Spirits for the Heart

I often prefer a stiff drink over a glass of wine. At the end of a long week, I may seek a very dry martini or a good scotch to ease the accumulated stresses. For me, these spirits cut the edge. Neither beer nor wine provides the same remedy. One, maybe two, is all. Generally, not more than 2 times per week.

The prevailing wisdom, however, has been that wine is the healthier alternative. Wine may well be an important element in the Mediterranean diet, a way of eating associated with longer life, reduced risk of cardiovascular and cancer mortality and reduced risk of dementia and declines in cognitive function as we age. Wine contains micronutrients that are beneficial.

A study released by researchers at the Harvard Medical School and the Harvard School of Public Health found that liquors and beer deliver some of the same health benefits as wine (1). The study focused on the relationship between moderate alcohol intake and a reduction in inflammation.

Normally, inflammation is part of a healthy immune response that heals injury and fight infection But chronic inflammation is very different. Cancer, diabetes, depression, heart disease, stroke, Alzheimer's—these seemingly diverse diseases--are increasingly thought to have inflammation as a common denominator.

And the concerns around cholesterol and cardiovascular health also center on inflammation. LDL cholesterol, the type of cholesterol that can clog your arteries, is most seriously an issue when the arteries are inflamed.

A marker for inflammation is the compound C-reactive protein (CRP) that can be measured through blood tests. Assessing CRP levels is currently recommended for those at increased risk of heart disease. High levels of CRP are associated with future heart attacks and strokes.

Prior to the Harvard study, much research did indicate that moderate levels of alcohol consumption led to reductions in CRP levels. Most studies examining this relationship focused on a single type of alcoholic beverage. As a result, it remained uncertain whether the impact differed by the type of alcoholic beverage consumed.

The Harvard study compared CRP levels and alcohol consumption of 11,815 women. Some were beer drinkers. Others drank wine. And others drank liquors. Still others enjoyed some each. Overall, the association between alcohol and CRP levels were found to be related to alcohol consumption rather than the type of alcohol consumed.

Needless to say, the power of alcohol consumption was found to be less than the power of good eating habits, lower weight and physical activity. The results, however, are consistent with the general recommendation. Alcohol, in moderation, may well be a useful component in a healthy lifestyle. Cheers!

American Heart Association Recommendations: At this point, the AHA does not recommend drinking alcohol, but if you drink, AHA emphasizes moderation. Moderation means not more than one to two drinks per day for men and one drink per day for women. Too much can increase weight, triglycerides and blood pressure. Excessive drinking can lead to other serious heart problems.

(1) Levitan, B, Emily, "Association Between Consumption of Beer, Wine, and Liquor and Plasma Concentration of High-Sensitivity C-Reactive Protein in Women Aged 39 to 89 Year" The American Journal of Cardiology Volume 96, Issue 1, July 1, 2005, pp 83-88.

Walnut Basil Pesto -- Lighter, Healthier

We grow a variety of herbs ---oregano, parsley, rosemary and basil-- in the Kardea garden. The oregano and rosemary retain wonderful flavors when they are dried, but the parsley and basil lose their zest. Pesto offers a great way to enjoy these herbs. The pesto also freezes well and can be enjoyed throughout the winter.

We have refined a standard pesto recipe to improve its heart healthy qualities. Sauteed walnuts replace the parmesan cheese, reducing both the sodium and saturated fat levels. The walnuts are a good source of L-arginine and ALA omega-3 fatty acids. Both these nutrients have been found to improve arterial function and blood flow. Moreover, the walnuts help maintain the great pesto consistence.

Both the basil and the parsley are a good source of anti-oxidants, particularly beta-carotene. Fatty acid ratio is a healthy 4:2:1 of monounsaturated: polyunsaturated: saturated.

Use over your favorite pasta or on sandwiches. A small dollop also can be used when serving a hearty soup.

Ingredients
4 Cups Fresh Basil Leaves, loosely packed
1 Cup Fresh Parsley, loosely packed
1 Cup Walnut
2/3 Cup Extra Virgin Olive Oil
4 Large Cloves Garlic, Chopped

Heat a pan over low heat. When hot, add 1/3 cups of olive oil, 3 cloves of chopped garlic and all the walnuts. Sautee 3-4 minute or until garlic is soft but not browned. Set aside and let cool.

In a food processor, add the second 1/3 cup of olive oil, the basil, the parsley and 1 clove of the fresh, chopped garlic. Blend with the sautéed walnuts.

Makes about 2 cups pesto. To freeze, place about .5 cup (enough for about a pound of pasta) in a small container. Cover with a thin coat of olive oil and freeze.

Admittedly, when serving with pasta, a bit of parmesan cheese brightens the dish, but keep it to a sprinkle. You will find that this pesto dish is far lighter than some of the more traditional pesto recipes.

Cholesterol Lowering Videos-Web MD & Kardea Nutrition

Two videos --- one at Web MD and one at Kardea Nutrition --- offer insight into the power of nutrition to lower cholesterol. This power extends beyond avoiding foods high in cholesterol; it looks to nutritions that actively affect your body chemistry to improve (and lower) how you absorbs and metobolizes the cholesterol naturally produced by your body. These active nutrients include plant sterols, selected soluble fibers and selected fatty acids. Click on the links below to view.

Kardea Nutrition Video
Web MD Video

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.

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.

Turning 50 with a Focus on Vitality Not Disease Prevention

I turned 50 this past June. I am told that 50 is not old. I am told that 50 is the new 40, or perhaps 35. I am a believer. I do not think like I am old. I remain eager to learn anew.

Yet, I have acquired a gnawing sense that time is bracketed, not limitless. The weekly mailings from the AARP provide the reminder. The challenges faced by my 85 year old parents sharpen the feelings. Neither is ravaged by a particular disease. Time, slowly but with increasing speed, erodes their vitality.

With an eye not only looking to disease prevention, but also towards extending my years of vitality, I approach a health consciousness. Overall, I believe that maintaining a healthy cardiovascular system is a key to extending vitality.

I exercise, but perhaps not with the intensity to optimize my cardiovascular health. The hip pains and lower back aches serve as a bit of an obstacle.

I watch my weight, but it still falls somewhere above the ideal range, although I am not defined as overweight.

I am perhaps most successful with assuring that I eat the right foods---balanced, high in fruits, vegetables, good fats (monounsaturated fats) and good carbs (whole grains and fibers), and enhanced with certain cholesterol-managing nutrients, notably plant sterols, viscous fibers, omega-3s and selected types of niacin. No doubt, my success here lies with the pleasure I derive from food shopping, gourmet cooking and social eating.

Natural Cholesterol Management: Looking Beyond Heart 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.

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.

Total Dietary Fat: Recommendations of the National Cholesterol Education Program

NCEP Evidence Statement: Unsaturated fatty acids do not raise LDL cholesterol concentrations when substituted for carbohydrates in the diet (Strength of Evidence: A2, B2).

NCEP Recommendation: It is not necesary to restrict total fat intake for the express purpose of reducing LDL cholesterol levels, provided saturated fatty acids are reduced to goal levels (less than 7% of daily calories).

NCEP Evidence Statement: The percent of total fat in the diet, independent of caloric intake, has not been documented to be related to body weight or risk for cancer in the general population. Short-term studies suggest that very high fat intakes (greater than 35% of calories) modify metabolism in ways that could promote obesity (C2). On the other hand, very high carbohydrate intakes (greater than 60% of calories) aggravate some of the lipid and non-lipid risk factors common in the metabolic syndrome (A2. B2, C2).

NCEP Recommendations: Dietary fat recommendations should emphasize reduction in saturated fatty acids. Further, for persons with lipid disorders or the metabolic syndrome, extremes of total fat intake--either high or low--should be avoided. In such persons, total fat intakes should range from 25-35 percent of calories. For some persons with metabolic syndrome, a total fat intake of 30-35 percent may reduce lipid and non-lipid risk factors.

NBC News Reports: Plant Sterols-A Natural, Safe & Easy Way to Lower Cholesterol

Wednesday, April 8, 2008
Reported by: Joe Vignolo, Denise Nakano, NBC News

A natural, safe and easy way to lower cholesterol. It's been around forever, but chances are, it's one alternative medicine you have never heard of.

"Nowadays, it is no longer good enough to know your total cholesterol level. You really need to know your breakdown - the breakdown between the good and the bad," said cardiologist Dr. Daniel Rader. This is the bad stuff: too much LDL, or bad cholesterol, circulating in the blood. It builds up in the arteries, slowly narrowing them or forming clots. And that can lead to heart attack or stroke.

Medicine can help, "but, there are an awful lot of people who have cholesterol levels that are higher than they should be, but not so high that they really need medication," said Dr. Rader.

Diet and exercise work. And, Dr. Rader says, so can eating phyto or plant sterols, naturally found in fruits, vegetables, nuts and seeds, added to other foods like spreads and snack bars, or taken as a supplement.

"There's no question that phytosterols, or plant sterols, are one of the best proven - if you will - 'alternative' methods of lowering cholesterol, short of drug therapy," said Dr. Rader.

Dr. Rader is a specialist in preventive cardiac medicine. He is a strong believer in plant sterols for people with high cholesterol who don't yet show signs of heart disease. He says they have almost no side effects and are safe for children and teens.

Research finds they can reduce bad cholesterol by 10 to 15 percent. And you can use them in combination with cholesterol-lowering prescription drugs. "I've never had really serious cholesterol trouble, but each time I went to the doctor, she was warning me that it was inching up," said David Hollenberg, who tried plant sterols. Hollenberg says he has never been shy about alternative medicine and decided to give a plant sterols supplement a try. He doesn't know yet what impact they have had on his cholesterol, but he thinks it is worth a try.

"Plant sterols are one of the rare things in the alternative medicine world that actually have been studied, have been proven to work, and are actually endorsed by people like me: card-carrying, regular doctors who actually think that this really makes sense to do," said Dr. Rader.
If you decide to try plant sterols to lower your cholesterol, dose really matters. To be effective, you must take it every day and be sure you're getting enough. For example, one or two tablespoons of sterol-containing spread a day has what you need.

Kardea Nutrition foods with plant sterols.

Kardea Exhibiting at Dietetic Conferences

As part of our ongoing efforts to work with those health professionals working directly with individuals seeking to improve their cardiovascular health through positive nutrition, Kardea will be exhibiting at the Food & Nutrition Conference & Expo , the national conference of the American Dietetic Association. The conference will be held in Chicago on October 25-28, 2008. In the Spring, 2008, we also will be presenting our system for natural cholesterol management at the Florida, New York, New Jersey, Connecticut and Massachusetts State Dietetic Conferences.

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.

Kardea Gourmet Nutrition Bars---Now Available!

Just returned from the first full production run of our gourmet nutrition bars for cholesterol management. A great experience! As many of your know, we took great care in the formulation of these bars. The criteria was to create great taste, use only all-natural ingredient, deliver effective levels of key cholesterol-managing ingredients (plant sterols, soluble fiber, soy protein), maintan a low fat, particularly low saturated fat, standards, and create a lower glycemic profile. Thanks to everyone who has been involved in this process. As we all agree, we have created a breakthrough product.

The bars will be available through our online store starting on February 25, and a limited supply of variety packs also are available (first come, first served). Single-flavor 15 counts are available in banana walnut, lemon ginger, chai spice and cranberry almond.


Thanks to all who made this start-up a huge success. I have spent a career in food manufacturing, and you folks delivered as one of the best cross-functional teams in the business.

Kardea Nutrition-enabling natural cholesterol management, heart healthy and inspired.

And our collective best wishes for Rod's grand daughter's recovery and health.

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!

So Now I Know What Menopause Feels Like

I was at a reception tonight celebrating the first anniversary of the Connecticut Center for Entrepreneurship and Innovation. I used some of the services of this Center in launching Kardea Nutrition.

As a leading Kardea missionary, I found myself in discussions with a couple in their 60's working to manage their cholesterol levels through natural means. They had some misconceptions, but they had many elements of the program down, including the use of niacin. We got to sharing our experiences of the flushing effect of this essential B vitamin. The wife looked me straight in the eye, and said "you've got to admit, it feels like menopause all over again."

Well, my wife tells me that launching Kardea Nutrition may be my manifestation of male menopause, but I think for the male, menopause is largely an emotional passage. In any event, I am grateful for the insight.

So guys, if you also want to be able to relate better to your spouse during a hot flash, try some niacin. Separately, I have learned not only to tolerate the niacin flush, but also to appreciate the sensation....and the science supporting niacin's role as part of a broader program for natural cholesterol management is impressive and extensive.

For an overview of natural cholesterol management, join us at http://www.kardeanutrition.com/cholesterol/index.aspx. You also can search on this site to find selected information and articles related to niacin.

Cumin Spiced Black Beans-Quick & Delicious

A great pleasure in the culinary arts is stumbling on an incredibly easy, quick and flavorful recipe. I can devote hours to the preparation of some dishes only to receive praise for a five minute side. Everything may taste great, but sometimes these easy dishes find their way to top honors. A spiced black bean salad falls into this category.

Spiced Black Bean Salad

How to Make
Ingredients
16 ounce Canned Black Beans
2 -3 Tablespoons White Distilled Vinegar
1/3 Cup Green Olives-Pitted & Chopped(with or without pimentos)
2 Tablespoons Extra Virgin Olive Oil fortified with Plant Sterols
3-4 Tablespoons Chopped Onion or Scallion
1/8-1/4 Teaspoon Cumin
Hot Sauce to Taste

Rinse beans until water flows clear and drain. This freshens the canned beans and provides a more natural flavor. It also reduces the amount of salt added by the manufacturer. Add all the other ingredients. It best if you let this marinate for about an hour or two, but it can be served immediately.

Depending on the availability of fresh produce, you can build this into a main dish that’s great for a summer lunch. Add cucumber, tomato, zucchini, radish, apple, pear.... let me know what's working.

Spiced Black Beans & Natural Cholesterol Management

As we have emphasized, natural cholesterol management (NCM) targets a daily intake of 10-25g of soluble fiber, 2-3g of plant sterols and at least 500mgs of Omega-3 fatty acids from marine sources. You also want to replace saturated fats with monounsaturated fats. Collectively, these nutrients can drop your LDL cholesterol by 30%.



For a 5 ounce serving, this spiced black bean salad delivers 2g soluble fiber and .25g of plant sterols. Utilizing only olive, this dish is high in monounsaturated fats and saturated fats are held to 5.6% of total calories, less than the 7% recommended by the National Cholesterol Education Program. (see chart above for % of therapeutic levels achieved with a single serving)

The spice black beans also complement a tumeric barley pilaf (see barley pilaf blog for recipe and NCM nutrient levels). To round out this meal, serve with a grilled chicken with a raisin port reduction (blog post coming).

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!

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.

Do You Have A Great Barley Recipe? Can you improve this recipe? Post your thoughts and recipes to this blog to share with the Kardea community.

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.