Creamer vs Creamer vs Creamer

Several years ago, lured by labels with lower levels of saturated fat and cholesterol, I ditched traditional Half & Half for soy creamer in my 2-cups-a-day hazelnut coffee habit.

It might not have been the right decision.

Or it might have been the right decision – but only for one particular soy creamer brand.

In reading the many articles about how even though the FDA has banned trans fats in the American food supply, they are lurking in many foods.  In fact, coffee creamers are one key culprit: non-dairy creamers (and other foods) can be labeled as containing 0g trans fat PER SERVING when in fact if you eat more than 1 serving (very likely) you will be consuming real amounts of trans fats.  This happens because, as Prevention author Caroline Praderio explains,

“Manufacturers are allowed to say a food contains no trans fat if each serving has 0.5 g or less. But eat more than one serving size of, say, chips—and really, who sticks to nine measly chips?—and you could be eating 2 g or more of trans fat in no time, which is over the limit for good health, according to the World Health Organization.”

Articles like this abound:

This propelled me to reconsider my Half & Half versus Soy Creamer decision. I compared the nutritional labels for Land O Lakes Half & Half and compared them with the two soy creamers I purchase: Silk Soy Creamer and Trader Joe’s Soy Creamer.  While I was not surprised to find that the soy creamers both delivered significantly less saturated fat per serving (a lo-co plus), there was a big difference between the two soy creamers.

This shocked me.

The chart below shows the nutritional values per serving pulled directly from the product label this morning (website or actual label) and to the right of that I’ve included what a 3 TB serving of each delivers.  Both soy creamers had dramatically less cholesterol and saturated fat.  But Silk Soy Creamer has 1.5 grams of saturated fat in a 3 TB serving while Trader Joe’s Soy Creamer has zero.

HalfHalfvsSoyCreamer

Why the difference?  A quick comparison of ingredient listings shows the reason:  Silk Soy Creamer uses PALM OIL while Trader Joe’s uses CANOLA OIL:

Silk Soy Creamer Ingredients: Soymilk (Filtered Water, Whole Soybeans), Palm Oil, Cane Sugar, Maltodextrin (from Corn), Soy Lecithin, Potassium Phosphate, Sodium Citrate, Tapioca Starch, Carrageenan, Natural Flavor.

Trader Joe’s Soy Creamer Ingredients: Organic soybase (filtered water, whole organic soybeans), expeller pressed organic canola oil, organic cane sugar, organic maltodextrin (from corn), potassium phosphate, soy lecithin, natural flavors, carageenan, sodium citrate, organic tapioca starch.

Palm oil is not considered a heart-healthy oil. In NPR’s Palm Oil In The Food Supply: What You Should Know, Allison Aubrey explains, “There are environmental concerns about how palm oil is produced. And what’s more, from a health perspective, palm oil is high in saturated fat.”

Ah. So the fact that Silk Soy Creamer uses Palm Oil, which is a SATURATED FAT explains why a 3 TB serving of Silk Soy Creamers has 1.5g of saturated fat, versus the 0g of saturated fat from Trader Joe’s Soy Creamer – which uses Canola Oil, a more heart-healthy oil according to many (though not Dr. Andrew Weill, but that’s another story).

While I’m shocked by this huge difference in what I thought were comparable products, I now know to pay more attention to the specific ingredient listings rather than assume a product like a soy creamer is healthier than full fat half & half, and that all soy creamers are equivalent.

To that end, I searched for a handy tool for what oils are more heart-healthy – as I can’t ever seem to remember which are the oils to use and which are the oils to avoid (just this week I stood perplexed in the grocery store wondering which is the most heart-healthy oil for popping corn and left with nothing.)

The Cleveland Clinic obliged with an article, Heart-Healthy Cooking: Oils 101 which confirmed the goal of AVOIDING PALM OIL and where I learned that I should have purchased canola oil for corn popping (I also learned that I need to bring reading glasses to the grocery store to read my iPhone). This article is wildly helpful, actually, with oils by smoke point and information on how to store and use oils.

In fact, on the Heart-Healthy Cooking Oils page, there’s an infographic where you can download a very handy tool with best oils for:

ClevelandClinicTopHeartHealthyOilsInfographic

  • Browning, Searing and Pan-Frying: almond, sunflower, canola, and olive
  • Stir-Frying, Baking and Oven Cooking: canola, grapeseed, and peanut
  • Sauteeing and Sauce Making: olive, walnut, and sesame
  • Dressing, Dips and Marinades: olive, toasted sesame, flaxseed, walnut, and avocado
  • Best All Around: extra virgin olive oil

You can click on the graphic to download the handy PDF or by clicking on this graphic in the Cleveland Clinic article.

In th end, I guess I’m happy that I switched to soy creamer as I still believe it best to avoid full-fat dairy in my quest to keep my cholesterol down via a healthy diet and exercise.

But now I need to choose only Trader Joe’s Soy Creamer so I can avoid palm oil. Oh, and bring my reading glasses to the grocery store in case Trader Joe’s is out of soy creamer.

Share

Peas For The Holidays

Looking for something green – and healthy – for your holiday table? Have you considered peas?

Yes, peas. Don’t scoff. I know you want to. I know I did. But this past Sunday I was at a dinner party where my friend Tina served up an outrageous pea dish.

Outrageous. Pea. Dish.

Nope. Not an oxymoron.

To be honest, mashed peas is a dish I had never before eaten, much less cooked. Frankly, the idea of mashed peas did not appeal. Actually it had never even occurred to me.

But Tina’s mashed peas were a revelation.

Healthy and delicious, check. Great for those of us leading lo-co lifestyles. But more than that, this dish is festive and fun. This recipe delivers peas that are a wonderfully vibrant green. So tantalizing were these peas in both taste and appearance that I plan to serve them for Christmas Eve and/or Christmas dinner.

My friend Tina found the recipe on Alex’s Kitchen column on House Beautiful.  The recipe is titled, Alex Hitz’s Roast Leg of Lamb and Mashed Peas.

Mashed Peas – serves 4-5 (recipe says serves 8)

  • 1 package frozen peas (16 oz.) – but see notes below
  • 1 package frozen peas and pearl onions (16 oz.) – but see notes below
  • 2 tablespoons heavy cream
  • 2 tablespoons salted butter, melted
  • 1/4 tsp. salt
  • 1/8 tsp. ground black pepper
  1. In two separate small saucepans (or in a microwave) thaw the frozen peas, and the frozen peas and pearl onions over low heat until just warm.
  2. In a food processor fitted with a metal blade, puree the peas and heavy cream until smooth. Do not puree the peas and pearl onions.
  3. In a medium-size mixing bowl, stir the pureed peas into the whole peas and pearl onions, along with the melted butter, salt, and pepper. Transfer mixture to a covered baking dish and reheat in a 350 degree oven.

Tina’s Cooking Notes:

  • This is not enough for eight people. To adjust, puree one package of peas and then add 1 1/2 packages of peas and most of a whole package of pearl onions. (Note: this is the adjustment my friend Tina made; you could probably make alternate adjustments but I can vouch that this adjustment was excellent.)
  • If you do not have salted butter, just add a bit more salt.
  • For fewer pots to clean and ease in general, thaw the peas in the microwave instead of using two saucepans.

While it’s not ideal that this dish uses both heavy cream and butter, the quantities of these high fat ingredients are small. In fact, compared with other high-fat holiday side dishes, I’d argue this mashed peas recipe is quite a good lo-co holiday option.

I’m headed out to the store to buy peas, pearl onions and heavy cream so I can test this side dish out pre-Christmas Eve. I’ll let you know how it turns out.

Share

Statins Reduce Flu Vaccine Effectiveness

If you take a cholesterol-lowering statin medication like Lipitor, you are likely familiar with statin side effects, including muscle issues and potential liver damage.

But did you know that taking a statin reduces the effectiveness of the flu vaccine?

Two new studies recently made that discovery. The studies were not small: four countries were involved, including the US, and almost 7,000 adults were evaluated. These two research studies concluded that adults who take statin medications had significantly reduced immune responses to the flu shot, compared with those who do not take statins. As well, the effectiveness at preventing serious respiratory illness was lower among adults taking statins.

In Medical News Today’s Flu Vaccine Effectiveness Reduced by Use of Statins article, the author explains:

“Statin users were found to have a significantly reduced immune response to vaccination compared with those not taking statins, as measured by the level of antibodies to the flu vaccine strains in patients’ blood 3 weeks after vaccination.

The effect was most dramatic in patients on synthetic rather than naturally derived statins.”

As millions of Americans over age 65 take cholesterol-lowering statins – and the flu can be very dangerous for older adults –  this diminished effectiveness of the flu vaccine is a significant, widespread concern.

Of course, this new finding does NOT mean that if you take a statin medication like Lipitor that you should not bother with the flu shot. Rather, it means you should do everything you can to enhance the flu shot’s effectiveness — for example, get the flu shot early in the season, and take extra precautions – don’t assume that since you got the flu shot that you can’t get the flu!

So if you must take a statin because you have had a cardiac event or you and your doctor have calculated your risk and statins are indicated (more info at Why You Should Use the New Cholesterol Guideline Calculator), please be careful this flu season.

But if you are on the fence about statin use for your particular medical situation, perhaps this newly discovered additional downside to statins is something to discuss with your doctor.

 

Share

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

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.

Eileen

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.

Share

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 (AHA) 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 exasperating – this is an ONLINE instrument and should be current. I found exactly one article on AHA’s site (their blog, actually) called FDA Approves New Cholesterol Drug. In a nutshell, what the AHA said about the new class of drugs is that MAYBE WE SHOULD THINK ABOUT IT VIS-A-VIS OUR GUIDELINES? (emphasis mine, obviously.)

Seriously? That’s it, AHA? Very disappointing. Here’s a quote from that article:

“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” 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 on treatment 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’ are 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 two 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.

**************

RESOURCE: CALCULATING YOUR CARDIOVASCULAR RISK:

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.

For reference, here’s a summary of my personal 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.”

Share