The term “metabolic syndrome” probably sounds like a term that is best left in the circle of the medical elite.  Well, I think it’s a concept that should be better understood by all Americans.  Metabolic Syndrome is a very American disease, for lack of a better term.  It only occurs in affluent nations.  Approximately 50 million Americans have this syndrome.  To understand this syndrome is to understand a major sickness affecting our nation today.

Increasing in Frequency

Metabolic syndrome is a risk factor for heart disease, stroke, and diabetes.  One focus of ATP III is the management of metabolic syndrome (syndrome X). Metabolic syndrome is a combination of risk factors such as high blood sugar levels, high triglycerides, low HDL cholesterol, obesity and high blood pressure. This syndrome is becoming more common in America and is being given more attention by the American Heart Association and other leading organizations.

There’s Still Hope

Metabolic syndrome is highly influenced by diet and life style choices.  Because it’s based on America’s bad diet, it’s necessary to include a variety of whole foods such as beans, nuts, seeds, whole grains, whole fruits,  and vegetables.  The only sure way to avoid Syndrome X is to lead a healthy life.

Every good story has to have a good guy and a bad guy.  We like nice distinct lines so we know how to label things in our minds.  When dealing with the body and health it is not always that easy to cut a line between good and bad.  You can run into problems like “too much of a good thing” or exceptions to the good vs. bad rule.  There’s gray area when it comes to health, and cholesterol often rests within that gray area.

Understanding Cholesterol

Lets first look at this issue by exploring what is cholesterol.  Cholesterol is a waxy substance that is produced by the body for a number of different functions in the body. It is used to make hormones such as estrogen, testosterone, progesterone, and cortisol. We need cholesterol for the productiion of vitamin D in the body. We also use cholesterol to help bring stability to the cell wall’s that surround each cell in our body.

LDL and HDL

Cholesterol is transported on carriers, the main two we call LDL and HDL.  LDL carries cholesterol from the liver to the various cells of the body.  HDL carries choelsterol from the cell to the liver so it can be processed and excreted.  You may be beginning to see how both LDL and HDL are beneficial, but also why there can be a problem if there is too little HDL and too much LDL.

LDL Builds Up

If cholesterol continues to move toward the cells, carried by LDL, without enough HDL to carry it back, it is thought to be able to build up in the cells of the body.  This becomes important for heart disease because a build-up of cholesterol in the blood vessels that feed the heart can cause problems.  This build-up can cause the vessel to become blocked.  This can lead to decreased flow of blood to the heart, resulting in chest pain, heart attack, even death.

How to Control Choleterol

It is therefore important to keep LDL levels under control by consuming a diet low in saturated fat and cholesterol and high in fiber.  Consume good fats that come from nuts, seeds, fish, and olives, which can raise HDL levels.  Also avoid hydrogenated oils, which contain trans fats, because they can lower HDL levels.  Also make sure you get plenty of good exercise, since it can be helpful with your LDL levels.

Balance is the key to good health.  LDL is not bad for us, but because of our  lifestlyes, heavy meat consumption, and consumption of the wrong fats we are far out of balance.  As long as your HDL levels are healthy enough to keep up with your LDL levels, you can continue to lead a healthy life.  Taking control while it’s still early can help to avoid major problems down the road.  The best way to treat heart problems is prevention, so learning about LDL and HDL cholesterol levels before they become too unbalanced is a step in the right direction.

One pill that does it all.  Isn’t that what most Americans are looking for?  How about a powder that does a lot?  One research study showed that Nutrim powder might be as good as it gets without any crazy side effects. 

The Plan

The study was carried out in 38 middle aged, overweight males with high cholesterol and normal blood pressure.  The men were split into two groups which ate two diffent diets for 8 weeks.  The first group followed the American Heart Association (AHA) step II diet with low amounts of saturated fats and cholesterol and exercise.  The second group was given this diet with the addition of Nutrim oat bran. 

Nutrim and Cholesterol

The Nutrim group increased their HDL on average 10 points(27.8%), lowered their LDL 47(27.3%), and lowered their total cholesterol about 48 points.  The other group also saw improvements in LDL and total cholesterol, but the decrease was not as great as with Nutrim.  The other group did not see an increase in their HDL like the Nutrim group did.

Nutrim and Glucose

Fasting glucose also dropped 6 points in the Nutrim group where there was a slight increase in fasting glucose in the other group.   Both groups had significant weight loss, but the Nutrim lost more weight (13lbs compared to 8lbs in the other group.)

Tolerance of Nutrim

Even though the Nutrim was in a higher dose than normal it was well tolerated.  This study utilized Nutrim in bread, which had significantly better flavor and texture compared to the wheat bread in the other group as rated by the participants.

Total Cholesterol

Cholesterol is a substance that has many beneficial functions in the body.  When too much is consumed or produced by the body and not enough is removed you can end up with excessive amounts.  Cholesterol can build up in the arteries and cut off blood supply to the heart and other areas of the body.  Having healthy cholesterol levels has been shown to lower the risk of heart disease and stroke. 

LDL Cholesterol

LDL (low density lipoprotein) is a combination of fat (lipid) and protein. LDL is a carrier for fat and cholesterol. It takes fat and cholesterol from the liver and transports it through the bloodstream. It eventually drops of the fat and cholesterol off at the cells to be utilized. High levels of LDL cholesterol are a major risk factor for coronary heart disease.  The LDL cholesterol number is the main therapeutic target for intervention.  All of the other numbers on your blood test determine what approach the doctor will take in lowering LDL cholesterol.

HDL Cholesterol

HDL runs opposite LDL and carries fat and cholesterol from the cells, through the bloodstream, and to the liver to be metabolized or excreted. Low levels of HDL in the blood are an independent risk factor for coronary heart disease.  High levels of HDL protect the heart by carrying away cholesterol that could build up in the walls of the arteries. 

Triglycerides

Triglyceride is a term that describes a common way fat is found in the body. Triglycerides are three fat molecules attached to another molecule called glycerol. Generally, when the term triglycerides is used in your doctor’s office it refers to the amount of fat found in the blood. There is an association between high triglyceride levels and coronary heart disease.

http://www.mayoclinic.com/health/heart-disease/HB00016

http://www.americanheart.org/downloadable/heart/110141046508901%20CholLevls.pdf

When we eat sugar it is absorbed into the body and makes its way to the bloodstream. The bloodstream then carries the sugar to the cells of the body. When a large amount of sugar is in the bloodstream, the body releases a large amount of insulin. This insulin drives sugar into the cells to be utilized for energy. After a long time of exposure to sugar the cells may become “resistant” to insulin.

The Effects of Sugar

If the cells do not accept insulin, sugar can build up in the bloodstream. High levels of sugar in the bloodstream are toxic to the body. High blood sugar will make changes in the body that make it more difficult for the arteries to open up and can increase the rate at which blood clots.

Sugar will also begin to combine with other substances in the blood, like protein and LDL cholesterol.
When sugar combines with proteins in the walls of the arteries, it can make the arteries more susceptible to atherosclerosis.

Blood Sugar and Your Cholesterol

If sugar combines with LDL cholesterol, it can cause it to become oxidized more easily. Oxidized LDL is much more dangerous than regular LDL and is more likely to build up in the arteries and cause atherosclerosis. LDL levels in diabetics are not that different from nondiabetics, but this oxidized form of LDL can play a greater role in the progression of heart disease.

Diabetics, those that have chronic high blood sugar, also tend to have low HDL “good” cholesterol and high triglycerides. 

Keeping Healthy

Part of the strategy to control your risk for heart disease should involve a restriction of foods that can spike blood sugar levels. We know candy, pop, and pasteries are not good for blood sugar, but refined flours can also have a negative effect on blood sugar. There are also many sources of hidden sugar in foods so make sure to check your labels.

The ATPIII is considered to be the most authoritative document on cholesterol in America. It was released by the National Cholesterol Education Program.  It gives guidance to physicians and those in the health care field on how to address high cholesterol levels in America.  It answers the why, what, how, and why of cholesterol treatment. Some components of the ATP III sound familiar, but other sections may surprise you.  We are highlighting some of the sections so you feel more informed as you approach the cholesterol issue.

Understanding ATP III and Your Cholesterol

The beginning of the document makes it clear what the focus of treatment is:  LDL cholesterol.  This is the form of cholesterol that is considered the “bad” cholesterol. It carries cholesterol to the cells to be utilized.  If there is not enough cholesterol carried away after it is delivered it can build up in the arteries.  The build up of cholesterol in the arteries can lead to a decrease in blood flow.  If blood flow to the heart is cut off it can cause a heart attack.

It’s Fact

Out of all the substances that contribute to heart disease, LDL has the most well studied and most direct link with heart disease. Other factors influence heart disease as well, but LDL has been chosen as the main target.  Other factors that increase your risk for heart disease, risk factors, are used to influence how low LDL cholesterol should be.

In the next blog we will give you a breakdown of the numbers and the risk factors that influence where those numbers should be.

One of the “good fats” is polyunsaturated fat.  This fat can be used a more health-conscious substitute for saturated fats.  It’s suggested that up to 10% of your caloric intake consists of polyunsaturated fats.  Research shows that a diet including moderation of polyunsaturated fats actually proves to be lower in LDL (or “bad”) cholesterol.

Too Much of a Good Thing is a Bad Thing

Polyunsaturated fats come from liquid fats.  If you’re careful, this fat can be considered “healthy.”  It can actually lower total and LDL cholesterol to help improve heart health.  However, if you include too much, this type of fat can make an unhealthy impact on your good cholesterol.  By reducing your HDL cholesterol beyond a healthy point, polyunsaturated fats can actually defeat the purpose of maintaing low LDL.

In addition to the issue with lowering HDL, polyunsaturated fats are still a form of fat, which means they carry some of the health threats that come with all forms of fat.  This is another reason it should only be the supply for a small portion of your caloric intake.  Any healthy diet calls for fat-control, so remember that there is such thing as “too much of a good thing.”

Out With the Bad, In With the Good

One of the major benefits of polysaturated fat is that it can be used as a substitute for saturated fats.  Rather than using the solids which are heavy in saturated fat, it is suggested that polysaturated fats are used.  This is why is it better to prepare a lean cut of meat marinaded with olive oil than to fry a a full-fat cut without oil.

It’s Natural!

Polyunsaturated fats are usually naturally-occuring.  They can be found in whole grain products, walnuts, olives, avocados, soy beans, as well as most kinds of fish.  Part of the reason health experts recommend fish oil pills to heart patients is because they serve as a reliable source of polyunsaturated fats called Omega-3 fatty acids and other good fats that help fight high cholesterol and heart disease.  These good fats can also be found in sunflower seeds and oil, olive oil and safflower oil.

An Essential to Heart Health

The National Institute of Health did research into the helpful qualities of polyunsaturated fats.  The main subject of the research was Omega-3 fatty acid, a polyunsaturated fat found in fish and certain plant seeds and oils.  The organization concluded that these were not only helpful, but in most cases necessary to a healthful approach to dietary needs.  However, the Institute also found that high doses over the recommended amount showed a decrease in overall health.

The “best” fat out there is monounsaturated fat.  While it is still a fat and shouldn’t be overdone, it’s the only fatty acid that has proven to reduce LDL cholesterol without hurting a good HDL level.  Of the fats, this one is most important to your diet and should be the largest portion of calories from fat.  Monounsaturated fats are vital to any heart-health regimen, as they are reliable reducers of unhealthy cholesterol.  Also, a person may consume more monounsaturated fat than others, because it takes more to cause harm.

A Natural Fat

Monounsaturated fats, like polyunsaturated fats, are for the most part naturally-occuring.  The primary benefit is, of course, its cholesterol-related activity.  However, monounsaturated fats are also high in beneficial fatty acids which can be helpful to healthy skin condition and reproduction of body cells.  These fats also are high in vitamin E, a nutrient which most Americans do no consume enough of.  These fats have also shown a potential for lowering risk of stroke.  Obviously, they’re a good thing.

It’s All Around Us!

This beneficial fat can be obtained from a number of different sources.  The number one source of monounsaturated fats is olive oil.  This is the speculative reason as to why heart disease and cholesterol problems are very low in the Mediterranean region, where olive oil is a staple of cooking.  Other sources of this helpful fat are canola oil, most nuts, nut-derived butters (like peanut butter), nut-derived oils, avocados, and whole olives. 

Moderation, Moderation, Moderation

Even with all the seemingly amazing benefits that it presents, there are risks to overdoing monounsaturated fats.  Like all other fats, they are high in calories.  By consuming too many, you may risk weight gain.  This once again puts you at risk for heart disease, which seems to be defeating the purpose of a heart-healthy diet.  With this in mind, experts suggest strict moderation of all fats, including monounsaturated fats.  Despite being healthy when rationed, it is not a complete cure.  It can actually pose as a risk.  So, keep in mind, moderation is a big deal with this heart-healthy stuff.

If you know someone who has suffered a heart attack or stroke, then the words “You have high LDL cholesterol” from your doctor may have some meaning to you. For the rest of us, the words “high cholesterol” may not conjure up many thoughts or images. Even if you know what cholesterol does in the body, it may not be self evident why high LDL cholesterol should be concerning. While having high cholesterol may not be a death sentence or a guarantee that we will be on medications for the rest of our lives, it does merit concern.

High cholesterol levels can lead to atherosclerosis, which in turn can lead to heart attack and stroke. Heart disease and stroke are the number 1 and number 3 causes of death in America. Heart attacks and stroke can cause some major problems to survivors, as well.  The aftermath can range from small debilitation, to major impairment, to death.

The Positive Power of Oats

All that being said, it is important to remember that atherosclerosis is a progressive state and needs to be addressed by consistent long term changes. There are many lifestyle and diet changes that are recommended to help stop your cholesterol from continuing to rise.  There are also a number of options that can be beneficial for lowering cholesterol. One of the main dietary changes being proclaimed today is the incorporation of soluble fiber from oats to the diet.

In clinical studies soluble fiber from whole oat products has been shown to lower cholesterol. The National Cholesterol Education Program wrote an authoritative document on cholesterol (ATP III).  It recommends dietary changes such as incorporating soluble fiber from oats, lower saturated fat intake and lower cholesterol intake.  It also covers weight management, medication, and other approaches to lowering cholesterol. This document covers a number of other dietary and lifestyle changes that are important to the high cholesterol issue.

Know the Facts

 Becoming informed should be your first step in addressing high LDL cholesterol. Ask your doctor for all the information they have available to them.  Also ask about how you can influence your cholesterol through diet and lifestyle choices. Become familiar with organizations like the American Heart Association and the National Cholesterol Education Program. We will also be diligent researchers and provide you with information that is both practical and accurate to help you on your journey to lower LDL cholesterol levels.  It’s our promise to do our best to keep you informed and to help you continue to live a full life, even after cholesterol test results.

(In mg/dL)

As we stated in the previous post the main target for whether or not cholesterol therapy is recommended is based on your LDL cholesterol score.

LDL Target Goals

• Risk Factors LDL Goal (in mg/dL)
• CHD or CHD Equivalents < 100
• Multiple Risk Factors (2 or more) < 130
• 0-1 Risk Factors < 160

CHD Equivalents – As shown in the chart above these modify your LDL Goal

• Currently having a disease that involves atherosclerosis in other parts of the body (leg, neck, etc)
• Diabetes
• A combination of other risk factors that put you at >20% risk of having CHD in the next 10 years.

Risk Factors – These also Modify your LDL Cholesterol Goals

• Cigarette Smoking
• High Blood Pressure (>140/90 mmHG or on High blood pressure medication)
• Low HDL cholesterol (<40 mg/dL)
• Family History of Early CHD (Father or brother who had a heart attack before age 55 or a mother or sister who had a heart attack before age 65)
• Age
  • Male:  > 45
  • Female:  > 55