Instead Of Emphasizing One Nutrient We Need To Move To Food
Dariush Mozaffarian, dean of the Friedman School of Nutrition, Tufts University and adjunct associate professor of epidemiology
In 1997, HSPHs Frank Huat the time a postdoctoral fellow at HSPH, now professor of nutrition and epidemiology published a landmark epidemiological study in theNew England Journal of Medicine. Hus report told a more subtle story about dietary fat and heart disease. His data, collected from 80,082 women enrolled in the long-running Nurses Health Studya collaboration by HSPH, Harvard Medical School, and Brigham and Womens Hospital suggested that replacing a mere 5 percent of saturated fat calories with unsaturated fat would reduce ones risk of heart disease by a whopping 42 percent. Replacing only 2 percent of trans-fat calories with unsaturated fat would reduce ones risk of heart disease by 53 percent. In other words, it wasnt total fat that mattered, but type of fat.
The discovery was so surprising that The New York Times splashed it on Page 1.
This was really a paradigm shift in terms of the fat message, says Hu. Not all fats are created equal. Dariush Mozaffarian, newly named dean of the Friedman School of Nutrition at Tufts University, notes that in 2005, an updated report from the Nurses Health Study by Hu and other HSPH researchers showed that neither overall fat, saturated fat, nor monounsaturated fat intake was linked to heart disease. Polyunsaturated fat intake, however, was found to be clearly protective.
Blood Sampling And Analysis
Blood samples were taken in duplicate on consecutive days after the run-in period and at the end of each intervention period from fasting study subjects. Values from each set of samples were averaged. Besides fasting for 12 h, study subjects were asked to refrain from smoking for 12 h as well as from performing any extreme sports for 36 h. Furthermore, study subjects were asked not to drink alcohol or take medicine for 24 h before the blood sampling.
Blood samples were drawn for measurements of serum blood lipids , hsCRP, serum insulin, and plasma glucose. Blood samples for measurement of blood lipids, hsCRP, and insulin were collected into dry tubes, and samples for glucose were collected into tubes with a 1 × 3 mLfluoride citrate mixture. Blood samples were kept at room temperature for 30 min to coagulate. Subsequently, samples for measurements of blood lipids, hsCRP, and insulin were centrifuged at 2300 × g for 10 min at 4°C and stored at 80°C until analyzed. Samples for glucose were centrifuged at 2300 × g for 10 min at 20°C and stored at 80°C until analyzed.
Serum C-reactive protein concentrations were measured by using a latex immunoturbidimetry analysis . Serum CRP concentrations were analyzed by using an ABX Pentra 400 Chemistry Analyzer . Interassay and intra-assay CVs for CRP were 6.5% and 1.9%, respectively.
Insulin resistance was calculated by using HOMA with the following formula :
A Complicated Message Gets Oversimplified
Unfortunately, amid all these nuanced research results, during the 1980s and 1990s conventional wisdom and national guidelines in the U.S. shifted the spotlight to reducing total fatperioddespite little or no evidence that this simplistic advice would prevent disease.
The complicated messagethat some fats are good for you and others are baddidnt reach the general public. Instead, doctors and scientists running the National Heart, Lung and Blood Institutes National Cholesterol Education Program in the mid-1980s decided to simplify it, explains Lilian Cheung, director of health promotion and communication in the HSPH Department of Nutrition. They thought of a shortcut: Just cut down fat.
In 1987, the Henry J. Kaiser Family Foundation launched a social marketing campaign called Project LEAN , encouraging Americans to reduce total fat intake to 30 percent of their diet, and spreading the message through advertising and supermarket promotions. The public ate it up, so to speak. Theres a simplistic, intuitive appeal to that message: Fat has more calories per gram, so if I eat fat, Ill get fat, says Willett. The food industry jumped on board, removing fat from food and replacing it with sugar and carbohydrates, filling supermarket shelves with fat-free salad dressing, fat-free ice cream, and low-fat SnackWells cookies.
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Food Supplements That Do Not Help With Cholesterol
Many extracts and supplements have been promoted for their overall health benefits and lipid-lowering effects, but do they work?
We reviewed the available scientific research and found that the following supplements had no good evidence to support those claims:
Selenium: Supplements may help lower cholesterol in people with low levels of selenium, but not in people with normal levels of selenium. There is not enough scientific evidence to say that selenium protects against cardiovascular disease.
Calcium: Results here are mixed, but the bottom line is calcium supplementation does not improve cholesterol levels.
Garlic supplements: Raw, powdered, and aged garlic supplements had no effect on cholesterol levels.
Policosanol: This substance, which is extracted from sugar cane wax, did not improve cholesterol.
Coconut oil supplements: There is mixed evidence about the cardiovascular benefits or harm of coconut oil. It is not an evidence-based alternative treatment for high cholesterol levels.
Coconut water: There is no high-quality data about coconut water improving cholesterol levels.
Resveratrol supplements: There is no evidence that these improve cholesterol levels in humans.
Soy isoflavones supplements: Taking supplements of soy isoflavones does not improve cholesterol levels.
Cholesterol Myths And Facts
Cholesterol can be confusing! Learn answers to common questions about blood cholesterol.
What do your cholesterol numbers mean? Can the foods you eat change your cholesterol levels?
Learn the difference between cholesterol myth and fact. Then commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
Commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
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Is Butter Good For You
Despite sensationalist news headlines and one-off pieces of research, the bulk of the evidence still proves that diets lower in saturated fat reduce our risk of heart disease.
The link between a higher intake of saturated fats, elevated blood cholesterol and heart disease is well established.
The current body of evidence supports replacing saturated fats with unsaturated fats to reduce the risk of heart disease. Therefore, the Heart Foundations position remains the same that we should continue to replace saturated fats in our diets with unsaturated fats.
Its Hard To Pinpoint Exactly When Fat Started To Become The Enemy On Our Plate But A Good Guess May Be January 13 1961
Keys work provided some hints about the culprit behind this yawning gap. He found that saturated fat consumption was strongly associated with regional rates of heart disease, but that total fat intake was not. Indeed, total fat intake in Crete was just as high as in Finland, which had the highest rates of heart disease at that time. Keys suggested that it was the type of fat, as well as the Mediterranean diet in general, that spelled the difference in heart disease risk.
Keys delivered his opinions with the force of fact. He found that nations where people ate lots of saturated fatthink of the Finns smearing butter on their cheesesuffered higher rates of heart disease. Keys work also suggested that diets high in saturated fat and cholesterol increased total cholesterol levels.
Yet based on the well-recognized limitations of cross-country studies, Keys was smart enough to conclude that this early evidence did not prove cause and effect, but rather suggested a need for further research, especially in cohort studies examining individuals within populations. Indeed, many better-designed studies have since proven that total dietary fat has no effect on heart disease.
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Swap Out Ice Cream For Fresh Fruit
According to the U.S. Department of Agriculture , the United States produced 49.9 million gallons of full-fat ice cream in 2019, up nearly 14 percent from the year before. The cold, sweet stuff is a staple in many American households. But did you know that a single cup of ice cream has more fat than a hamburger and almost double the saturated fat of a glazed doughnut? Skip the scoop and try a cup of fresh fruit for dessert instead. Fruit is low in calories and high in the fiber, vitamins, and nutrients you really need making it one of the best things you can eat to reduce the amount of cholesterol youre consuming.
What Causes High Cholesterol
Some causes of high blood cholesterol include:
- Low intake of foods containing healthy fats healthy fats tend to increase the good cholesterol.
- High intake of foods containing unhealthy fats such as fatty meats, full-fat dairy products, butter, coconut oil, palm oil and most deep-fried takeaway foods and commercially baked products . Foods high in trans-fats include most commercially baked products and deep-fried takeaway foods.
- Low intake of foods containing fibre foods that are high in dietary fibre, particularly soluble fibre, can reduce the amount of LDL cholesterol in your blood. Include fibre-containing foods in your diet by choosing vegetables, fruits, wholegrains, nuts and seeds every day.
- Cholesterol in food this has only a small effect on LDL cholesterol -saturated fats and trans-fats in food have a much greater effect.
- You can also eat up to 7 eggs a week as part of a healthy, balanced diet low in saturated and trans-fats, without increasing your risk of heart disease.
Some people will have high cholesterol even if they follow a healthy, balanced diet low in saturated fats and trans-fats. These people may need to take cholesterol-lowering medicine as prescribed by their doctor.
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Misconception: Only Men Need To Worry About Cholesterol
Both men and women tend to see higher triglyceride and cholesterol levels as they get older. Although atherosclerosis typically occurs later in women than men, cardiovascular disease remains the leading cause of death in women. Weight gain also contributes to higher levels.
Premenopausal women may have some protection from high LDL levels of cholesterol, compared to men. Thats because the female hormone estrogen is highest during the childbearing years and it tends to raise HDL cholesterol levels. This may help explain why premenopausal women are usually protected from developing heart disease.
But cholesterol levels can still rise in postmenopausal women, despite a heart-healthy diet and regular physical activity. So women nearing menopause should have their cholesterol levels checked and talk with their doctor about their risk factors and treatment options.
At one time, it was thought that hormone replacement therapy might lower a womans risk of heart disease and stroke. But studies have shown that HRT doesn’t reduce the risk of heart disease and stroke in postmenopausal women. The American Heart Association doesn’t endorse HRT as a means to lower cardiovascular risks.
Doctors should consider women-specific conditions, such as premature menopause and pregnancy-associated conditions, when discussing their cholesterol levels and potential treatment options.
Focusing On Foods Not Nutrients
But theres a deeper issue beyond the recent media ruckus, explains Mozaffarian. The findings demonstrate that, in practice, when people lower their saturated fat intake, they dont necessarily eat healthier diets. Saturated fat is found in a range of foodsincluding not only butter and meats but also milk, yogurt, cheese, nuts, and vegetable oils. Each of these foods has different effects on heart disease. Instead of emphasizing one nutrient, we need to move to food-based recommendations. Were not going to artificially create healthy diets by manufacturing low-fat, low-saturated-fat packaged foods. What we eat should be whole, minimally processed, nutritious foodfood that is in many cases as close to its natural form as possible.
In other words, the problem isnt just what we eat, but also how we think about food. We fixate on the nutrient of the day, even those that confer benefits we eat mindlessly in the car and in front of the TV we value volume of food over the quality of the ingredients, the beauty of presentation, and even taste.
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Does Butter Have Ldl Or Hdl Cholesterol
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How Does Saturated Fat Raise Your Cholesterol
Cholesterol is made and broken down in the liver. Eating foods that have too much saturated fat, and too little unsaturated fat, changes the way the liver handles cholesterol.
Our liver cells have LDL receptors on them. When LDL cholesterol passes by in the blood, these receptors take the cholesterol out of the blood and into the liver to be broken down. Research suggests that eating too much saturated fat stops the receptors from working so well, and cholesterol builds up in the blood.
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Is Peanut Butter High In Cholesterol
When you need to watch your cholesterol, it can feel daunting trying to find foods that are healthy and also satisfying. Fortunately, peanut butter fits the bill. When consumed in moderation, peanut butter is a cholesterol-friendly food that is nutritious and delicious.
This article will review the facts about peanut butter and your health.
Potential Risks Of Grass
Because all types of butter are a significant source of saturated fats, cholesterol, and calories, you should consult with your doctor before increasing the amount of butter in your diet. Consider the following before eating grass-fed butter:
If youre allergic to any form of dairy including milk, cheese, or yogurt you will also be allergic to grass-fed butter.
Butter of any sort is a significant source of cholesterol. People with high cholesterol levels may find that consuming grass-fed butter makes their cholesterol worse, not better.
Avoid consuming large amounts of any form of butter if youre at risk of heart disease. Grass-fed butter contains saturated fats, although it does contain less of these fats than standard butter. Saturated fats are connected to a higher risk of heart disease and coronary events. Current nutritional guidelines suggest that you should keep your saturated fat intake to less than 10% of your daily caloric intake.
Butter is a very calorie-dense food. Consuming grass-fed butter in significant amounts may make it more difficult to feel satiated and lead to weight gain.
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Q& a ‘if Cholesterol Is So Bad Why Do We Have It’
Why do we need cholesterol if it can be so bad for our bodies?
Cholesterol is a fatty substance produced by the liver and used to build cell walls, create a protective glove around nerves and to make other chemicals such as hormones.
Cholesterol gets round our bodies by combining with protein to form a protective coating around tiny balls of fat absorbed from our diet termed lipoproteins. The purpose of this coating is to hold fat together, so we dont have oil slicks of fat in our bloodstream.
The two lipoproteins usually measured are low-density lipoprotein and high-density lipoprotein . LDL is like a juggernaut big clumps of fat and protein that trundle along the arteries and can only be cleared from our system by the liver. As it travels, fat can break away and enter the artery walls, becoming embedded. This build-up called atherosclerosis causes artery walls to narrow so blood cannot get through, resulting in blood clots that can trigger a heart attack or stroke.
HDL is known as good cholesterol. It is much smaller in size and hoovers up fat deposits from the artery wall as it moves around the body. This is why its important to know how much LDL and HDL are in your blood, as the ratio between these two types of fat is what really matters when it comes to risk.
What causes levels to rise?
How is cholesterol measured?
Good news: You do not have to give up on steak, red wine and dessert to lower your cholesterol
How often do I need to get a test?
Cholesterol In The Body
Cholesterol is a waxy substance thats found in all of your cells and has several useful functions, including helping to build your bodys cells.
Its carried through your bloodstream attached to proteins.
These proteins are called lipoproteins. Our LDL or low-density lipoproteins, build up within the walls of our blood vessels and narrow the passageways, as we age.
Significant clots can form in these passageways, causing a heart attack or stroke.
LDL is known as thebad cholesterol.
Our HDL or high-density lipoproteins pick up the excess cholesterol in your blood and take it to your liver, where it is broken down and removed from your body.
HDL is your good cholesterol. However, be aware of your triglyceride numbers too.
High triglyceride levels combined with high LDL cholesterol or low HDL cholesterol increase your risk of heart attack or stroke.
Triglycerides are basically excess fat in your body.
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Misconception: If The Nutrition Facts Label Shows No Cholesterol The Food Is Heart Healthy
A foods Nutrition Facts label can be helpful for choosing heart-healthy foods, if you know what to look for.
Many foods marketed as low-cholesterol have high levels of saturated or trans fats, both of which raise blood cholesterol.
Look for how much saturated fat, trans fat and total calories are in a serving. Ingredients are listed in descending order of use, so choose products where fats and oils are near the end of the ingredients list.