply, his weight.

    Dr. Michael A. Newman, Mr. Russert’s internist, tells the Times that “if there’s one number that’s a predictor of mortality, it’s waist circumference.”

    Thank you, thank you, thank you.

    This is why weight control is at the pinnacle of health promotion.

    It’s simple. Plenty of evidence supports that when overweight people reduce those excess pounds, they also lower the risk and prevalence of a variety of diseases, including diabetes, certain cancers, and heart disease.

    What is frightening is that many people with heart disease appear to incorrectly think that taking cholesterol-lowering medications are “sufficient,” forgetting that reaching their desirable body weight is crucial.

    Also, although many cardiologists — and their patients — become fixated on lowering LDL’s (the “bad” cholesterol), many of them forget that increasing HDL’s (protective, “good” cholesterol) is just as important.

    In Mr. Russert’s case, autopsy findings revealed that his HDL figures were low.

    The procedure also concluded that there were “significant blockages in several coronary arteries.”

    This is why heart disease, in my opinion, should be in parents’ minds as they help develop their children’s eating habits.

    These conditions develop over decades. Mr. Russert’s health was not the product of the last 5 years, but of 25, 30, 35 years of consistent dietary patterns.

    Many people often comment that nutrition and health are complicated subjects, full of rules, numbers, facts, and figures.

    However, the best dietary advice is usually quite simple. In my case, one of the best recommendations I can make is to always be mindful of your ideal body weight and stay as close to it (no more than 5% above or below) as possible while consuming little junk food.

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    Survey Results: Nutrition Labels, Part Deux

    The latest Small Bites survey asked readers what values they paid most attention to when reading food labels.

    The most important figure on a label relates to calories per serving — at least that’s how seventy-five percent of respondents voted.

    The ingredients list (32%), fiber content (30%), and serving size (29%) also received a good deal of votes.

    While saturated fat was considered important by 23% of readers, total fat content received a significant 40% of votes.

    I’m not too sure why this is the case.

    Fat content in and of itself doesn’t tell us much about the food that we can’t already gauge by taking a look at calories per serving (since fat contributes 9 calories per gram, foods with higher fat contents provide more calories than lower-fat ones).

    If you only look at total fat values, wonderfully healthy foods like guacamole or walnuts appear no different than brownies or ice cream sandwiches.

    When it comes to fat content, saturated fat (and trans fat, although once food companies were mandated to display trans fat figures on their products they miraculously found new trans-fat-free formulas for their products) is the value to keep your eye on.

    Remember, high intakes of saturated fat are linked to higher risks of heart disease and a decrease in HDL (or “good”) cholesterol.

    Guacamole, though, is mostly composed of monounsaturated fats (the kind that help lower LDL — or “bad” — cholesterol).

    This is why fat content — without a more specific breakdown — isn’t an appropriate factor to base food purchases on (unless, as previously mentioned, you are trying to gauge calories).

    I was surprised to see that vitamin and mineral values are largely considered irrelevant. Only 5 percent of respondents consider vitamin content to be important, and a measly 4 percent feel that way about mineral figures.

    A huge thank you to those of you who took a minute to participate!

    Please leave comments and thoughts on the results in the “comments” section.

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