Lower CholesterolHow does cholesterol cause heart disease?
Here’s a question I was recently asked:
How does high cholesterol affect your cardiovascular system?
Let me see if I can explain and keep the process easy to understand!
Cholesterol does not necessarily need to be elevated for this process to take place.
First the endothelium (thin inner lining of your blood vessels) becomes damaged and inflamed. This damage can be caused by a variety of factors, such as high blood pressure, high stress level, poor diet, toxic chemicals and metals, tobacco smoke, etc.
What is the endothelium?
The thin layer of cells lining the inside of your blood vessels. When it’s healthy, it helps regulate blood flow and keeps the vessel wall smooth. When it’s damaged and inflamed, it becomes the starting point for plaque buildup.
Lower CholesterolHeart Disease – Does green tea lower heart disease risk?
All right, this green tea article has been hanging over my head for at least a month now. I just couldn’t get motivated to wade through all the research to determine if yes, this is an effective way to lower cholesterol and prevent heart disease, or no, it’s just a lot of hype.
Well, I sat down and sorted it all out today and here’s what I found.
Health Claim
The proposed health claim for green tea is that drinking at least 5 fluid ounces as a source of catechins may reduce risk factors associated with cardiovascular disease.
What are catchins?
Green tea contains catechins, which are a type of flavenoid with antioxidant properties. Antioxidants slow the oxidation process. The oxidation of LDL molecules is what results in plaque formation. Therefore, increasing antioxidant intake should slow oxidation of LDL, resulting in less arterial plaque formation.
Also, when molecules are oxidized, free radicals are released that damage cells. These free radicals can increase inflammatory issues associated with cardiovascular disease.
How flavenoids work
The body recognizes flavenoids as foreign particles and works to eliminate them from the body. Flavenoids themselves do not act as an antioxidant and they are poorly absorbed by the body. However, the proposed benefit of extra flavenoids is that as the body eliminates the unwanted flavenoids, damaging free radicals are also eliminated.
Tea production
The various types of tea are produced differently. The leaves of oolong tea and black tea are allowed to oxidize (enzymes in the tea change catechins to larger molecules). Green tea is not oxidized, but produced by steaming fresh-cut leaves whereby enzymes are inactivated and little oxidation occurs. The least processed tea is white tea, which contains the highest levels of catechins. Green tea contains the second highest catechin level, approximately 125 mg catechins per serving (or ~25% dry weight of fresh tea leaves).
Here’s a little breakdown on tea oxidation:
Black tea – Highest oxidation; also, highest caffeine content and strongest flavor; 90% of all tea served in the West is black tea
Oolong tea – 10-70% oxidized
Green tea – Low oxidation
White tea – Minimal oxidation; Uncured, unfermented; Lower caffeine content that other teas
FDA Review
In 2005, the FDA did not approve the health claim for green tea, because the link between green tea and reduced cardiovascular disease risk was too weak and more conclusive evidence was needed.
Recent Research
This past June, 2008, a study was published that links green tea to reduced flow-mediated dilation of brachial arteries (major blood vessels in the upper arms). Flow-mediated dilation is related to coronary endothelial function and is an indicator for cardiovascular disease risk. Increased dilation is good. It means the heart has to do less work to move blood throughout circulation. (The endothelium is the inner layer of an artery, which blood flows against.)
This was a study of 14 healthy individuals that consumed 6 grams of green tea, followed by a measure of flow-mediated dilation. The results showed an increased flow-mediated dilation with tea (peak at 30 minutes post consumption). There was no change to antioxidant status after consumption. It’s proposed that the improved flow-mediated dilation is how green tea reduces cardiovascular disease risk.
The Hype
I came across multiple articles with headlines screaming “Green Tea Protects Against Heart Disease” since this study was published in June. I think there is significant research that still needs to be completed before it can be determined for sure how tea works to prevent heart disease. A study of 14 individuals is a small study.
Drinking 6 grams of green tea, would equal about three – 6 ounce cups of green tea each day. (Based on making 1 six ounce cup of tea with 1 teaspoon or 2.25 grams of green tea.) However, the study results are based on consuming 6 grams of tea in one setting followed by improved flow-mediated dilation at peak levels 30 minutes after consumption. How likely is it for you to drink three cups of tea quickly, back-to-back to reproduce the short-term benefit shown in this study?
To me, that is not a very effective way to reduce heart disease risk. But, I will say that if you like green tea – drink it. Many studies are showing that green tea is beneficial to heart disease. The what, how, and how much is yet to be determined. Who knows what future studies will find?!
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All the best,
Lisa Nelson RD
Heart HealthHeart 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.
Sign up for The Heart of Health ezine to receive regular heart health and weight loss tips from dietitian Lisa Nelson. Subscribers receive the free course “8 Simple Steps to Lower Cholesterol”.
All the best,
Lisa Nelson RD
Heart HealthHeart Disease – Use the Mediterranean Diet to Lower Heart Disease
I’m sure you’ve heard of the Mediterranean Diet and its’ link to heart health. The Mediterranean Diet emphasizes fruits, vegetables, whole grains, fish, and monounsaturated fats (olive oil).
Those that follow a Mediterranean Diet have a reduced risk of developing heart disease and dying from a heart attack. Even those that have survived a heart attack and lived to adopt the Mediterranean Diet significantly reduced their risk of a second heart attack and other complications.
In an interesting twist, while many westerns try to follow a Mediterranean diet to reduce heart disease, the native Mediterranean population has gradually adopted a more Western diet. The Mediterranean area has seen an income rise that’s resulted in extra dollars being spent on meat and saturated fat food sources, leading to the negative results those of us in the U.S. are all too familiar with. Over the past 4 decades the average calorie intake in the Mediterranean countries has increased ~30%. So, the once healthy Mediterranean people now face increasing weight epidemics – 75% of the population overweight or obese in Greece, with over half of the population in Italy, Spain, and Portugal following suit. These countries are now supporting the “Mediterranean Diet” as a part of their cultural heritage they can not let die.
Here’s a quick breakdown of the characteristics common to a Mediterranean Diet:
- Consume high intake of fruits and vegetables
- Select whole grains
- Consume healthy fats (olive oil)
- Eat nuts in moderation
- Low red wine consumption
- Limit eggs to less than 4 times per week
- Consume little red meat
- Eat fish regularly
Let’s get into more specifics.
Fruits, vegetables, and whole grains
A high intake of fruits, vegetables, and whole grains reduces LDL (the “bad”) cholesterol that leads to a build-up of arterial plaque. Grains in the Mediterranean region are whole grain with very little unhealthy trans fats. Breads in the Mediterranean region are typically eaten without butter or margarine.
Healthy Fats
When following a Mediterranean diet you need to choose fats wisely. Include monounsaturated fat and polyunsaturated fats. Sources of these healthy fats include olive oil, nuts, and fish. The Mediterranean diet approach does not include a high saturated fat intake or trans fatty acids, both of which contribute to heart disease.
Olive oil – provides monounsaturated fat, which helps reduce LDL cholesterol. To receive the highest level of antioxidant benefits, select “extra-virgin” and “virgin” olive oils, the least processed forms. When you see the term “light” on olive oil labels, it indicates a reduced olive flavor.
Nuts – high in fat and calories, but low in saturated fat and depending on the nut you select can be a good source of heart healthy omega 3 fatty acids (i.e. walnuts). Eat in moderation due to high calorie content and limit the heavily salted nuts or honey roasted.
Wine
Red wine can have a similar affect to aspirin in that it reduces blood clotting. Red wine also contains antioxidants. If you’ve been following my posts, you know that I am not a supporter of using alcohol to reduce heart disease risk. If you already drink wine, continuing to do so in moderation (less than 4 ounces of wine per day) may be beneficial. If you do not currently consume wine, I do not recommend you start. Too much wine will counteract your good intentions and lead to additional complications, such as increased blood pressure.
Omega 3’s and Fish
Increase your intake of heart-healthy omega 3 fatty acids, which are linked to reduced triglycerides, reduced arterial inflammation, lower blood pressure and high HDL (good) cholesterol. Include fish (I don’t mean battered and fried) as a regular part of your diet in place of the more typical red meats, use flaxseed in your diet, and consider an omega 3 supplement.
All the best,
Lisa Nelson RD
Lower CholesterolEating red meat may shorten your life
A study from the National Cancer Institute found individuals consuming the most red and processed meats at greater risk of death from cancer and heart disease versus those eating lower levels.
The ten year study began in 1995 and evaluated the dietary intake of over 500,000 men and women between the ages of 50 and 71. The study divided types of meat into three categories – red meat, white meat, and processed meat.
Red meat was defined as beef, pork, ham, bacon, hamburger, hot dogs, liver, pork sausage, and steak. As well as meats found in foods like pizza, stews, and lasagna.
White meat was classified as fish, chicken, and turkey.
Processed meat included white or red meats that were cured, dried, or smoked, such as bacon, chicken sausage, lunch meats, and cold cuts.
Individuals eating red meat at the highest levels consumed ~4.5 ounces per day based on a 2,000 calorie/day diet. This is equal to approximately 2 pounds of beef or pork each week. Compare this to the group with the lowest intake of red meat at 5 ounces per week or ~ 0.5 ounce per day.
Those with the highest intake of processed meat consumed approximately 1.5 ounces per day versus the lowest intake group at 0.11 ounces per day.
Men eating red meat at the higher levels each day had a 31% greater risk of dying and women 50% greater risk of dying due to heart disease. The study found that 11% of all deaths in men and 16% of all deaths in women could’ve been prevented by consuming the lower levels of red meat. Looking at just heart disease, death due to heart disease could have been reduced 11% in men and 21% in women if red meat intake was reduced from the highest level to the lowest.
A high intake of processed was linked to a 16% increased risk of dying for men and 25% increased risk for women.
This doesn’t mean you need to switch to a vegetarian diet. Individuals eating white meat had a slightly lower risk of death.
Possible reasons for the increased risk of death linked to eating red meat and processed meat maybe due to the carcinogens formed during cooking, iron in red meat causing oxidative cell damage, and/or saturated fat in red meat increased cancer risk and elevated cholesterol levels.
Here are some tips for making wise meat selections.
- Select lean cuts of meat, such as your “loins” and “rounds”.
- Choose cuts of meat with the least amount of marbling (visible fat).
- Trim visible fat before cooking.
- Marinate before grilling. May decrease formation of carcinogens if marinated in beer or wine prior to cooking.
- Broil versus frying or roast large cuts and skim off the fat.
- Drain oil and rinse ground beef in hot water to decrease fat.
All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps
Lower CholesterolHeart Disease – Reduce Heart Disease by Eating More Whole Grains
Your risk of heart failure is increased by a variety of factors, such as coronary artery disease, obesity, diabetes, insulin resistance, and hypertension. What you eat has a major impact on these risk factors.
A new study was recently released in the Journal of the American Dietetic Association that supports eating whole grains to reduce heart disease risk.
The 13 year study evaluated the association between seven different food categories (fruits/vegetables, whole grains, eggs, high-fat dairy, nuts, fish, and red meat) and heart failure risk in over 14,000 adults. During the study, 1,140 adults were hospitalized for heart failure. The study found that heart failure risk was significantly reduced in individuals with a high whole grain intake. Heart failure risk was significantly higher in individuals with increased intake of eggs and high-fat dairy.
A much smaller scale survey of 800 American adults shows promising changes. The first diet and exercise survey conducted by the American Dietetic Association was in 1991 and the most recent in 2002. The goal of the survey is to measure current attitudes and behaviors toward diet and health and identify behavior changes over time.
Findings of the 2008 survey show that consumption of whole grains, vegetables, and fruit has increased, while trans fat, beef, pork, and dairy consumption has decreased.
Increased in the past 5 years:
Whole grains – 56%
Vegetables – 50%
Fruits – 48%
Low-fat foods – 48%
Omega 3 fatty acids – 38%
Decreased in the past 5 years:
Trans fat – reduced 56%
Beef – reduced 41%
Port – reduced 33%
Dairy – reduced 23%
Low-sugar foods – reduced 20%
The survey divided participants into three groups based on diet and exercise habits. Here are the divisions:
I’m already doing it – 43% (5% increase from 2002)
I know I should – 38% (8% increase from 2002)
Don’t bother me – 19% (13% decrease from 2002)
So, overall it looks like American’s are wising up. However, what’s important is you. Where do you fall? Are you increasing your whole grain intake, eating more fruits/veggies, and cutting back on trans fats? Are you doing what you need to, in order to reduce heart failure risk?
If you would like one-on-one help, please sign up for The Heart of Health ezine to stay up-to-date on the latest programs from dietitian Lisa Nelson. You’ll also receive the free report “Stop Wasting Money – Take Control of Your Health”.
All the best,
Lisa Nelson RD