The ideal diet for us

Here’s the lowdown on the ideal diet – read further if you want to know.. From the heart.org (http://www.theheart.org/article/1194951.do)

Mediterranean diet and metabolic syndrome

MARCH 7, 2011 | Michael O’Riordan

Athens, Greece – A diet high in monounsaturated fatty acids, fruits, vegetables, whole-grain cereals, and low-fat dairy products, coupled with fish, poultry, nuts, legumes, and a low consumption of red meat—also known as the Mediterranean diet—is associated with a lower prevalence and slower progression of metabolic syndrome, according to the results of a new meta-analysis [1].

In addition, adhering to the Mediterranean diet had favorable effects on individual components of the metabolic syndrome, including waist circumference, HDL-cholesterol and triglyceride levels, blood pressure, and glucose metabolism, report investigators.

“These results are of considerable public-health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for the primary and secondary prevention of the metabolic syndrome and its individual components,” write Christina-Maria Kastorini (Harokopio University, Athens, Greece) and colleagues in the March 15, 2011 issue of the Journal of the American College of Cardiology.

The results are from a meta-analysis of 35 clinical trials, two prospective studies, and 13 cross-sectional studies and include data on more than 500 000 study participants. Among the clinical trials and prospective studies, adherence to the Mediterranean diet was “highly protective,” report investigators, with those subjects adhering to the diet having a 31% lower risk of developing metabolic syndrome.

Two of four cross-sectional studies that looked at the relation between metabolic syndrome and the Mediterranean diet found that adherence to the diet was associated with beneficial effects on metabolic syndrome, but when all studies were combined, the protective effect of the diet did not reach statistical significance.

Data from the clinical trials also showed positive effects of the diet on the individual components of the metabolic syndrome. Overall, adherence to the diet in the 35 clinical trials was associated with a 42-cm reduction in waist circumference, a 1.17-mg/dL increase in HDL cholesterol, a 6.14-mg/dL decrease in triglyceride levels, a 2.35-mm-Hg and 1.58-mm-Hg reduction in systolic and diastolic blood pressure, respectively, and a 3.89-mg/dL reduction in glucose levels.

“The results of the present meta-analysis add to the existing knowledge, because they indicate that adherence to the Mediterranean diet has a positive effect on human health through different ways,” conclude Kastorini and colleagues. “The Mediterranean diet has a beneficial effect on abdominal obesity, lipid levels, glucose metabolism, and blood-pressure levels, all the components of the metabolic syndrome, which are also risk factors for the development of cardiovascular disease, insulin resistance, and diabetes.”


Anacetrapib {DEFINE Trial} – promising alternative to raise HDL chol and reduce LDL cholesterol

The recently released results of the DEFINE trial showed that patients taking anacetrapib, from a new class of medication (CETP inhibitors) reduced their LDL cholesterol (bad cholesterol) by approximately 40%, and raised their HDL cholesterol (good) by 140%. This trial is very promising, especially for patients who have primarily low HDL cholesterol, or those who are intolerant of the popular class of drugs called statins, like simvastatin, pravastatin, atorvastatin, or rosuvastatin. Please read further comments from the Heart.org website regarding this trial result.

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Lifestyle changes to help lower your cholesterol

From A.D.A.M.

Lifestyle Changes

The absolute mandate for improving cholesterol levels is to first make changes in lifestyle (both diet and exercise). Even when drugs are used, healthy diet and physical activity are critical companions.

HEART-HEALTHY DIETS

There are many major dietary approaches for protecting health, such as the Mediterranean diet, which emphasizes fruits, vegetables, and healthy types of fats. Doctors generally agree on the following recommendations for heart protection:

  • Choose fiber-rich food (whole grains, legumes, and nuts) as the main source of carbohydrates, along with a high intake of fruits and vegetables. Walnuts in particular have cholesterol-lowering properties and are a good source of antioxidants and alpha-linolenic acid.
  • Avoid saturated fats (found mostly in animal products) and trans fatty acids (found in hydrogenated fats and many commercial products and fast foods). Choose unsaturated fats (particularly omega-3 fatty acids found in vegetable and fish oils). For dairy products, choose low fat over high fat.
  • For proteins, choose soy protein, poultry, and fish over meat. Studies have found that soy does not help improve cholesterol. However, it is still a heart healthy food choice.
  • Fish is particularly heart protective. People who don’t or won’t eat fish can take a daily fish oil supplement. Omega-3 fatty acid fish oil supplements contain docasahexaenoic (DHA) and eicosapentaenoic (EPA) acids, which have significant benefits for the heart, particularly for lowering triglyceride levels. Fish oil supplements are also available in prescription form (Lovaza).
  • Controlling weight, quitting smoking, and exercising are essential companions of any diet program.

After embarking on any heart healthy diet, it generally takes an average of 3 – 6 months before any noticeable reduction in cholesterol occurs. However, some people see improved levels in as few as 4 weeks. An intensive program may be necessary to achieve significant improvements in cholesterol levels and to reduce heart risk factors. Continue reading


sthethoscope

Half of young adults have CHD risk factors

From Theheart.org, 22 July 2010

Atlanta, GA Approximately half of young adults have at least one cardiovascular disease risk factor, such as a family history of disease, smoking, hypertension, or obesity, according to the results of a new study [1]. An assessment of blood cholesterol levels, however, remains low in this population, and less than 50%, irrespective of cardiovascular risk status, are screened for high cholesterol levels, report researchers.

“Because the severity of atherosclerosis in young adults increases with the number of risk factors, the low screening rates, particularly among young persons with two or more risk factors, are of concern,” write lead author Dr Elena Kuklina (Centers for Disease Control, Atlanta, GA) and colleagues in the July/August 2010 issue of the Annals of Family Medicine.

The data are from an analysis of 2587 young adults—men aged 20 to 35 years and women aged 20 to 45 years—included in the 1999-2006 National Health and Nutrition Examination Surveys.

Overall, 55.2% of men and women had at least one cardiovascular disease risk factor; 17.9% had two risk factors. Of these men and women, 4.6% had CHD or a CHD risk equivalent. Regarding screening, less than 50% of people were screened for elevated cholesterol levels, although it was higher among women than men. Among those with CHD or a CHD risk equivalent, however, just 67% of young adults were screened for elevated cholesterol; 47% of adults with two or more risk factors were screened.

Among young adults, the prevalence of high cholesterol levels increased with the number of CHD risk factors—65% of those with CHD/CHD risk equivalent had high LDL-cholesterol levels, compared with 6.7% of those without any risk factors—but the screening rate was less than 50% regardless of risk status. Also, there was no statistically significant difference in screening rates among those with no risk factors and those with one or more risk factors.

“Our results indicate that improvement of risk assessment and management for cardiovascular disease among young adults through evidence-based clinical and public-health interventions is warranted,” conclude the authors.

Source

  1. Kuklina EV, Yoon PW, Keenan NL. Prevalence of coronary heart disease risk factors and screening for high cholesterol levels among young adults, United States, 1999-2006. Ann Fam Med 2010; 8:327-333. 

COMMENTARY by G. Szto:

Young adults are usually fairly unconcerned about their health. They think that they are immune to chronic health problems like coronary artery disease (CAD). Atherosclerosis (deposition of cholesterol along the linings of arteries) occurs very slowly – usually over decades. Autopsies of young American soldiers during the Vietnam war showed that they were already displaying early cholesterol streaks in their blood vessels. Blockages in arteries do not result in symptoms until they are more than 70% blocked. Hence, we hear frequently of people who were well one day, but died suddenly of a fatal heart attack. These people would have been identified, if they had gone to seek help to look for silent heart disease – to this end a Multi-slice Cardiac CT scan is of paramount importance in detecting asymptomatic coronary artery disease. In addition to simple bllod pressure checks and blood test looking at blood sugar and cholesterol, please look at my website section on Multislice Cardiac CT scanning for more information….


Excellent historical perspective on the history of statins (drugs that lower cholesterol)

I present here an excellent article about the history of how elevated cholesterol is a cause of atherosclerosis, and how statins were identified as a strategic key drug to reduce cholesterol and hence, reduce cardiovascular disease.

The statins are a key part of the cardiologist’s armamentarium to combat coronary artery disease. Several classes of new drugs are emerging to supplement statins in reducing atherosclerosis. These are undergoing clinical trials at present, and will hopefully assist patients in reducing their risk of developing heart attacks.

Click here for the article


Eprotirome further reduces cholesterol levels in statin-treated patients

From theheart.org, by Michael O’Riordan

Baltimore, MD – Adding the investigational thyroid hormone analog eprotirome (Karo Bio) to statin therapy in patients with dyslipidemia results in substantially further reductions in LDL cholesterol and other lipid and lipoprotein levels, a new study shows [1]. The improvements in the atherogenic profile occurred without adversely affecting the heart or skeletal system, two common side effects of thyroid hormone analogs, report investigators.

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