Cholesterol Diet

The good news is there are many lifestyle changes that will lower cholesterol and reduce the risk of heart disease and stroke.

The combination of a low-saturated-fat, total-fat, and low-cholesterol diet, physical activity, and weight control can have many positive effects on overall health.

In addition to lowering the “bad” LDL cholesterol, they can raise the “good” HDL cholesterol.

The body naturally makes cholesterol. Dietary cholesterol is found in foods that contain animal products (butter, milk, cheese, chicken, beef, eggs, etc.). Plant products do NOT contain cholesterol. There are many good things cholesterol does in the body, including:

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What Diet Is Best For You?

Dr. Nicole, what is the best diet?

The best diet is the diet that works for YOU.

The best diet is something that you can healthfully follow for the rest of your life.

The best diet for you is the diet that gives you energy, keeps your health in balance, helps you to be emotionally stable, maintains your religious or spiritual ethics and is sustainable for the environment.

With that being said, I am happy to announce that we have a variety of great diet plans to choose from and follow. If you are new to a particular diet and want some help simply leave your question or request for support in the comments section so that we may assist you with your goals.

Diets for health, wellness and weight loss:

The Whole Foods Diet

The Weight Loss Diet

The Low Glycemic Index Diet: stay feeling full longer, by eating a diet with a high “satiety index”.

Therapuetic Diets:

Allergy Elimination Diet

Anti-inflammatory Diet

Blood Pressure Lowering Diet and Helpful Tips for Reducing Sodium

Candida Diet

Cholesterol Lowering Diet

Diabetes Diet

Detox Diet

The Diet for Depression

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Best Chewable Fiber 2008

The best fiber sources obviously come from whole food dietary sources.

However, occasionally we need a little something something to “cheat the system” and this is my favorite weight loss trick, as I have mentioned the importance of utilizing fiber for satiety and stable blood sugar in my “Favorite Weight Loss Diet of 2008″.

You should never take fiber with your vitamins or minerals as it will absorb them and defeat the purpose, however, two of these chewable fiber pills pack 4 grams of the needed 25 grams (if not more!) of recommended daily fiber. Don’t forget to take these chewable fiber pills with an eight ounce glass of water, as we never take fiber without water.

Fiber is therapeutic for those with diabetes, high cholesterol, hypoglycemia, in need of losing weight, and detoxing or in need of liver support. Fiber binds with cholesterol and toxins in the bowel and prevents the cholesterol and toxins from recirculating into our blood stream as I explained in my natural cholesterol lowering plan. Instead we eliminate the toxins and cholesterol out.

No, these chewable fibers aren’t as delicious as candy but they do satisfy the sweet tooth and come in both vanilla and chocolate Even better, they are not a psyllium based fiber, as many people do not tolerate psyllium (found in Metamucil) very well, and it can make them extremely gassy or constipated.

Most Americans only get about 9 grams of fiber each day, according to the latest studies. If you want to increase the “satiety index” (the amount of time you feel satisfied before you get hungry again) of your meal or snack and decrease the “glycemic load” as I recommend for weight loss, diabetes, and anti-aging simply have a few of these fiber pills with your meal!

I also have a few fiber pills when I am stuck in that inevitable bad eating situation, and fiber at the very least helps to mop up excess saturated fat that we consume, or when I am out running errands and want to make it home to eat instead of eating out.

I buy a bunch of these bottles and stash them everywhere: in my car, in my purse, by the fridge, etc. An ounce of weight loss prevention is worth a pound of cure and fiber is a fantastic way to manage hunger.

Between meals these fiber pills can be used as a little sweet snack. Remember they are not free of calories, and two tablets have 25 calories, but they are free of a lot of the other typical refined garbage that goes in to supplements.

Of course my purest friend Dr. Ben would recommend chewing on chia seeds as the best chewable fiber, but sometimes I just need a little something sweet to get me through the rough patches and prevent me from grabbing some McInflammation in a mad hungry hypoglycemic rage.

The Enzymatic Therapy line was established by naturopathic physician Dr. Michael Murray and is a great widely available trusted supplement brand.

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Chocolate Chips Better than Viagra?

Are chocolate chips better than Viagra? According to Journal of Nutrition’s latest September and October issues, chocolate has some pretty exciting therapeutic potential.

If you want to avoid being on “the little blue pill” you should consider taking a daily dose of the little brown pill.

That’s right—50-200 chocolate chips a day may prevent the cardiovascular damage that is a leading cause of erectile dysfunction. ¹

According to recent studies, the flavonoids in dark chocolate naturally enhanced natural nitric oxide levels. The drug Viagra works mechanistically as a phosphodiesterase inhibtor to enhance nitric oxide. Our bodies also synthesize nitric oxide, and nitric oxide works on our blood vessels to dilate them and increase blood flow. With psychogenic etiologies ruled out, erectile dysfunction is typically an issue of blood flow. Increasing blood flow is how Viagra manufacturers have made a fortune.

In September of 2008, Journal of Nutrition published an Italian university study investigating the therapeutic potential of chocolate and found that, “Flavanols from chocolate appear to increase nitric oxide bioavailability, protect vascular endothelium, and decrease cardiovascular disease (CVD) risk factors….our findings suggest flavanol-rich, low-energy cocoa food products may have a positive impact on [cardiovascular disease] risk factors.”

Now as a women’s health physician, I typically avoid topics such as erectile dysfunction like the plague, so I am going to drop my men’s health commentary today and then run for dear life… Working as a family practice medical assistant for eight years throughout medical school taught me an important early lesson about men’s health. Most men simply DON’T care about cholesterol, blood pressure, atherosclerosis, diabetes, blood sugar, antioxidants or inflammation.

The second you start to nag about this stuff their eyes just glaze over. You can nag and nag and nag about cholesterol and blood sugar lab values, and still no changes will be implemented.

Eventually I realized the secret to men’s health while working as a urology assistant, the only way to get men to care about their health is to hit them below the belt with the facts that matter. Women are typically all about vanity and men are all about virility. These are the motivators I rely on to market and sell my preventive medicine concepts.

Doctors know that all of the aforementioned health issues contribute to erectile dysfunction. But, what most men don’t know is that without a properly functioning cardiovascular system, things below the belt aren’t going to function either.

It’s all about blood flow and elasticity. We would never leave our garden hoses to freeze out in the cold of winter, we instead take the time to properly care for them to insure they don’t harden and become permanently dysfunctional. Although garden hoses cannot auto-repair, our arteries do by making scar tissue, and the similar type of destruction from high blood pressure, cholesterol, inflammation, and diabetes is repaired by the body by throwing down scar tissue and inflammation.

The more scar tissue and inflammation in your arteries the less elastic they are, and thus the narrower their diameter. Blood pressure just continues to escalate and the damage to your arteries continues in a vicious cycle. Viagra and similar medications such as Levitra and Cialis all work to enhance blood flow.

They are designed to promote the elasticity of those frozen old er…stiff garden hoses. Viagra is a phosphodiasterase inhibitor which increases levels of nitric oxide. Nitric oxide causes our blood vessels to EXPAND. Eventually arteries become damaged and hardened to the point where they will no longer respond to nitric oxide. Keep in mind though that a “garden hose” left out in extreme harsh “winter conditions” will inevitably lose it’s elasticity, and the hose will have to be replaced. How many “winters” have you left your body out in the cold, not caring about diabetes, blood pressure, cholesterol, and inflammation? This is why many men with erectile dysfunction don’t find benefit from Viagra. Blood vessel expansion is the premise of which Viagra has made millions.

I am going to instead give away my natural medicine tips for free, and if the Toll House Chocolate Chip Company wants to send me a billion dollar thank you check, they are more than welcome. What is more important to me is that TODAY you feel inspired and motivated to prevent problems that will inevitably occur down the road TOMORROW.

“An ounce of prevention is worth a pound of cure”—right?

If you don’t have erectile dysfunction now wouldn’t you like to prevent it from happening? Medicine’s used to treat ED are expensive, have multiple side effects and drug interactions, and are not as well tolerated as the commercials on television make them out to be.

When I worked as a Urology assistant the main complaint was always headaches and that “it just didn’t work”. Well after a while when disease has advanced too far, no medication will be able to work. Think back to the garden hose example. You want your arteries to be elastic and healthy, not hardened from the “harsh winter conditions” of sub-optimally controlled high blood pressure, diabetes, and cholesterol.

So why chocolate chips?

Well chocolate chips are fantastic prevention because they are DARK chocolate and the darker the chocolate the more nitric oxide enhancing flavonoids.

A study was done on Italian men and found that Italian men that ate an ounce of dark chocolate had healthier lab markers.

Keep in mind that 50 chocolate chips or roughly an ounce of dark chocolate is the minimum amount needed to prevent disease according to that study.

I weighed them out and found that 48 chocoalte chips= 1oz. But you have my permission to throw in two extra chips for preventive measure!

Another study cited previously, showed therapeutic benefit with 100 grams of dark chocolate which is about 200 chocolate chips! Is this not the best news ever for chocolate lovers?

Remember though that chocolate as a medicine is not free of calories, cocoa butter, or refined sugar. Pure cocoa products are a great alternative as an ounce of chocolate chips have 140 calories. While 200 chocolate chips pack a whopping 500 calories!

But, for those of you that are already eating too much sugar and saturated fat, chocolate chips are a fantastic way to transition to a healthier dessert diet. I know most of you are probably eating fattening desserts anyways (I mean we do have to enjoy life a little bit right?) so dark chocolate chips are a healthier alternative and I like that they conveniently come in little bits that can be savored throughout the day.

But, chocolate chips are not the only foods that contain disease fighting flavonoids. So here is the bait and switch. Most fruits and vegetables are also rich in flavonoids.

Berries are chock full of proanthocyanins, citrus is a fantastic source of hesperidin and rutin, and onions are an excellent source of quercetin. Fruits and vegetables are likely going to prevent the need of Viagra too!

Yes–really this is just a giant strategically planned nag on my part to inspire the consumption of more whole foods, especially those rich in flavonoids. And yes it really was too easy to grab your attention with chocolate chips and Viagra and then turn this in to a fruit and veggie nag. But, my point with this “gotcha” is that preventing disease is where it is at when it comes to ED. Winter is coming, and it is time to think about your preventative plan for your “garden hose.”

A healthy dose of fresh fruits, raw or lightly steamed veggies, raw nuts and seeds, and chocolate will work synergistically to prevent the cardiovascular damage that causes disease.

I think any man suffering with ED reading this article would absolutely agree that an ounce of prevention is worth a pound of cure.

For diabetics that want to gain the flavanol benefits of chocolate chips, simply enjoy them with a small handful of raw almonds to decrease the glycemic load and increase phenolic compounds (anti-oxidant/anti-inflammatory/anti-cancer). Almonds are also high in fiber, and fiber consumption also is protective to the cardiovascular system. So add about ten raw almonds to your 50 chocolate chips or make a healthy trail mix with your other favorite raw nuts and seeds.

I don’t want to leave women out of this nag, so chocolate chips are good news for women too as Dr. Christiane Northrup in her latest book “The Secret Pleasures of Menopause” also emphasizes the importance of naturally enhancing nitric oxide levels through diet and lifestyle to improve sexual function. Grab the book through Amazon, if you care to learn more about ways to naturally enhance nitric oxide.

Those in need of losing weight should also benefit from this simple chocolate chip tip as eating a few chocolate bits throughout the day should help you feel satisfied for sweets and prevent those binges brought on by extreme deprivation and yo-yo dieting that sets the stage for binge eating.

Stick with me, subscribe to my feed, and I will teach you how to be healthy & enjoy life.

Dr. Nicole Sundene

Want more tips for preventing and treating erectile dysfunction through diet and lifestyle?

Try: Exercise, The Low Glycemic Index Diet, The Anti-Inflammatory Diet, Kegels for Men, Cholesterol Lowering Diet, Hypertension, Low Sodium Diet, Antioxidants, Anti-Inflammatory Diet and subscribe to my feed as we discuss the therapeutic potential of other healing foods and natural supplements for cardiovascular health and erectile dysfunction.

References

1. Grassi D, Desideri G, Necozione S, et al. “Chocolate and Blood Pressure” J Nutr. 2008 Sep;138(9):1671-6.

2. Romina di Giuseppe, Augusto Di Castelnuovo, et al. “Italian Men that eat Dark Chocolate are Healthier” J. Nutr. 138:1939-1945, October 2008

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Fish Oil vs Flax Oil? The Great Debate

One of the greatest flaws in the Standard American Diet (SAD) is a lack of omega-3 fatty acids.

Repleting this deficiency typically improves memory and mental functioning as well as corrects a gamut of other annoying health problems.

The reason for this is that these essential oils are necessary for proper brain functioning, immune function, hormonal balance and skin integrity as they are the necessary building blocks for the cellular membrane of every single cell in our body. Wow just ONE thing for all SIXTY TRILLION cells in your body!

This must be pretty important then… Read more

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Anti-Inflammatory Diet

Who should be on the anti-inflammatory diet?  Well– just about everyone!

Anyone with arthritis, chronic pain, chronic disease, cancer, cardiovascular disease such as high cholesterol and high blood pressure, autoimmune conditions such as rheumatoid arthritis, lupus, or sjogrens, as well as those looking to slow the aging process and disease prevention will benefit from an anti-inflammatory eating plan. Eating healthy is the gift that keeps on giving!

My first day in Human Pathology class back in med school I learned about how inflammation led to cellular destruction and that cellular destruction was ultimately the root cause of disease. Little did I know at the time that it was just about everything I needed to know for treating disease. Many years later, as I watch most chronic disease clear up if not vastly improve just from the implementation of the anti-inflammatory diet, I am consistently reminded of the importance of treating the inflammatory load in the body.

To understand the detriments of inflammation on a cellular level, imagine that your body is a factory.

Now let’s pretend that the cells that make up all your tissues are simply the product of an assembly line in this factory. The factory is required to produce a certain quantity of functional cells every day, regardless if cells are destroyed or made improperly. Every time the factory loses cells, or makes dysfunctional cells, the assembly line will then need to speed up that much more in order to achieve that day’s production quota.

I’m sure you can quickly see that the faster the line speeds up the more room for error there then becomes.As the line speeds up to max capacity quality goes down and quantity of error goes up.

In order to manage the “factories” called our bodies properly we must learn how to keep the assembly line running at a nice steady consistent virtually error free rate.

So what causes these errors?

Arachidonic acid is the biochemical “mother of all evil” when discussing inflammation.

Most pharmaceutical medications as well as anti-inflammatory herbs work to inhibit the enzymes like cycloxygenase and lipoxygenase that convert this bad fat in to the inflammatory products that cause us pain, destroy our joints, and ultimately make us sick. Most physicians heavily rely on anti-inflammatory meds like “COX Inhibitors” also known as “NSAIDS” that are either prescription or over the counter pain relievers for treating a myriad of complaints. COX just stands for cycloxygenase. COX is the enzyme that converts arachidonic acid in to inflammatory products that cause us pain or make us sick.

Why depend on taking a daily drug to reduce inflammation when you can simply achieve the most of it through diet?

Arachidonic acid (AA) is the fat found primarily in animal fats. The body can still produce AA on it’s own from vegetable fats in the event that we do need some inflammation to help the healing and remodeling process that is necessary for short term illness and injury. However the body tends to REALLY overshoot when it comes to inflammation.Anyone that has had some very painful swelling from an injury can understand how unnecessary most of the inflammatory response actually is. When dealing with chronic inflammation however, we need to do the best that we can to tone down this overshooting of the inflammatory response.

Fried foods are just like throwing gasoline on the inflammatory fire.

The unstable molecules in the fried foods just contribute to the chaos.

• The best thing you can do for your long term health is to get fried foods out of your diet. Do not use butter or margarine.
• Please never use shortening!
• Olive oil should be used at all times unless cooking over 350F which then cold pressed canola or rapeseed oil should be used.
• Flax seed oil should not ever be used for cooking due to it’s low smoking point, but can be used as salad dressing, or drizzled over steamed veggies for a nutty flavor.

The other most important step is to reduce if not eliminate animal fat consumption. This is why many people do well on a vegan diet (no animal products at all). You should check with your doctor to determine if a vegan diet is the right choice for you, as it is not the easiest to follow and may not be recommended for your particular body type and metabolism. At the very least you can eliminate red meat from your diet, all processed meats like hot dogs and sausages should absolutely be avoided as the nitrates in them particularly increase inflammation, as well as the ridiculously high fat content. Eggs have a high AA content and thus are best to be avoided or consumed in moderation.

Remember: Animal fat=Inflammation.

Eat lean poultry, fish, and plenty of wild Alaskan salmon.www.ewg.org to find a list of low mercury content fish that are not endangered. Fat free organic dairy products may also be acceptable for those without severe disease.

Although consuming omega 3 fats in the form of Alaskan salmon is most optimal, I understand it is not always practical.Those with severe inflammation will benefit from adding cod liver oil or fish oil in to their diet. Check with your naturopathic doctor to determine the dose that is appropriate for you. Those with bleeding disorders and on anti-coagulant medications should not take fish oil. The reason that fish oil is so anti-inflammatory is that it competes with arachidonic acid for the same enzymes to produce opposing products.In the presence of fish oil, arachidonic acid has less raw materials to produce inflammatory products. The average daily dose of fish oil is about 1tsp to 1 tbl daily. Be sure to take it with food. I like the lemon flavored cod liver oil by Carlson in the green bottle. It can be found at any health food store.

Other substances in the diet aside from arachidonic acid can also lead to inflammation.Anytime you have food allergies or intolerances, you will have an increased level of inflammation in your body as your immune system is forced to work overtime.You can do an ALLERGY ELIMINATION DIET to determine which foods you are most sensitive to.Most patients are triggered by a favorite food. Not typically what anyone ever wants to hear, but that is why I get paid the big bucks to be the bad guy. Aside from favorite foods top inflammation offenders are: Wheat, dairy, soy, citrus, peanuts/nuts, corn, chocolate, alcohol, caffeinated beverages, bananas, and beef.

Now at this point after I recite such a list most patients will look at me and say “But Doc that is my entire diet!” which then I will be forced to respond “Well no wonder you are so sick…”It may seem tough at first, but giving up foods that make us sick means giving up disease, and ultimately being healthy is what makes us the most happy and productive. Nothing should be more important to you than your health.Especially not a silly little food! If you are having a difficult time with these changes, and demonstrating to yourself this level of care and self love, please work with a therapist to sort out the issues surrounding making the necessary health improvements.

Some patients will notice a marked improvement in their arthritis by avoiding the night shade family, some will not.

The “night shade” family is comprised of potatoes, eggplant, tomatoes, and peppers.The chemical solanine is thought to specifically cause pain in some individuals although it is not specifically researched.

You can try a 2 week elimination of the nightshade family with a re-introduction challenge as explained on the ALLERGY ELIMINATION DIET page and see if these foods are problematic or not. You will simply need to play around with all these foods that typically cause allergies and irritations and figure out which if any are causing you trouble. Typically after a week you should notice a marked improvement without that food in your diet, more severe disease may require two to three weeks without the food. Children respond faster and will typically resolve in 3 to 4 days.

Reducing sugar consumption is also key to reducing the inflammatory load.

Sugar basically “rusts” our system. Sugars in our system get stuck to healthy cells and basically “tags” them for destruction.A process called “glycosylation”.To prevent this inflammatory/aging process start with eliminating all white refined sugars and flour products like white breads, bagels, white rice, and other “evil white foods” from your diet.Find substitutes whenever possible, and enjoy your favorites judiciously. Follow the LOW GLYCEMIC INDEX DIET and learn how to appropriately pair high protein and high fiber foods with your carbohydrates to reduce the total glycemic load, which will stop your system from prematurely “rusting”.

Learn to eat more cleanly by adopting a WHOLE FOODS DIET.

Getting processed foods out of your diet is extremely important.So now that we have discussed the bad stuff in the diet that needs to go, let’s talk about the good foods that should be eaten liberally. Certain foods have magical anti-inflammatory properties. The more you can learn to use foods as medicine, the less medication you should inevitably be required to take.

Foods as medicine are great for people that already are on medications as they are less likely to have negative interactions than herbs and other natural supplements.

Please however always check with your doctor before making any changes to your health care routine.

My favorite anti-inflammatory food is BLUEBERRIES

I prescribe one cup of frozen blueberries daily to all my patients with inflammation, heart disease, or diabetes. Most people are happy to add such a delicious food in to their diet, but occasionally I will have a patient balk at the cost of eating so many blueberries each month.If you are already taking medications or other supplements, you are clearly paying quite a bit for your health already so adding a superfood in like blueberries is well worth the $30 a month. You could buy a bottle of some herbal product for that same price, or you could just enjoy eating blueberries.

• Blueberries are highly anti-inflammatory and their proanthocyanin behavior is fundamentally protective to our cardiovascular system.
• In my opinion there is not a more delicious, advantageous way to improve your health than by eating a cup of frozen blueberries a day.
• I like to enjoy them as an evening snack, and let them sit out and thaw about 20 minutes before eating.
• You can also add them to smoothies or your morning cereal.
• Cooking them does not destroy their important pigments, and the freezing process actually makes these proanthocyanins more bioavailable for absorption. A rare exception to the rule that fresh is best!

Green leafy vegetables should also become your new best friend as they are an important anti-inflammatory and anti-oxidant food.

Greens are chock full of magnesium a nutrient that most of us are typically deficient in anyways, eating as many servings of green vegetables daily as possible will serve you well. A diet of brown rice, vegetables, lean meats, non-citrus fruits, water and green tea is the ultimate goal to work towards.And honestly, it is the basis of nearly every “therapeutic diet” that we prescribe for just about every disease out there. No wonder treating inflammation is so fundamentally important!

If you add in some turmeric (found in curry spice), ginger, and green tea you should do really well with reducing your total inflammatory load.

Turmeric is a natural COX2 inhibitor and is a better anti-oxidant than vitamin E. Ginger is highly anti-inflammatory as it inhibits phosopholipase which then has the dual effect of inhibiting both COX and lipoxygenase .The catechins in green tea are shown to be anti-oxidant and inflammatory modulating. These can be enjoyed as foods or taken in supplements. Again if you are on any medications please check with your physician before using any herbs or making any changes to your health care routine.

Last but certainly not least is my plug on addressing your emotional state.

Toxic emotions such as anger, depression, and excessive worry or anxiety can lead the body out of balance. A new exciting research field on the forefront is “Psychoneuroimmunology” this is the study of how our emotional state affects our nervous system and how that in turn affects our immune system.The immune system is largely responsible for most inflammation.Having a positive mind set and letting go of past issues is as important as diet in experiencing optimal wellness!

So that is my simple anti-inflammatory formula for success.

Follow the recommendations in order systematically making one change at a time, or start with the changes that will be the most simple for you to build up your confidence and energy to deal with some of the tougher ones. If you are doing all of that and still noticing symptoms after some marked improvement you should continue to work with your Naturopathic Physician or other healthcare provider to determine what other dietary modifications or alternative medicines will benefit you.

Please do drop me a comment if you have any questions!

~Dr. Nicole Sundene
Naturopathic Physician
www.KitchenTableMedicine.com

REFERENCES

“Biochemistry” Fifth Edition by Berg, Tymockzko, and Stryer. “Herbal Medicine: From the Heart of the Earth” by Sharol Tilgner, N.D. “Medical Herbalism” by David HoffmanEastwood MA. Interaction of dietary antioxidants in vivo: how fruit and vegetables prevent disease. QJM 1000;92(9):527-530 Hidaka H, Ishiko T, Furuhashi T, et al. Curcumin inhibits interleukin 8 production and enhances interleukin 8 receptor expression on the cell surface: impact on human pancreatic carcinoma cell growth by autocrine regulation. Cancer. 2002;95(6):1206-1214John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomized controlled trial. Lancet. 2002;359(9322):1969-1974. Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. AM J Clin Nutr. 2000;71:348-351.McDougall J, Bruce B, Spiller G, et al. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002;8(1):71-75Seaman DR. The diet induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-179.Stark AH, Madar Z. Olive Oil as a functional food: epidemiology and nutritional approaches. Nutr Rev. 2002;60(6): 170-176. Kawachi I, Sparrow D, Spiro A III, et al. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation 1996;94(9):2090-2095Kawachi I, Sparrow D, Vokonas PS, et al. Symptoms of anxiety and risk of coronary heart disease. The normative aging study. Circulation 1994;90:2225-2229. Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality: new perspectives from psychoneruoimmunology. Annu Rev Pschol. 2002;53:83-107

A user friendly book I recommend on this topic is “The Inflammation Cure” by William Joel Meggs, M.D., Ph.D. if you would like to read more on the biochemistry of what I have discussed here.

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Pomegranate Juice and Heart Disease

So, I had basically banned juice in our house for years either because of its high-fructose corn syrup content or because it is always a better idea to just drink water and eat a piece of fruit.

However, this has changed recently in regard to one particular fruit: the pomegranate. The pomegranate, when transformed into juice, does some amazing things for the body, and in particular, the cardiovascular system.

First and foremost it has been shown to lower blood pressure, and inhibit the formation of plaque along artery walls (aka atherosclerosis). Not only has it been shown to inhibit new plaque formation, but it also can reverse the atherosclerosis that has already occurred!

This last result is pretty amazing. The study was done in Israel and involved ten patients taking 50 mL of pomegranate juice every day for a year, after which a doppler ultrasound of the carotid artery showed up to a 30% decrease in the thickness of the artery. Patients who did not take the pomegranate juice showed a 9% increase in the thickness of their carotid arteries. Read more

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How to Naturally Lower Cholesterol

So you may have just received the bad news from your doctor that your “cholesterol is high” and that “you need to start a diet to lower your cholesterol”

Ugh!!! What to do?

This diet most likely excludes many of your favorite foods….meat and fried foods to say the least!!

Before we get started, let’s talk about why we even care about this thing called cholesterol…

High cholesterol levels over time deposit in the linings of your arteries and cause a condition known as “atherosclerosis” or hardening of the arteries. Hard arteries cause high blood pressure. Remember when you were a child and you would stick your thumb over the hose and watch how much further you can make the water shoot? Well this same principal is what causes your blood pressure to elevate from clogged arteries. The plaques that form can also be of concern as they can break off and close down blood supply to the heart or the brain and cause a “heart attack” or “stroke” respectively.

So, in the long term we are primarily concerned about this “high cholesterol” turning in to high blood pressure, heart attacks, stroke, erectile dysfunction, and other not so fun things.

Cholesterol levels become high as a result of increased dietary intake, or increased production in the liver. What your doctor is mostly concerned about is what is referred to as the “bad cholesterol” or “LDL cholesterol”. Contrary to popular belief, LDL is not actually a cholesterol, it is a protein that transports cholesterol molecules to be deposited in the arteries.

Yikes!!! No wonder this LDL thing is so bad!!!

So we want to decrease this LDL cholesterol while increasing the “good cholesterol” also known as the “HDL cholesterol”. HDL sucks up cholesterol from the arteries and brings it back to the liver for recycling. Hooray!! The more of this HDL cholesterol the better, right?

Aside from medications or natural supplements that should be instigated and monitored by your doctor there are several things that can be done on your own to improve this LDL/HDL ratio.

First of all we want as many molecules of HDL cholesterol out there sucking up cholesterol from the arteries as possible. Guess what the best way to do that is?

Exercise is the best known way to increase your HDL levels.

Please check with your doctor and insure that you are healthy enough to start a new exercise routine.

Aside from exercise we obviously need to follow a low cholesterol diet to reduce the amount of intake from foods.

A great way to reduce the amount of cholesterol that is already circulating through our system is through a high fiber diet.

Fiber sucks up cholesterol like a sponge. When we eat, the liver secretes cholesterol rich bile in to the intestine to help break down our food, this bile will get re-absorbed back to the liver through a process known as “Entero-hepatic circulation”.

One way to circumvent this process is to eat tons of fiber to bind the bile and thus cholesterol and other toxins so that they can be eliminated properly from the body and not re-absorbed.

Fiber is fabulous because it will not only lower your cholesterol levels but it is the best thing you can do to detox your system.

Be sure to drink plenty of water when increasing your fiber levels.

Be sure to also increase your fiber levels gradually.

The final key component that I will discuss to get you started on your cholesterol lowering program is the use of antioxidants.

Vitamins and nutrients found in fresh fruits and vegetables such as vitamin C are very important anti-oxidants for the reduction of cardiovascular disease that develops from high cholesterol levels. The free radicals in fried foods for instance help create the “Glue” for holding these plaques of cholesterol down. An anti-oxidant such as vitamin C destroys the shark like free radical molecules wreaking havoc in your bloodstream.

By reducing the amount of cholesterol that is allowed to be glued down to your arteries you are reducing the long term consequences of cardiovascular disease and other complications that typically result from high cholesterol.
A high fiber low cholesterol diet rich in anti-oxidants as well as exercise are the key to any cholesterol lowering program, if you are overwhelmed by making these changes all at once, simply pick one thing to work on at a time. Working hard on these foundations to a cholesterol lowering program should prevent having to increase your medication levels whether prescription or alternative in the future.

“Inch by inch is a cinch. Yard by yard is hard.”

Author: Dr. Nicole Sundene, Naturopathic Physician

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Coenzyme Q10

Coenzyme Q10 or “CoQ10”, also known as ubiquinone, is an anti-oxidant that is essential for mitochondrial energy production and may play a role in cellular defense against oxidative damage.

A growing body of research shows that using a coenzyme Q10 supplement alone or in combination with other therapies may be beneficial in the treatment of several health problems, including cardiac conditions and diseases, high blood pressure, high cholesterol, breast cancer, diabetes mellitus, immune deficiency, muscular dystrophy, and periodontal disease.

Dietary Sources
Most coenzyme Q10 is believed to be synthesized inside the body. Normal dietary intake is minimal, though primary food sources include oily fish, organ meats (such as liver), nuts, and whole grains.

Supplementation with higher doses of CoQ10 can be helpful in individuals with certain health conditions, and in the elderly, because levels can decline with advancing age. If taken as a supplement, coenzyme Q10 should be taken with a meal containing fat or oil since it is fat-soluble. The body does not absorb it as well in the absence of oil.

Consult your physician for specific recommendations CoQ10 supplementation.

Precautions
Coenzyme Q10 appears to be safe with no significant side effects. However, the safety of supplementation during pregnancy and breast-feeding is unknown.

Possible Interactions
Certain medications such as Adriamycin, lovastatin and other HMG CoA-reductase inhibitors, gemfibrozil, beta-blockers, tricyclic antidepressants, and phenothiazine may deplete the body of coenzyme Q10.

Resources
1. Combs, G.F., The Vitamins: Fundamental Aspects in Nutrition and Health. 2nd ed. 1998, San Diego, Calif.: Academic Press. xxii, 618.
2. Gaby, A.R. and J. Wright, Nutritional Therapy in Medical Practice. 2001, Seattle, WA: Nutrition Seminars.
3. MD Consult, Patient Handouts. 2002, http://www.mdconsult.com.

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The Mediterranean Diet

This diet is based on the diet typically consumed on the island of Crete that is high in omega-3 essential fatty acids, monounsaturated and polyunsaturated fats, healthy protein sources (fish, legumes, etc.) and complex carbohydrates. Fat calories account for 35-45% of total calories.

Omega-3 essential fatty acids have the potential to block and prevent all of the steps of the genesis and evolution of heart disease and heart attack: damage to the arterial wall, inflammation, plaque formation via oxidized LDL cholesterol, plaque accumulation, final blockage of the coronary artery and arrhythmia.

They will also assist in reversing the process that may already be advanced.(1)

Clinically speaking, this amounts to lowering blood levels of total and LDL cholesterol and triglycerides, maintaining or raising blood HDL cholesterol levels, improving blood insulin and glucose levels and decreasing blood pressure. Proof of the diet’s efficacy comes from two main studies: the Lyon Diet Heart Study and the Diet and Reinfarction Trial (DART). (2, 3)

In the 1989 DART study in England, two thousand men who were recovering from recent heart attacks were assigned to one of three quite different diets:

1. High fiber
2. Low saturated fat and high in omega-6 oils (standard heart diet)
3. A diet high in omega-3 fatty acids from fatty fish or supplements.

The patients on the high omega-3 fatty acids diet had a 29% lower death rate, which at the time was the greatest reduction in mortality from any heart diet.(4)

In a study of heart attack patients, those on the Mediterranean diet had a 76% lower risk for major cardiovascular events (subsequent heart attack, unstable angina and stroke) compared to a similar group of heart attack patients on a standard American diet.(5)

Concerns regarding the Mediterranean diet are the extra calories from the high olive oil intake, decreased iron and decreased calcium because of decreased dairy intake. Cooking in cast iron pans, consuming foods high in iron, calcium and Vitamin C or supplementing these nutrients will avoid these deficiencies.(6)

Note: The following dietary guidelines may include foods to which some individuals may have allergies, sensitivities or intolerances and in those cases those foods should be avoided. Dietary choices should be made according to your own individual needs.

Consult your physician for nutritional information pertaining to your specific medical condition(s). In the case of patients with heart disease, your naturopathic team will design a comprehensive treatment protocol that will likely include diet, exercise, stress management, supplements and other modalities.

DIETARY GUIDELINES FOR THE MEDITERRANEAN (OMEGA) DIET

• Eat foods rich in omega-3 fatty acids such as fatty fish (salmon, tuna, trout, herring, mackerel), walnuts, canola oil, flaxseeds and green leafy vegetables. Omega-3 fatty acids can also be supplemented.
• Use olive oil and canola oil as your primary fat sources.
• Eat seven or more servings of fresh vegetables and fruits daily.
• For protein sources, rely on fish and vegetable protein including legumes, beans, peas and nuts.
• Avoid saturated fat by choosing lean meat over fatty meat. Eat red meat only a few times a month, if at all.
• Choose nonfat or low fat over full-fat dairy products.
• Avoid oils that are high in omega-6 fatty acids including corn, safflower, sunflower, soybean and cottonseed oils.
• Minimize your intake of trans-fats by avoiding margarine, vegetable shortening, commercial pastries, deep fat fried foods and most prepared snacks, mixes and convenience food.
• Season with garlic, onions, herbs.
• Focus on high fiber from whole fruits, vegetables and whole grains.
• Enjoy a glass of red wine occasionally.

Resources
1. Simopoulos, Artemis P. MD and Robinson, Jo. The Omega Diet: The Lifesaving Nutritional Program Based on the Diet of the Island of Crete. 1999. HarperCollins, NY.
2. Renaud S and Paul T. “Cretan Mediterranean diet for prevention of coronary heart disease.” Am J Clin Nutr, 1995; 61 (supp) 1360S-7S.
3. Burr ML, Gilbert JF and Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial infarction: Diet and Reinfarction Trial (DART). The Lancet, 1989. September 30, 1989: 757-761.

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Guide to Fats & Oils

Fats & oils are made from building blocks of fatty acids. Fatty acids affect health in different ways.

Essential Fatty Acids (EFAs) have healing properties that are crucial for maintaining health. There are two types of EFAs: omega 3 and omega 6 fatty acids. Fatty acids like the omega 3 family promote normal cell growth and function, thus helping to maintain healthy tissues and prevent degenerative disease. To maintain overall health, it is a good idea to keep the dietary intake of omega-3 and omega-6 fatty acids in balance. This means consuming approximately 10 times more omega-6 than omega-3 fatty acids. To achieve more of a healthy balance select nutrient-dense, whole-foods high in omega 3 fats.

Monounsaturated oils are liquid at room temperature but start to solidify at refrigerator temperatures. They easily combine with oxygen in the air to become rancid; therefore it is best to store them in the refrigerator. When substituted for saturated fats in the diet, monounsaturated fats may help to reduce overall cholesterol levels.

Polyunsaturated oils or omega 6 fatty acids are liquid at room temperature and in the refrigerator. These fats are essential for health, but excessive amounts may promote inflammatory disease, cardiovascular disease, or cancer.

Saturated fats and trans-fats are the main dietary factors for raising blood cholesterol.

Saturated fats are usually solid at room temperature. When consumed in excess, foods high in saturated fat can promote inflammatory disease, cardiovascular disease, and cancer.

Hydrogenated fats & oils, and trans fats are a result of food manufacturing. During food processing fats may undergo a chemical process called hydrogenation that results in the formation of trans-fats. This process changes liquid oil, naturally high in unsaturated fatty acids, to a solid and more saturated form that may be as harmful to health as naturally occurring saturated fats. Many commercial products contain hydrogenated or partially hydrogenated vegetable oils – read ingredient labels on products to avoid consuming these harmful oils. Also, be aware that most restaurants and fast-food chains use hydrogenated oils in the making of fried foods.

Tips to Reduce Saturated Fat Intake:
• Limit foods high in saturated fat, trans-fat and/or cholesterol, such as full-fat milk products, fatty meats, tropical oils, partially hydrogenated vegetable oils and egg yolks.
• When consuming meat, use lean cuts and trim excess fat. Remember, lean cuts of meat still contain saturated fat even after trimming the excess. Limit portions to 3 ounces.
• Avoid consuming the skin of game birds (it is a high source of saturated fat).
• Use a fat separator (strainer) when making gravies or soup stock.
• Avoid frying or fried foods. When exposed to high heat during frying or cooking, most vegetable oils can form toxic products that can promote cell injury

Helpful Tips:
• Eat a variety of fruits and vegetables. Choose 5 or more servings per day.
• Eat a variety of whole grain products. Choose 6 or more servings per day.
• Eat fish at least twice a week, particularly fatty fish.
• Include fat-free and low-fat milk products, beans, and skinless poultry and lean meats.
• Choose fats and oils with 2 grams or less saturated fat per tablespoon, such as canola, corn, safflower, soybean and olive oils.
• Avoid processed food products that contain hydrogenated or partially hydrogenated oils in the list of ingredients.
• Avoid the use of hydrogenated shortenings. Choose those made from vegetable fat such as corn oil or canola oil.
• Use reduced-fat or no-fat dressings for salads, dips and marinades.
• Remember to count the “hidden fat” in bakery and snack foods as well as the fats used in cooking and on vegetables and breads.
• Remember that coconut oil, palm oil and palm kernel oil are high in saturated fat, even though they are vegetable oils and have no cholesterol.
• Use cooking styles that add little or no fat to food, and ask to have foods cooked that way when eating out.
• Read ingredient lists and food labels carefully. Pay attention to serving sizes.

Recipe Ideas:
• Substitute fish, vegetable or fat free chicken stock for part or all of the oil in a recipe.
• Onions sautéed in their own juice and pureed with light miso can be substituted for butter or margarine on toast or bread.
• A very loose oatmeal puree (1 c of rolled oats to 4 c of water) can be substituted for milk or cream in cream soup or gravy recipes.
• 2 egg whites can be substituted for each whole egg called for in a recipe.
• Use fats and oils sparingly. And use the ones lowest in saturated fat and cholesterol for cooking, baking and in spreads.
• Broil, bake, boil, or water sauté foods instead of frying. If frying, use minimal amounts of olive or canola oil. To water sauté instead of stir frying in oil, put 1/2 to 1 cup of water or stock into a wok or skillet, and bring to a rapid boil. Quickly add vegetables and keep stirring over high heat until done.
• Try “better butter” in place of butter. Use sparingly; it still contains saturated fat.

Better Butter Recipe:
Blend 1/4 cup of softened (or warmed) butter with
1/8 to 1/4 cup of oil such as olive, canola, sunflower, safflower, or almond oil
Spice up “better butter” by adding any spice of your choice: fresh garlic, hot chili pepper, tarragon, sage, rosemary, thyme, lemon, honey, vanilla, or bitter orange oil

source: http://www.americanheart.org

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Dietary Fat Balance

Decrease the consumption of total fat
• Saturated fat, in particular, gets converted to cholesterol and adds to blood levels.
• It is recommended to consume no more than 10% of total calories as saturated fat.
• Trans-fatty acids are also implicated in high cholesterol and associated diseases and should be avoided (sources include partially hydrogenated oils and margarine).

Decrease the consumption of cholesterol
• Research shows that in some people, reducing dietary intake of cholesterol can lower blood levels of cholesterol if an intake at or below 300mg/day is maintained.
• Increase the amount of plants and plant products you consume- fruits, vegetables, legumes, grains, seeds, and nuts. Remember, plants do not contain cholesterol.

Increase the consumption of dietary fiber
• Fiber, especially soluble fiber, aids in the excretion of cholesterol from the body. Legumes, oat bran, oatmeal, psyllium, and apples are excellent sources of soluble fiber.

Increase Antioxidants
• Antioxidants are effective at decreasing damage from the “bad” cholesterol. Good sources include fresh fruits, fresh vegetables, green and black tea, grape juice, garlic, raw and dry roasted nuts, and onions.

Physical Activity!
• Physical activity has been proven to raise the “good” (HDL) cholesterol. This kind of cholesterol helps rid your body of excess “bad” (LDL) cholesterol. Enjoy 30–60 minutes of vigorous physical activity on most (or all) days of the week.

Therapeutic foods:
• Fiber: legumes, oat bran, oatmeal, psyllium, and apples are excellent sources of soluble fiber, which is the most beneficial kind of fiber for lowing cholesterol.
• Omega 3 Essential Fatty Acids: cold-water fish such as salmon, tuna, mackerel, and herring are excellent sources. Flax seeds and flax seed oil, and walnuts are good plant sources of essential fatty acids.
• Garlic has been shown to decrease cholesterol levels (both fresh and from extracts)
• Whole, raw, unsalted seeds and nuts are high in vitamins, minerals, fiber and protein. They are excellent sources of essential fatty acids. The serving size equals 3-4 tablespoons.
• Lecithin: soybeans and soy products are the best sources.
• Fish and poultry: in place of red meat and processed deli meats
• Whole grains, vegetables, and fruits
• Increase use of flavonoids from tea (especially green tea), onions and grapefruit.

source: http://www.americanheart.org

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Dietary Fiber Sources

Fiber is the substance in plant food that we do not digest. The two main types of fiber are soluble and insoluble fiber. Both types of fiber are important to our health.

Soluble fibers are commonly found in fruits (especially pear, apple and citrus), oats, barley and legumes.

These water-soluble fibers form gels that provide beneficial effects including:

• Delayed stomach emptying which contributes to early fullness and decreased appetite.
• The delayed stomach emptying slows the absorption of carbohydrates, thus reducing after-meal blood sugar increases.
• Decreased cholesterol and triglycerides.

Insoluble fibers are commonly found in wheat bran, corn bran, whole grain breads and cereals, as well as vegetables. Insoluble fiber has the effect of preventing constipation. Fiber functions like a sponge by attracting water into the digestive tract, softening stools and preventing constipation.

Tips to Increase Fiber:

• Include raw fruits and vegetables in your diet. Increase vegetable consumption to at least 3 servings per day. Increase fruit consumption to at least 2 servings per day.
• Snack on fresh fruits and vegetables in place of sugary or refined foods.
• Increase whole grain consumption to at least 4 servings per day. Include oats, brown rice, bran, quinoa, barley and whole wheat. Choose whole grains; avoid white flour products.
• Substitute whole grain flour for white flour in recipes.
• Add oat bran, wheat germ or rice bran to hot cereal or yogurt.
• Add bran cereal or oatmeal to meat loaf, meatballs or hamburgers.
• Snack on unbuttered popcorn in place of potato chips, corn chips or pretzels.
• Eat legumes daily. Replace creamy dips and spreads with bean dips or spreads such as hummus, black bean dip or refried beans.
• Remember animal products do not contain fiber.

It is recommended that we consume adequate fiber from a variety of food sources. Some good sources of fiber are beans, whole grains, vegetables and fruits. Refined foods tend to have less fiber due to processing.

It is suggested to gradually increase fiber intake and drink plenty of water (at least 8 glasses per day) to avoid discomfort and gas that can occur with a sudden increase in fiber.

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Eat More Fat to Prevent Heart Disease?

This week, I will be discussing ways in which to prevent heart disease that may be, if not outright surprising, then at least somewhat intriguing.
The first surprising way to prevent heart disease is to eat more fat. So, I know what you are thinking, Wow! Are you telling me that I can go out and eat Big Macs and candy bars to my heart’s content???

Of course not…let’s have some common sense. What I am saying is that the more omega-3 fats you eat, the better it is for your heart. These fats are anti-inflammatory and inflammation has been shown to be a crucial step in developing plaque and heart disease.

Omega-3 fats are most commonly known to be found in fish, such as salmon, black cod or sablefish, and halibut. They are also found in foods like flaxseeds and walnuts. However, these vegetarian sources are made up of a slightly different type of omega-3 fat that your body has a harder time converting to the kind that it needs. In fact, research has not shown the same kinds of results from flaxseeds and walnuts as they have from fish.

So, eat your fish and love the fat because it loves you!

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