Category Archives: Heart Healthy

Fish Oil and Heart Disease – Beware

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Pick up a bottle of Omega 3 fish oil and you will read that it supports heart health, and may reduce the risk of coronary heart disease.  What it does not tell you is that it can elevate your low density lipoprotein or LDL, which is referred to as the bad cholesterol.  What is does improve is your triglyceride.  To better understand this let’s look at both fats.

Cholesterol is  waxy, odorless lipid (fat) made by the liver that is an essential part of cell walls and nerves.  It also plays an important role in body functions such as digestion, and hormone production.  In addition to being produced by the body, cholesterol comes from animal foods that we eat to include meat, poultry, eggs, fish, and diary products.  Eating too much saturated fat therefore increases cholesterol.  The guideline for total cholesterol level in healthy adults is less than 200mg/dl.

Triglyceride is a fatty substance referred to as a lipid.  It is the fat that is carried in the blood from the food we eat.  Most of the fats we eat, including butter, margarine and oils, are in triglyceride form.  Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.  The liver packages cholesterol with triglycerides and proteins as lipoproteins and transports it to sites throughout the body .  An elevated triglyceride level increases the risk of heart disease.  The guideline for a normal triglyceride level in healthy adults is less than 150 mg/dl.

The American Heart Association (AHA) does not recommend drug treatment to reach a normal triglyceride level.  Instead, for those trying to lower their triglycerides, lifestyle changes such as diet, weight loss and physical activity are encouraged.  That’s because triglycerides usually respond well to dietary and lifestyle changes.  The AHA recommends Heart-healthy polyunsaturated and monounsaturated fats found in oily fish as well as in flax seeds, walnuts and omega-3 eggs.  For those who need to lower their triglycerides the physician may order omega 3 capsules.  One should not take more than 4gms per day without a physicians care since it can increase the LDL

If you are taking omega 3 capsules for a healthy heart know what your heart status is.  If you have family history or told you have elevated triglyceride then omega 3 is right for you. On the other hand, if you have elevated cholesterol stop the fish oil and focus on other dietary measures.  Increase your soluble fiber since it forms a gel which binds some cholesterol in the small intestine and takes it out of the body.  The next time you are at the vitamin cottage ask about plant sterols.  It is a plant compound with chemical structures similar to that of cholesterol.  Interestingly because phytosterols so closely resemble cholesterol they can actually block food-based cholesterol from being absorbed into the blood stream.  The result is both phytosterols and dietary cholesterol end up excreted in waste matter.  Taking 0.8gms twice a day will decrease both LDL and total cholesterol. Your best options is to select foods with plant sterols added such as in orange juice and vegetable oil spreads,  otherwise to get 0.8gm naturally would require an excessive intake of  food items such as 12 cups of broccoli, 70 carrots or 26 oranges.

Written by Joanne Slyter, MBA, RD Westminster, CO

 

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Bet You Can’t Eat Just One!

To improve your blood pressure reading, eating less sodium is on top of the list.  In my previous blog I mentioned that The Dietary Approaches to Stop Hypertension, referred to as DASH, encourages you to  reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure.  Let’s look at this in more detail.

Sodium is a major component of table salt.  Our craving for salt is actually learned, and as such, can be unlearned.  If we cut back on our salt intake, the desire for salt will gradually decrease.   The American Heart Association  recommends to limit your intake to 1500 mg daily.  This can be a real challenge because food manufacturers add so much sodium to processed foods.  We need some sodium, but it is present in our foods as they are picked from the field because it is in the soil.  Most foods have some sodium even before they are processed, and that is OK, since it is enough to supply what we need but not enough to cause health problems.  It is the canned and processed foods that are the problem. If we cut out table salt, we only reduce our sodium intake by about 15%. Your best bet is to find items which state, “No Added Salt” on the label. You can also read the nutrition facts label.

The % Daily Value section on the food label tells you the percent of each nutrient in a single serving, in terms of the daily recommended amount. As a guide, if you want to consume less of a nutrient (such as saturated fat, cholesterol or sodium), choose foods with a lower % Daily Value of 5 percent or less. If you want to consume more of a nutrient (such as fiber), seek foods with a higher % Daily Value of 20 percent or more.

The typical sodium intake in our society is around 4000 – 5000mg/day.  As previously stated, the American Heart Association recommends cutting back to 1500mg to be heart healthy.  There are several steps you can take to reach that level.  Buy varieties of food with no added salt.  Rinse regular canned foods under running water to help reduce salt.  Skip items with added sauces.   Avoid food items that have been cured, smoked, processed, brined, or pickled since all have been prepared in salt.  For luncheon meats its better to cook fresh meat and slice up versus deli meats.  Cheese is high in salt so use sparingly. Be aware of products with the word sodium or salt in it such as monosodium glutamate, celery salt, onion salt, and garlic salt.  Use powders instead such as garlic powder. There are no limits on herbs and spices. There are also seasoning mixes with no salt you can try, like Mrs. Dash, which comes in various flavors.

So where is your level of sodium intake?  See if you can change your craving for salt by following the above recommendations for a month.  You may surprise yourself and suddenly decide salty chips are toooo salty and unappealing.

Signature by Joanne Slyter, registered dietitian who focuses her practice on nutrition consulting and coaching

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I Don’t Know Why I have High Blood Pressure

In my previous blogs I looked at elevated HDL and triglyceride as risk factors for heart disease.  Both of these can be elevated due to eating behavior and weight, but family history can also be a detriment.  The next risk factor I want to focus on is high blood pressure.

A high blood pressure is defined as 140/90 or higher.  It is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. The Dietary Approaches to Stop Hypertension, referred to as DASH, encourages you to  reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium.   Lifestyle changes such as losing weight if your body mass index is above 25, moderate alcohol consumption which is defined as no more than 1 glass per day for women and 2 glasses per day for men,  limit saturated fats, add more fiber in your diet, manage stress,  avoid smoking,  and exercise regularly will also lower your blood pressure and can improve your overall health. With exercise, take it slow at first with just 10 to 15 minutes a day and gradually increase the time and intensity of your activity.  Choose something you enjoy and can stick with, such as walking, swimming, or bike riding, and make it a daily habit.

In my next few blogs I will look at each of these life style changes in more detail. What do you see may be affecting your blood pressure?

Signature by Joanne Slyter, registered dietitian with nutrition consulting and coaching practice located in Westminster CO

 

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Triglycerides Need More Attention

There is always something on TV or in the newspaper talking about cholesterol and the need to lower it to prevent heart disease, but why doesn’t the triglyceride get the same attention? An elevated triglyceride is just as much a risk factor, and is even an indicator for other possible medical problems such as diabetes or pancreatitis.  So why not put warning signs on foods that could help lower this fatty substance known as a lipid in your blood?  The basic answer is that too much of anything we consume is converted into triglyceride, and therefore it’s simply not what we eat that counts.

Triglyceride is the fat that is carried in the blood from the food we eat. Most of the fats we eat, including butter, margarine and oils, are in triglyceride form. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body. The liver packages cholesterol with triglycerides and proteins as lipoproteins and transports it to sites throughout the body.  An elevated triglyceride level increases the risk of heart disease.  The guideline for a normal triglyceride level in healthy adults is less than 150 mg/dl

To turn an elevated triglyceride around is not simply avoiding types of fats  ( important for lowering elevated cholesterol) but the amount of fat, protein, and carbohydrates (sugar) you consume.  This implies  watching your calories, lose weight if greater than 25 body mass index,  ( To check your body mass index look on the right-hand column for Resource Tools and click on Body Mass Index Calculator), and exercise to help control weight.

Being overweight places extra stress on your body in a variety of ways.    Control the calories you consume to take action in managing your weight.  It takes 3500 calories to equal 1 pound (lb) of body fat. Cutting back just 500 calories/day can promote a 1 lb weight loss/week. What does 500 calories look like? A 20-fluid-ounce bottle of regular cola plus one regular-sized candy bar equals approximately 500 calories.   If you are overweight, just losing 5%-10% of your weight can significantly reduce your Triglyceride!  For weight management, the key  is assuring that your daily caloric intake does not exceed the amount of calories you burn off per day.

A Heart Healthy Diet is the most recommended program to follow.  It is not a diet but  a way of eating that is appropriate for anyone older than 2 years of age. A heart-healthy diet is low in saturated fat, trans fat, and dietary cholesterol and full of fruits, vegetables, legumes like dry beans and peas, nuts, whole grain foods, and fish (preferably fatty at least two times per week) at an appropriate level of calories to help reduce triglycerides and LDL cholesterol level.

The American Heart Association (AHA) also recommends including oils and foods rich in alpha-linolenic acid such as flaxseed, canola, and soybean oils, walnuts and omega 3 eggs.  The AHA does not recommend drug treatment to reach a normal triglyceride level.  For those who need to lower their triglycerides, your physician may order omega 3 capsules.   It is important to know that taking more than 4 gm should be done only under a physician’s care since it can increase the Low Density Lipoprotein or LDL, which is referred to as the bad cholesterol, in some people as well as cause excessive bleeding. The LDL should therefore be monitored on a monthly basis.

Limit alcohol intake.  Even small amounts can lead to large changes in plasma triglyceride levels.  Drinking more than three drinks a day has a direct toxic effect on the heart. Heavy drinking, particularly over time, can damage the heart and lead to high blood pressure, alcoholic cardiomyopathy (enlarged and weakened heart), congestive heart failure, and stroke. Heavy drinking puts more fat into the circulation in your body, raising your triglyceride level. That is why doctors will tell you, “If you don’t drink, don’t start.”   Moderate drinking is defined as no more than one drink/day for a woman and two drinks/day for a man.   One drink is equal to 12 fluid oz of beer or wine cooler, 5 fl oz wine, or 1.5fl oz of 80 proof liquor.

Exercise is a necessary component for weight management and overall health.  Take it slow at first with just 10 to 15 minutes a day and gradually increase the time and intensity of your activity.  Choose something you enjoy and can stick with, such as walking, swimming, or bike riding, and make it a daily habit.  Also, add motion to every aspect of your day, but gradually so it won’t seem like much effort at all.  This is particularly helpful for people who aren’t used to exercising, for those with a body mass index above 30, or those with medical conditions.  Some suggestions are taking the stairs versus elevator, parking farther away, getting off the bus a few stops early, and walking instead of driving.

If you have family history of heart disease or diabetes keeping your triglyceride level down is vital.  If you notice it  is going up, review the checklist to see what you need to change:

  • Body Mass index >25
  • Eating excess calories especially sweetened dessert items
  • Alcohol intake not in moderation
  • Minimum exercise

It’s possible that your elevated triglyceride is hereditary and may require pharmacological therapy, but this is always the last step if lifestyle changes with weight management, diet and exercise do not work.  Don’t wait for the doctor to tell you what to do, but make changes now!!

Signature by Joanne Slyter, registered dietitian living in Westminster, Colorado who does nutrition consulting and coaching

 

 

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Drink the Wine

I love life and only makes sense for me to do what I can to keep my chances  down of suffering and dying from cardiovascular disease and even cancer.  There are certain things beyond ones control that will put you at a higher risk, so first be aware of where you are starting out.  If you knew that your chances were few to none by following the 7 step guidelines from the American Heart Association, would you be prudent or risky with your health and life?

Before delving into what you can do, let’s first evaluate the risk factors that you have no control over.  Do you have family history of heart disease? You may be one whose genetic chemistry prevails you to have elevated cholesterol, low high density lipoprotein (HDL), elevated triglycerides,or elevated blood pressure which will not improve under the best of cardiovascular health behavior.

For this blog, let’s start by looking at cholesterol and HDL.  Your HDL, which  is called the “good” cholesterol, removes the bad cholesterol (LDL) from the arteries thus preventing plaque buildup that damages vessel walls and ultimately blocking blood flow. The goal for HDL is 40-50 for men and 50-60 for women.  HDL is not directly affected by watching the amount of fat you eat, but  by the kind of fat you eat, exercise, weight loss, quitting smoking, and moderate alcohol (wine) consumption.

Choose healthier fats.  This means avoiding saturated fat and trans fats, and consuming more monounsaturated and polyunsaturated fats.  Saturated fat is contained in animal products with the exception of tropical fats – palm, palm kernel and coconut oil.  These fats are usually added to bakery products and some candies.  Trans fats is a man-made fat which helps to increase the shelf life of foods.  Look for the words partially hydrogenated or hydrogenated oils on the label.   Monounsaturated and polyunsaturated fats — found in olive, peanut and canola oils — tend to improve HDL’s anti-inflammatory abilities.

Get more physical activity. Within two months of starting, frequent aerobic exercise can increase HDL cholesterol by about 5 percent in otherwise healthy sedentary adults. Your best bet for increasing HDL cholesterol is to exercise briskly for 30 minutes, five times a week. Examples of brisk, aerobic exercise include walking, running, cycling, swimming, playing basketball, raking leaves — anything that increases your heart rate. You can also break up your daily activity into three 10 minute segments if you’re having difficulty finding time to exercise.

Lose weight. Extra pounds take a toll on HDL cholesterol. If you’re overweight, losing even a few pounds can improve your HDL level. According to the Mayo Clinic,” for every 6 pounds (2.7 kilograms) you lose, your HDL may increase by 1 mg/dL (0.03 mmol/L).”

Don’t smokeIf you smoke, quit. The Mayo Clinic also states, “Quitting smoking can increase your HDL cholesterol by up to 10 percent.”

Enjoy a glass of red wine in the evening.  We can thank the French for this discovery.  The French paradox is wondering how a society that eats delicious creamy pastries, has cheese for a whole course at dinner, and a buttery croissant… sometimes with butter, perhaps with a bit of cheese or meat sausage, as a regular breakfast item, have less clogged arteries and are less obese than Americans or Brits.  For years this has been attributed to red wines “health benefits.”  According the the American Chemical Society, red wine specifically contain the compounds catechins and resveratrol called polyphenols that have antioxidant or anticancer properties, and saponins.  Resveratrol is thought to block cholesterol oxidation by its antioxidant action and saponins are believed to work by binding to and preventing the absorption of cholesterol.   Keep in mind, drinking a glass of wine can be good for you, but drinking more has its own health effects that can more than counteract the benefits of the wine.

Following all of these steps to improve you HDL is a prudent move , but if these changes don’t increase your HDL level, don’t beat yourself up.  Look into  your  family history of heart attacks and strokes and it may be that your low lab value is a familial issue.  You can’t remove the family genes but continue the lifestyle changes and discuss your concerns with your doctor or other health care professionals.  If needed, medications may be prescribed to help increase your HDL level.

In my next blog I will focus on elevated triglycerides, and what specific steps  you can take to improve it.

Signature Joanne Slyter, dietitian, Westminster, CO

 

 

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