Saturated Fat Not Linked to Heart Disease – What Do You Think?
The latest research published in the American Journal of Clinical Nutrition found that saturated fat is not linked to heart disease as we’ve always be told. This latest study was a meta-analysis and did not find significant evidence linking dietary saturated fat with increased risk of heart disease.
A meta-analysis combines the results of several studies completed with similar theories. In this particular analysis, 21 studies were compared in regards to dietary fat and heart disease risk. I do like meta-analysis results, because they can provide a big picture look at the overall findings. However, there are weaknesses.
Here are three known weaknesses:
- Reliance on published studies – Studies that do not show significant results have difficulty getting published. If a meta-analysis only includes studies showing a positive or negative association there could be many unpublished studies finding no link.
- Studies included are not controlled – A meta-analysis may include studies with a poor design which can skew results inaccurately. The studies included in a meta-analysis is a subjective design made by the researchers – they get to decide.
- Simpson’s Paradox – This deals with statistics and how study results are interpreted. There are different ways to measure results and there is no one agreed upon measurement method – with is of particular importance in the field of medicine.
Why am I sharing this information with you?
Because the results of this latest meta-analysis are interesting, but I do not recommend you throw out your olive oil and replace it with lard. It’s likely saturated fat does not deserve the “bad rap” it has received; however, that doesn’t mean excess amounts are good. Everything comes back to moderation.
Please let me know what you think by adding a comment below.
All the best,
Lisa Nelson RD
Heart Healthy Tips
http://www.hearthealthmadeeasy.com
Cholesterol Awareness with an Olympian
Mark Spitz is now a retired Olympic swimmer and he turns 60 years-old on February 10th. In case you do not know of Mark Spitz, Mark won 7 gold medals at the 1972 Olympic games. His record was just recently surpassed by Michael Phelps at the 2008 Beijing Olympics with 8 gold medals.
Back in 2002, Mark was diagnosed with cholesterol levels above 300 mg/dl. He worked with his physician to lower his levels through exercise and medication. His total cholesterol was back down below 200 mg/dl within one month. Mark’s been quoted as saying “I was shocked when I was diagnosed with high cholesterol because I had no symptoms at all.” In the past few years Mark has openly discussed his history with high cholesterol and has actively encouraged continued research and awareness.
One of the 2010 national health objectives is to decrease the number of adults with total cholesterol levels >240 mg/dl. A strategy used to reach this goal is increased public awareness. The CDC has found that the number of people screened for high cholesterol and told by a health professional they have high cholesterol has increased. Before you can take action to lower cholesterol levels you have to be aware your cholesterol is an issue. If you do not know your cholesterol levels discuss with your physician to have the necessary lab work completed.
Be sure to sign-up for the free e-course How to Lower Cholesterol in 8 Simple Steps provided by dietitian Lisa Nelson at http://www.lowercholesterolwithlisa.com.
All the best,
Lisa Nelson RD
LDL Cholesterol – Elevated LDL Cholesterol Prevalence Has Decreased
A Centers for Disease Control and Prevention (CDC) report found the number of individuals in the U.S. living with elevated LDL cholesterol levels has decreased by about 1/3 between 1999-2000 and 2005-2006. These findings are based on the results of the National Health and Nutrition Examination Survey (NHANES) with just over 7,000 participants over the age of 20. According to CDC scientists the rate of high LDL levels decreased from 31.5% to 21.2%. Individuals included in the study were not taking statin medications, although self-reported use of statin medications increased from 8% to 12.4%.
This report is a good sign that more individuals are taking steps to control cholesterol levels, such as monitoring saturated and trans fat intake. However, if you are living with elevated LDL cholesterol what’s important is that you take steps to control your levels to reduce your heart disease risk. Here is a post where you can learn more about lowering LDL cholesterol:
Please share your thoughts on the study results below.
All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps
http://www.lowercholesterolwithlisa.com
HDL Cholesterol – Are you concerned about levels being too high?
Lisa Nelson: Are you concerned by unusually high HDL levels, such as greater than 100 mg/dl?
Dr. Shelby-Lane: The main function of HDL is to help soak up excess cholesterol from the walls of blood vessels and carry it to the liver, where it breaks down and is removed from the body in the bile.
Measuring for particle size and particle number is the best way to tell if HDL cholesterol levels are safe/healthy. This involves testing and it is usually measured under the guidelines of an “expanded lipid profile.” The usual and optimal range for HDL is (40 for men and 50 for women).
Expanded lipid profiles are necessary to look at particle size.
There are several laboratories (see below) with different lab techniques, who specialize in performing these tests and measurements.
* Liposcience (NMR in North Carolina)
* Spectracell Labs Lipoprotein Particle Profile (LPP) (Houston, Texas…..my preferred lab)
* Berkeley Heart Lab with apoA phenotype (more expensive) in California
* Quest Labs with the VAP test (nationwide)
The laboratory test for HDL actually measures how much cholesterol is in the HDL, not the actual amount of HDL in the blood.
Normal Results and General Guidelines:
In general, your risk for heart disease, including a heart attack, increases if your HDL cholesterol level is less than 40 mg/dL.
Men are at particular risk if their HDL is below 37 mg/dL.
Women are at particular risk if their HDL is below 47 mg/dL.
An HDL 60 mg/dL or above helps protect against heart disease.
Women tend to have higher HDL cholesterol than men.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Low HDL levels may indicate an increased risk of atherosclerotic heart disease.
Abnormally high tests may be associated with:
Familial combined hyperlipidemia
Noninsulin-dependent diabetes (NIDDM)
According to (Natural News) The new scientific toolbox is being used to poke around in HDL’s “house”, only to find good news and bad news. HDL has been labeled “good” cholesterol because it helps remove damaged LDL cholesterol from your arteries and has generally been associated with having less cardiovascular disease. It is now coming to light that the quality of the HDL you have is as important, if not more important, than the amount of HDL you have. This means there is both “good HDL” and “bad HDL” and if you have too much of the bad HDL then it no longer protects you and actually helps cause heart disease. How do you know if you have good or bad HDL? You’d get an “expanded lipid profile” to learn the particle size and number of your HDL cholesterol molecules.
HDL is small in comparison to LDL, and it is higher in protein. It functions as a tow truck, latching on to spent or damaged LDL and returning it to your liver for recycling and/or clearance. The two main proteins that make up HDL are called apoA-I (75%) and apoA-II (25%). ApoA-I is the good guy, and its integrity of structure is vital for HDL’s ability to clear damaged LDL from your circulation and the walls of your arteries.
New discoveries are showing that apoA-I is also vital for HDL’s enzyme functions that give it anti-inflammatory and antioxidant activity. The role of apoA-II is much less understood, other than to say it is implicated as part of problems with fat metabolism and too much of it causes poor HDL function.
One aspect of HDL fitness is that as it does its work its supply of apoA-I is temporarily diminished and replaced by apoA-II. If HDL then fails to replenish apoA-I it loses its ability to function in a helpful cardiovascular way and actually becomes a problem to cardiovascular health. One key sign that a person lacks apoA-I and has too much apoA-II is elevating triglycerides.
Other research has more accurately defined the nature of the fatty substances that make up the HDL cell membrane. These are rich in phospholipids (phosphatidylcholine, phosphatidylserine, phosphatidylethanolamine, and phosphatidylinositol). These phospholipids are linked to a unique cell membrane fat called sphingomyelin, which is used to make a major signaling molecule (Sphingosine-1-phosphate).
Triglycerides should never be more than twice your HDL, a relationship that in my opinion is far more important than your LDL/HDL ratio. The new science helps clarify why this is the case, explaining that as triglycerides go up then HDL quality goes down. In this handicapped condition HDL loses its ability to remove LDL, quench inflammation, and perform antioxidant functions.
What really has the science world buzzing is a newly recognized function of HDL as a major signaling molecule in your circulation, one that is acting as a communication platform to help instruct other cells around it what to do. Researchers have proven direct communication from HDL to the endothelial cells that line your arteries, the smooth muscle that comprises your arterial walls, the macrophages that are involved with LDL-related plaque formation, and T cells of your immune system.
Now for the bad news on Cholesterol
HDL can become damaged or “spent” at which point it no longer does any of these good things and instead actually contributes to cardiovascular disease, even winding up with LDL in plaque. There are three main reasons this happens.
1) The failure to provide adequate nutrition to re-energize HDL after it has been out working. This leads to a lack of apoA-I and an HDL cell membrane that has lost functionality.
2) Oxidative damage to apoA-I, caused by inflamed and overheated immune cells. This means individuals with inflammatory health issues will have poor quality HDL. The greater the inflammation, the worse the HDL quality.
3) Sugar glycation of HDL, rendering it “cemented” so that it can’t work. The more uncontrolled the blood sugar, the worse the HDL problem.
Lab tests that help to evaluate your heart are C-reactive protein, homocysteine, lipoprotein/(Lp(a), fibrinogen, ferritin, Total cholesterol (elevated), LDL cholesterol (elevated small –dense ldl particles), HDL cholesterol (reduced), Triglycerides (elevated), LDL and HDL particle size (pattern A and B) –VLDL, LDL particle number (increased number of particles), Apolipoproteins A and B, TG/HDL ratio of > 3.5 simple sign of insulin resistance.
Even if normal, you may still have significant heart disease. Kidney disease must also be ruled out as a cause. The gold standard for the diagnosis of coronary artery disease is a cardiac catheterization, but this is a fairly invasive test, and is not usually done without a history of severe and/or persistent symptoms or an actual heart attack. Other tests may include studies such as an ultrafast CT scan of the heart (if available, lots of radiation and soon to be taken off the market), a CT Angiogram, a nuclear stress test, an echocardiogram, a lipid profile for very low density lipids (with a complete cholesterol panel to look at subparticles), homocysteine level, HS-C-reactive protein, and an ankle-brachial index, just to name a few.
****** Discussing symptoms with your doctor is very important. ******
Please see your doctor for a detailed evaluation and examination, if you have concerns. Tests are ordered by your doctor, only if indicated, and after thorough review and evaluation.
Lisa Nelson RD: Let’s make sure everyone understood what you’ve said. HDL is protective and generally the more the better; however, new research is showing that there is “good” HDL and “bad” HDL. The only way to know the type you have is by completely an “expanded lipid profile” lab test. Correct?
Dr. Shelby-Lane: No, HDL is generally thought to be protective and the levels for routine testing of HDL is as follows: greater than 50 for women and greater than 40 for men. The range for norms depends upon the lab reference ranges which can go from 40 to 90. More specific testing uses the measurements for particle size/number and particle density. Therefore, once you look at particle size for HDL cholesterol, you can determine if you are dealing with an abnormal HDL molecule (particle size, density, and particle numbers) as well. The only way to know the type you have is by completing an “expanded lipid profile” lab test which must be ordered by your doctor. Additional testing is also performed in the expanded lipid profile such as Lp (a), HS – C-reactive protein, homocysteine, VLDL, ferritin, etc.
To learn more about Dr. Cynthia Shelby-Lane, you can check out the services she offers at www.elanantiaging.meta-ehealth.com.
Please share your comments below!
All the best,
Lisa Nelson RD
Heart Healthy Tips
http://www.hearthealthmadeeasy.com
Would you like to ask Dr. Mark Houston, hypertension expert, a question?
Are you ready to get answers to your most pressing heart health questions from a nationally known blood pressure expert and director of The Hypertension Institute?
Well, I’ve got great news! Dr. Mark Houston has agreed to answer your questions and I will be interviewing him later this month. I want to ask the questions you want answers to. Post your question as a comment to this post.
Here’s a little background information on Dr. Houston. He’s been practicing medicine since 1974 when he graduated from Vanderbilt Medical School. He went on to complete his medical internship and residency in California. He returned to Vanderbilt University Medical School and from 1978-1990 performed many roles including Medical Director and Associate Professor of Medicine.
Dr. Houston is triple board certified by the American Board of Internal Medicine, the American Society of Hypertension, and the American Board of Anti-Aging Medicine. In addition to his medical background he also obtained a masters degree in clinical human nutrition in 2003. In 2008, Dr. Houston was selected by Consumer Research Council as one the TOP PHYSICIANS in the United States. Just this past November and May, 2009, Dr. Houston was selected by USA Today as one of the most Influential Physicians in the U.S. in both hypertension and hyperlipidemia.
Dr. Houston is a consulting reviewer for over 20 major medical journal in the U.S., he’s completed over 70 clinical research studies in hypertension, hyperlipidemia, and cardiovascular disease, and Dr. Houston has published over 150 medical articles in peer-reviewed journals. He speaks nationally and internationally on hypertension and has written three best-selling books – The Handbook of Antihypertensive Therapy, Vascular Biology for the Clinician, and What Your Doctor Does Not Tell You About Hypertension: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure.
The list of Dr. Houston’s accomplishments goes on and on. I’ve covered just some of the highlights of his career above. With all of his research commitments, speaking engagements, etcetera; he still works with patients one-on-one in Nashville, Tennessee, and teaches Vanderbilt medical students, interns, and residents.
This is a great opportunity for you to get your questions answered. When submitting your question, keep in mind Dr. Houston areas of specialty – hypertension (high blood pressure), lipid disorders (cholesterol/blood fats), prevention and treatment of cardiovascular diseases, nutrition, clinical age management and general internal medicine.
Make the most of Dr. Houston’s generous offer to make time in his busy schedule to answer your questions.
Submit your question by posting as a comment below.
All the best,
Lisa Nelson RD
Heart Healthy Tips
http://www.hearthealthmadeeasy.com
Increasing Fiber to Lose Weight – Here's what you need to do!
I’ve been working with a retired gentleman the past few months and he’s been making fantastic progress to lose weight; however, this past week we focused on his fiber intake and learned his intake was much too low. He averaged around 15-20 grams of fiber daily. You should consume 25-35 grams of fiber everyday.
Eating a high fiber diet plan promotes weight loss by stabilizing blood sugars and increasing satiety (i.e. your sense of fullness). Fiber can actually act as a natural appetite suppressant. In addition to promoting weight loss, a diet high in fiber supports a lower LDL cholesterol/cholesterol levels, blood sugar control, promotes digestive health, and has the potential to decrease risk of colorectal cancer (studies are showing mixed results so far).
So, for your weight loss success and overall heart health, let’s take a moment and evaluate the fiber content of your food choices.
To determine your typical daily fiber intake grab a piece of paper and write down what you typically have for breakfast, lunch, dinner, and any snacks in between. If you’ve been keeping a food journal, simply grab your journal and look at yesterday.
Let’s use the following day as an example:
Breakfast:
2 cups of Cheerios with skim milk
6 oz. OJ
Morning Snack:
6 oz. Yogurt
Lunch:
Grilled cheese sandwich on white bread
1 cup tomato soup
Afternoon Snack:
¼ cup Walnuts and Dried Fruit
Evening Meal:
3 oz. Baked Turkey Breast
½ cup baked potato
½ cup broccoli and cauliflower
Now, you’ll have to be in your kitchen, so you can look at the food label of different foods to add up your fiber intake. For example, Cheerios provides 3 grams of fiber per cup, so fiber intake at breakfast was 6 grams (2 cups x 3 grams) since OJ and skim milk provide 0 grams of fiber. Do this for all your foods and add up the total.
In this example, total fiber intake is around 16 grams, which is low. If your fiber intake is also below 25-35 grams, look for ways to boost your fiber intake. Using the above example, you could swap out the OJ for a piece of whole fruit to add ~4 grams of fiber, sprinkle 1 Tbsp of ground flaxseed on the yogurt to add 2 grams of fiber, select whole grain bread that provides 5 grams of more fiber per slice, swap the baked potato for a baked sweet potato, and increase your broccoli and cauliflower serving to 1 cup with your evening meal. These changes would increase total fiber intake to around 34 grams.
Now, something important worth mentioning! If you currently consume a low fiber diet, making a sudden drastic increase can result in unpleasant side effects (i.e. gas and diarrhea). Increase your fiber intake gradually to avoid side effects.
All the best,
Lisa Nelson RD
Heart Healthy Tips
http://www.hearthealthmadeeasy.com
