I have been reading a little lighter fare today - an article in the ACSM Certified News. The article is about cholesterol factors that are related to coronary heart disease and risk of a cardiovascular event - such as a stroke or heart attack.
Most of us are familiar with the Cs that are tested in annual blood work and the article gives a great overview and glossary of them. This includes the values associated with the tests. Sometimes we aim for a higher value and other times a lower one. In either case, they are a risk factor for disease.
The tests include:
TC = total cholesterol
HDL-C = high density lipoprotein cholesterol
LDL-C = low density lipoprotein cholesterol
TG = Triglycerides (another blood fat)
VLDL - C = very low density lipoprotein cholesterol
Each of the above tests has a target value and usually a person is trying to get below that number - i.e. below 200 for the TC. But the HDL value is one where we want to be high. If that value is above 60 it actually can protect a person from a heart event. You can read more about specific target values here.
The article describes a newer test as well. It is not at this time recommended as part of the adult cholesterol panel, but is used with persons who have very high TG - diabetics often have high TG even when they can control their LDL.
The new value is called Non-HDL and is the difference between TC and HDL. Literally - take the total cholesterol value and subtract away the high density lipoprotein value and that is your NON-HDL value - if you do not have heart disease and have less than 2 risk factors for heart disease (i.e. your other values are normal) than your Non HDL should be < 190.
All of our cardiovascular risk factors can be addressed with TLC - that stands for therapeutic lifestyle changes. TLCs that you may be familiar with include exercise, changes in what you eat (i.e. less red meat and more fish) and weight loss. Learn more about ways to improve your health and prevent heart disease at the American Heart Association website.
Here is the info on the article I referenced today:
Title: LIPIDS AND HEALTH; A GUIDE FOR THE FITNESS PROFESSIONAL
BY: WILLIAM SNYDER; CHANG CHAU; AND SARAH MAKOSH;
AND JAMES R. CHURILLA, PH.D., MPH, M.S., RCEP, CSCS
IN: ACSM’S CERTIFIED NEWS • APRIL—JUNE 2011 • VOLUME 21: ISSUE 2
Showing posts with label cholesterol. Show all posts
Showing posts with label cholesterol. Show all posts
Wednesday, July 27, 2011
Friday, June 19, 2009
Drugs Not Needed
I was pretty dumbfounded this morning when I heard a commercial regarding a medication created to treat the very condition discussed in my last blog. The reason I was taken aback is because as I wrote here, the experts state that the most effective treatment for lowering triglycerides and raising HDL-C is NOT a medication but watching your weight, exercising and eating lean proteins and including unsaturated fats in ones diet.
So why in the world would the FDA approve a medication for this. A medication which does not lower any heart disease death or disability over the statin therapy one takes for lowering their LDL-C. Even the TV ad tells us that the medicine will not do that.
The reason we lower any of the numbers, whether it is cholesterol, blood pressure, CReactive protein, triglycerides, etc is to lower the risk of disease and death. If this new medication lowers triglycerides while putting the patient at great risk for side effects for NO OTHER REASON than to have a lower number.... WHY would a person take it, a doctor prescribe it or an insurance company PAY for it. This is how our country spends so much money on health care without having the best healthy life expectancy.
So, I am blasting about a drug called Trilipix... cute huh. The scientific name is fenofibric acid. The drug company did complete severe phase III trials before gaining FDA approval and I was able to read a little about that. The company used the drug in conjunction with statins (i.e. Zocor and Lipitor) of different strengths compared to a group that just used the new drug. In the combo therapy all numbers changed to the better, lower LDL and TG and higher HDL but again, there are no improved health outcomes so why would you subject yourself to the risk factors and the cost of another medicine?
Better than that, the TV ads and the literature on the drug insist that it is to be used WITH a diet regimen. In fact, the print warnings and prescribing info for clinicians states that diet and other non medicine strategies should be exhausted before prescribing Trilipix. The consumer ads and website just say to talk to your doctor about this new drug. Heck they even give you a print out of talking points so that you, the patient, can educate the doctor and advocate for this treatment on your own behalf. This is certainly playing to our cultural leanings toward pill focused solutions.
But pills come with more than a financial cost. The physical risk can be great as well. For this drug, side effects include
Muscle Pain
Tenderness
Weakness
Tiredness
Fever
Abdominal Pain
Nausea
Vomiting
And more seriously, muscle wasting and possibly kidney and liver problems. The serious side effect risks go up when the drug is used in combo with the statins, but it is with statins that it works. Again, why would one take this drug.
Eat Smart Move More... Live better, longer... Extend your life not your death...
So why in the world would the FDA approve a medication for this. A medication which does not lower any heart disease death or disability over the statin therapy one takes for lowering their LDL-C. Even the TV ad tells us that the medicine will not do that.
The reason we lower any of the numbers, whether it is cholesterol, blood pressure, CReactive protein, triglycerides, etc is to lower the risk of disease and death. If this new medication lowers triglycerides while putting the patient at great risk for side effects for NO OTHER REASON than to have a lower number.... WHY would a person take it, a doctor prescribe it or an insurance company PAY for it. This is how our country spends so much money on health care without having the best healthy life expectancy.
So, I am blasting about a drug called Trilipix... cute huh. The scientific name is fenofibric acid. The drug company did complete severe phase III trials before gaining FDA approval and I was able to read a little about that. The company used the drug in conjunction with statins (i.e. Zocor and Lipitor) of different strengths compared to a group that just used the new drug. In the combo therapy all numbers changed to the better, lower LDL and TG and higher HDL but again, there are no improved health outcomes so why would you subject yourself to the risk factors and the cost of another medicine?
Better than that, the TV ads and the literature on the drug insist that it is to be used WITH a diet regimen. In fact, the print warnings and prescribing info for clinicians states that diet and other non medicine strategies should be exhausted before prescribing Trilipix. The consumer ads and website just say to talk to your doctor about this new drug. Heck they even give you a print out of talking points so that you, the patient, can educate the doctor and advocate for this treatment on your own behalf. This is certainly playing to our cultural leanings toward pill focused solutions.
But pills come with more than a financial cost. The physical risk can be great as well. For this drug, side effects include
Muscle Pain
Tenderness
Weakness
Tiredness
Fever
Abdominal Pain
Nausea
Vomiting
And more seriously, muscle wasting and possibly kidney and liver problems. The serious side effect risks go up when the drug is used in combo with the statins, but it is with statins that it works. Again, why would one take this drug.
Eat Smart Move More... Live better, longer... Extend your life not your death...
Friday, March 20, 2009
Weekly w/ Video
The News:
The American Heart Association: I hope that this volunteer health agency which is comprised of both medical and non medical volunteers is one that you trust. It has been in existence since 1924 and facilitates research into the prevention and treatment of heart disease. Their mission includes reducing deaths from heart attack and stroke by 25%. Research is published in peer reviewed journals and is used to create evidence based guidelines for health care professionals. The AHA recently spoke to Congress and shared concerns that the gains that have been made in reducing the above mentioned deaths will soon be lost due to increasing numbers of heart disease. A major concern is obesity and the Association is urging the government to increase funding for prevention in the schools and community. They are also very clear regarding the consequences of tobacco use and support FDA regulation of tobacco products which would limit if not prohibit some of the marketing and advertising by tobacco companies. The main risk factors for heart disease include: unhealthy weight, poor diet, smoking, and diabetes (type 2). These are modifiable risk factors, in other words, you can control them.
Carcinogens in Products: I am going to start sounding like a broken record but I cannot help but point out this type of discrepancy when I see it. An American consumer interest group had made claims that some Johnson and Johnson baby shampoo and lotions have two chemicals that are known to cause cancer at some level. They are formaldehyde and 1,4 dioxane. I have not researched this myself I only point out that the organization has gotten the attention of the Chinese government where these products are sold. They are also sold here but the FDA is not yet investigating. There is no report of death or illness at this time. This is of note because cigarette smoke contains at least those two chemicals and over 40 more carcinogens. These “cigarettes” are responsible for millions of deaths a year worldwide… so uh, where is the outrage? [post note: this issue has been cleared by China's state food and drug agency]
Pretending to Smoke: What an odd little “game” the children have created. From A WSJ article I learned that kids can crush up certain candies, sort of inhale the dust and then blow out smoke. They even practice blowing smoke rings. All I am saying, kids really need to get out and play more
PSA Testing: I recall talking about this test for prostate cancer when my newsletter was first being published. In the early 2000s then, the concern was whether to test and then whether to treat because this cancer, though the second cancer killer for men, was a slow killer and often the men could live the rest of their lives without much decline in quality of life and likely die of something else before the cancer killed them. [probably they will die from heart disease, no?]. The testing or screening can lead to biopsies and treatment that is rife with side effects. The treatment can be debilitating and or embarrassing. Two very large research studies, studies lasting 15 years, do not offer a disposition. Over 240,000 men were studied. The results were a very slight benefit in one study, but with significant side effect costs and the other found no benefit at all. This is exactly the kind of reporting I want to see on medical devices, tests and treatments. Not that they do not work, but whether or not they work and what the risk to benefit is.
Number One Cancer Killer?: Good question. Though men suffer from prostate cancer and women from breast, the number one killer of both men and women is lung cancer. There may be a higher prevalence of the other cancers, including colorectal, but those with lung cancer generally die from it, while the other cancers have better survival rates.
HDL: The Good Guy: A reader and friend recently asked me to tell him a way to raise his good cholesterol that he didn’t already know. Certainly he knows what most of you know, you raise it through exercise (though not exponentially) but more often those with high HDL have a gene that promotes it. I did take his challenge however and read what I could about the issue from sources that I consider valid or research based. I.e. you are NOT going to hear me recommend a supplement to increase your HDL. What you will get from me is a practical application of what I have vetted. Here it is then. The mayo clinic among others, notes that oils with mono unsaturated fats, like olive and peanut, enhance the anti-inflammatory properties of the HDL. So though you may not be able to change your number you may be able to increase the impact of that number, in my opinion. I strongly suggest that you follow my example from the cooking demos and do not cook in the oils but add limited amounts to your already cooked veggies or to a salad. A teaspoon for example, or even a tablespoon spread throughout the day. It is also true that HDL works in keeping you healthy by carrying out excess bad cholesterol. It is known that certain fibers can also aid in ridding the body of bad cholesterol so again I recommend something like my cereal bars. Lastly, do not smoke. Smoking lowers HDL. Some research supports that red wine may have an HDL promoting effect but not enough to make a standard recommendation for anyone to add wine if they do not currently drink it.
That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar. Today’s show is peanut butter cookies which in fact, are HIGH in fiber… and the peanut butter is a source of monounsaturated fats. These are not your mother’s PB cookies, nor my mom’s which are fantastic.. but this blog is about health not decadence.
Ingredients include:
Smucker’s All Natural Peanut Butter
(do not use jiff, peter pan, etc- for numerous reasons)
Splenda or Altern
Kellog’s All Bran Original
Loose Oat Bran
WATER
Non fat cook spray (butter)
Cookie Sheets
Large microwaveable bowl… glass is best
Heat oven to 375*
I forgot to say this in the video but cook the cookies for 20 minutes and then check them, move pans around, check every five or ten minutes, you will get the idea in time.
This is the original recipe from a cook book I made a long time ago, but it is hard to explain what I mean, thus the video!
4 Tbls smucker’s all natural peanut butter
water
2 c All Bran original
¼ cup loose oat bran
¼ to ½ c loose Splenda
In microwave if available, heat the peanut butter with about 1 ½ c or more water for about 2 minutes, then use beaters to mix this until it is peanut butter colored water mixture, also mix in the sweetener. Then add the cereals, set aside until moist. Mix this again adding some water until it is moister than other cookie dough. I use a scoop to make two trays with 20 cookies on each. Bake at 375, twenty or so minutes until done. More water and less cooking makes them seem moister. It is good to experiment until you like them!! Made my way, each has about 20 calories.
Serving size: 3 cookies
Amount per serving: calories: 60; fiber: 3g; protein: 2g; fat: 2g.
The American Heart Association: I hope that this volunteer health agency which is comprised of both medical and non medical volunteers is one that you trust. It has been in existence since 1924 and facilitates research into the prevention and treatment of heart disease. Their mission includes reducing deaths from heart attack and stroke by 25%. Research is published in peer reviewed journals and is used to create evidence based guidelines for health care professionals. The AHA recently spoke to Congress and shared concerns that the gains that have been made in reducing the above mentioned deaths will soon be lost due to increasing numbers of heart disease. A major concern is obesity and the Association is urging the government to increase funding for prevention in the schools and community. They are also very clear regarding the consequences of tobacco use and support FDA regulation of tobacco products which would limit if not prohibit some of the marketing and advertising by tobacco companies. The main risk factors for heart disease include: unhealthy weight, poor diet, smoking, and diabetes (type 2). These are modifiable risk factors, in other words, you can control them.
Carcinogens in Products: I am going to start sounding like a broken record but I cannot help but point out this type of discrepancy when I see it. An American consumer interest group had made claims that some Johnson and Johnson baby shampoo and lotions have two chemicals that are known to cause cancer at some level. They are formaldehyde and 1,4 dioxane. I have not researched this myself I only point out that the organization has gotten the attention of the Chinese government where these products are sold. They are also sold here but the FDA is not yet investigating. There is no report of death or illness at this time. This is of note because cigarette smoke contains at least those two chemicals and over 40 more carcinogens. These “cigarettes” are responsible for millions of deaths a year worldwide… so uh, where is the outrage? [post note: this issue has been cleared by China's state food and drug agency]
Pretending to Smoke: What an odd little “game” the children have created. From A WSJ article I learned that kids can crush up certain candies, sort of inhale the dust and then blow out smoke. They even practice blowing smoke rings. All I am saying, kids really need to get out and play more
PSA Testing: I recall talking about this test for prostate cancer when my newsletter was first being published. In the early 2000s then, the concern was whether to test and then whether to treat because this cancer, though the second cancer killer for men, was a slow killer and often the men could live the rest of their lives without much decline in quality of life and likely die of something else before the cancer killed them. [probably they will die from heart disease, no?]. The testing or screening can lead to biopsies and treatment that is rife with side effects. The treatment can be debilitating and or embarrassing. Two very large research studies, studies lasting 15 years, do not offer a disposition. Over 240,000 men were studied. The results were a very slight benefit in one study, but with significant side effect costs and the other found no benefit at all. This is exactly the kind of reporting I want to see on medical devices, tests and treatments. Not that they do not work, but whether or not they work and what the risk to benefit is.
Number One Cancer Killer?: Good question. Though men suffer from prostate cancer and women from breast, the number one killer of both men and women is lung cancer. There may be a higher prevalence of the other cancers, including colorectal, but those with lung cancer generally die from it, while the other cancers have better survival rates.
HDL: The Good Guy: A reader and friend recently asked me to tell him a way to raise his good cholesterol that he didn’t already know. Certainly he knows what most of you know, you raise it through exercise (though not exponentially) but more often those with high HDL have a gene that promotes it. I did take his challenge however and read what I could about the issue from sources that I consider valid or research based. I.e. you are NOT going to hear me recommend a supplement to increase your HDL. What you will get from me is a practical application of what I have vetted. Here it is then. The mayo clinic among others, notes that oils with mono unsaturated fats, like olive and peanut, enhance the anti-inflammatory properties of the HDL. So though you may not be able to change your number you may be able to increase the impact of that number, in my opinion. I strongly suggest that you follow my example from the cooking demos and do not cook in the oils but add limited amounts to your already cooked veggies or to a salad. A teaspoon for example, or even a tablespoon spread throughout the day. It is also true that HDL works in keeping you healthy by carrying out excess bad cholesterol. It is known that certain fibers can also aid in ridding the body of bad cholesterol so again I recommend something like my cereal bars. Lastly, do not smoke. Smoking lowers HDL. Some research supports that red wine may have an HDL promoting effect but not enough to make a standard recommendation for anyone to add wine if they do not currently drink it.
That will bring us to today’s cooking video. The point of these videos is to assist you in eating food, lots of food really, without adding non nutritive and even disease promoting extras.. like saturated FAT and sugar. Today’s show is peanut butter cookies which in fact, are HIGH in fiber… and the peanut butter is a source of monounsaturated fats. These are not your mother’s PB cookies, nor my mom’s which are fantastic.. but this blog is about health not decadence.
Ingredients include:
Smucker’s All Natural Peanut Butter
(do not use jiff, peter pan, etc- for numerous reasons)
Splenda or Altern
Kellog’s All Bran Original
Loose Oat Bran
WATER
Non fat cook spray (butter)
Cookie Sheets
Large microwaveable bowl… glass is best
Heat oven to 375*
I forgot to say this in the video but cook the cookies for 20 minutes and then check them, move pans around, check every five or ten minutes, you will get the idea in time.
This is the original recipe from a cook book I made a long time ago, but it is hard to explain what I mean, thus the video!
4 Tbls smucker’s all natural peanut butter
water
2 c All Bran original
¼ cup loose oat bran
¼ to ½ c loose Splenda
In microwave if available, heat the peanut butter with about 1 ½ c or more water for about 2 minutes, then use beaters to mix this until it is peanut butter colored water mixture, also mix in the sweetener. Then add the cereals, set aside until moist. Mix this again adding some water until it is moister than other cookie dough. I use a scoop to make two trays with 20 cookies on each. Bake at 375, twenty or so minutes until done. More water and less cooking makes them seem moister. It is good to experiment until you like them!! Made my way, each has about 20 calories.
Serving size: 3 cookies
Amount per serving: calories: 60; fiber: 3g; protein: 2g; fat: 2g.
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