Heart Disease – Does green tea lower heart disease risk?

All right, this green tea article has been hanging over my head for at least a month now. I just couldn’t get motivated to wade through all the research to determine if yes, this is an effective way to lower cholesterol and prevent heart disease, or no, it’s just a lot of hype.

Well, I sat down and sorted it all out today and here’s what I found.

Health Claim

The proposed health claim for green tea is that drinking at least 5 fluid ounces as a source of catechins may reduce risk factors associated with cardiovascular disease.

What are catchins?

Green tea contains catechins, which are a type of flavenoid with antioxidant properties. Antioxidants slow the oxidation process. The oxidation of LDL molecules is what results in plaque formation. Therefore, increasing antioxidant intake should slow oxidation of LDL, resulting in less arterial plaque formation.

Also, when molecules are oxidized, free radicals are released that damage cells. These free radicals can increase inflammatory issues associated with cardiovascular disease.

How flavenoids work

The body recognizes flavenoids as foreign particles and works to eliminate them from the body. Flavenoids themselves do not act as an antioxidant and they are poorly absorbed by the body. However, the proposed benefit of extra flavenoids is that as the body eliminates the unwanted flavenoids, damaging free radicals are also eliminated.

Tea production

The various types of tea are produced differently. The leaves of oolong tea and black tea are allowed to oxidize (enzymes in the tea change catechins to larger molecules). Green tea is not oxidized, but produced by steaming fresh-cut leaves whereby enzymes are inactivated and little oxidation occurs. The least processed tea is white tea, which contains the highest levels of catechins. Green tea contains the second highest catechin level, approximately 125 mg catechins per serving (or ~25% dry weight of fresh tea leaves).

Here’s a little breakdown on tea oxidation:
Black tea – Highest oxidation; also, highest caffeine content and strongest flavor; 90% of all tea served in the West is black tea
Oolong tea – 10-70% oxidized
Green tea – Low oxidation
White tea – Minimal oxidation; Uncured, unfermented; Lower caffeine content that other teas

FDA Review

In 2005, the FDA did not approve the health claim for green tea, because the link between green tea and reduced cardiovascular disease risk was too weak and more conclusive evidence was needed.

Recent Research

This past June, 2008, a study was published that links green tea to reduced flow-mediated dilation of brachial arteries (major blood vessels in the upper arms). Flow-mediated dilation is related to coronary endothelial function and is an indicator for cardiovascular disease risk. Increased dilation is good. It means the heart has to do less work to move blood throughout circulation. (The endothelium is the inner layer of an artery, which blood flows against.)

This was a study of 14 healthy individuals that consumed 6 grams of green tea, followed by a measure of flow-mediated dilation. The results showed an increased flow-mediated dilation with tea (peak at 30 minutes post consumption). There was no change to antioxidant status after consumption. It’s proposed that the improved flow-mediated dilation is how green tea reduces cardiovascular disease risk.

The Hype

I came across multiple articles with headlines screaming “Green Tea Protects Against Heart Disease” since this study was published in June. I think there is significant research that still needs to be completed before it can be determined for sure how tea works to prevent heart disease. A study of 14 individuals is a small study.

Drinking 6 grams of green tea, would equal about three – 6 ounce cups of green tea each day. (Based on making 1 six ounce cup of tea with 1 teaspoon or 2.25 grams of green tea.) However, the study results are based on consuming 6 grams of tea in one setting followed by improved flow-mediated dilation at peak levels 30 minutes after consumption. How likely is it for you to drink three cups of tea quickly, back-to-back to reproduce the short-term benefit shown in this study?

To me, that is not a very effective way to reduce heart disease risk. But, I will say that if you like green tea – drink it. Many studies are showing that green tea is beneficial to heart disease. The what, how, and how much is yet to be determined. Who knows what future studies will find?!

To receive regular heart health and weight loss tips for dietitian Lisa Nelson, sign up for The Heart of Health and grab your copy of the special report “Stop Wasting Money – Take Control of Your Health” today!

All the best,
Lisa Nelson RD

How to Lower Cholesterol: Step 3

In the last post I gave you the first step towards lowering cholesterol. Here is the third. Remember, by implementing these basic steps, you’re establishing a solid foundation that will support heart health and increase the effectiveness of medications and supplements.

Step 3: Lose weight and/or maintain a healthy weight.

Weight has a significant impact on your heart health and cholesterol levels. Weight loss alone may lower triglycerides, LDL cholesterol, and total cholesterol levels. Losing as little as 10% body weight could drop your cholesterol back to the heart healthy range.

All the best,
Lisa Nelson RD

Lower Cholesterol – Do you understand your lab results?

It’s very possible your MD orders lab work and you have no idea what or why you’re having blood drawn. Well, let’s clear up the confusion when it comes to your cholesterol labs.

The terms “lipid panel”, “lipid profile”, and “lipoprotein profile” are used interchangeably to order the same set of labs. To make reading this easier, I’m going to use “lipid profile” from here on out.

“Lipid” is simply a medical term for “fat”. A lipid profile measures fatty substances in your blood. Cholesterol is one type of fat.

When you eat food containing cholesterol or when your body produces cholesterol and releases it into your bloodstream, the cholesterol will attach to a protein. This package of cholesterol plus a protein is called a lipoprotein (lipid or fat plus protein). A lipid profile measures lipoprotein levels in your blood.

Lipid profiles include five components:

LDL – “bad” cholesterol
LDL (low-density lipoprotein) cholesterol carries mostly cholesterol, some protein, and minimal triglyercerides throughout your circulation. LDL should be less than 130 mg/dL, ideally less than 100 mg/dL.

VLDL – “bad” cholesterol
VLDL (very low-density lipoprotein) cholesterol contains minimal protein and mainly transports triglycerides. VLDL should be less than 40 mg/dL.

Triglycerides
Triglycerides are a type of fat in the blood, not a type of cholesterol. Triglycerides are frequently used to estimate VLDL (“bad”) cholesterol. Here’s the calculation: triglycerides divided by 5 equals VLDL cholesterol. Triglycerides should be less than 200 mg/dL, ideally less than 150 mg/dL.

HDL – “good” cholesterol
HDL (high-density lipoprotein) cholesterol removes cholesterol from your bloodstream and carries it back to the liver. I like to think of HDL as a vacuum cleaner, picking up cholesterol LDL leaves behind in your arteries, the more HDL the better. HDL should be greater than 40 mg/dL, ideally greater than 60 mg/dL.

Total cholesterol
Cholesterol is essential to bodily functions, such as building cells and producing hormones. However, too much cholesterol will build up on artery walls, form a plaque, and potentially “plug” the artery resulting in a heart attack or stroke. Total cholesterol is calculated from the above components (Total cholesterol = HDL + LDL + VLDL). Total cholesterol should be less than 200 mg/dL.

Do you see how if you only know your total cholesterol, you only have one piece of the lipid profile?

Now, sometimes your results will include ratios or a risk score. Here’s an explanation of what those numbers mean.

Risk Score
A risk score is based on you lipid profile results, sex, age, family history, and various other risk factors. If you have a high risk score for heart disease, it’s best to speak with your MD to evaluate your risk score.

Cholesterol:HDL Ratio
You want a low ratio of cholesterol to HDL. A ratio lower than 4.5 is good, but 2 or 3 is best. You can calculate your cholesterol to HDL ratio by dividing total cholesterol by HDL. For example, your total cholesterol is 195 and your HDL is 55. 195 divided by 55 equals a ratio of 3.5.

It’s actually not your total cholesterol that has the greatest impact on your heart disease risk. The ratio of total cholesterol to HDL is a critical factor. If your total cholesterol is less than 200, but your ratio is 5, you are still at increased risk for developing heart disease.

LDL:HDL Ratio
This ratio compares the amount of bad (LDL) cholesterol to your good (HDL) cholesterol levels. You want a ratio less than 3.5, ideally less than 2.5. To calculate your ratio, divide LDL by HDL. For example, your HDL is 55 and LDL is 100. 100 divided by 55 equals a ratio of 1.8.

Triglyceride:HDL Ratio
A low ratio of triglycerides to HDL is best, ideally less than 2. To calculate your triglyceride to HDL ratio, divide your triglycerides by your HDL. For example, your triglyceride level is 200 and your HDL is 55. 200 divided by 55 equals a ratio of 3.6.

Lipid profiles are commonly ordered to assess your heart disease risk. Your doctor or dietitian will use the results to determine the best treatment to reduce your risk.

A lipid profile is beneficial, because you know your “good” cholesterol level and “bad” cholesterol levels. The interventions that work best to raise HDL and lower LDL differ, so knowing all your numbers helps you make the most effective changes.

You’re probably wondering why a lipid profile isn’t always ordered versus simply checking your total cholesterol (and possibly HDL). Cost and time always play a part and if your risk for heart disease is low, then a quick and less expensive screening makes sense. If you are at increased risk, a more complete assessment (lipid profile) may be more appropriate. Everyone’s situation is unique, so it’s best to discuss what’s right for you with your MD.

Now, to receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health today!

All the best,
Lisa Nelson RD

Lose Weight the Healthy Way – New Tools

New Tools Added to the Balance Program

Balance Program members:

Besides getting an 8-step system and working one-on-one with dietitian Lisa Nelson, you also get unlimited use of our tools where you will find life balance exercises, cooking tips, exercise demos, Pilates video, and more!

The tools section of the Balance Program is continually updated. Here are three new fabulous resources:

1. The Dirty Dozen Organic Food Guide
This guide will show you which foods have the most pesticide residues and which have the least.

2. Functional Foods: The Secret to Weight Loss, Decreased Aging, and Health
Learn about the phytonutrients in foods that can improve your heart health, immune system, aid your body in detoxing, and decrease your risk of cancer.

3. 28 Foods under 25 Calories
You may be surprised at some of the foods that make the list. Learn how to add these foods to your meals so you can eat more food, feel satisfied, control blood sugar, and reach your weight loss goals.

Just login to your Balance Program and go to the Tools section in the upper right hand corner!

Not currently a member? Sign up today with the coupon code “bestyou” for $25 off! Use dietitian code 3019.

All the best,

Lisa Nelson RD
Lose Weight the Healthy Way

Trans Fats Banned in California

Good news if you live in California! Starting in 2010 restaurants will be banned from using trans fats in food preparation. This will be a major benefit to those of you struggling to lower total cholesterol, low LDL “bad” cholesterol, or raise HDL “good” cholesterol. To improve your lipid profile you should follow a diet with less than 30% daily calories from fat. Ideally your intake of trans fatty acids should be zero for heart health. Since numerous restaurants affected will be nationwide chains, hopefully the trend will start to spread and avoiding trans fats when dining out will not be an issue after a few more years.

All the best,
Lisa Nelson, RD, LN
eNutritionServices

Your Checklist to Lower Cholesterol

Here’s a checklist of the top 8 things you must do if you want to successfully lower your cholesterol and keep it low.

Know your numbers

Have you had a lipid profile? Do you understand the numbers? If you are going to successfully lower cholesterol you need to know your numbers and what they mean. The most effective way to raise HDL is not necessarily the best way to lower LDL.

Evaluate your lifestyle

There are risk factors for high cholesterol that you can not control, such as age, gender, and family history, but there are factors you can control. For example, you can reduce risk by not smoking, increasing your activity, and losing extra weight.

Balance your fats

Reduce unhealthy saturated fats in your diet and replace them with heart healthy unsaturated fats. Total fat intake should be 30% or less of your total daily calories. Out of this 30%, saturated fat should be limited to 7%.

Be active

Physical activity lowers triglycerides and raises HDL (good) cholesterol. Shoot for 30 minutes 5 or more days a week. If you are not currently active, check with your MD before beginning an activity program.

Eliminate trans fats

You need to be food label savvy and watch out for trans fats. Trans fats raise LDL (bad) cholesterol, lower HDL (good) cholesterol, and raise triglycerides. Limit trans fats to 1% or less of your daily caloric intake.

Understand triglycerides

Triglycerides are impacted the most by your simple sugar and alcohol intake. If you are struggling with high triglycerides, you need to use a different strategy to get your cholesterol under control.

Increase dietary fiber

A high fiber diet is necessary for heart health. You need 25-35 grams of dietary fiber daily, especially soluble fiber. For every 1-2 grams of daily soluble fiber intake, LDL (bad) cholesterol is lowered 1%.

Add omega 3 fatty acids

For heart health and lower cholesterol, you want to improve the ratio of omega 3 to omega 6 fatty acids. Omega 3 fatty acids are involved in the regulation of heart rate, blood pressure, and blood clotting.

If you’re ready for regular heart health and weight loss tips for dietitian Lisa Nelson, sign up for The Heart of Health today and grab your copy of the special report “Stop Wasting Money – Take Control of Your Health” today!

Vytorin to lower cholesterol

A reader from The Heart of Health is treating high cholesterol with Vytorin. The medication Vytorin is a combination of the statin drug Zocor and the cholesterol lowering drug Zetia. The two drugs differ in that statins function mainly in the liver to reduce production of cholesterol, while Zetia works in the digestive tract to block the absorption of cholesterol from food.

Vytorin is in the press right now, because of a possible link to increased cancer risk.  Studies including 20,000 patients compared cancer in those treated with Vytorin (313) to those taking a Zocor/statin drug (326).   Actual cancer deaths were greater in those taking Vytorin (97) versus Zocor (72).  From my perspective, that is not a significant difference; however, there are experts that agree with me and experts that disagree.

Anyway, The Heart of Health reader requested my thoughts.

First, absolutely discuss with your MD the best treatment for you. I would discuss the possibility of a statin lowering drug with proven effectiveness/safety as an alternative until the controversy regarding Vytorin is settled. Also, there is debate surrounding the effectiveness of Zetia at preventing heart disease.

Of course, I do not know your personal situation and if you have tried a statin with poor results in the past.

Anytime you have to take a medication, there is the risk of side effects.  Many times it’s simply a matter of weighing the pros and cons and deciding how much risk you’re willing to take.

Of course, I promote making lifestyle and diet changes to lower cholesterol to eliminate the need for medications or at least reduce the amount of medication needed to treat your condition. 

If you are not a current subscriber to The Heart of Health, you’ll receive a subscriber exclusive report: “Stop Wasting Money – Take Control of Your Health” and regular heart health and weight loss tips once you sign-up.

All the best,

Lisa Nelson, RD, LN
eNutritionServices.com

A Heart Friendly Starbucks?

I may have some good news for Starbucks lovers. 

 

Normally, the high sugar, high fat, high calorie beverage and menu items offered by Starbucks were reasons to steer clear if you struggle to lower triglycerides, lower cholesterol, or shed extra pounds.  Starbucks is typically not the best place to grab a quick breakfast with a Frappuccinno, while scanning the daily paper. 

 

Simply selecting a Grande Frappuccino and Cranberry Orange Muffin would start your day with a whopping 850 calories and 30 grams of fat!

 

In the past Starbucks has not embraced the idea of offering more nutritious items.  They did remove trans fats and started offering nonfat milk this past year, but there is still plenty of room for improvement.

 

The good news is Starbucks has decided to revamp their breakfast menu to offer six heart friendly breakfast options.  The goal was a menu with fewer calories, more protein, more fiber, and more fruit.

 

New menu selections include:

 

Apple bran muffin – 330 calories, 8 grams of fat, 7 grams fiber

Baked berry stella – 280 calories, 9 grams of fat, 6 grams fiber

Power Protein plate with peanut butter – 330 calories, 16 grams fat, 5 grams fiber

Chewy fruit and nut bar – 250 calories, 10 grams fat, 4 grams fiber

Perfect oatmeal – 140 calories, 2.5 grams fat, 4 grams fiber

 

These new options provide reduced calories and fat grams, while boosting dietary fiber content.  All good moves if you are looking to be heart friendly.

 

You still need to use your head when choosing a beverage.  Starbucks is not removing its’ high calorie, fat, and sugar beverage options.  One of the best choices is a simple Caffe Americano (15 calories, 0 grams fat). 

 

So, if you enjoy the Starbucks ambiance, you’ll now be able to enjoy a heart healthy breakfast, too.  Hopefully, the taste of the new menu items lives up to the flavor of their coffee!

 

To receive regular heart health and weight loss tips from dietitian Lisa Nelson, subscribe to The Heart of Health ezine.

Brown rice – New whole grain health claim.

I’ve always recommended clients make a switch from white rice to brown rice as a way to boost dietary fiber intake.  A diet high in dietary fiber (ideally 25-35 grams/day) is linked with reduced heart disease risk by lowering LDL and total cholesterol levels.

The FDA just approved a new ruling that will allow brown rice to use a health claim on its label.  So, when you’re shopping for groceries, be on the look out for the new whole-grain logo added to the brown rice packaging and don’t forget to reach for the brown rice over the white!  A 1/2 cup of cooked  brown rice contains two grams of fiber.

Brown rice takes extra time to prepare (~45 minutes).  I checked out the nutrition label on brown “minute” rice recently and it’s another option, still providing 2 grams of dietary fiber per 1/2 cup serving.  Best of all, only takes ~10 minutes to prepare.  Haven’t tried it yet, so can’t vouch for its flavor, but I have added it to my shopping list.

All the best,

Lisa Nelson, RD, LN
The Heart of Health

How to boost dietary fiber intake without elevating uric acid.

I received a good question from a Heart of Health reader related to my recent dietary fiber article.

Question:

How do you boost fiber intake if you have to watch your uric acid levels?

Answer:

Too much uric acid leads to problems with gout (inflammation/pain in your joints).

Fortunately, a diet that is “gout friendly” will also benefit your blood pressure and cholesterol levels, as well as weight loss efforts.

Here are 4 tips:

1. Avoid alcohol or limit intake
2. Drink plenty of water (stay hydrated!)
3. Maintain an ideal body weight – if you need to lose weight avoid fasting or quick weight loss schemes (Get a Mini Diet Makeover)
4. Avoid foods high in purines

Uric acid comes from the breakdown of purines.  Purines make up human tissue and they are found in foods.  Which is why limiting foods with high in purines content is beneficial.

Foods to limit/avoid – alcohol, anchovies, sardines in oil, herring, organ meat, legumes (dried beans, peas, mushrooms, spinach, asparagus, cauliflower, yeast, meat extracts, and gravies.

Foods that are beneficial to gout treatment include fresh berries, bananas, tomatoes, celery, cabbage, parsley, green-leafy vegetables, pineapple, red bell peppers, tangerines, oranges, potatoes, low fat dairy, whole grain breads and pastas, tuna, salmon, nuts, seeds, and tofu.

In my recent article – 4 Tips to Use Dietary Fiber to Lower Cholesterol – I recommended legumes as a good high fiber source to increase.  If uric acid levels are an issue for you, legumes is not the best source for increasing your fiber intake.  Instead, rely on whole grain breads, cereals, and pastas, as well, as fruits and vegetables beneficial to gout treatment that I’ve listed above to get your daily dietary fiber.

Not currently a subscriber to The Heart of Health?  Be sure to sign up, get your free bonus, and receive regular heart health and weight loss tips.

All the best,

Lisa Nelson, RD, LN