“Benecol Spread Reduces LDL Cholesterol in Patients Taking Statins”
WESTPORT, Jul 07 (Reuters Health) - For patients on statin therapy who still have elevated LDL-cholesterol levels, the plant stanol ester spread Benecol reduces total and LDL cholesterol, according to a report in the July 1st issue of the American Journal of Cardiology.
Dr. Steven N. Blair from The Cooper Institute, Dallas, Texas, and a multicenter team compared the effects of Benecol and a placebo in patients receiving statin therapy. Sixty-seven women and 100 men with LDL-cholesterol levels of at least 130 mg/dL and triglyceride levels of 350 mg/dL or less who had been taking statins for 90 days, were randomized and given three servings a day of Benecol spread or placebo. During the 8-week study the total daily intake of Benecol spread was 5.1 g.
"Plant stanol ester spread reduced total cholesterol at 8 weeks by 12% compared with a placebo reduction of 5%. Plant stanol ester spread reduced LDL-cholesterol at 8 weeks by 17% compared with a 7% reduction in the placebo group," according to the report. "That's a little more reduction in LDL-cholesterol than if they doubled their dose of statin," Dr. Blair told Reuters Health.
The team reports that at 8 weeks the absolute reduction in LDL cholesterol was 24 mg/dL for the Benecol group and 10 mg/dL for the placebo group. According to the report, Benecol was well tolerated with no adverse side effects.
Asked about the role of functional foods in general, Dr. Blair said there may be health benefits. "My personal view," he said, "is that many of the supposed benefits from functional food probably won't hold up under rigorous testing. Some others will, and there is the possibility that some may turn out to be harmful. Right now I think there is more hype and marketing and promises than we can really support with science."
Dr. Terry Bazzarre from the American Heart Association told Reuters Health that "there are studies that clearly show that plant stanol ester spread is an effective adjunct for developing new dietary strategies that take advantage of naturally occurring constituents in plants to affectively lower total and LDL cholesterol."
"We would not recommend this for children or pregnant women or people with normal cholesterol levels; [for those] we don't really know if there would be a major benefit or adverse side effects," Dr. Bazzarre said.
It is useful, Dr. Bazzarre noted, for people who have moderately elevated cholesterol who may not want to be taking a statin or another medication for a lifetime. These people as well as those who are on a cholesterol-lowering medication who are still not at their goal might want to work with their doctor to see if adding such a product to their diet can help them get down to their goal level, he explained.
"It's very exciting," Dr. Bazzarre added, "to see the food industry step up to the plate trying to develop or identify components in foods that can help lower our risk of disease. Certainly with heart disease we need to try to use every available strategy."
Am J Cardiol 2000;86:46-52.
Author: Jane Ramberg, www.glycoscience.com
SOURCE: oats, fungi
SYNONYMS: oat gum
HISTORICAL USES: several medicinal mushrooms containing beta-glucans have a long history of use in folk medicine.1 Glucans are polymers of glucose. Beta-glucan is a water-soluble fiber that cannot be digested by human enzymes, but is degraded by bacteria in the colon into short-chain fatty acids (SCFAs), an important fuel of the colonic mucosa.2 Rolled oats contain 4% beta-glucans and oat bran contains 7-9% beta-glucans.3 Studies have documented the health benefits of beta-glucan consumption. Some human studies have documented improved serum cholesterol,4, 5, 6 increased bile acid excretion,7 and improved insulin response.8 9 6 Consumption of beta-glucan from whole oats has been associated with a lower risk of coronary heart disease.10
Further studies on beta-glucan consumption suggest intriguing additional benefits, including possible enhanced immune function and anti-tumor activity.
4. Davidson MH, Dugan LD, Burns JH, Bova J, Story K, Drennan KB. The hypocholesterolemic effects of beta-glucan in oatmeal and oat bran. A dose-controlled study. JAMA. 1991;265:1833-1839.
5. Behall KM, Scholfield DJ, Hallfrisch J. Effect of beta-glucan level in oat fiber extracts on blood lipids in men and women. J Am Coll Nutr 1997;16:46-51.
6. Bourdon I, Yokoyama W, Davis P, et al. Postprandial lipid, glucose, insulin, and cholecystokinin responses in men fed barley pasta enriched with beta-glucan. Am J Clin.Nutr 1999;69:55-63.
7. Lia A, Hallmans G, Sandberg AS, Sundberg B, Aman P, Andersson H. Oat beta-glucan increases bile acid excretion and a fiber- rich barley fraction increases cholesterol excretion in ileostomy subjects. Am J Clin Nutr 1995;62:1245-1251.
10. Food and Drugs. 21CFR101.81; April 1, 1999.
Author: Jane Ramberg, www.glycoscience.com
SYNONYMS: α -phytosterol, α -dihydrofucosterol, sitosterin
SOURCE: sterol commonly found in many plants (including soybeans); for commercial use, it is typically isolated from wheat germ or corn oil.1 Beta-sitosterol, a phytoestrogen, may be used as a dietary supplement.2 The average American consumes up to 250 mg of plant sterols/day.3 Dietary beta-sitosterol is absorbed by the body 4 and results in plasma sitosterol levels of 0.3 – 1.0 mg/100 ml.5, 6 A review of over 200 epidemiologic studies found that phytosterols are among a group of fruit and vegetable-derived substances that show particular promise in cancer prevention.7 Animals receiving a diet supplemented with selenium, retinoic acid and beta-sitosterol experienced significantly fewer chemically induced tumors than non-supplemented animals.8 In an in vitro study, beta-sitosterol decreased growth and increased apoptosis of human prostate cancer cells.9
Phytoestrogens have been shown to exhibit hormone-like activities in rats,10 rabbits,11 fish,12, 13 and tumor cells.14 Beta-sitosterol is converted to steroid hormones (progesterone, pregnenolone, testosterone) by mitochondrial enzymes in rat testes,15 to pregnenolone in rat adrenal gland mitochondria,16 and urinary cortisol in guinea pigs.17 Phytoestrogens interact with the intracellular estrogen receptor in estrogen-responsive cells.18 Although it may not be estrogenic in itself, beta-sitosterol is metabolized to a hormonally active metabolite by intestinal microorganisms.13 Beta-sitosterol has shown promise in inhibiting cholesterol absorption,19 treating patients with hyperlipidemia,20 inhibiting chemically-induced carcinogenesis,8 and controlling benign prostatic hyperplasia 21 and prostate cancer.9
1. Budavari S, O’Neil MJ, Smith A, et al, eds. The Merck Index. 12th ed. Whitehouse Station, NJ: Merck & Co., Inc.; 1996.
2. Dietary Supplement Health and Education Act; 1994.
3. Connor WE. Dietary sterols: their relationship to atherosclerosis. J.Am.Diet.Assoc. 1968;52:202-208.
4. Gould RG, Jones RJ, LeRoy GV, Wissler RW, Taylor CB. Absorbability of beta-sitosterol in humans. Metabolism. 1969;18:652-662.
5. Salen G, Ahrens EHJ, Grundy SM. Metabolism of beta-sitosterol in man. J.Clin.Invest. 1970;49:952-967.
6. Bhattacharyya AK, Lopez LA. Absorbability of plant sterols and their distribution in rabbit tissues. Biochim.Biophys.Acta 1979;574:146-153.
7. Steinmetz KA, Potter JD. Vegetables, fruit, and cancer prevention: a review. J Am Diet Assoc 1996;96:1027-1039.
8. Nigro ND, Bull AW, Wilson PS, Soullier BK, Alousi MA. Combined inhibitors of carcinogenesis: effect on azoxymethane- induced intestinal cancer in rats. J Natl Cancer Inst 1982;69:103-107.
9. von Holtz RL, Fink CS, Awad AB. beta-Sitosterol activates the sphingomyelin cycle and induces apoptosis in LNCaP human prostate cancer cells. Nutr Cancer 1998;32:8-12.
10. Whitten PL, Naftolin F. Effects of a phytoestrogen diet on estrogen-dependent reproductive processes in immature female rats. Steroids 1992;57:56-61.
11. Shemesh M, Lindner HR, Ayalon N. Affinity of rabbit uterine oestradiol receptor for phyto- oestrogens and its use in a competitive protein-binding radioassay for plasma coumestrol. J.Reprod.Fertil. 1972;29:1-9.
12. Pelissero C, Bennetau B, Babin P, Le Menn F, Dunogues J. The estrogenic activity of certain phytoestrogens in the Siberian sturgeon Acipenser baeri. J.Steroid Biochem.Mol.Biol. 1991;38:293-299.
13. Mellanen P, Petänen T, Lehtimäki J, et al. Wood-derived estrogens: studies in vitro with breast cancer cell lines and in vivo in trout. Toxicol.Appl.Pharmacol. 1996;136:381-388.
14. Martin PM, Horwitz KB, Ryan DS, McGuire WL. Phytoestrogen interaction with estrogen receptors in human breast cancer cells. Endocrinology 1978;103:1860-1867.
15. Subbiah MT, Kuksis A. Conversion of beta-sitosterol to steroid hormones by rat testes in vitro. Experientia 1975;31:763-764.
16. Burstein S, Gut M: Biosynthesis of Pregnenolone, in Astwood EB (ed): Recent Progress in Hormone Research. NY, NY, Academic Press; 1971:303-349.
17. Werbin H, I.L.Chaikoff, Emmett E.Jones. The metabolism of H 3 -B-sitosterol in the guinea pig: its conversion to urinary control. Arch.Biochem.and Biophys. 1960;235:1629-1633.
18. Makela S, Vicki L.Davis, William C.Tally, et al. Dietary estrogens act through estrogen receptor mediated processes and show no antiestrogenicity in cultured breast cancer cells. Environ.Health Perspect. 1994;102:572-578.
19. Grundy SM, Mok HY. Determination of cholesterol absorption in man by intestinal perfusion. J Lipid Res 1977;18:263-271.
20. Lees AM, Mok HY, Lees RS, McCluskey MA, Grundy SM. Plant sterols as cholesterol-lowering agents: clinical trials in patients with hypercholesterolemia and studies of sterol balance. Atherosclerosis
21. Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group. Br J Urol 1997;80:427-432.
Author: from AlternativeMedicine.com
Greetings AlternativeMedicine.com Member!
All of us want to be fit and healthy and for too many of us this means losing weight. To lose weight we must burn fat. Fat is burned in particular parts of our cells called mitochondria. If you can not get fat into the mitochondria, you can not burn it. To burn fat optimally requires a sufficient supply of the nutrient carnitine. Carnitine is necessary to transport fat to the mitochondria, but it is only available in quantity in red meat! To learn about supplementing with carnitine, see the following web page.
“Putting Fat in its Place: The Power of Carnitine”
By Robert Crayhon, M.S.
Carnitine may be the number one nutrient missing from the American diet. Carnitine naturally helps you to lose weight, increase energy, and protect your heart and arteries. How? By helping fat burn optimally. Carnitine is the only nutrient that can transport fat to the part of the cell that burns it called the mitochondria. If you can¹t get fat into the mitochondria, you can¹t burn it. Only carnitine can get it in there. So without carnitine, no fat burning can occur. Optimal carnitine levels allow our body to burn fat at the fastest rate possible.
Signs of inadequate carnitine intake include:
Progressive Weight Gain
High Cholesterol and Triglycerides
Weak Heart Function
Lack of Mental Focus
Carnitine: The Most Important Nutrient to Take if You are Trying to Lose Weight
Everyone who wants to lose weight should take carnitine. Carnitine is a natural part of metabolism that works by picking fat up and putting it in the part of the cell that burns it off. 2 So we can deduce that limited carnitine means limited fat burning. There is scientific evidence that increased levels of carnitine in tissues leads to increased fat burning. 3 Fat transported to the mitochondria where it is burned not only gives you energy but encourages weight loss. Carnitine also helps increase metabolic rate while also maintaining the amount of muscle tissue.4 This can aid in long term weight loss because muscles burn calories even when you are sitting still. The more muscle you have the more calories you burn throughout the day. Eliminating cravings can be one of the hardest parts of changing your diet. Carnitine is one of the most important nutrients for keeping blood sugar constant and eliminating these cravings.5 Overall, carnitine is the best nutrient you can take for promoting weight loss by increasing the amount of fat you burn, maintaining your muscle mass, and to help you eliminating cravings.
Because carnitine plays a critical role in fat burning, and fat is the best fuel for endurance athletics, it should come as no surprise that carnitine is a great aid to increasing sports endurance. Research shows that carnitine enhances aerobic performance and allows athletes to exercise longer without fatigue.6 Carnitine also prevents muscle damage during vigorous exercise and delays the onset of the lactate burn (the burning feeling felt during intense exercise that slow you down).7
How to Take Carnitine
Start by taking two 500 mg capsules of carnitine before or with breakfast. After one week the dosage can be increased if needed to two 500 mg capsules before breakfast and lunch. Carnitine can also be taken in powder form, starting with _ to a _ teaspoon before breakfast. Increase your dose of carnitine gradually until you see a difference in weight loss, energy, and overall well-being. Taking carnitine after 4:00 p.m. may make it harder to fall asleep at night, so try not to take carnitine after 4:00 p.m. This is the only side-effect of taking too much carnitine: too much energy! Heart patients and those with serious illness should take carnitine with the supervision from their physician, as carnitine can reduce the need for many heart-supporting medications.
Commonly asked questions about Carnitine
When will I start feeling the benefits of carnitine?
You should begin to feel an increase in energy within the first few days. For sports endurance, it may take a week or more to see the benefits in sports performance. Cholesterol and triglyceride lowering effects can take a month or more.
How do I know whether to take carnitine or acetyl-L-carnitine?
For weight loss, lowering cholesterol, increasing energy, and sports endurance, carnitine is the preferred form. For maximizing brain health, acetyl-L-carnitine is the ideal form. For those over forty, taking both is optimal.
Should carnitine be taken with other nutrients?
Combining carnitine with CoQ10 is always a good idea, as these nutrients work together in your cells. Taking carnitine along with chromium and zinc can be very helpful for weight loss. Magnesium, taurine, and vitamin E, EPA, as well as CoQ10 help carnitine benefit the heart more effectively. Carnitine should always ideally be taken with a variety of other nutrients for aiding health problems. Remember also that health problems should always be treated with guidance of your health care practitioner.
1. Crayhon R. The carnitine miracle : the supernutrient program that promotes high energy, weight loss, brain wellness, and longevity. New York: M. Evans, 1998.
2. Rebouche CJ, Paulson DJ. Carnitine metabolism and function in humans. Annu Rev Nutr 1986;6:41-66.
3. Avogaro P, Bon GB, Cazzolato G, Rorai E. Acute effects of L-carnitine on FFA and beta-OH-butyrate in man. Pharmacol Res Commun 1981;13(5):443-50.
4. McCarty MF. Promotion of hepatic lipid oxidation and gluconeogenesis as a strategy for appetite control. Med Hypotheses 1994;42(4):215-25.
5. Kaats. The short-term therapeutic efficacy of treating obesity with a plan of improved nutrition and moderate calorie restriction. Curr Ther Res 1992;51(2):261-274.
6. Clarkson. Nutritional ergogenic aids: Carnitine. International Journal of Sports Nutrition 1992;2:185-190.
7. Siliprandi N, Di Lisa F, Pieralisi G, et al. Metabolic changes induced by maximal exercise in human subjects following L-carnitine administration. Biochim Biophys Acta 1990;1034(1):17-21.
Contact: Robert Cayhon, M.S., is the director of the Designs for Health Institute, offering advanced training in clinical nutrition. 1750 30th Street, #319, Boulder, Colorado 80301 / TEL: 303.415.0229 FAX: 303.415.9154. Website: www.dfhi.com
Author: Omni Nutraceuticals
Real Cholesterol Control. In keeping with Omni Nutraceuticals commitment to developing clinically proven and unique patented products, Cholestaid is the first cholesterol reduction supplement that eliminates cholesterol before it enters the bloodstream. Our patented esterin process alfalfa renders a Physicians who state that: "Through its ability to neutralize cholesterol (Cholestaid) may reduce cholesterol levels by up to 40% "Dear Sirs, Cholestaid, an alfalfa saponin, is used by millions of people in Europe since 1990. It may reduce cholesterol levels by up to 40% through its ability to neutr http://www.omninutra.com/brands/cholestaid_testimonials.asp Cholestaid Clinical Research: About Esterin Process Alfalfa.. Esterin Process Alfalfa contains only this specially processed alfalfa. More importantly, this exclusive patented Esterin process removes the toxic substances coumesterol and canavanine and provides a highly potent form of saponins from the alfalfa l
What is Cholestaid? Cholestaid is a food supplement that neutralizes cholesterol in the stomach, thereby preventing new cholesterol from reaching the bloodstream. By blocking new cholesterol, Cholestaid allows the body to rid itself of bad cholesterol naturally.
What is the active ingredient in Cholestaid? The active ingredient in Cholestaid is a non-toxic extract of alfalfa called saponin, a concentrated form found only in Cholestaid.
How does Cholestaid work and how is it completely unique? Cholestaid is revolutionary in that it is the only cholesterol-reduction product that neutralizes new cholesterol before it gets into the bloodstream. The Esterin process alfalfa extract in Cholestaid binds with cholesterol in the stomach before it enters the bloodstream, enabling this new cholesterol to be excreted from the body and allowing the body to rid itself of bad cholesterol naturally.
How much does cholestaid reduce LDL or "bad" cholesterol levels? A clinical study has concluded that Cholestaid reduces LDL (low-density lipoproteins) or "bad" cholesterol by 29%.
How are HDL or "good" cholesterol levels affected by Cholestaid? Good cholesterol levels appear to be raised by Cholestaid. In a recent clinical study, Cholestaid was shown to increase serum HDL cholesterol 34.7% in men, and increase serum HDL cholesterol 27.2% in women. When this increase is factored together with the reduction in LDL or "bad" cholesterol, it has been shown that Cholestaid may reduce overall cholesterol by up to 42%.
How do other anti-cholesterol agents typically work? Most anti-cholesterol agents generally act on the liver. Since the liver is the cholesterol production center of the body, these anti-cholesterol agents may block cholesterol synthesis by going right to the "factory" of cholesterol. But good cholesterol is also produced in the liver. Moreover, these agents act on the liver after cholesterol's absorption into the bloodstream.
Who can benefit from taking Cholestaid? The beneficiaries of Cholestaid are people who wish to reduce cholesterol through natural means with no side effects.
Are any doctors currently recommending Cholestaid? Yes, please refer to testimonials section.
How does Cholestaid compare to garlic, a typical anti-cholesterol supplement? Cholestaid's Esterin process alfalfa extract produces a 20% greater reduction in cholesterol than garlic. Clinical documentation shows that the Esterin process alfalfa in Cholestaid reduces cholesterol by up to 29%, as compared to garlic at 9%. Unlike garlic formulas and other cholesterol reducing agents which act upon the liver, Cholestaid neutralizes cholesterol in the stomach and prevents it from reaching the bloodstream.
Why not simply take an alfalfa supplement instead of Cholestaid? Cholestaid contains a concentrated saponin extract of alfalfa not found in conventional alfalfa supplements. It is impossible to consume an effective amount of saponins that way - unless one consumes barrels of alfalfa at a time! Only Cholestaid puts the power of non-toxic, concentrated saponins in a supplement that allows the body to rid itself of bad cholesterol naturally and effectively.
Are there any side effects? None when taken as directed.
How should Cholestaid be taken? As a dietary supplement, it is recommended that adults take two tablets three times daily with meals for the first four to six weeks. Thereafter, take one tablet three times daily with meals or as prescribed by your physician.
Where can consumers buy Cholestaid? Cholestaid is available at mass-market retailers, club stores, and health food stores.
Where can consumers find out more about Cholestaid? For more information about Cholestaid and the entire line of Omni Nutraceuticals products, visit the rest of the Omni Nutraceutical web site at www.omninutra.com.
What are the ingredients in Cholestaid? Each Cholestaid tablet contains 900 mg of Esterin alfalfa extract and 100mg citric acid. Cholestaid has no sugar, starch, no artificial preservatives, flavors, or colors. It's is sodium-free. It contains no corn, wheat, or soy products. No dairy and no meat or meat by products. Cholestaid is yeast free and contains no known allergens. Cholestaid is (K) Kosher approved.
What is cholesterol? Cholesterol is largely misunderstood. It is not bad in and of itself, but a vital building block of the body that must be kept in balance. Cholesterol is a waxy, fat-like substance also called lipid (fat) alcohols. Important tissues and organs such as the brain, spinal cord, kidneys, and adrenal glands utilize cholesterol. It is also essential in the manufacture of nerve tissue, bile, and many hormones. Low-density (LDL) and high-density (HDL) lipoproteins transport cholesterol through the blood stream.
What is bad cholesterol (LDL)? Low density lipoproteins, or LDL, carry cholesterol through the bloodstream for participation in the cell-building needs of the body, but leave behind excess deposits called plaque, which accumulate on the walls of arteries.
What is good cholesterol (HDL)? High-density lipoproteins, or HDL, remove these excess deposits, "cleaning" the arterial walls for the free flow of blood through the body. This excess LDL, or "bad"cholesterol is transported by the HDL, or "good" cholesterol and is excreted.
Why are bad cholesterol levels so high in Americans? When there is too much cholesterol in the diet, an imbalance results where HDL, or "good" cholesterol cannot "clean" all of the excess LDL, or "bad" cholesterol left behind. Plaque remains. Heart disease, heart attack, hardening of the arteries and a host of other problems are invited.
Author: Robert E. Kowalski, The 8-Week Cholesterol Cure (New York: Harper & Row, 1987).
A prescription drug that reduces blood cholesterol levels. It functions by binding fats in the intestine, from which they are excreted in feces. The drug comes in granular form and is mixed with water or juice. It is taken three to four times per day.
Author: Jane Ramberg. www.glycoscience.com
Chromium is an essential trace element that potentiates the action of insulin in carbohydrate, lipid, and protein metabolism. When compared with control animals, rabbits receiving a cholesterol-enriched diet for over 3 months experienced reduced aortic plaque following treatment with chromium chloride. Abraham AS, Brooks BA, Eylath U. Chromium and cholesterol-induced atherosclerosis in rabbits. Ann Nutr Metab 1991;35:203-207.
Author: Jane Ramberg. www.glycocience.com
Chromium is an essential trace element in certain forms that potentiates the action of insulin in carbohydrate, lipid, and protein metabolism 1 and activates certain enzymes involved in the production of energy from carbohydrates, fats, and proteins.2 Chromium picolinate, a biologically active form of chromium, has been used as a nutritional supplement.3 Complexing chromium with picolinate renders it lipophilic, thus facilitating its entry through the plasma membrane of cells.4 Dietary chromium picolinate has demonstrated antioxidant activity.5 Type II diabetics receiving chromium picolinate supplementation showed improved post-prandial glucose, fasting insulin and total plasma cholesterol levels.7
Anderson RA, Cheng N, Bryden NA, Polansky MM, Chi J, Feng J. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes.
See the entry titled “Statins Reduce CoQ10 Level”
SOURCE: roots of Dahlia variabilis
HISTORICAL USES: Prior to WWI, German companies extracted laevulose (“diabetic sugar”) from Dahlia tubers or chicory roots 1
Originally a native of Mexico, Dahlia variabilis as been introduced to other parts of the world. DAHLULIN is a patented blend of inulin and fructooligosaccharides [oligofructose is a chain of 3-6 fructose molecules; inulin is a polysaccharide composed of fructose molecules in long chains] from the roots of Dahlia variabilis. Prebiotics are non-digestible food ingredients that benefit the host by selectively stimulating the growth of beneficial colonic bacteria. Inulin and oligofructose are fructans that resist degradation by human enzymes. Found in many fruits and vegetables, their properties lend support to their technical classification as a dietary fiber.2
Oligofructose, a product of inulin hydrolysis, is fermented in the colon by bacteria, producing short-chain fatty acids and lactate. Oligofructose and inulin consumption increases fecal bacterial biomass.2
In vitro and animal experiments suggest that fructooligosaccharide consumption may alter liver lipid metabolism, resulting in reduced plasma triglyceride, phospholipid and cholesterol levels.8 Human diabetics consuming oligofructose showed a decrease in serum total and LDL cholesterol.9
Fiordaliso M, Kok N, Desager JP, et al. Dietary oligofructose lowers triglycerides, phospholipids and cholesterol in serum and very low density lipoproteins of rats. Lipids 1995;30:163-167.
Yamashita K, Kawai K, Itakura M. Effects of fructo-oligosaccharides on blood glucose and serum lipids in diabetic subjects. J Nutr Res 1984;4:961-966.
“Diet for Dyslipidemia”
Frank A. Franklin, Jr., MD, PhD, and Cynthia C. Franklin, MPH, RN, CPNP, Birmingham, Ala
[Clin Rev Spring:39-46, 2000. © 2000 Southern Medical Association]
Introduction [first two paragraphs only are excerpted here]
Diet and activity modification is the first step in the control of dyslipidemia, and for many patients with mild dyslipidemia, it may be the only therapy necessary. In more severely affected patients who require lipid-lowering medications, diet should remain an important component of their care. Many patients become confused about dietary recommendations and often abandon therapy because of their perception of conflicting reports in the popular media and constantly changing recommendations by national organizations. One role of the physician is to assist patients in these interpretations and to guide them to additional credible resources, such as dietitians and several national organizations and their publications and Web sites.
Some Web sites are the American Dietetic Association at www.eatright.org; American Heart Association at www.americanheart.org; National Heart, Lung, and Blood Institute at www.nhlbi.nih.gov; Tufts University at www.navigator.tufts.edu; US Department of Agriculture at www.nal.usda.gov/fnic; Center For Science in the Public Interest at www.cspinet.org.; and Mayo Clinic at www.mayohealth.org. Also, some newsletters for the general public are usually reliable sources for unbiased and current nutrition information, especially those published by Tufts (Tufts University Health and Nutrition Letter), Harvard (Harvard Heart Letter) and the Center for Science in the Public Interest (Nutrition Action Health Letter). This review is an update for practitioners based on a previously published chapter.1
1.Heimburger DC, Weinsier RL: Handbook of Clinical Nutrition. St. Louis, Mosby, 3rd Ed, 1997
Table 1. Dietary Recommendations for Lowering Serum Cholesterol Levels
Nutrient Step I Diet Step II Diet Average American Diet
Fat (%energy) </=30 </=30 34
SFA (% energy) <10 <7 13
MUFA (% energy) </=15 <15 14
PUFA (% energy) </=10 </=10 5
Cholesterol (mg) <300 <200 260 to 360
Carbohydrate (%energy) >55 >55 ~50
Protein (% energy) ~15 ~15 14 to 15
Total calories To achieve and maintain desirable body weight
SFA = saturated fatty acid; MUFA = monounsaturated fatty acid; PUFA = polyunsaturated fatty acid.
Table 2. Major Sources of Saturated Fat in the American Diet
Food Group (% of SFA of Current American Diet)
Food to Decrease Food to Choose
Meat and mixed dishes (39%)
Hamburgers, beefsteaks, roasts, hot dogs, ham, luncheon
meats, pork, bacon, sausage, high- saturated fatty acid (SFA) dishes (pizza, soup,
casseroles, chili, pot pies)
Fish, shellfish, poultry without skin, lean red meats,
beans, peas, other meat substitutes
Dairy products (23%)
Whole or 2% milk, whole-milk yogurt, regular cheese, butter,
ice cream, frozen dairy desserts
Skim milk or 1% milk or buttermilk, low-fat yogurt, and
frozen dairy desserts
Sweets and snacks (14%)
High-saturated-fat items (doughnuts, cookies, cakes, chips,
Sweets and angel-food, low-fat sweets, fruit, baked
goods and chips made with unsaturated oil
Cooking fat/convenience foods (13%)
Hard margarine, animal fat
Unsaturated, unhydrogenated oil (olive, canola,
safflower, soybean, peanut, sunflower); liquid
margarine; seeds and nuts
Egg whites, egg substitutes
Invisible fat (3%)
High-saturated-fat items; processed, packaged foods;
breads, rolls, and crackers
Whole-grain breads, low-fat rolls, muffins, crackers
Frank A. Franklin, Jr., MD, PhD, is Professor of Pediatrics and Nutrition Sciences and Director of the Division of Gastroenterology and Nutrition, and Cynthia C. Franklin, MPH, RN, CPNP, is Research Assistant in the Department of Pediatrics and Nutrition Sciences at the University of Alabama at Birmingham.
Jane Ramberg, MS and Steve Nugent, PhD, NMD, www.glycoscience.com
Dioscorea is one of the largest plant genera known, containing 600-800 species.1 Found largely in tropical regions,2 some species are also found in North America.3 It is a member of the family Dioscoraceae….The Dioscoraceae belongs to the order Liliales, which also contains the family Aloaceae, of which Aloe vera is a member.3 ,5
Dioscorea plants give rise to delicate vines and large tuberous roots. These roots store the nutrients that allow these plants to survive dramatic climactic extremes and are the part of the plant prized by humans. They are true yams; that is, they are not related to the sweet potato, erroneously called yam in the U.S.1
True yams have been cultivated since prehistory,2 and are a staple food throughout the tropics,1 ,2 Central America, and the Caribbean.6 In China, roots of D. bulbifera are used to treat cancers, stop bleeding, and reduce inflammation; roots of D. opposita are used as a tonic for the spleen, stomach, lungs, and kidneys.7 Extracts of D. dumetorum have been used in African traditional medicine for the treatment of diabetes.8 In North America, the roots of D. villosa were used before the arrival of Europeans to relieve the pains of childbirth, and as a diuretic, emetic, expectorant, and remedy for colic and muscle spasms.9
In numerous studies, plant steroids have been shown to lower plasma cholesterol levels in animal models26 and similar results have been documented for dietary Dioscorea. Dietary diosgenin has been shown to decrease plasma cholesterol levels in numerous animal models17 ,27 ,28 and decrease cholesterol absorption,28 liver cholesterol levels and synthesis of bile acids.26 ,29 When the bile duct of rats was obstructed, which usually causes damage of liver cells due to the accumulation of toxins, diosgenin was able to reduce the extent of the liver cell damage.26 In addition, synthetic glycosides of diosgenin decreased cholesterol absorption in rats,28 ,30 ,31 decreased plasma cholesterol, and increased excretion of neutral steroids.30
1. Norton SA. Useful plants of dermatology. III. Corticosteroids, Strophanthus, and Dioscorea. J Am Acad Dermatol. 1998;38(2 Pt 1):256-259.
2. Bruneton J. Pharmacognosy Phytochemistry Medicinal Plants. 2nd Edition. Paris, France: Lavoisier Publishing, 1995.
3. Fernald ML. Gray's Manual of Botany. 8th Edition. New York: D. Van Nostrand Company, 1970.
4. Castleman M. The Healing Herbs Edition. New York: Bantam Books, 1995.
5. Coates BC, Ahola R. The Silent Healer. A Modern Study of Aloe Vera . 2ndBill C. Coates, 1984.
6. Rosser A. The day of the yam. Nurs Times. 1985;81(18):47.
7. Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica (Revised Edition). Edition. Seattle, Washington: Eastland Press, 1993.
8. Iwu MM, Okunji CO, Ohiaeri GO, et al. Hypoglycaemic activity of dioscoretine from tubers of Dioscorea dumetorum in normal and alloxan diabetic rabbits. Planta Med. 1990;56(3):264-267.
9. Magic and Medicine of Plants. Readers Digest. Pleasantville, NY: The Reader's Digest Association, Inc., 1986.
16. Hostettmann K and Marston A. Saponins. Chemistry and Pharmacology of Natural Products. Cambridge University Press; Cambridge, England. 2001.
17. Sauvaire Y, Ribes G, Baccou JC, et al. Implication of steroid saponins and sapogenins in the hypocholesterolemic effect of fenugreek. Lipids. 1991;26(3):191-197.
26. Accatino L, Pizarro M, Solis N, et al. Effects of diosgenin, a plant-derived steroid, on bile secretion and hepatocellular cholestasis induced by estrogens in the rat. Hepatology. 1998;28(1):129-140.
27. Laguna A, Gomez-Puyou A, Pena A, et al. Effect of diosgenin on cholesterol metabolism. J Atheroscler Res. 1962;2(459-470.
28. Cayen MN, Dvornik D. Effect of diosgenin on lipid metabolism in rats. J Lipid Res. 1979;20(2):162- 174.
29. Uchida K, Takase H, Nomura Y, et al. Changes in biliary and fecal bile acids in mice after treatments with diosgenin and beta-sitosterol. J Lipid Res. 1984;25(3):236-245.
30. Malinow MR, Elliott WH, McLaughlin P, et al. Effects of synthetic glycosides on steroid balance in Macaca fascicularis. J Lipid Res. 1987;28(1):1-9.
31. Malinow MR. Effects of synthetic glycosides on cholesterol absorption. Ann N Y Acad Sci. 1985;454(1):23-27.
11/29/99 source temporarily lost
The skinny on essential fatty acids (good fats) and proper labeling of trans fatty acids (bad fats)
Good fat, bad fat, low fat, no fat. We've heard it all. Sorting out truth from hype is essential. In fact, essential is the key word. Essential fatty acids (EFAs) are essential to our health. Cutting out all fat does not equate with good health.
The body does not manufacture these EFAs; we have to get them from our diets or from supplements. The American diet is generally lacking in the essential fatty acids linoleic acid (Omega-6) and linolenic acid (Omega-3). EFAs are found in fish oils, flaxseed oil and unrefined polyunsaturated vegetable oils. Gamma Linolenic Acid is found in the highest concentration in borage seed oil.
Essential fatty acids play important roles as components of the nervous system and cell membranes; they help produce prostaglandins, a hormone-like substance found in virtually all body tissues; they help provide energy; and they play a role in preventing heart disease, cancer, and autoimmune diseases. An insufficient amount of EFAs plays a role in chronic degenerative disorders.
Fatty Acid Deficiency
There is a strong correlation between the American diet and our high incidence of heart disease, cancer and stroke. Studies show that we may only be getting 10% of the essential fatty acids needed for good health.
Most doctors do not recognize EFA deficiency. Symptoms are often overlooked or mistaken for something else. Many chronic diseases—from heart disease to chronic fatigue—that are not adequately remedied by modern medicine may be signs of fatty acid deficiency. Dr. Elson Haas, author of Staying Healthy With Nutrition, and director of the Preventive Medical Center of Marin recommends EFAs for people suffering with allergies and asthma. EFAs such as evening primrose oil are also recommended for reversing Candida.
The best way to prevent fatty acid deficiency is to reduce animal products and increase plant foods including nuts and seeds.
All Fats are Not Created Equal
Here's another hype and another danger brought to us courtesy of the advertising industry—hidden, unnatural fats.
Many packaged and processed products are boasting that they are "low-fat," meaning they are free of a specific category of fats (saturated fats) that are believed to stick to arterial walls and build up as plaque. The manufacturers and advertisers may be colluding to "stick" to the letter of the law while hiding important information. Many of these products contain hydrogenated fats or trans fatty acids (transformed fats)—unnatural products, and the worst offenders.
Such labeling preys on the public's knowledge that it is best to eliminate saturated fats. The American Cancer Association and the American Heart Association recommend that less than 30% of dietary intake should be fat, and that unsaturated fats such as olive and canola oils are the healthiest. Claiming to be low in fat may be a lie if the products contain hydrogenated fats.
The problem comes when foods containing fats or oils are commercially refined. Not only are the essential fatty acids destroyed when foods are adulterated, but the process of refining (involving excessive heat and light) causes a chemical reaction. The molecules of polyunsaturated fatty acids (healthy when unrefined) change from a C-shape to a straight line, creating an unnatural fat molecule. Another synthetic fat is created when hydrogen is added to liquid polyunsaturated fatty acids. The chemical reaction results in hydrogen bonds that create a solid or semisolid fat. The process, called hydrogenation, is an unnatural way to avoid spoilage. The body is ill-prepared to handle these synthetics.
Trans fatty acids are used to increase the shelf life of food and perk up taste, especially in snack foods. Stick margarines are likely to contain both hydrogenated fats and trans fatty acids, as do certain baked goods (crackers, cookies, doughnuts, etc.) and deep fried foods (French fries, chicken). Do they tell us this clearly on the labels? Of course not.
Truthful Food Labeling
The FDA is finally trying to do the right thing by proposing labeling laws that let us know about these unnatural, unhealthy fats. Proposed food labeling would alert consumers about this dangerous category of fats trans fatty acids or hydrogenated fats that are known to clog arteries and increase the risk of heart disease.
Experts believe that these transformed fats may be more harmful to the heart than saturated fats. With the new labeling, products would have to be low in transformed fat as well as saturated fat in order to call themselves low fat. The American Heart Association and National Cholesterol Education Programs say the new labeling is long overdue.
What to do
The typical American diet, leaning heavily on processed foods, does a double disservice: insufficient dietary intake of essential fatty acids, coupled with excessive intake of unhealthy or unnatural fats. Not only are we not getting enough essential fatty acids from our diet, but the unnatural fats may be competing in our systems to be metabolized first.
What should you do: Supplement to get EFAs, and read the fine print on labels to avoid hydrogenated fats.
And speaking of reading, Jade Beutler, RRT, RCP, has written extensively on the topic, including Understanding Fats and Oils, Your Guide to Healing with Essential Fatty Acids and Flax for Life! 101 Delicious Recipes and Tips Featuring Fabulous Flax Oil.
For more information on good and bad fats on this website, go to our search engine. Entering "trans fatty acid" as a keyword will access six articles; entering "essential fatty acids" accesses over 200 items; and for the use of all kinds of oils from primrose to shark oil entering "oils" lists 500 articles.
Author: Jane Ramberg. www.glycoscience.com
SOURCE: seed of Trigonella foenum graecum
SYNONYMS: Greek Hay
HISTORICAL USES: used for thousands of years in Egypt, India, and the Middle East as a food and spice and medicinally for fevers, mouth ulcers, bronchitis, and as a digestive aid. 1 Fenugreek seed is GRAS and may be used as a spice or natural seasoning.2 It is recognized by the German government as an approved herb for inflammation of the upper and lower respiratory tracts and is used externally to alleviate rheumatic and neuralgic pains, although repeated external applications can result in undesirable skin reactions.3 Fenugreek seed is a source of protein, fiber, high galactose galactomannans, sesquiterpenes, trigonelline and the steroidal saponin diosgenin.4
Animal studies have documented health benefits of fenugreek seed supplementation. Rats consuming fenugreek galactomannans experienced lower liver and plasma cholesterol and increased fecal weight when compared with animals consuming either fiber-free or cellulose-supplemented diets.5 In a study of hypercholesterolemic rats, 4 weeks of fenugreek supplementation significantly lowered serum cholesterol levels.6
Human studies have also documented health benefits. Consumption of powdered fenugreek seed significantly lowered postprandial serum glucose levels in type II diabetics.8 When compared with subjects consuming a control diet, type I diabetics experienced significantly reduced fasting blood sugar, improved glucose tolerance, and reduced serum triglycerides, total and LDL cholesterol, and very low density lipoprotein (VLDL) cholesterol following a 10-day period of fenugreek seed supplementation.9
4. Bruneton J. Pharmacognosy Phytochemistry Medicinal Plants. 2nd ed. Paris, France: Lavoisier Publishing; 1995.
5. Evans AJ, Hood RL, Oakenfull DG, Sidhu GS. Relationship between structure and function of dietary fibre: a comparative study of the effects of three galactomannans on cholesterol metabolism in the rat. Br.J Nutr 1992;68:217-229.
Stark A, Madar Z. The effect of an ethanol extract derived from fenugreek (Trigonella foenum-graecum) on bile acid absorption and cholesterol levels in rats. Br.J Nutr 1993;69:277-287.
8. Madar Z, Abel R, Samish S, Arad J. Glucose-lowering effect of fenugreek in non-insulin dependent diabetics. Eur.J Clin.Nutr. 1988;42:51-54.
9. Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur.J Clin.Nutr. 1990;44:301-306.
Authors: Jane Ramberg and Tom Gardiner. www.glycoscience.com
SOURCE: Fiber is simply a polymer (soluble and insoluble) from a plant, typically from the plant cell wall. Cellulose, pectin, lignin, waxes, gums, and mucilages are some of the many types of dietary fiber.1 Vegetarians consume a diet that is lower in fat and higher in fiber than the diet of meat eaters. Mortality from all causes of death is significantly lower for vegetarians than for age- and gender-matched non-vegetarians.2 Vegetarians have less coronary heart disease and cancer, and also have lower serum total and low-density lipoprotein (LDL) cholesterol, blood pressure and body weight.3 In 1975, Burkitt and Trowell were the first to propose a link between low dietary fiber intake with several Western diseases.4 Populations that consume high-fiber diets also have a lower incidence of numerous GI complaints, including gallstones, constipation, irritable bowel syndrome, diverticular disease of the colon, appendicitis, hemorrhoids, and hiatal hernia.5
Soluble fiber can also sequester bile salts, thereby significantly affecting lipid absorption. Over 200 human studies have supported the conclusion that a diet rich in soluble fiber may lower plasma cholesterol.25 A recent review of human clinical studies (including some studies of normal volunteers, others of subjects with elevated plasma lipids or with diabetes) examining the effects of soluble fiber on blood chemistry found that 88% reported lowered serum total cholesterol and 84% reported lowered serum LDL cholesterol. The majority of studies reported no significant improvements in serum high-density lipoprotein (HDL) cholesterol or triglycerides.26 Eight out of ten studies of children with hypercholesterolemia found that soluble fiber supplementation (1-38 g/day) lowered serum LDL cholesterol by 6% to 23%.27 Six grams or more of daily soluble fiber can lower total and LDL cholesterol.28 As little as 8 grams of gums can lower serum total cholesterol.26
The above-documented effects of soluble fiber on blood pressure and serum cholesterol impact coronary artery disease (CAD). A 20-year study of initially healthy middle-aged men found an association between increased dietary fiber intake and lowered risk of coronary heart disease 39 A 12-year study reported that a 6-gram increment in daily fiber intake was associated with a 25% reduction in ischemic heart disease mortality. This protective effect endured following multivariate adjustments for age, sex, blood pressure, plasma cholesterol, obesity, fasting plasma glucose, and cigarette smoking.40
The American Heart Association recommends a diet that includes a generous amount of dietary fiber and complex carbohydrates.41
Anderson JW. Dietary fiber and human health. Hort Sci 1990;25:1488-1495.
4. Burkitt DP, Trowell HC. Refined carbohydrate foods and disease. Some implications of dietary fiber. London: Academic Press; 1975.
Truswell AS. Dietary fibre and blood lipids. Curr.Opin.Lipidol. 1995;6:14-19.
26. Glore SR, Van Treeck D, Knehans AW, Guild M. Soluble fiber and serum lipids: a literature review. J.Am.Diet.Assoc. 1994;94:425-436.
27. Kwiterovich POJ. The role of fiber in the treatment of hypercholesterolemia in children and adolescents. Pediatrics. 1995;96:1005-1009.
Anderson JW, Gilinsky NH, Deakins DA, et al. Lipid responses of hypercholesterolemic men to oat-bran and wheat-bran intake. Am.J Clin.Nutr. 1991;54:678-683.
Morris JN, Marr JW, Clayton DG. Diet and heart: a postscript. Br.Med J 1977;2:1307-1314.
Khaw KT, Barrett-Connor E. Dietary fiber and reduced ischemic heart disease mortality rates in men and women: a 12-year prospective study. Am.J Epidemiol. 1987;126:1093-1102.