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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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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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