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Archive for the ‘Managing cholesterol’ Category

Baking For A Healthy Heart

In Holiday Eating Strategies, Managing cholesterol, Recipes on November 19, 2012 at 7:37 PM

Are you interested in baking up some healthier holiday goodies this year?  Modifying a traditional recipe is not as difficult or unsavory as it may seem… actually, it is a piece of cake!    Read on:

Heart-healthy baking is all about choosing the right variety of added fat.  All fats, regardless of their source, contain a unique combination of three primary components:  saturated, monounsaturated, and polyunsaturated fat.  Some fats contain trans fat as well, either occurring naturally (as in butter and beef) or from partially hydrogenated oil added during processing.  Eating too much saturated and/or trans fat is likely to result in clogged arteries and higher cholesterol levels, and should, therefore, be limited as much as possible.   Ideally, it is best to avoid all foods made from partially hydrogenated oil, and it is easy to do so by consulting the ingredients list.  Do not rely on the container’s Nutrition Facts panel, as “0 grams trans fat” or “trans fat free” claims are allowable for foods that contain less than 0.5 grams of trans fat per serving, according to the FDA.  This is a big loop-hole that many folks are not aware of… Be sure to verify the absence of “partially hydrogenated oil” from the ingredient list.

For the majority of your baking needs, with the exception of pie crust, you can use regular (non-light) soft tub margarine spreads containing no partially hydrogenated oils, such as Country Crock, I Can’t Believe It’s Not Butter!, Promise Buttery, Smart Balance, Olivio, Canoleo soft, and BestLife.  Do you realize that cookies, cakes, quick breads, muffins, brownies, and other baked bars, do not require solid fat?   In addition to the soft spreads mentioned above, you can even get away with using naturally trans fat free corn, canola, or blended vegetable oils as a substitution for solid fats—–doing so will modify the texture and make your baked goods softer and moister.  Sounds like a worthwhile trade-in, right?  Using Grandma’s old-fashioned recipe?  Substitute 3/4 cup oil for 1 cup of butter or shortening called for in the recipe; 2/3 cup oil for 3/4 cup butter; 1/3 cup oil for 1/2 cup butter; 3 Tbsp. oil for 1/4 cup butter.  Make sense?  It’s as easy as pie!  Ahem…

Speaking of pie, you will want to use a solid fat when making your own crust.  The good news is that there are healthier options than the typical butter, Crisco shortening, solid stick margarines, and lard used to make flaky crusts & pastries:  Country Crock solid stick margarine claims to be “Great for Baking and Cooking” and actually lives up to that expectation, as a tablespoon contains only 2.5 grams of saturated fat  (compared to butter’s 7 grams) and 0 grams of trans fat (compared to Parkay, Imperial, and Fleischmann’s 1.5-2.5 grams), and behaves itself in the oven too!  Margarines have come a long way over the years, that’s for sure.  Promise sticks, containing 3 grams saturated fat per tablespoon, come in a close second, while I Can’t Believe It’s Not Butter! sticks rank third, containing 3.5 grams saturated fat and no partially hydrogenated oil.

If you desire to lower the overall fat content in a recipe, you may replace part or all of the fat with applesauce, mashed over-ripe bananas, pureed prunes, low fat yogurt, or buttermilk.  These substitutions work best in quick breads, muffins, brownies, and other bars.

A final modification to reduce the fat and cholesterol content would involve substituting 2 egg whites or 1/4 cup of egg substitute (like Egg Beaters) for each whole egg.

Did you know that pumpkin pie is one of the most nutritious Thanksgiving desserts?  The nutritious part is the pumpkin…however, the traditional pumpkin pie recipe is loaded with calories, fat, and sugar, potentially requiring you to loosen your belt at the table and have 911 on speed-dial!  Stay tuned for a sumptuous pumpkin custard recipe that will allow you to enjoy the fall bounty without adding to your waistline.

Enjoy a happy and healthy Thanksgiving!


Strategies for Preventing Heart Disease

In Managing cholesterol, Wellness on February 15, 2012 at 8:34 PM

February is Heart Awareness Month—a time in which the American Heart Association ramps up it’s awareness campaign in the fight against heart disease.  Did you know your personal lifestyle habits have a great impact on your risk of suffering a heart attack or stroke during your lifetime?  It’s true!  In other words, heart disease is PREVENTABLE—through the development of good-for-you lifestyle habits such as a healthy diet, weight control, regular exercise, quality sleep, and stress management, you can significantly reduce your chances of suffering a heart attack or stroke, and more importantly, dying from it.  Did you know more women die of heart disease than all forms of cancer combined?  Most women don’t realize this, but there are statistics to prove it.  Yes, breast cancer screening is important for a woman’s health, but so is the adoption of healthy lifestyle practices that will keep her heart happy as well.

I’ll keep this easy.  A simple list of “do’s & don’ts” is outlined below.  Follow these guidelines and you are on your way to preventing heart disease, regardless of whether you are a man or woman, young or old.  It is never too early to develop heart-healthy habits!

Add more of these: 

Healthy oils: monounsaturated fats from olive, canola, peanut oils; avocado; nuts and seeds; and polyunsaturated fats, such as omega-3’s, from fatty fish, flaxseeds, walnuts, canola oil

Fruits & vegetables:  choose a variety of deep colors for maximum antioxidant and anti-inflammatory effect such as sweet potatoes, dark leafy greens, broccoli, tomato products, kiwi, blueberries, blackberries, cherries, apples, and red grapes

Herbs & Spices:  get anti-inflammatory and antioxidant benefit from garlic, cinnamon, basil, cumin, paprika, etc.

Low-fat dairy:  choose low-fat or fat free milk and yogurt for extra potassium and calcium to help lower blood pressure

High fiber foods:  all unprocessed whole grains are healthy, but those high in soluble fiber, such as oats and barley, as well as legumes (dried beans) help lower cholesterol 

Heart-healthy beverages:  green tea, coffee, coconut water, red wine

Exercise:  sustained heart-pounding activity for at least 150 minutes per week

Limit or avoid these: 

Sodium:  new guidelines suggest less than 1500 mg per day for all adults;  check labels on processed food items and avoid those with more than 400 mg sodium per serving; choose foods considered low sodium (< 140 mg per serving) or very low sodium ( < 40 mg per serving)

Saturated fat:  cut down on high fat meats, dairy products (cheese, cream, butter) and desserts

Trans fat:  avoid foods made with hydrogenated oils (processed; deep fried; baked goods)

Sugars:  liquid beverages, such as soda, lemonade, and fruit juices raise triglyceride levels; limit sweets overall

Processed foods:  packaged foods are often higher in sodium and made with refined flour

Alcohol:  can help raise healthy HDL cholesterol levels, but must be consumed moderately:  no more than 1 drink per day for women; 2 drinks per day for men (1.5 oz liquor, 12 oz. beer, 5 oz wine)

Extra pounds:  losing 10% of current body weight can lower your risk of heart disease (i.e. 20 # loss for 200 # person)

Cigarettes:  stop smoking…the best decision you can make for your heart

Seems simple enough, doesn’t it?  For more ideas on eating healthy and leading a heart-healthy lifestyle, visit or

From my heart to yours 😉   Cheers!

Power Up, Peeps!

In Autoimmune disease, Diabetes, Fighting Cancer, Managing cholesterol, Wellness on October 23, 2011 at 10:47 PM
As a dietitian who specializes in chronic disease management, I spend the majority of my time helping people prevent or manage conditions such as diabetes, high cholesterol, high blood pressure, cancer, and autoimmune disorders (scleroderma, lupus, rheumatoid arthritis, etc).  Of course, the dietary suggestions I make for each client are based on his or her individual health needs and taste preferences.  However, there are specific fruits, vegetables, and herbs that I consider “power” foods and encourage everyone to eat them on a regular basis, regardless of health status.  My judgments are based on a food’s ability to lower blood sugar, cholesterol or blood pressure; provide antioxidants for heart disease and cancer prevention; and/or as act as anti-inflammatory agents, important for taming autoimmune disease, and preventing heart disease and diabetes.  I will share my so-called “power foods” and suggested serving sizes with you now.  It will be impossible for the average person to include all 15 of these foods on a daily basis, but aiming for 3-5 times per week for each will certainly “power up” your nutritional status and help you thwart disease.
1.  Sweet potato/Yam:  easier on blood sugar than a white potato and helps lower cholesterol due to its high soluble fiber content; great source of carotenoids and other antioxidants for eye health, heart health, and cancer prevention; anti-inflammatory properties for those with autoimmune conditions.  Serving size: 1 cup.  
2. Dark green leafy vegetables: such as spinach, kale, arugula, collards, mustard greens.  Contain potent antioxidant and anti-inflammatory properties for heart health, autoimmunity, and cancer prevention; excellent source of potassium to help lower blood pressure.  Serving size:  the more, the better.  Caveat:  be careful if on blood thinning medication, as these are high in vitamin K.
3.  Cooked tomato products:  such as tomato/vegetable juice, spaghetti sauce, tomato soup, pizza sauce.  Contain potent antioxidant and anti-inflammatory properties for heart health, cancer prevention, and autoimmune modulation; excellent source of lycopene for men’s prostate health; rich in potassium for lowering blood pressure (especially if no salt added during processing).  Serving size:  1/2-1 cup.
4.  Broccoli:  exceptional source of cancer-fighting compounds; anti-inflammatory benefits good for heart and autoimmune conditions.  Easy on blood sugar.  Serving size:  1 cup.  Substitute: Brussels sprouts, cauliflower, Bok choy, or other cruciferous vegetables.
5.  Starchy beans:  such as kidney beans, black beans, red beans, white beans, garbanzo beans, etc.  Excellent source of soluble fiber which is easier on blood sugar and helps lower LDL cholesterol; many varieties are rich in potassium for lowering blood pressure.   Antioxidant properties.  Serving size:  1/3 cup.  
Power fruits:
1.  Avocado:  YES!  IT’S A FRUIT!  Rich in monounsaturated fat, known to fight inflammation and raise healthy HDL cholesterol.   Serving size:  1/8-1/4 medium size.  Caveat:  high in calories, so don’t consume a whole avocado every day or your body will take on the shape of an avocado…
2.  Cherries:  potent source of antioxidants and anti-inflammatory properties, great for heart health, joint pain, and autoimmune conditons;  2 tbsp cherry juice daily can ease arthritis pain.  Serving:  12-20 fresh cherries or 1/4 cup dried cherries (2 Tbsp. dried with diabetes).  Caveat:  can raise blood sugar if you have diabetes, so watch portion size.
3.  Blueberries:  highest antioxidant/anti-inflammatory power for cancer prevention, heart disease, brain health, and autoimmunity.  Serving:  3/4 cup  fresh/frozen or 1/4 dried blueberries (2 Tbsp dried with diabetes).
4.  Apples: excellent source of soluble fiber for lowering LDL cholesterol; potent antioxidant/anti-inflammatory properties for heart health, cancer prevention, and easing autoimmune flare-ups.  Serving size:  “an apple a day keeps the doctor away”, but you knew that already, right?  Caveat:  organic is best, as conventionally grown apples have high pesticide residues.
5.  Kiwi:  excellent source of vitamin C, particularly important during “cold and flu season”; rich in potassium for lowering blood pressure; contains papain, a natural enzyme that can aid protein digestion for those with digestive disorders; high fiber makes it easier on blood sugar and speeds intestinal transit for optimal colon health and for those with autoimmune-related intestinal motility issues.  Serving:  1-2 medium kiwis.   
Power herbs/spices:
1.  Cinnamon:  potent anti-oxidant/anti-inflammatory properties for cancer and autoimmune conditions; helps lower blood sugar.  Serving:  1/4-1/2 tsp. daily, added to coffee, tea, oatmeal, yogurt, etc.
2.  Basil:  potent antioxidant/anti-inflammatory for heart health, cancer prevention, autoimmunity.  Serving:  add liberally to salads, sauces, meats, side dishes.  Fresh or dried.  Acceptable substitute:  oregano or rosemary.
3.  Tumeric (curcumin):  loaded with antioxidants and anti-inflammation properties  for heart, cancer, autoimmunity;  Serving:  1/8-1/4 tsp  Substitute:  cumin, curry
4.  Fresh Garlic:  cooked lightly to release antioxidant/anti-inflammatory components, excellent for fighting inflammation, lowering cholesterol, and cancer prevention.  Serving:  1-2 cloves.  Caveat:  may need to hand out nose plugs…
5.  Paprika:  potent antioxidant/anti-inflammatory properties, for the same reasons as other herbs listed above.  Excellent topper for chicken and fish.  Serving: 1/8-1/4 tsp.  
As I have said time and again, it is always best to eat real, wholesome foods rather than to rely on pills and supplements to give your body what it needs to look and feel well.  Taking so-called fruit or vegetable pills or powders will not provide the same benefits.  Add these powerful foods to your shopping list this week and be on your way to feeling your best!

The Lowdown on Cholesterol Supplements

In Managing cholesterol on March 1, 2011 at 1:28 PM

January and February are the most popular months for scheduling annual physical exams.  This may be as a result of a new year’s resolution “to take better care of yourself” or  because your insurance benefits have rolled over to start another coverage year.  Whatever your motivation, this exam will likely include an evaluation of various blood parameters, potentially revealing issues with blood sugar, cholesterol, and/or thyroid levels.  Several of my friends have recently gotten less than favorable blood cholesterol reports, and have sought my advice for “natural” ways to lower their cholesterol.  They don’t want to risk negative side effects, such as muscle pain, weakness, fatigue, and/or liver or kidney injury, from taking the well-known prescription drugs, Lipitor (atorvastatin) or Zocor (simvastatin).   So, the big question is this:  Are “natural” remedies safer than prescription meds, yet equally effective?

Most alternative cholesterol lowering products sold today contain a combination of so-called “natural ingredients”, which may include fish oil, garlic, niacin, phytosterols, policosanol, red yeast rice, and/or soy isoflavones.   Even though many of these substances have been studied quite rigorously over the past 10-15 years, and shown favorable results, the supplement world is still largely unregulated.  Since there are no government-regulated standards for supplement products, we can’t necessarily trust that a particular product contains an effective amount of the active ingredient(s) or that they are safe for regular consumption.  For example, the well-respected supplement testing company,, has often found dramatic variations in the active ingredients in a wide variety of supplements, so you are not necessarily getting what is indicated on the label.  A claim that a product is an “all natural, safe formula” is not necessarily something you can count on.

Let’s take a look at some of these “active” ingredients:

Fish Oil:  omega-3 fatty acids contained in fish oil, EPA and DHA,  have been found to lower rates of coronary artery disease, by exerting anti-inflammatory and anti-atherogenic (anti-artery clogging) effects.  Up to 3 grams, or 3000 mg, of the active ingredients (DHA/EPA) is recognized as safe for lowering triglycerides and LDL levels.  Taking a  “1000 mg fish oil” capsule does not mean you are getting 1000 mg of DHA/EPA.  Check the label and then do the math.   Supplements typically provide approximately 180-300 mg EPA and 120-200 mg DHA per capsule.  You will likely need at least 2-3 fish oil capsules to get 1000 mg of the active ingredients.  If you enjoy fish, I highly recommend eating 3-4 oz of fatty fish, two or three times per week, which provides approximately 3 grams of fish oil.  Farm-raised fish contain less omega-3 than fish found living in coldwater oceans, rivers, and lakes.  Living in ice cold water = more fatty insulation on the fish.  Think Lake Superior whitefish and Alaskan salmon.

Garlic: this is one of the best-selling herbal supplements in the United States.  Research studies have found garlic to be rather effective in lowering cholesterol levels, reducing blood pressure, and improving overall circulation.  The question is always “how much do you really need” to get the desirable effect?  Most studies showing cholesterol-lowering benefit have used 40-1200 mg dried powder or 1-7.2 grams aged garlic extract (approximately equivalent to 1-2 garlic cloves).  That is a tremendous amount of variation…  Check supplement labels for the quantities contained within, but keep in mind that you might not be getting all that is really listed.  Garlic supplements are relatively well-tolerated and have mild adverse effects, such as intestinal discomfort or undesirable body odor, at high doses.  If you want to be certain you are getting a “therapeutic dose”,  I suggest adding more crushed, raw garlic to your food if you (and your neighbors) can tolerate it!

Niacin: nicotinic acid, at pharmacological doses (1-3 grams/day), has been used to treat high cholesterol for over 50 years.  Supplementation at such requires medical supervision due to the potential for serious side effects, such as liver toxicity, high blood sugar, and severe flushing of the skin.  Newer prescription time-released niacin preparations approved by the FDA for treating high cholesterol/triglycerides (such as Niaspan) are reported to be safe and well tolerated.  Self-administration of nicotinic acid is not recommended.  The RDA for niacin is 14-16 mg NE (niacin equivalents) per day with the upper limit set at 35 mg NE for adults.   It is easy to get your daily requirement from foods such as chicken, tuna, beef, peanuts, and avocado.  Niacin is available in single preparation supplements, B-complex formulations, multivitamins, and in a few popular cholesterol supplements (such as Vasacor).  Be careful you are not exceeding the 35 mg NE upper limit with any supplements.

Phytosterols:  there is substantial evidence supporting the use of phytosterols in the treatment of high cholesterol, but most research has been limited to the development of plant sterol-enriched food products, such as Take Control and Benecol, rather than dietary supplements.  Phytosterols, such as beta-sitosterol, have chemical structures similar to that of cholesterol, and have been found to block the body’s natural cholesterol production.  Plant sterols are present naturally in fruit, vegetables, nuts, seeds, seafood, whole-grains, and legumes.  The drawback to using sterol-enriched food products, such as margarine and other fats, is that you end up consuming too many extra calories to get the required dosing for cholesterol lowering effect (3.4 to 5.1 grams per day) .  Popular supplements such as Choles Lo, Vasacor, and Cholest Off, all list phytosterols as an active ingredient, but as mentioned earlier, there is no surefire way of knowing that you are getting the amount listed on the label.   Phytosterols are safe and effective at the recommended doses.

Policosanol: this supplement, in its most effective form, is derived from sugar cane wax.  It is often referred to as a “natural statin” and is approved for treatment in more than 20 countries.  Policosanol seems to reduce cholesterol by increasing bile acid secretion and inhibiting cholesterol production in the liver, but not all research studies have been supportive of this.  It is generally well-tolerated with minimal side effects.  Research subjects have shown results with dosages of 10-20 mg/day.  Popular supplements, such as Choles Lo, Poli-Cholest, and the newly reformulated, Cholestin, identify policosanol as an active ingredient.  (Cholestin used to contain red yeast rice, but was forced to reformulate 10 years ago…see below)  Will these popular supplements work?  Again, since active ingredient content can vary dramatically, it is hard to know if you are spending your money wisely.

Red Yeast Rice:  the active component in red yeast rice, monacolin K,  is chemically identical to the commonly-prescribed drug lovastatin, which effectively reduces the production of cholesterol by the liver.  Red yeast rice is produced by fermenting the yeast Monascus purpureus with red rice.  It was previously available in the U.S. as a supplement marketed under the name Cholestin, but in 2001, the US district court ruled that because Colestin contained the drug lovastatin, it could not be sold without a prescription.  (Cholestin has now been reformulated to contain policosanol, as noted above).  It is very likely that similar products containing cholesterol-lowering medications are also on the market, but the FDA has not yet identified them to seek legal action.  Red yeast rice may seem more natural because it comes from a plant and is sold in health food stores, but it really is a drug.  As with statins, muscle and liver problems are possible and should not be taken with other cholesterol-lowering drugs.  Supplements containing trace amounts of red yeast rice are permissible by the FDA, but are essentially ineffective.

Soy Isoflavones: back in 1999, the FDA approved a soy protein health claim on food packaging indicating that 25 grams of soy protein daily may reduce the risk of heart disease.  By 2006, research was not showing much clinical efficacy that soy could significantly lower cholesterol levels.  As a result, the American Heart Association suggested that soy NOT be considered as an effective supplement, but rather as a low saturated fat meat alternative to support a heart healthy diet.

In my opinion, the most effective way to lower cholesterol is through a healthy diet, weight loss, and good old-fashioned exercise.  To do so, cut back on foods high in saturated fat (cheese, high fat meats, butter, chocolate, coconut); choose whole foods rather than processed (trans fats are often added); eat more heart-healthy sources of fat such as olive oil and nuts; and cut back on sugars (desserts, sugary beverages, including juice).  Add garlic to your food.  Eat fatty fish several times per week.  Aim to drop 10-20 pounds.  Rev up your heart with some vigorous exercise for at least 30 minutes, five times per week.  You are exercising vigorously when your breathing rate has exceeded your ability to carry on a conversation. 

If you truly desire to take a supplement,  you are better off choosing simple formulations that contain only one or two of the above mentioned safe, active ingredients such as garlic, phytosterols, fish oil, or policosanol.  

For more cholesterol-lowering ideas, refer to my April 20, 1010 posting entitled:  “How I Conquered My High Cholesterol Genes”.

To your health 😉

Falling For Sweet Potatoes

In Managing cholesterol, Meal Ideas, Nutrition Basics on October 6, 2010 at 4:58 PM

Let’s answer your burning question first: “Is that a yam or a sweet potato”???  Traditionally, it depends on the skin and flesh color.  Scientifically, they are one in the same.  The true, traditional ‘sweet potato’ is tan on the outside with a creamy yellow interior.  The more common form of sweet potato found in markets across the US is copper-skinned, with deep orange flesh, and is often sold as a “yam”.  The yam is botanically a sweet potato. 

Are you interested in adding a nice splash of color and robust flavor to your fall dinner plate?  With autumn in full swing, a variety of nutritous, flavorful, yellow-orange vegetables have come into season:  sweet potatoes (ahem…or yams), acorn squash, pumpkin.  YUM.  A word of caution:  adding butter, sugar, and marshmallows to your sweet potato spoils the nutritional benefit—just like turning pumpkin into pumpkin pie—vitamins are still there, but so are loads of calories, fat, and sugar—demoting good-for-you vegetables to bad-boy dessert status.

Here are some impressive stats on a plain ol’ sweet potato:

90 calories per half cup (half baseball size) or 180 calories per cup (small fist size)

7 grams of fiber per cup:  this helps fill you up and makes your blood sugar rise more slowly–helping to prevent carb cravings a couple of hours later.  Some of this fiber is “soluble”, which helps lower cholesterol much the same way as oatmeal.  (fyi:  white potatoes have only 2 grams of fiber per cup)

950 mg of potassium per cup:  potassium helps regulate your blood pressure

38433 IUs of Vitamin A per cup:  this comes in the form of beta-carotene—a key nutrient for vision and immune health.  Remember mom telling you to eat your carrots because they are “good for your eyes”?  Well, she was right.  And the same goes for the sweet potato.

Chock-full of carotenoids:  the rich orange color indicates a high concentration of these cancer fighting phytochemicals, such as beta-carotene as mentioned above.  Another one, called lutein, helps protect against age-related macular regeneration—another boost for your peepers!

Fat free: to help keep them this way, try adding spices such as cinnamon, nutmeg and/or ginger, as well as apples, olive oil, or nuts (pecans), instead of the butter, sugar, and/or marshmallows.

Sweet potatoes are very versatile and can be boiled and mashed; baked whole or cut up as “fries” in the oven; sliced and cooked in a skillet; etc.   Whatever you would do with a white potato, you can do with a sweet potato.

Try one tonight!


Get Nutty With Me!

In Managing cholesterol, Snacking, Weight Loss on July 19, 2010 at 10:13 PM

Throughout the 80’s and 90’s, the majority of health experts emphasized the need for a low-fat diet to achieve weight-loss success.  Anything containing high levels of fat, natural or otherwise, was considered “off limits”.   Hence, the boom of “fat free” foods was born.  This excited the average person trying to watch their weight, as they were given PERMISSION to stock up on FAT FREE cookies, cakes, and ice cream, with new choices becoming available year after year–SnackWells made a fortune during this time!  The widespread belief was that if a food did not contain fat, then you wouldn’t get fat eating it, regardless of portion size—WOO HOO!  Well, after about 10 years of eating an abundance of processed fat free foods, our waistlines were bigger than ever.  Oops…what happened here??

Fads come and go, but the basics of weight control remain the same:  a calorie is a calorie whether it comes from carbs, protein, OR fat; calories in must equal calories out in order to maintain our weight.  Have you ever taken a look at the calorie content of fat free or reduced fat junk foods?  Often times, the fat-modified product is similar in calories to the original product—this is often due to added sugars used in place of fat.  So, if they have the same number of calories, yet we allow ourselves to go gangbusters with the fat free variety, we are looking for trouble and a bulging waistline.

In response to the fat-free/high sugar dieting debacle, carbs developed the bad reputation for the remainder of the 90’s and into the new millennium.  High protein diets ruled—bring on the meat, eggs, and bacon, baby!  As more studies revealed that the TYPE of fat consumed has an impact on cholesterol levels and overall heart-disease risk, health experts began emphasizing the value of including moderate amounts of heart-healthy fats in the diet.  This is the train I have been riding since becoming a dietitian over 11 years ago: including foods rich in the “healthy” fats  (monounsaturated and polyunsaturated fats–such olive oil, avocados, nuts, and nut-butters) in a balanced diet is a smart thing to do!!   Particularly, I am a big fan of nuts and nut butters—they are loaded with nutrients, protein, and fiber, and make for a very portable snack to get me through the busiest of days.  To convince you to do the same, I’d like to share some other notable-nut-nutrition-nuggets with you:

-at least 3/4 of the calories in nuts come from fat, which is mostly mono- and polyunsaturated, the kind that improves cholesterol levels.

-people who eat nuts regularly have lower blood cholesterol, are at lower risk for heart disease, and are less likely to develop diabetes.

-nuts are all cholesterol-free.

-other healthful substances in nuts include potassium, copper, magnesium, fiber, arginine (an amino acid that helps relax blood vessels), sterols (which also help lower cholesterol), and phytochemicals that have antioxidant effects.

-people who eat nuts regularly tend to weigh less than those who don’t—or at least they don’t weigh more, studies show.  The protein, fat, and fiber in nuts help make you feel full longer, so you are less hungry, and presumably, eat less later.

-to get the heart-health and weight control benefits of nuts, eat 1 oz (1/4 cup) per day—approximately 150-190 calories depending on the nut variety.  Dry roasted nuts typically have as many calories as oil-roasted.   If your weight is well-managed, eating up to 3 0z. per day is reasonable and healthy.

-nut butters have the same nutritional advantages as nuts—just be careful to purchase one made without hydrogenated (trans) fat and sugar. 

-people who eat nuts are NOT more likely to develop problems related to diverticulosis, contrary to popular belief—if you are concerned, chew your nuts well before swallowing, and/or choose smooth nut butters.

-nuts are naturally low in sodium—the salt is added during processing, so it is wise to purchase nuts without the added salt.

-walnuts are a good source of omega-3 fats, known to lower triglyerides and keep blood flowing smoothly.

-peanuts have the most protein of all nuts.

-ONE Brazil nut provides a whole day’s worth of selenium—55mcg.  (be careful not to eat too many to avoid selenium toxicity!)

-almonds help meet your calcium needs–74 mg per ounce.

Are you convinced yet?  Assuming you are not allergic to nuts, they are essential to a healthy diet—grab a handful today!

How I Conquered My “High Cholesterol” Genes

In Managing cholesterol on April 20, 2010 at 12:12 AM

I think most people would agree with the following statement: GROWING OLDER IS NO FUN.  Turning 40 this past year forced me to face the fact that I am not going to be young forever.  So, in my effort to gain some control over how quickly my body ages, I chose to undergo a variety of preventative health tests without delay, such as a mammogram, blood cholesterol panel, and dilated eye exam.   While I assumed that my aging body was probably getting ready to just slip down the tubes, I ended up with the biggest surprise: I achieved my best cholesterol numbers in nearly a decade!!!  Woo hoo!    I have some family history of premature heart disease, high blood pressure, and high cholesterol, so it is important for me to do my part in keeping my pesky genes under control.  In 2007, I was quite disappointed to learn of more elevated cholesterol numbers, as I had been intensely training for and running long distance races over the previous years.  It seemed like I was destined to struggle with higher than ideal cholesterol numbers for the rest of my life despite my living a healthy, active lifestyle… This frustration led to a more determined effort to eat and exercise better than ever  before.  I’d like to share with you what I added to and subtracted from my diet, in combination with sustained levels of physical activity, which most  likely led to the overall improvement in my cholesterol profile.

Let’s first review the individual cholesterol profile components:

LDL (low density lipoprotein) is the artery-clogging “bad” cholesterol produced by your liver that is negatively impacted by genetics, poor diet, and inactivity.  The higher this number, the greater your risk of experiencing a heart attack or stroke.  Ideally, this number should be less than 100 mg/dL for most individuals, and less than 70 mg/dL for people with diabetes or those who have already suffered a heart attack or stroke.

HDL (high density lipoprotein) is “good” cholesterol that helps your body get rid of the unhealthy LDL cholesterol naturally.  The higher this number, the lesser your risk of suffering a heart attack or stroke.  Ideally, this number should be greater than 60 mg/dL for optimal heart-protective benefits, but your number is considered “o.k.” as long as it is above 40 mg/dL for men and 50 mg/dL for women.

TG (triglycerides) is not cholesterol per se, but it is a measure of circulating fat in your system.  The higher this number, the greater your risk of cardiac events.   To minimize heart disease risk, this number should be less than 100 mg/dL.

Total Cholesterol = LDL + HDL + TG/5
Total cholesterol levels should be less than 200 mg/dL, but it is important to realize that a high total could be due to a high HDL or a high LDL, or a combination of both.  In this case, it is most valuable to look at the individual components to determine your risk rather than thinking you are “safe” as long as your total number is below 200. 

The first set of numbers I show you below from June 2007 are from a period in which I was running approximately 25-30 miles per week.  Usually during intense training, I eat more calories overall in the effort to maintain my weight, and most of the extra calories end up coming from my favorite junk foods such big, juicy cheeseburgers, French fries, fried chicken fingers, ice cream, and desserts.  (After all my “long runs”, I deserved it!) I was curious to see if all my exercise training would somehow negate the effects of a less than stellar diet on my cholesterol levels.  As you can see from my numbers below, that was clearly NOT the case…

My results from June 2007 were as follows: 

Total  cholesterol         212  

LDL      120                           

HDL      74                     

TG          90        

Results from April 2010:

Total  cholesterol         182

LDL     80        down 40 points

HDL    94        up 20 points

TG       39        down 51 points


In 2007, my LDL was 20 points above ideal levels.  This was likely due to my high saturated fat intake from cheeseburgers, ice cream, and rich chocolate desserts, in addition to trans fat from fried foods such as fries and chicken fingers, as well as flaky desserts.  My HDL was nice and elevated, most likely due to my high level of activity.  Vigorous exercise is the most effective way to raise your HDL cholesterol to higher, more cardio-protective levels.  My triglyceride levels were within recommended limits, but this number was higher than ever before, most likely due to a diet higher in fat and sugar. (ahem—- desserts!)  Considering my genetic tendency towards high cholesterol, it was critical for me to make some significant dietary changes  in order to stay off  cholesterol-lowering medication as long as possible.

Especially in the past year, I cut back on foods that are known to raise LDL cholesterol levels such as high fat meats, deep fried foods, and desserts.  To tip the scales even more in my favor, I added more heart-healthy foods such as nuts, peanut butter, avocado, and olive oil to my diet.  These foods contain high levels of monounsaturated fats, which have been found to raise HDL and lower LDL.  I also added more water-soluble fiber in the form of oats, barley, starchy beans, apples, and citrus, as this type of fiber helps rid the body of excess LDL.  Exercise will also help lower LDL and raise HDL levels.  I have not been doing much running over the past year, but have continued my usual 45-60 minutes of sustained physical activity 6-7 days per week.  My trememdous HDL level is an indication that it is not so much what activity you do, but how much total exercise you do on a regular basis.  The more exercise, the better.

Fatty fish, such as salmon, is an excellent form of omega-3 fatty acids, which are known to help lower triglyceride levels.  I made the effort to eat 2-3 servings of fish per week in the form of tuna salad or salmon salad sandwiches for lunch, as well as more salmon and whitefish at dinner.  Triglycerides can also be elevated by high levels of sugar intake (natural or added), so I cut out all forms of liquid sugar (juice, milk, soda, lemonade, sweetened tea, etc), and limited other added sugars as well.  My primary beverages were unsweetened coffee, dry wine, and water. 

Speaking of wine, moderate alcohol consumption has been found to increase levels of the good HDL cholesterol. My current HDL is at its highest level to date. It was not my intent to raise my HDL by drinking more alcohol—it was simply an added bonus to a very social year 😉  On a side note, alcohol can increase triglyceride levels too, which would not be a good thing.  In this particular case, my triglycerides were unaffected, but someone else’s levels might be aggravated by alcohol.

My current cholesterol profile is exactly where I want it to stay.  In order to accomplish this, I will need to maintain my current diet and exercise habits, otherwise I risk sending my cholesterol numbers off in the wrong direction again.  If you would also like to lower your LDL and triglyceride levels this year, while raising your healthy HDL, I encourage you to give some of my successful changes a try.  Even if you are currently taking cholesterol lowering medication, such as simvastatin or Lipitor, your medication will work even better with improved diet and exercise habits.

Any questions?  Feel free to ask in the comment section below.  You deserve a happy heart 😉

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