Cholesterol lowering it with natural - Microsoft PowerPoint by leader6


									Improving blood lipid profiles                   A few interesting facts…
   with natural medicine
                                    Around 50% of people who have heart
                                    attacks have normal cholesterol values
                                    Most cholesterol in the blood is made by
                                    the liver
                                    Cholesterol is an important component of
                                    cell walls and is also the building block for
                                    many hormones in the body

Risk factors for heart disease         Normal values for blood lipids
                                                     desirable     borderline        abnormal

                                 Total            <5.2           5.2-6.2        >6.2
 High LDL, low HDL               cholesterol
 Chronic inflammation
                                 Triglycerides    <1.7           1.7-2.3        >2.3
 Sedentary lifestyle             HDL              >1.6           1.0-1.6        <1.0
 Family history
 Chronic stress                  LDL              2.6-3.4        it depends     >4.1
                                 Risk ratio       <3.5           3.5-5          >5
Non-pharmaceutical methods to
     improve lipid values                                Tips for weight loss
  Weight loss
  Exercise                                    Always eat breakfast
  Fruits and vegetables
  Fish oil
                                              Have regular meals that include a low GI
  Eat less saturated fat                      carbohydrate, some lean protein, some
  Avoid trans fat                             healthy fats and at least two servings of
  Low GI/GL carbohydrates                     fruits and vegetables
  Portfolio diet
  Low fat vegan diet                          Regular physical activity
  Supplements                                 Support your mood: make sure you are
  Stop smoking                                getting enough vitamin D, B vitamins and
  Reduce chronic stress
                                              essential fatty acids

                    Exercise                       Fruits and vegetables
                                              Increased consumption is associated with:
Think about strength, aerobic conditioning      Lower risk of cardiovascular disease
and flexibility                                 Lower risk of stroke
Aerobic activities such a cycling, walking,     Lower total and LDL cholesterol
swimming, rowing etc can be done daily          Plus many other benefits: lower cancer risk,
Strength training is best done 2-3 times        stronger bones, lower risk of diabetes, etc
per week
Aim for 30-45 minutes of physical activity
most days of the week
Exercise is especially good for raising HDL
                Fruits and                                   Types of fats
                                              Saturated fats from meat and dairy
Choose a wide variety of deeply colored
                                              products tend to raise TC and LDL
fruits and vegetables
Aim for 8- 10 servings per day                Trans fats are even worse and raise TC,
                                              LDL while also lowering HDL
Include some deep orange (squash, sweet
potato, carrots), dark leafy green (romaine   Choose mono and polyunsaturated fats
lettuce, Swiss chard, spinach), cabbage       from avocados, nuts, fatty ocean fish and
family (broccoli, cabbage, kale), some        extra virgin olive oil
onions/garlic, some red foods such as         It is fine to eat up to around 30% of your
tomatoes, some red/blue food such as
                                              calories from fat as long it is ‘healthy fat’
blueberries, raspberries, etc

                   Benefits of fish oil                    Warning!!!!
                      (omega 3)
                                              Low fat products are
    triglycerides                              often high in sugars
    HDL cholesterol                             which can tend to
    risk ratio cholesterol/HDL                  raise triglycerides
  Anti-inflammatory effects                          and LDL
  Anti-depressant effects
    The glycemic index (GI)
                                                          The glycemic index

                                       Eating lower on the glycemic index can:
                                         Support weight loss
                                         Lower the risk of heart disease
                                         Lower LDL cholesterol
                                         Lower triglycerides
                                         Help to prevent diabetes
                                         Improve diabetes control

   low ≤ 55 medium 56-69 high ≥ 70

    The glycemic load (GL)             1. Factors that influence the GI:
Glycemic load= GI x carbohydrate (gm      rate of stomach emptying
per serving) divided by 100
Low 0-10 low medium 11-19 high >20     Slowing the rate of
                                       stomach emptying:
                                          soluble fiber

   GI 80 GL 7.8      GI 72 GL 25.6
  1 cup watermelon       ½ bagel
   2. Factors that influence the GI:
                                                      3. Factors that influence the GI:
       amylose vs amylopectin
                                                            starch gelatinization
   Foods high in amylose                                Gelatinization of starch increases
   starch: Basmati rice,
   kidney beans, lentils                                the rate of digestion
                                                          Sticky rice, Jasmine rice
   Foods high in                                          Pasta cooked 20 minutes
   amylopectin starch:
   potatoes, wheat flour,
   sticky rice

  Amylose starch molecules take longer to be acted
upon by digestive enzymes than amylopectin starches

   4. Factors that influence the GI:                                      Low GI
          physical barriers                                            carbohydrates
     Physical barriers to digestion: whole             Breads: 100% whole grain breads,
     grains are more resistant to action by            pita bread, sourdough breads
     digestive enzymes than finely                     Rice: Basmati rice, Uncle Ben’s™
     pulverized flours                                 converted rice
                                                       Pasta: al dente
                                                       Cooked grains: quinoa, bulgur, steel
                                                       cut oats, large flake oats
                                                       Cereals: All Bran
     Bulgur 46   Whole wheat bread 69   Baguette 95    Beans
   Higher GI carbohydrates                     Nutrient density/quality
Most breads, bagels
and other flour products
Puffed grains
Most cold breakfast
Gooey starches                                     Apple           High fat ice cream
                                                   GI 37                 GI 37

             GI/GL and weight loss
             2007 Cochrane review               GI/GL and weight loss
Overweight and obese people lost the
most weight on low GI/GL diets             Ludwig (obese teenage boys):
compared to other diets (1 kg greater      High GI meals led to:
weight loss)                                   availability of metabolic fuels
When only obese subjects were studied,       excessive hunger
benefits of a low GI diet were even more     overeating
apparent (mean weight loss -4.2 kg)
Total cholesterol and LDL also
decreased the most on low GI diet
                High insulin                               Advice to patients re:
              secretors vs low                               glycemic index
Low GL diet/high fat: 40% carb/ 35% fat/    Use it to choose the types of starchy foods
25% protein                                 you eat
High GL/low fat diet: 55% carb/ 20% fat/    Ignore the GI of proteins, fats, nuts and
25% protein                                 (most) fruits and vegetables
Weight loss: high insulin secretors lost
more weight on low glycemic load diets      Combine high GI foods with low GI foods
(5.8 kg vs 1.2 kg P=.004)                   Eat smaller portions of high GI foods
Lipids: Low glycemic load diet had          Add lemon juice or vinegar to the meal
beneficial effects on lipids ( HDL and      Include healthy fats and lean proteins with
  TG’s)                                     every meal

                                                        Portfolio diet
               The Bottom Line
                                               Soluble fiber
Large excursions in postprandial glucose       Nuts
levels are harmful to health
Low GI/GL, nutrient dense carbohydrates
from whole foods are recommended               Plant sterols
Overweight or obese people should be
especially careful to choose low glycemic
index/load carbohydrates
           Soluble fiber                            Nuts
Psyllium 1 TBS before each meal
                                    Almonds ~ 23/day
                                    Nuts can help to
Flax, barley, oatmeal               prevent diabetes.
Beans                               They are also a great,
Okra                                very satisfying, low
Apples                              glycemic index food for

                Soy                              Some easy ideas for
50 gm soy protein/day                              soy in your diet
Soy milk
                                  Make smoothies with soy milk, a banana
Soy nuts
                                  and some frozen berries
                                  Substitute soy milk instead of cows milk in
Edamame                           recipes or on breakfast cereal
                                  Snack on soy nuts. They are high in
                                  protein, very filling and low glycemic index
                 Plant sterols
                                                                     Low fat vegan diets
 Special margarine was used in
 the study                                         Consist mainly of whole grains, beans, fruits
 Sources of plant sterols:                         and vegetables
   Whole grains, bran, wheat germ,                 Can support weight loss
   legumes, peanuts, nuts, seeds                   Can lower LDL cholesterol by ~ 21%
   Some foods are now fortified with               Can improve diabetes control more
   plant sterols
                                                   effectively than the American Diabetes
 “Cholesterol Success” by                          Association Diet

Concerns about low fat vegan diets                    Coenzyme Q10
     Vitamin B12
                                                   An important antioxidant, and a cofactor
     Vitamin D                                     in many metabolic pathways
                                                   Increases plasma levels of HDL, and
     Essential fatty acids                         decreases LDL and total cholesterol
                                                   HMG CoA reductase inhibitors (statins)
     Iodine                                        reduce serum COQ10 levels
                                                   CoQ10 can help to lower blood pressure
 Becoming Vegan by Brenda Davis & Vesanto Melina
                                                   Recommended dose 60-120 mg/day
                                                       Niacin (nicotinic acid)
                    Vitamin C
                                             Vitamin B3 vitamin
                                             Lowers LDL and raises HDL
                                             Use immediate release form
 Vitamin C can lower triglycerides and LDL
                                             Can cause an unpleasant flushing reaction
                                             Flushing can be reduced by gradually increasing
 Vitamin C can also help to prevent          the dose, taking with meals and taking a low
 diabetes and to improve diabetes control    dose ASA 30 minutes beforehand
 In one study, 1000mg/day of vitamin C       May increase glucose and uric acid levels
                                             Monitor liver function
 lowered HBA1c by 1.16%
                                             Use with medical supervision as per
                                             recommended protocol

Stress physiology: activation of the             Chronic stress initiates a
   sympathetic nervous system                destructive physiological cascade
                                             Raised FBG, insulin and lipids
      Heart rate                             Hypertension
      Respiratory rate                       Proinflammatory & procoagulation
      Blood pressure
                                             Increased oxidative stress
      Blood glucose
                                             Impaired endothelial function
      LDL cholesterol
                                             Acute coronary events
                                             Depression, anxiety and anger
   Mind body medicine                   Summary
Meditation              Weight loss and exercise
                        Choose low glycemic index carbohydrates
Guided Imagery          Eat more good fats/eat less bad fat
Self Hypnosis           Eat lots of fruits and vegetables
Breath work             Eat more soluble fiber and nuts
Yoga                    Increase soy intake to 1-2 servings of whole soy
                        foods per day
Biofeedback             Consider taking plant sterols and/or niacin
                        Coenzyme Q 10 is recommended for all patients
                        on statin medications
                        Reduce stress with mind body medicine

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