Is TMAO from Fish, Meat and Eggs Harmful?

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In another confusing nutrition story that should be titled “is there anything left for us to eat?” recent research threw a curveball. Fish, a staple of the Mediterranean diet, as well as meat and eggs may be doing more harm than good thanks to a compound called trimethylamine-N-oxide (TMAO). TMAO is found in fish and produced in the body after eating meat and eggs. TMAO is linked to greater risk for heart attack, stroke and death; yet the research isn’t crystal clear. Is it time to give up fish meat and eggs or ignore the recent media headlines?

This post will cover:

  • TMAO: More than a Gut Reaction—What gives us higher TMAO levels?
  • TMAO and health?
  • The bottom line

TMAO: More than a Gut Reaction

Blood levels of TMAO are ~ 50 times higher after eating fish compared to eggs or beef. The human body absorbs intact TMAO like the kind found in fish, easily. However, the human body’s production of TMAO, after eating foods containing the essential nutrient choline (found in eggs and meat) and the compound l-carnitine (found in meat and pork and in much smaller quantities in chicken breast and dairy products), depends on the makeup of bacteria in your gut, kidney functioning and genetics.

In one study, regular meat eaters produced more TMAO than a vegetarian did after eating steak (which contains ~ 180 mg of l-carnitine). After wiping out their gut bacteria with antibiotics, the carnivores didn’t produce any TMAO after consuming 250 mg l-carnitine. The makeup of gut bacteria in the habitual meat eaters was presumably responsible for greater TMAO production compared to the vegetarian, yet this was a small study and we don’t know anything else about the participants’ diet. Was it the meat that altered gut bacteria or something else in their diet? After all, a steady diet of red meat may mean double cheeseburgers on white bread with regular servings of French fries and soda on the side. This isn’t exactly the diet you want for promoting good bacteria in your gut.

Another study found blood levels of TMAO were greater in those with a less diverse makeup of microbes and greater amounts of a less healthy type of bacteria (firmicutes), compared to one that is healthy (bacteroidetes). A diet higher in saturated fat will promote this environment.

While bacteria seem to influence TMAO production from l-carnitine, l-carnitine also influences the makeup of gut bacteria. A study in mice found those with their gut bacteria wiped out thanks to antibiotics produced a different makeup of bacteria in the gut after consuming l-carnitine while also doubling the risk of plaque buildup in their arteries.

Higher TMAO levels come from:

  • Eating fish
  • Less diverse array of gut bacteria and increased levels of bad versus good bacteria
  • Consuming l-carnitine (mouse study)

TMAO and Health

A few human studies found higher blood levels of TMAO were associated with greater risk for heart disease. However, all research isn’t pointing in the same direction. One study in over 300 patients found blood TMAO levels were not associated with heart attack or heart disease over the course of eight years, following the initial test for TMAO. However, TMAO levels were higher in those with diabetes, patients with metabolic syndrome and those with declining kidney functioning. Another study examined over 800 people between the age of 33 and 55 and found blood TMAO levels were not associated with clogged arteries, insulin resistance (this comes before type 2 diabetes) and inflammatory markers or negative changes in blood lipids suggesting TMAO levels might not contribute significantly to the progression of clogged arteries. However, this study shows TMAO levels were significantly lower than in previous research, showing an association between TMAO and heart disease.

TMAO is considered a risk factor for cardiovascular disease. In those with type 2 diabetes, higher TMAO levels are associated with greater risk for death, heart attack, heart failure and unstable angina (chest pain). Also, higher levels of circulating TMAO are associated with higher risk of death in those with chronic kidney disease and greater risk of certain cancers. Yet, there are several confounding factors. Fish is the primary culprit for higher acute circulating TMAO levels, yet fish-based diets are associated with reduced risk for heart disease. Also, levels of TMAO are dependent upon disease state and the makeup of gut bacteria. Therefore, at this time it isn’t entirely clear which came first – does TMAO cause disease or does TMAO increase due to disease?

The Bottom Line

The story on TMAO isn’t crystal clear, so there’s no reason to avoid fish, meat and eggs in an effort to decrease TMAO levels. All three of these foods are good sources of several nutrients important for health. Though processed red meats are linked to higher risk of colorectal and stomach cancers, when cooked appropriately (lower, moist heat for example) red meat can fit into a healthy diet and deliver important nutrients including iron, zinc and vitamin B12. Eggs are an economical source of protein and contain many nutrients and compounds that contribute to health including two antioxidants important for eyesight.

Though there is no reason to completely avoid these foods, you can alter your diet to help diversify gut bacteria and also increase the amount of good versus bad bacteria. Probiotic rich foods such as yogurt and kefir with live and active cultures, miso soup, tempeh and other fermented foods contain good bacteria. Fiber-rich plant foods (fruits, vegetables, legumes) are important food sources for bacteria to thrive in your body.

Disclosure: this post was sponsored by USFRA. All views are my own and backed by research.

References
Koeth RA, Wang Z, Levison BS et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013 Apr 7.

Cho CE, Caudill MA. Trimethylamine-N-Oxide: Friend, Foe, or Simply Caught in the Cross-Fire? Trends Endocrinol Metab 2016 Nov 4. [Epub ahead of print]

Cho CE, Taesuwan S, Malsheva OV, Bender E, Tulchinsky NF, Yan J, Sutter JL, Caudill MA. Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial. Mol Nutr Food Res 2016 Jul 5.

Carnitine. Health Professional Fact Sheet, NIH. https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/

Mueller DM, Allenspach M, Othman A, Saely CH, Muendlein A, Vonbank A, Drexel H, von Eckardstein A. Plasma levels of trimethylamine-N-oxide are confounded by impaired kidney function and poor metabolic control.Atherosclerosis 2015;243(2):638-44.

Meyer KA, Benton TZ, Bennett BJ, Jacobs DR Jr., Lloyd-Jones DM, Gross MD, Carr JJ, Gordon-Larsen P, Zeisel SH. Microbiota-Dependent Metabolite Trimethylamine N-Oxide and Coronary Artery Calcium in the Coronary Artery Risk Development in Young Adults Study (CARDIA). J Am Heart Assoc. 2016 Oct 21;5(10). pii: e003970.

Get Cultured: Probiotics can Help You Lose Weight & Stay Healthy

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From Greek to Icelandic Skyr, yogurt is everywhere. Choose the right kind, one packed with probiotics and protein, and yogurt can help you trim your waistline while supporting overall health at the same time.

In this article, I’m covering:
• How gut bacteria influence your weight and health
• Probiotic-rich foods for health & healthy weight

Your Gut Bacteria Influence Your Weight & Health

There is an entire community of over one trillion microbes (bacteria) taking up valuable real estate in your gut. Some are good, some are bad and the rest are neutral. The good guys are key players for digestive and immune functioning (remember about 70% of your immune system is located in your gut). They have many other functions as well:
bacteria, probiotics and body weight

Research studies show lean and obese people have a different makeup of bacteria in their gut. In addition, lean individuals have a greater diversity of bacteria in their gut. Diversity is important –  think of bacteria like a team of people each one has a different job and they work better together than in isolation.

If an obese person loses weight their overall makeup of bacteria more closely resemble’s a lean person’s gut. Greater weight loss = even greater the changes in gut bacteria. Also, changing bacteria seems to influence weight, though scientists know less about the influence of altering gut bacteria and changing body weight. Lean mice transplanted with bacteria from obese mice experienced a 60% increase in body fat without changing their food intake (calories in) or physical activity (calories out). The authors of this study believe the change in gut bacteria resulted in an increased absorption of some carbohydrates, increase in the production of fat and increase in fat storage. Authors from another study, this one examining human twins, also found a connection between types of bacteria in the gut and body weight, particularly visceral fat – deep layers of fat that coat the organs and are tied to higher risk of certain chronic diseases such as heart disease. The authors of this study believe, like the study in mice, obese individuals may be absorbing more calories from the food they eat.

Probiotic-Rich Foods for Health & Healthy Weight

How did they swap out bacteria in studies? Poop transplants. This isn’t exactly something you should try at home. But there’s another, easier way to keep your gut healthy. Get cultured by picking up foods that contain healthy bacteria including yogurt (with live and active cultures), kefir (drinkable yogurt, it’s so good!), miso soup, homemade sauerkraut, and tempeh (made from soy, this has a nutty taste). There might be something special about yogurt – a meta-analysis (a study that combined the results of other studies) looked at dairy intake and weight changes over time. They found greater yogurt intake was associated with lower body weight. Plus the protein in Greek yogurt seems to help people feel full so they eat less at their next meal. Also, feed the bacteria by eating plenty of fruits, vegetables and whole grains, particularly onions, greens, beans, legumes, berries and bananas, to get enough prebiotics (food) to support their growth.

 

References
Benno Y. Mitsuoka T. Development of intestinal microflora in human and animals. Bifidobacteria Microflora 1986; 5:13-25.

Quigley EMM, Quera R. Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics. Gastroenterology 2006;130:S78-S90.

O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO Rep 2006;7:688-93.

Ramakrishna B. The normal bacterial flora of the human intestine and its regulation. J Clin Gastroenterology 2007;41:S2-S6.

Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc 2008;108:510-521.

Million M, Maraninchi M, Henry M et al. Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii. Int J Obesity 2012;36:817-825.

Hempel S, Newberry SJ, Maher AR, Wang Z et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. A Systematic Review and Meta-analysis. JAMA 2012;307(18):1959-1969.

An Introduction to Probiotics. National Center for Complementary and Alternative Medicine. National Institutes of Health. http://nccam.nih.gov/health/probiotics/

Marik PE. Colonic flora, probiotics, obesity and diabetes. Front Endocrinol 2012;3:87.

Bäckhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A, Semenkovich CF, Gordon JI. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A. 2004;101:15718-23.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444(7122):1022-3.

Kalliomäki M, Collado MC, Salminen S, Isolauri E. Early differences in fecal microbiota composition in children may predict overweight. Am J Clin Nutr 2008;87(3):534-8.

Yang YX, He M, Hu G, Wei J, Pages P, Yang XH, Bourdu-Naturel S. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol 2008;14(40):6237-43.

Yaeshima T et al. Effect of yogurt containing Bifidobacterium longum BB536 on the intestinal environment, fecal characteristics and defecation frequency: a comparison with standard yogurt. Bioscience Microflora 1997;16:73-77.

Hempel S et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea
A Systematic Review and Meta-analysis. JAMA 2012;307;1959-1969.

Semova I, Carten JD, Stombaugh J et al. Microbiota Regulate Intestinal Absorption and Metabolism of Fatty Acids in the Zebrafish. Cell Host & Microbe 2012;12:277.

Schwingshackl L, Hoffmann G, Schwedhelm C, Kalle-Uhlmann T, Missbach B, Knuppel S, Boeing H. Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies. PLoS One 2016; 11(6): e0157461.

Top 10 Flat Belly Foods

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Your abs are made in the gym and revealed in the kitchen. A good training program develops the muscles in your midsection and the right diet helps banish bloating so you can see your abs. Here are the 10 flat belly foods you should add to your diet for a better looking (and better feeling) mid-section):Greek yogurt for belly fat

Greek Yogurt with Live and Active Cultures

Look for Greek yogurt with “live cultures (aka good bacteria)” or the “Live & Active Cultures” seal. The cultures are good bacteria that take up valuable real estate in your gut, helping your body digest food and decreasing gas and bloating. The amount of healthy, versus harmful, bacteria influences body weight and how much weight you can lose while following a lower calorie diet. Plus, a study published in the International Journal of Obesity found people who get their calcium from yogurt, as opposed to other foods, may lose more weight in their belly. Even more evidence to support yogurt consumption comes from a study showing dieters who ate five servings of dairy, such as Greek yogurt, daily lost more weight and abdominal fat than those who ate just three servings every day. A more recent review of the research found higher dairy intake was associated with lower risk of obesity in the midsection and yogurt seems to help keep weight in check.

2 Nuts

Though nuts are relatively high in calories for a small amount of food,  people don’t gain weight when they add nuts to their previously nut-free diet. A study in over 13,000 adults revealed nut eaters, those who ate at least ¼ ounce of nuts or peanuts (technically a legume) per day had smaller waists than adults who didn’t eat nuts. Additionally, tree nuts and peanuts contain a considerable amount of monounsaturated fat. Dieters who eat more foods containing monounsaturated fats may lose more belly fat than those who eat the same number of calories per day with less monounsaturated fat.

3 Asparagus

When examining dietary patterns, weight and waist circumference in close to eighty thousand people over a 10-year period, researchers found those who ate more vegetables every day had both a lower BMI and smaller waistline compared to adults who ate few vegetables. Asparagus contains prebiotic fiber, a type of fiber that is food for the good bacteria in your gut. Plus, asparagus is a natural mild diuretic making it the perfect food before hitting the beach or wearing a more formfitting outfit.

4 Avocados

Avocados contain a good amount of monounsaturated fat, not to mention nineteen vitamins and minerals. But, their monounsaturated fat is the ticket to a smaller waistline. In one study scientists gave obese adults with type 2 diabetes diets rich in saturated fat, monounsaturated fat or  carbohydrates. Those on the high carbohydrate diet ended up with fat redistributed to their stomachs while the monounsaturated fat rich diet prevented fat redistribution to the belly area. Plus, a look at dietary intake data from close to 18,000 adults found body weight, BMI and waist size were all significantly lower in avocado consumers versus those who didn’t include avocados in their diet.

5 Popcorn

Popcorn is a whole grain and when you pop it yourself on the stovetop (or in a brown paper bag in the microwave, just add good old fashioned popcorn kernels in a brown paper bag and fold the top) and top it with a little spray butter or spices for flavor, you’ll end up with a snack that takes a long time to eat and fills you up on relatively few calories. In addition, several studies show people who eat about three servings of whole grains per day weight less and have a smaller waistline compared to those who don’t.

6 Cold Pea Salad

Peas are naturally rich in resistant starch, a type of fiber that isn’t completely broken down or absorbed during digestion. Cooking and cooling peas to make a pea salad will significantly increase the amount of resistant starch they content. Rodent studies show resistant starch helps reduce stomach fat and increase hormones that tell the brain it’s time to stop eating.

7 Eggs

Choose eggs over cereal in the morning and you’ll tame hunger pangs for hours after breakfast, decreasing the likelihood of overeating later in the day. Make a meal containing at least 25 – 30 total grams of protein (the protein is in the white of the egg so this equates to 4 – 5 egg whites though you can choose any combination of whole eggs and egg whites as long as you consume at least 4 -5 of the whites) so you can cash in on the satiety-enhancing benefits of eggs. Added bonus: following a high protein diet for a short period of time can lead to significant reductions in belly fat.

8 Green Tea

The combination of caffeine and antioxidants in green tea may lead to small to moderate reductions in body fat and waist size. However, you need to consume quite a bit of it so get creative and cook with green tea by brewing it and using it to cook rice (it’s particularly good with jasmine rice), make stews, soups or stocks. You can also poach fruit green tea or use dried green tea leaves as part of a rub for meats, tofu or fish.

9 Barley

Barley is a cereal grain with a nutty taste and consistency that is a cross between pasta and rice. In a double-blinded trial (both the men and the researchers didn’t know which food they were getting), Japanese men were given rice or a mixture of rice with pearl barley. The group receiving the pearl barley and rice mixture lost a significant amount of visceral fat, the kind that covers your organs like a thick winter blanket and increases risk of heart disease, stroke and type-2 diabetes. Compared to the rice only group, the group who ate pearl barley decreased their waist size.

10 Blueberries

Blueberries are an excellent source of dietary fiber, which will not only help keep you full but also help keep your waistline in check. Plus they are a natural source of prebiotic fiber – the kind that the good bacteria in your gut munch on.

A flat belly is one of the most recognized signs of a fit body. Blast away abdominal fat with high-intensity cardio and build the underlying muscle by regularly switching up your training program. Also, incorporate a 30-minute abs classes to your routine. At least one study found you can spot reduce if you exercise the same muscle group for at least 30 minutes at a time. Keep in mind abs are made in the gym but revealed in the kitchen. Add the top 10 flat belly foods to your diet while cutting down on sugar alcohols (sorbitol, maltitol, and mannitol are the worst for causing gas and bloating), fizzy drinks and chewing gum (all of these can increase bloating at least temporarily) and you may fall in love with skinny jeans.

 

References
Clifton PM, Bastiaans K, Keogh JB. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardiovasc Dis 2009;19(8):548-54.

O’Neil CE1, Keast DR, Nicklas TA, Fulgoni VL 3rd. Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in U.S. adults: NHANES 1999-2004. J Am Coll Nutr 2011;30(6):502-10.

Kahn HS, Tatham LM, Rodriguez C, et al. Stable behaviors associated with adults’ 10-year change in the body mass index and likelihood of gain at waist. Am J Public Health 1997;87:747-54.

Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 2013;341:6150.

Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006;444:1027-1031.

Vidrine K, Ye J, Martin RJ, McCutcheon KL et al. Resistant starch from high amylose maize (HAM-RS2) and dietary butyrate reduce abdominal fat by a different apparent mechanism. Obesity (Silver Spring) 2014;22(2):344-8.

Bisanz JE, Reid G. Unraveling how probiotic yogurt works. Sci Transl Med 2011;3:106.

Dhurandhar NV, Geurts L, Atkinson RL et al. Harnessing the beneficial properties of adipogenic microbes for improving human health. Obesity Reviews 2013;19:721-735.

Delzenne NM, Neyrinck AM, Bäckhed F, Cani PD. Targeting gut microbiota in obesity: effects of prebiotics and probiotics. Nat Rev Endocrinol 2011;7(11):639-46.

Furet JP, Kong LC, Tap J et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes 2010;59:3049-3057.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444: 1022–1023.

Santacruz A, Marcos A, Warnberg J et al. Interplay Between Weight Loss and Gut Microbiota Composition in Overweight Adolescents. Obesity 2009;17:1906–1915.

Harland JI, Garton LE. Whole-grain intake as a marker of healthy body weight and adiposity. Public Health Nutr 2008;11(6):554-63.

Yadav BS, Sharma A, Yadav RB. Studies on effect of multiple heating/cooling cycles on the resistant starch formation in cereals, legumes and tubers. Int J Food Sci Nutr 2009;60 Suppl 4:258-72.

Keenan MJ, Zhou J, McCutcheon KL et al. Effects of resistant starch, a non-digestible fermentable fiber, on reducing body fat. Obesity (Silver Spring) 2006;14(9):1523-34.

Nagao T, Komine Y, Soga S et al. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr 2005;81(1):122-9.

Paniagua JA, Gallego de la Sacristana A, Romero I et al. Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects. Diabetes Care 2007;30(7):1717-23.

Fulgoni VL 3rd, Dreher M, Davenport AJ. Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutr J 2013;12:1.

Shimizu C, Kihara M, Aoe S et al. Effect of high beta-glucan barley on serum cholesterol concentrations and visceral fat area in Japanese men–a randomized, double-blinded, placebo-controlled trial. Plant Foods Hum Nutr 2008;63(1):21-5.

Du H, van der A DL, Boshuizen HC et al. Dietary fiber and subsequent changes in body weight and waist circumference in European men and women. Am J Clin Nutr 2010;91(2):329-36.

Peters EM, Anderson R, Nieman DC, et al. Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running. Int J Sports Med 2001;22(7):537-43.

 

The Ketogenic Diet Craze: Fat-Filled Lies, Part 1

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ketogenic diPicture this: a thick, juicy, tender eventeak grilled to perfection with melted butter glazed on top, gently dripping down the sides. Lying next to the steak there’s a side of dark green asparagus sautéed in coconut oil and dusted with a sprinkle of sea salt. Could a diet loaded with fat help you lose diet-resistant body fat that’s been taunting the seams of your dress pants and poking through buttons on your shirt? Will eating fat turn you into an all-star athlete? This is part 1 of a 2 part series on the ketogenic diet.

Here is what I will cover in this blog post:

  • What is the ketogenic diet?
  • Adverse health effects.

Here is what I will cover in tomorrow’s blog on this topic:

  • The issue with ketogenic research studies.
  • Is the ketogenic diet superior for losing fat?
  • How will the ketogenic diet affect muscle?
  • How will the ketogenic diet impact athletic performance?

What is the Ketogenic Diet?

For nearly a century, epileptic patients have used ketogenic diets to control seizures when common medications provide no relief. Scientists aren’t sure why following a ketogenic diet decreases the incidence and severity of seizures but it works.

The ketogenic diet contains – 80-90% of calories from fat, 15% from protein and 5% from carbohydrate (1, 2). Food choices may include heavy cream, bacon, eggs, non-starchy vegetables, mayonnaise and sausage while fruits, starchy vegetables, breads, pasta, cereal and other carbohydrate-rich foods are not allowed.

During the first several days on a ketogenic diet, your body’s limited supply of carbohydrate stored in liver and muscle tissue decreases dramatically. As a result, you will feel like you have mono – exhausted, with headaches and easy exercise will feel like you’re climbing Mount Everest (3). Once your stored carbohydrate has dwindled, ketones, formed from the breakdown of dietary fat, become the primary source of energy for brain and body. Ketogenic means “ketone forming.” It takes at least seven days to reach nutritional ketosis and several weeks to fully adapt to the diet (12). If you aren’t in nutritional ketosis (as measured by blood, urine or breath ketones; ketone levels > 0.5 mmol/L), then you aren’t following a ketogenic diet, you are on a low carbohydrate diet.

Adverse Health Effects from the Ketogenic Diet

Much of the research on adverse effects comes from studies in epileptic children since they have been on the diet for long periods of time. These studies show soon after starting a ketogenic diet, blood cholesterol levels and artery stiffness increase (4, 5). High total and LDL cholesterol are risk factors for cardiovascular disease (diseases of the heart and blood vessels). When arteries are stiff, they cannot expand as well in response to changes in blood pressure. Think of this like a garden hose when you turn up the water pressure, your hose either expands or the water bursts out of the space between the faucet and the hose. When arteries cannot open widely to accommodate increases in blood flow, blood pressure increases leading to microscopic tears on artery walls, development of scar tissue and the perfect surface for plaque buildup (6). Blood cholesterol levels returned to normal in patients who went off the diet and in those who stayed on it, they returned to normal after 6 to 12 months. Artery stiffness returned to normal after 24 months on a ketogenic diet.5 Studies in obese patients suggest ketogenic diets improve blood sugar and blood cholesterol levels over time, either due to the diet, weight loss from the diet, a combination of the two or carbohydrate restriction (7, 8). Lose weight, regardless of what you eat and blood cholesterol, blood pressure, inflammation, blood sugar and many other disease risk factors will improve.

Ketogenic diets are typically low in calcium, vitamin D, potassium, magnesium, folic acid and fiber. There are several potential consequences associated with consistently low intake of each of these micronutrients including softening of the bones, decreased bone density, muscle damage, muscle weakness or spasms, and abnormal heart rhythm. However, with careful planning, a fiber supplement, multivitamin and under the guidance of a physician who may prescribe potassium and sodium supplements (blood sodium could drop to dangerously low levels while on this diet), nutrient needs can be met. Also, to prevent constipation when on a ketogenic diet, a fiber supplement may be necessary along with more water / fluid intake then you are used to.

Here are some other potentially bad side effects from following a high fat diet:

  • Harm to your Brain. Studies in mice show a high fat diet, even when followed for as little as two months leads to chronic inflammation, sedentary immune cells in the brain – these cells typically act like janitors picking up trash and infectious compounds but when they become sedentary they stop doing their job, leading to cognitive impairment (9).
  • Mad Bacteria in Your Gut. A diet with no probiotics (healthy bacteria) and low in prebiotics (certain types of fiber that the healthy bacteria much on for food keeping them happy) will likely change the composition of bacteria in your gut so you have more harmful and less beneficial bacteria.
  • Leaky Gut. High saturated fat meals increase bacterial toxins (endotoxins) in the intestines and intestinal permeability. In other words: leaky gut (10, 11).
  • Free radicals in overdrive? If you can’t eat a number of colorful foods including blueberries, beets, corn, oranges, and more, chances are you won’t get a wide array of antioxidant compounds to quench free radicals (compounds that are important for good health but can wreck your body when they aren’t tamed by antioxidants) as well as other plant-based compounds that keep your arteries, muscles and other parts of your body healthy.

Are the side effects and potential negative side effects worth it if you can lose weight on this diet? Stay tuned for tomorrow’s post on how the ketogenic diet impacts body fat and athletic performance.

References

1 Freeman JM, Freeman JB, Kelly MT. The ketogenic diet: a treatment for epilepsy. 3rd ed. New York, NY: Demos Health; 2000.

2 Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. BioMed Research International 2014, Article ID 474296, 10 pages, 2014.

3 White AM, Johnston CS, Swan PD et al. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. J Am Diet Assoc 2007;107(10):1792-6.

4 Tanakis M, Liuba P, Odermarsky M, Lundgren J, Hallböök T. Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 2014;18(4):489-94.

5 Coppola G, Natale F, Torino A et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 2014;23(4):260-5.

6 Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 2012;1(4):1-10.

7 Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol 2004; 9(3): 200–205.

8 Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) 2005;2:31.

9 Hao S, Dey A, Yu X, Stranahan AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun 2016 Jan;51:230-9.

10 Mani V, Hollis JH, Gabler NK. Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia. Nutr Metab (Lond) 2013; 10: 6.

11 Lam YY, Ha CW, Campbell CR, Mitchell AJ, Dinudom A, Oscarsson J, Cook DI, Hunt NH, Caterson ID, Holmes AJ, Storlien LH. Increased gut permeability and microbiota change associate with mesenteric fat inflammation and metabolic dysfunction in diet-induced obese mice. PLoS One 2012;7(3):e34233.

12 Paoli, A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr 2012;9:34.

Full Fat or Low Fat Dairy?

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If you are totally against low-fat dairy, it’s time to take a closer look at the research. After listening to this dairy debate and watching the finger pointing, I started searching through the literature for an answer to this question “does dairy fat increase LDL cholesterol and risk for cardiovascular disease?” Then I came to my senses. No one eats dairy fat. Unless you’re a food scientist, you aren’t separating the fat from milk or full-fat yogurt and eating it or adding it as an ingredient to your recipes. However, we do eat cheese and yogurt and drink milk. The array of compounds in each of these foods influences how they affect your cholesterol and risk for heart disease. So, I revised the question to: “how does full fat cheese, yogurt and milk impact cholesterol and risk for heart disease?”

Here’s what I’ll cover in this article:

  • Why people are up in arms about saturated fat – saying it is either good or bad;
  • How does full fat cheese, yogurt and milk impact cholesterol;
  • What should you do with this information?

Dairy Fat isn’t the Only Factor

The research on dairy generally follows the research on saturated fat: the replacement strategy matters. For instance, it isn’t a good idea to take cheese out of your diet and replace it with a highly refined carbohydrate (not a good move for blood fats). Butter isn’t better than liquid oil. Butter raises LDL cholesterol. Some research suggests dairy fat might raise the large, less artery clogging LDL cholesterol compared to small dense LDL. However, “less artery clogging” does not mean “not artery clogging” and this area of the science needs more work before we can draw firm conclusions. Also, there are a few differences based on the type of food (milk, cheese, yogurt, butter); aged cheese reigns.

dairy and cheddar cheese

-> Aged cheese does not raise LDL as much as butter (accounting for total fat in each). In fact, several studies show aged cheese appears to have a “relatively minor” impact on LDL cholesterol or no impact at all. This could be due to the calcium content, which leads to the excretion of some fat or, fermentation may have an effect. Aged cheese stands out in the research.

-> Yogurt appears to have less of a cholesterol raising effect than expected. However this research is inconsistent possibly due to differences in the type of bacteria in the yogurt (aka probiotics). I recommend choosing yogurt with “live and active cultures.”

– > Milk – when consuming the same amount of fat from whole milk or butter, both raise LDL to the same extent. Milk contributes substantially less total fat per amount consumed compared to full fat yogurt and butter. Cross-sectional studies suggest milk consumption doesn’t raise coronary artery disease risk, however, this may reflect lower total fat intake from milk compared to butter.

-> Cottage cheese –  this incredible food is oftentimes forgotten yet an excellent addition to your diet. I couldn’t find any studies on cottage cheese, however, the highest fat cottage cheese I could find  (4% milk fat) contained 5 g total fat per serving so we can expect the impact cottage cheese may have a lower impact compared to whole milk.

What Should You Do with this Information?

If your LDL is high, choose skim, 1% or low fat milk. Opt for a good quality yogurt with naturally occurring probiotics. As far as cheese goes – I’d take out all of the other offending foods and work on other aspects of heart health before ditching the cheese (unless your LDL is very high) and cottage cheese. However, always follow the dietary advice of your registered dietitian since there are many variables that should be taken into consideration.

What about the trans fats in dairy? They are good for you right? No. In large amounts, the trans fats in dairy have the same impact as those found in partially hydrogenated oil (not good for cholesterol, cardiovascular disease risk etc.). However, we don’t eat dairy trans fats in significant quantities (they make up very tiny amounts of dairy fat and beef fat).

Take Home Points

In general, dairy foods help lower blood pressure plus there is emerging evidence about the positive role dairy foods may play in metabolic syndrome. What about dairy fat? Consider the whole food and your diet overall so you can make the right choices based on your personal risk factors for cardiovascular disease. Also, keep in mind there are many factors that influence cardiovascular disease pathology, some of which are unrelated to cholesterol.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Hjerpsted J, Leedo E, Tholstrup T. Cheese intake in large amounts lowers LDL-cholesterol concentrations compared with butter intake of equal fat content. Am J Clin Nutr 2011;94:1479–84.

Biong AS, Muller H, Seljeflot I, Veierod MB, Pedersen JI. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine. Br J Nutr 2004;92:791–7.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Thorning TK et al. Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial. Am J Clin Nutr 2015.

Labonté MÈ et al. Dairy product consumption has no impact on biomarkers of inflammation among men and women with low-grade systemic inflammation. J Nutr 2014;144(11):1760-7.

Sjogren P et al. Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. J Nutr 2004;134(7):1729-35.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

Grebe A, Latz E. Cholesterol crystals and inflammation. Curr Rheumatol Rep 2013;15(3):313.

 

 

Is Saturated Fat Good for You?

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Though largely driven by misinterpretation of the science and cherry-picked population studies, the “Butter is Back” movement comes with very persuasive sound bites followed by arrogant punctuation marks. No wonder so many people hopped on board the bandwagon while looking back, pointing fingers and shouting “health professionals have been misleading us for decades!” Yet the flawed reasoning behind the pro-saturated fat movement comes with a hefty price tag – you could be making food choices that, over time, will increase your risk for cardiovascular disease and type 2 diabetes.

Here’s what I’ll cover in this article:

  • Why is there so much confusion about saturated fat?;
  • The science behind saturated fats, cardiovascular disease (diseases of the heart & blood vessels) and type 2 diabetes;
  • Best food choices for heart health.

Why is there so Much Confusion about Saturated Fat?

There are a few reasons for the confusion about saturated fat (fat that is solid at room temperature such as butter, shortening, coconut oil and the fat on meat) and misinterpretation of the science. First off, some people group all saturated fatty acids (saturated fatty acids make up saturated fat) together as a team. However, there are several types of saturated fatty acids. Some raise LDL cholesterol (the kind that contributes to clogged arteries and is a risk factor for cardiovascular disease) as well as HDL cholesterol (“good” cholesterol, the kind that removes bad cholesterol; SN: drugs that increase HDL do not lower risk of heart disease so there is some considerable debate regarding the role of HDL), others don’t raise LDL cholesterol and some we aren’t quite sure about. Secondly, using population-based studies alone to draw conclusions about saturated fat intake and heart disease is misguided.  These studies are not designed to determine cause and effect (that’s the job of well-designed clinical trials) plus, there are inherent issues with the methods used in many of these studies.  Nutrition research is not easy, especially in humans living their life (those not in a metabolic ward where all factors are controlled and measured including diet and physical activity).

Lastly, some research studies (and the media) take the results way out of context. So, here’s the lowdown based on sound science:

The Science Behind Saturated Fat, Cardiovascular Disease and Type 2 Diabetes

  • There is no dietary requirement for saturated fat. Your body can make all of the saturated fatty acids it needs.
  • Foods high in saturated fat typically increase total, HDL and LDL cholesterol. However, the impact dietary saturated fat has on increasing LDL-cholesterol (the kind that contributes to clogged arteries and an inflammatory cascade in arteries) may depend on the amount of polyunsaturated fat (PUFAs) in your diet (as well as the type of saturated fatty acids consumed).
  • In general, replacing saturated fat with polyunsaturated fat (and monounsaturated fat though there is less evidence for monounsaturated fat) reduces LDL and total cholesterol, both risk factors for cardiovascular disease.
  • saturated fat and cholesterolOverweight, obesity and insulin resistance may reduce the beneficial effects (lowered LDL cholesterol) generally noticed from a reduction in saturated fat intake. *If obese or overweight, losing excess body fat (regardless of the type of diet used to lose the weight) has powerful effects on lowering risk for cardiovascular disease, some cancers, and type II diabetes.
  • Food contains a complex mixture of compounds that may affect cholesterol and cardiovascular disease risk (it is not just the fat). The food “matrix” matters.
  • Many factors impact how a food affects cholesterol and blood lipids (fats) including fats eaten at the same time, overall diet, and carbohydrate intake (and type of carbohydrates consumed – high fiber vs. foods high in added sugar with few other nutrients).
  • There are individual, genetic differences in response to saturated fat intake – your cholesterol might shoot up after eating a diet containing a diet high in the type of saturated fatty acids that raise LDL cholesterol and I might be able to get away with this diet without a problem (blame your genetics or consider it an opportunity to open your taste buds to foods containing less saturated fat; particularly the kind that is artery clogging).
  • Certain saturated fatty acids, or a diet high in saturated fat, may increase risk for type 2 diabetes.

Best Choices for Heart Health

If you are overweight, focus on losing excess body fat. Even small amounts of fat loss will improve health and risk factors for cardiovascular disease. If you have high total and LDL cholesterol, swap foods high in saturated fat for foods high in polyunsaturated fat (liquid oils, nuts, seeds, olives, avocados). Minimize your intake of foods high in added sugars and refined, white flour, carbohydrates. Instead, choose higher fiber carbohydrates as often as possible.

Don’t get sucked into the media headlines written by journalists who could sell ice to an eskimo. Butter isn’t back (for good health anyway). The bulk of your fat intake should still come from foods that are higher in polyunsaturated and monounsaturated fats. However, food is a complex matrix of compounds and therefore, some foods higher in saturated fat may have little to no impact on cholesterol and therefore fit into your diet while contributing to your vitamin and mineral needs and providing plant-based compounds important for good health.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

 

Is Coffee Good for You?

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CoffeeDrinking coffee will leave you dehydrated and geeked out on caffeine. For several decades we’ve been warned about America’s favorite beverage. Yet these dire warnings were largely based on assumptions rather than actual science. A growing body of evidence suggests your morning Cup O’ Joe may be good for you! Here’s a look at the latest research.

What’s in a Coffee Bean?

Coffee beans are actually seeds from coffee cherries. They are picked, dried, and roasted turning them from green to those familiar aromatic brown beans we know and love. It’s ironic that a beverage made from seeds has gotten such a bad rap. Green coffee beans are naturally rich in antioxidants including chlorogenic acids, compounds that are readily absorbed in the human body, have antibacterial and anti-inflammatory actions and are associated with many health benefits including a reduction in cardiovascular disease, type II diabetes and Alzheimer’s disease. Antioxidants protect plants from disease and pests. Some antioxidants also protect human cells from harm. Roasted coffee beans are loaded with antioxidants (contrary to popular belief, they are not destroyed during roasting) and scientists are slowly uncovering the metabolic fate of each type antioxidant as well as the potential health benefits associated with regular coffee intake.

Potential Health Benefits

A National Institutes of Health study published in 2012 found older adults who drank caffeinated or decaffeinated coffee were less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections. Those who drank over 3 cups per day had a 10% lower risk of death compared to those who did not drink coffee. Though this study only showed an association between coffee consumption and a decreased risk of death, it provided some reassurance to people who couldn’t seem to give up their favorite beverage. Studies published over the past three years lend strength to the relationship between regular coffee intake and a decreased risk of certain diseases.

Heart Health
A study published in the British Medical Journal’s publication Heart, examined diet and artery health in over 25,000 Korean men and women. Those who drank 3 to 5 cups of coffee per day were 19% less likely to have the first signs of atherosclerosis,  plaque buildup on artery walls, compared to those who were not coffee drinkers. Lower intakes were not associated with a reduction in plaque buildup. Drawbacks to this study: diet was examined at one point in time and study subjects were asked to recall their coffee intake over the previous year (people generally don’t recall their food / drink intake with great accuracy). Also, keep in mind this study showed an association between coffee intake and artery health, it doesn’t prove that coffee reduces plaque buildup on artery walls or that it can prevent cardiovascular disease. More research is needed to understand how coffee intake could potentially support heart health.

Cancer
A recently published study found individuals previously treated for stage III colon cancer who were regular coffee drinkers, consuming at least 4 cups of caffeinated coffee per day, had a 42% lower risk of recurrence of colon cancer and 33% lower risk of dying from the disease. This study found an association between coffee intake and decreased risk of colon cancer recurrence.

Research on coffee intake and risk of various cancers is mixed with some showing it is protective and others suggesting it may increase risk. Keep in mind there are many potential factors that impact cancer risk and risk of cancer recurrence with a sedentary lifestyle, high body fat and alcohol intake strongly associated with increased risk of certain types of cancer. Fruit and vegetable intake is associated with a decreased risk of some types of cancers. As for your Cup O’ Joe, time and more research, will tell us how America’s favorite beverage fits in the picture.

Should You Increase Your Coffee Intake?

All of these studies on regular coffee consumption include higher intakes. No benefits are noted for lower intakes – one to two cups per day. Keep in mind that some people should avoid or be cautious with caffeine intake including kids, teens, people with anxiety disorders, glaucoma, heartburn or cardiovascular disease. Also, pregnant women should avoid higher intakes of caffeine – more than 3 cups of coffee per day (regular sizes cups). Now about the caffeine – regular intake of moderate amounts of caffeine will not dehydrate you.

If you drink coffee in moderation, enjoy it! Don’t increase your intake based on these studies or start drinking if you aren’t a regular coffee consumer. Future research will tell us more about the many naturally occurring compounds in coffee, their actions in the body and the potential link between coffee and disease risk.

References
Heart 10.1136/heartjnl-2014-306663
New Eng J Med 2012;366:1891-1904.
J Nutr 2008;138(12):2309-15.
Mol Nutr Food Res 2005;49:274–84.
J Agric Food Chem. 2006;54:8738–43.
Am J Epidemiol 2002;156:445–53.
Biol Pharm Bull 2006;29:2236–4
Pest Manag Sci 2003 Apr;59(4):459-64.
J Clin Oncol 2015 Aug 17. [Epub ahead of print]

 

 

The Truth about Detox Diets

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Detox Diets and Cleanses

Detox diets promise to clean up the mess left behind from daily life so you feel better, more energetic and lose excess body fat. Consider them the Merry Maids for your body. They come with an army of equipment and compounds to attack years of buildup from environmental toxins, pesticides, allergens, waste, and inflammatory substances. This “sewage sludge” is stuck to your gut, interfering with digestion, leaving you bloated, tired, fat and with joints and muscles that feel like they are on fire.

In theory this sounds great. But there’s one glaring issue. The human body doesn’t need to “detox” because it comes equipped with organs designed to remove waste products. Plus, many detox diets are simply very low calorie plans with added laxatives and diuretics (because instant, yet temporary, weight loss might fool you into believing the outrageous claims on detox and cleansing products). Instead of wasting your money, take the top 3 good points about many of these diets and incorporate them into your overall nutrition plan:

Drink More Water

There are a few studies showing that individuals who are obese can lose weight by drinking 2 glasses of water before each meal. Plus, many people don’t get enough water or total fluids each day anyway and dehydration can make you feel sluggish and grouchy. So, grab it from the tap or if it’s more convenient, fill up your stainless steal water bottles and carry them with you at all times.

Eat More Fruits and Vegetables

The average American is falling short on fruit and vegetable intake. According to the National Cancer Institute, people with diets rich in plant foods, such as fruits and vegetables, have a lower risk of getting some types of cancer as well as diabetes, heart disease and high blood pressure. Produce generally has fewer calories than many other foods making it a great addition to a weight loss diet.

Get Friendly with Bacteria

Many detox plans include unfiltered apple cider vinegar – the kind that has a cloudy appearance – is full of probiotics. Probiotics are friendly (beneficial) bacteria – the kind that live in your gut and have a number of important functions in your body. Improving your gut bacteria may support immune functioning, improve the health of your intestinal tract, increase your body’s absorption of certain nutrients and alleviate constipation. Apple cider vinegar is acidic so I don’t recommend drinking it straight. Instead, dilute it in a big glass of water or another beverage. Other great sources of probiotics include kefir, yogurt (check the container for “live and active cultures”), miso soup, tempeh, sauerkraut, kimchi.

Add 2 glasses of water before each meal, load up on vegetables and fruits and make an effort to consume probiotic-rich food daily and you will reap the rewards of better nutrition without wasting money on detox diets and cleanses.

References:
Parvez J et al. J Appl Microbio 2006;100(6):1171-1185.
Parretti HM et al. Obesity 2015, 23(8):1785-1791.
Dennis EA et al. Obesity 2010;18(2):300-307.

 

Which Fat is Best for Heart Health?

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Butter

If you are more confused than ever about dietary fats, you’re not alone. Can a high fat diet help you lose body fat? Which fat is best for heart health – butter, coconut oil or vegetable oil?

What is Cholesterol & Why is it Essential?
Cholesterol is an essential component of all cell membranes and a precursor to hormones, vitamin D and bile acids (needed for the digestion of fat). It is so important that your body regulates cholesterol balance to ensure your cells receive a continuous supply of cholesterol.

How does High LDL Contribute to Cardiovascular Disease?

Though cholesterol is critical for life, low density lipoprotein cholesterol, LDL cholesterol, is considered a risk factor for heart disease because excess LDL can lead to an increase in plaque buildup in your arteries. Think of this process like a garden hose with gunk stuck in it. The gunk interferes with water flowing through the hose. If too much debris gets in there, no water will flow through.  Likewise, plaque in your arteries will decrease the amount of blood that moves through your arteries at one time and a complete blockage could lead to a heart attack or stroke.  Now, this is a simplistic view, especially considering LDL isn’t just one particle but instead, several that contain different amounts of cholesterol. Some research suggests that smaller, more dense LDL particles are more artery clogging. However, in addition to particle size, total number of LDL particles and oxidation of LDL contribute to the disease process.

As LDL particles travel through the bloodstream, excess LDL particles can stick to artery walls (particularly walls that are damaged due to smoking, high blood pressure and other insults). Trapped LDL becomes oxidized and sets off an inflammatory cascade resulting in the development of plaque (gunk) stuck to arteries – atherosclerosis.

Coronary Artery Disease

How Can I Lower my LDL Cholesterol?

Cholesterol in food has little effect on your blood cholesterol.

Years ago we were told to stay away from shrimp, eggs and other high cholesterol foods. Yet this advice wasn’t based on sound science – cholesterol in food has little effect on your blood cholesterol levels. So there is no need to take these nutrient-rich foods out of your diet. Shrimp is loaded with protein, and is a good source of iron plus it contains just 80 calories per serving. Eggs are also packed with nutrition – the whites are an excellent source of protein and the yellow color you see in the yolk is from antioxidants – plant compounds that protect plants from disease and protect your body from the damaging effects of free radicals, compounds that are essential but can cause damage as well.

Coconut Oil, Butter and Other Solid Fats are Not the Best Options

Man-made trans fats (partially hydrogenated oils) are the worst kind of fat you can eat. However, they should, finally, be making their way out of our food supply over the next few years. High levels of *saturated fat, the kind that is solid at room temperature like butter, increases HDL (the “good” cholesterol but not a target of therapy – doctors don’t focus on HDL levels because increasing HDL does not lower heart disease risk) and LDL cholesterol in the blood. In controlled diet experiments where saturated fat is replaced with polyunsaturated fat rich vegetable oils, risk of heart disease is reduced. Replacing saturated fat with monounsaturated fat, the kind found in olive oil, also lowers LDL but not to the extent that polyunsaturated fat does.

Coconut oil is popular and calorie for calorie it might be better for weight management than other fats. However, coconut oil raises our total, good and bad cholesterol levels. And therefore, it is not the best option for heart health.

Excess Carbohydrate Intake can Increase LDL

Overconsumption of carbohydrate-rich foods can also increase VLDL cholesterol (very low density lipoprotein). Foods with added sugars, in particular, are potent stimulators of VLDL production when the energy (calories) aren’t needed right away for energy or increasing glycogen stores (stored carbohydrate in your liver and muscle).

Best Fats for Your Heart

Nuts, seeds, avocados, olives and liquid oils are your bets for heart health. Oils with more polyunsaturated fat have a greater impact on LDL cholesterol than those rich in monounsaturated fat. Make sure you are choosing the right oil for the right cooking application. Many oils can’t stand high heat and they break down, damaging the structure (and function) of the oil.

Fatty Acids in Oils

Conclusion

Many factors contribute to high blood cholesterol levels, including genetics, overweight/obesity, inactivity, smoking, diabetes and age, making cholesterol management a multifactorial issue. Saturated fat increases LDL cholesterol but, as I’ll say over and over, we are all different and, people vary in their response to dietary saturated fat due to intrinsic differences in fat metabolism as well as other factors including obesity, insulin resistance and high triglycerides.

Replace fats that raise cholesterol with liquid oils, nuts, seeds, avocados, and olives. Consider your overall diet as well. Eat a plant-based diet including vegetables (non-starchy veggies as well as beans, lentils and peas), fruits, nuts, seeds and whole grains (oats, barley etc.). Consume fatty fish ( salmon, mackerel, herring, halibut, sardines etc.) at least two times per week. Limit your intake of foods with added sugars and refined starches as well as your alcohol consumption. 

* There are differences in specific saturated fatty acids and their effects on blood cholesterol. Therefore, some foods high in saturated fat do not raise LDL cholesterol. Also, oils have a different array of vitamins (primarily vitamin E) and plant-based compounds that may be beneficial for heart health.

Fatty acids composition of oils taken from the USDA Nutrient Database.

Get off the Dieting Cycle and Lose Weight for Good

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Are you a yo-yo dieter, stuck in a seemingly endless cycle of losing weight and gaining it back again?  If so, you aren’t alone. I’ve met many people who say they are experts at losing weight but they just can’t seem to keep it off. So I’m going to share my top tips for taking the weight off and keeping it off for good – the very same steps I shared with Fox 5 viewers this week. But first, let’s talk about dieting….

All diets have one thing in common – they help you cut calories so you lose weight. And when you lose weight you’ll lose both fat and muscle. However, when you go on a juice fast or low calorie diet that doesn’t contain enough protein (and most don’t), you will lose a considerable amount of muscle tissue. And that’s a huge problem because muscle burns more calories at rest than fat (just a few but it adds up over time) so when you lose muscle you’ll need fewer calories each day just to maintain your weight. Over time, repeated bouts of protein poor diets could decrease your calorie needs even further, making it increasingly difficult to keep the weight off without dieting. And therefore, if you want to go on a diet there are two things you need to do:

  • Feed the Muscle to Keep the Muscle. You’ll need even more protein when you cut your calories to help ensure you are preserving muscle while losing fat. A good rule of thumb, start by consuming at least 25 – 30 grams of protein per meal. At breakfast consider mixing a packet of protein powder in 6 oz. of milk or higher protein soy milk, eggs (2 large egg whites + 2 large eggs = about 28 grams of protein and just 200 calories), plain Greek yogurt + 2 Tbsp. of peanut butter or eat foods that aren’t traditionally associated with breakfast (last night’s leftovers). At lunch and dinner, you’ll need about the serving size of a female’s palm worth of chicken, turkey or fish or mix and match proteins by adding tofu, tempeh, beans, bean pastas, nuts and seeds.
  • Have an exit strategy – a plan for transitioning off your diet. Don’t stay on a very low calorie diet for an extended period of time. You will decrease your metabolism – the amount of calories you need each day. If you are cutting calories for more than just a few months, take a day or two each week and don’t drop your calories – eat what you need to if you wanted to maintain your weight (bump up your calorie intake).

Now let’s focus on fitness. There are two mistakes I see people making over and over – spending hours on cardio machines and sitting around the rest of the day. If you spend some quality time burning calories on the treadmill, bike or other cardio machine, its time to trade in some of your aerobic sessions for resistance training – lifting weights, power yoga, or anything that requires you to exercise a muscle or muscle group against external resistance. As we age we lose muscle. Losing muscle means your body will require fewer calories each day (again, this means you’ll need to eat less over time just to stay at the same body weight). Maintaining muscle will be easier to maintain your weight. If you already lift weights, change your routine to continue to make gains. Incorporate different exercises, lift until failure – until you can’t squeeze out any more reps (you do not necessarily have to use a heavy weight but instead can lift lighter weights using more reps till failure) or try doing compound sets – two or more exercises in a row targeting the same muscle group without rest.

Last but certainly not least, get moving and stay moving. Simply going to the gym isn’t enough to help you maintain your weight or counteract the health hazards of sitting most of the day. Sitting for long periods of time slows blood circulation, increases your risk of developing blood clots, leads to tight muscles and, sedentary behavior is tied to an increased risk of heart disease. So get moving and stay moving all day long. Ignore modern conveniences including escalators, elevators, the drive-through, pay at the gas pump and more. All of these rob you of the chance to move your body, burn calories and improve your health. If you need a little motivation, buy a fitness tracker. I prefer the ones that show you how many steps you’ve walked on the device versus those that require you to log on to your computer or smart phone just to see how active you are.