Chocolate Might Help You Lower Your Cholesterol!

Who does not like chocolate? People, especially ladies, tend to eat more chocolate when they were in bad mood. But many reports had linked eating chocolate to weight gain that might lead to many medical disorders including diabetes, heart disease, high blood pressure, and stroke.

In a paper published on May 26, 2010 in the American Journal of Clinical Nutrition, researchers from the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing argued that eating chocolate could help reduce the cholesterol levels. Their theory, however, only applied to people already had risk factors for heart disease and who consumed in modest amounts.

After analyzing 8 trials involving 215 people, they found that eating cocoa would reduce levels of low-density lipoprotein (LDL) or bad cholesterol by about 6 mg/dL and cut the total cholesterol by the same amount. Further analysis showed that only people who ate small amounts of cocoa (an amount containing 260 milligrams of polyphenols or less) had their cholesterol levels lowered, and no effect was shown in people who ate more.

Polyphenols are antioxidant compounds found in fruits, vegetables, chocolate and red wine. A 1.25-ounce bar of milk chocolate contains about 300 milligrams of polyphenols.

While healthy people did not benefit from consuming cocoa, people with heart disease risk factors like diabetes had their LDL cholesterol and total cholesterol level reduced by around 8 mg/dL each.

However, researchers suggested more rigorous randomized trials with longer follow-up should be carried out in future research so as to resolve the uncertainty about the clinical effectiveness.

In fact, several studies suggesting that chocolate might be good for the health had been conducted before. A study on 19,300 people, which was released in March 2010, suggested that people who consumed the most chocolate had lower blood pressure and were less likely to suffer stroke or heart attach over the next 10 years.

A New Risk Factor for High Cholesterol!

Bad cholesterol refers low-density lipoprotein, or LDL. A person with high LDL is at high risk of developing heart disease, hypertension (high blood pressure), and stroke.

High fat diet and lack of physical activity could be 2 of the common causes for getting high LDL. But United States researchers from West Virginia University recently found that chemicals used to make non-stick coatings on cookware and to waterproof fabrics might increase cholesterol levels in children. Their findings appeared on September 6, 2010 in the Archives of Pediatrics & Adolescent Medicine.

In the study, children with highest levels of these chemicals in their blood had higher levels of total cholesterol and LDL, compared with children with lower readings.

The 2 chemicals studied were perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS). They enter into people through air and occupational exposure, breast milk, cord blood, drinking water, dust, food packaging, and microwave popcorn.

Studies in animals had suggested that perfluoroalkyl acid, which is a known neurotoxin, could affect the liver ad so result in changes in cholesterol levels. Perfluoroalkyl acid could interfere with brain development, which leaves its mark on later behavioral functions such as cognitive performance.

The cholesterol levels in blood samples, taken from more than 12,000 children in the mid-Ohio River who had PFOA in their drinking water, were examined. These children and teens had more PFOA in their bodies than the national average, and a PFOS concentration about the same as the national average.

After analyzing the data, it was found that children and teens with the highest PFOA concentration had total cholesterol levels that were 4.6 points higher and LDL levels that were 3.8 points higher than those with the lowest PFOA levels.

Nevertheless, the researchers admitted that their findings only indicated there is a link between the compounds and higher cholesterol. They suggested more studies should be carried out to prove chemical exposure was the cause.

Have People Strived Hard to Lower Their Bad Cholesterol?

When people’s bad cholesterol or low-density lipoprotein (LDL) is high, they actually have a much higher risk of developing high blood pressure, stroke and even heart disease. As such, it is advisable for them to lower their LDL level.

A recent study by researchers from the University of California, San Francisco showed that over the last decade, the number of patients who have lowered their LDL to the recommended level has nearly doubled in 9 countries, namely Brazil, Canada, France, Mexico, the Netherlands, South Korea, Spain, Taiwan and the United States.

Published in the American Heart Association's journal Circulation on June 22, 2009, the findings revealed that patients in the United States, Brazil, France and South Korea had accepted a combination of medical treatment and lifestyle changes to improve their bad cholesterol.

In the study, close to 10,000 people with an average age of 62 were surveyed. The number of patients, who had successfully reached their target LDL level, was found to rise from 38 percent to 73 percent over the last 10 years.

On the other hand, only 30 percent of the high-risk patients, who have existing coronary artery disease or risk factors such as obesity, diabetes or smoking, had successfully reached their target LDL of 70mg per deciliter or less.

Although there is still some room for improvement, particularly in very high-risk patients, the results did indicate that LDL-lowering therapy has been applied much more successfully than it had been a decade ago.

The target LDL level in the United States depends on how many risk factors are present in the patient.

For patients without coronary artery disease, diabetes, or other cardiovascular risk factors, the ideal LDL is 160 mg/dL or less. People without either coronary artery disease or diabetes but with at least 2 other risk factors should keep their LDL level to less than 130 mg/dL

Patients who have cardiovascular diseases or diabetes should keep their bad cholesterol level no higher than 100 mg/dL, and should try to maintain a level lower than 70 mg/dL if they also have other risk factors.

Do Children Have High Blood Cholesterol?

About 1 in 5 Singaporean have high blood cholesterol, as reported by a 2004 National Health Survey. Perhaps, these people should be blamed for their love of artery-clogging foods. In fact, some of these people are just teenagers. For example, there is a 13 year-old pupil has a cholesterol level of 320 mg/dl, will you believe?

The American Academy of Pediatrics guidelines stipulated that the acceptable cholesterol level for children and teenagers aged 2 to 19 should be below 170 mg/dl, while the low-density lipoprotein (LDL) cholesterol should be kept under 110 mg/dl. LDL is also known as the bad cholesterol that increases the risk of cholesterol deposits within the walls of blood vessels.

It is not uncommon that children or teenagers, like adults, can have high blood cholesterol. As no official figures are available presently on the number of children with high cholesterol, not many parents are aware of the problem.

High blood cholesterol can be a silent killer because the bad effects do not show immediately but much later in life. Therefore, many parents do not realize the danger behind this. In fact, it has been linked to coronary heart disease and stroke. The earlier a person has high cholesterol, the more health problems he or she will encounter in the future.

In general, high blood cholesterol level is due to excessive consumption of foods high in cholesterol, saturated and trans fats. Nevertheless, genes and family history could also be the cause for high cholesterol in young patients. According to the figures provided by Health Promotion Board (HPB), it affects 9.5 percent of Singaporean children.

A recently study, published by National University Hospital (NUH), on 250 severely obese Singaporean children revealed that more than one-third of these children had high LDL cholesterol levels.

Does this mean that all parents must send their kids for cholesterol screen? Not really, parents should start by watching their child’s diet from the time they were young.

Parents should limit their children’s cholesterol intake to no more than 300 mg per day and saturated and trans fats intake to less than 10 and 1 percent of their total daily calorie intake respectively. These recommendations are for children aged 2 and above.

Moreover, parents should encourage their children to adopt positive healthy practices, such as regular exercise and healthy diet as these can help prevent obesity and other chronic conditions like diabetes later in their life.

How Effective Is Crestor In Preventing Heart Disease?

Being manufactured by AstraZeneca, Crestor is a cholesterol-lowering medicine that aims to reduce levels of bad cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, and in the meantime increase levels of good cholesterol (high-density lipoprotein, or HDL). It has been approved for use in over 95 countries with nearly 15 million patients being prescribed presently worldwide.

By lowering the bad cholesterol, it is possible to help prevent heart disease and hardening of arteries. These two conditions can develop heart attack, stroke, as well as vascular disease. Nevertheless, how effective is this medicine?

Presented during November 2008 at an annual meeting of the American Heart Association in New Orleans and published online by the New England Journal of Medicine, the study known as “JUPITER” revealed that Crestor could actually reduce by 44 percent the risk of heart problems among patients who currently do not face a high risk of getting a heart disease.

The study involved 17,802 men and women, of the age of 50 and more, who took 20 milligrams of Crestor on a daily basis. It was found that the combined risk of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes was reduced by 44 percent as compared with placebo among men and women with elevated hs-CRP but low to normal cholesterol levels.

By the way, CRP is a protein that is produced by the liver. It plays an important role in inflammatory processes and serves as a biological marker to measure the risk of artery blockage.

Also shown in the study, patients who took Crestor also had the combined risk of heart attack, stroke or death from heart disease reduced by 47 percent. Meanwhile, their risk of heart attack was cut by more than half, the risk of stroke was reduced by nearly half and the total mortality of the participants was lowered by 20 percent.

It was also recorded in the study that a daily dose of 20 milligrams of Crestor was well tolerated in nearly 9,000 patients during the course of the trial, and there was no difference between treatment groups for major adverse events, including cancer or myopathy.

No Trans Fat Is Allowed In All New York Restaurants!

Trans fat has been classified as bad stuff that not only increases LDL (bad cholesterol) but also reduces HDL (good cholesterol). People with such pattern of cholesterol level are at higher risk of heart disease, and several other medical ailments.

Foods with trans fat can be found almost everywhere. Besides candy, noodles, cookies, chips, there are hundreds of other processed products available in supermarket do contain trans fat in different amounts. Despite its unhealthy nature, most foods with trans fat are favored by both children and adults.

On July 1, 2008, the artificial trans fat can no longer be presented in the menu in New York restaurants. In this way, the authorities in New York help remove a major cause of heart disease from their residents’ diets.

Last year, the authorities had already banned all restaurants from using frying oil and spreads containing trans fats. Now, the restriction will apply to all types of food, including the fat used by bakers and pastry chefs.

For all foods served, including baked goods, oils, shortenings and margarine used for baking, and pre-prepared items, the amount of artificial trans fat, must not be more than 0.5 grams of trans fat per serving. However, foods served in the manufacturer's original, sealed packaging, such as candy and crackers, can still be exempted for the time being.

According to the health department in New York, there was widespread acceptance of its last year's ban, with more than 98 percent of inspected restaurants were in compliance as at June 2008. Many restaurants had gone even further to voluntarily cut down the amount of saturated fat.

As confessed by the owner of one of the restaurants in New York, the transition he made 7 months ago by cooking his patties and baked goods with replacement shortenings has hurt neither the products nor his business. Meanwhile, he feels happy that the move is healthier for his customers.

The Food and Drug Administration (FDA) has pointed out that trans fat, which is made by adding hydrogen to vegetable oil. This increases "bad" cholesterol levels, raising the risk of coronary heart disease.

New York was the first city in the United States to start banning trans fats in restaurants, followed by Philadelphia last year.

Beware of Heart Disease Even If You Have Normal BMI!

Body mass index (BMI) is the ratio of weight to height. The formula used to calculate BMI is:

BMI (kg/m2) = (weight in kg)/(height in meter x height in meter)

With the help of BMI, a person can be classified as underweight or overweight. Based on the guidelines provided by WHO (World Health Organization), people with BMI of 30 and above will be classified as obese, those with 25 to 29.9 as overweight, and those with less than 18.5 as underweight. A healthy person should have a BMI reading between 18.5 and 24.9.

An overweight or obese person tends to have a higher risk of getting heart disease. Therefore, if your BMI falls within the healthy range, you should be relieved. Unfortunately, this might not be true. Why?

During the American College of Cardiology's 57th Annual Scientific Session held in the month of April 2008, findings from Mayo Clinic revealed that patients with a normal BMI could still have a high body fat content that can increase the risk of cardiovascular disease.

The researchers studied on so-called 'Normal Weight Obesity' of 2,127 subjects with a BMI in the normal range. Normal weight obesity was defined as a body fat content higher than 20 percent for men and 30 percent for women.

All the participants’ body composition was measured and a full assessment was made of body size variables and cardiovascular risk factors.

It was found that 1,321 participants had normal weight obesity, while the balance 806 had a normal body fat content. Meanwhile, the investigators also found that 13.6 percent of the normal weight obese individuals met the criteria for metabolic syndrome, comparing to 5.3 percent of those who had a normal weight without a high body fat content.

The metabolic syndrome refers to a cluster of risk factors for cardiovascular disease, including high blood sugar, high levels of the 'bad' cholesterol (LDL) and triglyceride levels, low levels of the 'good' cholesterol (HDL), high blood pressure and excess belly fat.

In the study, those participants found with normal weight obesity actually had a high waist circumference, high triglyceride levels, high fasting blood sugar levels or a diagnosis of diabetes, and other metabolic markers associated with an increased risk of cardiovascular disease.

The researchers suggested that public health measures to prevent heart disease should measure the belly or assess percentage of body fat instead of just tracking weight and BMI.

Lower Bad Cholesterol with Dietitian’s Support!

It is not uncommon nowadays to find people with high level of cholesterol, even among the young ones. Person having high cholesterol, especially the bad cholesterol or in short LDL, has a greater chance of getting stroke, high blood pressure, and heart disease.

Doctors will usually ask you to watch your diet if they find your bad cholesterol level reach a certain high level. Unfortunately, it seems that diet alone usually would not help reduce the cholesterol level for most people. Therefore, as the last resort, doctors would have no choice but to put you on medication to cut down your bad cholesterol.

A new study by the University of Michigan Health System in Ann Arbor reported during March 2008 that with the support from dietitian, some people might be able to bring down their bad cholesterol levels without drugs.

The researchers followed 51 registered dietitians who implemented the 1998 Medical Nutrition Therapy Hyperlipidemia Protocol with their patients. You may ask, “What is this protocol?”

The protocol recommends people to:

- eat more fruits and vegetables,
- eat fish twice weekly,
- take more good fats such as olive oil,
- consume less saturated and trans fat,
- exercise more.

Meanwhile, the patients were supposed to meet with a dietitian for an initial one-hour visit, followed by at least 2 or 3 half-hour appointments. More visits may be recommended by the primary care doctor, if necessary. Dietitians have to check the patients’ blood work at the outset of the study and 3 months later.

The study took in 377 patients who met the criteria. Follow-up data was available for 74.3 percent, while 42.9 percent participated in 3 to 4 visits with the dietitian as recommended.

On average, patients working with dietitians cut their fat consumption to less than 30 percent of total calories. Furthermore, they did lose weight and exercise more.

Among the 175 patients whose initial triglyceride levels were below 400 mg/dL, 44.6 percent of them reported a 15 percent drop in their LDL or reached their goal for reducing LDL.

While the protocol only recommended 3 to 4 weeks between appointments, the actual intervals were in fact longer, ranging from an average of 8 weeks between the first and second appointments to nearly 13 weeks between the third and fourth.

Many patients did not make follow-up appointments, or keep scheduled appointments because of the lack of insurance reimbursement or their inability to pay.

The researchers did have difficulty in carrying out the study. Not many registered dietitians wanted to participate because they could not obtain necessary lab tests or lacked time and administrative support.

Higher Total Cholesterol May Increase The Risk of Plaque Rupture!

We always accuse LDL (so-called bad cholesterol) as the culprit that causes heart attack, stroke, high blood pressure, etc. Not so much attention is given to someone with higher than average total cholesterol level, provided the HDL (good cholesterol) level is at healthy level.

However, the findings of a new study conducted by a group of investigators from Johns Hopkins School of Medicine, Baltimore may change such perspective. Published in February 2008 in the medical journal Stroke, the report revealed that the total blood levels of cholesterol in individuals without symptoms but have thickened walls of the carotid arteries are strongly associated with the presence of a lipid (or fat-based) core within plaque, which can cause the arteries to rupture.

The carotid arteries are two major arteries located on each side of the neck that provide blood and oxygen to the brain.

Made up of fatty dead tissue deposits, a lipid core within an atherosclerotic plaque puts the plaque at risk for causing an adverse clinical event, such as a stroke if the plaque is in the carotid artery or a heart attack if the plaque is in the coronary artery.

By taking part in a study of atherosclerosis (also referred to as hardening of the arteries), the participants were examined by ultrasound to ensure they are free from cardiovascular disease and those with the thickest carotid artery walls were selected.

The researchers used MRI and analysis software to assess the composition of 214 plaques with a thickness of at least 1.5 millimeter and found a lipid core in 151 (71 percent) of these plaques.

Compared with patients with the lowest levels of total blood cholesterol, those with medium levels had a 2.8-fold increased risk of having a lipid core, after adjusting the possible effects of age, sex, high blood pressure and diabetes. Those with the highest cholesterol levels had a 4.6-fold increased risk of having a plaque with a lipid core. None of the cardiovascular risk factors other than high serum cholesterol was associated with having a lipid core.

The researchers concluded that a person’s total cholesterol level is the most important risk factor for developing the dangerous feature of plaque mentioned above. This indeed supports the claim that by lowering a person’s cholesterol level and hence the risk of the formation of lipid core might reduce his or her risk of the possible clinical events.

Knowing Heart Disease Risk May Prompt You Adopting Heart-Healthy Lifestyle

In order to reduce the risk of a heart attack and heart-related death, one should try to lower levels of bad cholesterol (LDL) while raising levels of good cholesterol (HDL). Regretfully, most patients do not obediently follow recommendation from their doctors so as to change their lifestyle or taking their cholesterol reducing medications.

However, when the doctor tells the patients who are at risk of coronary heart disease exactly what their risk is and how they can help lower their risk, they seem to respond better to preventive treatment. This is the findings of a recent study conducted by a group of researchers at the McGill University in Montreal, Quebec and published in the Archives of Internal Medicine.

The researchers actually found that people who had discussed openly with their doctor about their coronary risk profile achieved better improvement in their cholesterol levels than those who did not discussed with their doctor. As found out by the study, about one-third of people, who are not convinced that they need their cholesterol medications, stop taking them.

In order to ascertain whether boosting patients' knowledge of their heart risk profile might help them to adopt heart-healthy lifestyle, the researchers randomly assigned 3,053 adults being treated for cholesterol problems into 2 groups: one group received usual care while the other group received a 1-page computer printout displaying the probability that they will develop heart disease in the next 8 years based on their current lifestyle, blood pressure, cholesterol levels, and other risk indicators. The printout group also received ongoing feedback on how much they could cut their risk through lifestyle modification and drug therapy.

There were 2,687 patients completed the 12-month study. Those in the intervention group who kept track of their heart risk profile had small but significantly greater improvements in their cholesterol profiles.

In addition to communicating risk, there are also other means that can be used to improve adherence to heart-healthy lifestyle. These include enhancing self-monitoring and using support of family and friends.

Is Cholesterol Tied To Stroke Or Heart Disease?

A group of researchers reported in the Lancet medical journal that "lower total cholesterol was associated with lower death rates from coronary artery disease (also called ischemic heart disease) among men and women of all ages studied."

Being a leading cause of worldwide death, coronary artery disease is caused by fatty deposits that clog arteries. The deposits build up in the arteries, which supply the heart with blood, will narrow the arteries and reduce the blood flow to the heart. This can lead to heart attack and other conditions.

The researchers' initial aim for their study was to establish whether high cholesterol raises the risk of stroke but what they found at the end of their research was that "lower cholesterol levels were not linked to reduced stroke deaths."

Definitive previous research established that drugs called statins, which lower low density lipoprotein cholesterol (also called LDL or 'bad cholesterol) substantially reduce stroke risk. However, based on the researchers' analysis of 61 previous studies involving almost 900,000 adults, conducted mostly in western Europe and North America, people with lower total blood cholesterol levels had a lower heart disease death rate.

The study tracked on people who aged between 40 and 89, and found that about 34,000 of them died of heart disease and 12,000 died of a stroke. The study, nevertheless, did not separate those died of ischemic stroke (caused by blocked arteries) from haemorrhagic stroke (caused by a burst blood vessel).

Surprisingly, the study could not establish any relationship between total cholesterol levels and risk of stroke death, especially at older ages and among people with higher blood pressures.

The researchers could not really understand what is going on. And they stressed that they need to know more about cholesterol and more about stroke sub-types to find out the reasons behind this. In the meantime, they do not want people already on a statin thinking that they should stop taking the drug because if their cholesterol gets lower, then they are at a higher risk of stroke. That is absolutely not the case.

How Does Cholesterol Relate To Fats In Food?

Cholesterol is either formed in our bodies by our livers or acquired from foods like eggs, seafood, meats, organ meats and animal products. If we have too much cholesterol in our body (or more precisely, bad cholesterol), we will be at a higher risk of developing cardiovascular disease and other diseases.

Then, what are fats? In general, there are 4 types of fats, namely saturated, mono-unsaturated, polyunsaturated, and trans fats.

The unsaturated fats increase our HDL (high density lipoproteins or the 'good' cholesterol) and decrease our LDL (low density lipoproteins or the 'bad' cholesterol). Trans fats do just the opposite: reduce HDL and raise LDL, and saturated fats are known to raise both HDL and LDL.

Mono-unsaturated fats are found in olives; olive oil; canola oil; peanut oil; cashews, almonds, peanuts and most other nuts; avocados, while poly-unsaturated fat is available in corn, soybean, safflower and cottonseed oils; fish.

Saturated fats can be found in foods like animal fat, animal skin, animal products such as butter, and dairy products. Trans fats are formed when vegetable oil goes through a process known as hydrogenation. Therefore, products that have 'partially hydrogenated' or 'hydrogenated' vegetable oil printed in their ingredient list do contain trans fats.

It is not easy to find a meal without fats when we dine out, especially at fast-food outlets. But we must understand one fact: we do need a certain amount of fats for absorption of vitamins as well as other daily functions. Since unsaturated fats are healthier, our meals should comprise most of this kind of fats. On the other hand, we should cut down the amount of saturated fats and trans fats and they should take up only 10 per cent of our daily caloric intake.

Fat-Rich Meal Can Affect The Health Of Your Heart!

In my previous post titled "Do You Want A Healthy Heart? Watch What You Eat!", I mentioned that research had shown that oily food can increase the risk of heart attack and stroke.

The bad cholesterol (LDL or low-density lipoprotein) is responsible for the build-up and blockage in the arteries. But our body also has good cholesterol (HDL, high-density lipoprotein), which is considered as being able to to counteract bad cholesterol (LDL), or even prevent heart disease.

According to recent report published in the Journal of the American College of Cardiology, a study of 14 healthy adults had found that 3 hours after participants were fed a single high-saturated-fat meal, the inner linings of blood vessels in the participants showed a decreased ability to expand. This would therefore affect the blood flow.

It was found that the ability of HDL-cholesterol to prevent inflammation was weakened within 6 hours after the fatty meal. The inflammation is one of the causes that build up the arterial plaque. But on a separate occasion, when participants were fed a meal rich in polyunsaturated fats, the protective quality of HDL-cholesterol in their bodies was actually increased. The number of inflammatory agents were found to be lesser.

In conclusion, when a person consumes a single meal of high saturated fat, his or her normal protective property of HDL is impaired. Conversely, when he or she eats a meal that is high in polyunsaturated fat, the HDL in the body is found to be more protective.

The Denmark's Experience In Handling The Trans Fat Issue!

The Danish Nutrition Council recognized the harms of Trans Fat: increase the bad cholesterol level (LDL) and decrease the good cholesterol level (HDL) which may increase the risk of getting heart disease.

Hence in 1990s, Denmark made margarine makers to reduce Trans Fat levels. As a result, the national average consumption of Trans Fat fell from about 2.5 g per day to between 1 g and 2 g per day.

However, Denmark aims for a healthy level of Trans Fat consumption, which is zero, instead of a compromise level of about 2 g. Realizing its citizens were still consuming a lot of Trans Fat from imported food, Denmark finally announced a ban on Trans Fat in 2003.

Significant response was reflected among the food industries. The manufacturers had no choice but had to reformulate its products to reduce Trans Fat for all of Europe.

Meanwhile, Danes are not complaining that they have fewer choices in food. For example, they are still enjoying French fries and chicken nuggets from McDonald’s. The only difference is theirs contain a mere 0.33 g of Trans Fat.