Reasons For High Cholesterol

Beat Cholesterol Guide

Beat Cholesterol In 30 Days is the latest program that teaches people how to control their cholesterol levels, and reduce their risk of a heart attack dramatically. The program also provides people with easy and simple exercises to get lean, fit, and healthy. In addition, this program is designed by Scott Davis, an alternative health expert and medical researcher who has over 14 years of experience in the healthcare industry. Davis shows that lowering your cholesterol is a straightforward process: changing your diet according to the guidelines in the guide will reduce your cholesterol to healthy levels. There's nothing relative or interpreted in this book. Certain foods will make your cholesterol levels better. But some will make them worse, and Davis makes it easy to determine and identify the cholesterol-raising culprits in your cupboard. Davis believes so much in the results of this test that he is offering a no-risk guarantee when you buy his e-book. If for any reason you arent satisfied in the first 60 days you can get your money back. At the very worst, even if you dont learn anything new from this e-book you will get your money back. Continue reading...

Natural Cholesterol Guide Overview

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Dietary Cholesterol and Plasma Cholesterol

The effect of dietary cholesterol on plasma cholesterol levels has been an area of considerable debate. In 1972, the American Heart Association recommended that dietary cholesterol intake should average less than 300mgperday as part of a 'heart-healthy,' plasma cholesterol-lowering diet. Since that initial recommendation, a number of other public health dietary recommendations in the United States have endorsed the 300 mg daily limit. Interestingly, few dietary recommendations from other countries contain a dietary cholesterol limitation. The evidence for a relationship between dietary cholesterol and plasma cholesterol indicates that the effect is relatively small, and that on average a change of 100 mg per day in dietary cholesterol intake results in a 0.057 mmoll-1 (2.2mgdl-1) change in plasma cholesterol concentrations. Studies have also shown that the majority of individuals are resistant to the plasma cholesterol-raising effects of dietary cholesterol 'nonresponders' and have...

Dietary Cholesterol Intake Patterns

Dietary cholesterol intakes in the United States have been declining, from an average of 500 mg per day in men and 320 mg per day in women in 1972 to levels in 1990 of 360 mg per day in men and 240 mg per day in women. This decline is due in part to dietary recommendations to the US public to reduce total and saturated fat intake and to reduce dietary cholesterol daily intake to less than 300 mg and in part from the increased availability of products with reduced fat and cholesterol content. Major efforts in the early 1970s by public health agencies and advertising emphasized reducing dietary cholesterol as a means to lower plasma cholesterol levels, leading to a high degree of consumer concern regarding cholesterol-containing foods and demand for low-cholesterol products. Today, practically all foods sold in the United States are labeled for their cholesterol content and their percentage contribution to the daily value of 300 mg for cholesterol.

Hypertension And Cholesterol Lowering

CoQ10 has been studied both as stand-alone and adjunctive treatment in hypertension. According to a review of 8 studies, supplemental CoQ10 results in a mean decrease in systolic blood pressure of 16 mmHg and in diastolic blood pressure of 10 mmHg (Rosenfeldt et al 2003). The effect on blood pressure has been reported within 10 weeks of treatment at doses usually starting at 100 mg daily. One small 10-week open study of 26 subjects with essential hypertension study found that an oral dose of 50 mg taken twice daily also reduced total serum cholesterol levels with a modest increase in serum HDL-cholesterol (Digiesi et al 1994).

Reduces Serum Cholesterol Levels

A 2000 meta-analysis of 13 clinical trials concluded that garlic is superior to placebo in reducing total cholesterol levels, exerting a modest effect (Stevinson et al 2001). The mechanism of action involves inhibition of cholesterol synthesis by deactivating HMG-CoA reductase via enhanced phosphorylation, but not changing theamount of the enzyme, according to in vitro research (Liu & Yeh 2002). The compounds containing an allyl-d sulfide or a I lyl-su If hyd ryl group are most likely responsible for the inhibition of cholesterol synthesis by garlic and that this inhibition is likely to be mediated at sterol 4-alpha-methyl oxidase (Singh & Porter 2006). Clinical evidence also suggests it raises HDL levels and reduces triglyceride levels (Bordia et al 1998).

Type II or Familial Hypercholesterolemia

Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by elevation of plasma LDL cholesterol levels. Mutations at the LDL receptor gene locus on chromosome 19 are Apo C-II deficiency High Familial hypercholesterolemia Familial combined hyperlipidemia Polygenic hypercholesterolemia High Familial hypercholesterolemia The ranges of LDL cholesterol levels in plasma of FH subjects are 200-400 mgdl1 in heterozygotes and above 450mgdl 1 in homozygotes. The frequency of defects at the LDL receptor locus is about 1 in 500 for the heterozygous state and 1 in a million in the homozygous state. The genetic defect(s) associated with a common form of hypercholesterolemia present in most subjects with cholesterol levels between 250 and 300mgdr1 has not been elucidated. This disorder may be due to a combination of minor gene defects (i.e., presence of apo E-4 allele) that in combination with the environment (i.e., diet, lack of exercise) predispose individuals to...

Hypercholesterolaemia And Hypertriglyceridaemia

Niacin has been used for the treatment of hypercholesterolemia and hypertriglyceridaemia since the 1950s. Large doses of niacin reduce total cholesterol, LDL-cholesterol, triglycerides and lipoprotein (a) levels and also markedly raise HDL-cholesterol C levels (lllingworth et al 1994). Considering these factors are also predictive of cardiovascular events, niacin is used to reduce overall risk of cardiovascular disease (Canner et al 1986). According to a recent meta-analysis effects on LDL- 2007 Elsevier Australia Extended-release niacin (nicotinic acid) has been evaluated in at least four randomised, placebo-controlled trials, with the most efficacious results occurring at doses of 1 500-2000 mg day (Goldberg 1998, Grundy 2002, Guyton et al 2000, Morgan et al 2003). Results were dose- and time-dependent, with trials ranging in length from 4 to 16 weeks. At the 1500 and 2000 mg doses, reductions were noted in total cholesterol (-7 to -12.1 ) total cholesterol to HDL-C ratio (-17 to...

Familial Hypercholesterolemia

Synthetic vectors are being evaluated for the treatment of familial hypercholesterolemia (FH) and hyperlipidemias. FH is an autosomal dominant disorder caused by mutations in the low-density lipoprotein (LDL) receptor. Patients have persistently elevated levels of LDL in their serum, which leads to the development of atherosclerosis and coronary artery disease (43). Tomita et al. (44) injected a complex of hemagglutinat-ing virus of Japan (HVJ) liposomes and a plasmid expressing the human LDL receptor into the hepatic portal vein of LDL receptor knockout mice. RNA was detected in the livers that peaked at days 7 to 10 after injection, but became undetectable by day 21. At day 7 there was a modest but statistically significant decrease in total cholesterol levels. Another approach being taken to treat hypercholesterolemia is to express apoli-poprotein E, which is involved in removing excess lipopro-teins and cholesterol from tissues. Rinaldi et al. (45) injected a plasmid that...

Curcumin Lowers Serum Cholesterol Levels

Numerous studies suggest that curcumin lowers serum cholesterol levels (78-84). Soudamini et al. investigated the effect of oral administration of curcumin on serum cholesterol levels and on lipid peroxidation in the liver, lung, kidney, and brain of mice treated with carbon tetrachloride, paraquat, and cyclophosphamide (81). Oral administration of curcumin significantly lowered the increased peroxidation of lipids in these tissues produced by these chemicals. Administration of curcumin also significantly lowered the serum and tissue cholesterol levels in these animals, indicating that the use of curcumin helps in conditions associated with peroxide-induced injury such as liver damage and arterial diseases. Soni and Kuttan examined the effect of curcumin administration in reducing the serum levels of cholesterol and lipid peroxides in 10 healthy human volunteers receiving 500 mg of curcumin per day for 7 days (82). A significant decrease in the level of serum lipid peroxides (33 ), an...

Cholesterol Reduction

Flavonoids are known to reduce cholesterol. A 30-day study of induced hyperlipidaemia in rats found that baicalein, quercetin, rutin and naringin reduced cholesterol, with baicalein being the most potent. Baicalein was also the most effective flavonoid in reducing triglyceride levels (De Oliveira et al 2002). In another in vivo study, rats were fed a cholesterol-laden diet and half were also given 5. baicalensis radix extract (Regulska-llow et al 2004). The treatment rats displayed a significant reduction in plasma triglycerides and total cholesterol as compared with control animals.

Hypercholesterolemia high blood cholesterol

Tion, sequestration, or excretion from the body is called the cholesterol balance. When cholesterol accumulates, the balance is positive when it declines, the balance is negative. In 1993, the NHLBI National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults issued an updated set of recommendations for monitoring and treatment of blood cholesterol levels. The NCEP guidelines recommended that total cholesterol levels and subfractions of high-density lipoprotein (HDL) cholesterol be measured beginning at age 20 in all adults, with subsequent periodic screenings as needed. Even in the group of patients at lowest risk for coronary heart disease (total cholesterol < 200 mg dL and HDL > 35 mg dL), the NCEP recommended that rescreening take place at least once every 5 years or upon physical examination.

Dietary Cholesterol

All dietary cholesterol is derived from animal products. The major sources of cholesterol in the diet are egg yolks, products containing milk fat, animal fats, and animal meats. Many studies have shown that high intakes of cholesterol will increase the serum cholesterol concentration. Most of this increase occurs in the LDL cholesterol fraction. When cholesterol is ingested, it is incorporated into chylomicrons and makes its way to the liver with chylomicron remnants. There it raises hepatic cholesterol content and suppresses LDL receptor expression. The result is a rise in serum LDL cholesterol concentrations. Excess cholesterol entering the liver is removed from the liver either by direct secretion into bile or by conversion into bile acids also, dietary cholesterol suppresses hepatic cholesterol synthesis. There is considerable variability in each of these steps in hepatic cholesterol metabolism for this reason the quantitative effects of dietary cholesterol on serum LDL...

Better Than Statins

Researchers gave 120 men with high cholesterol either the statin drug, Zocor, or a placebo (sugar pill) and instructed them to eat either their usual diet or a Mediterranean-type diet. After 12 weeks, the diet had cut LDL by 11 percent, Zocor had cut it by 30 percent, and diet plus Zocor cut LDL cholesterol by 41 percent. A bonus the Mediterranean diet wiped out the (unwanted) 13-percent rise in insulin levels caused by the Zocor.29 In our practice, we lower cholesterol up to 40 percent by eliminating sugar and eating beets.

High Cholesterol

Probiotics modestly reduce cholesterol levels in healthy subjects and may have stronger effects in people with hyperlipidaemia. In another study, 32 subjects with serum total cholesterol ranging from 5.7 to 7.25 mg dL were randomly assigned to two treatments (1) Intake of a low-fat drinking yoghurt prepared with two ordinary yoghurt starters (Streptococcus thermophilus and Lactobacillus delbrueckii subsp. Bulgaricus placebo group) and (2) intake of a low-fat drinking yoghurt prepared with the two yoghurt starters plus Bifidobacterium longum strain BL1 (probiotic group). After intake for 4 weeks at 3 100 mL day, reduction of serum total cholesterol was observed in approximately half of the probiotic group subjects a particularly significant decrease in serum total cholesterol was found among subjects with moderate hypercholesterolemia (serum total cholesterol > 6.2 mg dL). The serum lipid concentrations in the placebo group subjects were almost stable during the experimental periods...

Age and Risk Factor Profile

A few studies have indicated that subjects already at high risk of coronary disease experience a greater beneficial effect of drinking alcohol moderately conversely, only in those with a high risk level is coronary heart disease prevented. Hence, the large Nurses Health Study found that the J-shaped relation was significant only in women older than 50 years of age, whereas younger women who had a light alcohol intake did not differ from abstainers with regard to mortality. Fuchs et al. found that women at high risk for coronary heart disease (due to risk factors such as older age, diabetes, family history of coronary heart disease, high cholesterol, and hypertension) who had a light alcohol intake were at a lower risk of death than women who were at the same risk level but did not drink alcohol. In a study by the American Cancer Society, the finding by Fuchs et al. was confirmed among men,

The Next Wave of Disease Management

In Maximum Energy for Life, cardiologist Chip Lavie made the startling statement that 95 percent of all heart disease is preventable. We gave you the facts and the program to prove it. In this book I am taking this concept one step further. I believe that obesity should be named the number one preventable disease in this country, because almost all major health problems have overweight or obesity at their core. Obesity is responsible for a whole constellation of problems generally known as heart disease high cholesterol, hypertension, heart attack, and stroke. It is the number one cause of adult-onset type 2 diabetes. A recent landmark study involving 90,000 cancer-free individuals designed to examine the relationship between cancer and fat found that the risk for all types of cancer was increased by being overfat or obese.

Acceptable Macronutrient Distribution Ranges For Healthy Diets

When fat intakes are low and carbohydrate intakes are high, intervention studies, with the support of epidemiological studies, demonstrate a reduction in plasma high density lipoprotein (HDL) cholesterol concentration, an increase in the plasma total cholesterol HDL cholesterol ratio, and an increase in plasma triacylglycerol concentration, all consistent with an increased risk of CHD. Conversely, interventional studies show that when fat intakes are high, many individuals gain additional weight. Weight gain on high fat diets can be detrimental to individuals already susceptible to obesity and will worsen the metabolic consequences of obesity, particularly risk of CHD. Moreover, high fat diets are usually accompanied by increased intakes of saturated fatty acids, which can raise plasma low density lipoprotein cholesterol concentrations and further heighten risk for CHD. Based on the apparent risk for CHD that may occur on both low and high fat diets, and the increased risk for CHD at...

What This Book Can Do for

If you choose to go to your doctor and get a lipid profile, you will most likely see an improvement in your total cholesterol, HDL (good cholesterol), triglycerides, and glucose. While heredity plays a part in the lipid profile for example, high cholesterol runs in some families studies have shown that people can control approximately 70 percent of hereditary factors through lifestyle. 7. Fifty percent of our children are obese or overweight and a significant number of kids are already experiencing major health problems such as high blood pressure, type 2 diabetes, deformities of the hips and knees, asthma, premature puberty, increased triglycerides, high cholesterol, and decreased levels of HDL. When an airplane is in trouble, parents are told to put on their oxygen mask so that they can help their children. The only way that we are going to save our kids is to put on the mask to take responsibility for developing healthy nutritional and exercise patterns ourselves.

Answers To Patients Frequently Asked Questions

Astragalus appears to have numerous biological effects, such as digestive and immune system stimulation and heart muscle stimulation. Early research suggests that it may have a role in the treatment of asthma, memory deficits, elevated cholesterol levels and as an adjunct to chemotherapy treatment for cancer. When will it start working

Permanent Weight Control

Fats are the most concentrated source of food energy, contributing 9 calories per gram, which is more than double that of carbohydrates and proteins. So our Enlightened cakes, brownies, muffins, and quickbreads do not make use of added fat. You'll discover throughout The Enlightened Kitchen that we keep the use of oil to a minimum. At the start of my characteristic braise, I use only a scant teaspoon or two of olive oil. Olive oil is the only oil that I use, and there are several reasons for that. The flavor is superior to other oils, but more importantly, olive oil is monounsaturated, and monounsaturated fats are thought to lower cholesterol.

Deficiency Signs And Symptoms

Low serum beta-carotene levels have been associated with male gender, younger age, lower non-HDL-cholesterol, greater ethanol consumption and higher BMI (Brady et al 1996), increased lipoprotein density and the presence of inflammation (Kritchevsky 1999), high C-reactive protein (Erlinger et al 2001), high blood glucose (Abahusain et al 1999), hypertension (Coudray et al 1997), exposure to environmental tobacco smoke (Farchi et al 2001), as well as all measures of obesity (Wallstrom et al 2001), including obesity in children (Strauss 1999).

Cardiovascular Protection

There are a number of ways in which beta-carotene may act to protect against cardiovascular disease. Free radical scavenging may prevent cellular transformations leading to atherosclerosis and protection of LDL oxidation may further act to protect against atheroma formation (Halliwell 1993). Other mechanisms proposed for the possible favourable effect of antioxidants include an increase of HDL cholesterol and the preservation of endothelial functions (Tavani & La Vecchia 1999). Patients with acute myocardial infarction (AMI) have also been shown to have reduced plasma antioxidant vitamins and enhanced lipid peroxidation upon thrombolysis, suggesting that antioxidants may reduce free radical generation processes in reperfusion injury in AMI (Levy et al 1998). In an animal study, atherosclerosis was inhibited in rabbits fed a high-cholesterol diet supplemented with all-trans beta-carotene. In that study all-trans beta-carotene 2007 Elsevier Australia

The Observational View of Dietary Antioxidants

Cancer and cardiovascular disease (CVD) are the two leading causes of death worldwide, diabetes mellitus is reaching epidemic proportions, and dementia and maculopathy are largely untreatable irreversible disorders that are increasingly common in our aging population. The prevalence and standardized mortality rates of these diseases vary considerably between and within populations. Mortality from CVD varies more than 10-fold amongst different populations, and incidences of specific cancers vary 20-fold or more across the globe. This enormous variation highlights the multiple factors at play in the etiology of chronic age-related diseases. These factors include smoking habit, socioeconomic status, exposure to infectious agents, cholesterol levels, certain genetic factors, and diet. Dietary factors have long been known to play an important role in determining disease risk. Indeed, 30-40 of overall cancer risk is reported to be diet-related, and there is a wealth of compelling...

Cardiovascular Disease

In contrast, analysis of the data from the ATBC cancer prevention study, which involved 23,144 male smokers, found that beta-carotene supplementation slightly increased the risk of angina (Rapola et al 1996) and intracerebral haemorrhage while having no overall effect on the risk of stroke (Leppala et al 2000a,b), abdominal aortic aneurysm (Tornwall et al 2001), or symptoms and progression of intermittent claudication (Tornwall et al 1999). Beta-carotene, however, was found to decrease the risk of cerebral infarction modestly among a subgroup with greater alcohol consumption (Leppala etal 2000a,b). In a 6-year post-intervention follow-up study, beta-carotene was found to increase the risk of first-ever myocardial infarction while continuing to have no overall effect on the incidence of stroke (Tornwall et al 2004). An analysis of 52 men from the CARET Study concluded that there was no significant effect on total, HDL- or LDL-cholesterol levels that could account for the observed...

Mechanisms Of Risk Reduction

One of the first clinical trials that investigated the role of nut consumption in CV disease was performed by Sabate and colleagues, and evaluated the effects of implementing walnuts into a standard cholesterol-lowering diet. It found that subjects who consumed nuts in their diet had significantly lower total cholesterol and more favorable lipoprotein profiles (Sabate et al., 1993). Individuals randomized to a nut consumption diet had a 16 lower level of low-density lipoprotein cholesterol (LDL-C) and a 12 lower LDL-C to high density lipoprotein cholesterol (HDL-C) ratio (Sabate et al., 1993). Subsequent to Sabate and colleagues' study, many more published studies added to the evidence that nut consumption had beneficial effects on lipid profiles. In a study conducted by Jenkins and colleagues, patients were randomized to a low saturated fat diet, to the same diet with lovastatin, or to a diet with cholesterol-lowering foods that included plant sterols and nuts (Jenkins et al., 2003)....

Substances reducing the rate of de novo lipogenesis and their possible therapeutic potential for the control of obesity

Finally, so far it is unclear whether long-term HCA treatment may have adverse effects. Most animal studies indicate that HCA is a safe, natural supplement that does not cause any changes in major organs or in hematology, clinical chemistry and histopathology (Ohia et al. 2002 Shara et al. 2004 Soni et al. 2004 Oikawa et al. 2005). However, in one study a high dose of HCA caused potent testicular atrophy and toxicity (Saito et al. 2005), and we recently observed that long-term application of HCA increased liver lipid content and plasma cholesterol levels in rats (Brandt et al. 2006). One explanation for the unexpected effects of HCA on lipid metabolism might be that HCA stimulates the enzyme ACC (Hackenschmidt et al. 1972). Thus, HCA acts as an inhibitor of DNL only if cytoplasmatic acetyl-CoA is produced by the citrate cleavage enzyme reaction, whereas HCA will not affect (Zambell et al. 2003) or even activate fatty acid synthesis whenever an alternative source of cytoplasmatic...

Mutations in the LDLR gene

Missense mutations are the most numerous of the small DNA variations (58.5 , 821 1404) reported in the LDLR gene in association with Familial Hypercholesterolemia (FH). Like the other small DNA variations in the LDLR gene, missense mutations are widely distributed throughout the whole sequence of the gene (Figure 2). Therefore, no real mutation hot spot can be defined which sustains the need to scan the whole gene sequence to identify FH-causing mutations in the diagnostic procedures. Sterne-Weiler et al. 2011). Within the LDLR gene, 28.4 of the reported missense mutations are predicted to alter functional splicing signals. The missense mutation c.2140G> C (p.Glu714Gln) that was predicted to be benign with four prediction tools for substitutions (Polyphen*, SIFT*, Pmut* and SNPs3D*) was predicted to create the loss of the intron 14 donor splice site with either NetGene2* and NNSPLICE* prediction tools for splice site mutations (Marduel et al. 2010). It is clear, however, that mRNA...

General Chemical Structure

Testosterone has a four-ring structure composed of nineteen carbon atoms. Accordingly, the carbon atoms are labeled by number from one to nineteen (see Figure 1). Many synthetic forms of testosterone are made by adding either an alkyl group or an ester to the seventeen-carbon atom. An alkyl group is a chain of carbon and hydrogen atoms. An ester is formed by reacting an acidic chain of carbon and hydrogen atoms to the -OH group on the seven-teen-carbon atom. In general, when an alkyl group is added to the seventeen-carbon atom, the resulting drug can be taken as a pill however, these so-called seventeen-alkylated AASs are relatively toxic to the liver and are more likely to cause negative effects on cholesterol levels. By contrast, when an ester is formed at the seventeen-carbon atom, an injectable form of testosterone is created that is less toxic to the liver and cholesterol levels. Other AASs are created by making modifications at other carbon atoms.

What is an obesityrelated illness

Obesity-related illnesses and conditions include elevated cholesterol and triglycerides, gallstones, pancreatitis, abdominal hernia, fatty liver, diabetes and prediabetes, polycystic ovary syndrome, high blood pressure, heart disease, pulmonary hypertension, stroke, blood clots in the legs and lungs, sleep apnea, arthritis, gout, lower back pain, infertility, urinary incontinence, and cataracts. If you have one of these conditions gastric surgery can be considered when the BMI is 35 or higher. In many cases gastric bypass surgery can dramatically improve obesity-related conditions. I have had many patients who after gastric bypass surgery were able to give up their blood pressure, diabetes, and cholesterol lowering medications. Many young women who have been unable to become pregnant conceive and go on to have healthy babies (more on this later).

Presentday Cultivation And Usage

Almonds continue to be used in various foods, but they have now become of particular interest in nutraceuticals as a means of therapy. They have been linked to disease prevention and management in numerous studies. An example of almond incorporation into present-day diets is the use of almond milk. Almond milk, a dairy milk substitute, is processed from almonds, and makes an efficient and well-liked soy-free choice analog for lactose-intolerant people and for vegans. More innovative methods of incorporating almonds in diets as healthy alternatives continue to be explored and developed. Recently, a low carbohydrate nut-bread recipe was conceived at the St Michael's Hospital Clinical Nutrition and Risk Factor Modification Center in Toronto, and this, due to its high palatability and beneficial nutrient profile, was used in the successful EcoAtkins weight loss and cholesterol lowering trial (see Table 18.1 for the recipe) (Jenkins et al., 2009).

Dietary Carbohydrate

High carbohydrate (low fat) intakes tend to increase plasma tri-acylglycerol and decrease plasma HDL cholesterol concentrations (Borkman et al., 1991 Brussaard et al., 1982 Marckmann et al., 2000 West et al., 1990 Yost et al., 1998). This effect has been observed especially for increased sugar intake (Mann et al., 1973 Rath et al., 1974 Reiser et al., 1979 Yudkin et al., 1986). Fructose is a better substrate for de novo lipogenesis than glucose or starches (Cohen and Schall, 1988 Reiser and Hallfrisch, 1987), and Parks and Hellerstein (2000) concluded that hypertriacylglycerolemia is more extreme if the carbohydrate content of the diet consists primarily of monosaccharides, particularly fructose.

Are there any age requirements for gastric bypass surgery

Tion, however, that the obesity epidemic in this country also includes children. Many obese children develop adult diseases or conditions such as high blood pressure, type 2 diabetes, and high cholesterol. Obese children are often taunted and teased by their peers. Clearly, obesity can take a physical and emotional toll on the young. Because of these concerns a few centers in the United States are offering this surgery to carefully selected teens. In general surgeons wait until a teen has achieved adult height. For young women this is typically by thirteen or fourteen years of age, and for young men by fifteen or sixteen. As this book goes to press guidelines for selecting appropriate pediatric candidates for gastric bypass surgery are being drafted.

Learn How to Interpret Your Full Lipid Profile

High-density lipoprotein (HDL) is the type of cholesterol that we think of as good or protective. If small amounts of plaque (LDL or bad cholesterol) have been laid down in your blood vessels and you have enough HDL, you will be able to dissolve this plaque and use it as an energy source.

Health Effects of Carbohydrates

Certain NSP (for example fi glycans) have been shown to reduce low-density lipoprotein (LDL) and total cholesterol levels on a short-term basis. Therefore, a protective effect for CVD has been shown with consumption of foods high in NSP. This High-GI diets have been shown to slightly increase hemoglobin A1c, total serum cholesterol and triacylglycerols, and decrease HDL cholesterol and urinary C-peptide in diabetic and hyperlipi-demic individuals. In addition, low-GI diets have been shown to decrease cholesterol and triacylgly-cerol levels in dyslipidemic individuals. There are insufficient studies performed on healthy individuals and further research on the role of GI in lipid profile and CVD risk factors is warranted.

The risk factors paradigm

High blood pressure Tobacco use High blood glucose Physical inactivity Overweight and obesity High cholesterol Unsafe sex Alcohol use Childhood underweight Indoor smoke from solid fuels Unsafe water, sanitation, hygiene Low fruit and vegetable intake Suboptimal breastfeeding Urban outdoor air pollution Occupational risks Vitamin A de ciency Zinc de ciency Unsafe health-care injections Ironde ciency

Carrie Amazing Changes in Her Lipid Profile

With a body fat percentage of 20.5, Carrie had dropped from a size 12 dress to a size 6. She told me, I had no idea that eating and exercising right would make such a dramatic difference. Whenever someone in her family comes back from their yearly physical with high cholesterol and triglycerides, she tells them about my program. Recently she told me, My brother in Pennsylvania called and said that he had been to his doctor. He had gained 30 pounds, his triglycerides were 300, and his cholesterol was 323. I read him the riot act Then I went right down the list with him, coaching him with everything you had taught me and promising to send him a copy of your books Lose Your Love Handles and Maximum Energy for Life. Yesterday he called me back and told me that he had lost 16 pounds, his triglycerides had dropped to 156, and his cholesterol was now 232, just from following your program. Thank you, Mackie.

Lipidlowering Activity

Although the mechanism of action is yet to be fully explained, studies show that chromium supplementation may decrease triglyceride levels, total and LDL-cholesterol and modestly increase HDL-cholesterol (Bahijri 2000, Lee & Reasner 1994, Press et al 1990, Preuss etal 2000).

The Role Of Lifestyle

Lower risk of all cause and cardiovascular mortality seen in wine drinkers in this and other studies is a consequence of the multiple healthier lifestyle characteristics and higher socio-economic status in wine drinkers resulting in lower fatality, rather than the result of a specific benefit of wine. HDL-cholesterol cannot explain the lower absolute risk of wine drinking compared to other types of alcohol drinkers as the dose-response relationship between alcohol intake and HDL-cholesterol was similar in male beer, spirit and wine drinkers 27 and wine drinkers showed identical levels of HDL-cholesterol to non-wine drinkers (Table 3.2).

Pathophysiology Of Cholesterol Gallstone Formation

It is not surprising, that in a polygenetic disorder as cholesterol gallstone disease, several underlying mechanisms may be involved in its pathogenesis. Nevertheless, the common theme remains excess biliary cholesterol compared with solubilizing bile salts or phospholipids. In Chilean patients (especially of Amerindian descent), increased bile salt and cholesterol synthesis have been reported.42 The defect was supposed to be secondary to increased intestinal loss of bile salts, and preceded gallstone formation. Interestingly, decreased expression of ileal bile salt transport proteins apical sodium-dependent bile acid transporter, cytosolic ileal lipid binding protein, and basolateral organic solute transporter a and b were recently described in female nonobese patients as a possible explanation of these findings.43,44 It has also been reported that high dietary cholesterol increases biliary cholesterol secretion and decreases bile acid synthesis and pool in cholesterol gallstone...

Exogenous Cholesterol Transport

Cholesterol is absorbed in the unesterified state, whereas the cholesterol secreted into the lymph is 70-80 esterified. This esterification process generates a concentration gradient of free cholesterol within the mucosal cell that may facilitate absorption rates. Cholesterol is esterified in intestinal mucosal cells by acyl-coenzyme A cholesterol acyl-transferase-2 to form cholesteryl esters, which are secreted from the basolateral surface of the entero-cyte as part of the chylomicrons. At this stage, it is assumed that cholesterol molecules from exogenous and endogenous sources are indistinguishable and have similar effects on endogenous cholesterol and lipoprotein metabolism. Chylomicrons are large particles (> 70 nm in diameter) composed mainly of triacylglycerols (95 by weight) and contain 37 cholesterol by weight, with the esterified cholesterol localized in the hydrophobic core and the free cholesterol primarily in the hydrophilic outer layer. The data indicate that the...

Tissue Uptake and Storage

The body pool of cholesterol is approximately 145 g, with one-third of this mass localized in the central nervous system. The remainder of the metabolically active cholesterol pool exists in the plasma compartment (7.5-9 g) and as constituents of body tissues. In humans, tissue cholesterol levels are relatively low, averaging 2 or 3 mg g wet weight. Little information exists regarding changes in hepatic and extrahepatic tissue cholesterol concentrations with changes in dietary cholesterol intake. Animal studies, which are usually carried out using very high levels of dietary cholesterol, have shown that hepatic cholesterol can increase from 2-fold up to 10-fold, depending on the species and other dietary constituents, when dietary cholesterol is increased.

Regulation of Synthesis

Research shows that in most individuals, dietary cholesterol alters endogenous cholesterol synthesis and that this feedback regulation can effectively compensate for increased cholesterol input from dietary sources. The precision of these regulatory responses depends on a number of genetic factors, and data suggest that multiple genetic loci are involved. For example, family studies have shown that in siblings of low cholesterol absorption families, cholesterol absorption percentages are significantly lower and cholesterol and bile acid synthesis, cholesterol turnover, and fecal steroids are significantly higher than in siblings of high absorption families.

Major Dietary Sources

The major sources of cholesterol in the diet are eggs, meat, and dairy products. A large egg contains approximately 215 mg of cholesterol and contributes approximately 30-35 of the total dietary cholesterol intake in the United States. Meat, poultry, and fish contribute 45-50 , dairy products 12-15 , and fats and oils 4-6 . In the United States, the range of dietary cholesterol intake is 300-400 mg per day for men and 200-250 mg per day for women thus, for much of the population the national goal of a dietary cholesterol intake of less than 300 mg per day has been met.

Considering How Fibromyalgia Relates to Womens Ages

By abdominal obesity (a body shape like an apple instead of a pear), high triglycerides, high blood pressure, low levels of high-density lipoprotein (HDL, the good cholesterol), and high fasting glucose (blood sugar) levels. The researchers also found that higher urinary levels of norepinephrine and cortisol were associated with a risk for metabolic syndrome.

Metabolic Functions Of Vitamin E

It was noted in Section 4.1 that the tocotrienols can be considered to be derivatives of mevalonate, the product of HMG CoA reductase, which is the key regulatory enzyme of cholesterol synthesis. Dietary tocotrienols have a cholesterol-lowering effect they act by reducing the activity of HMG CoA re-ductase. The main effect is posttranslational tocotrienols cause an increased

Clinical Effects of Inadequate Intake

Of particular concern in a Western, urbanized society is the long-term consequences of a diet sufficiently low in carbohydrate such that it creates a chronically increased production of P-hydroxybutyric and acetoacetic acids (i.e., keto acids). The concern is that such a diet, deficient in water-soluble vitamins and some minerals, may result in bone mineral loss, may cause hypercholesterolemia, may increase the risk of urolithiasis (Vining, 1999), and may affect the development and function of the centra1 nervous system. It also may adversely affect an individual's general sense of well being (Bloom and Azar, 1963), although in men starved for an extended period of time, encephalographic tracings remained unchanged and psychometric testing showed no deficits (Owen et al., 1967). It also may not provide for adequate stores of glycogen. The latter is required for hypoglycemic emergencies and for maximal short-term power production by muscles (Hultman et al., 1999).

Potential Mechanisms Indicating a Role in the Etiology of Coronary Heart Disease

The mechanism for risk reduction and the fiber components responsible need resolution. Elevated plasma total and low-density lipoprotein (LDL) cholesterol concentrations are established risk factors for coronary morbidity and mortality. There are abundant human and animal data showing that diets high in soluble fiber lower plasma cholesterol. One population study has shown a significant negative relationship between viscous (soluble) fiber intake and carotid artery atherogensis as measured by intima-media thickness. This association was significant statistically even though average fiber intakes were not particularly high. When dietary fiber intakes have been related to measures of actual disease outcomes, the evidence is less convincing. A protective effect is often observed on univariate analyses, but once confounding variables are added, dietary fiber intake tends not to be a significant independent predictor of risk for developing CHD. However, in one 12-year follow-up study of...

Dietary Fiber and the Etiology of Hormone Dependent Cancers

Direct binding of sex hormones is possible but is subject to the same concerns as were raised for cholesterol reduction. In addition, it is possible that other components in, or associated with, fiber (phytooestrogens or antioxidants) may be responsible for any observed protective effect. Soy phytooestrogens are believed to play a role in lowering the risk of breast cancer in Asian populations. Lycopenes are antioxidant carotenoids from tomatoes, and their intake has been correlated with a lower risk of prostate cancer.

Functional Interactions

Reduction in the concentration of bile acids A reduction in the concentration of bile acids will affect the absorption of most fat-soluble compounds. Lower bile-acid concentration may result from increased binding and excretion or from decreased production. For example, the antibiotic neomycin binds to bile acids and increases their faecal excretion, thus reducing their luminal concentration and, in this fashion, decreasing the absorption of fat-soluble vitamins. This interaction, like many others, can be used ther-apeutically to reduce bile-acid turnover in patients with certain liver diseases and to lower cholesterol levels by reducing their reabsorption.

Box 1 The metabolic syndrome changes associated with insulin resistance

Depressed patients who do not have overt diabetes also have an increased relative risk for developing cardiovascular complications that varies between 1.5 and 2.7 depending on the magnitude of depressive symptoms 9 . Notably, also in the absence of predefined psychiatric diagnoses as major depression, psychologic factors (especially when occurring in combination) result in an increased risk for cardiovascular complications are to the risks associated with hypercholesterolemia, hypertension, and other major risk factors 10,11 .

Prevention Of Morbidity And Mortality Of Cardiovascular Disease

For over 25 years, fish and fish oils have been linked to cardiovascular health. This association was first recognised when significantly lower death rates from acute myocardial infarction (Ml) were found among Greenland's Inuit population, despite only moderate differences between the Inuits' blood cholesterol levels and those of other populations (Holub 2002). A high dietary omega-3 fatty acid intake in the form of marine mammals (seal, whale) and various fish were thought responsible for the protective effect (Bang et al 1980). In 1989, results from the first large, randomised, clinical trial investigating the effects of fatty fish consumption on survival and risk of secondary Ml confirmed a link to cardiovascular health (Burr et al 1989). The DART (Diet and Reinfarction study) found a modest intake of 2-3 portions weekly of fatty fish reduced mortality in men who had previously experienced a Ml and produced a relative reduction in total mortality of 29 during the 2-year follow-up,...

Elevated Triglyceride Levels

DHA and EPA supplementation significantly reduces triglyceride levels and is used as sole therapy in cases of elevation or as adjunctive therapy with cholesterol-lowering medication when indicated. According to Din et al, omega-3 fatty acids reduce triglyceride concentrations in a dose-dependent manner, with intakes of about 4 g day lowering serum triglycerides by 25-30 (Din et al 2004).

Oat Products and fiGlucans

Normalization of Blood Lipid Concentrations. In one study, oat gum supplementation (9 g d of P-glucan) did not significantly decrease serum total cholesterol concentration compared to the placebo, leading the authors to conclude that the cholesterol-lowering capacity of oat gum in healthy young men is weak (Beer et al., 1995). In contrast, when hyper-cholesterolemic individuals were fed oat gum providing 5.8 g d of P-glucan or a maltodextrin placebo for 4 weeks, mean total and LDL cholesterol concentrations decreased throughout the oat gum phase, and both concentrations were reduced 9 percent relative to initial values (Braaten et al., 1994b). In a larger study, adults with multiple risk factors and LDL cholesterol concentrations above 4.14 mmol L or between 3.37 and 4.14 mmol L were randomized to one of seven groups to receive either oatmeal or oat bran at various levels or a placebo control (Davidson et al., 1991). There was a dose-dependent reduction in LDL cholesterol...

Summary of the Intervention Trials

Viscous Functional Fibers and foods sources of viscous Dietary Fiber reduce both total and LDL cholesterol concentrations, and may also reduce serum triglycerides. The amount of cholesterol reduction appears to be related to the amount of fiber consumed, although only a few studies report dose-response data. A meta-analysis of 20 trials that used high doses of oat bran, which is rich in viscous Dietary Fiber, showed that the reductions in serum cholesterol concentrations ranged from 0.1 to 2.5 percent g of intake (Ripsin et al., 1992). If one accepts the proposed 2 percent risk reduction Although the calculations above are hypothetical and are based on a number of assumptions, (including the linearity of response of fiber consumption to risk reduction), the finding that the degree of risk reductions per gram of fiber consumed are within a reasonable range of each other are suggestive that the results of the clinical trials for viscous fibers are supportive of the epidemiological...

Heart Involvement in SLE

Another problem for children with SLE is the development of arteriosclerosis, the hardening of the arteries that occurs normally as people get older. In its severe forms, it causes narrowing of the coronary arteries, which leads to heart attack. Chronic use of corticosteroids promotes the development of arteriosclerosis, so children who have received a lot of corticosteroids may develop arteriosclerosis in their teens or twenties. High cholesterol levels (which may occur in children with severe kidney damage) also promote arteriosclerosis. High blood pressure may be a consequence of corticosteroids and or kidney disease. Inflammation in the blood vessels promotes high blood pressure and arteriosclerosis, too. Some children with SLE have all of these factors. As a result, a number of children with lupus who have been treated with moderate doses of corticos-teroids for many years will have a heart attack in their twenties or thirties. This is one of the strongest arguments for using...

Health and nutritional benefits of soybeans

Food and Drug Administration approved a health claim based on the role of soybean protein in reducing the risk of coronary heart disease (Mateos-Aparicio et al., 2008). This claim establishes that soybean protein included in a diet low in saturated fat and cholesterol may reduce the risk of coronary heart disease. It has been suggested that frequent soybean protein consumption lowers cholesterol levels (Mateos-Aparicio et al., 2008). It has also been claimed that soybean dietary fiber plays a role in the reduction of cholesterol levels in some hyperlipidemic individuals and has a major protective effect on cardiovascular disease (Anderson et al., 1999 Mateos-Aparicio et al., 2008). Therefore, the possible use of soybean in baked foods in developing countries could provide economic and health advantages because the consumption of soybean protein and dietary fiber seems to reduce the risk of cardiovascular disease. Furthermore, soybean isoflavones have been...

Ldl Hdl and atherosclerosis

Membrane function is compromised if it contains either too much or too little cholesterol. Epidemio-logical studies have classified raised plasma cholesterol levels as a risk factor for atherosclerosis, and it is one of the more important predictors of coronary heart disease (CHD). Elevated plasma cholesterol concentration (hypercholesterolemia) is associated with an increased concentration of LDL, owing to either an increased rate of LDL formation or a decrease in the rate at which they are cleared from plasma, and usually a decreased concentration of HDL. Numerous dietary-intervention studies have aimed both to prevent CHD and to reduce total mortality, but almost all have been ineffective.

Endothelial dysfunction

Relaxing factors, production of an endogenous NO synthase inhibitor, and overproduction of oxygen-derived free radicals including O2. The release of the free radical O2 from smooth muscle cells is believed to be responsible for the oxidation of LDL cholesterol. Raised cholesterol levels and - more importantly - increased levels of oxidatively modified LDL cholesterol (OxLDL) are considered to be among the most powerful inhibitors of normal endothelial function and hence contribute to the process of atherogenesis.

Eicosanoid Metabolism and Biological Effects of n6 and n3 Fatty Acids

Because of the increased amounts of n-6 fatty acids in the Western diet, the eicosanoid metabolic products from AA, specifically prostaglandins, thromboxanes, leukotrienes, hydroxy fatty acids, and lipoxins, are formed in larger quantities than those formed from n-3 fatty acids, specifically EPA. As a result (Figure 5), ingestion of EPA and DHA from fish or fish oil leads to (1) decreased production of prostaglandin E2 metabolites (2) decreased concentrations of thromboxane A2, a potent platelet aggregator and vasoconstrictor (3) decreased formation of leukotriene B4, an inducer of inflammation and a powerful inducer of leukocyte chemotaxis and adherence (4) increased concentrations of thromboxane A3, a weak platelet aggregator and vasoconstrictor (5) increased concentrations of prostacyclin prostaglandin I3 (PGI3), leading to an overall increase in total prostacyclin by increasing PGI3 without decreasing PGI2 (both PGI2 and PGI3 are active vasodilators and inhibitors of platelet...

Total Saturated Fat Content of Diets

Using statistical techniques, results from independent experiments have been combined to develop equations that estimate the mean change in serum lipoprotein levels for a group of subjects when carbohydrates are replaced by an isoenergetic amount of a mixture of saturated fatty acids. The predicted changes for total LDL and HDL cholesterol and triacylglycerols are shown in Figure 1. Each bar represents the predicted change in the concentration of that particular lipid or lipoprotein when a particular fatty acid class replaces 10 of the daily energy intake from carbohydrates. For a group of adults with an energy intake of 10 MJ daily, 10 of energy is provided by about 60 g of carbohydrates or 27 g of fatty acids. A mixture of saturated fatty acids strongly elevates serum total cholesterol levels. It was predicted that when 10 of dietary energy provided by carbohydrates was exchanged for a mixture of saturated fatty acids, serum total cholesterol concentrations would increase by...

Effect of trans Fatty Acids on Plasma Lipoproteins

Raised plasma concentrations of low-density lipopro-tein (LDL) are considered to be a risk factor for coronary heart disease (CHD) in contrast, reduced concentrations of high-density lipoprotein (HDL) are considered to increase risk. It therefore follows that to help protect against CHD, diets should ideally help to maintain plasma concentrations of HDL cholesterol and to lower those of LDL cholesterol. Dietary factors that raise LDL and lower HDL concentrations would be considered to be undesirable in this context. C18 monounsaturated trans fatty acids decrease HDL cholesterol concentration this is in contrast to saturated fatty acids which produce a small rise in HDL levels. In comparison with the effects of oleic and lino-leic fatty acids, C18 monounsaturated trans fatty acids raise LDL cholesterol and lower HDL cholesterol levels. The influence of trans fatty acids on plasma lipo-proteins in relation to CHD risk would thus appear to be more unfavorable than that of saturated fatty...

BPharmacotherapy Trials

Rationale The effects of pharmacological therapy on weight loss and subsequent changes in total serum cholesterol levels were evaluated by examining eight RCTs 386 390-393 395 407408 (Table III-3). The four trials of dexfenfluramine showed no consistent effects on total cholesterol three trials showed decreases in triglycerides ranging from 14 to 40 percent and two trials showed increases in HDL-cholesterol of 8 percent in women to 27 percent in men. One trial of phentermine plus fenfluramine showed a 24 percent decrease in triglycerides and a slight change in HDL-cho-lesterol. 395 The trial of orlistat showed a decrease in total cholesterol and an increase in triglycerides, while the trial of fluoxetine showed the opposite. 407, 408 Other RCTs using orlistat have shown a modest improvement in lipids with weight loss. 388 In a combined summary of data presented at the FDA Endocrinologic and Metabolic Drugs Advisory Committee Meeting (held in Bethesda, Maryland, in September 1996), use...

Cardiovascular Health

Premature atherosclerosis and coronary heart disease (CHD) are long-term adverse events that occur at much greater frequency among patients with SLE than would be expected. Patients with SLE have a five- to six-fold increased risk of CHD, and in young women between 20 and 40 years, this risk is reported to be as high as 50-fold greater than peers (26). Although the actual risk of a cardiac event related to atherosclerosis is relatively low in adolescence, clearly the process of accelerated atherosclerosis may begin during this time. The etiology of early CHD in patients with SLE involves both classic risk factors as well as factors relating to disease such as chronic inflammation, autoantibodies such as antiphospholipid antibodies, and vascular perturbation by vasculitis (27). Table 2 lists risk factors for early atherosclerosis in patients with SLE. Certain classic cardiovascular disease risk factors are more common among patients with SLE, such as diabetes, hypertension, and...

Cardiovascular Effects

Antihyperlipidaemic Ginsenoside Rb1 has been shown to lower triglyceride and cholesterol levels via cAMP-production in the rat liver (Park et al 2002b). P. ginseng extract (6 g day) for 8 weeks resulted in a reduction in serum total cholesterol, triglyceride, LDL and plasma malondialdehyde levels and an increase in HDL (Kim & Park 2003) in eight males. Ginseng has also been reported to decrease hepatic cholesterol and triglyceride levels in rats, indicating a potential use of ginseng in the treatment of fatty liver (Yamamoto et al 1983).

The significance of psychosocial stress

Other studies have linked sympathetic hyperresponsivity to the induction of myocardial ischemia during exercise and mental stress and to predictions of the future development of hypertension and progression of atherosclerosis 66-72 . Increased systemic vascular resistance during mental stress testing is the most significant hemodynamic factor associated with mental stress-induced myocardial ischemia and most likely is the result of peripheral endothelial dysfunction 73 . Inhibition of cortisol production has been shown to prevent mental stress-induced endothelial dysfunction and baroreflex impairment, again pointing to a significant role of the HPA axis 74 . Interestingly, endothelial dysfunction after mental stress has been shown in hypertensive subjects but not in patients who have hypercholesterolemia 75 . This finding is noteworthy because both hypertension and hypercholesterolemia are risk factors for atherosclerosis and cardiovascular disease, and endothelial dysfunction is a...

Cigarette Smoking And The Risk Of Stroke

Heavy smoking (> 20 cigarettes day) increases both the incidence 37-41 and mortality from stroke 40,41 , Cigarette smoking is a major modifiable risk factor for subarachnoid hemorrhage 42-48 , In contrast, evidence concerning the role of tobacco in the risk of intracerebral hemorrhage is still controversial, yet it appears that heavy, but not light-to-moderate cigarette smoking, increases the risk 9,38,49,50 , Smoking is dose-dependantly associated with the risk of ischemic stroke 38,46 , Cessation of smoking reduces stroke risk 37,39 , with major reduction within 2-5 years after cessation 37,39,46 , indicating that part of the effects of smoking is reversible. The risk of stroke seems to return to the level of never-smokers in light smokers, but heavy smokers seem to retain an increased risk even though also they benefit from cessation 37 , There are several mechanisms by which smoking may cause stroke. Cigarette smoking causes an immediate, yet reversible increases in blood...

The Effect Modification Of Alcohol By Smoking

There are only two epidemiologic studies on the effect modification of alcohol by smoking and neither of them examines it in relation to the risk of stroke. In a Japanese cohort of 19,231 men, alcohol consumption and all-cause mortality had a J-shaped association in nonsmokers but not in smokers 78 , In a cross-sectional study of 5,312 German men and women, the rise in blood pressure associated with drinking was higher in smokers than in nonsmokers 79 , Some studies have instead examined the effect modification of smoking by alcohol. In a cohort of 22,071 US male physicians, alcohol attenuated the linear effect of smoking on the risk of total stroke 38 , In a Japanese cohort of 1,775 men, a dose-dependent decrease in diastolic blood pressure and serum HDL cholesterol by increasing cigarette smoking was evident in nondrinkers but not in drinkers The effects of both alcohol and tobacco are manifold, which makes them complicated to examine and understand. The effects may be additive or...

Guide for Separating Food Folklore Facts from Fiction in Clinical Situations and A Practical Example

For example, when the patient's prescription drug is one that is metabolized by cytochrome 3A (CYP 3A), a dramatic effect can occur if grapefruit juice or other forms of the fruit are consumed. Grapefruit juice enhances the effects of these drugs over time by decreasing their oral clearance. However, the effects of the interaction depend on the nature of the drug (for some drugs there is little or no effect) and the size of the interaction. Interaction occurs only if the drug is metabolized by CYP 3A, if it normally undergoes pre-systemic extraction with CYP 3A, and if it is given orally. The interactions vary. For example, with the statins - drugs commonly used to lower serum cholesterol -they are strong for simvastatin and lovastatin, moderate for atorvastatin and cervastatin, and low for fuvastatin and pravastatin. Similarly, sedatives, hypnotics, and other drugs vary as to whether they induce interactions or not.

Effects of Pglucans on lipid metabolism

More data on the effect of dietary fibre on cardiovascular diseases have been gained from intervention trials. Over 50 studies have investigated the effect of P-glucans on blood cholesterol levels. Some investigators have also addressed the task to make overall evaluations on the relation between oat P-glucan intake and its cholesterol-lowering effects. A large meta-analysis of oat products and their lowering effects on plasma cholesterol was made by Ripsin et al.51 The included studies presented differences in study designs, oat products, doses of oats and control products, and subjects with different initial cholesterol levels, gender and age the influence of these parameters was assessed in the meta-analysis. To be included in the meta-analysis, studies had to be controlled and randomized and the control product had to have a low soluble fibre content. Moreover, the trial should also have included a dietary assessment and measurement of body weight. Twelve trials were included in...

Central Europeans and Russians Diets of

A health gap separates Central and Eastern Europe from the United States, Canada, Japan, and the Western part of Europe. This East-West gap in health started during the 1960s. Almost half of this gap was due to cardiovascular disease (CVD) mortality differentials. There has been a marked increase of CVD in Central and Eastern Europe, which is only partially explainable by the high prevalence of the three traditional CVD risk factors (hypercholesterolemia, hypertension, and smoking) in these countries. There is an extreme nonhomogeneity of the former Soviet bloc, and the data from each country must be analyzed individually. The aim here is to present the latest available data, which show the health status of various regions of postcommunist Europe. All data used are taken from the World Health Organization (WHO) Health for All Database (as updated in June 2003). The last available data from most countries are from the year 2002. hypercholesterolemia high levels of cholesterol in the...

Edible Plants and Phytochemicals

Soy protein extracts have been found to lower cholesterol in humans, an effect that appears to be related to amino acid composition. Soy protein extracts frequently contain nonprotein isoflavones, which have received considerable attention because of their structural similarity to estrogen. Soy isofla-vones are weak estrogen agonists and partial estrogen antagonists. Epidemiologic and experimental data indicate that isoflavone exposure during adolescence may diminish the incidence of adult breast Regular consumption of tea, green or black, is associated with a decreased risk of heart disease and several kinds of cancer. These benefits are attributed to tea's high content of catechin polymers, especially epigallocatechin gallate (ECGC), which has potent antioxidant and anti-inflammatory effects, that may lower cholesterol in hyperli-pidemic individuals and alter the activity of several enzymes involved in carcinogenesis. Catechin content is highest in young leaves. Aging and the...

Pathophysiology of Stone Formation

Among lipid-lowering drugs, Clofibrate seems to have the greatest association with increased gall stone formation. The role of statins in gall bladder disease remains to be elucidated. Approximately one-third of patients treated with octreotide, a somatostatin analog, develop new gall stones. Cef-triaxone (Rocephin) has been shown to cause sludge formation in children. A large fraction of ceftriax-one is secreted in bile (40 ) and forms complexes with calcium, resulting in an insoluble salt. The sludge disappears when ceftriaxone is discontinued. Diet and lipid profile The ingestion of refined sugars has been shown to be associated with gall stone disease. However, no such association has been shown for alcohol or tobacco. It is not clear if high serum cholesterol predisposes to gall stone formation. In fact, the contrary has been shown in some studies. This is also the case for dietary cholesterol ingestion, which was shown to be a protective factor for gall stone formation in one...

Benefits of Low Glycemic Index Carbohydrates on Cardiovascular Disease Risk Factors

High glycemic index foods induce postprandial hyperinsulinemia, which is a powerful predictor for metabolic risk factors and CVD in epidemiological studies. Both cross-sectional and prospective population studies have shown favorable lipid profiles in association with high carbohydrate diets. Initially, these benefits were attributed to a high fiber content. However, when the glycemic index is controlled for, it is the low glycemic index diets rather than high fiber content that have the greatest influence on high-density lipoprotein (HDL) cholesterol, insulin sensitivity, and fibrinolytic parameters. In a cross-sectional study on more than 2000 middle-aged subjects, the glycemic index was a stronger determinant of HDL cholesterol than any other dietary factor, be it carbohydrate or fat. In this study, the HDL cholesterol of the women whose habitual diet was within the lowest quintile for glycemic index was 0.25 mmol l higher than that for women whose dietary carbohydrate was within...

Contemporary Low Calorie Carbohydrate Restricted Diet

In view of the well-recognized link between insulin resistance syndrome, hyperuricemia, and gout, a diet emphasizing reduced calorie intake with moderate restriction of carbohydrates and liberalization of protein and unsaturated fat consumption has been espoused for patients with gout. Low-purine foods are often high in both carbohydrate and saturated fats these foods tend to further decrease insulin sensitivity, thereby contributing to even higher levels of insulin, glucose, triglycerides, and low-density lipo-protein cholesterol and lower high-density lipoprotein cholesterol levels, all of which result in increased risk of coronary heart disease among these patients. Conversely, a calorie-restricted, weight-reduction diet that is low in carbohydrates (40 of total calories) and relatively high in protein (approximately 120 g per-day compared to 80-90 g in the typical Western diet) and unsaturated fat content, with no limitation of purine content, has been studied and found to result...

Findings By Life Stage And Gender Group

Given the capability of all tissues to synthesize sufficient cholesterol for their metabolic and structural needs, there is no evidence for a biological requirement for dietary cholesterol. As an example, many Tarahumara Indians of Mexico consume very low amounts of dietary cholesterol and have no reported developmental or health problems that could be attributed to this aspect of their diet (McMurry et al., 1982). Therefore, neither an Adequate Intake (AI) nor an Estimated Average Requirement (EAR) and Recommended Dietary Allowance (RDA) are set for cholesterol. The question of whether cholesterol in the infant diet plays some essential role on lipid and lipoprotein metabolism that is relevant to growth and development or to the atherosclerotic process in adults has been difficult to resolve. The idea that the early diet might have relevance to later lipid metabolism was first raised by Hahn and Koldovsky (1966) in prematurely weaned rat pups and later supported by observations that...

Plasma Total HDL and LDL Cholesterol Concentrations

Numerous studies in humans have examined the effects of dietary cholesterol on plasma total and lipoprotein cholesterol concentrations (Tables 9-2 and 9-3, Figures 9-1 and 9-2), and empirical formulas have been derived to describe these relationships. Although most studies have TABLE 9-2 Effects of Adding Dietary Cholesterol to Defined Diets with Strict Control of Dietary Intake on Serum Cholesterol Concentration TABLE 9-3 Effects of Adding Dietary Cholesterol to Self-Selected Diets with Strict Control of Dietary Intake on Serum Cholesterol Concentration TABLE 9-3 Effects of Adding Dietary Cholesterol to Self-Selected Diets with Strict Control of Dietary Intake on Serum Cholesterol Concentration Added Dietary Cholesterol (mg d) Added Dietary Cholesterol (mg d) Change in Dietary Cholesterol (mg d) FIGURE 9-1 Relationship between change in dietary cholesterol (0 to 1,000 mg d) and change in serum total cholesterol (TC) concentration. FIGURE 9-2 Relationship between change in dietary...

Cardiovascular Disease and CHD

An association of dietary cholesterol with cardiovascular disease is based on several lines of evidence, including studies in animal models, epidemiological data in humans, and the effects of dietary cholesterol on plasma lipoproteins (Table 9-4). There is compelling evidence that dietary cholesterol can induce atherosclerosis in several animal species, including rabbits, pigs, nonhuman primates, and transgenic mice (Bocan, 1998 McNamara, 2000 Rudel, 1997). However, given the existence of marked inter- and intraspecies differences in cholesterol metabolism and athero-genic mechanisms, it is not possible to extrapolate these data directly to humans. A number of prospective epidemiological studies have investigated the relationship of dietary cholesterol and other nutrients to the development of coronary heart disease (CHD) (reviewed in Kritchevsky and Kritchevsky, 2000 McNamara, 2000). Significant univariate relationships of cholesterol intake to risk for CHD have been observed in the...

Dose Response Assessment

The main adverse effect of dietary cholesterol is increased serum LDL cholesterol concentration, which would be predicted to result in increased risk for CHD. Serum HDL concentration also increases, although to a As reviewed above, on average, an increase of 100 mg d of dietary cholesterol is predicted to result in a 0.05 to 0.1 mmol L increase in total serum cholesterol, of which approximately 80 percent is in the LDL fraction. This effect of added cholesterol is highly variable among individuals and is considerably attenuated at higher baseline cholesterol intakes. The LDL cholesterol concentration increase would predict approximately a 1 to 2 percent increase in CHD, with possibly offsetting effects of increased HDL cholesterol concentration. Epidemiological studies have limited power to detect effects of such magnitude and thus do not provide a meaningful basis for establishing adverse effects of dietary cholesterol. Therefore, it would seem reasonable to define the...

Medications and Supplements

Earlier in the book, I described my journey as a cardiologist firmly committed to the prevention first approach, especially as it pertains to diet. But nutrition and exercise alone can't always ensure cardiac health. In the late 1980s a new class of amazing cholesterol-lowering drugs known as the statins medications such as Mevacor, Pravachol, Lescol, Zocor, and Lipitor became available. With these, we were able to cut cholesterol quite easily and dramatically 20 to 30 percent initially, and now, up to 50 percent. By taking these drugs, we thought, patients could have their cake and eat it, too literally. They could diet or not and still enjoy low cholesterol. Of course, statins did nothing for the waistline. Still, the prevailing wisdom was to forget about diet and take the drugs. Statins were (and still are) expensive. However, studies showed that the incidence of heart attacks could be diminished by approximately 30 percent with this class of medications. I won't burden you with...

Epidemiological Studies

Recently, the South Bay Heart Watch (Torrance, CA) reported a study ofl,196 asymptomatic subjects with coronary risk factors who were assessed for alcohol consumption history and for the presence of calcium deposits in coronary atherosclerotic lesions as measured by electron beam computed tomography (EBCT). Participants were followed prospectively for 41 months for coronary events, defined as the occurrence of myocardial infarction or CHD death 6 , Subjects who drank alcohol had a relative risk of 0.3 ofhaving a coronary event compared with abstainers. The diminished risk of myocardial infarction or CHD death associated with moderate alcohol consumption was independent of serum HDL cholesterol levels, EBCT coronary calcium scores, and all other coronary risk factors. Abstention from alcohol in this study was as strong a predictor of coronary events as diabetes, smoking, hypertension, and coronary calcification 6 , Also reported recently was an analysis of the relationship between...

Homocysteine and Vascular Disease

In the mid-1970s, David and Bridget Wilcken rein-vigorated McCully's hypothesis with their observation that a subset of patients with premature coronary artery disease had reduced ability to metabolize homocysteine. Notably, this association was observed in individuals who did not have any of the severe genetic defects that underly homocystinuria, suggesting that less severe or modest impairment of homocysteine metabolism may contribute to vascular disease risk. Subsequently, the advent of reliable, high-throughput assays for total plasma or serum homocysteine in the 1980s (see below) allowed for large-scale epidemiological assessment of associations between homocysteine and vascular diseases, both cross-sectionally and longitudinally. Through the 1990s, an explosion of population and case-control studies established that hyperhomocysteinemia is, indeed, a risk factor for heart attack, stroke, thrombosis, and peripheral atherosclerotic disease. Moreover, the risk associated with...

Identification of patients at very high absolute risk

The following disease conditions or target organ damage in hypertensive patients denote the presence of very high absolute risk that triggers the need for intense risk factor modification as well as disease management. For example, the presence of very high absolute risk indicates the need for aggressive cholesterol-lowering therapy. 142

Advanced Blood Testing

Lowering total cholesterol is an important goal in preventive care, but it's not nearly enough. In fact, most people who suffer heart attacks have average cholesterol levels. The fact is that one person can have a low cholesterol number and be at grave risk for a heart attack, while someone else with a higher figure will be fine. The familiar total cholesterol figure alone doesn't tell the entire story.

Other Dietary Approaches for the Prevention and Management of CVD

When considering diets very low in fat and high in carbohydrates ('very low-fat' diets), it is important to separate the effects of the composition of the diet from confounding factors associated with intentional weight loss. For the purposes of this discussion, a very low-fat diet will be defined as less than 15 of energy as fat. Consumption of a very low-fat diet without a decrease in energy intake frequently decreases blood total, LDL, and HDL cholesterol levels and increases the total cholesterol HDL cholesterol ratio (less favorable) and triglyceride levels. A mitigating factor may be the type of carbohydrate providing the bulk of the dietary energy complex (whole grains, fruits, and vegetables) or simple (fat-free cookies and ice cream). The reason for this later observation has yet to be investigated. Notwithstanding these considerations, for this reason moderate fat intakes, ranging from < 30 to 25 to 35 of energy Current interest in the area of weight loss is centered on...

Dietary Factors with Limited or Uncertain Effect on Blood Pressure

Numerous studies, including both observational studies and clinical trials, have examined the effects of fat intake on blood pressure. Overall, there is no apparent effect of saturated fat and n-6 polyunsatu-rated fat intake on blood pressure. Although a few trials suggest that an increased intake of monounsa-turated fat may lower blood pressure, evidence is insufficient to make recommendations. Likewise, few studies have examined the effect of dietary cholesterol intake on blood pressure. Hence, although modification of dietary fat and cholesterol intake can be recommended as a means to prevent and treat hyperlipidemia and dyslipidemia, evidence is insufficient to recommend these changes alone as a means to lower blood pressure.

Estimated Therapeutic and Loael Doses of Garlic

A One may wonder why relatively high doses of DADS are required when oral garlic can reduce cholesterol production in humans at moderate doses. The difference is probably because allicin concentrations in the liver are high after oral administration of garlic, and the liver is the major producer of cholesterol in the body. Allicin is about 10-fold more effective at inhibiting isoprene synthesis than DADS.

Identification of cardiovascular risk factors that impart a high absolute risk

Patients can be classified as being at high absolute risk for obesity-related disorders if they have three or more of the multiple risk factors listed below. The presence of high absolute risk increases the intensity of cholesterol-lowering therapy 142 and blood pressure management. 545 4.d. Low high-density lipoprotein cholesterol A low HDL-cholesterol is defined as a serum concentration of < 35 mg dL.

Glycogen Storage Disorders

Glycogen storage disease (GSD) type I (GSD I) (Figure 6), the most common disorder, is due to a deficiency of glucose-1-phosphatase in the liver, kidney, and intestinal mucosa. Symptoms typically occur in infancy when the frequency of feeding decreases. Profound hypoglycemia can occur progressive hepatomegaly and liver dysfunction are due to storage of glycogen. Other metabolic derangements include lactic acidaemia, which is due to increased pyruvate production increased fatty-acid synthesis causes hypertriglyceridemia and hypercholesterolemia (causing xanthomas) hyperuricemia (causing gout and renal calculi) is due to decreased renal excretion (lac-tate is preferentially excreted) and increased uric-acid production owing to phosphate depletion. Other long-term complications include progressive renal disease (proteinuria) and hepatocellular carcinoma. Treatment involves frequent meals and continuous nocturnal feeding (in infants) supplemental uncooked cornstarch provides exogenous...

Hypocholesterolemic Activity

Hawthorn fruit has hypolipidemic activity. Chen et al. (10) demonstrated that serum total cholesterol, triglyceride, and apo-B decreased by 15 , 10 , and 8 , respectively, with HDL cholesterol being unchanged, in 30 hyperlipi-demic humans who consumed hawthorn fruit drinks. In a recent unpublished study, we have also evaluated the clinical efficacy of hawthorn in lowering blood cholesterol using a randomized, double-blinded, placebo-controlled, crossover design. Seventy-three mildly hypercholesterolemic patients were asked to take a 250-mL hawthorn or placebo drink three times a day for 4 weeks. At the end of this period, a washout of 4 weeks was implemented before the crossover. Blood samples were taken at baseline and week 4, 9, and 12 for total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride for analysis. Toxicity was monitored by blood chemistry. The results of this study are shown in Table 1 and Table 2. The hawthorn group had a 7.8 reduction in total blood...

Fat Craving Snack Food

Trans fat is vegetable oil that has been heated and hydrogen added. This fat was developed in volume to lower cholesterol levels but in actuality it raises the LDL cholesterol and lowers the HDL cholesterol. You cannot fool mother nature. Trans fat is incorporated into cell membranes causing the cells to become hardened. The metabolism of other fat pathways are sabotaged with trans fat snack food consumption for up to 102 days. ADHD, depression, Alzheimer's, and pain can all result because of trans fat. But don't overdo safflower or sunflower oil for snacks either. Even though they are not trans fat and are healthier, over-consuming these oils can result in pain.

Applications To Health Promotion And Disease Prevention

The biochemical metabolism of omega-6 fatty acids can produce eicosanoids (arachidonic acid) and stimulate thromboxane A2 synthesis (Figure 74.3). This can induce platelet aggregation (Simopoulos, 2008). Because of this, hempseed has been studied for its effects on platelet aggregation in normal and hypercholesterolemic animals. Hypercholesterolemia indirectly increases the risk of cardiovascular disease by enhancing the ability of platelets to aggregate (Prociuk et al., 2008). Prociuk and colleagues have shown that if male New Zealand White rabbits with an underlying hypercholesterolemic condition are supplemented with 10 of hempseed for 8 weeks, there is a return of the accelerated cholesterol-induced platelet aggregation to normal levels. The authors found that this normalization was not related to a reduction in plasma cholesterol levels, but was associated with an increased level of plasma g-linolenic acid a unique PUFA found in hempseed (Prociuk et al., 2008). The direct...

Antioxidant Activity of RSVPotential Cardioprotective Effect

Phenolic compounds present in red wine elicit antioxidant activity and prevent LDL oxidation (Whitehead et al., 1995). In line with this, epidemi-ological studies have linked moderate intake of wine with an appreciable decrease in the risk of coronary artery disease, particularly in regions of France where the diet is high in fat (Fuhrman et al., 1995). Studies have demonstrated that RSV is a potent inhibitor of the oxidation of polyunsat-urated fatty acids (PUFA) found in LDL, which plays a major role in atherosclerosis (Miller and Rice-Evans, 1995). Other reports indicate that RSV is more potent than flavonoids in preventing copper-catalyzed oxidation, and as LDL has high affinity for copper, this copper-chelating activity impedes oxidative modification of LDL (Frankel et al., 1993). Further evidence of the protective effect of RSV on lipid accumulation was reported in human hepatocarcinoma cells HepG2, which elicit most of the normal liver parenchymal functions (Goldberg et al.,...

Cigarette Smoking And Cardiovascular Disease

In addition, cigarette smoking is associated with unhealthy eating patterns, including increased intakes of alcohol, total fat, cholesterol, saturated fat, a lower consumption of foods with fibers such as fruits and vegetables that may lower cholesterol levels, as well as deficiencies of vitamin C, E and beta-carotene 11,12 , These factors make smokers and heavy alcohol users more predisposed to cardiovascular disease.

Background And Relevant Pharmacokinetics

Lower serum concentrations of zeaxanthin have been associated with male gender, smoking, younger age, lower non-HDL cholesterol, greater ethanol consumption and higher BMI (Brady et al 1996). Lutein and zeaxanthin, together with other carotenoids, have also been found to be lower in people with chronic cholestatic liver disease, which can be attributed to malabsorption of fat-soluble vitamins, as well as other mechanisms of hepatic release (Floreani et al 2000). In an epidemiological study

The Coeffect Of Alcohol And Tobacco Smoking

Numerous studies have indicated a correlation between ethanol intake and cigarette smoking in heavy drinkers 30 , On a pharmacological basis, an ethanol-induced potentiation of nicotinic currents may enhance the acute positive reinforcement associated with nicotine, increasing tobacco use during heavy ethanol intake. Ethanol may enhance acute nicotine-mediated receptor activation. Moreover, the opposing effect of ethanol on nicotine-induced desensitization could account for the increased tobacco use observed with excessive drinking. The dose relationship between the combined use of these two social habits and the changes in serum lipids, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides, has been investigated 31 . Both social habits raised serum cholesterol levels in a dose-related manner the more cigarettes a subject smokes and the more alcohol consumed, the higher the total serum cholesterol 31 ,

Gene Therapy For Hyperlipidemia And Systemic Diseases

Hyperlipidemia, in both its acquired and inherited forms, has been clearly shown to be an independent risk factor for the development of atherosclerotic vascular disease, myocardial infarction, and stroke. The use of drug therapies in the treatment of acquired forms of this disease, through either 3-hy-droxy-3-methylglutaryl-coenzyme A (HMG CoA) reductase inhibitors or bile acid binding resins, has proven effective in decreasing the morbidity and mortality associated with hyper-lipidemia. However, these same regimens have had their limitations in the treatment of inherited disorders such as familial hypercholesterolemia (FH) and apo E deficiency. The shortcomings of conventional pharmacological therapy have therefore stimulated an interest in the genetic replacement of these missing proteins in hepatocytes as a potential means of reducing cholesterol levels in patients with these rare disorders.

Effects of Dietary Fats and Cholesterol on Lipoprotein Metabolism

The cholesterolemic effects of dietary fatty acids have been extensively studied. The saturated fatty acids Ci2 o, C14 0, and C16 0 have a hypercholester-olemic effect, whereas Cig 0 has been shown to have a neutral effect. Monounsaturated and polyunsatu-rated fatty acids in their most common cis configuration are hypocholesterolemic in comparison with saturated fatty acids. The effects of trans fatty acids on lipid levels are under active investigation. Our current knowledge shows that their effect is intermediate between saturated and unsaturated fats. The effect of dietary cholesterol on lipoprotein levels is highly controversial. This may be due in part to

Effects of Diet on Chylomicron Metabolism

Diets very high in saturated fat have been associated with increased postprandial chylomicrons and chy-lomicron remnants compared with diets rich in n-6 polyunsaturated fats however, human experiments carried out using moderate to high fat intake have not shown significant effects of different types of dietary fat or dietary cholesterol on postprandial lipoproteins.

Effects of Diet on LDL Metabolism

The effects of dietary fat and cholesterol on LDL metabolism have been extensively studied. However, the effects of dietary cholesterol are still highly controversial. Whereas some studies have demonstrated increased LDL production and decreased catabolism associated with high cholesterol intakes, others have failed to find such associations.

External Treatment Of Minor Inflammatory Conditions And Wounds

HYPERLIPIDAEMIA, HYPERCHOLESTEROLAEMIA, HYPERTRIGLYCERIDAEMIA Szapary et al (2005) conducted a double-blind, placebo-controlled, randomised trial with 103 subjects with LDL-cholesterol levels of 3.37-5.19 mmol L. A standardised dose of 1000 mg of guggulipid (containing 2.5 guggulsterones) was given to one treatment group, while a higher standardised dose of 2000 mg was given to the other, three times daily for 8 weeks. Results showed a decrease of LDL-cholesterol in the placebo group of 5 , an increase of 4 in the 1000 mg group and an increase of 5 in the 2000 mg group. Overall this constituted a 9 and 10 increase in LDL-cholesterol with guggulipid treatment. In comparison, several randomised clinical trials and in vivo tests using various extracts of guggul have reported significant lowering of total cholesterol, triglycerides and LDL-cholesterol levels and increases in HDL-cholesterol (Gopal etal 1986, Malhotra etal 1977, Nityanand etal 1989, Singh et al 1990). In two reports, the...

Familial Combined Hyperlipidemia

Familial combined hyperlipidemia (FCH) was initially described as the combination of hypercholester-olemia and hypertriglyceridemia within the same kindred, and with kindred members having one of these abnormalities or both. Moreover, most subjects with FCH have HDL cholesterol levels below the 10th percentile. Affected subjects have elevation in VLDL, LDL, or both. This disorder has a frequency of approximately 10 in survivors of

Lower Your Cholesterol In Just 33 Days

Lower Your Cholesterol In Just 33 Days

Discover secrets, myths, truths, lies and strategies for dealing effectively with cholesterol, now and forever! Uncover techniques, remedies and alternative for lowering your cholesterol quickly and significantly in just ONE MONTH! Find insights into the screenings, meanings and numbers involved in lowering cholesterol and the implications, consideration it has for your lifestyle and future!

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