Looking Beyond Lowering LDL Cholesterol

The risk of developing cardiovascular diseases is typically assessed based on a standard cholesterol test measuring LDL (low-density lipoprotein) and HDL (high-density lipoprotein) levels and then factoring advanced age, gender, family history of heart disease, high blood pressure, diabetes, and smoking. Taking these factors into account, LDL lowering targets can then be established, and a program of therapeutic changes in lifestyle and nutrition can be established. If these changes are unable to bring cholesterol levels in line, medications are routinely provided.

However, studies indicate that these risk factors can account for only a portion, perhaps 50%, of the incidence of coronary artery disease. The scientific community has continued its investigations, and is finding that a number of other risk factors can be identified through blood test. On its website, Berkeley Health Lab, a leading medical lab with an integrated program for cardiovascular treatment, identifies many of these important factors including:

Size of LDL Particles: Some LDLs Are Worse Than Others

• Small LDL particles can cause plaque build up to progress much faster because they can enter the artery wall easier than large LDL particles
• Too many small LDL particles can increase your risk for a heart attack beyond any other risk factors you may have, such as smoking, high blood pressure, diabetes, etc.
• Certain medications, proper nutrition, and regular exercise can help your body produce fewer small LDL particles

Size of HDL Particles: Some HDLS Are Better Than Others

• HDL helps to protect against progression of plaque build-up in the artery wall
• HDL2b is the workhorse of all of the HDL particle types. It has the ability to pick up and remove cholesterol
• Certain medications, improved nutrition, loss of body fat, stopping tobacco use, and increased physical activity are some ways that HDL-C and HDL2b can be improved

Apolipoprotein B: Accurate LDL Particle Number

• ApoB is a direct measurement of the amount of LDL ("bad" cholesterol) particles
• A high apoB number indicates increased risk for heart disease
• Improved eating habits, increased physical activity, and loss of body fat are some lifestyle changes that improve apoB
• Your physician uses apoB to determine if certain medications are needed and to monitor their effectiveness

C-Reactive Protein-hs (CRP)

• High levels of CRP indicate inflammation within the body due to infection or tissue injury; it can also predict heart disease risk levels
  Certain medications may help reduce this risk
  Certain foods have anti-inflammatory benefits

ApoE Genotype

• ApoE is a genetic test that plays a role in helping to identify how people respond to different amounts of dietary fat. Your body's response to dietary fat impacts the formation of small or large LDL particles
• There are 3 types of apoE genotypes: apoE2, apoE3 and apoE4
• People with an apoE4 have a greater risk for heart disease
• ApoE can be used to help guide the right nutrition plan for you

Other risk factors measurable through blood tests also are discussed on this site.

Overall, most of us typically receive the standard test for cholesterol, with these more thorough tests reserved for those individuals at high risk. Yet, for those of us interested in the information needed to optimize our long term health, this more complete assessment can be very useful. Check with you healthcare provider about obtaining these more extensive blood test to better direct your unique course for optimizing your health.

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.

Plant Sterols: What Are They? How Do They Work?

Plants produce plant sterols. Animals produce cholesterol. Structurally similar, both bind to sites in our intestines where the cholesterol produced in our livers and consumed in our foods are absorbed into our blood.

Yet, our bodies have evolved the ability to distinguish between these types of sterols. On average, we absorb about 55% of cholesterol and less than 1% of the plant sterols. Plant sterols work to lower cholesterol by filling the "absorption gateways," thus blocking the cholesterol from entering the blood stream. Blocked cholesterol is execreted along with most of the plant sterols.

In nature, small quantities of plant sterols can be found in a range of foods, particularly vegetable oils (sources of plant sterols). The average plant sterol intake in the U.S. 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 are typically required to obtain these levels.

The effectiveness of plant sterols will vary from person-to-person. Many people absorb cholesterol more effectively than others. For these individuals, the impact of plant sterols may be more significant.

Overall, plant sterols are an important component of a nutritional system designed to promote healthier cholesterol and blood lipid levels. Achieving maximum benefits from natural cholesterol management may require other nutrients---including the soluble fibers found in oats, beans, fruit and psyllium, certain types of niacin, Omega-3s, monounsaturated fats in place of saturated fats----all in the context of balanced nutrition, calorie-mindfulness and physcial activity.

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!