Kardea Nutrition Teams with The Cooking Cardiologist®

Kardea Nutrition™ is pleased to announce that it has teamed with Dr Richard Collins, a Mayo Clinic trained cardiologist, also known as The Cooking Cardiologist®, to advance an integrated nutritional approach promoting cardiovascular health and wellness.

“What you eat and how much you eat can significantly alter cardiovascular health,” say Dr. Collins, ”Certain nutrients can be very helpful. Others can be quiet harmful. The power of nutrition lies with the overall eating patterns and preferences.”

The National Institutes of Health and the American Heart Association have long asserted that dietary choices are the foundation of cardiovascular disease prevent and health promotion. The NIH recognizes that lifestyle choices, emphasizing nutrition “compares well with many of the cholesterol-lowering drugs.[i]” For some, food choices allow individuals to maintain healthy cholesterol, blood pressure and blood sugar levels without the use of medications. For others, food choices reduce the medications required to achieve healthy levels.

In addition to serving on Kardea’s Board of Advisors, Dr. Collins will join Kardea’s founder, Robert Leighton, in co-authoring The Kardea Gourmet: Great Science, Fantastic Foods and Cardiovascular Health. This book will provide readers with a clear understanding of how inflammation and cholesterol, blood pressure and blood sugar levels interact to affect cardiovascular health. It then will review the impact of specific nutrients and overall diet. Gourmet chefs from noted restaurants around the country also will be providing the meal plans that deliver the right nutritional balance and heart healthy nutrients including Omega-3s, fibers, plant sterols and antioxidants.

Sections of the book, including recipes, are posted on kardeagourmet.com . Updates are being added on a weekly basis. Kardea is seeking input from interested readers.

Founded in 2007, Kardea Nutrition™ LLC was launched to empower people to manage their cholesterol, naturally and nutritiously. Kardea Nutrition™ has since extended its scope to enable the power of nutrition to advance overall cardiovascular health. It products are currently available at many retailers throughout the United States including Whole Foods , Nordstrom, drugstore.com and Hy-Vee. Products can also be purchased directly from Kardea’s online store.


[1] Your Guide to Lowering Cholesterol with Therapeutic Lifestyle Changes (TLC), U.S. Department of Health and Human Service, National Institutes of Health, National Heart, Lung, and Blood Institute, December 2005. www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf

From Heart Health Claims to Cardiovascular Health Optimizing Nutrition

Take a stroll through any grocery store, and you may become overwhelmed by the dizzying array of heart healthy products. Cereals, soups, super-fruit drinks, popcorn and chocolate, salad dressings, margarines and oils, yogurts and nutritional bars, pastas and many other food categories have products proclaiming their ability to lower cholesterol and blood pressure, fight inflammation and control blood sugar levels —all factors in the development of cardiovascular diseases. No food or specific nutrient rules in the quest for the healthiest. “Low in sodium,” “low in saturated fat,” “no cholesterol and no trans-fats,” “high in potassium or high antioxidants”, “with plant sterols”, “an excellent source of Omega-3’s ,” and “contains cholesterol lowering fiber” are only some of the pronouncements. Walk over to the vitamin aisle and you will find numerous supplements with similar associations to heart health: CoQ-10, Vitamin E, psyllium, niacin and red yeast rice are just a few.

Many consumers remain dubious. See full article at The Kardea Gourmet.

Kardea Nutrition for Natural Cholesterol Lowering

Mixing Meds---Another Alert

Cholesterol managing medications remain the single largest class of drugs sold in the world. High blood pressure medications are not far behind. The reason: unlike a medication to treat an acute and passing infection, these medications are often taken for a lifetime.

Here at Kardea, we look to the power of therapeutic nutrition and other lifestyle changes to allow an individual achieve healthy heart results either without the medications or at least with lower dosage levels.

Our interest is motivated less by the potential power of a given medication to achieve the specific result. Rather, our interest lies with the fact that a given drug is likely to be appropriate for one health concern. Yet, as we age, we often will face multiple condition --- and we take multiple medications for each condition---sometimes simply to treat the side effects of the first medications. I certanly have been watching my 83 year old mother and 90 year old father add an another medication with each passing birthday. It is the cocktail of medications that I find alarming. The long term interactions among these drugs are uncertain....but each drug is a powerful chemical agent.

Here is a case in point:

On November 17, 2009, the Food and Drug Administration warned consumers not to take popular heartburn medications Nexium or Prilosec if they use Plavix, a widely prescribed blood thinner that guards against heart attack and stroke.

The two heartburn formulations can reduce the protective blood-thinning effect of Plavix, a medication widely advertised directly to consumers, by nearly one-half, according to a study undertaken at the request of the FDA.

Heartburn medications are commonly used with Plavix because it can cause upset stomach.

A leading medical industry watchdog welcomed the FDA's action, but said it's late and not forceful enough. The FDA should have required a more prominent "black box" warning, said Sidney Wolfe, director of Public Citizen's Health Research Group. "You're getting a less effective dose of a potentially life-saving drug," said Wolfe, who also is a member of the FDA's Drug Safety and Risk Management Committee. "This is a serious issue."

Kudos to Dr Wolfe and the FDA...but one can only guess that more than one patient taking both Plavix and on these heartburn medications was prescribed a higher dosage or this Plavix or treated with yet another medication.

Niacin Useful In Natural Cholesterol Management

Hamden, CT Niacin available as non-prescription supplements can be an effective component of a broader natural nutritional approach to improve cardiovascular health and healthy blood lipids including cholesterol, a White Paper released by Kardea Nutrition reported.

Niacin, also known as Vitamin B3, is vital for good health. Niacin helps convert food into energy, build red blood cell counts, and synthesize hormones. For basic good health, a relatively small amount of niacin, about 20mg/day, is needed. Americans typically obtain this level from a balanced, healthy diet. Our bodies also can manufacture niacin.

At substantially higher levels—1000-2500mg/day--- a specific type of niacin significantly improves cholesterol levels. At these levels, Niacin as nicotinic acid can lower plaque-forming LDL cholesterol by up to 25%. It also has been shown to raise the healthful HDL cholesterol by as much as 35%, and lower triglyceride levels by 20% to 50%. The medical community defines these high dosages as a drug available that should be taken under a physician’s care. Nicotinic acid is available in a prescription form or as supplements.

Between the 20mg of niacin recommended to avoid a deficiency and the 1000+mg that may be prescribed by a physician lies niacin levels that has been shown to be useful in promoting a healthier cardiovascular system. The intake of nicotinic acid at 100-1000mg/day has been shown to significantly improve the levels of both HDLs and triglycerides. At these lower levels, niacin has not been shown to consistently lower LDL cholesterol levels.


Cholesterol Management: Beyond LDL Reduction

LDL cholesterol reduction has been the primary focus of the medical and pharmaceutical community. This focus is supported by the significant and extensive research confirming the positive health effects of lowered LDL, including reduced heart attacks, strokes and other cardiovascular diseases.

Increasingly, medical science now understands that LDL reduction alone is only part of solution in cholesterol management to promote cardiovascular health and wellness.

Researchers are expanding the targets to more broadly address the composition of cholesterol and triglycerides in our blood. For instance, the NIHs’ National Cholesterol Education Program (NCEP) reports that “strong epidemiological evidence links low levels of serum HDL cholesterol to increased heart disease. High HDL-cholesterol conversely conveys reduced risk.” The NCEP identifies HDLs less than 40mg/dl has a risk factor for heart disease. Levels above 60mg/dl are associated with a reduced risk of heart disease.

Low HDL levels without elevated LDL levels are fairly common. Up to 50% of patients not typically candidates for LDL lowering medications have low levels of HDLs. In patients with premature coronary artery disease, low HDL levels are the most common abnormality in blood lipids.

Many recent studies indicate that small increases in HDLs can significantly reduce the incidence of cardiovascular-related death. A 1mg/dl increase in HDL has been associated with a 2%-3% reduction in coronary artery disease. Another extensive study showed that increasing HDL by 6% in patients with low HDL cholesterol decreased heart related deaths and non-fatal heart attacks by 22%

Integrated Approach to Natural Cholesterol Management

Coupled with the HDL raising/LDL lowering benefits associated with niacin (nicotinic acid) LDL reductions can be achieved through the restricted intakes of saturated and trans fats, higher intakes of monounsaturated fats, and therapeutic levels of plant sterols and selected types of fibers (including soluble fiber from oats, barley, psyllium, beans and certain fruits) Modest weight loss and increased physical activity can further raise HDLs.

The White Paper is based on studies conducted over the past two decades and published in the various peer reviewed journals. The paper also addresses other issues associated with niacin intake including flushing and consumer confusion associated with the different types of niacin.

Strategies to Increase Good HDL Cholesterol

When it comes to cholesterol, most people think lower is better. But when we're talking about the cholesterol in our blood, it's a bit more complicated.

Low-density lipoprotein, or LDL, is known as the "bad" cholesterol and high-density lipoprotein, or HDL, is known as the "good" cholesterol. LDL optimally should be less than 100 mg/dL (milligrams per deciliter)---above this level, some amount of arterial plaque (the stuff that causes blocks in the arteries that can lead to heart attacks and stroke) is likely to develop. You and your doctor may or may not seek to lower your cholesterol levels if they are higher. This depends on a variety of risk factors. To assess your maximum LDL targets, click to the Kardea LDL Cholesterol Calculator based on the recommendations of the National Cholesterol Education Program. And if you are at high risk of heart disease, you and your doctor may seek to drive your cholesterol below 70mg/dL.

HDL cholesterol removes excess cholesterol from the blood, which slows the build-up in the arteries and ultimately lowers heart disease risk. Since estrogen increases HDL, women tend to have higher levels than men. Women should strive for an HDL above 50 mg/dL and men above 40 mg/dL. While genetics plays a role in your HDL level, there are some things you can do to modestly boost a sagging HDL:

• Lose weight if you're overweight. Exercising and cutting a few calories can give HDL a little boost, especially if you carry most of your excess weight in your abdomen.
• Quit smoking. Smoking, as well as secondhand smoke, can lower HDL.
• Recognize that different types of fats affect your HDL levels. Healthy fat choices such as omega-3s found in fish and monounsaturated fats found in olive oil and canola oil, nuts, seeds and avocados should be used---replacing the satured and trans fats found in processed foods, certain meats and dairy products.
  • Alcohol can raise HDL. If you can safely fit alcohol into your eating plan, keep it moderate -- no more than one drink a day for women and two drinks for men.

Also, you can consider the use of niacin as nicotinic acid. Available as both a supplement and a prescription medication, this form of niacin can significantly raise your HDLs. For an overview on niacin, read Kardea's discussion paper. And remember, in developing a program that optimizes your heart health and cholesterol profiles, it is best to collaborate with your health care professionals.

Kardea Nutrition Links Dietitians & Natural Foods Retailers with Natural Cholesterol Management Speakers’ Bureau

Lifestyle changes emphasizing therapeutic nutrition offer significant opportunities to positively affect a range of interconnected health issues --- including cholesterol management, metabolic syndrome, diabetes and hypertension. Generally, where these multiple issues occur, the importance of cholesterol management is amplified.

The challenge: consumers are often confused or misinformed in regard to the best ways to use nutrition to naturally improve cholesterol levels. Numerous studies, including those reviewed by the Food & Drug Administration, the American Heart Association and the National Institutes of Health, have shown that a 20-30% reduction in LDL cholesterol levels is readily achievable with nutritional therapy.

As part of an initiative to enhance consumer understanding, Kardea Nutrition is developing a program to link food retailers, particularly natural foods retailers, with registered dietitians.

Among the components of this Kardea initiative is the creation of a Natural Cholesterol Management Speakers’ Bureau. As part of this program, dietitians with proven expertise in cholesterol management will be providing in-store classes that address the integrated roles of fiber, plant sterols, niacin, omega-3s, and monounsaturated fats.

Nutritional health professional and natural foods retailers interested in participating in this program should contact Kardea Nutrition directly at customerservice@kardeanutrition.com.

Maximizing Sterol Effectiveness: Study

A recent study, published in Food & Nutrition Research (January 2009), found that while sterols uniformly worked to lower LDL cholesterol, their power is affected by a number of factors. The study assessed 59 randomized clinical trials published from 1992 to 2006. Maximum results were found where patients:

• Consumed 2.5 grams of sterols or stanol per day. The FDA allows a health claim for products containing as little as .4 grams of plant sterols or .65 grams of plant sterol esters. As such, individuals will often need to take multiple servings of plant sterol products to attain the optimum daily intake. Consumption beyond 2.5 grams did not lead to further reductions ( Foods with Plant Sterols).
• Took plant sterols over the course of the day. Multiple servings were generally found to be more effective than a single serving.

Not surprising, sterols lowered LDL cholesterol by more among individuals with high or very high cholesterol levels, but sterols also proved effective among individuals with optimal to borderline-high LDL cholesterol. The authors also sought to assess the power of sterols across different types of foods. While they generally found that foods with some fat content (greater than 3 grams per serving) and low-fat milks and yogurts may be somewhat better, the evaluation does not appear to control for other elements of diet, lifestyle and medications. More research in the role of plant sterols coupled with a broader approach to therapeutic nutrition for cholesterol management is merited.

Foods with Plant Sterols

Plant sterols are an effective nutritional tool for lowering LDL cholesterol by 10-15%. As part of a diet that is both low in saturated fats, trans fats and cholesterol, and high monounsaturated fats and soluble fiber from oats, beans, barley or psyllium, individuals can achieve cholesterol reduction of 30%+.

In nature, small quantities of plant sterols can be found in a range of foods, particularly vegetable oils. The average plant sterol intake is about 250 milligrams. Vegetarians consume in a range of 400 to 750 milligrams. Plant sterol intake in traditional diets has been estimated to be about 1g (1000mg). Medical studies have concluded that 2-3g (2000-3000mg) effectively lower cholesterol. Fortified foods or supplements are typically required to obtain these levels.

Click for Chart of Foods with Plant Sterols

kardea - gourmet nutrition for cholesterol management

Omega-3s & Heart Health: Strong Science Supports Broad Recommendations

Broad medical recommendations, like those now advanced by the American Heart Association (AHA) and National Cholesterol Education Program, come only after extensive research has confirmed usefulness. Multiple types of research are used. Epidemiologic studies compare the difference in disease and diet across groups of people. Experimental studies assess the role of a nutrient or medication in laboratory animals. Clinical studies assess the impact when given to a test group of people. This impact is compared to a “control” group not taking the nutrient or medicine.

Omega-3s from fish oils have been subject to all types of studies, and the benefits associated with cardiovascular health and disease prevention have been consistently shown. As a result, leading medical organizations now recommend Omega-3s from fish oil for cardiovascular health. The recommendations include:

• 500mg/day of Omega-3s from fish oil for adults that have not been diagnosed with coronary artery disease.


• 1000mg (1g)/day for adults that have been shown to have coronary artery disease.


• 3000mg-4000mg (3-4g)/ day for adults with highly elevated triglycerides.

Omega-3s are not associated with reductions in LDL (bad) cholesterol levels. Yet, cholesterol alone is only part of the cause of heart disease. A number of other factors can determine the damage that cholesterol can do. Omega-3s appear to favorably affect these factors including decreased blood pressure, reduced inflammation that leads to plaque formation, and the stabilization of existing plaque.

How significant is the impact on Omega-3s? Studies have indicated as much as a 18-20% reduction in a cardiovascular event such as a heart attack for healthy adult. For those with a history of heart disease, the impact has been shown at least as significant, and perhaps higher.

Omega-3s from fish oil represent an important component of an integrated and comprehensive nutritional approach to cardiovascular health. Other broad recommendations include the consumption of 10+ grams/day of selected soluble fibers such as those from oats, beans, barley and psyllium, 2 grams/day of plant sterols, and diet that restricts saturated fats, trans fats and dietary cholesterol. Click here for more information on nutritional and natural cholesterol management.

Link to report on Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease in Circulation Journal of the American Heart Association, 2002.

Cardiovascular Disease Prevention: Between Healthy Habits and Prescription Medications

With cardiovascular disease the largest cause of death and disability in the United States, the scientific community continues intense investigations into approaches for prevention. In the New England Journal of Medicine, Doctor Mark Hlatky of Stamford University School of Medicine, writes, "The aphorism 'prevention is better than cure' makes perfect sense when applied to healthy habits such as following a sensible diet, maintaining an ideal body weight, exercising regularly, and not smoking. But increasingly, prevention of cardiovascular disease includes drug therapy, particularly statins to lower cholesterol levels."

In this editorial, Dr. Hlatky is reponding to the growing interest in prescribing cholesterol-lowering medications to a much larger segment of the American population---including those with cholesterol levels well below the risk standards established by the National Cholesterol Education Program of the National Institutes of Health. These medications already are the single largest class of drugs sold in the U.S. today, exceeding $30 billion/year.

There is mounting evidence that lowering LDL cholesterol below the NCEP risk-adjusted standards is reducing the incidence of cardiovascular events such as heart attack and strokes. Further, recent studies, notably the JUPITER study published in the New England Journal of Medicine, reinforces the evidence that statin medications not only favorably alters cholesterol levels but also reduce the level of inflammation in the arteries. In addressing inflammation, the medication may reduce a root cause of arterial plaque development.

Yet, what remains lost in the discussions between healthy habits and drug treatment is the positive, therapeutic power of nutrition. Nutritional solutions extends beyond the restriction of saturated fats, trans fats and cholesterol to nutrients that actively improve cholesterol levels and reduce inflammation. For many, these nutritional tools can allow the individual to achieve target cholesterol levels and serve as an effective statin alternative. For others, the nutritional approach offers an opportunity for reductions in the dosages and number of medications required to achieve heart healthy targets.

The tragedy: compared with the funding for pharmaceutical studies, an incredible small amount of money is being spent to advance the nutritional science. With few major studies reporting on the benefits of nutritional cholesterol management, the news media reports on the pharmaceutical studies. The extensive and widely reviewed understanding of the nutritional solution is then overshadowed.

Here at Kardea, we are working to provide you with both the knowledge and the natural products that advance heart health. We are only one source. For others, discuss with your medical providers. Also, check out our the resource page on the Kardea Nutrition website or for great recipes for cholesterol management, click over to Kardea Gourmet .

Another good source of information: http://cholesterol.about.com/od/treatments/u/Treatments.htm

Kardea Nutrition, Heart Healthy & Inspired.

Bloggers Taste Test Kardea Nutrition Bars

Yep, we are a mission-driven start-up with a love and a passion for what we do. Delivering plant sterols and soluble fiber for cholesterol management, the bars also deliver wonder aromas, great tastes and satisfying texture and finish. Here is what some bloggers are saying about the Kardea Gourmet Nutrition Bars:


Mark at Hangry Pants
Unlike some other bars I have eaten in this category, eating one gave me the feeling that Kardea bars are made with love ...

Vicky at Frenchy Addict
Yes, I love the Kardea bar "almost" as much as I love my beloved Larabar. Check your health food markets to see if they're available in your neck of the woods. I encourage you to try them, they're moist and chewy. ...

Caoline at Eat, Pray, Run
Try This Bar!! So, y’all know that I am a devout Larabar lover. But I just have to introduce to you this bar that I had the opportunity to try this weekend. This Kardea Nutrition Bar was sent to me last week from founder Rob Leighton. I had one of these babies pre-workout on Friday, and I have got to tell you — it is YUMMY, YUMMY, YUMMY! I went in with the intention of eating just half, but ended up gobbling the whole thing down!

Abby at Eat, Drink and Be Aware
Lemon Ginger- We loved the lemon ginger! The texture is a little more hearty than Larabars and the taste combination is out of the world good! Does anyone ever buy those Carr's English Ginger Lemon Creme Cookies at the store? ...
Banana Nut- first words out of Emmet's mouth was Wow! "I like the taste and texture- tastes like Banana Bread"- we all like the texture of these bars. They look like caramel and are moist and chewy but have a little nibble to them as well.Cranberry Almond- extremely fresh tasting. I can't seem to put my finger on it but this bar reminds me of something.... something good. The one thing that I come back to is the flavorings-- they all taste really fresh and are not overpowering.

Heather at Hangry Pants
Delicious! I love lemon flavor…the best way I can describe it is “gentle… I was pleasantly surprised when I bit into it and it had some chew, but was still soft. I looked more closely at the ingredients and realized it must be the rolled oats I am loving in there…

Juilet at Daily Eats
Well, in the case of Kardea Nutrition, food not only tastes good, but it’s also very good for you. Kardea’s snack bars deliver 50% more heart healthy soluble fiber than found in oatmeal, and each provides 1 gram of cholesterol lowering ...

Tina at Carrots 'N' Cake
The Chai Spice Kardea Bar had an amazing chai aroma, which hit me as soon as I opened the package. The flavor of the bar was equally wonderful-- nice and strong...

Rose at On a Lobster Placemat
I am certainly going to add Kardea bars to my shopping list. They feel like a good alternative to Larabars and Clif Bars, which I eat on a regular basis. It would probably be good to have something with a little less fat and calories ...

Sammie at Running with a Recipe
I had a Lemon Ginger Kardea bar - these bars are really becoming a favorite of mine. This was the 3rd flavor that I have tried and I love them all. The flavor was delicious …

As our sampling budget allows, we will send out more products for review. Interested. Email us at customerservice@kardeanutrition.com.

Cholesterol Education Month A Good Time to Consider Statin Alternatives

September is National Cholesterol Education Month.

The stakes are high. Cardiovascular disease remains the leading cause of death and morbidity in the U.S. Cholesterol management is a leading focus for disease prevention. Sales of related medications now exceed $30 billion in annual sales.

With a passion for natural health, we know well that therapeutic nutrition---based on balanced diets incorporating good fats, viscous soluble fiber, plant sterols and selected other nutrients---can achieve significant improvements in blood lipid profiles. We can lower LDL (bad) cholesterol and triglycerides. We can raise HDL (good) cholesterol. We can reduce the inflammation that trigger arterial plaque development.

The science is more than solid. It is endorsed by the National Institutes of Health, the American College of Cardiology and the American Heart Association. The FDA endorses health claims associated with these nutritents. Overall, therapeutic nutrition can deliver results comparable to many cholesterol-lowering medications.

Yet, the new Lipitor ad campaign eclipses any public education promoting the natural alternatives.

We certainly are not opposed to the medical solution, but as a matter of public policy, our society would be far better served by an extensive therapeutic nutrition campaign than by the Pharma consumer campaigns.

Perhaps we should insist on equal time---for every dollar Big Pharma spends to promote a cholesterol-lowering medication, it should be required to spend an equivalent amount on a separate therapeutic nutrition campaign. In the meantime, raising consumer awareness remains an important function of the natural and health food retailers, and the nutritional health professionals.

Kardea Nutrition--hearty health and inspired---enabling natural cholesterol management.

Cholesterol Management: Beyond Disease Prevention

The guidelines of the National Cholesterol Education Program define LDL cholesterol below 100mg/dl as optimal for otherwise healthy people. Yet, as a matter of disease prevention, these same guidelines suggest that substantially higher levels of LDL cholesterol may be acceptable. These standards are used as a baseline for determining the appropriateness of cholesterol-lowering medications.


Many doctors also are well aware that the non-optimal LDL standards are only a baseline. These doctors are apt to prescribe a cholesterol-lowering medication to achieve the more optimal level.

Here at Kardea, we look to natural cholesterol management to achieve the more optimal levels. Yes, medications may be needed by some, but a nutritional approach has proven as potent as many pharmaceutical therapies. And we recognize that cholesterol management extends well beyond simply lowering LDLs. Our prior blog posts and the numerous links and articles found on our resources page explore this more comprehensive approach.

The important point: cholesterol management is consistent with good health, not simply disease prevention. Whatever your currents levels ---- even if you believe that your cholesterol is not at risky levels ---- consider the benefits of pursuing a more integrated and comprehensive approach.

Statins for Our Kids?

The American Academy of Pediatrics is recommending wider cholesterol screening for children. Underpinning these recommendations is the understanding that elevated LDL (bad) cholesterol in kids can lead to an onset of cardiovascular disease earlier in adulthood. It recognizes that the plaque in an adult's arteries may have begun developing very early in life.

The recommendations call for cholesterol screening of children and adolescents, starting as early as the age of 2 and no later than the age of 10, if they come from families with a history of high cholesterol or heart attacks before 55 for men and 65for women.

Screening is also recommended for children when family history is unknown, or if they have other risk factors, like being at or above the 85th percentile for weight, or have diabetes. If the child’s cholesterol level is normal, retesting is suggested in three to five years.

The report also suggests that for a selected group of children, prescribing a statin medication might be appropriate. Drug treatment, according to these recommendations, should be considered for children 8 and older who have very elevated LDLs, or when family history or weight indicate multiple risk factors for developing heart disease.

Not surprisingly, these recommendations raised an outcry.

“When you have a kid whose cholesterol looks like an overweight 65-year-old, what do you do?” asks Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital in Boston and quoted in The New York Times. In developing the recommendations, we "had to balance the risks of treating children with powerful drugs, about which there is limited long-term data, with the risks of not treating children with unprecedented cardiovascular disease risk factors.”

Dr Ludwig also is reflective about these recommendations. Quoted in the Times, he comments “my concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective”.

For many, the systematic solution focuses on addressing childhood obesity. No doubt, an extraordinarily important challenge in its own right. Yet, cholesterol management in children go beyond issues associated with obesity. Elevated cholesterol can be found in otherwise fit and thin adults and children alike.

Between weight loss and medication lies therapeutic nutrition as outlined by the National Cholesterol Education Program (NCEP) of the National Institutes of Health. Eating a balanced diet that replaces saturated fats and trans fats with monounsaturated fats (e.g. fats in olive oil, nut butters), adds high levels of soluble fiber from oats, beans, high-pectin fruits, and psyllium) and adds plant sterols can significantly improve cholesterol and blood lipid profiles. Other nutrients, including Omega-3s from fish oils, also have been found useful.

The NCEP asserts that therapeutic lifestyle changes with a particular emphasis on what we eat (not simply how much we eat) can deliver results comparable to many cholesterol-lowering medications. For links to the NCEP reports, clinical research and other educational materials advancing natural cholesterol management: Kardea Nutrition http://www.kardeanutrition.com/. For recipes: http://www.kardeagourmet.com/

Red Yeast Rice: Statin Alternative or Natural Statin

A study recently published in the Mayo Clinic Proceeding has confirmed the power of natural alternatives for cholesterol management. The study, authored by group of doctors and researchers associated with University of Pennsylvania, found that a combination of the Therapeutic Lifestyle Changes (TLC) recommended by the National Cholesterol Education Program (NCEP) of the National Institutes of Health coupled with red yeast rice and fish oil supplements led to a more substantial reduction in LDL (bad) cholesterol than did simvastatin, a statin medication sold by Merck Drug under the brand name Zocor.


The authors wrote “our study was designed to test a comprehensive and holistic approach to lipid lowering…. These results are intriguing and show a potential benefit of an alternative, or naturopathic, approach to a common medical condition, hyperlipidemia”

Statin Alternative or Natural Statin

The media reported the study as an “alternative to statins.” In reality, the choice is between a prescription, controlled statin and a natural source of statins. The active ingredient in red yeast rice supplements is a naturally occurring statin. It is chemically similar to the prescription lovastatin sold by Merck under the brand name of Mevacor. In short, red yeast rice does not represent a statin alternative, but rather a natural source of statins.

For those of us with a predisposition to natural products, this may seem like an intriguing option, but red yeast rice supplements face some important challenges. The authors of this study outlined the issues:
• In 2001, the US Food and Drug Administration determined that red yeast rice with a controlled level of the lovastatin was a drug, not a dietary supplement.
• As a result, the supplement manufacturer cannot control or test for the active compounds in red yeast rice supplement. While the chemical composition of the red yeast rice supplement used in the study was known and controlled, the composition of various products and the batch consistency between lots from the same source make recommending red yest rice supplements difficult.
• Taking red yeast rice without a physician’s supervision could also have unknown risks. The lovastatin component can cause the same side effects as any statin, and a potentially dangerous metabolite, citrinin, can form in poorly manufactured preparations.

Statin Alternative Do Exist

The American Heart Association, the American College of Cardiology, the American College of Preventive Medicine and many other health and medical organization participated in developing the NCEP recommendations. The recommendations emphasize that “many people will be able to lower their LDL enough” with lifestyle and nutritional changes alone. The NCEP reports that “if your LDL needs more lowering, you may have to take a cholesterol-lowering drug” in addition to the lifestyle changes . “However, by staying on the TLC Program, you’ll be keeping that drug at the lowest possible dose. “

The Kardea website provides an extensive amount of information about TLC. It also addresses some of the nutrients not specifically recommended by the NCEP, but widely reviewed by the medical community. The important point: before taking a statin----from a prescription or an herbal supplement---consider your alternatives.

Foods with Plant Sterols

In nature, small quantities of plant sterols can be found in a range of foods, particularly vegetable oils. In the American diet, the average plant sterol intake is about 250 milligrams. Vegetarians consume in a range of 400 to 750 milligrams. Plant sterol intake in traditional diets has been estimated to be about 1g (1000mg). Medical studies have concluded that 2-3g (2000-3000mg) effectively lower cholesterol. Fortified foods or supplements are typically required to obtain these levels.


At our sister site, Kardea Gourmet, you can find a listing of a variety of foods with plant sterols --- naturally-occurring and fortified. You also can find (and contribute) great recipes for foods that actively work to improve cholesterol levels.

WebMD Addresses Natural Cholesterol Management

WebMD has recently released an online video addressing natural cholesterol management. View Video.

In the accompanying artcle, WebMD reports, "To lower your cholesterol, ...a handful of some "functional foods" have been shown to make a big impact on your cholesterol levels."

"These foods may not be magic, but they're close to it," says Ruth Frechman, RD, a spokeswoman for the American Dietetic Association quoted in the WebMD article.

The article continues that "studies have shown that a diet combining these "superfoods" may work as well as some cholesterol-lowering medicines to reduce your "bad" LDL cholesterol levels." This is great news for the 105 million adults in the U.S. with high cholesterol, particularly for the many people that can't handle the side effects from cholesterol drugs.

The Kardea website provides an excellent overview of how these key nutritions fit into a heart health diet. And for recipes enabling therapeutic nutrition for cholesterol management, click to Kardea Gourmet.

Carbohydrates & Cholesterol: Recommendations from the National Cholesterol Education Program

NCEP Evidence Statement: When carbohydrate is substituted for saturated fatty acids, LDL cholesterol levels fall (Strength of Evidence: A2, B2). However, very high intakes of carbohydrates (greater than 60 percent of total calories) are accompanied by a reduction in HDL cholesterol and a rise in triglyceride (B1, C1). The latter responses are sometimes reduced when carbohydrate is consumed with viscous fiber (C2); however, it has not been demonstrated convincingly that viscous fiber can fully negate the triglyceride-raising or HDL-lowering actions of very high intakes of carbohydrates.

NCEP Recommendations: Carbohydrate intakes should be limited to 60 percent of total calories. Lower intakes (e.g. 50% of calories) should be considered for persons with the metabolic syndrome who have elevated triglyceride or low HDL cholesterol. Regardless of intakes, most of the carbohydrate intake should come from grain products, especially whole grains, vegetables, fruits, and fat-free or low-fat dairy products.

Macronutrient NCEP Dietary Recommendations

Carbohydrate: 50-60% of Total Calories* **

Protein: 15% of Total Calories

Total Fat: 25-35% of Total Calories*

Monunsaturated Fat: Up to 20% of Total Calories

Polyunsaturated Fat: Up to 10% of Total Calories

Saturated Fat: Less than 7% of Total Calories

Dietary Cholesterol: Less than 200mg/day.

*Allows an increase of total fat to 35% of total calories and reduction in carbohydrate to 50% for persons with the metabolic syndrome. Any increase in fat intake should be in the form of either polyunsaturated or monounsaturated fat.
**Carbohydrate should derive perdominantly from foods rich in complex carbohydrates including grains--especially whole grains---fruits, and vegetables.

Trans Fatty Acids: Recommendations of the National Cholesterol Education Program

NCEP Evidence Statement: Trans fatty acids raise serum LDL cholesterol levels (Strength of Evidence: A2). Through this mechanism, higher intakes of trans fatty acids should increase risk for CHD (coronary heart diseases). Prospective studies support an association between higher intakes of trans fatty acids and CHD incidence (C2). However, trans fatty acids are not classified as saturated fatty acids, nor are they included in the quantititative recommendation for saturated fatty acid intake of less than 7 percent of calories in the TLC (therapeutic lifestyle changes) Diet.

NCEP Recommendation: Intakes of trans fatty acids should be kept low. The use of liquid vegetable oil, soft margarine, and trans fatty acid-free margarine are encouraged instead of butter, stick margarine and shortening.

NCEP Discussion: Substantial evidence from randomized clinical trials indicates that trans fatty acids raise LDL cholesterol levels, compared with unsaturated fatty acids. These stuides also show that when trans fatty acids are substituted for saturated fatty acids, HDL (good) cholesterol levels are lower.

Click recommendations on unsaturated fats, both monounsaturated and polyunsatured.

Polyunsaturated Fatty Acids: Recommendations from the National Cholesterol Education Program

NCEP Evidence: Linoleic acid*, a polyunsaturated fatty acid, reduces LDL cholesterol levels when substituted for saturated fatty acids in diets (Strength of Evidence: A1,B1). Polyunsaturated fatty acids can also cause a small reduction in HDL cholesterol when compared with monounsaturated fatty acids (B2). Controlled clinical trials indicate that substitution of polyunsatuarated fatty acids for saturated fatty acids reduces risk for CHD (coronary heart diseases) (A2,B2).

NCEP Recommendations: Polyunsaturated fatty acids are one form of unsaturated fatty acids that can replace saturated fat. Most polyunsaturated fatty acids should be derived from liquid vegetable oils, semi-liquid margarines, and other margarines low in trans fatty acids. Intakes of polyunsaturated fat can range up to 10 percent of total calories. (Note: recommendation for monounsaturated fatty acid is a higher at up to 20 percent of total calories).

*Linoleic acid is a colorless to straw-colored, polyunsaturated fatty acid that is liquid at room temperature and of the omega-6 series. Good sources of linoleic acid from vegetarian sources are sunflower oil, and safflower oil.

Viscous Soluble Fiber: Recommendations from the National Cholesterol Education Program

NCEP Discussion (excerpt): Because of the favorable effects of viscous fiber (soluble fiber from oats, fruit pectins, guar, beans and psyllium) on LDL cholesterol levels, the NCEP recommends that the therapeutic diet be enriched by foods that provide at least 5-10 grams of viscous fiber daily (Source of Soluble Fiber Chart). Even higher intakes of 10-25 grams per day can be beneficial.

NCEP Evidence Statement: 5-10 grams of viscous fiber per day reduces LDL cholesterol levels by approximately 5 percent (Strength of Evidence: A2, B1).

NCEP Recommendation: The use of dietary sources of viscous fiber (soluble fiber from certain sources) is a therapeutic option to enhance LDL lowering.

Plant Sterols: Recommendations from the National Cholesterol Education Program

NCEP Evidence Statement: Daily intakes of 2-3 grams per day of plant stanol/sterol esters will reduce cholesterol by 6-15 percent Strength of Evidence (A2, B1)

NCEP Recommendation: Plant stanol/sterol esters (2g/day) are a therapeutic option to enhance LDL cholesterol lowering.

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.

Zetia/Vytorin Study: A Perspective

You may have heard the considerable debate regarding the cholesterol-lowering medication, Zetia. Unlike statins which affect your cholesterol production, this drug blocks the absorption of both dietary and biliary (liver-produced) cholesterol into the blood stream. The drug is intended to provide individuals who cannot reduce LDL cholesterol using diet and exercise with an alternative to high dosages of statin medications. It also was developed for those who simply cannot tolerate statins.

In a recent controversial study reported in the New England Journal of Medicine, the effects of taking Zetia and the statin, Zocor, combined (together known as the drug Vytorin) was compared to the effects of taking Zocor only.

Here are results:

The group taking the two drugs experienced an LDL cholesterol decline that was 27% greater than the Zocor-only group.

Despite the increased lowering of LDL cholesterol in the group that received both medications, both groups saw arterial plaque build at rate that was similar (although those on the combination drug saw a somewhat larger, but not statistically significant, increase).

This finding is at odds with our traditional understanding of the favorable relationship between lower LDL cholesterol and atherosclerosis.

The trial, however, did not directly address whether lowering of LDL cholesterol with the combination drug reduces heart attacks, strokes and other cardiovascular “events.” The combination drug may or may not provide an additional benefit.

So how is the medical community responding?

An editorial in the New England Journal of Medicine observes that “it seems prudent to encourage patients whose LDL cholesterol levels remain elevated despite treatment with an optimal dose of a statin to redouble their efforts at dietary control and regular exercise,” leaving Zetia for special situations. Yet, well trained, qualified doctors continue to prescribe the combination drug more broadly, believing that a single study does not unseat established wisdom.

The human body is profoundly complex, and we simply do not know with certainty how any particular approach will affect our long term health and longevity. We can only play the odds as we know them today. This requires that each of us take an educated approach to our health. Kardea aims to enable the members of its community to make more informed decisions about cholesterol management and natural nutrition.

Plant Sterols or Plant Sterol Esters: Count Correctly!

Here at Kardea, we use natural plant sterol esters that combine the free plant sterol found in soy bean with a safflower oil. Sterol esters are considerably more expensive than the plant sterols, but much of the research in regard to the efficacy of sterols to consistently lower total and LDL cholesterol without adversely lowering HDL (good) cholesterol was based on the sterol ester.

The FDA first approved the sterol heart health claim only for the plant sterol ester. In this claim, the FDA defines that individuals should consume 1.3 grams/day of plant sterol esters to have a meaningful effect on heart health. To make this claim, food manufacturers are required to incorporate at least .65 grams of plant sterol esters into each serving as listed on the nutritional statement. Generally, sterol esters contain about 60% free sterols.

Since then, the FDA has allowed the claims for the free plant sterol. Under this claim, the FDA targets .8 grams of plant sterols per day with each serving containing .4 grams.

Looking beyond the FDA health claims, the National Cholesterol Education Program of the NIH, along with the American Heart Association and the American College of Cardiology, recommends daily consumption of 2 grams/day of plant sterols.

For those of us utilizing a natural and nutritional approach for cholesterol management, we must make certain that we are counting our sterol intake correctly. Kardea seeks to make this as clear as possible. We provide you with the numbers for the free sterol content in our products. For example, our bars contain 1 gram of plant sterols, and we utilize a significantly greater amount of plant sterol esters to reach this level. So, you need two bars per day to reach the NCEP recommendation.

Alternatively, a bar and two tablespoons of our sterol-fortified olive oil will achieve the same results. For recipes using Kardea olive oil with other heart healthy foods, visit www.kardeagourmet.com.

Other products might fit into your lifestyle. If you are a chip snacker, you might try the natural products at Corazonas Foods. One serving contains .4 grams of the sterols. For products containing non-natural ingredients, try Proactiv Supershots and their margerine-like spreads. Lots of other products are available.

There also are plant sterol supplements on the market. Different brands deliver different levels of sterols. Count correctly!

Red Yeast Rice Supplements-Can They Still Be Effective?

FDA Consistent in Restricting Sale of Lovastatin-Natural or Synthetic

Summary: Certain types of red yeast rice naturally contain lovastatin, the same active ingredient in Merck’s prescription statin medication Mevacor. Whether natural or synthetic, the FDA has consistently maintained that lovastatin has serious potential side effects and should remain a controlled (prescription) medication. As such, the FDA denied Merck’s multiple petitions to sell low-dose Mevacor on an over-the-counter basis. The FDA also has placed restrictions on red yeast rice supplements with verified levels of the naturally-occurring statin. For those interested in natural alternatives, certain nutrients, notably plant sterols, soluble fiber from oats, barley, beans, psyllium and fruit, Omega-3’s from marine sources, niacin, and monounsaturated fats replacing saturated fats, should be considered as an effective alternative approach.

Red Yeast Rice: A Particular Type is a Natural Statin

Red yeast rice is the product of yeast grown on rice. As a food, red yeast rice can be found as a paste, whole dried grains, or as a ground powder. In these forms, it has been a common food in certain Asian diets. In its traditional forms, red yeast rice contains no more than trace amounts of the active cholesterol-lowering agent. In fact, some types of red yeast rice contain no actives.

As a supplement, a particular type of enhanced red yeast rice was shown to significantly lower total cholesterol and LDL (bad) cholesterol. The active ingredient has been identified as lovastatin, the same as found in the popular statin drug, Mevacor and its generic equivalents.

Lovastatin, in turn, is a controlled prescription medication.

Can red yeast rice supplements offer benefit in comparison with prescribed statin medications?

For those preferring naturally-derived solutions, red yeast rice sources of statins could be preferred. This conceptually would be equivalent to a naturally-derived vitamin E as opposed to a synthetic. As we have further come to understand, the active agents in a natural product may be more bioavailable or more effective due to other compounds that accompany whole food. Yet, the FDA consistently views statins--natural or synthetic-- as powerful medication with potential side-effects and potential drug interactions. As such the FDA restricts the sale lovastatin, regardless of its source.

Most recently, the FDA rejected the petition of pharmaceutical giant Merck to offer Mevacor without a prescription. Merck has made three tries to have this statin sold over the counter. In rejecting Merck’s latest petition, the FDA indicated that too many of the wrong people would use the drug if it no longer required a prescription.

Last summer, the FDA issued warnings to consumers not to buy or eat certain red yeast rice products. FDA testing revealed the products contained lovastatin.

The FDA stated that “these red yeast rice products are a threat to health because lovastatin can cause severe muscle problems leading to kidney impairment. This risk is greater in patients who take higher doses of lovastatin or who take lovastatin and other medicines that increase the risk of muscle adverse reactions. These medicines include the antidepressant nefazodone, certain antibiotics, drugs used to treat fungal infections and HIV infections, and other cholesterol-lowering medications.”


What’s in Red Yeast Rice Supplements Today?

Back in 1999, when the clinical studies on the efficacy of red yeast rice were first released, supplements with identified and controlled levels of the active compounds could be purchased. Today, however, such supplements cannot be produced. In fact, red yeast rice supplements may be made from the varieties of red yeast rice that does not the cholesterol-lowering compound. We simply do not know.

Natural Cholesterol Management Alternatives

The coupling of target levels of plant sterols (2-3g/day) and soluble fiber (10-25g/day) with a calorie-mindful diet replacing saturated and trans fats with monounsaturated fats can achieve results similar to many cholesterol-lowering medications. Niacin and omega-3s from fish oil also can play a role. Check with your health care professional about a complete program. Click Here to Learn More.

Natural Cholesterol Management-Study Reaffirms Efficacy

A new study reaffirmed the recommendations of the medical community related to the power of nutrition to lower cholesterol independent of cholesterol-lowering medications.

"In the context of a low-saturated fat diet and in combination with other cholesterol-lowering dietary components, plant sterols appear to exert a very significant effect on LDL-C reduction of the order of 10 per cent for two grams per day of plant sterols," wrote lead author David Jenkins from St Michael's Hospital, Toronto."This figure is similar to studies where plant sterols have been given as the only cholesterol-lowering agent. "Numerous clinical trials in controlled settings have reported that daily consumption of 1.5 to 3 grams of phytosterols/stanols can reduce total cholesterol levels by eight to 17 per cent, representing a significant reduction in the risk of cardiovascular disease.

Participants in the new study adhered to the guidelines set out by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). According to these guidelines, "therapeutic lifestyle changes" can achieve results similar to some cholesterol lowering medications. The study sought to assess the effectiveness of "each functional food component to the overall cholesterol reduction observed and whether all ingredients have to be present," explained the researchers. Jenkins and co-workers prescribed the 42 subjects (average age 63) to a diet containing viscous fibres (10 g/1,000 kcal), soy protein (22.5 g/1,000 kcal), and almonds (23 g/1,000 kcal) for 80 weeks. In addition, plant sterols were taken (one gram per 1,000 kcal), except during weeks 52 to 62.

"Increased plant sterol intakes are likely to have been a part of the ancestral human diet at about one gram per day and are part of a more plant-based diet as currently recommended for CHD risk reduction, including green leafy vegetables, raw or dry roasted nuts, and non-hydrogenated vegetable oils," wrote the authors. "Their reintroduction into the Western diet to prevent CHD may be seen as similar to the desire to reintroduce fibre into the diet to reduce the risk of a number of chronic diseases....Plant sterols therefore appear a good fit with other cholesterol-lowering components in a dietary portfolio to reduce CHD risk," they concluded.


D Jenkins et al. Effect of plant sterols in combination with other cholesterol-lowering foods.
Metabolism, Volume 57, Issue 1, Pages 130-139

Sources of Good Fats for Natural Cholesterol Management

Natural cholesterol managers seek to obtain 25-35% of their calories from fats, striving for zero trans fats, less than 7% from saturated fats, and no more than 10% and 20% of their calories from polyunsaturated and monounsaturated fats respectively. We have extolled the virtures of extra-virgin olive oil , but many people are asking us for more information on the levels of these fatty acids in the products they consume. Here is a good chart from the Harvard School of Public Health:

And if you are looking to build a framework for natural cholesterol managementt, consider our extra-virgin olive oil with added plant sterols (.5g plant sterols from plant sterol esters).

Vegans & High Cholesterol

Free of all animal products, a strict vegan diet contains no cholesterol. Yet, a vegan may face elevated levels of cholesterol. A paradox? Not really. We all are highly effective at producing and recycling cholesterol. Each cell wall requires cholesterol. Cholesterol serves as a building block for important hormones. Cholesterol plays a role in the digestion of dietary fats. We can manufacture cholesterol at a cellular level. We produce cholesterol in our livers. For many Americans, their own body produces 70%-80% of the cholesterol found in the blood stream. Only the residual comes from foods.

Within the context of our modern lifestyles and extended life spans, our well developed ability to manufacture cholesterol can adversely affect our heart and vascular health. This is true for vegans, vegetarians and omnivores alike.

If you are a vegan, how should you think about your cholesterol levels? Start with the facts. Get a blood test that provides information on your total cholesterol and its components—LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. Then factor in your own family history to frame your understanding of these numbers. Then consider that a health circulatory system can play an important role in your long term health and wellness.

Other Benefits of a Vegan Diet

In terms of cholesterol management, vegans often enjoy benefits other than restricted intake of dietary cholesterol. The diet may be lower in saturated fats. Research shows that these fats, particularly those from animal and dairy products, elevate cholesterol levels. Interestingly, certain saturated fats from plants have been shown to be cholesterol neutral.

Vegans and vegetarians also consume a higher level of plant sterols. Plant sterols are the plant kingdom’s equivalent of cholesterol. At 2 grams per day, these sterols have been shown to lower LDL blood cholesterol levels by 15% or more. Omnivores typically consume 250mg (.25g) per day, while vegetarians consume between 400mg and 750mg.

Other Nutritional Measures for Cholesterol Management

If you are a vegan and still face issues related to your cholesterol levels, you can consider other measures consistent with your philosophy and commitment. Utilize high monounsaturated oil, like extra –virgin olive oil, in place of other oils and fats, search out plant sterol fortified foods, and increase your intake of cholesterol-lowering soluble fiber from oats, barley, beans, psyllium and fruit. For additional resources on Natural Cholesterol Management , click on to the Kardea Nutrition website.

Is Your Doctor Doubtful? Developing a Partnership with Your Health Providers

O.K. you have done your homework, and you are convinced that natural cholesterol management can and should be a meaningful part of your personal approach to long term health and longevity.

But you want to engage your doctor in setting up a system to monitor your progress. You know you need to monitor what is working and what is not. This will require periodic blood tests prescribed by your doctor and hopefully paid for by your health insurance.

But you are concerned that your doctor will be dismissive of your desired course of action.

No doubt, some physicians are more knowledgeable than others about natural nutritional approaches to cholesterol management. But most physicians, when presented with the evidence, are willing to explore the options.

So, if you meet resistence, suggest that your doctor read the recommendation of the NIH's National Cholesterol Education Program most recent report of the effecteness of "therapeutic lifestyle changes." In the NCEP recommendations, it is noted that this approach can achieve results similar to that attained by cholesterol lowering medication.

The NCEP reports, plus a listing of related research and studies, can be found on the Kardea Nutrition website.

Your doctor's views about natural cholesterol management also may hinge on concerns about compliance. Many doctors routinely recommended the therapeutic lifestyle changes, but patents often have difficulty changing their habits. It is on this point that you need to be honest with yourself. Can you maintain --- on a daily basis--the steps necessary to be effective with natural cholesterol management.

Sometime this is not easy. I know. I have been working on it. I designed the Kardea Nutrition products to make it easier for me to maintain the program and achieve measurable and signficant improvements in my blood lipid levels.

Give us a holler and let know how you are developing your relationships with your health care provider. Others will find your experience and advice really helpful!

Kardea Nutrition's Natural Bars for Cholesterol Management

O.K. I have gone off on a policy & political tangent over the past view days. I do think that the events and debates of last week regarding cholesterol medications required that I chime in.

Focusing back to the core goal of Kardea: to develop nutritional tools that enable natural cholesterol management. As a formulation standard we look to multiple product attributes: delicious, convenient, natural, calorie-mindful and therapeutic.

To optimize these attributes, I started looking at those foods that I am likely to eat everyday. If I was already eating, I was likely to keep eating it. If I wasn't already eating, I did not want to add a new source of calories. The trick was how to keep it something I crave while being effective, being therapeutic.

The nutritional bars were a really convenient place to start. Before founding Kardea, I had spent the last 12 years of my life running a specialty chocolate company. I had developed a habit--a craving--for a daily piece piece of dark chocolate (with a late morning cup of coffee--this has to be one of nature's great taste combinations!).

Certainly, dark chocolate is getting good reviews for its cardiovascular benefits. I certainly have tracked this, and discussed it with some people over at the Yale Medical School. This science seems promising, but I am not sure I would yet incorporate chocolate into my program for natural cholesterol management. Instead, I looked to develop a substitute for my morning craving. The Kardea bars achieved this goal, and then some.

First off, I think these bars really are tasty. All natural ingredients such as almond butter, authentic spices like nutmeg, clove or cardamom, real fruit and full flavors.

These bars also provide meaningful levels of plant sterols (1 full gram), fiber (7 grams; 3 grams of heart hearthy soluble fiber) and protein (7 grams total and close to 4 grams of soy protein). The FDA has endorsed these nutrients for their ability to help improve blood lipid profiles including a lowering of LDL (bad) cholesterol.

While only 150 calories each, these bars are more satisfying that the morning chocolate fix. I suspect this is a tribute to the protein and fiber levels.

Further, the bars are sweentened with lower glycemic agave syrup and brown rice syrup. Couple these with the fibers which slow glucose uptake, and I feel that I evened out the sugar spike. So by lunch, I no longer have the urge to eat too fast and too much.

The whole family has been eating the samples through the development process. We all ---friends and family--really enjoy them. Our first production run is now scheduled for mid-February, and they will be available to ship at the end of this month.

To get a product availability alert with an introductory 25% coupon, sign up for our newletter, UpBeat. http://visitor.constantcontact.com/email.jsp?m=1101913937814&p=oi

For additional product information: http://shop.kardeanutrition.com/merchant.mvc?Screen=SFNT&Store_Code=KNFNCM

The Cholesterol "Pill" & Health Policy

Over the past few days, the media has meted out criticisms of Big Pharma and their cholesterol medications. Certainly, some of it is well deserved. Some, however, confuses the issues and does not consider some fundamental issues related to health policy.

A Bit of Background

Statins and other cholesterol medications represent a critical piece of Pharma's profits. Worldwide, cholesterol meds represent the single largest class of drugs sold--exceeding $25 billion per year.

Why so much?

These medications do work to reduce LDL (bad) cholesterol, and the relationship between LDL cholesterol, heart disease and stroke has been well study and confirmed.

Then there is the magnitude of the issue. Combined, cardiovascular diseases are the primary causes of death and morbidity in the United States.

But, these medication do not "heal". Stop taking these medications, and your LDL cholesterol will rise--all other things being equal. Users of cholesterol medications thus may find themselves on these drugs for decades.

Overall, couple the huge population at risk of cardiovascular disease with the length of time that these medications are potential used, and a huge market is created.

An Oversold Solution?

Cholesterol medications have been oversold and hyped in their ability to remedy heart issues.

Managing cholesterol can improve the cardiovascular system, but it is not and cannot be a guarantee of heart health. Cholesterol also can be managed by means other than medications--nutrition, weight control and exercise. Nutritional approaches that combine nutrients that actively and positively influence blood lipids ---Omega-3 & monounsaturated fatty acids in lieu of saturated fats, plant sterols, soluble fiber, niacin---can achieve results equivalent to many of medications, particularly for the borderline line high cholesterol types like me. This view is widely endorsed in the medical community including the American Heart Association and the American College of Cardiologists.

Certainly, this does not mean that these drugs are without value. For many, the lifestyle and nutritional approaches are not adequate. Medications is required, and for those at high short term risk, they may be essential. Yet, theses meds should complement the therapeutic lifestyles. The approaches should be integrated and the medications should not be the first line of therapeuty.

Moreover, these medications are most effective in affecting only a component of cholesterol---lowering LDL cholesterol. There are other aspects of blood lipids that are important for heart health---the level of HDLs, the ratio of total cholesterol to HDLs, the size of the LDL particle--to name just a few.

Even in regard to LDL cholesterol, a single medication may not achieve heart risk adjusted targets (to calculate your risk-adjusted ldl targets, go to http://www.kardeanutrition.com/cholesterol/ldl_calculator.aspx ). The pharmaceutical solution is to identify other drugs to be taken with the existing medications.

No doubt, new drugs are coming to market or are in development that work with existing medications to favorably affect blood lipid levels. So, you can look forward to taking more medications! Today, we find ourselves with many people taking many drugs, and overall, we are only dimly aware of their interactions and long term afffects on health.

Drivers of a Healthcare Imbalance

From a health policy perspective, we need to give careful thought to what is going.

One issue is that we allow Big Pharma to spend hundreds of millions dollars per year promoting these medications. At whose expense? Well for one, the consumer advertising campaigns dwarf the public health education campaigns that advance nutritional and lifestyle alternatives. We all would be well served if the consumer received more balance input.

A few policy alternatives could be considered. We could require the pharmaceutical companies to contribute an equivalent amount of advertising money to lifestyle and nutrition public health education. This would not be unlike the tobacco companies funding of smoking cessation programs. Alternatively, we could require those media outlets that air these promotion to donate airtime to publilc health education.

Consumer behavior and incentives also are at issue. The advertising ---this unnecessary hype- works in large part because many consumers want to believe that a single pill will eliminate the risk of heart disease--regardless of what they eat, how much they weigh or how much exercise they get. Intellectually, not many of us would ever concede that we believe in the power of the single pill. Practically, the single pill gives us comfort when we fail to live heart healthy lifestyles.

At least for the well-insured consumer, it also may be cheaper, both in terms of time and money, to pursue the pharmaceutical approach than to embrace the alternatives.

Presidential candidates from both parties are discussing fundamental changes in our health care system. Special interest, including Big Pharma, can be expected to mold this system to their benefit. As citizen, we will be best served by making sure that real public health is advanced. Make your voice heard in this debate!

"Cholesterol Drug Bombs"-New York Times Editorial Misses Opportunity

Yesterday, the New York Times editorial board wrote "there have long been suspicions, but it was still very disturbing to learn this week that a heavily promoted cholesterol-lowering drug had flunked a clinical trial of its effectiveness in reducing fatty deposits in arteries....The drug, Zetia, and a combination pill that contains it, Vytorin...generated more than $5 billion in sales last year."

You probably know the ads for Vytorin. They have run on T.V., in magazines and on-line. They certainly are clever, creative and very expensive. According to Nielsen Monitor-Plus, in 2006 the companies spent $136.3 million to advertise Vytorin and $115 million from January to October of 2007.

Vytorin combines Zocor, a statin produced by Merck (and also marketed by generic drug manufactures and sold at lower prices) with the Schering-Plough's Zetia. Statins work by reducing the production of cholesterol in the liver. Zetia works to reduce the absorption of dietary and liver-produced cholesterol from the intestines into the blood stream.

The study compared the effects of treating patients with Vytorin, the combination drug, with a statin alone. The patients all had abnormally high LDL cholesterol. In the study, LDL cholesterol was reduced more significantly by Vytorin than with the statin alone. These results are consistent with the results of a number of other studies.


It also was hypothesized that the added cholesterol-lowering effect of Vytorin would lead to a more significant reduction of arterial plaque growth. This relationship did not hold. The lower cholesterol achieved by the Vytorin did not yield a reduction in plaque build-up as compared to the statin only. In fact, the Vytorin group was found to have a more rapid development of plaque than the statin-only group.

The Times reports that these companies had been “cynically sitting on the results for more than a year” while spending hundreds of millions of dollars to convince consumers that the Vytorin is a preferred cholesterol drug. This certainly is a very legitimate criticism.

The Times continued that "the findings also raise doubts about the current belief that lowering cholesterol is the key to cardiovascular health. The study showed that Vytorin reduced bad cholesterol significantly more than Zocor alone. The problem was that it failed to reduce the formation of plaque."


And here is perhaps were the Times should have been somewhat more careful. This study now represents a single set of data among a sea of data that concludes lower LDL cholesterol lowers the risks of heart attacks and strokes. Numerous studies also indicate that LDL cholesterol above 100mg/dl will lead to the development of arterial plaque.

Instead of casting doubt on the general wisdom of cholesterol management, the Times would have served the public well by offseting the barrage of pharmaceutical advertising and reinforce the well-documented science regarding natural alternatives to cholesterol management. An extensive NIH report (http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.htm), for instance, concludes that the "amount of LDL reduction from Therapeutic Lifestyle Changes compares well with many of the cholesterol-lowering drugs." Among the recommendations are the consumption of certain positive nutrients such as plant sterols, soluble fibers, monounsaturated fats in place of saturated and trans fats, and Omega-3s. Needless to say, weight management and exercise is part of the NIH recommendations.

For more information on natural cholesterol management nutritients: http://www.kardeanutrition.com/cholesterol/program.aspx

Soluble Fiber--From Hype to Health

Take a walk through the grocery aisle, and you will quickly find many products claiming to be heart healthy.

For many of these products, the heart healthy claims flows from two essential nutritional characteristics. They are low in saturated and trans fats, and they deliver levels of soluble fiber sufficient to meet certain FDA-allowed heart health claims. To make these claims, the FDA requires that the products deliver in each serving at least .75 grams of soluble fiber from oats or barley, or 1.7 grams of soluble fiber from psyllium.

For those of us seeking measurable improvements in our cholesterol levels, success requires consuming substantially greater levels of soluble fiber. The National Cholesterol Education Program of the National Institutes of Health recommends 10-25 grams per day. Depending on your chemistry, consumption at these levels can lower LDL cholesterol by up to 8-10%. Some studies have suggested that results could be more significant.

How much oatmeal is required to reach 10 grams of soluble fiber? Roughly 5 servings, or about 2 lbs of prepared oatmeal. For 25 grams, you would need to consume about 5 lbs of prepared oatmeal, or about 2000 calories per day from oatmeal. Nay!

While oats certainly are a good starting point, I begin the day with a heaping tablespoon (=3 teaspoons) of whole psyllium husk. Psyllium seed husks are nature's most concentrated source of cholesterol-lowering soluble fiber. Where oats are only about 5% soluble fiber, psyllium husks are about 60%. With a tablespoon of psyllium husk, I start the day with 9 grams of soluble fiber (note: start with a teaspoon and work your way up).

5-6 servings of fruits and vegetables through the course of the day gets me another 5-6 grams.

From here, I shoot for the upper levels of the cholesterol-lowering soluble fiber targets. Success typically requires some culinary creativity and an understanding of the sources of soluble fiber.



Here is one recipe that you may find a useful addition to your weekly food choices:

Barley Pilaf
4 Servings of About 1 Cup Each

Barley never came to my mind as something I would crave. Yet, I discovered that barley stands side-by-side with oats as an FDA-endorsed food for promoting heart health by lowering cholesterol. I have since set out to explore how barley could be enjoyed in something other than a malted beverage.

As it turns out, a barley pilaf can be a delicious alternative to the rice, potato or pasta “starch” in protein/starch/vegetable triad my mom insists constitutes a meal.

A pilaf can be cooked to complement any number of dishes. Adapt by incorporating any number of spices. Start with the basic pilaf and create from there.

So, you ask "why don't more people eat barley." Part of the answer lies with the fact that cooking barley can be a bit tricky. If you're not careful, you might find your pilaf with hot cereal qualities---perhaps great for a cold morning but not the best for a dinner. But if you take a bit of care, you barley pilaf can be a great nutritious alternative to high glycemic, low fiber carbs.

Ingredients
1 Cup Rinsed Pearled Barley
2 Cups Water
1 Small Onion-Finely Chopped
2 Tablespoons Extra Virgin Olive Oil (preferably fortified with plant sterols)*
½ Teaspoon Turmeric
Salt & Pepper to Taste

*to double-up on the cholesterol lowering abilities of this dish, I formulated an extra-virgin olive oil with added plant sterols. This olive oil is available through the Kardea Nutrition website
http://www.kardeanutrition.com/products/food.aspx . If you want to reduce total fat, cut recipe to 1 tablespoon of oil.


Direction
Heat a sauce pan over medium heat. When pan is hot, add olive oil and chopped onion. Saute for a few minutes. Add rinsed pearl barley and saute for 5 or so minutes, stirring regularly and making sure that barley does not burn or stick to bottom of pan. Add turmeric and then water to the hot barley and stir. Cover, lower heat and cook until tender but still a bit chewy (30 minutes). Remove cover and on very low heat, let steam escape. Periodically fluff to prevent sticking to bottom of pan. Serve when barley appears about the consistency of steamed rice. This all may sound a bit cumbersome, but it works. The turmeric also give the barley a beautiful yellow color, accenting the visual appeal of an entire meal.


Nutritional Facts
(about a cup of cooked barley pilaf)
Calorie: 240 Calories from Fat: 70
Total Fat: 8g from olive oil; monounsaturated: 5.7g; polyunsaturate fat: 1.15g; saturated fat: 1.15g (4.3% of total calories); Trans fat: 0.0g.
Cholesterol: 0.0
Total Carbohydrates: 40g; Total Fiber: 8g; Soluble Fiber: 2g.
Protein: 5g.
Plant Sterol: .25g

Stepping-Up
You can try adding any number of spices. Try curry or cumin when serving lean meats or roasted root vegetables. Try ginger and currents when serving fish. Serve with a kidney bean chili or black bean salad (recipe in next blog) to create a meal that delivers 3-4g of soluble fiber.

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