Eileen’s Going Lo-Co Inspired Grapefruit-Metamucil Smoothie

In honor of Thanksgiving week, I’d like to thank (see what I did there?) Going Lo-Co reader Eileen S. for sharing both her experience and the cholesterol-lowering recipe she invented. Inspired in part by my post, Grapefruit Pros and Cons (which will forevermore be dubbed, ‘the post that keeps on giving’ as I wrote about grapefruit way back in 2013 and Eileen ran across it two years later!), Going Lo-Co blog reader Eileen S recently invented a new cholesterol-lowering recipe.

As you may recall, Grapefruit Pros and Cons is about the amazing fact that grapefruit – plain old grapefruit – actually lowers cholesterol…so anyone who wants to lower LDL (bad) cholesterol naturally should add grapefruit to their diet** (as long as they are not taking a statin medication or any other medication that interact with grapefruit.)

You may also recall that at the end of that post, I wondered if you could mix cholesterol-lowering grapefruit with cholesterol-lowering Metamucil. But as grapefruit is too tart for me, I never tried the double-shot cholesterol-lowering Grapefruit-Metamucil mix.

But Going Lo-Co blog reader Eileen did!

She emailed me with her experience and the recipe she created – and I felt hers was such a clever idea (and I was so tickled to have been an inspiration for that idea) that I wanted to share her emails in case you have a similar experience and/or just want to try grapefruit mixed with Metamucil:

Eileen email #1 – about trying to incorporate Metamucil into her daily life to lower LDL (bad) cholesterol naturally, and how frustrated Eileen was with the sugar/sugar-free Metamucil options:

Hi Karen!

I came across your blog today about grapefruit and lowering cholesterol. At the very end you wondered if you could mix it with your Metamucil. Such a coincidence! I started taking Metamucil couple months ago to try to lower my LDL’s so that I don’t need to take a statin medication. After going through a whole container with artificial sweetener followed by a whole container with real sugar I realized I wanted neither and tried an unflavored unsweetened version. YUCK! Just yesterday I came across a recipe to throw red grapefruit into a blender with a little honey. Just this morning I decided to try the grapefruit with the Metamucil and the honey altogether. I’ll be going to the store today and trying the concoction tomorrow morning. Did you ever try this? I can let you know how it goes if you are still interested.


Eileen’s second email — she invented a naturally sweetened Grapefruit – Metamucil Smoothie (I assume it’s smooth so have dubbed it so) and the ‘recipe’ is included here:

Hi again!

So tonight after dinner I scooped out the inside of one grapefruit and put it in my Ninja along with a bit of honey and a few ice cubes.  Once that was blended I added a round teaspoon of plain psyllium husks and a couple ounces of cold water and blended it again. Not bad at all! Now I have a double whammy for lowering my  LDL without artificial sweeteners and colors that is much more palatable!  A win/win deal.  I would love to know if anyone else tries this.


So if you are looking for a more palatable way to take Metamucil and the idea of mixing it with cholesterol-lowering Metamucil appeals**, try Eileen’s Going Lo-Co Inspired Grapefruit-Metamucil Smoothie!  I’ve included a ‘recipe’ version on the Going Lo-Co recipe page.

A big thanks to Eileen for sharing (and giving me permission to post).  Comment or email if you try this or other cholesterol-lowering recipes: Eileen and I would love to know your experience and ideas.

** VERY IMPORTANT:  do NOT eat grapefruit if you take Lipitor or any other statin medication to lower cholesterol without speaking first to your doctor.  Same grapefruit warning exists if you take other types of medications that can also interact with grapefruit juice, including drugs for blood pressure, heart rhythm, depression, anxiety, HIV, immunosuppression, allergies, impotence, and seizures.  It is dangerous to start eating grapefruit if you take any of these medications – unless you speak to your doctor first.


Is the New Class of Cholesterol-Lowering Drugs For You?

The quick answer to ‘Am I a candidate for one of the two new PCSK9 cholesterol-lowering drugs?’ is Probably Not (unless you have FH or have heart disease / have had a heart attack.)

The reason? Two, actually. First, this totally new class of (injectable) cholesterol-lowering drugs is approved ONLY for those with high cardiac risk. And secondly, clinical study results with key safety data won’t be available for YEARS.

The two new drugs, Praluent and Repatha, were approved this past summer by the FDA only for those with a serious, genetically inherited disease that causes very high LDL (bad) cholesterol called Familial Hypercholsterolemia (FH) and/or for those who have heart disease / have suffered a heart attack. Said differently, this new class of drugs is NOT for those with “regular” high cholesterol — and that’s key because these drugs have potentially serious (neurological and other) side effects which won’t be fully known until clinical results are released in 2017.

As reported by CNN’s FDA Approves Second In New Class of Cholesterol Lowering Drugs:

“Repatha provides another treatment option in this new class of drugs for patients with familial hypercholesterolemia or with known cardiovascular disease who have not been able to lower their LDL cholesterol enough with statins,” Dr. John Jenkins, director of the FDA Office of New Drugs, Center for Drug Evaluation and Research, said in a news release.”

A similar CNN article, FDA Approves New Cholesterol Lowering Drug, explains:

“It focuses on those who’ve truly had clinical disease or those who start out with such high levels of LDL they can’t get anywhere near where they should be and I think those are the most at-risk people,” said Dr. Donald A. Smith, associate professor of medicine and cardiology at Mount Sinai Hospital in New York.”

So, yes, this new class of drugs is amazing news for those with FH and those with cardiac disease who cannot tolerate statins. These folks should run, not walk, to their cardiologists. But for the rest of us, Repatha and Praluent are drugs we can ask our internists and cardiologists about at our next appointments, not race there with questions now.

What’s fascinating frustrating to me about these new drugs is that there is a lack of clarity from the American Heart Association and the American College of Cardiologists about how this new class of drugs fits in with their 2013 “New Guidelines” for treating high cholesterol.  Indeed, in ‘Understanding The New Guidelines,’ the new class of drugs is not even mentioned. I find this wildly frustrating – this is an ONLINE instrument and should be current. I found one, count-em-one article on AHA’s site (their blog, actually) called FDA Approves New Cholesterol Drug, and here’s what it said about the new class of drugs (in a nutshell, they said MAYBE WE SHOULD THINK ABOUT IT VIS-A-VIS OUR GUIDELINES? Seriously? That’s it? Very disappointing…) Here’s what they said:

“The AHA revised its scientific guidelines about cholesterol in 2013. They de-emphasize the setting of specific LDL targets and recommend statin use for all at-risk patients with elevated LDL. The recommendations also suggest statin treatment for people who don’t have cardiovascular disease but who by using an at-risk estimator tool are determined to have at least a 7.5 percent risk of developing it over a decade.

Now with the possibility of having ultra-low levels of LDL, Eckel, who sat on that guideline-writing panel, said it is unclear whether there will be a move soon to rewrite the guideline to take into account the developments with PCSK9 inhibitors.

“Some people feel the guideline could be re-written now and others believe it should wait until the PCSK9 outcome trials are completed,” he said.”

(NOTE: ‘he’ refers to “Dr. Robert H. Eckel, an endocrinologist and professor at the University of Colorado Anschutz Medical Campus and director of the medical school’s Lipid Treatment Clinic” and who sat on the AHA/ACC new guidelines panel.) 

This equivocating statement (and no real guidance at all) is the sum total of what I could find in terms of opinion from the American Heart Association about this new class of drugs. One can only hope they are providing more to doctors and cardiologists, but I doubt it. Which leaves doctors deciding based on information presented by (necessarily biased) drug companies. Because you can be sure reps from Amgen and Sanofi are banging down the doors of US cardiologists.

Personally, I’m confused.  Every single adult in my family takes statins to lower cholesterol. ALL of them.  But I’m trying not to; I’m trying to manage my risk with lifestyle and diet. And following the American Heart Association’s guidance, I should not be taking statins (my results from the AHA ‘risk calculator’ below. And clearly I’m not a candidate for the PCSK9 drugs as I don’t have FH nor have had a heart disease event, yet. And further, my advanced lipid panel testing also confirms I am not at great cardiac risk.

But what if they’re wrong?  What if the AHA changes the guidelines again and I waste 2 years not taking statins? Or find out that everyone should be taking PCSK9 to lower cholesterol dramatically?

Dr. Mercola doesn’t think that will happen. In his FDA Approves Potentially Disastrous Cholesterol-Lowering Drug, he argues this new class of drugs is likely to be widely prescribed before it’s safety is known, and that there are early indicators of safety issues.

But I’m left wondering.  Luckily I have a follow up appointment with my cardiologist in December, so I’ll ask him what he thinks of the 2013 Guidelines now that two PCSK9 drugs have been approved. I plan to ask if he thinks I should continue to follow AHA/ACC guidelines or consider further tests or treatment.



If you haven’t used the AHA/ACC’s  2013 CV Risk Calculator, you should. It’s free, online (or an app) and is simple to use – all you need are your cholesterol results and your blood pressure (both my internist and my cardiologist used this app during my appointment). Click on the link and fill in the very few boxes and you’ll get a personalized result.

Here’s a summary of my inputs and result / recommendation. “Based on the data entered (assuming no clinical ASCVD and LDL-C 70-189 mg/dL):

  • “Total Cholesterol: 240
  • HDL-Cholesterol: 88
  • Systolic Blood Pressure: 130
  • Hypertension Treatment: No
  • Diabetes: No
  • Smoker: No

Not In Statin Benefit Group Due To 10-Year ASCVD Risk <5%   (THIS IS MY RECO)

In individuals for whom after quantitative risk assessment a risk-based treatment decision is uncertain, additional factors may be considered to inform treatment decision making. These factors may include primary LDL-C ≥160 mg/dL or other evidence of genetic hyperlipidemias, family history of premature ASCVD with onset <55 years of age in a first degree male relative or <65 years of age in a first degree female relative, high-sensitivity C-reactive protein ≥2 mg/L, CAC score ≥300 Agatston units or ≥75 percentile for age, sex, and ethnicity, ankle-brachial index <0.9, or elevated lifetime risk of ASCVD. Additional factors may be identified in the future. (IIb C)

Lifestyle Recommendations

AHA/ACC guidelines stress the importance of lifestyle modifications to lower cardiovascular disease risk. This includes eating a heart-healthy diet, regular aerobic exercises, maintenance of desirable body weight and avoidance of tobacco products.”




Heart Healthy Tomato Sauce Recipe

If you still have tomatoes left over from this summer’s amazing tomato season, you might want to give fresh tomato sauce a try.

I know, I know. It seems hard. And it’s so much easier to pour sauce from a jar.

But it’s not, actually. Well, OK, it is. But not that much harder, it turns out!  A few weeks ago, I read David Tanis’ NYT article, The Time Is Right To Make Tomato Sauce and my eyes flew to the 6 gorgeous tomatoes my friend Chris had given me (which truth be told, had been sitting on my counter for longer than I’d like to admit.)

Could this solve my, ‘I don’t know what to do with that tomato bounty’ dilemma? I decided to try it – spurred to action by these phrases Mr. Tanis used in describing his recipe:

  • “just make a small-batch” and “in a matter of minutes”
  • “quick-cooking sauce with relatively fast preparation. There’s no need to blanch and peel tomatoes or even use a food mill”
  • “All you need is a hand-held grater”

Quick and easy — check that as an ‘always’ requirement for me.  And while I normally like to use equipment, I do not own a food mill and I could not quite imagine how one attacks a tomato with a hand-held grater!

Plus, tomatoes are heart healthy. In fact, a study published in 2007 by the The National Center for Biotechnology Information is actually titled, “Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation.”  As I despise tomato juice and don’t get enough tomatoes in my diet, I thought I should pop a Prilosec and try this dinner.

And I’m glad I did.  While the sauce was a little thin flavor-wise (which would be great for kids / picky eaters) it was very fresh and light – a terrific change of pace from jarred sauce. Plus, I love learning a new cooking technique – and well, OK, using a grater isn’t actually a cooking ‘technique; but still, I’d never done it and didn’t quite believe it could work.

I mean, what does it mean, actually, to grate a tomato? Bizarre, right? Turns out it was easy and actually does work. Here’s how Mr. Tanis describes it in his Quick Fresh Tomato Sauce recipe – and it’s totally accurate: “Cut the tomatoes in halves or quarters. Squeeze out the seeds, or don’t (I never mind a few seeds in the sauce). Place the cut side against the large holes of the grater and gently rub until only the tomato skin remains in your hand.”  It actually worked and I was surprised to find it was kind of fun.

Here’s what it looked like while I was grating – and the resulting flat tomato skin, which made me giggle as it reminded me of Flat Stanley.

TomatoGrating TomatoesGrated









There’s a second recipe – for how to make the pasta dish using this quick fresh tomato sauce. Pasta With Fresh Tomato Sauce And Ricotta was an equally easy recipe and quite tasty.  It also held up well for lunch the next day – a winner in my book. Plus, the ricotta adds protein so this is a good meat-less dinner option, with the heart-healthy benefits of lycopene.

If you have fresh from the garden, sun-ripened tomatoes on hand, give this a whirl.  The recipe calls for 5 pounds of tomatoes which is A LOT – so I made a half batch and that worked fine.

BTW – in case you’re like me and don’t know how many tomatoes are in a pound, I looked it up. It’s about 3 ‘medium’ tomatoes to a pound. I had 6 tomatoes so halved the recipe – which isn’t exactly the right proportions, but exact measurements are not vital in this kind of recipe – close is good enough (which is why I much prefer cooking to baking!)

PastaFreshSauceRicotta_TanisHere’s how mine turned out – as I said, it was a little mild on taste (next time I’ll up the garlic and the red pepper!) and both my husband and I enjoyed it.

Click on the recipe links to see Mr. Tanis’ original article (with beautiful photos) or my recipe page has both of these recipes downloadable as a PDF: Pasta With Fresh Tomato Sauce and Ricotta…including Fresh Tomato Sauce.





Grilled Orange and Bourbon Salmon

With a name like “Grilled Orange-and-Bourbon Salmon” how could I not try this Cooking Light recipe? And I’m glad I did; it’s terrific. In fact, I prepared this recipe several times this summer — with both salmon and Arctic Char, of course — to test it out for a Cape Cod family vacation dinner-for-16 (yes, cooking dinner for 16 in an only-ok-equipped rental cottage should not be part of anyone’s vacation – but somehow it is for me!)

Grilled Orange and Bourbon SalmonHere’s what’s great about this recipe: it’s easy to make in general and for a crowd, it’s flavorful, and is a healthy choice. All 16 at our family dinner liked it – believable because there was none left!

Here’s what’s not so great about this recipe: it takes a lot of time to prepare the marinade – especially if you are doubling or tripling the marinade. There are oranges and lemons to juice and scallions, chives and garlic to chop. That might not sound like a lot (and it’s not difficult), but trust me, you need 45 minutes to 1 hour to prep this marinade. Just letting you know.

You can easily print the PDF from my Going Lo-Co Recipes page or grab the PDF here: Grilled Orange-and-Bourbon Salmon.  Oh, and some of the Cooking Light reviews suggested saving the marinade and cooking it down into a glaze which is likely delicious, though I didn’t try it but plan to, next time.

Now if you’re like me and are more of a vodka and wine person versus a bourbon person (OK, truth, I know not one thing about bourbon) there’s the liquor store to visit. Where they might sell you Jack Daniels – which may or may not technically be bourbon. Sigh. Twice I made this recipe with Jack because that’s what my liquor store guy sold me – and then when I made it at Cape Cod, I made it with Jim Beam bourbon (I know that’s bourbon because it’s printed on the label, LOL). While I preferred it made with Jim Beam, that might just be because I’d had a lot of wine by the time I finished all the chopping for the triple version of this recipe!

Since this whisky vs bourbon thing was kind of a big part of my experience with this recipe, I was going to include information about whisky vs bourbon but all the sites I visited to learn the difference between bourbon and whisky require you to enter your birthdate, so that would likely lead to broken links. Topline, bourbon appears to be somewhat sweeter as legally it must be made from a grain mixture that is at least 51% corn (bourbon/whisky people, if I’m wrong, feel free to correct me!). If you care for more details than that, search for bourbon vs whisky and research away. If you don’t care but want to try this recipe, go to a liquor store and get a small bottle of Jack or Jim – they’ll both be fine!

As for fish, I liked this with both salmon and Arctic Char, so take your pick. But do try it – especially now with the summer winding down – making this recipe in September will give you the opportunity to swill a bit of warming bourbon while grilling!


Arctic Char – Better Than Salmon

At the height of summer grilling season, you may be looking for an alternative to salmon. For those lucky enough to easily find it locally, Arctic Char is my grilled fish of choice.

Actually, it’s my cook-at-home-all-year-round fish of choice for three reasons:

  • It is easy to cook and tastes great – milder and creamier than salmon
  • Those who like salmon will likely also like Arctic Char – and even those who don’t care for salmon (I do not) might like char!
  • It is far less expensive than wild-caught salmon (and you know farm-raised salmon is an eco-no-no, right?)

I was stumped, recently, when a friend asked me what the difference was between Arctic Char and Salmon.  While there was some conflicting (and largely old) information on the internet, I’ve gleaned a few key facts about Arctic Char.

A member of the ‘salmonid’ family along with salmon and trout, char is a cold-water fish and nearly all of the US supply is farmed.  However, the environmentally friendly method used to farm char is completely different than farmed salmon; indeed, the Environmental Defense Fund (EDF) Seafood Selector gives char a “best” eco-rating and describes how char is sourced as follows:

  • “This member of the salmon family is an environmentally friendly alternative to farmed salmon.
  • Char are mostly raised in tanks and raceways onshore, unlike salmon which are generally raised in open netpens in coastal waters.
  • Onshore systems discharge less pollution and are much less likely to let fish and parasites escape than netpens.”

As many likely know, the EDF cites Atlantic and farmed salmon as an eco-rating of WORST. If you are one of the many who avoid Atlantic or farmed salmon entirely and have a local source who carries Arctic Char, you’ll be pleasantly surprised at both the taste and the price compared with wild salmon.


Artwork credit: www.fishchoice.com

As for nutrition, I had a little difficulty with conflicting information: some websites claimed Arctic Char is high in heart-healthy omega 3s but the EDF Seafood Selector does not give it the same high-rating in omega 3s as salmon. The best figure I came up with was to compare two articles on Dr. Andrew Weill’s site.  About char, he says, “a 3.5-ounce serving gives you one gram of omega-3 fatty acids and 182 calories.”  That is about HALF that of wild salmon, when compared with another quote from Dr. Weil’s site: “A 3-ounce serving of Alaskan salmon or herring contains about 2 grams of omega-3 fatty acids, while 3 ounces of sardines has about 1.3 grams.”  That said, I’ll take 1 gram of heart-heallty omega-3 with my protein over red meat any day.

As for taste, it happens that I far prefer char to salmon – though my husband likes both equally and finds them very similar. I agree with the broad description of mild flavor and delicate texture, and it tends to be less dense/chewy than salmon. Because of its high fat content (healthy fat!), it is easy to grill or bake without drying out – as long as you don’t over-cook it. I grill or bake it at 450 for about 12 minutes – see my Lo-Co Recipes page for a quick & easy recipe.

For more info on Arctic Char, beyond the EDF and Dr. Weill’s sites, I found these resources most helpful (and likely most reliable):

  • The very interesting and informative Artic Char page on the Fish Choice website was the most comprehensive and included a great ‘infographic’ which is where the illustration above is from. I wish that site had Omega-3 information as everything else was so clearly well documented on this site. This was also the only site that was updated in the past year or two!
  • The Arctic Char page on both the Seafood Choices Alliance and the New England Aquarium sites explain how Arctic Char live in the wild and how they are farmed
  • The Chef’s Resources site – which was new to me, but I will visit again as it was very useful – confirmed the rough amount of omega-3 (though it cited 1.3 grams for 3 oz of fish) and other useful background and how-to-cook information about Arctic Char.

You can substitute Arctic Char for any recipe that calls for salmon or trout; I’m fortunate my local fish market always carries char –  if yours does, throw some on the grill with a little olive-oil and herbs for a quick, delicious, heart-healthy meal.