Cholesterol Guidelines

Let Food Be Thy Medicine

Thursday, August 19, 2010 by Jan Sinatra

Dr. Sinatra has long believed in the famous words of Hippocrates, the Greek physician of

centuries past who is now recognized as the “Father of Medicine.” Hippocrates employed food to assist his patients in healing their physical ailments. With all our high tech medical approaches and complex pharmaceutical agents, it is amazing how much we have forgotten that simple approach!

After years of applying nutritional solutions to the myriad faces of heart disease—high blood pressure levels; chronic hypertension; high triglycerides; elevated L(p)a; angina; and heart attack and stroke—Dr. Sinatra has finally answered his patients’ many requests for a book that they can have as a reference at home. His research and personal experiences with his family, friends, and cardiac patients has continually impressed my husband that Hippocrates was so right on—and provided the foundation for this effort.

Dr. Sinatra has collaborated with former pro athlete and health editor Jim Healthy, as well as recipe queen Rebecca Bent to write Bottom Line’s The Healing Kitchen. The Healing Kitchen is a strategic resource for making healthy grocery selections and healing meal planning guidelines, as well as specific recipes to assist you in selecting the right healthy foods to meet your specific health and fitness needs.

Subscribers to Heart, Health, and Nutrition have been reading Dr. Sinatra’s take on which foods, herbs, and supplements can help with their cardiovascular problems (not to mention cancer and other diseases caused by inflammation) for many years. Now all that information and more is the basis for this one reference to help guide you to foods that can heal your body.

For instance, the omega 3 essential fatty acids—especially those found in squid and fish oils—assuage cardiac arrhythmia, lower blood pressure levels, reduce LDL cholesterol levels, and even prevent plaque rupture.

Garlic is a potent blood thinner and, like onions which are rich in quercetin, helps you prevent the oxidation of LDL cholesterol. Garlic and onions are both superb foods for lowering blood pressure levels. And, speaking of hypertension, Dr. Sinatra also recommends sardines and wakame seaweed as natural blood pressure lowering foods.

And that’s just the beginning! Did you know that the right diet can help alleviate your migraines headaches, or that non-inflammatory foods can heal your arthritis?

Foods can also protect women from menopausal symptoms, as well as heal and protect us from cancer. The lutein in tomatoes along with pumpkin seeds and other fine herbs and spices can help men with their prostate concerns. From heart disease and diabetes to sleep and sex, The Healing Kitchen will educate you about natural, tasty remedies for many of the illnesses that afflict the 20th century.

If you are looking to use simple, healthy foods, herbs and spices to get your body back on track, and keep it there, you will love this book!

For more information on healthy heart nutrition or some of Dr. Sinatra’s famous recipes, visit his Web site at www.drsinatra.com.

When Does Cholesterol Become A Threat?

Friday, July 9, 2010 by Stephen Sinatra

Maintaining good cholesterol levels is important, but, contrary to popular belief, cholesterol is not a villain. Your body needs cholesterol to synthesize certain nutrients and hormones, construct the semi-permeable membranes around each of the 100 trillion cells that make up your body, and facilitate cell communication and memory in the brain.

Cholesterol moves through the body with the help of two proteins: LDL, or low-density lipoprotein, and HDL, or high-density lipoprotein. LDL carries ready-to-use cholesterol molecules that can be absorbed by cells that need it, and HDL picks up excess cholesterol and carries it back to the liver for recycling and excretion.

Healthy LDL cholesterol levels are always of great concern, as they should be, but few people know that it’s impossible for your cells to absorb too much of it. LDL becomes unsafe only when it interacts with molecular fragments called free radicals. The effect of such interaction is that the LDL becomes oxidized. Unlike normal LDL, oxidized LDL has toxic effects on the cells it attaches to.

When you get down to it, though, the real problem is not cholesterol—it’s whether your body’s antioxidant system can effectively neutralize the free radicals that damage LDL molecules.

Here’s what you need to remember about cholesterol: It’s a relative heart risk factor and it’s influenced by other factors. You should also keep in mind that good cardiovascular nutrition and a cholesterol lowering diet can go a long way to helping you keep good cholesterol levels.

For more information on cholesterol guidelines, reducing hypertension, and overall heart health, visit www.drsinatra.com. While there, sign up for FREE e-letters or subscribe to Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition.

Lp(a) Cholesterol Guidelines

Thursday, July 8, 2010 by Jan Sinatra

Lp(a) cholesterol has been of great interest to many of you, and we’ve had many comments

posted on the topic. I’d like to take the opportunity to answer a sound question from a concerned mom, because it is exemplary of what folks often ask us in the office that all of you can benefit from it.

Like many of you looking at the results of your cholesterol profiles, she reports that she is not sure what constitutes an alarming abnormal Lp(a) value. In her 50-year-old daughter’s case, the blood work read as follows:

Total Cholesterol: 173
HDL: 74
LDL: 87
LDL cholesterol-C: 90
Lp(a) : 12

In this particular case, there is no family history of cardiovascular disease, and the lipid panel results were within normal limits.

As with other blood level parameters, there may be some variation in normal ranges for Lp(a) as reported by different labs. I have seen some labs where up to 30 was within the normal range for the equipment and reagents they use. Our concerned mom reports that, for her daughter’s lab, anything over 10 is out of the normal range; hence her concern.

Her question is a good one. In the absence of any family history of cardiovascular problems and good cholesterol levels, how much should one be concerned about slightly elevated Lp(a)?

In this particular case, Dr. Sinatra and I would like to reassure her not worry about this finding. First of all, her daughter’s Lp(a) is only elevated two points (or 20 percent above the limit). Secondly, her high HDL “good” cholesterol levels of 74 (HDL > 60 for a woman, and > 45 for men is considered desirable) is a very protective component. And, thirdly, there is no family or personal history of heart disease.

When do we get concerned? Dr. Sinatra takes action when he sees Lp(a) levels that are twice the normal limit (he sees some that are even four times higher or more!). In those cases, he recommends fish oil (a total of 2 grams/day in divided doses) and nattokinase (50 mg twice daily).

Even if your Lp(a) levels are normal, borderline, or even slightly elevated and you want to be more aggressive in your preventive medicine efforts, then just be sure that omega 3s are part of your daily vitamin and mineral plan. About one to two grams of a high quality fish oil—or squid oil—should do the trick.

Lp(a) may still be a new blood component to know about for many of you. Be sure to watch for an upcoming newsletter article on the seriousness of this risk factor. For other tips on healthy cholesterol levels, visit Dr. Sinatra's Web site. While there, don't forget to sign up for his FREE eLetters!

The Magic of Garlic

Friday, July 2, 2010 by Stephen Sinatra

A few years ago, a small-scale trial conducted at UCLA explored the effects of aged garlic extract (AGE) on the natural course of calcified coronary artery (hard) plaque. The 19 subjects

who completed the protocol were well-matched for important variables like statin use and heart risk factors.

Researchers measured plaque at the study’s start and after twelve months. In the placebo group of ten people, the annual plaque progression rate was 22.2% (the range was actually an increase of 3.7 to 40.7% in this group).

Now, while levels for CRP and cholesterol parameters didn’t change significantly for any of the 19 individuals, the nine taking aged garlic extract tended to that it helped to increase HDL cholesterol levels and improved plasma homocysteine levels. Progression of calcific coronary disease detected by EBCT was significantly less, measured at 7.5% +/- 9.4%.

This preliminary finding should provoke larger scale investigation, but for now, it’s just another potentially good reason to add AGE to your program—especially if you know you have hard plaque and/or other cardiovascular problems.

For more information on cholesterol guidelines and cardiovascular problems, visit www.drsinatra.com.

Cardiology Terminology: Lp(a)

Tuesday, June 15, 2010 by Jan Sinatra

Lately, Dr. Sinatra has been getting a lot of questions about the very small, dense, and highly inflammatory cholesterol particle known as lipoprotein(a)—or Lp(a) for short.

Good questions! Dr. Sinatra is one cardiologist who just doesn’t think that total cholesterol levels are the evil culprits behind cardiovascular problems that they have been made out to be. In fact, he believes that it is high time we switch the heart disease prevention paradigm from total cholesterol to Lp(a). There are too many folks with normal cholesterol levels having heart attacks not to believe that something is amiss.

But before we discuss ways to lower or prevent high Lp(a) levels, you must first know what you are up against.

Lp(a) is small, dense, highly inflammatory sub-fraction of a cholesterol particle and is made in the liver. Dr. Sinatra believes that it is so dangerous, it should be listed as a specific risk factor for heart disease—instead of total cholesterol.

While we know a lot about what it does in terms of how it affects the body, we are still in the theoretical stages in terms of how Lp(a) is metabolized and all of its physiological functions. So, here is what we’ve got on it to date:

Because of its small dense properties, Lp(a) has been shown to contribute to atherosclerosis;
Your Lp(a) level is often hereditary, with DNA determinants;
Lp(a) is thought to have something to do with coagulation and clot formation;
It can help with wound healing because of its ability to turn on inflammatory reactions; and
At high levels, it can promote excessive inflammation.

In short, Lp(a)’s characteristics include:

small—it can easily sneak in and permeate the cell wall and wreak havoc;
dense— like a stone that sinks to the bottom, it can pile up on the walls of your blood vessels; and
highly inflammatory—it is a provocative little monster.

Everyone should know what their Lp(a) level is, especially anyone with known heart disease. Anyone with a family history of heart disease should also know, since Lp(a) blood levels are inheritable, and its production is controlled by a specific gene (an apolipoprotein(a) gene on chromosome 6q26-27 to be specific). That’s why we see elevated Lp(a) levels run in families. Also, if you are of African-American or some European heritages, you may be more at risk.

Lp(a) levels can range from 0.2 to 200, and because folks with very low Lp(a)s appear to be quite healthy, whatever its functions, they are not thought to be critical. Dr. Sinatra likes to see levels less than 35 nmol/l, according to the Quest Diagnostics standards he usually sees.

Here are the usual parameters, depending on how your lab expresses this level:

Desirable: < 14 mg/dL (< 35 nmol/l)
Borderline risk: 14 - 30 mg/dL (35 - 75 nmol/l)
High risk: 31 - 50 mg/dL (75 - 125 nmol/l)
Very high risk: > 50 mg/dL (> 125 nmol/l)

Should you find your Lp(a) elevated, then you need take action. Later this week, I’ll tell you the most effective natural ways to reduce or even prevent Lp(a) cholesterol.

For more information on cholesterol guidelines and other cardiovascular problems, visit www.drsinatra.com.

Sugar Equals Poor Cardiovascular Nutrition

Thursday, June 10, 2010 by Jan Sinatra

Just this year, Dr. Sinatra wrote in his newsletter Heart, Health & Nutrition about a study from the Journal of the American Medical Association showing that diets high in added sugars raise the levels of blood fats and increase cardiovascular disease risk. Specifically, people who ate about 20 percent of their daily calories in the form of sweeteners of any kind were much more likely to have lower HDL good cholesterol levels and higher triglyceride levels.

In the study, Emory University researchers surveyed about 6,000 adults and determined that average sugar intake was 16 percent of daily calories—21.4 teaspoons, about 359 calories. These findings also support guidelines released last year by the American Heart Association recommending that men keep their daily intake of added sugars below 150 calories (10 tsp.) and women limit themselves to 100 calories (6 tsp.).

I found the study perhaps most interesting for what it didn’t say: that sweeteners contribute to higher blood viscosity, a major overlooked component of cardiovascular problems. Research shows sugar stokes inflammation and increases C-reactive protein (CRP), and the added calories also contribute to weight gain and abdominal body fat, in turn, generating more CRP.

An earlier 2001 Harvard study found ultra-high CRP levels among women who ate large amounts of high-glycemic carbohydrates (ones that break down into glucose more quickly), such as potatoes, cereals, white bread, muffins, and white rice. Those women also tended to be overweight. So go easy on the sugar and limit your intake of foods that contain added sugar. Your body, especially your heart, will thank you.

For more information on healthy heart nutrition, visit www.drsinatra.com.

Low-Carb Diets Can Make It Difficult To Achieve Healthy Cholesterol

Monday, February 1, 2010 by Stephen Sinatra

Many of today’s fad diets revolve around modifying insulin resistance by consuming low-carbohydrate, high-protein foods and also advocate eating foods high in saturated fats and dairy products. This type of diet is likely to contain high levels of insecticides, pesticides, and radiation, which in the long run may increase your risk of cancer of the bowel, prostate, and breast and can increase your heart risk factors.

Also, as you start to lose weight and your body is forced to break down stored fat for energy, your good cholesterol levels may be challenged and it may become difficult to keep them within the recognized cholesterol guidelines. This may be an artificial rise in cholesterol, however, it is a good idea to be cautious and work with a physician if you decide to start one of these diets.

Based on this, I suggest that anyone trying to lose weight adhere to a diet akin to my Pan-Asian Modified Mediterranean diet, making sure to eat fresh fish at least two to three times a week. You’d can also enjoy fresh fruits, legumes, cold-water fish such as salmon, sardines, and mackerel or fish oils, particularly docosahexaenoic acid (DHA), which blocks the inflammatory and blood-clotting capabilities of Lp(a).

I’d also urge you to omit saturated fats. Instead, choose monounsaturated fats like olive oil and polyunsaturated fats like alpha-linolenic acid, found in flaxseed.

For more information on ways to achieve healthy cholesterol, visit www.drsinatra.com.

10 Must-Know Facts About Cholesterol

Monday, June 1, 2009 by Stephen Sinatra

One of the most important parts of maintaining healthy cholesterol is understanding how your body uses and manages this essential lipid. Why? Because having a cholesterol level that is too low is just as dangerous as having a cholesterol level that is too high. Most people don't realize it, but blindly following the cholesterol guidelines put forth by pharmaceutical companies (whose primary interest is to sell you their drugs, not to make you healthy) could put your long-term health in jeopardy.

To help you get some perspective on what constitutes a good cholesterol level, I've identified 10 vital facts about cholesterol in the body. Keep them in mind the next time your doctor raises the issue of reducing cholesterol, and make sure that any decision to do so is truly in your best interest (and if you must improve your numbers, opt for natural therapies such as a cholesterol lowering diet, as well as lifestyle changes and nutritional supplements that can help increase HDL cholesterol and reduce LDL cholesterol levels).

1) Cholesterol is a raw material made by your liver, brain, and almost every cell in your body. Enzymes convert it into vitamin D, steroid hormones (including the sex hormones estrogen, progesterone, and testosterone, and stress hormones), and bile salts needed for digesting and absorbing fats. Cholesterol is a major part of the membranes surrounding cells and the structures within them.

2) The body makes cholesterol as needed. When you eat more in your diet, the body makes less. If you eat less, the body makes more. On average, 85 percent of blood cholesterol is made in the body, and the rest comes from food.

3) You can have different levels of cholesterol at different times of the day.

4) Cholesterol tends to go up in the winter and down in the summer.

5) Cholesterol soars after any surgery, and it increases when you have an infection, mental stress, or have suffered a heart attack. The reason for this is that cholesterol is a healing agent needed to help create new cells, and it’s produced whenever healing is required. Your cholesterol level will also rise and fall depending on exposure to environmental agents and toxins.

6) When a doctor finds a high level of cholesterol, instead of reaching for the prescription pad, he or she should look for the reason the cholesterol is high and treat the cause. If the cause is successfully addressed, cholesterol often comes down.

7) It’s interesting to note that the herbs, antioxidants, and nutraceuticals that reduce cholesterol do so by neutralizing damaging agents in the blood stream. Thus, the liver doesn’t have to produce as much cholesterol. Moreover, the supplements support other biochemical processes necessary to heal wounds.

8) The endothelium is the razor-thin lining of blood vessels. The damaging agents we are exposed to—toxic chemicals, pathogens, free radicals, and inflammatory substances—wind up in our blood stream and damage this thin layer of cells. When this happens, the liver sends LDL to the site to make repairs. As the healing process concludes, the spent LDL particles are carried back to the liver by HDL and removed from the body.

9) The brain is particularly rich in cholesterol and accounts for about one-quarter of all the cholesterol we have. About 20 percent of the fatty myelin sheath that coats every nerve cell and fiber is made of cholesterol, and neuron function depends on it. It’s not surprising that a connection has been found between naturally occurring cholesterol and mental function, and that lower cholesterol levels are linked to poorer cognitive performance.

10) Some research suggests that doctors should be extremely cautious about prescribing statin drugs to the elderly, particularly those who are frail. I agree. I have seen frail individuals become even weaker and more prone to infections after taking these medications. Many of these patients later told me that their strength, energy, appetite, and vitality returned when they discontinued the statins. These folks clearly need their cholesterol—as do the very young.

For more information on cholesterol guidelines, visit www.drsinatra.com.