Tuesday, April 29, 2008

Cholesterol Hell

Have you ever been bitterly disappointed in a product and wondered what the heck you were thinking when you tried it? I feel that way today. I went for my biannual ICD check-up and found out I was doing fine except for one thing--somewhat high cholesterol. My cholesterol has always been a bit high--even when I had it checked in my twenties. The funny thing is, I don't have coronary artery disease despite having had a heart attack. However, cardiologists still want cholesterol low no matter what after this type of event. I can't take statins and tried many of them including Zetia, which gave me muscle pain like all the rest.

So, anyway, for the past three months, I ordered these Caramel Benecol Smart Chews--I know, it sounds like some kind of dog treat that Rachel Lucas would give to her obese dog Sunny, but these are of the human variety and are supposed to lower cholesterol, specifically LDL. Here is the pitch from Amazon:

Start to lower your cholesterol in as little as 2 weeks with Benecol Smart Chews
Contains plant stanol esters, which are proven to reduce your LDL, or "bad" cholesterol
May be used by those taking statin medications for additional cholesterol lowering
Enjoy 2-4 delicious caramel chews twice a day with meals
More than 25 clinical studies validate the safety of plant stanol esters


I followed the directions carefully and figured if two of these things was good, four would be better. At first they tasted a little odd, but I soon got used to the taste and after a while, they tasted delicious, just as advertised. I was popping one with meals throughout the day, all the while patting myself on the back for lowering my cholesterol. Except that it didn't.

Today, when I went to the doctor's office and got my cholesterol test back, it was 11 points higher overall than it was four months before. My LDL was up 30 points. My triglycerides, a type of fat found in your blood, were up over 20 points. "Bummer," I thought. I was shelling out about 28 bucks a month for these darn chewy things and all they did was increase my cholesterol. At least I didn't gain any weight--that would have really bummed me out.

If anyone has a product other than statins--or these chewy caramels-- that they have used successfully to reduce their cholesterol, let me know. I would love to find something that works.

Update: Thanks so much to everyone so far who has commented, emailed and even posted on this important topic. All of your helpful suggestions have given me a lot to think about!

84 Comments:

Blogger DADvocate said...

DNA seems to play a major in cholesterol. My father always had low cholesterol. The highest mine has ever been read (I've had it checked about a dozen times over the years.) is 152.

I watch my diet more than the average person but I am far from a fanatic. I eat read meat, fried chicken, mayonnaise and such.

High cholesterol, triglycerides, etc. don't bother some people. Any Italian ancestry?

8:43 PM, April 29, 2008  
Blogger Joe said...

Why bother? The blood serum theory of heart disease is nonsense. There is also very good evidence that lowering your cholesterol levels causes heart attacks.

I say again that in 20 to 30 years statin drugs will be shown to be one of the biggest, most damaging medical fiascoes of all time.

9:02 PM, April 29, 2008  
Blogger B. Durbin said...

About the only natural product I know that is good for cholesterol lowering is grapefruit, and that doesn't do much. (You are not supposed to have grapefruit when on statins because the combination of the two can trigger certain reactions.)

But if you like grapefruit, that's something, at least.

Then there's oatmeal or Cheerios. Again, only a good idea if you like them. And dried fruit can't hurt. (I LOVE dried fruit.)

But really, I have no idea what the deal is with cholesterol. I had mine drop thirty points once with no appreciable lifestyle change, then go back up. Last year's test showed me firmly in the healthy range, and I attribute that to living in the land of fruits and nuts. The politics are crazy but boy, the food is wonderful.

10:30 PM, April 29, 2008  
Blogger David Damore said...

Dear Dr. Helen,
Was gonna suggest oatmeal. See a prior commenter has already done so. To make it taste better I add cinnimon and a little bit of honey [and sometimes Canadian Maple Syrup]. I try to start each day with a 1.5 cups + or -.
This might be a good topic to research a bit further. Certianly you have already done some.

What have you found?

Any other readers have some ideas?

David

11:53 PM, April 29, 2008  
Blogger Unknown said...

Helen,

Oatmeal cooked overnight in the crockpot is fantastic and healthy for you.

I like the steel-cut/pinhead oats from Whole Foods. Put in a cup of the oats and 3 cups of water with some cinammon and leave it on the crockpot's low setting overnight. It makes enough for 3 people or so. (I took these tips from Good Eats on FoodTV and simplified them.) It takes about 3 minutes to do before you go to bed, but makes the whole house smell great by morning.

1:28 AM, April 30, 2008  
Blogger Misanthrope said...

Fenugreek, co-q10, and resveratrol. You need the co-q10 with statins anyway.

1:36 AM, April 30, 2008  
Blogger Vreni said...

Hi Dr. Helen,

From the research I've done, cholesterol is not the problem - as Dr. Mary Enig, well respected fats researcher who wrote the book "know your fats" says, "blaming cholesterol for heart disease is like blaming firefighters for starting fires." Cholesterol arrives at the scene to repair damage to arteries caused by free radicals, high blood pressure etc. If you study the research you will notice that just as many people that die of heart disease have low cholesterol as have high, and just as many people without heart disease have high cholesterol as low. Cholesterol levels are completely irrelevent. Check out this You Tube video put out by Dr. Malcolm Kendrick looking at the data from the MONICA study.

Furthermore, when one considers that the first heart attack on record occurred in 1921, and prior to that heart disease was very rare, it is interesting to note that saturated fat consumption has declined dramatically since that time, and sugar consumption has gone up by 60% and vegetable oil consumption has climbed by 400%. Seems to me we are putting the blame on the wrong thing. Here is another short You Tube Video which kinda nails it on the head when it comes to blaming fat/cholesterol for heart disease.

Far more dangerous are triglyceride levels, and to lower them, just cut out all sugar and starch. I bet your cholesterol levels will decline if you do this too. I would also HIGHLY recommend the book "Good Calories Bad Calories" by Gary Taubes. Extremely well researched, and I would bet that once you've read that book, you will make different food choices.

The problem with the "low fat/low cholesterol" issue is that once the scientific debate about whether it was fat or sugar/flour products that caused heart disease was taken over by the politicians with the publication of the Dietary Guidelines in 1977, the scientific debate was pretty much squelched, and the public was led to believe that the science for the fat hypothesis was overwhelming. Nothing could be further from the truth - the scientific community was very divided at the time. I think the politicians picked the wrong hypothesis. Since 1977 heart disease has continued to rise, alongside the increase in sugar consumption (often in the form of HFCS)and vegetable oils, and despite the decrease in saturated fat consumption. I've written quite a lot on this topic on my www.wellnesstips.ca site in case anyone is interested ...

1:55 AM, April 30, 2008  
Blogger Helen said...

To all,

Thanks so much for the comments thus far. As far as oatmeal, I have eaten it in every form for years and it seems to make no difference. I still eat it for breakfast every morning just in case my cholesterol might go even higher without it.

I also wonder, like some, if cholesterol is really the culprit. When I went to a cardiac class after my heart attack, noone there had high cholesterol, yet had suffered a heart attack or had stents put in.

Vreni,

My triglycerides are not high, usually under 100 although this time they were 119 which is still normal but higher than before. Thanks for your site, I will check it out.

7:20 AM, April 30, 2008  
Blogger Cham said...

I'd have to agree with what some of vreni says. I'm no doctor but am very fascinated with staying as healthy as possible. My cholesterol had been low so I didn't watch my diet too much. My mother's went through the roof a few years ago and she suggested that I have mine checked, sure enough, it had gone from 145 to 195. I wasn't going to die but I did take notice.

So I cleaned up my diet substantially since then. I axed the saturated fats with the exception of those found in chicken meat (no skin). I became very familiar with oatmeal, and got rid of the dairy products. A year later it was down to 170.

I'm in complete agreement about sugar and starch. I'm of the opinion the excessive sugar consumption is causing all that face puffiness that many people are sporting these days. Sugar and corn are the enemy.

The advantage of cutting all these American staples out of one's diet is that I no longer have to watch my weight and calorie intake. You can eat only so much kale in one day.

7:24 AM, April 30, 2008  
Blogger FrontPorchPhilosopher said...

As someone who USED to be the poster child for statins (cholesterol in the 2000's and triglicerides in the 3000's) I WAS the poster child for LIPITOR, which I was on for more than 10 years.

Remember the liver tests that were supposed to indicate problems? Never a peep. I reached the stage where I was sleeping like a corpse with my arms crossed on my chest because that was the only way that I COULD sleep. A friend gently punched me in the arm and I went to my knees in pain. When I informed my doctor of that he took me of the LIPITOR immediately. It took almost a year of physical therapy to get a reasonable range of motion back.

Currently I am on 2000mg of NIASPAN every night, plus 2000mg of fish oil plus 20 mg of LESCOL and 10Mg of Zetia in the AM. (I am also a Type II diabetic who needs to drop 20 lbs, but hey....)

On my current regimen, my cholesterol is <200, which for me is good.

LESCOL is a very minor and OLDER statin, which I seem to tolerate fine.

I wish you well, it IS a pain.

7:33 AM, April 30, 2008  
Blogger Kevin said...

Response to cholesterol treatment seems to be such a personalized thing. My parents, siblings, and I all take cholesterol medication, but even among us, what works for one doesn't necessarily work for another. So, what works for some may not for you. I'm not a doctor, but here are some of my experiences:

My father takes Lipitor. At first, he had abnormally high liver enzymes, so his doctor reduced his Lipitor and supplemented it with niacin (not niacinamide). That's been working well for him. I don't know if niacin is effective if you take it all by itself, though.

One commenter mentioned Co-enzyme Q10. I've read in a few places (including the label of the container) that this is good for people who take statins. Statins deplete it, and I think that may be one reason why some people experience muscle pain. I take it now (I take Vytorin, which works great for me). Maybe taking Co-enzyme Q10 would make you more capable of handling a statin?

So, niacin + co-enzyme Q10 + a very weak dose of a statin?

More about liver enzymes: I measured abnormally high liver enzymes every single blood test I've taken while on Vytorin, until the latest one. Several months ago, I started taking NAC (n-aceytl cysteine) because I read it was good for chest congestion while running, which I have trouble with. Later, I read that it's most common use is to detoxify the liver. My next blood test showed that my problematic liver enzymes had dropped to well within normal range. I don't know if this is coincidence, if the NAC is masking the problem now, or of the problem has gone away.

Good luck finding a solution.

8:37 AM, April 30, 2008  
Blogger Quasimodo said...

2 tsp of metamucil with every meal

11:14 AM, April 30, 2008  
Blogger Mercurior said...

statins are dangerous.

have a read of this

http://www.second-opinions.co.uk/statin_index.html

http://www.second-opinions.co.uk/polyneuropathy.html

Study showing that the use of statins causes nerve damage.

http://www.second-opinions.co.uk/lipitor.html

This book by a highly qualified doctor tells the story of his complete loss of memory when he took the cholesterol-lowering drug Lipitor


i am overweight, but my cholesterol is normal everything is normal. bp is normal heart rate at rest is the best my dr saw in years.

11:49 AM, April 30, 2008  
Anonymous Anonymous said...

Statin drugs made me feel as if my kidneys have been rabbit punched 100 times. I quit taking them and have not tried anything else. I have "floaters" in my eyes if I bend down and back up too quickly. I've heard that is triglycerides? Don't know. I have enough stuff on my plate, to worry about that.

I like ice cream. I eat a bowl every evening reading Drudge. Breyers Vanilla Bean, drowning in chocolate syrup. I don't drink, and I don't mess around. A man's gotta have a vice.

12:49 PM, April 30, 2008  
Blogger Helen said...

br549,

"A man's gotta have a vice."

Women too. My vice is diet coke. I'm not supposed to drink it at all because of my heart rhythm problems but I drink half a can a day on most days. I've tried to quit but I eat the most bland of diets, exercise and rarely, if ever drink. Eat your ice cream and be happy. There is only so much a person can take.

1:53 PM, April 30, 2008  
Blogger Serket said...

I seem to have naturally low cholesterol, so I am lucky.

Dadvocate: That article reminds me of a joke:

The Japanese eat very little fat and suffer fewer heart attacks than the British or Americans.
On the other hand, the French eat a lot of fat and also suffer fewer heart attacks than the British or Americans.
The Japanese drink very little red wine and suffer fewer heart attacks than the British or Americans.
The Italians drink excessive amounts of red wine and also suffer fewer heart attacks than the British or Americans.
Conclusion: Eat and drink what you like. It's speaking English that kills you.

2:17 PM, April 30, 2008  
Blogger Alex said...

What the Japanese and Italians have in common is low sugar consumption. That's the key.

2:33 PM, April 30, 2008  
Blogger Ignorance is Bliss said...

I've heard walnuts are good for lowering colesterol, and I've added some to my diet, but probably not enough to be noticable, and I haven't had my colesterol checked since then, so I'm not speaking from personal experience.

3:52 PM, April 30, 2008  
Blogger Joe said...

The only reliable predictor of heart disease and heart attacks is high blood pressure.

3:57 PM, April 30, 2008  
Blogger Helen said...

Joe,

Funny, my blood pressure has always been too low, sometimes 90/50 and has never been high.

4:12 PM, April 30, 2008  
Blogger SarahW said...

Two bowls of oatbran (hot). Every day.

I love the stuff. I had similar dodgy cholesterol, all fixed now.

5:21 PM, April 30, 2008  
Anonymous Anonymous said...

"what they have in common is low sugar consumption."

What kinds of sugar? I eat fruit, and I like eating fruit. Does that count? Or is it only refined sugar? I like milk. I drink milk, and eat cheese and yogurt. Does the lactose count?

I just read in a pregnancy magazine that studies have shown women with the best chances of getting pregnant and the lowest chances of infertility eat fats, including saturated fats, and drink a lot of milk (ice cream seems perfect), and each more protein than carbohydrates. It's hard to know how to do that and keep one's cholesterol low, isn't it? Another data point on wondering what cholesterol matters...

5:26 PM, April 30, 2008  
Blogger Beto_Ochoa said...

My mother's medical speciality was Geriatrics. Her studies found that an ounce of powdered Lecithin twice daily on an empty stomach induced healthy cholesterol levels, even in difficult cases with poor diets.

5:28 PM, April 30, 2008  
Blogger Virtual Mule said...

I started to take high quality fish oil capsules and red yeast rice capsules on the advice of my primary care physican and my cholesterol numbers came down enough that he stopped mentioning statin drugs. Which I was happy about.

5:28 PM, April 30, 2008  
Blogger Byron said...

Try cinnamon in 500 mg gelatin capsules. Four a day, after meals.
Sam's Club sells them, not expensive, or you can buy empty gelcaps and make your own. Reference here, with link to original research on diabetic subjects:

http://diabetes.about.com/b/2006/11/17/can-cinnamon-help-lower-blood-glucose-and-cholesterol.htm

5:31 PM, April 30, 2008  
Blogger Donna B. said...

abnormal blood pressure, whether too high or too low is an indicator of heart problems.

As for cholesterol, triglycerides, etc., my cardiologist is amazed that I don't have heart problems and that all those "indicator" levels are normal because I am obese.

It's genetic, I think. The family into which my oldest daughter married all have high cholesterol and high triglycerides. Their most common food? Rice. Their ethnicity? Asian. Go figure.

Anyway, I hope that you and my son-in-law will always be healthy no matter what the indicators indicate.

5:32 PM, April 30, 2008  
Blogger Dr. Goodheart said...

You can see that lots of folks have anecdotal complaints about statins. I used to be a skeptic when they first came out, but have been convinced by the evidence: that is, many thousands of people in randomized controlled trials, lasting years, with total mortality (not just heart disease mortality) as the end point.
That lowering cholesterol alone is not a marker of reducing heart disease risk has been shown by the recent trial of Zetia. In fact, we suspected that the benefit of statins was not just from cholesterol, when the 4S (Scandinavian Simvastatin Survival Study) showed improvement in risk of cardiac events (heart attack, angina, bypass surgery) within months, not years, after starting simvastatin.
Since then research has looked into potential other effects of statins, which seem to include stabilization of cholesterol plaque, thus decreasing the risk of rupture.

Bile acid resins such as colestipol and cholestyramine, together with high doses of niacin, were used before the statins came along. They do lower cholesterol (as do other soluble fibers, including Metamucil and oatmeal), but the benefits on actual reduction of mortality and heart disease events has been much less than the benefit of statins.

Since you are an outlier in having had heart disease at a young age for a female (I'm sorry, I don't know the details of your history), it's quite possible that your risk is not much related to cholesterol. I can't really comment on that, again, because I'm not your doctor and haven't seen, for example, your coronary angiograms.

I used to be much more on top of this issue when I directed preventive medicine services for a large west-coast HMO, and was in charge of developing guidelines for cholesterol management and other prevention issues.

5:33 PM, April 30, 2008  
Blogger Dave said...

A low glycemic diet drops my cholesterol, triglycerides, blood pressure, and helps raise my HDL. It also dramatically lowers my glucose levels.

What works for me is lots of meat, red or white, plenty of fat, lots of greens. Basically if I eat like Grandaddy and Granny, I do well, but if I eat like Mom and eat lots of cookies, cakes, pies, potatos, and bread, then I do poorly.

This is without fail every time I've gone on a low carb type diet I do very well with bloodwork done before and after 4-6 weeks.

The Harvard Nurses study gets a lot of play on these issues. I could get you some other peer reviewed literature if you like. I keep a list.

5:39 PM, April 30, 2008  
Blogger daleosborn said...

Helen,

I've been taking Lipitor for over 7 years. While on Lipitor, and other perscription meds, I noticed certain side effects, but no muscle pains. I read on someone's blog that they had side effects from statins and began to take CoQ10. After researching CoQ10 and determining that there was no detrimental side effects I began to take it also. A good number of negative side effects disappeared. YMMV.

5:43 PM, April 30, 2008  
Blogger Joseph Thvedt said...

Oatmeal with flax seed and oat bran muffins, or maybe just the weight I lost simultaneously, brought my numbers down a couple of years ago.

5:44 PM, April 30, 2008  
Blogger Unknown said...

From what I've read, oat bran is far more powerful than oatmeal at lowering cholesterol. I started having a big bowl of oatbran most days, and my cholesterol has gone done about 20 points (it was at 240). I've heard rice bran is even more effective than oat bran, and on smaller doses (like a tablespoon a day), but it's just not as fun to eat as oatmeal. When my hubby's cholesterol shot up to 230, I put him on fish and flax oil, (12 caps a day), and it went back to 170.

I did like "The 8-Week Cholesterol Cure"--that's where I got most of these ideas.

Barb Oakley

5:50 PM, April 30, 2008  
Blogger OdysseusInRTP said...

Starting in my early 30's, I have had really high LDL and triglycerides. My HDL was practically non-existent.

Eventually, I started taking Zocor and it had minimal impact. All my numbers were still considered bad.

At the same time, my mother was diagnosed with liver problems. Excess ammonia destroyed 80% of her liver. My grandfather had the same thing. He died from it.

Even though I am not over weight I decided to lose the fat I had after my mother's diagnosis. I went on a high protein diet with about 30g of carbs/day and started working out just a little more. From 2 to 3 days per week to 3 to 4 days per week.

Guess what happened on my high protein diet? My LDL and triglycerides came down to normal. My HDL went up to almost perfect. It totally surprised me.

The last time I went to the doctor he made the comment, “That low fat diet I put you on is really helping you.” I didn’t say anything because he is adamant a low fat diet is the best. He has high cholesterol also and is now a proud semi-vegetarian. I didn’t want to debate the point with him, but my numbers are better than his and I get to eat the food I actually enjoy.

I tell everyone now that they should give it a try for a few months and then get their blood work done. If it doesn't help the numbers then switch back to the low fat diet. I don't think a few months of a high protein diet will hurt anyone.

5:56 PM, April 30, 2008  
Blogger Rick said...

Go Vegan. Adopting a diet of fruits and vegetables is almost guaranteed to lower cholesterol. As well as weight, and blood pressure, and risks of many other actual diseases. Read The China Study. Go to www.drmcdougall.com for background studies. The Standard American Diet (SAD), along with our nutritionally-misguided medical community, is killing us.

5:58 PM, April 30, 2008  
Blogger Ellen said...

I have had some measurable improvement on my cholesterol with Red Yeast Rice (acts like a statin) which must be taken with CoQ10 and policonasol from sugar cane: From Goodhealth.com


First, the potentially good one - policonasol, used particularly in Cuba, where some of the best research has taken place. Policonasol is a long chain alcohol that is found in sugar cane, beeswax, and yams. Several well-conducted studies indicate that policonasol, 5 to 10 milligrams a day, can lower total cholesterol levels and its dangerous component, low-density lipoprotein cholesterol (LDL - bad cholesterol) to almost as great an extent as powerful statin drugs. Policonasol will also increase levels of high-density lipoprotein cholesterol (HDL - good cholesterol).

I recently moved and my doctor affirms these and has also recommended niacin and phyto sterols from the health food store. Haven't tried these yet; I try to avoid statins since I have the terrible muscle pain/weakness reaction.

Good luck!

5:59 PM, April 30, 2008  
Anonymous Anonymous said...

Hi Helen,
I very much enjoy reading your blog and this is the first time I have posted a comment as I have some experience in helping people lower their cholesterol using a natural nutritional supplement. The product is called Bios Life Complete. Essentially it is concentrated oatmeal in that it contains plant fibers. But it also contains a group of plant chemicals called phytosterols which have been demonstrated in studies to block the absorption of cholesterol from food. I was as skeptical as can be when I heard and learned about this product (it sells through direct sales or MLM groups) but I have seen first hand data on clinical trials done with this product. It performs as well if not better than statins (one caveat is that statins work in terms of days and weeks while this product works on a longer time scale weeks months). I would highly recommend it.

6:04 PM, April 30, 2008  
Blogger Burt said...

I had high cholesterol and lowered mine with oatmeal (or generic Cheerios) and at least half a large apple a day, EVERY day. Plus very little red meat and frequent meals of black beans and brown rice, instead. They're great on a large whole wheat tortilla with salsa and a little mozarella.

Then my Doc told me my HDL was 35 and it would be better to have it at least at 40. She suggested Lipitor. I said no thanks. I maintained the healthy food regimen but added a Natrol brand lemon-flavored fish oil capsule twice-a-day to the diet and 6 months later my HDL is just a bit above 40. I had also got back on the weight-lifting regimen. Nothing drastic (I'm 62 yrs old), but I do a split routine 5 days a week.

It takes discipline but I improved my numbers with diet and exercise.

Of course, your mileage may vary. But whatever you choose, good luck with it and all the best to you!

6:08 PM, April 30, 2008  
Blogger Dr. Ben said...

Oh my, oh my, Helen, you need to read Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, Jr., MD. And for a broader approach Spectrum by Dean Ornish MD. These are scientific, peer reviewed books. Please, please read them. You can control this.
Dr. Ben

6:08 PM, April 30, 2008  
Blogger Jeff said...

Red Rice Yeast is very good - but it does contain a statin drug (lovastatin, I believe).

I had horrible cholesterol numbers a few years back (280), tried the traditional low fat diet on the advice of my doctor and it did not change a thing. I switched to an adkins type diet (ckd/tkd) several years ago, and that seems to have done the trick. Nothing like eating bacon and eggs everyday for breakfast and having your cholesterol drop. Last time I went in for a checkup he did a test (non fasting) and it came back at 200, plus I have lost and kept off almost 30lbs.

6:09 PM, April 30, 2008  
Blogger M. Simon said...

The best drug is: don't give a damn.

As the Sgt. said in WW1 when exhorting his troops over the top for an attack:

"Comon you bastards, do you want to live forever?"

I spit in death's eye.

6:09 PM, April 30, 2008  
Blogger Tim Wright said...

I've also had terrible problems with statins -- severe muscel aches. My MD has put me on WelChol, which doesn't enter the bloodstream but does all its work in the gut...only been on it four days, but no side effects so far. Good luck. Tim Wright

6:11 PM, April 30, 2008  
Blogger paul a'barge said...

Helen,
The Atkins Diet worked for me. Cholesterol to the basement.

6:12 PM, April 30, 2008  
Blogger Hucbald said...

Your nominal cholesterol levels are programmed by genetic disposition. If you give your body what it needs to regulate them, it will do the job just fine. Only people with stupid genes, like me, really need to worry about it.

My family history is of death by heart attack at a young age... for men. I have no problems, and I've outlived my grandfather (Dad is upcoming, but he had a heart attack at a younger age than I am now).

Why? I give my body what it needs.

I eat lots of nuts (My favorite is made with two jars of Planters dry roasted almonds, two jars of dry roasted cashews, one jar of dry roasted peanuts, one jar of dry roasted sunflower seeds, two packs of Ocean Spray Crazins, and one box of Sunmaid raisins - put it all in a sauce pan and shake it up, put three serving spoons each in ziploks, and you have lunches). I'm also as regular as clockwork: One sip of coffee in the AM, and... well, you know.

Added to this, I take natural garlic (The smelly kind), fish oil, and cod liver oil... plus two aspirin every day (I'm very tolerant of aspirin).

Oh, and I do 30-60 minutes on a Bowflex four times a week and run about 35-40 miles every week also. The human body was made to work. If you don't work it, it gets sick. How hard is that to figure out?

Most of the crap pushed by "Big Pharma" is no better than the snake oil they pretend to replace.

6:24 PM, April 30, 2008  
Blogger Doug Sundseth said...

You might want to take a look at Derek Lowe's post from yesterday. It covers the (primary and side) effects of niacin (mentioned above) on cholesterol in some detail.

6:26 PM, April 30, 2008  
Blogger Alcibiades said...

Start using more extra virgin coconut oil in your food/cooking.

Here's Mary Enig cited on pure coconut oil:

Enig reported in her article that the effects of coconut oil on persons with low cholesterol levels was the opposite of persons with high cholesterol levels. Of persons with low total cholesterol counts, she wrote that "there may be a rising of serum cholesterol, LDL cholesterol and especially HDL cholesterol." In persons with high cholesterol levels, "there is lowering of total cholesterol and LDL cholesterol." The studies she cited showed that in both groups the LDL/HDL ratio moved in a favorable direction. In persons with AIDS or immune-compromised from other causes, the conclusions of this research are profound. It means everything the public has been told about vegetable oils on television for the past 15 years has been half truths and leading the public to the wrong conclusions. The public has been led to believe that tropicals will clog your arteries and cause heart disease. In fact, the opposite is true; natural tropical oils will help prevent hardening of the arteries while most liquid vegetable oils will increase hardening of the arteries! In a phone call to Mary Enig in April, 1997, she told me that the worst oil to use for any purpose is Canola oil. When used in cooking, it produces the very high levels of transfatty acids.

6:29 PM, April 30, 2008  
Blogger Unknown said...

Garlic, tofu, okra, & eggplant will all help reduce your cholesterol. (Not fried, of course!)

6:35 PM, April 30, 2008  
Blogger Teresa said...

About 8 years ago I dropped nearly all additives in my diet. That does not make for a bland diet at all, but it got rid of my migraines.

You might consider the additives in what you are eating and drinking. I was a huge drinker of Coke which I gave up for tea I brewed myself with fresh lemon squeezed in it. I do have a Soy Mocha from Starbucks once a day (which so far has not bothered me)

It's very difficult with the additives because they are everywhere - from seasoned salt, to peanut butter, to soda, to nearly all prepackaged food.

I find that most people who tell me they don't eat "anything" with additives, generally have no idea that about half of what they eat is filled with "shelf life / flavor extenders". It may be worthwhile to look into in this case, or it may not. It certainly is a diet that won't hurt anyone, but is a bit difficult. (when I go out I generally stick with fish and veggies or salad... I'm dead in the water at places like Chili's or TGI Fridays since everything they sell is processed)

I hope you can find something that works for you. In the meantime, not worrying would be the best medicine. *grin*

7:03 PM, April 30, 2008  
Blogger Carl H said...

Some good information here:

http://heartscanblog.blogspot.com/

7:15 PM, April 30, 2008  
Blogger Andrew Morriss said...

I've got the same cholesterol/triglyceride issues - zetia and some other statin work well, but I'm also using a multivitamin and fish oil, which a number of doctors have recommended to me. I take one fish oil capsule daily; my current physician suggests taking as much as one can without getting fishy breath. (I quickly skimmed the comments and didn't see other recommendations for fish oil or vitamins.) THe combination has brought my levels to normal ones, but that might just be the Zetia.

7:21 PM, April 30, 2008  
Blogger Derve Swanson said...

Maybe I'm old fashioned, but have you tried replacing the candy-cholosterold habit with drinking a glass of water, or snacking on apple quarters or carrot sticks or other fruits/veggies when you need something to put in your mouth.

Sometimes less is more, and some of these products -- like all the GREEN things you now see -- really are just to make a buck off those looking for quick fixes to meet their needs.

Also, have you tried the Oatmeal-for-Breakfast every morning thing? Blaming "genes" or looking to buy your way to good health seems kinda easy, if you ask me. (And of course, you did.)

7:27 PM, April 30, 2008  
Blogger Derve Swanson said...

Just reading the comments now, and it strikes me you may be in some type of denial, "Dr."helen.

"Really folks-- I'm in great shape, aside from that young-age heart attack and all..."

Step away from the daily sugar water, stick with the basics, and push yourself to exercise harder. There really is no quick fix, and pills usually only mask the underlying symptoms (ie/ the "pop a statin, order a burger and coke" mentality.)

Remember, home-cooked heart-healthy meals make take some time, but it you commit to them regularly, you can avoid clogging up your inners.

7:31 PM, April 30, 2008  
Blogger Pat said...

Unfortunately you opened the flood gates here and there is a lot of bad advise from the “cholesterol is not the problem” crowd with quite a few word and statistical games, like “just as many people that die of heart disease have low cholesterol as have high”. First how do you define low cholesterol, A total level below 125 mg/dl or less than 200 mg/dl? If you use the first than the statement is absolutely false since the risk is near zero. Unfortunately there are not many of us who can get their total cholesterol to this level or their LDL below 70mg/dl. If you use 200 and below as the definition of low, then the statement is almost true with half way point for all myocardial infarctions being about 220 mg/dl, that is half of all MIs occur above and the other half below that number. The problem is that far far more people are below that number so their risk of an MI is less.

The recent failure of the Vytorin trial is more of a problem with the absolute level of cholesterol than the relative reduction. It is like crashing cars at 200 mph and 120 mph and saying the survival rate didn’t get any better. Sure the latter group was going slower but not slow enough.

Now for all of those out there who will say cholesterol is not THE problem, I am saying it is a factor, a significant but not the only factor. Snow cannot cause an avalanche if there are no mountains. You need both. CAD is a multifactorial disease. Statins appear to have a reduction benefit beyond their cholesterol lowering effect, believed to be anti-inflammatory; zetia(ezetimibe) does not.

To decrease your risk of CAD, decreasing your LDL cholesterol with a statin is the most potent. (BTW, “red rice” is a natural statin.) The advise for increasing dietary fiber is good. Oatmeal and the natural cholesterol blocker act in a manner akin to zetia. Ethanol, particularly red wine, but not too much is also good. Along with exercise, and niacin, it increases HDL – the ‘good’ form of cholesterol. Omega-3 fatty acids were suggested via walnuts and fish oil. The DHA form seems to be the most effective and you need to take a lot. The Omega-3’s may also lower arrhythmogenicity, but since you already have and ICD that is not a big issue. The advice regarding niacin and bile acid resins is good, but these tend to be poorly tolerated so compliance is poor. The evidence for CoQ10 is weak, but some people swear that is alleviated their problems with statins. While HTN is a risk factor, I have never read that it is the most important risk factor. Joe may be confused in that BP goes up with age and so does CAD and is confusing cause and effect. Elevated blood glucose level is also a big risk factor, but diabetes mellitus is part of the metabolic syndrome.

Now to raise the issue of lipids or fats, not all fats are equal with saturated fats, trans fats and omega-6 fats being on the bad side with omega-3 and some others on the good sided. A low fat diet will lower your cholesterol, as I noticed with Alli(orlistat), if you can manage to side-effects. With corn being fed and used it, seem in everything now days, its omega-6 FA are ubiquitous.

Oddly enough, the people who say lower you carbs also are correct, although it is likely the glycemic effect.

There is the hypothesis that lowering homocysteine will reduce CAD. That is the reason you will see Vit B12, folate and B6 recommended. Trimethylglycine (betaine) will also lower homocysteine through an alternate pathway.


Good luck.

7:32 PM, April 30, 2008  
Blogger Seerak said...

Joe writes:

The only reliable predictor of heart disease and heart attacks is high blood pressure.

Heart disease runs in my family on my father's side. So does low blood pressure; my dad's got so low that it actually restricted his treatment options after his third heart attack.

There is another factor that is dominant in his genes, however, and that's diabetes. ALL of my relatives on his side, including his brothers, sisters, and cousins (some younger than me), have diabetes or one of its precursors.

So far my brothers and I seem to have dodged that bullet, with some good genes from my mom (her mother lived to be 98), but I'll be watching those numbers now that I'm over 40.

7:41 PM, April 30, 2008  
Blogger Felix Kasza said...

Dear Dr. helen:

Have you considered fibric acid (rather, its salts)? When statins caused unpleasant side effects -- muscle pain -- my doctor put me on fenofibrate (brand name Tricor), which worked exceedingly well for me.

Cheers,
Felix.

7:52 PM, April 30, 2008  
Blogger Unknown said...

Go for simple. Try niacin. You can avoid most or all of the flushing with the right brands. William Parsons has done a lot of research on niacin and has lots of good advice. You should only use niacin at high doses with a doctor's supervision. One big advantage is that it raises your HDL.

I have some notes at my Squidoo lens on cholesterol control.

8:02 PM, April 30, 2008  
Blogger Patm said...

My FIL and all of his sons have absurd cholesterol numbers and its entirely congenital. They eat chicken and avoid fats and their numbers are still in the 300-380 range unless they take statins. In every case, they tried diet and exercise before taking the meds. Upon elimination ALL cheeses, their numbers dipped dramatically, but then leveled out too high. They started using the Steel Cut Oatmeal that comes in a tin and that made another dramatic reduction, bringing all of them into the 250 range. Using the statins, eating the oatmeal and avoiding most cheeses, they hover between 190-220. They swear by the oatmeal, and it's much tastier than the mushy stuff.

8:05 PM, April 30, 2008  
Blogger Ivanhead said...

Helen,
I went from 350 to 157. Here are some points. Stop drinking. Lose weight. Excercise, daily. Take metamucil in the morning. Take nican tablets in the morning and afternoon. Oatmeal is good, steel cut, takes an hour to cook. I cook a weeks worth and refrig it and reheat it in micro wave. Fiber, Oatmeal, metamucil, moves the bad stuff out. Red meat, once a week. Fruit and veggies, lots. Exercise and weight loss are THE most important things. Get a crp test when you go to the Dr, it is the best test for heart disease. Weigh EVERYDAY. No cheating. Good Luck!

8:40 PM, April 30, 2008  
Blogger Ivanhead said...

Helen,
I used to use the benacol spread, too many calores. The chews WORK, you just can not expect them to work WITHOUT the other things. Also you need to take them with a meal. I take them, only 20 calores a chew. Take 3-4 a day WITH meals.

8:45 PM, April 30, 2008  
Blogger Peter Blogdanovich said...

Ok;
1. Take lecithin gel caps. I buy mine from Trader Joe's. You have to take a lot-5 or 10 a day. The good news is anything you change in your life will show up in two weeks as the new status quo, so you can experiment every two weeks on dose with cholesterol monitoring. This will raise HDL and lower LDL.

2. They're learning that statins prolong life more through their anti-inflammatory effects than cholesterol lowering effects. Especially lipitor. It turns out the essential fatty acids are equally potent anti-inflammatory agents. I take Trader Joe's EFA complete gel caps.

3. Your spell checker suggests I replace lipitor with clitoris. What is that about?

9:26 PM, April 30, 2008  
Blogger Unknown said...

My wife is pre diabetic and started taking 500 mg of cinnamon and it helped her lower her blood sugar. I have heard Niacin can help lower cholesterol but have not tried it since lifting weights seems to help me and my wife walks a lot to lower her cholesterol.

Steve

9:49 PM, April 30, 2008  
Blogger Herman said...

"Ralph said...
Go for simple. Try niacin. You can avoid most or all of the flushing with the right brands. William Parsons has done a lot of research on niacin and has lots of good advice. You should only use niacin at high doses with a doctor's supervision. One big advantage is that it raises your HDL."

My grandfather and father died at about 49 from heart attacks. My brother had a heart attack at 51 and barely survived. I am 1 1/2 years younger than my brother and was very motivated at this point to reduce my cholesterol. My cholesterol was 8.6. I am Canadian so the numbers are different than the US tests but this number is high. I read Parsons book on reducung cholesterol and started taking niacin. After one week my choesterol went down to 3.5. This is about as good as you can get it. My HDL was only slightly lower than my LDL. Triglycerides were cut by 2/3rds. I flushed like crazy for a few days but then it went away. The trick is to take 3 grams a day and stick to it. Don't start with a lower number and work up it just prolongs the flush. I tried the no flush kind and my cholesterol shot right back up. This may not be for everybody but it works great for me.
My brother takes statins and a bunch of other stuff and has had two more attacks. He is too scared to try niacin because his doctors warn him against it. What can you do?
The side effects were that my mood improved and I have a lot more energy.
I am sixty now with no indication of a problem, but that too can change quickly so I'll just be happy with the results I have. PS the flush isn't too bad if you enjoy a buzz. The flush is apparently due to the release of histamines just like when one is sexually aroused. You can get some synergy going here. Hey don't knock it.

11:19 PM, April 30, 2008  
Blogger dmh said...

Hi Dr. Helen,

Thanks so much for all the great work you and Glenn do!

I've had some very good results on the blood chemistry front using diet, exercise, and supplements.

I am a big fan of Dr. Andrew Weil's approach to health and medicine, and so I decided to find a local doctor who was trained in his methods. Luckily, there was one in my area. She is a board certified MD, teacher at UCLA Med, has a thriving practice, and took an extra year of training in the Weil program at the University of Arizona.

I was having minor heart rhythm problems, and she told me that my blood chemistry was way out of whack. She suggested changes in diet, supplements, and exercise. Here's the bottom line:

I've been taking Omega 3 fatty acids in the form of Orthomega brand omega 3 at 2500 mg EPA, and 1800mg DHA daily. (6 capsules) My triglycerides went down from 329 to 91.(<100 is desirable) This is the highest dose, purest non prescription brand of omega 3 fish oil available, developed for doctors. (amazon has it)

I've been taking Niacin (gnc niacin 500) at 1500 to 2000mg per day. My HDL went from a low of 38, to 51 last time checked. (>40 is desirable) My LDL was 123 on last check. (niacin raised it a bit too, from a low of 98) Weil trained physicians seem to think that high HDL is now a very important objective, to help avoid heart attacks.

You need to check your liver function every 6 or 8 weeks if you take niacin at this level, but I have no problems with it. Also you need to slowly work up the dose to avoid "flushing". I find that if I take it 3 times per day with meals, I don't get it much. Taking baby aspirin supposedly helps, but it causes me to bleed too much. Another much more expensive option is the prescription form called Niaspan. Causes most people less flushing, but not covered by my insurance, and $3 a pill here.

For the rhythm stuff and general heart support, I've been taking magnesium citrate at 600 mg per day, coenzyme q10 at 150mg per day, and quercetin at 500mg per day. Almost no skipped beats since I've been taking the magnesium, but it might just be co-incedental to my overall improved blood chemistry.

It's great to see my doctor so happy that she has a compliant patient, who is actually dramatically improved. (It's tough out there in the medical trenches...)

You can read about this stuff at drweil.com, and search the various terms. Or read his books (no adds). He also has a cd/book on heart health you might want to check.
http://tinyurl.com/5h2hk3

The other thing I would look into is the mind/body connection. This device looks very promising:
http://store.soundstrue.com/os01096d-review.html I might give it a try just for stress reduction!

Best, DMH

http://www.dmhstudio.com/
http://www.dmhstudio.etsy.com

11:32 PM, April 30, 2008  
Blogger Mr Brad said...

Check into the "Portfolio Diet" named because the researchers at the University of Toronto took put the foods that showed a 5-10 percent effect on cholesterol and the ilk into a "portfolio" of foods. The upshot is that it eaten together they can effect up to a 35% change in LDL, etc.

While this particular site is set up by the almond growers assc., it'll get you started, as will the second from WebMD

http://portfolioeatingplan.com/

http://www.webmd.com/cholesterol-management/features/portfolio-diet-recipe-for-lower-cholesterol

11:35 PM, April 30, 2008  
Blogger OregonJon said...

It was while working in India in the mid-90's that I discovered their many excellent vegetarian dishes. While never a vegetarian my diet changed to no red meat, very occasional chicken, more seafood, fruit and of course the veggie dishes. Oh yes, and about an hour a day of either the gym or swimming. Upon return to New York the company doctor was amazed at the drop in my cholesterol levels. After ten years back in the USA the old habits have return as has the old cholesterol levels. It may have been the food, it may have been the exercise or it may have been the combination. Or it may have been that the spices in Indian food, for me the hotter the better, simply dissolve cholesterol. Good luck.

11:39 PM, April 30, 2008  
Blogger Unknown said...

Helen
I concur with vreni and the others that point out cholesterol is not the problem. I would recommend reading up on inflammation and it's role in chronic diseases like heart disease. There are many books on the links between diet and inflammation, including these two, which I've read and recommend:

The Anti-Inflammation Zone
The Inflammation Syndrome

The best diet advice from these books is to avoid the same foods that lead to diabetes (heart disease and diabetes are linked) and get plenty of Omega 3 fats. If you're not taking mega doses of fish oil now, you should start.

It's just starting to dawn on the medical establishment that the conventional dietary wisdom of the last thirty years (low fat, high carbohydrates) has been disastrous on American health. The low-fat mantra has made us all fat, and sick to boot.

1:29 AM, May 01, 2008  
Blogger Puff65537 said...

Everybody who has high "cholesterol" doesn't have the same issue, my triglycerides were 1800, niacin made it worse, and Tricor chewed up my muscles, but 10 eggs a day brought me down to 300. Patching the 5aR and aromatase leak cut the need for eggs down to 4, and I'm much better now that I don't have to deal with 2000mg a day of 17ß-estradiol glucuronide and 3a/5a DHT metabolites (created a lovely benzo withdrawal every morning).

I would pay attention to your low BP and diet coke craving. Aspartame contains both aspartic acid and phenylalanine (both of which can be taken as supplements w/o the methanol that also comes bundled with aspartame).

Looking up aspartic acid I see "Aspartic acid is non-essential in mammals, being produced from oxaloacetate by transamination" oxaloacetate is part of the citric acid cycle (an essential part of energy metabolism) so if you find that supplementing it helps, you'll want to check out the wikepedia page: http://en.wikipedia.org/wiki/Citric_Acid_Cycle and note that NADH and FAD are cofactors in the area (guilt by association) and try taking niacin and vitamin B2. Here is a bit more info: http://www.vitaminstuff.com/amino-acid-aspartic-acid.html

Next up, try taking phenylalanine, or tyrosine, as well as copper. Your low BP may be due to dopamine's relaxing effects. The extra amino precursors will help push dopamine through dopamine-beta-hydoxylase to norepiniphrine which will raise BP (go slow!!!). The copper is to help make more DBH, which is a copper metalloenzyme.

I suspect the panic isn't just low NE, but also high cholecystokinin, which indicates diversion of metabolic energy into fatty acid synthesis. So, not only do you have an energy leak, but it is leaking into your cholesterol. Green Tea extract is decent FAS inhibitor (particularly the EGCG part at 800mg, get it with piperine, or just take some black pepper with it), note that it also lowers blood pressure.

I'm going to guess your fumarase (ec 4.2.1.2) is bent (uterine and kidney cancer in family?) so you'll want to stay away from fructose, cyanates (hot tubs might be bad) and glucocorticoids. Ibuprofen protects against the first two, nothing for the last but to lay off the stress. Thyroid hormones upregulate TCA enzymes, so you might want to make sure you are fine there.

Fumarase is an iron-sulphur metalloenzyme, so iron supplements and MSM/methionine/N-Acetyl-Cysteine might help.

Good luck.

4:11 AM, May 01, 2008  
Anonymous Anonymous said...

Yeah, Glen innocently links to his higher-earning wife again. Must I read another fluff piece about feelings and biases (men are not so bad after all etc...and YOU BETTER LINK TO ME or I will remove your second ball, Glenny).

O.K. I'll read the article now.

Aw Jesus: "If anyone has a product other than statins--or these chewy caramels-- that they have used successfully to reduce their cholesterol, let me know. I would love to find something that works."

STOP. Your body regulates cholesterol, so dietary intake will not help, and drugs are, albeit somewhat effective, uh, obviously not going to the source, eh?

So many things. First, stress. Second, again, stress. Third, not being a HYPOCHONDRIAC. Get the heck off those doctor pills. Cholesterol is NOT predictive of heart disease. Wasn't it just you and hubby who turned me onto 'Good Calories/Bad Calories'?

Take a few multivitamin pills. The best I've found are at:
http://www.proteinpower.com/product.php?id=14

Hey, sue me for a product plug, but they are small packets and contain small amounts of dozens of antioxidants (instead of my former youthful enthusiasm for mega-doses of a few).

But attitude has been shown to be the main factor in longevity, so your question itself is worrisome.

God, it's the ratio of fat (triglycerides) to HDL that is actually predictive, not your "cholesterol level". Get a younger doctor, and Google the ratios that suck or are actually predictive.

http://www.cbn.com/health/NaturalHealth/drsears_heartattack.aspx

There are also suppliers of refined fish oil, which I think are good for you, this one being the only one that actually purifies the burpy junk:

http://www.omegabrite.com

But! Attitude and exercise are 90% of the effect on heart disease though. Attitude, you lack. Fine. Listen to your depressing doctor. Exercise? Interval training, either aerobic or weight lifting. You want to ULTRA stress yourself, very quickly (SPRINT or lift weights up fast, down slow, more weight than you can imagine doing more than that three times), then allow yourself a minute or two to start breathing normally again. Then do it two more times.

I don't mean this as a definitive answer, but do mean it to be a call to arms, namely, do NOT listen to a mere DOCTOR. They are NOT scientists, but more akin to cubical dwellers in a big factory, even more akin to salesmen in a sweatshop.

-=DrNikFromNYC=-

P.S. If you are on the pill, get off it. Your body isn't supposed to think it's pregnant for twenty years.

6:05 AM, May 01, 2008  
Anonymous Anonymous said...

Gee, Peter...replacing lipitor with clitoris is a compelling suggestion.

Sometimes, it is better not to ask why. Some spell check programs are pretty smart if you ask me.

Yeah, my mind is in the gutter this morning.

6:26 AM, May 01, 2008  
Blogger bearbee said...

Walnuts - omega 3 fatty acids

7:05 AM, May 01, 2008  
Blogger Deb said...

"Thyroid hormones upregulate TCA enzymes, so you might want to make sure you are fine there."

From the prior comment, did you know that high cholesterol can be connected to low thyroid levels, ones that the doctor says are "within normal limits" but are still low for you? See this
article:
The High Cholesterol Thyroid Connection - Undiagnosed Thyroid Disease May Be the Reason for Your High Cholesterol

http://thyroid.about.com/cs
/symptomsproblems/a/cholesterol.htm

DCW

7:58 AM, May 01, 2008  
Blogger Quasimodo said...

One more thing ... floss everyday. It reduces inflamation.

8:32 AM, May 01, 2008  
Blogger vnjagvet said...

Here's my story, FWIW. I had my first heart attack at 26 and I am now 68. I had bipass surgery at 40 and a "redo" at 51. My dad died at 48 of his only heart attack.

In 1991, I became diabetic.

Until 1998, I was on a typical lo fat, lo chol, cardiac diet with little effect on my blood chemistry. Then, one of my doc's had a blood test run at Berkely Labs which analyzes all aspects of the makeup of fats, including cholesterol, in the blood. The result:

I have a rare, hereditary blood disorder in which my body manufactures a particularly deadly form of LDL. The cure:

Niacin, folic acid and statins, along with a modified atkins (normal fat, whole grain/lo sugar/lo carb) diet.

On this regime my chemistry has been optimal for 10 years.

I have since had other heart problems, but these apparently are not related to my diet, and haven't killed me yet:>)

The lesson for me is find out what your particular problem is and treat it. Do not take general advice. We are all different. Sometimes there are different reasons for the same symptoms, including hi cholesterol.

12:48 PM, May 01, 2008  
Blogger Vreni said...

Yes the bottom line cause of heart disease is arterial inflammation, which is caused by consuming foods that didn't exist before the industrial revolution - refined sugar, flour, and vegetable oils especially. Funny how grain products and vegetable oils are what we are being told to eat because they are "healthy" - NOT!!! Now our food is laced with chemicals like colourings, flavourings, preservatives, and other stuff that make us want to eat more - those food companies are pretty clever, and our poor livers are trying to figure out how to detoxify chemicals that they never came in contact with for most of our human existance. No wonder we are inflamed!

Let's face it. We spent most of human existance as nomads - we followed the meat. Read Weston A Price's book Nutrition and Physical Degeneration, and it becomes blatantly clear that primitive societies were fiercely healthy until they came in contact with "white man's food" - white sugar, white flour, vegetable oils, and processed and canned food etc., afterwhich they suffered from type 2 diabetes, heart disease, and other diseases of civilization, not to mention tooth decay.

I think it is important to realize that vegetable oils are polyunsaturates - they are highly unstable oils that go rancid with heat. And we are being told to cook with them??? That is completely crazy! Heated, rancid polyunsaturated fats cause huge free-radical damage in the body. We need to cook with saturated fats, like butter, ghee, coconut oil or animal fats.

Furthermore, vegetable oils are omega 6 oils, which are highly inflammatory to the body, which is why reducing consumption of vegetable oils while increasing omega 3 oils like fish, flax etc. can lower body inflammation.

It drives me crazy to see the food guides promoting damaged fats, bread and pasta as healthy, while telling everyone to stay away from eggs, full-fat dairy (low-fat dairy=high sugar dairy!), and other sources of healthy saturated fats, that have so many vital functions in the body. We've eaten saturated fat since the beginning of time. No sense blaming fat for the recent explosion in degenerative diseases we face today.

1:05 PM, May 01, 2008  
Blogger B. Durbin said...

You know, I'm seeing a lot of contradictory advice here. I'm just going to link some of my favorite healthy recipes... and just about everybody will agree that they're healthy, because it's salad time.

Blame It On the Vinaigrette Salad
Smoothies From Scratch
Orzo Salad (okay, that one's higher on the carbs)
Smoked Salmon Salad
Dad Salad.

With any luck you'll find at least one of them tasty and easily affordable, and you can tell your doctor that you're getting more greens in your diet.

1:18 PM, May 01, 2008  
Blogger Hal Finney said...

Boy, you got a lot of conflicting advice.

Here's the deal, I'm pretty sure this is true. There are NO compelling, large-scale, randomized prospective diet-intervention studies that show benefits to longevity. That's the bottom line.

So far NO ONE has found a diet which can be PROVEN to work and substantially improve people's health.

Most of the recommendations come from observational studies in which they note that people who eat one diet or another seem to live longer or have less cancer, heart disease, etc. The problem is that there are almost always extra factors here. People who try to "eat healthy", and people from traditional non-western cultures, may well have other healthy aspects to their lifestyle beyond diet, and although the analysts try to control for these extraneous effects, that can never be done perfectly. Time after time, diets which seem to correlate with health, when tested by prescribing them to people and getting them to try them for a while, do not actually produce health.

Even something as seemingly obvious as eating more fruits and vegetables DID NOT produce improved health!

Unfortunately, all we can conclude at this point is that science does not know what constitutes a healthy diet. Into this vacuum then rush a thousand contenders, each with their own pet theories that they are pushing. The result is what you see on display on this blog.

I don't have much advice for you, other than, when a doctor or someone else gives you dietary recommendations, ask whether there are randomized controlled prospective studies showing that these changes will help.

2:08 PM, May 01, 2008  
Blogger Serket said...

Allison - I've heard that yogurt is a dairy product and has lactose, but isn't it made from a bacteria? Perhaps the other stuff is added?

4:01 PM, May 01, 2008  
Blogger William said...

I'm nearly 48, a successful competitve runner and I replaced starches like cereals, grains, potatoes, pasta, bread, etc... with more nuts and fish, and increased exercise. My total cholesterol dropped from 220 to 150.

Oatmeal is starch. It's not going to help you. I wouldn't eat it more than once a week in moderation. Overall, I've found simply just eating less is best. At my age, if I ate the normal American 3 square meals a day, I would be overweight, especially now that I'm taking a break from running/training.

You are much better off eating raw sugar than aspartame and artifical sweetners. Stevia is an herbal sweetner, much safer. I have hot sweet tea in the morning w/raw sugar, an apple or banana and a handful of nuts later in the day, and usually just one full meal - dinner only after exercise in the evening. It's a good routine and to boast a bit, I am the same weight now as I was when I was 16 yrs old. 5'7" 143 lbs and my blood work is great. (not many American males can claim that these days) The more you eat, the more you want to eat. The more amount of drugs and chemicals you can avoid, the better.

I recomend the 'grizzly bear diet' - big on fish, fruits, nuts, greens, and raw natural sweetners. You won't be hungry.

7:56 PM, May 01, 2008  
Blogger observer said...

Dr. Helen:

I am sorry you had such bad luck at picking your parents! Being so prone to heart attacks at a young age is no fun.

I can see why you would be so concerned about cholesterol levels since cholesterol=heart disease is such a stubborn meme. But, is it worth getting all stressed-out over ? (Chronic stress IS a proven major cause of heart disease.)

I don't think so. Some comments which may well lower that stress :) :

1.) IMHO, ignore the dietary advice: NONE has been proven to work.

Now, that does not mean--absent a true food intolerance/allergy (a medical condition for which food avoidance is the only safe treatment)--one should not eat the recommended foods...if one likes them. In contrast, "how to eat" schemes--which are ALL oriented to weight loss--are nothing but self-delusion disguised as health advice.

No matter who issues the same.

2.) Statins for cholesterol reduction? Unless you have familial hypercholestemia, cholesterol reduction is irrelevant (and may increase risks of a coronary event if it goes too low). Therefore, statin dosing to accompish this (to lower and lower--and unnatural--levels) is a waste of time and money.

In addition, such huge doses raise significantly the risk of side effects.

Side effects that make the possibility of a slow, agonizing death by meds a much bigger risk than going through another heart attack.

Even for men, the usefulness of statins is not to the extent believed, and such benefit has been demonstrated only in middle-aged men with heart disease!

Dr. Helen, I am sure "middle-aged man" does not apply to you. :D

The only benefit from statins that might be worth risking nasty side effects for, rare or not--is in their anti-inflammatory effect. An effect which has been shown to occur with the administration of microdoses (2.5-5 mg/day). These are doses that almost NO doctor will prescribe because those doses will NOT lower cholesterol although the level of benefit is just about as good while minimizing side effect risks in the patient.

If you are a man who is not too old, that is:

It has been found that women don't benefit from statins at all for primary prevention.

For secondary prevention? There is a slight reduction in coronary events, but all cause mortality is unchanged. In other words, a woman takes a big risk in taking statins but the only reason to do so--longer life--does not happen.

Older people? They are more likely to suffer side effects than get benefit. Same with younger people.

The side effects of statins (including ALS, dementia, transient global amnesia, cognitive deficits and mental illness of all kinds) are far too severe (and not as rare as the pharmaceutical companies and doctors want you to believe)for a medication which has to be taken for potentially decades until one's death.

IMHO, if a medicine needs to be taken "for life", it has to: 1.) Prevent a death which would truly be imminent in the short term if the med were not taken (and CHD is not such an illness) or, 2.) Is truly "so safe it should be put in the drinking water".

No effective medication known at this time meets requirement #2; statins certainly do not.

12:10 PM, May 02, 2008  
Blogger water said...

lots of good advice here. The heart scan blog is the best place to start to determine which of it applies to YOU and to get the quickest results for your hard work.

Taubes is great for understanding the science behind it all.

If there are glycemic issues, look at www.bloodsugar101.com.

8:34 AM, May 03, 2008  
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