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Heart Disease and Your Enemy’s Best Friend – Triglycerides
In the last column, we discussed about the harmful effects of bad cholesterol (LDL) on your cardiovascular system. I call LDL enemy number one. Today, we move on to our enemy number two – triglycerides.
Triglyceride is another type of lipoprotein which carries harmful fat-carrying particles. That means it is a bad one. It is the main constituent of vegetable oil and animal fats. It is a major component of chylomicrons and very-low-density lipoprotein (VLDL).
Chylomicron is one of the microscopic particles of fat occurring in a ‘milky’ fluid composed of fat and lymph formed in the intestine during digestion. Next, VLDL is produced in the liver and later becomes the bad LDL.
Triglycerides are the most common form of fat in the body. In fact, almost all the excess calories you consume, whether from fats or carbohydrates, are converted to triglycerides and stored in your fat cells. Once at capacity these cells divide. If you ‘lose weight’ these cells decrease in fat content but never in number. This makes it easier to get fat again.
High levels of triglycerides in the bloodstream have been linked to atherosclerosis (hardening of the arteries), and the risk of heart disease and stroke. High triglyceride levels can
cause pancreatitis, a painful and potentially dangerous inflammation of the pancreas.
What causes elevated triglycerides?
Elevated triglyceride levels can be related to your diet (high in bad fats, carbohydrates and alcohol) and your genetic makeup. In addition, high triglyceride levels can be produced by several medical conditions including: obesity, diabetes, metabolic syndrome and hypothyroidism (low thyroid).
How can we manage high triglyceride levels and reduce the risk of CAD, stroke and death?
It starts with lifestyle modification. Your diet has to change. The key is to replace bad fats with good fats in your diet.
Bad fats are: saturated fats (found in meat and dairy products, some plant foods such as coconut oil, palm oil and palm kernel oil) and trans fats (found in commercially packaged foods and fried foods).
Good fats are: monounsaturated fats (found in nuts, almonds, pistachios, avocado, canola and olive oil) and polyunsaturated fats (found in seafood, fish oil, omega-3, corn, soy, safflower and sunflower oils). Monounsaturated fats have also been found to help in weight loss, particularly in reducing body fat.
Eat plenty of fruits and vegetables. Avoid alcohol, lose weight, exercise, do not smoke, and control your blood sugar and blood pressure. Wow, sounds easy! Well, sort of. There is plenty of help around to achieve your goals. You and your doctor should work together. But you have to have the motivation to start the ball rolling.
This plan will help reduce LDL bad cholesterol, the bad triglycerides (friend of enemy number one) and increase HDL good cholesterol. Next week, look for more fodder for your healthy heart besides love and chocolates on Valentine’s Day. Who is your enemy number three?
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Survival of the fittest – are you fit and healthy?
We are what we repeatedly do.
-Aristotle, Greek philosopher (384 BC – 322 BC)
On July 1, we proudly celebrated Canada’s 143rd birthday. My brief research tells me that the first settlers came to Canada over 400 years ago. I also discovered that First Nations have inhabited this beautiful land for over 2000 years. In all this nostalgia, on July 1, my wife and I quietly celebrated our 25th anniversary of our settlement in Medicine Hat. This is the longest I have lived in one city. This says a lot about the wonderful people of Medicine Hat and surrounding areas.
In the last 25 years, much water has flown through the South Saskatchewan River. We are now 25 years older and our family has grown from two to four. My children say I am getting shorter as I get older. I guess this may be true or it may be relative as these days most children are taller than their parents. But one thing for certain is that as I get older I find my abdominal girth gets bigger. My struggle to stay fit and healthy is an ongoing battle. It becomes harder as I get older. And this may be true for most people who care about their health.
There are many things I do to stay fit and healthy. Two basic foundations are healthy diet and regular exercise. For the next few columns, I hope to do a lot of research on various aspects of exercise and share that information with you. I think that is going to be an interesting exercise in itself – pun intended! I will see if I can get my abdominal girth to where I want. That is a good challenge.
As we get older, we are going to face two major health hazards – cardiovascular diseases and physical weakness. Our looks will change. We will be overweight, walking around with some difficulty carrying extra 20 to 100 pounds on us. That will be no good for our morale, nor for our backs, hips, knees, ankles and feet.
For the most part, our survival depends on how fit we are. I have an editorial piece from New England Journal of Medicine (NEJM 2002) titled, Survival of the Fittest – More Evidence, which recounts Charles Darwin’s 1859 published theory of evolution as an incessant struggle among individuals with different degrees of fitness within a species. Now, after almost 160 years later, research supporting the concept of survival of the fittest are strong and compelling, says NEJM editorial.
There is plenty of evidence, unequivocal and robust, showing relation of fitness, physical activity and exercise to reduced mortality overall and from cardiovascular causes and reduced cardiovascular risk, says the NEJM editorial.
It is obvious that healthier people, that are people who have no physical or mental illness, are physically fit and live longer. What is exciting is that there is evidence to show a person with or without cardiovascular disease who is less fit or less active, can improve his/her survival if the person increase the level of fitness or physical activity. A program of regular exercise can improve fitness by 15 to 30 per cent within three to six months. Isn’t that exciting?
This begs us to ask the next question: what is the dose (total energy expended per week) and at what intensity (the energy requirements per unit of time for a given activity) I should exercise to achieve a specific health benefit? We will look into that and many more questions in the future columns. For now, generally speaking, it is recommended that all people adopt a physically active lifestyle and, specifically, that all adults engage in moderately intense physical activity for at least 30 minutes on most – and preferably all – days of the week, says the NEJM editorial.
Stay tuned for more exciting information on this subject next week.
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Nuts – what about them?
You may ask, “What kind of a nut are you to ask such a question?”
The word nut has many meanings, depending on how you use it. The word can be used to express love, disgust or enthusiasm. It can be a fruit. It can be used as a slang to describe your head, testicles, your boss, your spouse, your foolish, silly or eccentric friend, an insane psychotic person and for tools like nuts and bolts. Well, I can go on and on at the risk of you saying, “You’re off your nut doc, make your point now.”
The point is, we are going to talk about a seed borne within a fruit having a hard shell, as in the peanut or almond. We know that Mediterranean diet is good for your heart and brain. A Mediterranean diet is described as a diet rich in plant foods (vegetables, fruits, legumes, nuts), including fish, some poultry, limited red meat, and primarily unsaturated vegetable oils.
Then there is the Portfolio eating plan. This is a vegetarian/Mediterranean-type diet with less than seven per cent of calories from saturated fat. It consists of 2000 cal/day. Besides other things, Portfolio diet requires you to eat 30 gm of almonds (one handful= 23 almonds = one ounce).
In general, nuts are a rich source of unsaturated fatty acids, plant protein, fibre, vitamins and minerals, plant sterols and flavonoids, all of which have health benefits. Studies have shown that if you eat one ounce of nuts (¼ cup) or more per day then you can reduce the risk of coronary heart disease by 50 per cent. Isn’t that wonderful?
Studies of walnuts, almonds, pecans, peanuts, macadamias and pistachios show modest changes in blood lipid levels. Similar to other foods rich in unsaturated fat, nuts help maintain HDL (good cholesterol) levels. To control calorie intake, moderate quantities of nuts should be substituted for other foods, since one ounce of nuts (¼ cup) contains approximately 170 calories (Rakel: Integrative Medicine, 2nd ed.)
According to US Department of Agriculture, 68 per cent of the nuts eaten in the United States are peanuts and peanut butter, about six per cent are almonds, six per cent are coconuts, five per cent are pecans, five per cent are walnuts and 10 per cent are all other nuts combined.
Peanuts are considered to be mother-nature’s complete food. They belong to legume or dried bean family and are a great source of protein, fibre, a variety of vitamins and minerals and beneficial unsaturated fats. Since they are a plant food, they contain no cholesterol.
Harvard School of Public Health researchers report that consuming a half serving (one tablespoon) of peanut butter or a full serving of peanuts or other nuts (an ounce), five or more times a week is associated with a 21 per cent and 27 per cent reduced risk of developing type 2 diabetes, respectively (JAMA 2002).
Many studies have examined the eating patterns of both men and women and found that small, frequent servings of peanut butter, nuts and peanuts can reduce the risk of heart disease by 25-50 percent.
Americans consume 2.4 billion pounds of peanuts each year. About 50 per cent is consumed as peanut butter. Research published in Paediatrics shows that high risk overweight adolescents, ages 10-15, can lose weight while substituting an ounce of peanuts or peanut butter for other less healthy snack choices.
A serving of peanuts is simply a handful and is only 160 calories. And a serving of peanut butter (two tablespoons) contains 190 calories – just enough to make a peanut butter and jelly sandwich. In addition, studies show that peanuts and peanut butter satisfy hunger longer than other foods (www.peanut-institute.org).
So, have you gone nuts yet?
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