What is the Real Deal behind Preventing Cardiac Risk?

It's been quite a while since my last post.  I am neck deep in preparing for my PhD Comprehensive exam (early Dec 2013), working full time & caring for my almost 2 year old daughter as my wife and I have another child on the way (due Feb 2014).

I have to tell you honestly, that I am constantly disappointed by the current medical profession specifically when it comes to dealing with chronic diseases! As a registered dietitian I see it as my duty to constantly review the literature to see what new innovations might show promise. It's my responsibility to understand these novel studies so that when clients inevitably ask about them, I will be able to give them legit advice & not just tow some antiquated party line!

Okay, enough venting!  Let's dive into some of the newer evidence on Heart Disease Risk!


The Popular Dogma is Not Supported by Current Evidence

1)      Saturated Fat

a.       The current dogma is that eating too many saturated fats increases blood cholesterol, which in turn increases risk for heart disease.

b.      A few studies have shown that there increased levels of LDL increase risk for CHD.

c.       But, recent research concluded that there was in fact no association between dietary cholesterol and CHD.

d.      As of 1977 AMA/CMA recommended lowering fat intake to 30% or less in diet – result=significant change in diet composition - ­ Carb/­ PUFA (specifically vegetable oils – all ­ omega 6).

e.      If we oversimplify and just ask two basic questions, we start to see the challenges that have arisen: i) What about evolution? Did we evolve eating more carbs and seeds & nuts or animal & coconut fats? ii) What about inflammation? Which is more inflammatory in nature: SFA or omega 6 + refined carbs?

2)      Apo lipoprotein Changes

a.       This change in diet comp – resulted in changes to our circulating lipoproteins that actually increase our risk for CHD (specifically - ­ Triglycerides/ ¯ HDL particles).

b.      New technology explains why LDL amount is not as telling as once believed.  Particle size of   Think of cholesterol as the passengers in a car and the particle number is the number of cars on the road.  If there are more particles around then they are more likely to crash into the arterial linings and become trapped (atherosclerosis).  If LDL particles are smaller, there will be more of them present, when they are fluffy and big, and then there will be less of them.  Theoretically, the amount of LDL could be the same in both scenarios, but it’s the small, dense LDL particles (that are more abundant) that increase the risk for CHD.
LDL particle size is far more predictive of atherogenic risk.

3)      The Role of Carbohydrates in CHD

a.       Carbohydrates were pre-farming available in unrefined forms (vegetables & fruits) and only in the late summer and fall.  Today, we have year round access to the most highly refined carbohydrate sources we’ve ever seen.

b.      High carbohydrate intake shuts down fat burning & promotes fat storage.  This increased fat storage leads to an increased production of triglycerides.

c.       Hypertriglyceridemia is accentuated in people with abdominal obesity/insulin resistance.

d.      This insulin resistance occurs in the face of high carbohydrate diets & is now considered a protective measure by the liver to prevent substrate overload.

4)      The Role of Inflammation

a.       Athersclerosis does not occur in a vacuum (so to speak).  Inflammation and oxidation are required to promote infiltration of lipids within the arterial walls and the binding of minerals to them (plaque formation).

b.      High carbohydrate diets & especially refined carbohydrates are highly pro-inflammatory.

c.       Omega 6 fats are essential (small amounts) but in excess are highly pro-inflammatory.  They are highly available in Western diets (corn, soy & wheat oils) as well as most nuts & seeds.

d.      Recent studies have shown that low carbohydrate diets are effective at reducing cardiovascular risk factors.

Citations:

http://www.stlawrencedentistry.com/wp-content/uploads/2013/07/heart-disease.jpg

Djousse, L and Gaziano, JM, 2009.

German, JB and Dillard, CJ, 2004.

http://www.mayoclinic.org/news2011-mchi/6264.html

http://chriskresser.com/the-diet-heart-myth-why-everyone-should-know-their-ldl-particle-number

http://www.longevitytesting.com/pub/images/PARTICLES_web.jpg

http://img.springerimages.com/Images/ImagesMD/AHD/10/10/WATER_AHD1004-10-032.jpg

Agius, L, 2013.

http://www.realw8site.com/images/brochureillustration_clr.jpg

The Best all natural appetite suppressants

Hi Everyone,

Let's face it when we are working on changing our nutrition to decrease our calorie intake and limit our exposure to processed food, we can use some help overcoming cravings & the natural increase in appetite that some people feel in response to a lowering in calorie intake.

Remember, the first thing is to never drop your calories more than 20-30% of your needs.  Whichever end you can handle, stay there.  Otherwise, you're setting yourself up for failure.

The Best all natural appetite suppressants

1) Pure Water - drinking 1-2 cups 15-20 minutes before each meal can help hydrate the digestive system and also decrease the appetite going into a meal.

2) Low carb vegetables especially leafy greens - These are extremely low in calories, but are very high in micro nutrients & fiber.  As a result they are the most nutrient dense food.  These do not have to be counted (carbohydrate or calorie wise) but obviously contribute to your 10 fists of fruits & vegetables daily.




3) Soluble fiber - this can be either in the form of a fiber supplement (Benefiber, etc...) or a specific supplement like PGX (soluble-fiber like). Guar gum, Xanthan gum or Pectin could all work individually or combined together (and mixed with liquid).  These will essentially swell up in the stomach and hold the food in the antrum (lower part of the stomach) longer before emptying. This ensure that your satiety (fullness felling) lasts longer.  Again, doing this 15-20 minutes before a meal can significantly reduce your appetite at meal times.

4) Fresh apples or pears - these fruits contain a high amount of soluble fiber (pectin) and water.  So eat one of these 15-20 minutes before a meal and combine with 1) to see maximal results.  Remember to count the carb and calorie content of this choice.







5) Broth, - this combines number 1) (water) with the flavor of chicken or beef and some of the nutritional content if made from scratch that help decrease appetite.  Choose chicken or beef broth that is lower in sodium (if store bough it will still be relatively high).

6) Green tea or lemon in hot water - these provide an astrigent/sour flavor which override the taste buds and effectively shut down our perception for sweet and salty for a period of time following consumption.  These are great strategies not only to use at meal times but also for times when you might be struck with cravings for sweet or salty foods (i.e. junk foods), for example in the evening.


 I hope you find these strategies useful!  Try them and see what they do for you!

Follow me on Twitter and friend me on Facebook for more useful tips & motivation.

www.twitter.com/dietitiandant

www.facebook.com/dietitiandant

Also, subscribe to my YouTube channel for more cutting edge nutrition information delivered to your home for free!

https://www.youtube.com/chizlefuel

Have a great day!

Dietitian Dan T

The Meal Building Formula

As a registered dietitian for over 8 years and having been in the life-changing profession for over 12 years, I have counselled tens of thousands of people, however the bulk of the questions that are asked boil down to dozens of questions repeated over and over again (with slight variations).

Interestingly, one of the main issues that consistently arises, especially in newbies is what is a good formula for building meals.  Obviously, there are many camps around this issue. Various diets & meal planning strategies focus on certain combinations of a + b, while others only look at calorie content and pay no regard to anything else.  The truth is that all of them have their merit and of course people can be successful for a time on all of them, as long as they get themselves to comply (fancy word for sticking with it).

However, over the years I've noticed some major trends and they've led me to what I consider the optimal formula for meal building for leanness, health and fitness.  The main reason that this formula is so effective, is that based on the bias towards nutrient dense, low calorie containing foods, it all but eliminates the need for measuring and weighing items, which is what often causes newbies to curl up into the fetal position on the floor or freeze like a deer in the headlights. I hope to detail this formula more in a future ebook.

Formula for meal planning success:

1) Build your meals from the lean source protein out. Choose grass fed meats, poultry or wild caught fish and seafood.

2) Focus on non-starchy vegetables to primarily accompany your lean source protein (as much as you can handle). Remember that we are shooting for 10 fist of fruits and vegetables per day.  In this case because I'm assuming you are trying to lose weight, we should emphasize the bulk of those 10 fist coming in from non-starchy vegetables. For a period of about 1-4 hrs after workouts, this post workout snack should include either starchy vegetables or fresh fruits in addition to lean source protein.

3) Use healthy (olive, macadamia, coconut and avocado) fruits & their oils, as well as seasonings for cooking and to flavor things.

4) Non calorie containing hydration of choice - could be water, coffee, espresso, teas.

5) Avoid using white sugar or white flour as these will completely destroy your progress. Ideally, expunge them from your life!

6) Remember other healthy lifestyle changes & make those also.

• Exercise regularly.
• Sleep well.

Ideally, that's it. By building all your meals in this way and you will be significantly limiting your exposure to carbohydrate-rich foods and especially process foods that are essentially designed to turn on your appetite and not turn it off.

Just try this approach for 1 month to start and see how it goes. Remember to take baseline measurements and repeat them monthly (or at most weekly).  Take a quality multivitamin during any weight loss program and obviously check with your doctor before undertaking a new weight management program.

I hope you find this information useful.  Please click on the ads to help support my site.

Also, be sure to follow me on Twitter or Google + if you'd like regular daily useful nutritional information tips and motivation.

Take care and see you next time.

Dan

Vegetables in your diet

Vegetables are the edible portions of plants.

Main nutrients delivered in Vegetables:

1)      Vitamins and Minerals.

Green-Yellow-Orange – high in Calcium, Magnesium, Potassium, Iron, Beta-carotene, Vitamin B-Complex, Vitamin C, Vitamin A and Vitamin K.

Folate (birth defects) – black eyed peas, cooked spinach, great northern beans, asparagus.

Potassium (blood pressure) – sweet potatoes, tomato paste, tomato puree, beet greens, white potatoes, white beans, lima beans, cooked greens, carrot juice.

Vitamin A (skin, eyes, infection) – sweet potatoes, pumpkin, carrots, spinach, turnip greens, mustard greens, kale, collard greens, winter squash, cantaloupe, red peppers, Chinese cabbage.

Vitamin C (skin healing, gums and teeth) – red and green peppers, sweet potatoes, kale, broccoli, Brussel sprouts, tomato juice, cauliflower.

2)      Phytochemicals.

Antioxidants – These help protect the body from oxidative stress, diseases and cancers. These also boost immunity.

Flavonoids – Provide benefits by acting on the cell-signaling pathways in the body.  Include red, purple, blue or orange in color vegetables (i.e. Eggplant, red cabbage, onions, broccoli, kale, celery and hot peppers).

Catechins – is a natural phenol antioxidant plant secondary metabolite.  Rich sources of these are found in cacao beans and was first called kakaool.

Carotenoids – beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, lycopene and alpha-carotene.  Found in orange, yellow and red vegetables (i.e. carrots, squash, corn, tomatoes).

Phytosterols – plant-derived compounds that are similar in structure and function to cholesterol.  Numerous clinical trials have demonstrated that daily consumption of foods enriched with at least 0.8 g of plant sterols or stanols lowers serum LDL cholesterol.  Foods rich in phytosterols include unrefined vegetable oils, whole grains, nuts, and legumes.

There are thousands more of these compounds still unknown in fresh fruits & vegetables.

Studies show that steaming for around 10 minutes retains more of the activated beneficial compounds than either consuming raw or over cooking.

3)      Dietary Fiber.

Fiber is a diverse group of compounds, including lignin and complex carbohydrates that cannot be digested by human enzymes in the small intestine.

Vegetables contain both soluble and insoluble fibers.  We strive to obtain both from as natural sources as possible in order to maintain health and manage weight.

Insoluble: Non-starch polysaccharides (NSP) like cellulose, gums, mucilage, pectin, etc…

Adequate fiber intake has been associated with reduction in hemorrhoids, constipation, rectal fissures, overweight/obesity, rectal and breast cancers, etc…

Soluble or Viscous fibers, such as those found in oats and legumes, can lower serum LDL cholesterol levels and normalize blood glucose and insulin responses.  This is also found in smaller amounts in most vegetables.

Some examples of fibers found in vegetables include:

• Lignin: Lignin is a polyphenolic compound with a complex three-dimensional structure that is found in the cell walls of woody plants and seeds.
• Cellulose: Cellulose is a glucose polymer found in all plant cell walls.
• Hemicelluloses: Hemicelluloses are a diverse group of polysaccharides (sugar polymers). Like cellulose, hemicelluloses are found in plant cell walls.
• Gums: Gums are viscous polysaccharides often found in seeds.
• Inulin and oligofructose: Inulin is a mixture of fructose chains that vary in length and often terminate with a glucose molecule. Inulin and oligofructose occur naturally in plants, such as onions and Jerusalem artichokes.
• Resistant starch: Naturally occurring resistant starch is sequestered in plant cell walls and is therefore inaccessible to human digestive enzymes. Legumes are sources of naturally occurring resistant starch. Resistant starch may also be formed by food processing or by cooling and reheating.

4)      Low/No Calorie high satiety foods.

Contain carbohydrates; however, these carbohydrates are not readily available to the body (i.e. difficult to digest).

The high fiber and water content make these high satiety foods via delaying emptying of the stomach into the small intestine.

Satiety = time from when you’ve last eaten until you’re hungry once again.

Five things you can do tonight to get more Vegetables into your daily diet

1)      Fill your plate at lunch and supper as above with Vegetables.  If you are trying to manage weight, eat these first with your healthy protein to maximize your satiety.

2)      Keep pre-cut and pre-washed vegetables in your fridge as snacks.  You can pair with healthy dips (i.e. hummus, peanut butter, etc…).

3)      Steam vegetables for 5-10 mins (maximum) when preparing.

4)      Use vegetables in smoothies with fruit and water in order to get more in your diet.

5)      Aim for 5 or more servings of vegetables as part of your 7-10 servings of fruits and vegetables daily.  Remember to focus on the non-starchy vegetables which are fibrous and very low calorie.

Citations:

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/

http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/phytochemicals

http://articles.elitefts.com/wp-content/uploads/2010/07/hunger.jpg

http://www.livestrong.com/article/271230-phytochemicals-in-fruit-and-vegetables/

http://lpi.oregonstate.edu/infocenter/phytochemicals