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Can I Lower My Cholesterol


									    The Spine and Sports Medicine Center
      Rick H. Morris,              D.C., C.C.S.P., Q.M.E., A.B.A.A.H.P.
      1243 7th Street, Suite B ∙ Santa Monica, California 90401 ∙ 310-451-5851 ∙ ∙ fax:310-458-0051

        Can I Lower My                          Cholesterol
                            Without Drugs?
                                      By Rick Morris

It‟s been 20 years since I completed the Ironman Triathlon. Now my Olympic dreams
have given way to the nightmare of paying for my kids education. Still, I workout
regularly, eat well and almost fit into the jeans I wore in the „80s. So…

    How Could I Possibly Have A Cholesterol Problem?
Since I‟m your doctor, I‟m a little embarrassed to reveal my cholesterol numbers. But if
we‟re going to beat it together-here they are:

      My total cholesterol is 213 (not terrible, since the goal for total cholesterol
     is below 200).
      My LDL (low density aka bad cholesterol) is 155. The ideal for bad
     cholesterol is below 130 (100 if you have heart problems). LDL, cholesterol‟s
     evil step brother, got its bad reputation by filling your arteries with fat causing high
     blood pressure, heart attacks, strokes and dementia. The LDL may be the single
     most important number we measure.
      My HDL (good cholesterol) is 55. HDL should stay over 45 for men and
     55 for women. The higher the better since HDLs remove the fatty plaques from
     your arteries and brings them to the liver for elimination

The ratio of total cholesterol to HDL is important to measure. It tells us the
amount of fatty material floating around in comparison to the amount being removed.
The ideal ratio is 3.5 or less. So if my HDL is 55, to have an ideal cholesterol to HDL
ratio of 3.5, my total cholesterol has to be 192 or less (your HDL x 3.5 = the highest
total cholesterol you can have and still be ideal.) Try it out…plug in your HDL, multiply it
by 3.5 and see if your cholesterol is out of balance.

     All Men May Be Created Equal, But All Fats Aren’t
The leading causes of death in the U.S. are heart attacks, cancer and strokes. These
diseases all have one thing in common; they are all related to the type of fat we eat.
Notice that I didn‟t say the amount of fat. That‟s not nearly as important (although
obesity is!).

Some fats actually improve our health. They correct our cholesterol balance, prevent
heart attacks, reduce the chance of stroke and prevent inflammatory diseases such as
Rheumatoid Arthritis.

You’ll spot the good fats. They’re liquid at room temperature and consist of:

    Monounsaturated Oils like olive oil, canola oil, oils derived from nuts and
    Polyunsaturated Oils like corn, soybean, and safflower oils and fish.

Some Fats Aren’t So Good. They’re solid in room temperature and are called:

  Saturated Fats. They‟re found in whole milk, red meat, chicken skin, butter,
 cheese, chocolate and even coconuts. Basically, milk products and meat contain
 saturated fats. They raise both good and bad cholesterols, but hurt the proper
 cholesterol/HDL ratio.

Some of us have to be more careful than others since 75% of our cholesterol is
manufactured by the liver. In other words, if you‟ve got the bad cholesterol genes and
your liver continually pumps out cholesterol, you need to act on this newsletter.
Others can just pass it on to those who aren‟t so blessed.

The Most Evil Fat of All is:
  Man made and prematurely ages and kills thousands of
 people every year.
  Not safe in any amount to anyone (Institute of Medicine).
  Responsible for Significantly Raising our Bad Cholesterol While
 Lowering Our Good Cholesterol.
  So unhealthy that even bacteria and mold won‟t grow on it.
                              They are called…
                                Trans Fats
These are fake, man made fats. They started as real oils but were heated then
cooled until they became solid. This process is called hydrogenation (because it adds
hydrogen). You know who they are; they‟re the fried foods, fast foods, commercial
packaged baked goods, margarine, vegetable shortening and all products that say
“hydrogenated or partially hydrogenated” in the ingredients.

You‟ll see them all over packaged foods because they never die or go bad.
They nearly last forever, since mold and bacteria won’t even grow
on them. Nothing will!

In fact, The Nurses' Health Study found when they replaced only 30 calories of
carbohydrates with 30 calories of trans fats the risk of heart disease nearly doubled.
When they replaced 80 calories of carbohydrates with 80 calories of either
polyunsaturated or monounsaturated fats (the good fats), your chance of heart disease
dropped by 30 to 40 percent. THAT’S A BIG HEALTH GAIN WITH LESS THAN 100

Let’s put it another way…
By replacing that glob of margarine with olive oil, you’ll lower
your chance of heart disease by one-third.

                                 Is it worth it?
This is so important that in January 2006, a law requiring all food packaging to state
whether it contains trans fats goes into effect.

To summarize, fats can be either liquid or solid at room temperature. Always choose
liquids, they are the good fats. Fats that are solid at room temperature should be
avoided. When cooking with oil, stir fry…don‟t deep fry.

If you need to buy foods with trans fats, make sure they are listed as low as possible on
the ingredient list. The higher on the list, the more in the food.

  Is There Anything I Can Take, Naturally, To
            Balance My Cholesterol?
There appears to be three or four effective products worthy of a try, such as:
Garlic:     While there is disagreement in the literature, the garlic that hasn‟t had its
odor removed (wild garlic) may lower your total cholesterol, bad cholesterol and
triglycerides (circulating blood fat) about 10%.1,2

Fish Oil:       An abundant quantity of research seems to conclude that 1-2 grams of a
fish oil supplement per day reduces your chance of a heart attack and stroke by
preventing dangerous, irregular heart rhythms, thinning the blood, lowering
triglycerides and preventing inflammation3. In fact, one large trial found that by taking
just 1 gram per day of fish oil over a 3.5 year period reduced the risk of dying from
heart disease by 25 percent in those who already survived one heart attack. While it
significantly lowered triglycerides, it seemed to slightly raise bad cholesterol.4

Since women‟s hearts are especially sensitive to high triglycerides. Those whose levels
are high may benefit from taking 4 g/day of fish oil. 5 Adding apple pectin (a type of
fiber) to the fish oil seems to increase its triglyceride lowering ability even further.6 Flax
seed oil, also an Omega 3 fatty acid (like fish oil), doesn‟t seem to lower triglyceride
levels.4 So make sure it‟s fish oil not just Omega 3 Fatty Acids.

Niacin:      (Nicotinic acid) Lowers bad and total cholesterol and raises good cholesterol.
It also can lower triglycerides. Unfortunately the dose needed for treatment is about
100 times more than the Recommended Daily Allowance and can potentially be toxic,
especially to your liver. It should be considered a medication and taken only under
your doctor‟s directions if the other natural alternatives weren‟t effective or appropriate.

Plant Sterols and Stanols:              These plant products are added to some
margarines and prevent the absorption of cholesterol in our intestines. In daily use, it
has consistently lowered bad cholesterol about 10%.3,7 So far it does not appear to
have long term negative effects. Life long use is predicted to result in a 20% decrease
in coronary events.8

                      But, The Best Is Saved
                                     For Last
Policosanol:         A sugar cane derivative that lowers total cholesterol by 16% to
21%, bad cholesterol by 21% to 29% and raises good cholesterol by 8% to 15%.
Although it‟s triglyceride lowering effects have not been consistent, other cardiac
benefits such as the prevention of clots and the dangerous oxidation of bad cholesterol
have been demonstrated. Three year follow-ups have not shown negative side effects.
10-20 mg/day seems to be just as beneficial as higher doses.3,9,10
Standard pharmaceutical treatments today include Statin
Drugs, such as:

     Mevacor
     Zocor and
     Pravachol
They work by interfering with the liver‟s ability to produce cholesterol and increasing its
ability to remove cholesterol from the blood. Although statins can lower LDL
cholesterol by as much as 60 percent, they can also damage the liver and, in rare
incidences, cause a serious or deadly illness.

But, there’s good news. The chances of dying from the three leading causes
of death (coronary vascular, cancer and strokes) are largely under your

Don’t Tell Me These Three Steps Are Too
    1. Test your cholesterol (good, bad and total) and triglycerides
    2. Watch the type of fats you eat.
           o Eat fats that are oils at room temperature
           o Moderately limit meat and dairy fats
           o Severely limit margarine, fried foods and packaged food with the word
              “hydrogenated” in the ingredients.
    3. If your cholesterol or triglycerides are elevated or out of balance, talk to us about
       whether you are a candidate for natural treatments. They can be very effective
       and may prevent the need for medications. Sometimes medications are
       necessary but the supplements may allow you to take a lower dose.

    To get started, just call our office and we‟ll write you a prescription to have your
    blood tested. We‟ll set it up over the phone and without an office visit. If the results
    should be improved, we‟ll set up an appointment to discuss your treatment options.
    The results will be shared with your internist.
 J Nutr Biochem. Effects of garlic extract consumption on blood lipid and
oxidant/antioxidant parameters in humans with high blood cholesterol.2004
 J Am Acad Nurse Pract, A systematic review of the effectiveness of garlic as an anti-
hyperlipidemic agent. 2003 Mar;15(3):120-9.

3 Curr Atheroscler Rep, Meta-analysis of natural therapies for hyperlipidemia: plant
sterols and stanols versus policosanol. 2004 Nov;6(6):461-7.
 Harris, William S. n-3 fatty acids and serum lipoproteins: human studies. American
Journal of Clinical Nutrition, Vol. 65 (suppl), 1997, pp. 1645S-54S
  Cullen, Paul. Evidence that triglycerides are an independent coronary heart disease
risk factor. American Journal of Cardiology, Vol. 86, November 1, 2000, pp. 943-49
  Effect of high fiber intake in fish oil-treated patients with non-insulin-dependent
diabetes mellitus. American Journal of Clinical Nutrition, Vol. 66, November 1997, pp.
1183- 87
 Metabolism. Impact of margarine enriched with plant sterols on blood lipids, platelet
function, and fibrinogen level in young men.2003 Nov;52(11):1373-8.
 Ann Med, Plant stanol and sterol esters in prevention of cardiovascular diseases
  Gouni-Berthold I, Berthold HK, Policosonol: Clinical pharmacology and therapeutic
significance of a new lipid-lowering agent. AmHeart J. 2002 Feb; 143(2):356-65
  Castano G et al, Effects of policosanol 20 versus 40 mg/day in the treatment of
patients with type II hypercholesterolemia: a 6-month double-blind study. Int J Clin
Pharmacol Res. 2001;21(1); 43-57

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