Shellfish, Mediterranean Diet & Cholesterol

Open any book on the heart-healthy mediterranean diet and you are likely to see recipes celebrating all sorts of shellfish.

While all shellfish, particularly shrimp, are a source of dietary cholesterol, many also deliver significant levels of Omega-3s. Mussels, for instance, deliver more of these heart-healthy fatty acids than many fin fish, and deliver an amount equivalent to a swordfish or albacore tuna. Oysters provide even higher levels.

Shellfish also are low in fat–only 10% in shrimp, about 20% in mussels and oysters. Enjoy grilled shrimp, mussels marinara, clams with linguine, or sauted scall0ps as exciting alternatives to red meats typically higher in the unhealthy saturated fats. Scallops and shrimp also freeze well. Store a few pounds of each in the freezer for a quick and delicious meal. Canned clams can awake a mid-week pasta dish and deliver an significant level of Omega-3s. Even fresh mussels, clams or oysters can be stored in your refrigerator for a few days—but remember, do not store in an air-tight bag. These mollusks need to breath until cooked.

Overall, the benefits of shellfish consumption — particularly to the extent that they enable you to dramatically reduce the consumption of higher saturated fats in red meats and dairy products and increase the weekly intake of Omega-3s from marine sources—outweighs the cholesterol. Remember: most of the cholesterol in our bodies is produced by our bodies. It does not come from the food we eat. Further, look to pair your shellfish with foods high in plant sterols and selected soluble fibers to block cholesterol absorption into the blood stream.

Mediterranean Diet Works As A Whole System

Researchers continue to find an association between the Mediterranean diet and increased longevity.

"Overall diet is more important than individual components, with emphasis on moderate—but not excessive—wine consumption, particularly during meals, preference for olive oil as the main added lipid, low consumption of meat, and high consumption of vegetables, fruits, and legumes," author Dr Dimitrios Trichopoulos (Harvard School of Public Health, Boston, MA).

The researchers examined data from healthy individuals in Greece who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) trial.
The researchers looked at data from the Greek segment of EPIC, from over 23 000 healthy men and women aged 20 to 86 at enrollment. As is typical in the Greek population, many individuals were overweight or obese and many men were smokers. Most were moderately active.

This work confirms that it is not one single component of the Mediterranean diet that is driving reduced risk of mortality. "In order to promote longevity, people have to do several things at the same time. They just can't focus on one food—just eat blueberries or take a folic-acid pill. It's a whole lifestyle, whole diet approach for health promotion," say Dr. Teresa Fung of the Harvard School of Public Health.

Updated Mediterranean Diet Pyramid From Oldways

Despite the fact that calories from fats may account for upwards of 40% of a Mediterranean diet, many studies show reduced incident of cardiovascular diseases in those populations that follow the traditional eating habits of this region.

Certainly, there is no single Mediterrean cuisine. The aromas, flavors and recipes vary widely from Spain and Italy to Greece and Lebanon and then across North Africa. Moreover, not all foods of these regions are necessarily healthful. Oldways, a leading advocate of traditional, healthful eating has released a revised Mediterranean diet pyramid to provide clear direction.

The major change in this updated Mediterranean Diet Pyramid, writes the staff of Oldways, is that all plant foods (fruits, vegetables, grains, nuts, legumes, seeds, olives and olive oil) are grouped together to emphasize the health benefits they provide. A new addition to the Mediterranean Diet Pyramid is herbs and spices—for reasons of both health and taste. Increasingly, nutritional science is identifying active micro-nutrients in herbs, spices and other plant compounds that collectively may deliver health benefits well beyond what is provided by the better known vitamins, minerals, proteins, fats and carbohydrates.

The Oldways pyramid also points out the healthfulness of fish and shellfish, and suggest that it is beneficial to eat fish and shellfish at least two times per week.

Other specific recommendations of Oldways include:

• Make olive oil your primary source of dietary fat
• Eat low to moderate amounts of cheese and yogurt daily
• Drink a moderate amount of wine (one to two glasses per day for men, one glass per day for women)
• Snack on almonds instead of fat-free cookies.
• Spread avocado on a sandwich to replace the mayonnaise.

Monounsaturated Fats: Recommendations from National Cholesterol Education Program

NCEP Evidence Statement: Monounsaturated fatty acids lower LDL cholesterol relative to saturated fatty acids. Monunsaturated fatty acids do not lower HDL cholesterol nor raise triglycerides. Strength of Evidence: A1, B2

NCEP Evidence Statement: Dietary patterns that are rich in monounsaturated fatty acids provided by plant sources and rich in fruits, vegetables, and whole grains and low in saturated fatty acids are associated with decreased CHD (cardiac heart disease). However, the benefits of replacement of saturated fatty acids with monounsaturated fatty acids has not been adequately tested in controlled clinical trials. Strength of Evidence C1

NCEP Recommendations: Monounsaturated fatty acids are one form of unsaturated fatty acid that can replace saturated fatty acids. Intake of monounsaturated fatty acids can range up to 20 percent of total calories. Most monounsaturated fatty acids should be derived from vegetable sources, including plant oils and nuts.

Natural Cholesterol Management - Numbers are In

In a four month period, I naturally lowered my LDL (bad) cholesterol from 161mg/dl to 131mg/dl (about 19% improvement), increased my HDL (good) cholesterol from 55 to 61 (about a 10% improvement). Total cholesterol was reduced from from 228 (it had been as high as 239) to 201. I am not yet at the "under 200" target, but with my relatively high HDLs and declining LDLs, I was now closing in on some desireable cholesterol levels.

I achieved these goals with a less-than-disciplined, natural approach combining plant sterols, viscous soluble fiber and low levels of immediate release niacin from nicotinic acid.

I always have eaten fairly well. Low in terms of red meat and dairy, low in terms of saturated fats, processed foods and dietary cholesterol. Mediterranean cuisine also has long been a personal preference, and I use olive oil (and occassionally canola oil) in all cooking and food prep. I also eat a fair amount of vegetables and whole grains, and lots of fruit.

My internist had suggested that I might need to consider the use of a medication to achieve better cholesterol levels. As an otherwise healthy 49 male, I was not ready to start a lifetime of medication to create healthier cholesterol levels. I began a search for the alternatives, and found that a number of nutrients ---viscous soluble fibers, plant sterols, niacin and Omega-3 fatty acids --- can collectively enable an individual to substantially improve one's blood lipid profiles.

So, I began developing a personal program that incorporates these nutrients in foods and supplements. More importantly, I was looking to enjoy these foods (food and cooking are my pre-occupation and a source of daily joy). With my somewhat less-than-disciplined approach to consuming soluble fiber, plant sterols and niacin, I achieved the results noted above.

Note on full disclosure: While I weigh about the same amount, I did increase the frequency of exercise from 2 to 4 days per week. My workout intensity also increased.

I am now looking to refine my approach to further improve my blood lipid levels. As someone with year's of experience in the natural and gourmet foods, I also decided to create Kardea Nutrition to develop products that comfortably fit into my daily eating habits (and hopefully yours!). I also do not want these foods to lead to an increase in the total level of calories I take in each day.

My first set of products should be available in early February, but early in Janary, you will be able to log onto my website to see what's coming (http://www.kardeanutrition.com/).

Overall, I am sincerely interested in networking with others that are attempting to manage cholesterol levels naturally. Let's share what is working.....and based in part on these exchanges, I will be developing other foods and supplements that strive to meet the combined goals of delicious, natural, calorie-mindful and effective in terms of natural cholesterol management.