The Shrimp and Cholesterol Connection

Posted on May 13, 2013 by KLS

For years, I’ve avoided shrimp because it’s high in dietary cholesterol. But when Answers.com asked me to write an article entitled, “Clarifying the Connection Between Shrimp and Cholesterol” I was stunned to find I’d been avoiding one of my favorite (and easy to prepare) foods for far too long.

Yes, it’s true – shrimp does have a lot of dietary cholesterol. Specifically, one serving of 4 large shrimp contains 42.5 milligrams of cholesterol (according to the NYU Langone Medical Center’s All About Shellfish).  And that 42.5 mg is about 20% of the 200 mg maximum dietary cholesterol recommended for those with high cholesterol or at risk for heart disease.  And that’s just the shrimp – not the butter that frequently accompanies it. (And who eats just 4 shrimp – you know you need to double it…)

So for years, high-cholesterol shrimp was a no-no.

But it turns out that dietary cholesterol is no longer believed to be a key factor when trying to lower overall cholesterol. In the fight to lower cholesterol, avoiding saturated fat and trans-fat is key.

And shrimp is a ZERO FAT protein.

Zero, people.

Oh, and it gets better.  Shrimp delivers cholesterol-lowering Omega-3 fatty acids to boot.

So go ahead — break out a cookbook or two and find a shrimp dish where the shrimp is grilled or sautéed in heart-healthy olive oil.  And if you’ve got a good recipe, please send it to me. I’m on the hunt now for easy-to-cook shrimp dinner recipes for my lo-co cookbook.

Share
Posted in daily | Tagged , , , | Leave a comment

Chewable Lipitor – Pfizer Targeting Kids with Cholesterol

Posted on April 16, 2013 by KLS

Lipitor, Pfizer’s blockbuster cholesterol-lowering statin medication, has been approved for use in children with heterozygous familial hypercholesterolemia in the US since 2002, according to Pharmafile. (FH is an “inherited disorder that leads to aggressive and premature cardiovascular disease”). And those with FH are likely in great need of Lipitor.

But FH is a pretty rare disease.  And Pfizer’s putting a lot of effort into chewable Lipitor.

Why?

Is Pfizer is positioning itself to profit – at the expense of children – by inducing pediatricians to more broadly prescribe Lipitor for children?

Perhaps.  And that is very distressing.

Pfizer gained approval in the EU to market a grape-flavored, lower-dose, chewable form of Lipitor — in exchange for patent extension of regular Lipitor (read, short-term profit). Indeed, according to Andrew Jack of the Financial Times,

“Pfizer could earn $800m after European Union countries extended exclusive rights to sell its top-selling drug Lipitor until summer next year, in exchange for tests that will provide a slightly modified form of the medicine to just a few thousand children.”

So Pfizer used the EU’s controversial pediatric regulations, “which were introduced in 2007 with the offer of extended exclusivity as a financial incentive to encourage drug companies to ensure they expanded testing of experimental medicines to include children,” for short-term financial gain.

Typical big pharma move. Totally legal. Much debate about ethics.

More worrisome is what could come down the road.

For there is potential for Pfizer to use the same agressive marketing tactics they have employed to induce over-medication of adult Americans with high cholesterol and no other heart disease risk factors…now with KIDS.

Of course, for those with FH who have a serious need for a statin to reduce cholesterol, that a chewable, grape-flavored version of Lipitor is available in the EU is good news.

But if chewable Lipitor for kids gets approved in the US, who will make sure that Pfizer won’t repeat the marketing strategy that’s been so successful with adults? Who will make sure they don’t resort to scare tactics to convince people – parents of KIDS with high cholesterol — that Lipitor is indicated when it perhaps is not?

Let’s hope if chewable Lipitor ever arrives in the US (and if it stays in the EU) that it’s limited to those who really need it – those with FH.  And that Pfizer will not look to profit on the backs of children who have high cholesterol but no other risk factors.

For more information on the risks and guidelines for cholesterol for children, see my recently published article on Answers.com, High Cholesterol in Children.

Share
Posted in daily | Tagged , , , , , | Leave a comment

Coffee – The good, the bad and the cholesterol-ugly

Posted on April 8, 2013 by KLS

Back in December 2011 I wrote a post, ‘Cholesterol-y Coffee,’ about the sad, sad fact that drinking unfiltered coffee has been shown to raise cholesterol. Specifically LDL (bad) cholesterol. As there have been recent updates on this topic (see my The Cholesterol-Coffee Connection article on Answers.com) I thought it was a good time for a Going Lo-Co coffee-cholesterol update.

First, some good news. A 2008 study published by the Harvard School of Public Health stated, “Drinking up to six cups a day of coffee is not associated with increased risk of death from any cause, or death from cancer or cardiovascular disease.”

Yay.

And it gets better: Catherine Pearson recently reported on The Huffington Post, “Researchers from Harvard University found that women who consumed two to three cups of caffeinated joe per day had a 15 percent lower risk of depression than non-coffee drinkers, while those who drank four-plus cups daily had a 20 percent lower risk.”

Indeed, there’s a surprisingly long list of potential health benefits from a daily dose of coffee. In the January 2012 Harvard Health Letter, the article “What Is It About Coffee” lists seven – count ‘em 7 — diseases that regular coffee drinking helps minimize. It also has a cool chart of how much caffeine is in tea vs Starbucks drinks (a perennial argument in my house). I highly recommend checking out this online Harvard Health article, it is well written and very informative.

All that said… there is STILL a problem for high cholesterol sufferers who drink unfiltered coffee. As Harvard’s Dr. van Dam explains, unfiltered coffee raises cholesterol:

“Coffee contains a substance called cafestol that is a potent stimulator of LDL cholesterol levels. Cafestolis found in the oily fraction of coffee, and when you brew coffee with a paper filter, the cafestol gets left behind in the filter. Other methods of coffee preparation, such as the boiled coffee common in Scandinavian countries, French press coffee, or Turkish coffee, are much higher in cafestol. So for people who have high cholesterol levels or who want to prevent having high cholesterol levels, it is better to choose paper filtered coffee or instant coffee, since they have much lower levels of cafestol than boiled or French press coffee.Espresso is somewhere in the middle; it has less cafestol than boiled or French press coffee, but more than paper filtered coffee.”

ChemexSo if you have high cholesterol and love your jolt of joe, make sure you’re drinking filtered coffee — either a classic American coffee pot with a filter or a single-serve Keurig machine or other single-serving coffee pod (the tiny pods have tiny filters inside -see my prior post for a photo!).  Or you could try the gorgeous Chemex pot my friend Jill recommended.  But you should toss the French press… and, sadly, minimize espresso drinks.

As for me, I think I need to switch to caffeinated coffee; that caffeine can help lower depression risk in women is startling, welcome news indeed.

Oh, and one more thing. I think I need to acquire this gorgeous Chemex coffee pot even though I love my Keurig machine.

Because you can’t have too many kitchen gadgets, right?

Share
Posted in daily | Tagged , , , , , , , , , | Leave a comment

Calculate Your Heart Attack Risk Online

Posted on March 25, 2013 by KLS

Did you know there are quick, easy-to-use, online calculators that will tell you how likely you are to have a heart attack in the next 10 years?

There are several, in fact.  Most of these online risk calculators are based on the Framingham risk score, which assesses heart disease risk in the next 10 years based on six pieces of information: age, sex, total cholesterol, HDL cholesterol, smoking status and systolic blood pressure.

The Reynolds risk score goes beyond the Framingham risk score.  In addition to all the factors required by the Framingham risk score, the Reynolds risk score asks for C-reactive protein test results (which are not included in a typical lipid panel) and whether a parent had a heart attack before age 60.

While these online calculators are certainly not the be all and end all, they can be very handy in discussing with your doctor whether (and how long) you can manage high cholesterol without turning to statin Rx medication.  You can read about how these heart disease risk calculators work and where to find them online in my recently published article on Answers.com: Calculating Heart Disease Risk.

Share
Posted in Cholesterol Test Results | Tagged , , , , , , , , | Leave a comment

Grapefruit Pros and Cons

Posted on March 19, 2013 by KLS

In all the ‘bazillion ways to lower cholesterol’ lists I’ve read, not once did I see grapefruit listed. Well, it may have been listed (I don’t like grapefruit so it’s entirely possible likely I, um, skipped by it) but grapefruit is certainly not prominent on any list of foods that can help lower cholesterol.

And yet, apparently, it should be.

At least according to a 2006 (small) Israeli study posted online in the Journal of Agricultural and Food Chemistry. While the study is a few years old and included just  57 people, these were a pretty motivated group IMHO: they’d been unsuccessful lowering cholesterol with Rx statins, had suffered through heart surgery and still needed to reduce their cholesterol. My gut tells me they were a pretty compliant group.

WebMd’s Grapefruit May Improve Cholesterol article explains this study and its results:

“The researchers split the patients into three groups. For 30 days, all groups ate a low-calorie, low-fat diet. One group added a daily red grapefruit. Another group got a white grapefruit every day. For comparison, the third group didn’t eat any grapefruit during the study.

The red grapefruit group improved their cholesterol most, followed by the white grapefruit group. They ended up with notably lower total cholesterol and LDL (“bad” cholesterol) than the comparison group.

The red grapefruit group also improved their triglycerides (blood fats). Triglycerides didn’t change much for the other two groups.”

Red grapefruit alone seems to have lowered LDL (bad) cholesterol and tryigycerides!

Why is this barely out there?  Why, if grapefruit – grapefruit, people – can help lower cholesterol, why is this not widely touted?

It must be because grapefruit can cause serious medical issues IF it’s consumed along with one of many, many medications (the list – see quote below – is startlingly long and broad).

As explained in my recent Answers.com article, ‘Grapefruit Danger‘, the juice of grapefruit changes the rate certain drugs are absorbed into the bloodstream. With several cholesterol-lowering drugs, grapefruit juice can boost the level of statin to potentially dangerous levels.

However, it’s not just statins that interact with grapefruit.

Shela Gorinstein, PhD, one of the authors of the above Israeli study says, “…remember to check with your doctor first if you take any medicine, even if it’s not a cholesterol-lowering drug. Other types of medications that can interact with grapefruit juice include drugs for blood pressure, heart rhythm, depression, anxiety, HIV, immunosuppression, allergies, impotence, and seizures.”

Because grapefruit juice interacts with such a broad variety of prescription medication, my guess is that it’s been intentionally omitted from the lists of cholesterol-lowering foods. Which is understandable, I guess – but a huge shame.  Because for those of us not on any Rx meds, maybe grapefruit can keep us off statins!

As I don’t take any prescription meds other than Nexium (which is not on the many-drugs-grapefruit-interacts-with-list), I think I’m going to try me some red grapefruit.

Even though I despise its puckery taste.

Because if I can lower my triglycerides with grapefruit, I can eliminate my nightly wine misgivings. And puckery in the morning is a small price to pay for guilt-free wine in the evening.

I wonder if I can put my Metamucil in red grapefruit juice?  I’ll have to get back to you on that.

 

Share
Posted in daily | Tagged , , , , , | Leave a comment

New Role: Cholesterol ‘Expert’ for Answers.com

Posted on March 13, 2013 by KLS

A few months ago, I got an email from the online behemoth Answers.com about this very blog: they liked Going Lo-Co (!!) and asked if I’d be interested in becoming an Answers.com category expert. After a writing test, an editing test, and much back-and-forthing, I am pleased to announce that I am now publishing articles as the cholesterol ‘category expert’ on Answers.com.

Check out the Answers.com overall cholesterol page; it has many useful articles, a few I’ve written and many written by others.  It’s a good place to learn more about cholesterol.

Want to know more about me? Check out my ‘Cholesterol Expert Profile Page’ on Answers.com. There you’ll find a bit more about my ‘expert’ background, as well as a Q&A explaining why I write about cholesterol.

And finally, here are links to the first five articles I published on Answers.com:

I’ve created a new page on Going Lo-Co, and will publish links to all my Answers.com articles on the new Going Lo-Co Answers.com Expert page.

Share
Posted in daily | Tagged , , | Leave a comment

I love me some nutrition graphs

Posted on February 22, 2013 by KLS

My last post was about how MyFitnessPal actually improved my eating habits. And I’m happy to report that by using this app, I managed to (relatively easily) lose the extra 4 pounds that somehow materialized over the holidays.  Seems my last post was aptly titled, “I heart My Fitness Pal.”

So I’ve been using – and loving – this easy-to-use app for a few months, but hadn’t realized until today that it also boasts some very cool reporting tools! (Many will feel that ‘cool’ and ‘reporting tools’ are oxymoronic, but I am proudly nerdly.)

You may recall that one of the things I loved about MFP (I just really can’t keep typing the word ‘pal’ with a straight face) is that it showed how much cholesterol I consumed in a day, without me making any effort – none at all-  to find this measure.  Probably I was happy because I was pleasantly surprised at my results.

But today I found a new level of analysis that made me grin. On the web version of MFP, I hit ‘report’ and was stunned to find that MFP tracks & graphs things like cholesterol and total fat and fiber.  It shows all of what I’ve eaten in the past 2 months – in a bar chart. How cool is that?

And while my ingest-able cholesterol (I am sure that’s not a term, but I’m going with it) is better than I expected, my graphs pointed out a few…um…areas for improvement.

Let’s start with the Nutrition – Cholesterol Guidelines posted on The Cleveland Clinic’s well-done site. I’ve excerpted their daily guidelines here – this chart below is based on an 1,800 calories per day diet; my goal’s more like 1,200-1,500 but I’m ignoring that and using these daily recommended figures anyway:

Dietary Guidelines

 

 

 

 

 

Here’s why I’m happy – check out MFP’s graph of my cholesterol – other than 3 outlier days, I was way, way lower (OK, just lower) than the 200 milligrams/day recommended!

Cholesterol Consumed

So I was feeling pretty good.  Until I downloaded graphs for ALL of the measures in the guidelines above.  Some were good, some not so good.  I won’t bore you with them all. Here’s the topline: though I’ve lost 4 lbs and am not eating a lot of dietary cholesterol (yay), I am eating too much fat and protein, and nowhere near enough fiber (sad face).

The fiber graph is particularly sad – goal is 20-30 grams and I’m under 2o nearly every day. Sigh.

FIber

So, MyFitnessPal has been a big help in changing my habits and losing some weight – and ‘forcing’ me to exercise daily (so I get to have my glass or wine with dinner without exceeding my daily calorie goal.)  But now that I’ve used the ‘reports’ function, I see I need to make some further dining modifications.

Looks like I’ll be heading to WalMart for some more Metamucil.

And trying to add more leafy greens (ugh, salad) to my dinner plate.

Share
Posted in daily | Tagged , , , , | Leave a comment

I heart My Fitness Pal

Posted on January 22, 2013 by KLS

Apologies for the lame post title, but I thought it fit with the lameness of the name of my new favorite app: My Fitness Pal. Why Mike and Albert Lee, the brothers-developers who created this wildly handy app, thought the word ‘pal’ was a good idea I’ll probably never know. But in the end I don’t care – because this app is awesome.

Though I will admit to the need of dropping a few post-holiday pounds, I was not in the market for an exercise or food tracking tool. I like love technology, sure, but the thought of tapping into my iPhone every single morsel of food that passed my lips sounded…let’s just say less than fun.

What made me try My Fitness Pal was this cholesterol-compelling NYT article. The opening paragraph made me both LOL (literally) AND groan with recognition (cross outs are mine):

“When I received the results of a routine cholesterol test this summer, I was certain there had been some kind of mistake.  I’m young, unstressed and healthy, or so I imagined. I work out, too, and most impartial observers — and some partial ones — would describe me as lean. Plus, I eat a nutritious diet, I swear. So why did my LDL levels surpass my I.Q. — or, for that matter, Einstein’s?

The facts were stark: My genes predisposed me…”

Read the whole article here.  It was page 2 that sold me on the (sadly-named) app where the author describes My Fitness Pal’s enormous food database. And I concur – it is EASY AS PIE (sorry) to find and enter meals and snacks.  Truly.

In the ten days I’ve used this app I’ve lost 2 pounds (!) but best of all, I’ve made different (better, more low cholesterol) food choices – and felt good great about it.

Like, I went to Wendy’s and ordered a (gasp) salad.

This has NEVER happened before. Two years of blogging about adopting a more lo-co lifestyle and every time I lunched at Wendy’s I still ordered my traditional single hamburger, small fries and small chocolate Frostee (and I don’t finish the fries or Frostee). Yes, they have salads and baked potatoes, but NO I never once ordered one. Instead I just tried to limit how often I went. Rather unsuccessfully. Then felt the guilt.

But MyFitnessPal caused me to alter my order.

What happened was this. There was a long line at Wendy’s so to pass the time, I used MyFitnessPal to type in what I considered my pretty-low-fat-for-fast-food typical order. I was horrified to find it had over 1,000 calories (my goal for the day was 1,500 calories!) and 128 grams of cholesterol.

YIKES!

If that’s what’s in my teeny tiny order, how many calories and cholesterol are in the double bacon and other burgers? No wonder America has an obesity problem.

So, still in line, I studied the ‘Healthy Choices’ posters and typed Apple Pecan Chicken Salad into iPhone’s MyFitnessPal app. This healthy choice has just 340 calories and 55 grams of cholesterol: much more appropriate to lunch (meaning, only 1/3 of my goal calories for the day). Not to mention, it was a far more lo-co choice than my usual.

So I ordered the salad, which is topped with WARM CHICKEN (the only way I’ll eat a salad – something  has to be hot!) and some blue cheese, and was shocked to find it was delicious pretty tasty.

And that smug feeling as I looked around at the overweight diners eating enormous burgers?  Priceless.

My MyFitnessPal victory (see, it’s just a bad name, all around) was not limited to this solo outing.  At dinner last night at our local diner, I tried Multigrain Pancakes instead of my usual 2 eggs-over-easy on whole wheat toast (no butter) with sausage links and home fries.  Didn’t love it, but loved that I’d made a  healthier dining out food choice twice in one week.

Astonishing.  I guess knowledge really is, um, power.

Another great thing about MyFitnessPal is that it helped me exercise every day. Yes, I know I’m supposed to exercise daily – and I do, a lot, but, well, never DAILY.  But I have for 10 days in a row. Why, you ask? Well, when you put in your desired weight loss you get a calorie goal for the day and you get more calories when you exercise. I wanted needed those calories for wine. And it worked. Daily exercise meant I got to have wine, guilt-free, every night and still be at my calorie (and cholesterol) limit. Frankly, I can’t remember the last time I exercised for 10 days in a row.

One last great thing about My Fitness Pal: this easy-to-use app helped me see just how lo-co my daily diet is – and the answer was surprisingly low cholesterol except for the eggs and sausage diner order.  That felt great.

For weight loss AND cholesterol counting, I can’t think of a single thing I’ve done in the past two years that I had more fun using & was more motivating than My Fitness Pal.

Oh, wait – I forgot.  The really great one last thing about My Fitness Pal – IT’S FREE.

Share
Posted in daily | Tagged , , , , , , , , , | 2 Comments

Statin, statin, do you really need a statin?

Posted on January 2, 2013 by KLS

At my family’s annual holiday party, I was again stunned at the fact that all of my blood relatives my age or older take statins to lower cholesterol.

All. Of. Them.

Even though none are overweight and we do not have a family history of cardiac disease. Yes, we do have a family history of high cholesterol; all of us have cholesterol levels that top out at well over 200. But our family history is rife with high cholesterol, not heart disease.

So why? Why has every single one of my relatives heeded their internist or GP’s advice and gone on a statin to lower cholesterol when they don’t have other cardiac risk factors?

Am I the crazy one?

Sometimes I think so (and others might agree) but I spent a few hours researching this topic – again – and found two compelling articles supporting my fight to stay off Lipitor. Two articles that suggest that managing my cholesterol to a level my doctor is unhappy with – but not so unhappy she insists on Lipitor – is the non-crazy route.

Because there are side effects, people. Some serious.

It turns out that my family is not alone in their ‘don’t question the doctor, just take the pill’ stance. I was startled to find that 30 million American adults are on statins.  That’s roughly TWENTY-FIVE PERCENT of Americans aged 45 and older taking statins!

That many people must be right, right?

Or not.

Here’s why I think my family – and maybe a lot of these 30 million American adults on statins — should reconsider their statin use, or at least discuss it with their doctor.

In the May/June 2012 issue of The Saturday Evening Post, Sharon Begley explains in ‘The Cholesterol Conundrum‘ that widely respected cardiologist Eric Topol feels that

“…only one or two out of 100 patients “without prior heart disease but at risk for developing such a condition will actually benefit” from a statin.”

And further, Topol has long believed that, “medicine must become personalized with treatments tailored to a patient’s DNA and other characteristics. Yet statins are the poster child of taking a drug that benefits some people and then prescribing it to many more.”

This compelling, easy to understand article explains why statins, which have proven very effective for patients WITH heart disease already, should NOT be prescribed for those without pre-existing heart disease.

Um.  Like me.  And my family.

Please read Ms. Begley’s article.  The entire thing.  It’s eye-opening.

Further evidence: in an August 2011 Huffington Post article, “Are Cholesterol Medications Just a Scam?” Dr. Jacob Teitelbaum lays out a similar argument:

“…if you already have Cardiovascular disease (CVD), an LDL-lowering statin might save your life through what medical experts call ‘secondary prevention.’

But most people who take statins haven’t been diagnosed with CVD. A blood test simply showed they had high cholesterol, and their doctor prescribed a statin to prevent a heart attack or stroke — a use medical experts call primary prevention. Shockingly, a new scientific review of 14 studies shows that statins are virtually useless for primary prevention.”

He goes on to explain that some had issues with analysis of these 14 studies: “the meta-analysis was published by The Cochrane Collaboration, one of the most respected scientific reviews in the world… it’s important to note that the UK researchers faulted the studies in several areas.”  But to me, upon reading the issues, it seems clear that this analysis — along with the one cited earlier — indicate a real need to at least DISCUSS the benefits of statins for those without known cardiac disease with a doctor.

I’ll be sending this to all my relatives, urging them to talk to their doctor about their personal situation.  And hoping at least some will get a ‘hey, maybe you don’t need a statin,’ answer.

Share
Posted in daily | Tagged , , , , | Leave a comment

Going Lo-Co Turkey Chili

Posted on December 4, 2012 by KLS

A recipe for using up leftover turkey would have been better timed last week, so I will start this post with apologies.

That said, I almost never make this Turkey Chili with leftover turkey – I use ground turkey as I make it year round.

The reason I’m posting it now is that a friend emailed this morning, asking for a recipe recommendation.  Her neighbor is having some health issues and she wants to bring over a family dinner.

I can’t believe in the 2+ years I’ve been writing this blog that I’ve never before posted my go-to recipe for “bring to a friend family dish.” So here goes.

My Going Lo-Co Turkey Chili recipe, adapted from a 2003 Cooking Light recipe, is easy to make, healthy(ish,), kids love it because it’s not spicy AND I serve it with Tostitos Scoops. Plus it freezes well. All that, and you can make a double batch and have dinner for your family as well.  What more could you ask for?

The ingredient list is long but don’t be daunted – the hardest thing about this recipe is opening cans. Seriously. And usually, I don’t cook with canned veggies but for some reason it works well in this dish.

So next time you want to bring family dinner to a friend, try this Turkey Chili recipe. Bring it over along with a bag of (reduced fat) shredded cheddar, a carton of (reduced fat) sour cream, and a bag of tortilla chips.

Seriously, don’t forget the tortilla chips.

 

Share
Posted in daily, recipes | Tagged , , , | 2 Comments