Heart Disease – Is flax oil or fish oil better to reduce heart disease?
A recent study published this past September compared the benefits of flax oil versus fish oil in raising blood levels of heart healthy omega 3’s. Adequate omega 3 intake is linked to lower blood pressure, lower triglycerides, increased HDL cholesterol, and reduced arterial inflammation.
Flax oil contains the omega 3 fatty acid ALA (alpha-linolenic acid), while fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The benefits of ALA continue to be studied, but EPA and DHA have been positively linked to heart benefits.
The body can convert ALA to EPA and DHA, but it’s been well known that this conversion process is not efficient. According to a recent study published in Nutrition Reviews, 8-20% of ALA is converted into EPA. From this, only 0.5-9% is converted to DHA.
To test the benefits of ALA supplements (flax oil) in amounts commonly consumed, the study followed 62 firefighters. The participants were divided into 6 groups and monitored for 12 weeks. Here are the six groups:
1.2 grams of flax oil per day
2.4 grams of flax oil per day
3.4 grams of flax oil per day
0.6 grams of fish oil per day
1.2 grams of fish oil per day
Sunflower placebo
Results showed an increase of EPA and DHA in the blood for those taking both levels of fish oil supplements. The EPA levels in red blood cells almost doubled by the studies end.
Now, the flax oil supplements did not have the same result. Those receiving 1.2 grams of flax oil daily did not show a significant rise in EPA and DHA, only ALA. The 2.4 g and 3.6 g flax oil supplements increased ALA, EPA, and DHA levels. EPA was increased 30% with a 2.4 g supplement and 40% with 3.6 g of flax oil daily. However, there was no corresponding increase in DHA. This confirmed the original belief that conversion of ALA into DHA is minimal.
The results of this study support my recommendations related to omega 3 supplements. First, consume a diet rich in omega 3 fatty acids (i.e. fish, nuts, flaxseed). Second, select a fish oil supplement high in EPA and DHA. Choose a supplement with 850 mg of DHA and EPA per gram of fish oil. Third, if you do not tolerate fish oil, select a flax oil supplement providing at least 1 gram of omega 3 fatty acids daily.
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All the best,
Lisa Nelson RD
Barley Nutrition – How to use barley nutrition to lower cholesterol
Barley contains the same soluble fiber and beta-glucan as oats. Individuals who regularly consume barley have lower LDL cholesterol, triglycerides, and total cholesterol.
A review of studies found the beta glucan in barley linked to decreased total cholesterol of 13 mg/dl, decreased LDL cholesterol of 10 mg/dl, and a reduced triglyceride level of 12 mg/dl. The review found no relationship between barley intake and HDL cholesterol. Beta-glucan is a type soluble fiber.
There are two types of dietary fiber – soluble and insoluble. You want to include between 25-35 grams of dietary fiber in your diet everyday. Of this, soluble fiber should make up 15 grams. Soluble fiber promotes lower total cholesterol and LDL cholesterol levels.
Barley nutrition is unique in that it contains fiber throughout the entire grain kernel. For most grains, when the outer bran layer is removed you’ve also removed the fiber. This isn’t the case with barley. Pearled barley is the easiest form of barley to find. Even though the grain is processed to remove the hull, bran, and some of the inner layer, it still provides 3 grams of dietary fiber in a half cup serving. Other varieties of barley include scotch or pot barley, barley flakes, quick-cooking barley, and hulled or hull-less barley.
Including barley as a regular part of your diet is a nutritious and simple way to promote heart health, lower LDL cholesterol, and lower total cholesterol levels.
Be sure to sign up for the free e-course How to Lower Cholesterol in 8 Simple Steps.
All the best,
Lisa Nelson RD
Heart Healthy Tips
How to Lower Triglycerides for a Lower Total Cholesterol
I’ve recently answered several questions related to triglycerides. These questions range from “What are triglycerides?” to “My triglycerides are 400, do I need to worry?” on to “Help, my triglycerides are 1200, how do I fix this?”
So, I’m going to answer all these questions here for those of you who are wondering, but haven’t asked.
What are triglycerides?
Triglycerides are a type of fat. Actually, they’re the most common type of fat in foods and in your body. When you eat foods containing fat and oil, such as butter, French fries, and chocolate chip cookies, the body takes the fat and stores it in your body as triglycerides. So, all those “fat cells” in your body are made up of triglycerides.
What do triglycerides have to do with cholesterol?
When you see your MD, he or she may order a “lipid panel” (lipid is a fancy term for fat). From the lipid panel you will learn your total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides.
Total cholesterol = HDL + LDL + VLDL
Well, what in the world is VLDL? Not something you’ve probably seen or heard of before. VLDL is an acronym for Very Low Density Lipoproteins, another “bad” type of cholesterol. Triglycerides are used to calculate VLDL levels in your blood.
Triglycerides x 20% = VLDL (bad) cholesterol
Also, the liver uses triglycerides as fuel for cholesterol production. So, if you eat a high fat (triglyceride) diet, the liver will increase its’ production of cholesterol and put more cholesterol out into your blood.
What is a normal triglyceride level?
You want your triglycerides to be below 200 mg/dL. Borderline high triglycerides are from 200-500 mg/dL. Triglycerides are high risk above 500 mg/dL.
Some experts argue that 200 mg/dL is too high and that a normal level should be less than 150 mg/dL. The numbers I’ve listed above are the current guidelines from the National Cholesterol Education Program Expert’s Panel.
If your triglycerides are high your heart disease risk increases.
What you can do when lowering triglycerides?
1. Limit simple sugars.
Unlike other types of cholesterol, triglycerides are affected by sugars you eat. You need to limit foods such as soft drinks, candy, baked goods, syrup, table sugar, jelly, and honey. A high intake of fruit juice can also raise triglyceride levels since juice contains a high content of natural sugars.
2. Limit alcohol.
If your triglycerides are borderline high or high risk, discuss your alcohol intake with your MD. My recommendation for borderline high (200-500 mg/dL) is to limit alcohol to no more than 1 drink per day for women, 2 drinks per day for men. One drink equals 12 ounces beer, 4 oz wine, or 1 ½ ounces liquor. If your triglyceride level is high risk (great than 500 mg/dL) I recommend NO alcohol. Again, discuss your situation with your MD.
3. Lose weight and/or maintain a healthy weight.
Many times weight loss alone will lower your triglycerides. Losing as little as 10% body weight could drop your triglycerides back to the normal range.
4. Choose a low-fat diet.
To achieve lower triglyceride levels, maintain a dietary intake of 30% or less of total calories coming from fat. A healthy diet for normal triglyceride levels should consist of whole grains, beans, fruits, vegetables, low-fat dairy, and lean meat.
5. Increase your physical activity.
Boosting your activity can lower your triglycerides up to 40%. If you’re not currently active, talk to your MD before starting an activity program. To reduce triglycerides, be physically active at least 30 minutes on 3 or more days each week. The more activity the better.
Triglycerides aren’t all bad. They provide efficient energy storage, cushion your organs, transport certain vitamins, and keep you warm by providing insulation. What’s important is to keep them under control!
All the best,
Lisa Nelson RD
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Heart Health Made Easy: Master the Basics to Lower Blood Pressure and Cholesterol for a Longer, Healthier Life
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Physical Activity – How much do you really need?
As I previously mentioned, The Health and Human Services Department sets physical activity guidelines after reviewing a good decades worth of research related to physical activity and health.
This report encompasses everyone from the age of 6 and up. Let’s go into a little more detail on the adult guidelines.
Adult Physical Activity Guidelines
- All adults should avoid inactivity. Any type of activity is better than nothing. Adults who include activity as part of their everyday life gain some form of health benefit.
- To see substantial health benefits, include at least 150 minutes (2 ½ hours) per week of moderate-intensity activity. If times a factor, you can see the same benefits by bumping up the intensity and being vigorously active 75 minutes (1 hr. 15 min.) each week.Yes, it is still okay to break your activity into chunks.For example, if your schedule doesn’t allow 30 minutes at the gym, you can include a 10 minute brisk walk during lunch break to count towards the goal of 150 minutes for the week. However, workout segments less than 10 minutes in length are not as beneficial.
Also, the most benefit is seen by spreading your activity throughout the week. If you’re tempted to hit the gym for a power workout session on a Saturday for 2 ½ hours, that is not as beneficial as 30 minutes of activity 5 days out of the week. But, remember, any form/amount of activity is better than nothing!
- If you want to take things to the next levels, more extensive health benefits are seen when activity is increased to 300 minutes (5 hours) per week of moderate intensity activity or 150 minutes of vigorous intensity aerobic activity.
- Don’t forget strength training! You want to include all major muscle groups on two or more days each week. Especially beneficial as we age and see a decline in metabolism (and corresponding weight gain) if muscle mass is not maintained.
Now, don’t let yourself be overwhelmed and give up without even attempting to meet these guidelines. Activity does not have to be hard or expensive. You can walk your dog, go dancing, climb the stairs at work, mow the lawn, and go to the gym. There are many, many options available to get 2 ½ hours of physical activity every week.
All the best,
Lisa Nelson RD
Physical Activity – How much physical activity is recommended?
By now you know being heart healthy and losing weight go hand-in-hand with physical activity. If you want to lose weight and keep it off, you have to be regularly active. If you want to lower triglycerides you have to be active. If you want to raise HDL you have to be active.
The Health and Human Services Department sets physical activity guidelines after reviewing a good decades worth of research related to physical activity and health.
Here’s a quick review of the adult guidelines:
- All adults should avoid inactivity.
- To see substantial health benefits, include at least 150 minutes (2 ½ hours) per week of moderate-intensity activity. If times a factor, you can see the same benefits by bumping up the intensity and being vigorously active 75 minutes (1 hr. 15 min.) each week.
- If you want to take things to the next levels, more extensive health benefits are seen when activity is increased to 300 minutes (5 hours) per week of moderate intensity activity or 150 minutes of vigorous intensity aerobic activity.
- Don’t forget strength training! You want to include all major muscle groups on two or more days each week. Especially beneficial as we age and see a decline in metabolism (and corresponding weight gain) if muscle mass is not maintained.
All the best,
Lisa Nelson RD
Lower Cholesterol – Do you understand your lab results?
It’s very possible your MD orders lab work and you have no idea what or why you’re having blood drawn. Well, let’s clear up the confusion when it comes to your cholesterol labs.
The terms “lipid panel”, “lipid profile”, and “lipoprotein profile” are used interchangeably to order the same set of labs. To make reading this easier, I’m going to use “lipid profile” from here on out.
“Lipid” is simply a medical term for “fat”. A lipid profile measures fatty substances in your blood. Cholesterol is one type of fat.
When you eat food containing cholesterol or when your body produces cholesterol and releases it into your bloodstream, the cholesterol will attach to a protein. This package of cholesterol plus a protein is called a lipoprotein (lipid or fat plus protein). A lipid profile measures lipoprotein levels in your blood.
Lipid profiles include five components:
LDL – “bad” cholesterol
LDL (low-density lipoprotein) cholesterol carries mostly cholesterol, some protein, and minimal triglyercerides throughout your circulation. LDL should be less than 130 mg/dL, ideally less than 100 mg/dL.
VLDL – “bad” cholesterol
VLDL (very low-density lipoprotein) cholesterol contains minimal protein and mainly transports triglycerides. VLDL should be less than 40 mg/dL.
Triglycerides
Triglycerides are a type of fat in the blood, not a type of cholesterol. Triglycerides are frequently used to estimate VLDL (“bad”) cholesterol. Here’s the calculation: triglycerides divided by 5 equals VLDL cholesterol. Triglycerides should be less than 200 mg/dL, ideally less than 150 mg/dL.
HDL – “good” cholesterol
HDL (high-density lipoprotein) cholesterol removes cholesterol from your bloodstream and carries it back to the liver. I like to think of HDL as a vacuum cleaner, picking up cholesterol LDL leaves behind in your arteries, the more HDL the better. HDL should be greater than 40 mg/dL, ideally greater than 60 mg/dL.
Total cholesterol
Cholesterol is essential to bodily functions, such as building cells and producing hormones. However, too much cholesterol will build up on artery walls, form a plaque, and potentially “plug” the artery resulting in a heart attack or stroke. Total cholesterol is calculated from the above components (Total cholesterol = HDL + LDL + VLDL). Total cholesterol should be less than 200 mg/dL.
Do you see how if you only know your total cholesterol, you only have one piece of the lipid profile?
Now, sometimes your results will include ratios or a risk score. Here’s an explanation of what those numbers mean.
Risk Score
A risk score is based on you lipid profile results, sex, age, family history, and various other risk factors. If you have a high risk score for heart disease, it’s best to speak with your MD to evaluate your risk score.
Cholesterol:HDL Ratio
You want a low ratio of cholesterol to HDL. A ratio lower than 4.5 is good, but 2 or 3 is best. You can calculate your cholesterol to HDL ratio by dividing total cholesterol by HDL. For example, your total cholesterol is 195 and your HDL is 55. 195 divided by 55 equals a ratio of 3.5.
It’s actually not your total cholesterol that has the greatest impact on your heart disease risk. The ratio of total cholesterol to HDL is a critical factor. If your total cholesterol is less than 200, but your ratio is 5, you are still at increased risk for developing heart disease.
LDL:HDL Ratio
This ratio compares the amount of bad (LDL) cholesterol to your good (HDL) cholesterol levels. You want a ratio less than 3.5, ideally less than 2.5. To calculate your ratio, divide LDL by HDL. For example, your HDL is 55 and LDL is 100. 100 divided by 55 equals a ratio of 1.8.
Triglyceride:HDL Ratio
A low ratio of triglycerides to HDL is best, ideally less than 2. To calculate your triglyceride to HDL ratio, divide your triglycerides by your HDL. For example, your triglyceride level is 200 and your HDL is 55. 200 divided by 55 equals a ratio of 3.6.
Lipid profiles are commonly ordered to assess your heart disease risk. Your doctor or dietitian will use the results to determine the best treatment to reduce your risk.
A lipid profile is beneficial, because you know your “good” cholesterol level and “bad” cholesterol levels. The interventions that work best to raise HDL and lower LDL differ, so knowing all your numbers helps you make the most effective changes.
You’re probably wondering why a lipid profile isn’t always ordered versus simply checking your total cholesterol (and possibly HDL). Cost and time always play a part and if your risk for heart disease is low, then a quick and less expensive screening makes sense. If you are at increased risk, a more complete assessment (lipid profile) may be more appropriate. Everyone’s situation is unique, so it’s best to discuss what’s right for you with your MD.
Now, to receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health today!
All the best,
Lisa Nelson RD
