Simple Tips for Lowering Your Cholesterol

from the Heart Health Center

 For many Americans working toward better heart health, an important first step is getting cholesterol to a healthy level. Diet and exercise are important steps to reduce high cholesterol. However, many people may find that with diet and exercise alone, cholesterol numbers are not where they should be. More than one hundred million Americans have high cholesterol, an important risk factor for heart disease. Though diet is very important, many people don’t realize that cholesterol is also produced in the body based upon heredity. Learning about your family health history is important—we recommend talking to your family about their health and creating a family health tree.

 Bringing this information to your next doctor visit will help you discuss your family history regarding cholesterol and other hereditary health concerns. Understanding Cholesterol What you eat affects your health, by raising or lowering the blood fats (cholesterol, triglycerides) that circulate through your body. Some foods increase your levels of total cholesterol, LDL or “bad” cholesterol and triglycerides. Over the years, excess cholesterol and fat are deposited in the inner walls of the arteries that supply blood to your heart. Eventually, these deposits can make your arteries narrower and less flexible, a condition known as atherosclerosis. Left unchecked, this buildup can lead to heart attack, stroke and death. Additionally, because of your family health history, your body may be genetically predisposed to make more cholesterol than you may need, in addition to the cholesterol from your food intake.

 Know your numbers!

Each one of us has a cholesterol goal level, based upon our individual risk factors and our risk for heart disease. The National Cholesterol Education Program (NCEP) recommends that everyone age 20 and over have a blood cholesterol test every five years to check their cholesterol levels.

 To learn more about your goal, visit http://www.nhlbi.nih.gov/chd for the National Cholesterol Education Program’s Live Healthier, Live Longer Web site.

 If your cholesterol levels are mildly to moderately higher than your goal, making a few dietary changes may be all you need to get back on track. According to current NCEP recommendations, people with coronary heart disease or others considered to be at high risk for coronary heart disease generally have an LDL cholesterol goal of less than 100 mg/dL. An LDL cholesterol goal of less than 70 mg/dL is a therapeutic option for people considered to be at very high risk. Work with your doctor to develop a plan to help reduce your LDL cholesterol number to goal. Here are guidelines for your cholesterol and triglyceride levels according to NCEP guidelines (new guidelines will be released in 2010): Total blood cholesterol levels less than 200 mg/dL Desirable 200 to 239 mg/dL Borderline high 240 mg/dL or above High LDL blood cholesterol levels less than 100 mg/dL Optimal 100 to 129 mg/dL Near optimal/above optimal 130 to 159 mg/dL Borderline high 160 to 189 mg/dL High 190 mg/dL and above Very High HDL blood cholesterol levels above 60 mg/dL. Levels above 60 mg/dL are considered especially beneficial and can offset risk factors for heart disease, according to NHLBI. The higher the level, the healthier it is. Optimal 50 to 60 mg/dL for women; 40 to 50 mg/dL for men Average less than 50 mg/dL for women; less than 40 mg/dL for men. Below these levels is considered a major risk factor for heart disease. Low Triglyceride levels less than 150 mg/dL Normal 150 to 199 mg/dL Borderline High 200 to 499 mg/dL High 500 mg/dL or higher Very high It is important to remember that these recommendations are for healthy individuals, not for women with existing risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease. If you are at risk for heart disease, your target goals likely will be lower.

Fighting Back:  There are things that you can do now to help you gain a better understanding of your risk factors and perhaps lower your chances of high cholesterol and heart disease. For starters, it’s important that you eat right, get plenty of exercise, as recommended by your physician, and begin to understand your family health history. A healthy diet may help reduce total cholesterol. In general, you want to get “good” cholesterol higher and “bad” cholesterol lower. You can still enjoy a wide variety of foods by making healthful dietary choices and changes. If elevated cholesterol is part of your family genetics, or you have other conditions such as heart disease or diabetes, you may need medication in addition to eating a heart-healthy diet. But whether you have normal cholesterol, high levels, or are currently taking a cholesterol-lowering drug, eating a healthy diet is important for everyone. Good fats/bad fats Fats can be good for you and your heart, when they’re the right kind and consumed in limited amounts; but even good fat is packed with calories. Those include monounsaturated and polyunsaturated fats, which decrease “bad” cholesterol, and omega-3 fatty acids, which lower triglycerides. Unsaturated fats are liquid at room temperature. Monounsaturated fats include olive oil, canola oil and peanut oil. Polyunsaturated fats include corn oil, safflower oil and soybean oil. Saturated fats are the bad guys that may endanger your heart. They increase LDL or “bad” cholesterol more than anything else in your diet. Saturated fats, found mostly in animal products, are hard at room temperature or in the refrigerator. Think butter, shortening, fat on and in meat and poultry skin. Whole milk or two-percent milk products, half-and-half and cream all have a lot of saturated fat. Tropical oils—coconut, palm and palm kernel oils—also contain a lot of saturated fats. These oils are used in commercially baked crackers, cookies and non-dairy creamers. Foods containing saturated fats often also contain high amounts of cholesterol, which is only found in animal products. Trans fats are another culprit to watch out for. Trans fats raise “bad” cholesterol. Trans fats are found in foods made with hydrogenated or partially hydrogenated oils—stick margarine and some store-bought cookies and cakes, fast-food French fries, potato chips and other snacks. Read your food labels before purchasing. If there are .5 grams or less of trans fats in an item, the company can claim 0 trans fats on the label, so check the ingredient list for hydrogenated oils.

Heart-Healthy Choices

1. Switch your dairy Make the change from whole or two-percent milk to one-percent and then to skim, for drinking and in recipes. Or try almond milk or rice milk for a nondairy alternative. Use low-fat or nonfat sour cream, yogurt, cream cheese and ice cream. 2. Choose lean cuts Beef tenderloin, sirloin, eye of round, ground beef with 10 percent or less fat and pork tenderloin are good choices. Other alternatives include white meat chicken or turkey. Remove the skin before cooking any poultry. 3. Cook with monounsaturated or polyunsaturated Oils These include olive, canola, peanut, safflower, sunflower, sesame and soybean oils. 4. Use more plant-based proteins instead of animal products These include beans and peas—black beans, kidney beans, pinto beans, chickpeas, lentils—and tofu or soy. Try veggie burgers (soy-based or grain-based) for an alternative to beef. 5. Boost your intake of foods that are high in soluble fiber This type of fiber binds to cholesterol in the digestive tract and helps remove it from your body. Good sources include oatmeal, oatmeal bread, oat bran cereal, beans and peas, apples, bananas and citrus fruits. 6. Increase whole grains in your diet Choose bread with at least 3 grams of dietary fiber per slice, whole-grain pastas and brown rice. 7. Use products containing plant sterol and stanol esters These components help keep your body from absorbing cholesterol. Consuming two to three grams a day decreases LDL cholesterol by 6 percent to 15 percent. Food products that have added cholesterol-lowering sterols and stanols include margarines, orange juice and yogurt. 8. Eat fatty fish twice a week Choose wild salmon over farm-raised to reduce possible toxin exposure. Pregnant or nursing women and children should limit tuna intake to 6 ounces a week and avoid swordfish, due to concerns about methyl mercury levels. 9. Increase the amounts of fruits and vegetables you eat Most women should have 1-1/2 cups of fruit and 2 to 2-1/2 cups of vegetables (without cheese sauce!) every day, according to new guidelines. Adding more of these to your diet fills you up, adds fiber and important nutrients and helps replace foods with saturated fats. For details on the new dietary recommendations, visit http://www.mypyramid.gov . 10. Keep an eye on dietary cholesterol Dietary cholesterol, such as is found in eggs, dairy products and some other foods, may raise cholesterol in the blood slightly, but newer studies find that consumption of dietary cholesterol is unlikely to substantially increase risk of coronary heart disease or stroke among healthy men and women. If you have other existing health conditions or risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease, you may need to monitor dietary cholesterol more closely. Egg yolks are filled with dietary cholesterol—213 milligrams in each. If you have elevated cholesterol, the National Cholesterol Education Program recommends you keep your consumption under 200 milligrams per day. Egg whites are cholesterol-free, so use two for each whole egg in recipes, or use cholesterol-free egg substitute, which works well in baking and omelettes.

Heart-Healthy Tips for Eating Away from Home

 Here’s how to eat out and have a terrific meal without taking in too much fat and cholesterol: Preparation counts. Order your food fresh, sautéed, grilled/broiled, or poached. If sautéed or broiled, ask for it to be cooked with olive oil or without fat. Have sauces served on the side, so you add only what you need. Divide and conquer. Resist the pitfalls of inflated portions by eating only half of what you order. Take the rest home for an easy lunch or dinner the next day. Ask if you and your dining partner can share an entrée, with each of you ordering individual salads. Balance. Have the nachos if you really want them, but order a healthy entrée. Dessert isn’t a no-no—pick fresh fruit or sorbet. Enjoy the bread or rolls, just skip the butter and drizzle on olive oil. Sip slowly. Wine may raise HDL “good” cholesterol a bit, but there’s also evidence it can boost your triglyceride levels. Fast food stops are OK. Most fast-food restaurants now offer healthier items than a bacon double cheeseburger. Depending upon which chain you visit, you may find salads (ask for nonfat or olive oil dressings), grilled chicken, yogurt, baked potatoes and fresh fruit cups. Look for a heart-healthy symbol. Some restaurants put a heart or other sign next to healthful menu items. Choose from those.

 For more information on the health topics mentioned in this article visit the HealthyWomen.org areas below. Heart Health Center: http://www.healthywomen.org/healthcenter/heart-health Weight Management: http://www.healthywomen.org/condition/weight-management Heart Disease: http://www.healthywomen.org/condition/heart-disease Atherosclerosis: http://www.healthywomen.org/condition/atherosclerosis Metabolic Syndrome: http://www.healthywomen.org/condition/metabolic-syndrome Healthy Living: http://www.healthywomen.org/ages-and-stages/healthy-living/diet-and-nutrition © 2011 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (tollfree). On the Web at: http://www.HealthyWomen.org.

Too Many Stroke Patients are Missing an Important Medication

The May 27^th online issue of Stroke: Journal of the American Heart Association reported that more than 16% of stroke patients are being discharged without a potentially life-saving medication.  These medications are called statins and they are generally used to reduce levels of the artery clogging cholesterol, LDL.  Common names for the statins are Lipitor, Zocor, and Crestor.

Dr. Bruce Ovbiagle, associate professor of neurology and director at the UCLA Stroke Prevention Program, UCLA Stroke Center and Department of Neurology stated that about one in ten stroke patients experience a second stroke within a week.  If statin therapy is started immediately at the hospital, a second stroke could possibly be prevented.

The good news is that there has been an increase in the number of patients being given prescriptions for the statin medicines between 2005 and 2007.  There has been an increase from 76% to nearly 85% of patients receiving statins.

There did seem to be a disparity in the type of patient and geographic location of the patient receiving the statin prescriptions.  Women had a 13% lower rate of receiving the medication than men and hospitals in the South were 34% less likely to discharge a patient on a statin than hospitals in the West.

If you or someone you know has suffered a stroke, check your medication list and be sure that a statin (Lipitor, Zocor, Crestor, or one of the others) is on the list.  If not, discuss it with your healthcare provider!  There are certain medical conditions that would prevent a person from taking a statin medication.

 For more valuable health information visit us at www.heart-strong.com.

Women and Heart Disease Across the Lifespan (Part 2 – Baby Boomers)

During this show we will discuss heart problems women may start to experience around menopause. “The Menopause Triple Threat” – weight gain, high blood pressure & cholesterol problems. Heart attack & stroke risk factors, “Broken Heart Syndrome”

Listen to internet radio with Heartstrong on Blog Talk Radio

The Egg Controversy: Healthy or Harmful?

The egg controversy still continues…

Eggs are a great source of protein, folate, riboflavin, choline, vitamin B12, A, D, and K.  So why have eggs gotten a bad wrap?

In the 1970’s the American Heart Association recommended decreasing the consumption of eggs and other sources of cholesterol to help decrease the risk of heart disease.  But the relationship between egg cholesterol, increased blood cholesterol and heart disease is still not clearly understood.

Studies have reported that consuming eggs can increase blood cholesterol levels in SOME people but not everyone.  The interesting finding is that egg cholesterol was found to increased LDL (bad) cholesterol levels and increase HDL (good) cholesterol levels.  Also in some people egg cholesterol promotes the formation of large LDL cholesterol particles, which are better than small LDL particles and are less likely to cause plaque formation (narrowing in blood vessels).  Researchers believe that genetics, ethnicity, BMI and hormone status all may play a role in how eggs affect cholesterol levels differently in different people.

The NHANES III observational study evaluated over 27,000 people and found that people who ate 4 or more eggs per week had significantly lower cholesterol levels than people who ate less than one egg per week.

 So what is the final word on eggs? We still do not have the answer….

Our recommendation is eggs are probably a healthy food source for most people IN MODERATION!

 Looking for more heart healthy info visit www.heart-strong.com or check out our books “Take Charge: A Woman’s Guide to a Healthier Heart” and “Take Charge: A Man’s Roadmap to a Healthier Heart”

Lower Your Cholesterol

from the Heart Health Center

For many Americans working toward better heart health, an important first step is getting cholesterol to a healthy level. Diet and exercise are important steps to reduce high cholesterol. However, many people may find that with diet and exercise alone, cholesterol numbers are not where they should be.

More than one hundred million Americans have high cholesterol, an important risk factor for heart disease. Though diet is very important, many people don’t realize that cholesterol is also produced in the body based upon heredity.

Learning about your family health history is important—we recommend talking to your family about their health and creating a family health tree. Bringing this information to your next doctor visit will help you discuss your family history regarding cholesterol and other hereditary health concerns.

Understanding Cholesterol

What you eat affects your health, by raising or lowering the blood fats (cholesterol, triglycerides) that circulate through your body. Some foods increase your levels of total cholesterol, LDL or “bad” cholesterol and triglycerides. Over the years, excess cholesterol and fat are deposited in the inner walls of the arteries that supply blood to your heart. Eventually, these deposits can make your arteries narrower and less flexible, a condition known as atherosclerosis. Left unchecked, this buildup can lead to heart attack, stroke and death.

Additionally, because of your family health history, your body may be genetically predisposed to make more cholesterol than you may need, in addition to the cholesterol from your food intake.

Know your numbers!

Each one of us has a cholesterol goal level, based upon our individual risk factors and our risk for heart disease. The National Cholesterol Education Program (NCEP) recommends that everyone age 20 and over have a blood cholesterol test every five years to check their cholesterol levels. To learn more about your goal, visit http://www.nhlbi.nih.gov/chd for the National Cholesterol Education Program’s Live Healthier, Live Longer Web site.

If your cholesterol levels are mildly to moderately higher than your goal, making a few dietary changes may be all you need to get back on track.

According to current NCEP recommendations, people with coronary heart disease or others considered to be at high risk for coronary heart disease generally have an LDL cholesterol goal of less than 100 mg/dL. An LDL cholesterol goal of less than 70 mg/dL is a therapeutic option for people considered to be at very high risk. Work with your doctor to develop a plan to help reduce your LDL cholesterol number to goal.

Here are guidelines for your cholesterol and triglyceride levels according to NCEP guidelines (new guidelines will be released in 2010):

Total blood cholesterol levels
less than 200 mg/dL	Desirable
200 to 239 mg/dL	Borderline high
240 mg/dL or above	High

LDL blood cholesterol levels
less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near optimal/above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very High

HDL blood cholesterol levels
above 60 mg/dL. Levels above 60 mg/dL are considered especially beneficial and can offset risk factors for heart disease, according to NHLBI. The higher the level, the healthier it is.	Optimal
50 to 60 mg/dL for women; 40 to 50 mg/dL for men	Average
less than 50 mg/dL for women; less than 40 mg/dL for men. Below these levels is considered a major risk factor for heart disease.	Low

Triglyceride levels
less than 150 mg/dL	Normal
150 to 199 mg/dL	Borderline High
200 to 499 mg/dL	High
500 mg/dL or higher	Very high

It is important to remember that these recommendations are for healthy individuals, not for women with existing risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease. If you are at risk for heart disease, your target goals likely will be lower.

Fighting Back

There are things that you can do now to help you gain a better understanding of your risk factors and perhaps lower your chances of high cholesterol and heart disease. For starters, it’s important that you eat right, get plenty of exercise, as recommended by your physician, and begin to understand your family health history. A healthy diet may help reduce total cholesterol. In general, you want to get “good” cholesterol higher and “bad” cholesterol lower.

You can still enjoy a wide variety of foods by making healthful dietary choices and changes.

If elevated cholesterol is part of your family genetics, or you have other conditions such as heart disease or diabetes, you may need medication in addition to eating a heart-healthy diet. But whether you have normal cholesterol, high levels, or are currently taking a cholesterol-lowering drug, eating a healthy diet is important for everyone.

Good fats/bad fats

Fats can be good for you and your heart, when they’re the right kind and consumed in limited amounts; but even good fat is packed with calories.

Those include monounsaturated and polyunsaturated fats, which decrease “bad” cholesterol, and omega-3 fatty acids, which lower triglycerides.

• Unsaturated fats are liquid at room temperature.
• Monounsaturated fats include olive oil, canola oil and peanut oil.
• Polyunsaturated fats include corn oil, safflower oil and soybean oil.

Saturated fats are the bad guys that may endanger your heart. They increase LDL or “bad” cholesterol more than anything else in your diet.

• Saturated fats, found mostly in animal products, are hard at room temperature or in the refrigerator. Think butter, shortening, fat on and in meat and poultry skin. Whole milk or two-percent milk products, half-and-half and cream all have a lot of saturated fat.
• Tropical oils—coconut, palm and palm kernel oils—also contain a lot of saturated fats. These oils are used in commercially baked crackers, cookies and non-dairy creamers.
• Foods containing saturated fats often also contain high amounts of cholesterol, which is only found in animal products.

Trans fats are another culprit to watch out for.

• Trans fats raise “bad” cholesterol.
• Trans fats are found in foods made with hydrogenated or partially hydrogenated oils—stick margarine and some store-bought cookies and cakes, fast-food French fries, potato chips and other snacks.
• Read your food labels before purchasing. If there are .5 grams or less of trans fats in an item, the company can claim 0 trans fats on the label, so check the ingredient list for hydrogenated oils.

Heart-Healthy Choices

1. Switch your dairy

• Make the change from whole or two-percent milk to one-percent and then to skim, for drinking and in recipes. Or try almond milk or rice milk for a nondairy alternative.
• Use low-fat or nonfat sour cream, yogurt, cream cheese and ice cream.

2. Choose lean cuts

• Beef tenderloin, sirloin, eye of round, ground beef with 10 percent or less fat and pork tenderloin are good choices.
• Other alternatives include white meat chicken or turkey.
• Remove the skin before cooking any poultry.

3. Cook with monounsaturated or polyunsaturated Oils

• These include olive, canola, peanut, safflower, sunflower, sesame and soybean oils.

4. Use more plant-based proteins instead of animal products

• These include beans and peas—black beans, kidney beans, pinto beans, chickpeas, lentils—and tofu or soy. Try veggie burgers (soy-based or grain-based) for an alternative to beef.

5. Boost your intake of foods that are high in soluble fiber

• This type of fiber binds to cholesterol in the digestive tract and helps remove it from your body. Good sources include oatmeal, oatmeal bread, oat bran cereal, beans and peas, apples, bananas and citrus fruits.

6. Increase whole grains in your diet

• Choose bread with at least 3 grams of dietary fiber per slice, whole-grain pastas and brown rice.

7. Use products containing plant sterol and stanol esters

• These components help keep your body from absorbing cholesterol.
• Consuming two to three grams a day decreases LDL cholesterol by 6 percent to 15 percent.
• Food products that have added cholesterol-lowering sterols and stanols include margarines, orange juice and yogurt.

8. Eat fatty fish twice a week

• Choose wild salmon over farm-raised to reduce possible toxin exposure.
• Pregnant or nursing women and children should limit tuna intake to 6 ounces a week and avoid swordfish, due to concerns about methyl mercury levels.

9. Increase the amounts of fruits and vegetables you eat

• Most women should have 1-1/2 cups of fruit and 2 to 2-1/2 cups of vegetables (without cheese sauce!) every day, according to new guidelines.
• Adding more of these to your diet fills you up, adds fiber and important nutrients and helps replace foods with saturated fats.
• For details on the new dietary recommendations, visit www.mypyramid.gov .

10. Keep an eye on dietary cholesterol

• Dietary cholesterol, such as is found in eggs, dairy products and some other foods, may raise cholesterol in the blood slightly, but newer studies find that consumption of dietary cholesterol is unlikely to substantially increase risk of coronary heart disease or stroke among healthy men and women. If you have other existing health conditions or risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease, you may need to monitor dietary cholesterol more closely.
• Egg yolks are filled with dietary cholesterol—213 milligrams in each. If you have elevated cholesterol, the National Cholesterol Education Program recommends you keep your consumption under 200 milligrams per day.
• Egg whites are cholesterol-free, so use two for each whole egg in recipes, or use cholesterol-free egg substitute, which works well in baking and omelettes.

Heart-Healthy Tips for Eating Away from Home

Here’s how to eat out and have a terrific meal without taking in too much fat and cholesterol:

1. Preparation counts. Order your food fresh, sautéed, grilled/broiled, or poached. If sautéed or broiled, ask for it to be cooked with olive oil or without fat. Have sauces served on the side, so you add only what you need.
2. Divide and conquer. Resist the pitfalls of inflated portions by eating only half of what you order. Take the rest home for an easy lunch or dinner the next day. Ask if you and your dining partner can share an entrée, with each of you ordering individual salads.
3. Balance. Have the nachos if you really want them, but order a healthy entrée. Dessert isn’t a no-no—pick fresh fruit or sorbet. Enjoy the bread or rolls, just skip the butter and drizzle on olive oil.
4. Sip slowly. Wine may raise HDL “good” cholesterol a bit, but there’s also evidence it can boost your triglyceride levels.
5. Fast food stops are OK. Most fast-food restaurants now offer healthier items than a bacon double cheeseburger. Depending upon which chain you visit, you may find salads (ask for nonfat or olive oil dressings), grilled chicken, yogurt, baked potatoes and fresh fruit cups.
6. Look for a heart-healthy symbol. Some restaurants put a heart or other sign next to healthful menu items. Choose from those.

For more on heart health, visit: www.healthywomen.org/healthcenter/heart-health

© 2010 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (tollfree). On the Web at: www.HealthyWomen.org.

50-year-old cholesterol medication makes a comeback?

 A recent cholesterol trial called ARBITER 6-HALTS was discussed at the American Heart Association national meeting and published in the New England Journal of Medicine last month. Three hundred and sixty three men and women with known heart disease or vascular disease were enrolled in this study. All of the patients LDL (bad) cholesterol levels were < 100 mg/dl (goal LDL in this high risk group is < 70) so the LDL was good but could be better. Their HDL (good) cholesterol levels were acceptable but a little low (< 50 mg/dl). When HDL levels are low patients are not receiving adequate protection against heart disease and stroke. Half of the patients received treatment with ezetimibe (Zetia) in addition to a statin treatment to further lower LDL levels. The remaining patients received extended-release niacin in addition to a statin to improve HDL levels. So this study set out to see which treatment would be more beneficial – further lowering of LDL (bad) cholesterol or raising HDL (good) cholesterol in a high-risk group of patients.

After 14 months of treatment cholesterol results improved in both patients receiving ezetimibe and patients receiving niacin. The interesting finding was the niacin patients had a reversal of plaque inside the blood vessels in the neck; this was measured by a test called carotid IMT. The patients in the ezetimibe (Zetia) group surprisingly did not experience the same benefit. This was a small study but clearly suggests that niacin, which is a 50-year-old medication, may be more beneficial than some of the newer medications like ezetimibe. Remember all of these patients were also receiving a statin medication for cholesterol management. Unfortunately many patients are unable to tolerate high doses of niacin due to the side effects. Niacin is an inexpensive medication and available over the counter but we recommend you talk with your health care provider before starting niacin treatment.

For more heart healthy info visit www.heart-strong.com

Heart Healthy Vitamins and Supplements (Part 2)

Premature Heart Disease Common in Indians and South Asians

Heart disease is the number one killer of men and women in the United States.  The prevalence of heart disease varies among ethnic groups.  Immigrants from India (South Asia) have a four times greater risk of developing heart disease than other Americans.  Indians are also more likely to develop premature heart disease, have heart attacks at an earlier age and develop diffuse disease due to a genetic predisposition and a multitude of lifestyle risk factors.  This includes both vegetarians and non-vegetarians.

 Genetic risk factors include: high lipoprotein (a) levels, elevated triglyceride levels and lower levels of less protective HDL (healthy) cholesterol.  Indians are also more prone to have abdominal obesity, diabetes, sedentary lifestyles and diets high in fat and starches which can increase the risk of developing heart disease.  The traditional Indian diet includes deep-fried foods (re-use of vegetable oil when cooking), coconut milk, roti, naan and other white breads, white rice, paneer (cheese), whole milk and high fat yogurt.

 Even though Indians have a strong genetic risk for heart disease they can lower their risk by making healthy lifestyle changes. 

 Below are some tips that may help reduce the risk of heart disease:

• Avoid deep frying, try to broil, bake, steam instead
• Use low fat milk and dairy products
• Increase fruit and vegetable and fiber intake
• Use olive oil or canola oil, do not re-use cooking oil
• Avoid ghee (clarified butter)
• Increase intake of fish, nuts
• Decrease intake of starches like white rice, roti, white potatoes and naan
• Avoid eating all or majority of carbohydrates at one meal, do not skip meals
• Increase activity level (walking 30 minutes a day counts as exercise)
• Weight loss (lose abdominal fat, waist circumference goal men <36 inches, women <32 inches)

 Lipoprotein (a) is a sub-class of LDL (Bad) cholesterol, when levels are elevated in the blood the risk for heart disease and stroke are increased.  Elevated lipoprotein (a) levels are associated with premature heart disease and have little to do with diet or lifestyle, they are usually hereditary.  All Indians/South Asians should have a lipoprotein (a) level checked at least once in their lifetime, preferably when they are younger since it is a marker of premature heart disease.

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Exercise 1 Hour a Week & Lower Your Cholesterol

Previous studies have found that exercise can improve good (HDL) cholesterol levels.  This is one of the first studies to find a link between exercise and significant lowering of bad (LDL) cholesterol in women.  This study did not find a benefit in men and this needs to be evaluated further.  Almost 9,000 sedentary middle-aged adults were followed in this 9 year study which was published in The Journal of Lipid Research (August 2009).  

 Women who did as little as one hour a week of moderate physical activity (like taking a brisk walk) or 30 minutes of vigorous activity a week had a decrease in their bad (LDL) cholesterol levels.

White women had a 4 mg/dl decrease in LDL cholesterol

African American women had a 10 mg/dl decrease in their LDL cholesterol

 Postmenopausal women had an even greater benefit.

Postmenopausal white women had a 5.9 mg/dl decrease in LDL cholesterol

Postmenopausal African American women had a 14.7 mg/dl decrease in LDL cholesterol

 Now we can all fit 1 hour a week of exercise into our busy schedule.  Your Heart with Thank You!!

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes.  “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009.  For more info visit www.heart-strong.com

Lower Your Cholesterol with Heart Healthy Choices

from the Living Well Center

For many Americans working toward better heart health, an important first step is getting cholesterol to a healthy level. Diet and exercise are important steps to reduce high cholesterol. However, many people may find that with diet and exercise alone, cholesterol numbers are not where they should be.

More than one hundred million Americans have high cholesterol, an important risk factor for heart disease. Though diet is very important, many people don’t realize that cholesterol is also produced in the body based upon heredity.

Learning about your family health history is important—we recommend talking to your family about their health and creating a family health tree (a sample is available on our Web site). Bringing this information to your next doctor visit will help you discuss your family history regarding cholesterol and other hereditary health concerns.

Understanding Cholesterol

What you eat affects your health, by raising or lowering the blood fats (cholesterol, triglycerides) that circulate through your body. Some foods increase your levels of total cholesterol, LDL or “bad” cholesterol and triglycerides. Over the years, excess cholesterol and fat are deposited in the inner walls of the arteries that supply blood to your heart. Eventually, these deposits can make your arteries narrower and less flexible, a condition known as atherosclerosis. Left unchecked, this buildup can lead to heart attack, stroke and death.

Additionally, because of your family health history, your body may be genetically predisposed to make more cholesterol than you may need, in addition to the cholesterol from your food intake.

Know your numbers!

Each one of us has a cholesterol goal level, based upon our individual risk factors and our risk for heart disease. The National Cholesterol Education Program (NCEP) recommends that everyone age 20 and over have a blood cholesterol test every five years to check their cholesterol levels. To learn more about your goal, visit http://www.nhlbi.nih.gov/chd for the National Cholesterol Education Program’s Live Healthier, Live Longer Web site.

If your cholesterol levels are mildly to moderately higher than your goal, making a few dietary changes may be all you need to get back on track.

According to current NCEP recommendations, people with coronary heart disease or others considered to be at high risk for coronary heart disease generally have an LDL cholesterol goal of less than 100 mg/dL. An LDL cholesterol goal of less than 70 mg/dL is a therapeutic option for people considered to be at very high risk. Work with your doctor to develop a plan to help reduce your LDL cholesterol number to goal.

Here are guidelines for your cholesterol and triglyceride levels according to NCEP guidelines (new guidelines will be released in 2010):

Total blood cholesterol levels
less than 200 mg/dL	Desirable
200 to 239 mg/dL	Borderline high
240 mg/dL or above	High

LDL blood cholesterol levels
less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near optimal/above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very High

HDL blood cholesterol levels
above 60 mg/dL. Levels above 60 mg/dL are considered especially beneficial and can offset risk factors for heart disease, according to NHLBI. The higher the level, the healthier it is.	Optimal
50 to 60 mg/dL for women; 40 to 50 mg/dL for men	Average
less than 50 mg/dL for women; less than 40 mg/dL for men. Below these levels is considered a major risk factor for heart disease.	Low

Triglyceride levels
less than 150 mg/dL	Normal
150 to 199 mg/dL	Borderline High
200 to 499 mg/dL	High
500 mg/dL or higher	Very high

It is important to remember that these recommendations are for healthy individuals, not for women with existing risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease. If you are at risk for heart disease, your target goals likely will be lower.

Fighting Back

There are things that you can do now to help you gain a better understanding of your risk factors and perhaps lower your chances of high cholesterol and heart disease. For starters, it’s important that you eat right, get plenty of exercise, as recommended by your physician, and begin to understand your family health history. A healthy diet may help reduce total cholesterol. In general, you want to get “good” cholesterol higher and “bad” cholesterol lower.

You can still enjoy a wide variety of foods by making healthful dietary choices and changes.

If elevated cholesterol is part of your family genetics, or you have other conditions such as heart disease or diabetes, you may need medication in addition to eating a heart-healthy diet. But whether you have normal cholesterol, high levels, or are currently taking a cholesterol-lowering drug, eating a healthy diet is important for everyone.

Good fats/bad fats

Fats can be good for you and your heart, when they’re the right kind and consumed in limited amounts; but even good fat is packed with calories.

Those include monounsaturated and polyunsaturated fats, which decrease “bad” cholesterol, and omega-3 fatty acids, which lower triglycerides.

• Unsaturated fats are liquid at room temperature.
• Monounsaturated fats include olive oil, canola oil and peanut oil.
• Polyunsaturated fats include corn oil, safflower oil and soybean oil.

Saturated fats are the bad guys that may endanger your heart. They increase LDL or “bad” cholesterol more than anything else in your diet.

• Saturated fats, found mostly in animal products, are hard at room temperature or in the refrigerator. Think butter, shortening, fat on and in meat and poultry skin. Whole milk or two-percent milk products, half-and-half and cream all have a lot of saturated fat.
• Tropical oils—coconut, palm and palm kernel oils—also contain a lot of saturated fats. These oils are used in commercially baked crackers, cookies and non-dairy creamers.
• Foods containing saturated fats often also contain high amounts of cholesterol, which is only found in animal products.

Trans fats are another culprit to watch out for.

• Trans fats raise “bad” cholesterol.
• Trans fats are found in foods made with hydrogenated or partially hydrogenated oils—stick margarine and some store-bought cookies and cakes, fast-food French fries, potato chips and other snacks.
• Read your food labels before purchasing. If there are .5 grams or less of trans fats in an item, the company can claim 0 trans fats on the label, so check the ingredient list for hydrogenated oils.

Heart-Healthy Choices

1. Switch your dairy

• Make the change from whole or two-percent milk to one-percent and then to skim, for drinking and in recipes. Or try almond milk or rice milk for a nondairy alternative.
• Use low-fat or nonfat sour cream, yogurt, cream cheese and ice cream.

2. Choose lean cuts

• Beef tenderloin, sirloin, eye of round, ground beef with 10 percent or less fat and pork tenderloin are good choices.
• Other alternatives include white meat chicken or turkey.
• Remove the skin before cooking any poultry.

3. Cook with monounsaturated or polyunsaturated Oils

• These include olive, canola, peanut, safflower, sunflower, sesame and soybean oils.

4. Use more plant-based proteins instead of animal products

• These include beans and peas—black beans, kidney beans, pinto beans, chickpeas, lentils—and tofu or soy. Try veggie burgers (soy-based or grain-based) for an alternative to beef.

5. Boost your intake of foods that are high in soluble fiber

• This type of fiber binds to cholesterol in the digestive tract and helps remove it from your body. Good sources include oatmeal, oatmeal bread, oat bran cereal, beans and peas, apples, bananas and citrus fruits.

6. Increase whole grains in your diet

• Choose bread with at least 3 grams of dietary fiber per slice, whole-grain pastas and brown rice.

7. Use products containing plant sterol and stanol esters

• These components help keep your body from absorbing cholesterol.
• Consuming two to three grams a day decreases LDL cholesterol by 6 percent to 15 percent.
• Food products that have added cholesterol-lowering sterols and stanols include margarines, orange juice and yogurt.

8. Eat fatty fish twice a week

• Choose wild salmon over farm-raised to reduce possible toxin exposure.
• Pregnant or nursing women and children should limit tuna intake to 6 ounces a week and avoid swordfish, due to concerns about methyl mercury levels.

9. Increase the amounts of fruits and vegetables you eat

• Most women should have 1-1/2 cups of fruit and 2 to 2-1/2 cups of vegetables (without cheese sauce!) every day, according to new guidelines.
• Adding more of these to your diet fills you up, adds fiber and important nutrients and helps replace foods with saturated fats.
• For details on the new dietary recommendations, visit www.mypyramid.gov.

10. Keep an eye on dietary cholesterol

• Dietary cholesterol, such as is found in eggs, dairy products and some other foods, may raise cholesterol in the blood slightly, but newer studies find that consumption of dietary cholesterol is unlikely to substantially increase risk of coronary heart disease or stroke among healthy men and women. If you have other existing health conditions or risk factors for heart disease, such as diabetes, kidney disease, being overweight, smoking or having a family history of heart disease, you may need to monitor dietary cholesterol more closely.
• Egg yolks are filled with dietary cholesterol—213 milligrams in each. If you have elevated cholesterol, the National Cholesterol Education Program recommends you keep your consumption under 200 milligrams per day.
• Egg whites are cholesterol-free, so use two for each whole egg in recipes, or use cholesterol-free egg substitute, which works well in baking and omelettes.

Heart-Healthy Tips for Eating Away from Home

Here’s how to eat out and have a terrific meal without taking in too much fat and cholesterol:

 

1. Preparation counts. Order your food fresh, sautéed, grilled/broiled, or poached. If sautéed or broiled, ask for it to be cooked with olive oil or without fat. Have sauces served on the side, so you add only what you need.
2. Divide and conquer. Resist the pitfalls of inflated portions by eating only half of what you order. Take the rest home for an easy lunch or dinner the next day. Ask if you and your dining partner can share an entrée, with each of you ordering individual salads.
3. Balance. Have the nachos if you really want them, but order a healthy entrée. Dessert isn’t a no-no—pick fresh fruit or sorbet. Enjoy the bread or rolls, just skip the butter and drizzle on olive oil.
4. Sip slowly. Wine may raise HDL “good” cholesterol a bit, but there’s also evidence it can boost your triglyceride levels.
5. Fast food stops are OK. Most fast-food restaurants now offer healthier items than a bacon double cheeseburger. Depending upon which chain you visit, you may find salads (ask for nonfat or olive oil dressings), grilled chicken, yogurt, baked potatoes and fresh fruit cups.
6. Look for a heart-healthy symbol. Some restaurants put a heart or other sign next to healthful menu items. Choose from those.

For More Heart Healthy Info visit www.heart-strong.com

References

Lichtenstein, A.H. Dietary fat and cardiovascular risk: quantity or quality? Journal of Women’s Health. 2003 Mar.;12(2):109-14.

Mozaffarian, D., Rimm, E.B., King, I.B., Lawler, R.L., McDonald, G.B., Levy, W.C. Trans fatty acids ad systemic inflammation in heart failure. American Journal of Clinical Nutrition. 2004 Dec.;80(6):1521-5.

Thompson, G.R., Grundy, S.M. History and development of plant sterol and stanol esters for cholesterol-lowering purposes. American Journal of Cardiology. 2005 July 4;96(1 Suppl):3-9.

Associated Press. “U.S. Government Discards One-Size-Fits-All Food Pyramid.” 2005 Apr. 19.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.