Good Triglycerides

• Choose to seek natural ways to lower blood pressure if that’s a problem for you.
• Choose to adhere to good cardiovascular nutrition, which may include increasing the amount of fresh vegetables you consume and lowering the amount of breads and other starches you eat each day.
• Choose to do what you need to do to maintain good cholesterol levels, improve blood circulation, and healthy triglycerides.
• Choose to exercise so that you can more easily prevent blood clots and maintain a healthy weight.

• 4 (5 to 6 oz.) halibut steaks
• Juice of 1 lemon
• 2 Tbsp. olive oil
• 3 cloves garlic, crushed
• ½ tsp. grated lemon peel
• 3 Tbsp. fresh basil, chopped and divided
• 2 tsp. capers, drained
• Fresh ground pepper to taste

Time is of the essence when you’re dealing with a heart attack. The best chance for survival and optimum recovery occurs if you are treated within two hours of the onset of symptoms.

At the hospital, things will move quickly. Up to 50 percent of the time, sudden death is the first symptom of heart disease, so any patient who survives the first two hours after a heart attack has passed a significant milestone. However, even with the best of medical care, 10–12 percent of those who survive the initial attack never leave the hospital (they die in the days following).

When it’s time for a patient to be discharged from the hospital, close caregivers should be present for any medical instructions because patients frequently don’t remember details. In fact, patients sometimes fail to recognize hospital staff members when they return for follow-up visits—that kind of psychological side effect is common during times of shock and trauma. At home, one of the biggest challenges that patients and loved ones face is a sense of day-to-day suspense. Many patients say they feel like they are just waiting for the other shoe to drop. These feelings are normal.

While I hope you’ll never need this information, I want you to be aware of it. I also want you to recognize common heart risk factors so that you can avoid ever being victim to heart attack or other cardiovascular problems. The key is prevention, which includes good cardiovascular nutrition, the ability to control high blood pressure, and maintaining healthy cholesterol and healthy triglycerides levels.

For more information on heart attack and stroke, heart risk factors, or other cardiovascular problems, visit www.drsinatra.com. While there, sign up for FREE e-letters or subscribe to Dr. Sinatra’s monthly newsletter, Heart, Health & Nutrition. 
 

• high blood pressure levels;
• cardiac arrhythmias;
• high LDL cholesterol levels;
• high triglycerides;
• elevated L(p)a; and
• heart attack and stroke….just to name a few.

For more information on overall health and nutrition, visit www.drsinatra.com.

While exercising, I urge you to learn to listen to your body. Is the exercise you’re doing causing pain? Tight muscles? Does it hurt your posture? Is it affecting your sleep? Is it disturbing your breathing, digestion, vision, or other functions not normally associated with fitness?

If you experience any of the following symptoms, stop immediately.

• Lightheadedness or dizziness
• Palpitations
• Shortness of breath (unable to carry on a conversation)
• Jaw pain
• Arm tingling or numbness
• Tight feeling in the lungs (bronchospasm)

After a great deal of research, I’ve concluded that the best overall diet for healthy blood pressure, healthy cholesterol, healthy triglycerides and to reduce your risk of heart attack and stroke is a combination of Mediterranean and Asian eating. 

In essence, this combines the healthy eating of Mediterranean cultures with the Asian emphasis on soy foods and seaweed. They have in common an absence of saturated and hydrogenated fats and an emphasis on fish and vegetables. There’s a remarkable amount of research to back up this healthy and delicious approach to nutrition. And best of all, it’s not really a “diet” so much as a lifestyle choice.

My Pan-Asian, Modified-Mediterranean (PAMM) Diet

I have been a proponent of the modified Mediterranean diet for years—even before it became fairly mainstream. In recent years, I’ve expanded that foundation to include the Japanese diet, because I believe that combined, they deliver the best of both worlds. They share an absence of saturated and hydrogenated fats and emphasize fish and vegetables. However, while Mediterranean people do not consume a lot of soy or seaweed, the Asians do.

I decided to call this updated approach to healthy eating the PAMM diet. It includes fresh fruits and vegetables in season, fish, and whole grains. Meat is used sparingly, often just enough for flavoring. Meals are based on numerous small portions for lots of variety, and the lightest meal is at the end of the day, when the body is quieter and the metabolism slower.

My PAMM eating plan includes 45 to 50 percent slow-burning, low-glycemic index carbohydrates; 30 percent healthy fats; and 25 percent protein. I’d also urge you to eat organic as much as possible.

Moderate Carbohydrates, More Protein and Healthy Fats

In a nutshell, the Mediterranean diet encourages eating cold-water fish such as salmon and halibut; “healthy fats” such as olive oil; low-glycemic carbohydrates such as beans, lentils, and oatmeal; and plenty of fruits, vegetables and nuts.

Instead of eating large chunks of meat, Mediterranean people use meat to flavor their sauces. At most meals, they eat fiber-rich fruits and vegetables teeming with phytonutrients and packed with vitamins, carotenoids, flavonoids, polyphenols and monounsaturated fats crucial to well-being and cardiac health. Their diets are naturally rich in omega-3 fatty acids, coenzyme Q10, potassium, calcium and magnesium.

The Mediterranean diet can help balance blood sugar and insulin levels and give you more energy. My patients report that they consistently feel better and experience a better quality of life.
 
For more information on cardivascular nutrition, visit www.drsinatra.com. 
 

• If you’re as concerned about good cardiovascular nutrition as I am, I hope you’ll follow my Pan-Asian Modified Mediterranean diet.  You’ll eat fresh fish (cold-water fish such as salmon, sardines, and mackerel) and fish oils at least two to three times a week.  You’ll also want to omit saturated fats. Instead, choose monounsaturated fats like olive oil and polyunsaturated fats like alpha-linolenic acid, found in flaxseed and flaxseed oil. (Visit me here on the Web for additional details on my Pan-Asian Modified Medietrranean diet.)
• Take 100 mg of niacin, twice a day. If you experience side effects like flushing, headache, and diarrhea, follow the diet and stop the niacin. You can try a lower dosage at a later date, then slowly increase the dose to 500 mg a day, twice a day for further protection. TwinLabs' quick-acting Niacin is a good product.
• Take 1–2 grams of vitamin C and 100–200 mg of CoQ10 each day.
• Policosanol—20 mg daily at bedtime.
• Exercise regularly.
• Ask your doctor about screening techniques to assess your risk factors for heart disease. If you’re concerned, you and your family members should have your Lp(a) and other risk factors (homocysteine, fibrinogen and serum ferritin) evaluated by your doctor.
• Be aware of other risk factors for heart disease, including smoking, high blood pressure, circulatory problems, high triglycerides, obesity, glucose intolerance and repressed emotions, which can have a harmful effect on the health of your heart.

After a great deal of research, I’ve concluded that the best overall diet for healthy blood pressure, healthy cholesterol, healthy triglycerides, and to reduce your risk of heart attack and stroke is a combination of Mediterranean and Asian eating. 

In essence, this combines the healthy eating of Mediterranean cultures with the Asian emphasis on soy foods and seaweed. They have in common an absence of saturated and hydrogenated fats and an emphasis on fish and vegetables. There’s a remarkable amount of research to back up this healthy and delicious approach to nutrition. And best of all, it’s not really a “diet” so much as a lifestyle choice.

My Pan-Asian, Modified-Mediterranean (PAMM) Diet

I have been a proponent of the modified Mediterranean diet for years—even before it became fairly mainstream. In recent years, I’ve expanded that foundation to include the Japanese diet, because I believe that combined, they deliver the best of both worlds. They share an absence of saturated and hydrogenated fats and emphasize fish and vegetables. However, while Mediterranean people do not consume a lot of soy or seaweed, the Asians do.

I decided to call this updated approach to healthy eating the PAMM diet. It includes fresh fruits and vegetables in season, fish, and whole grains. Meat is used sparingly, often just enough for flavoring. Meals are based on numerous small portions for lots of variety, and the lightest meal is at the end of the day, when the body is quieter and the metabolism slower.

My PAMM eating plan includes 45 to 50 percent slow-burning, low-glycemic index carbohydrates; 30 percent healthy fats; and 25 percent protein. I’d also urge you to eat organic as much as possible.

If you’re trying to drop a few pounds, I invite you to visit my online Weight Loss Center.  There I provide tips, recipes, and support that will help you along your journey toward your ideal weight.

For more information on good cardiovascular nutrition, visit www.drsinatra.com.

Let’s take a look at how women’s risk factors for heart disease are different from men’s.

Diabetes. Diabetic women have a higher risk for heart disease than diabetic men. This is because the incidence of diabetes and its complications (including heart disease) is much higher in women. If you are a diabetic woman, your risk for heart disease is five to seven times normal, compared with a risk of only two to three times normal for a diabetic man. For you, proper heart sense means you should increase your physical activity and watch your diet to maintain a healthy body weight.

Overweight. Women have a higher heart disease risk from being overweight than men do. Recent studies indicate that being only 20 pounds overweight doubles your risk of heart disease. If you are overweight, I don’t want you to go on a diet. Instead, get physically active—it’s your most powerful weapon against fat—and begin eating more fresh fruits and vegetables, pasta, fish and lean poultry.  Eating this way is what I call “healthy heart nutrition” and it just makes sense. (See other blog entries for additional advice on cardiovascular nutrition.)

Cholesterol. Women have a higher risk for heart disease than men if they don’t have good cholesterol levels. More specifically, if they have have low levels of HDL (“good” cholesterol) they increase their heart risk factors.

You probably already know that there are two types of cholesterol. LDL is the “bad” cholesterol, which oxidizes in your blood and forms the plaque that clogs arteries. HDL carries LDL out of your blood vessels before it can do its damage. Volumes of data have shown that a high LDL is a powerful risk factor for heart disease in men. But for women, the story is different. Recent research indicates that a low HDL, not a high LDL, is the more significant risk factor for a woman to develop heart disease. (This means that some women may need to increase HDL cholesterol levels.)

The good news is that HDL is sensitive to factors such as smoking, obesity and lack of exercise. If your HDL is low (less than 35 mg/dL) you can raise it by quitting smoking and dropping excess weight through a combination of smart eating, healthy heart nutrition, and physical activity such as walking and dancing. If you are postmenopausal, you might also consider estrogen replacement therapy (ERT), which raises HDL, lowers LDL, and has other beneficial effects on your heart. Have your HDL level checked six weeks after you start an HDL-raising program. Chances are you will see a change for the better.

High Triglycerides. When you get your cholesterol checked, I also want you to have your doctor check to see if you have healthy triglycerides levels. Triglycerides are another type of blood fat. A high triglyceride level is more dangerous for women than for men, so if your triglycerides are elevated (above 200 mg/dL), I want you to put some effort into lowering them, especially if you are a diabetic. This is because if you are a diabetic woman who also has high triglycerides, your risk of developing heart disease increases to 200 times normal. Please stop and think about this. You can lower your triglycerides using the powerful combination of exercise and weight control.

For more information on heart risk factors for women, visit www.drsinatra.com.

With all of the unnecessary attention lavished on HDL and LDL cholesterol levels, the importance of healthy triglycerides has been largely lost. And that’s too bad—because keeping them in a healthy range is essential to heart health.

Triglycerides are the chemical form of most fats in the body. The triglycerides in your blood come from dietary sources, primarily fats and carbohydrates. I consider a healthy triglyceride level to be 50–150 mg/dL. Levels above that have been linked to coronary artery disease and metabolic syndrome.

Given that the typical American diet is laden with processed and fast foods, it’s no surprise that high triglyceride levels are a problem for many people. To bring them down, cut back on the amount of sugar and carbohydrates in your diet, and eat more protein. I would also strongly recommend that you exercise regularly. Lifestyle changes such as these are very effective in keeping triglycerides in the healthy zone. Remember, the lower your weight, the lower your triglycerides, so weight loss and weight management are KEY to success!

Another good option for lowering triglycerides is a high-quality fish oil supplement. Start with 2–3 grams daily in divided doses, and let me know how it works for you.

 For more information on how to bring down high triglycerides, visit www.drsinatra.com.

More than 30 clinical studies have shown that soy is highly effective as part of a cholesterol-lowering diet. Case in point, an August 1995 meta-analysis from the New England Journal of Medicine found that people who ate an average of 47 grams of soy protein per day had a 13 percent decrease in LDL cholesterol levels, a 10.5 percent decrease in triglycerides, and a nine percent decrease in total cholesterol levels.

A November 2001 issue of Archives of Internal Medicine also found that a high consumption of legumes, including soybeans, meant a lowered risk of coronary heart disease (CHD). They concluded that increased legume intake may be an important part of a dietary approach to preventing CHD.

Additionally, a report in the August 2002 issue of Arteriosclerosis, Thrombosis and Vascular Biology found that a diet rich in tofu and other soy products may help protect postmenopausal women from arterial disease. According to researchers, phytoestrogens were associated with less arterial stiffness among more than 400 postmenopausal women. The benefit was most pronounced among the oldest women, or those who had been postmenopausal the longest.

Surprisingly, even the FDA agrees that soy is beneficial for maintaining good cholesterol levels. In 1999, they authorized of the use of health claims on the labeling of foods containing soy protein, based on research which shows that soy foods may reduce risk of coronary heart disease by lowering blood cholesterol levels. According to the FDA, foods must contain 6.25 grams per serving of soy protein in order to qualify for the claim, and a daily intake of 25 grams is recommended in order to achieve a significant cholesterol-lowering effect. Now that's healthy heart nutrition!

You’ve heard me say time and again that reducing cholesterol is not the magic bullet that will prevent heart attack and stroke. I stand by this statement wholeheartedly—but I don’t want you to interpret it to mean that cholesterol is unimportant.

Optimum cardiovascular health requires maintaining a healthy cholesterol ratio—that is, keeping your LDL cholesterol levels (the so-called “bad” cholesterol) in proper balance with your HDL levels (the “good” type of cholesterol). It also calls for minimizing the amount of Lp(a) in your blood, and not letting your triglyceride levels get out of hand.

Although regular exercise and a cholesterol lowering diet will go a long way toward helping you achieve these goals, I also recommend that you try some targeted nutritional supplements for an extra boost. One of them is niacin (vitamin B3). It’s a fantastic nutrient that can help you increase HDL cholesterol, as well as lower both triglycerides and the dangerous subtype of cholesterol known as Lp(a).

These are huge benefits. For me, keeping HDL levels high and Lp(a) down are more significant than lowering LDL or even total cholesterol. Elevated Lp(a) is a serious, widespread, and underemphasized problem, and niacin is probably one of the best nutrients to lower it. And the higher your good cholesterol levels, the more protection you have in your blood vessels.

The only downside to niacin is the flushing sensation it generates. This hot, tingly, pins-and-needles feeling is disconcerting to a lot of people, but it usually lasts no more than 30–60 minutes, and it is most pronounced during the first week or so that you take the supplement (it can also occur when you increase your dosage). You can find no-flush forms of niacin, but they’re not as effective. I would stick with the regular kind.

I recommend taking 1–2 g a day in divided doses with meals. Start with 250 mg and slowly work your way up to minimize the flushing effect. Let me know how it works for you!

For more information on how to increase HDL cholesterol while lowering LDL cholesterol levels, visit www.drsinatra.com.

 

• Decreases triglycerides
• Reduces arterial wall inflammation
• Makes blood less sticky and less likely to form clots
• Stabilizes plaque and prevents plaque rupture
• Soothes and nurtures heart rate variability, actions that counteract arrhythmias
• Contributes to the bioenergy of the heart muscle