FitSugar

3 Words to Know When You're Ordering Vegetarian

FitSugar — Tue, 18 Nov 2008 11:00:00 -0800

Vegetarians pay particular attention to ensuring they're consuming enough protein because there's no meat centerpiece to take care of that important nutritional component. There are often choices like tempeh and seitan for building a veggie-friendly salad that goes beyond tofu, and quinoa is a go-to grain because it contains high levels of protein. When you're choosing a meatless meal out, don't skim over these selections because you're not sure how to pronounce them. Expand your vegetarian vocab by learning how to say these three words.

Tempeh: Pronounced tem-pay, 4 ounces of this soy-based meatless alternative contains 22 grams of protein.
Seitan: Made from wheat gluten, this veggie option is pronounced say-tan or see-tan. Just 3 ounces of it contains 19 grams of protein.
Quinoa: Often referred to as the mother grain, the options with this protein-rich grain are endless. Ask for keen-wa, and you'll get 6 grams of protein in just 1/4 cup.

Source

5 Things: Highest Sources of Vegan Protein

FitSugar — Mon, 31 Mar 2008 09:30:00 -0700

Whether you are cutting back on meat and dairy products for health or moral reasons, it's good to remind ourselves that there are other forms of protein out there besides cheeseburgers, steak, and chicken satay. Check out these vegan sources.

Tempeh: 4 ounces gives you 22g of protein
Tofu: 1/2 cup serving equals 19.9g of protein.
Seitan: If you eat 3 ounces, you'll have consumed 19g of protein.
Plain soy milk: 1 cup of soymilk has 11g of protein.
Edamame: You'll get 10g of protein by eating 1/2 a cup of these beans.

Incorporating these foods into your meals will not only give you cholesterol and saturated fat free sources of protein, but since many of them contain fiber as well, they're even healthier.

Fit's Tips: Not sure how much protein you should be getting in a day? Then check out this chart.

Source

Learn to Love: Tempeh

FitSugar — Mon, 03 Mar 2008 03:00:00 -0800

If you're working on getting more protein in your diet, but are concerned about getting too much cholesterol and saturated fat from beef, then tempeh is a great alternative. It has a much firmer consistency than tofu, so many people think it looks and feels more like meat.

Why should you love tempeh? Take a look at the nutritional info:

Serving Size	4 ounces (half the package)
Calories	250
Total Fat	10g
Saturated Fat	1.5g
Cholesterol	0mg
Sodium	60mg
Carbs	17g
Fiber	14g
Sugar	0g
Protein	22g

Check out all that protein and fiber! I'm amazed one serving has that much. Tempeh is great because you can flavor it anyway you want.

Not sure how to cook it? To check out my easy recipe for bell peppers and tempeh read more.

What you need:

1 package of tempeh
3 peppers (1 red, 1 orange, 1 yellow)
tamari (soy sauce)
2 cloves of garlic, minced
cumin
thyme
honey
olive oil

What you do:

Cut the tempeh up in little cubes. Place them in a pan with 1 tbsp olive oil on low heat.
Pour on tamari, enough to turn each piece a dark brown color.
Drizzle a drop of honey on each piece of tempeh, then sprinkle with cumin and thyme.
Stir it all up and let it cook on low heat for about ten minutes.
While that's cooking, cut up all three peppers.
Add the sliced peppers and minced garlic to the pan and let them cook next to the tempeh for about five minutes.
Now mix the two together and let cook for another five minutes.
Serve hot and enjoy.

Print recipe with images | without images

Soy Wars: Tofu vs. Tempeh

FitSugar — Wed, 13 Feb 2008 03:00:00 -0800

Whether you're a vegetarian or not, everyone can benefit from adding a little soy to their diet. Although there's some talk about a connection between soy and breast cancer, there's no evidence to back up the claim. Since soy products are a healthy source of protein they're a great alternative for people trying to cut back on meat and dairy products that are high in cholesterol.

Tofu and tempeh are both made from soybeans, but what's the difference between the two? Is one healthier than the other? To find out read more

Check out this chart comparing tofu and tempeh.

	Tofu	Tempeh
How it's made	By curdling fresh hot soymilk with a coagulant.	By fermenting cooked soybeans with a mold.
How it's sold	It comes in five inch sized blocks, and you can buy it in four varieties: silken (used for creamy dishes), soft (great for soups), firm, and extra firm (the last two are great for stir fries). It's usually packaged in water to help it stay moist.	It's sold in flat rectangular pieces about eight inches long.
Appearance	White, smooth, and wet.	Brownish in color and dry. You can see the whole soybeans.
Consistency	Soft, smooth, and spongy.	Firm and chewy.
Flavor	Has hardly any taste on its own, but when added to recipes, takes on the flavor of whatever you're making.	Has a slight earthy sweet taste.
Protein in 1/2 cup	10.1g	15.4g
Fiber in 1/2 cup	.5g	3.5g
Calories in 1/2 cup	97	160

Since tempeh is less processed than tofu, it's healthier in general, so that's why it has more protein and fiber than tofu. If you've never tried tempeh, you can find it at most health food stores (it's refrigerated). Start to incorporate this soy product into your recipes by crumbling it up and adding it to soups, casseroles, and your pasta sauce. It'll add a chewy consistency and some extra protein and fiber.

Mock Meat

FitSugar — Thu, 22 Mar 2007 14:30:00 -0700

Beef is loved by many a person, maybe a little too much perhaps. Diets high in red meat have been linked to heart disease due to its high fat content.

A recent study found a link between eating high amounts of red meat and developing colon cancer. It can also increase the risk of heart disease in diabetics.

Anyway you slice it, eating a ton of beef just doesn't do a body good. Instead of simply switching to the other "white meat," why not try a meat alternative instead? Take a walk on the healthy side of life and check out some mock meats. Now don't get me wrong - they don't taste exactly like real beef, but they can be pretty tasty just the same.

Tofu, made from soaked and ground up soybeans, can be cubed and baked or stir-fried. It is also used to make Tofurky and Tofu Pups.

Tempeh is made with whole, fermented soybeans. It's great to marinate and bake. Fakin Bacon is made out of tempeh. Some people find it easier to digest than tofu.

The chewy consistency of Seitan (the vegetarian wheat meat), made from wheat gluten, is great in mock chicken nuggets, or mock steak strips for fajitas. You can make it yourself, or buy the pre-made ones at the store.

TVP (textured vegetable protein) can be used to make veggie burgers, or added to chili or other soups to replicate a meaty texture.

These meat alternatives taste fairly bland, making them perfect for marinades. Plus they're great alternative sources of protein.

Fits Tips: Many Asian restaurants offer dishes with these mock meats. If you're nervous about making them yourself, order them the next time you go out to eat. Their delicious taste and texture is not only satisfying but healthier for you than red meat.

6 Meatless Ways to Get Five Grams of Protein

FitSugar — Wed, 29 Apr 2009 10:00:00 -0700

Eating enough protein daily helps with weight loss, since this macronutrient satiates your hunger better than carbs or fats. Plus, protein is the building block of the human body. Your muscles, skin, hair, and connective tissues are mostly made up of protein, but it also plays a huge role in every cell in your body. Our enzymes, hormones, and DNA are also partially made up of protein, so it's important to get enough every day. Depending on your weight and activity level, a woman needs between 40 and 60 grams per day. Check this chart to see exactly how much you need.

Since I'm always hearing that women feel like they have a difficult time getting their daily amount, here are five easy ways to get an added five grams of protein.

Add 1/2 a cup of garbanzo beans (chickpeas) to your salad for 5.9 grams of protein. If you're not a fan of beans, then sprinkle one ounce of organic shredded cheddar cheese instead to get six grams of protein.
Crumble 1/8 of a block of tofu and mix it into your pasta sauce for an added 6.4 grams of protein.

To see the other ways to get five grams of protein, read more.

Spoon out two ounces of cottage cheese and add it to cut-up cantaloupe for 7.8 grams of protein.
Snack on 1/4 cup edamame (boiled green soybeans) and you'll consume 5.6 grams of protein.
Just one ounce of tempeh (1/8 of a package) can be added to your stir fry to get 5.5 grams of protein.
Munch on 20 almonds, which contain 5.1 grams of protein. Or if you prefer, you can spread two tablespoons of almond butter on crackers to get 4.8 grams of protein.

Source

What Does Your RDI Look Like: Vitamin B12

FitSugar — Wed, 18 Mar 2009 03:30:00 -0700

Vitamin B12 is extremely important for your health because it helps maintain nerve cells and red blood cells. More importantly though, it's needed in order to make DNA, the genetic material found in every cell in your body. An adult woman needs 2.4 micrograms (mcg) of B12 a day. If she's pregnant she needs 2.6 mcg, and if she's breastfeeding, she needs 2.8 mcg. That's a pretty small amount, but the thing is, it's found mostly in animal products, so if you don't eat meat, you want to be sure to get B12 from other sources.

Are you getting your RDI? To find out read more.

1 cup milk

Food	Amount of B12
1 piece chicken breast	.6 mcg
3 oz. turkey (dark meat)	.3 mcg
3 oz. shellfish	84 mcg (whoa!)
3 oz. shrimp	1 mcg
3 oz. trout	5.4 mcg
3 oz. haddock	1.2 mcg
3 oz. tuna	1 mcg
3 oz. pork	.6 mcg
3 oz. sirloin steak	1.5 mcg
3 oz. hamburger	2.1 mcg
1 cup tempeh	.1 mcg
6 oz. yogurt	1.4 mcg
.9 mcg
1 cup Edensoy Extra vanilla soy milk	3 mcg
1 cup Organic Valley chocolate soy milk	3 mcg
1 oz. cheddar cheese	.2 mcg
1/2 cup ricotta cheese	.4 mcg
1 cup cottage cheese	1.6 mcg
1 egg	.6 mcg
1 tbsp. Red Star nutritional yeast	4 mcg
3.4 cup Kashi Heart to Heart cereal	6 mcg
3.4 cup Barbara's Honey Nut O's cereal	.6 mcg
1 Barbara's Apple Cinnamon Fruit & Yogurt Bar	.2 mcg

Source

What's the Deal With Seitan?

FitSugar — Fri, 14 Dec 2007 11:00:00 -0800

There are so many meat alternatives out there, which is wonderful for vegetarians. There are tofu turkey, tempeh bacon, and seitan chicken nuggets. Tofu and tempeh are both made from soybeans, but seitan is actually made out of wheat gluten. It's sometimes referred to as the vegetarian wheat meat.

When cooked, seitan has more of a chewy texture than tofu or tempeh, making it a popular meat substitute. Many vegetarian restaurants use it to make mock steak strips, mock chicken in stir-frys, and I've even had mock eel made out of seitan.

Since people eat meat alternatives as a source of protein, I was curious to see how seitan compared to tofu and ground beef? To find out read more

	3 oz. Nasoya Chinese Spice Seasoned Firm Tofu	3 oz. LightLife Teriyaki Seitan	3 oz. 85 percent Fat-Free Ground Beef
Calories	90	110	181
Total Fat	5g	0g	12.6g
Saturated Fat	1g	0g	4.9g
Cholesterol	0mg	0mg	57mg
Sodium	220mg	380mg	55mg
Carbs	3g	6g	0g
Fiber	1g	1g	0g
Sugar	less than 1g	4g	0g
Protein	8g	19g	15.6g

Check out the difference in protein! I'm totally amazed that seitan has 19g and is only 110 calories. It even has more protein than ground beef. Very impressive. If you're looking for new ways to get your daily protein, give seitan a try. Since wheat gluten doesn't have a very strong flavor, you can flavor it any way you want. It'll give your dishes the chewy consistency you get from meat, but without all the cholesterol and saturated fat.

Lactobacillus acidophilus

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Overview

Lactobacillus acidophilus (L. acidophilus) is the most commonly used probiotic, or "friendly," bacteria. Such healthy bacteria inhabit the intestines and vagina and protect against the entrance and growth of "bad" organisms that can cause disease. This is accomplished through a variety of mechanisms. For example, the breakdown of food by L. acidophilus leads to production of lactic acid, hydrogen peroxide, and other byproducts that make the environment hostile for undesired organisms. L. acidophilus also produces lactase, the enzyme that breaks down milk sugar (lactose) into simple sugars. People who are lactose intolerant do not produce this enzyme. Symptoms such as gas, bloating, and discomfort develop. For this reason, L. acidophilus supplements may be beneficial for these individuals.

Other potential probiotics include a variety of Lactobacillus species (spp.), such as the caseiGG, rhamnosus, NCFM, DDS-1, and johnsonii strains, Bifidobacterium longum, Bifidobacterium bifidum, Streptococcus thermophilus, Enterococcus faecium, Saccharaomyces boulardii, Bacillus spp., and Escherichia coli.

Prebiotics refers to the soluble fiber component found in certain foods or supplements that stimulate the growth of probiotics in the gastrointestinal tract. Examples include fructooligosaccharides (FOS).

Uses

Probiotics offer a variety of potential therapeutic uses. These include the following:

Vaginal infections

Several clinical studies support the use of Lactobacillus acidophilus vaginal suppositories in the treatment of bacterial vaginosis and candida (yeast) infections. A small number of clinical studies suggest that eating yogurt enriched with Lactobacillus acidophilus may be beneficial. Additional clinical research is needed.

Diarrhea prevention

Some clinical research exists that suggests Lactobacillus acidophilus may be effective when used to prevent diarrhea in travelers or in people taking antibiotics, although there are also some negative studies. Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) had significant efficacy on treating traveler's diarrhea. No serious adverse reactions were reported in 12 clinical trials for this condition. Additional human studies are needed in these areas.

Other uses

Other uses of Lactobacillus acidophilus includes:

Replacing the "friendly" intestinal bacteria destroyed by antibiotics.
Aiding digestion and suppressing disease-causing bacteria.
Used in the treatment of chronic constipation.
Treating overgrowth of "bad" organisms in the gastrointestinal tract (a condition that tends to cause diarrhea and may occur from use of antibiotics).
Alleviating symptoms of irritable bowel syndrome and, possibly, inflammatory bowel disease (such as Crohn's disease and ulcerative colitis).
Preventing or reducing the recurrence of urinary tract infections, and cystitis (bladder inflammation).
Improving lactose absorption digestion in people who are lactose intolerant.
Enhancing the immune response. Studies have suggested that consumption of yogurt or milk that contains specific strains of Lactobacillus or supplements with Lactobacillus or Bifidobacterium may improve the natural immune response. Further research is needed to confirm these early findings and to best understand how the improved immune function may or may not help in warding off infections.
Aiding the treatment of respiratory infections such as sinusitis, bronchitis, and pneumonia. More research is needed in this area.
Lowering risk of allergies. Examples include asthma, hay fever, food allergies to milk, and skin reactions such as eczema.
Helping to treat high cholesterol.
Reducing the risk of recurring bladder tumors once this cancer has been treated.
Other conditions under investigation for use of probiotics include colon cancer, human immunodeficiency virus (HIV) related diarrhea, and Helicobacter pylori (an organism that can lead to development of ulcers).

Dietary Sources

The primary dietary sources of L. acidophilus include milk enriched with acidophilus, yogurt containing live L. acidophilus cultures, miso, and tempeh.

Prebiotics are found in breast milk, onions, tomatoes, bananas, honey, barley, garlic, and wheat.

Available Forms

L. acidophilus preparations consist of dried or liquid cultures of living bacteria. These cultures are usually grown in milk but can sometimes be grown in milk-free cultures. L. acidophilus is available in the following forms:

Freeze-dried granules
Freeze-dried powders
Freeze-dried capsules
Liquid L. acidophilus preparations
Yogurt enhanced with probiotics

L. acidophilus supplements should be refrigerated for best quality. However some preparations are in a spore form which is resistant to breakdown under normal temperatures and are often used by travelers who do not have access to refrigeration who use probiotics supplements to help prevent intestinal infections. Check the package label for storage instructions.

Prebiotics occur naturally in foods, but supplements provide a more concentrated source of this substance. Prebiotics are oligosacchrides, chains of sugar units linked together. Inulin is a long-chain oligosacchride (from 2 - 60 sugars) and fructooligosaccharides (FOS) are short-chain oligosaccharides (from 2 - 7 sugars). It is not clear at this time which type of prebiotic is most effective, although fructoligosaccarhides (FOS) are the most commonly used.

How to Take It

Pediatric

Newborns and Infants (0 - 1 year): Liquid preparations may be used as a lotion and applied topically to diaper area for yeast infections and diaper rashes. If the child is on antibiotic therapy, ¼ tsp or ¼ capsule can be taken orally, 2 hours after each dose of antibiotics to replace beneficial bacteria. Use products specifically formulated for infants. Always check with your pediatrician before giving dietary supplements to an infant or child.

Add ¼ tsp or ¼ capsule to water for the treatment of oral infections.

Adult

Recommended doses of L. acidophilus vary depending on the health condition being treated. Check the specific dosage recommendations on the product label. The following list provides guidelines for the most common uses:

For prevention or treatment of diarrhea: Take 1 -2 billion viable cells per day, called colony-forming-units or CFUs. Some health care providers may recommend up to 10 - 15 billion cells per day).

For vaginal infections: Take 8 ounces of yogurt (with live active cultures containing one of the Lactobacillus or Bifidobacterium strains listed above) daily or an oral daily supplement containing at least 1 - 2 billion live organisms. Clinical experience also suggests that placing yogurt with live acidophilus cultures directly to the vaginal area, using a disposable spatula and wearing a sanitary pad, helps to relieve itching and inflammation. Similarly, lactobacillus capsules or tablets may be inserted directly into the vagina.

For cystitis: Use 1 - 2 capsules or tablets inserted into the vagina nightly for 2 weeks.

For maintaining normal intestinal flora: Take 1 - 15 billion viable cells daily. If using for prevention of antibiotic associated diarrhea, start taking the probiotic supplement after conclusion of the antibiotic treatment.

If diarrhea occurs with the dosage you are taking, decrease the dosage or stop taking the product and talk with your health care provider.

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Mild gastrointestinal upset and diarrhea may occur in some individuals (not on antibiotic therapy) who take more than 1 - 2 billion L. acidophilus cells daily.

There has been one report of anaphylaxis (a serious allergic reaction accompanied by shortness of breath and loss of consciousness) in a person taking inulin, a type of prebiotic.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use Lactobacillus or other probiotics without first talking to your health care provider.

Sulfasalazine -- A laboratory study suggests that L. acidophilus speeds up metabolism of sulfasalazine, a medication used to treat ulcerative colitis. The significance of this information is unknown.

Supporting Research

Alvarez-Olmos MI. Probiotic agents and infectious diseases: a modern perspective on a traditional therapy. Clin Infect Dis. 2001;32(11):1567-1576.

Cunningham-Rundles S, Ahrne S, Bengmark S, et al. Probiotics and immune response. Am J Gastroenterol. 2000;95(1 Suppl):S22-25.

de Roos NM, Katan MB. Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogenesis: a review of papers published between 1988 and 1998. Am J Clin Nutr. 2000;71(2):405-411.

de Vrese M, Marteau PR. Probiotics and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 Suppl 2):803S-11S.

Donnet-Hughes A, et al. Modulation of nonspecific mechanisms of defense by lactic acid bacteria: effective dose. J Dairy Sci. May 1999; 82(5):863-869.

Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. [Review]. JAMA. 1996;275(11):870-876.

Ewaschuk JB, Dieleman LA. Probiotics and prebiotics in chronic inflammatory bowel diseases. World J Gastroenterol. 2006;12(37):5941-50.

Favier C, Neut C, Mizon C, Cortot A, Colombel JF, Mizon J. Fecal ß-D-galactosidase production and Bifidobacteria are decreased in Crohn's disease. Dig Dis Sci. 1997;42(4):817-822.

Fedorak RN, Madsen KL. Probiotics and the management of inflammatory bowel disease. Inflamm Bowel Dis. 2004;10(3):286-299.

Friedrich MJ. A bit of culture for children: probiotics may improve health and fight disease. JAMA. 2000;284(11):1365-1366.

Gill HS, Rutherford KJ, Cross ML. Dietary probiotic supplementation enhances natural killer cell activity in the elderly: an investigation of age-related immunological changes. J Clin Immunol. 2001;21(4):264-271.

Gill HS, Rutherford KJ, Cross ML, Gopal PK. Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019. Am J Clin Nutr. 2001;74(6):833-839.

Gionchetti P, Rizzello F, Venturi A, Campieri M. Probiotics in infective diarrhea and inflammatory bowel diseases [Review]. J Gastroenterol Hepatol. 2000;15:489-493.

Gismondo MR, Drago L, Lombardi A. Review of probiotics available to modify gastrointestinal flora. Int J Antimicrob Agents. 1999;4:287-292.

Gorbach SL. Probiotics in the third millennium. Dig Liver Dis. 2002;34 Suppl 2:S2-S7.

Hatakka K, Savilahti, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centers: double-blind, randomized trial. BMJ. 2001;322(7298):1327.

Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med. 1992;116(5): 353-357.

Hilton E, Kolakowski P, Singer C, Smith M. Efficacy of Lactobacillus GG as a diarrheal preventive in travelers. J Travel Med. 1997;4(1):41-43.

Hove H, Norgaard H, Mortensen PB. Lactic acid bacteria and the human gastrointestinal tract [Review]. Eur J Clin Nutr. 1999;53(5):339-350.

Ishida Y, Nakamura F, Kanzato H, et al. Effect of milk fermented with Lactobacillus acidophilus strain L-92 on symptoms of Japanese cedar pollen allergy: a randomized placebo-controlled trial.Biosci Biotechnol Biochem. 2005;69(9):1652-60.

Jang T, Saviano DA. In vitro fermentation by human colonic bacteria is modified by Lactobacillus acidophilus supplementation. J Nutr. 1997;127(:1489-1495.

Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomized placebo controlled trial. Lancet. 2001;357(9262):1076-1079.

Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1571-1573.

McFarland LV. Meta-analysis of probiotics for the prevention of traveler's diarrhea. Travel Med Infect Dis. 2007;5(2):97-105.

Malin M, Suomalainen H, Saxelin M, Isolauri E. Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab. 1996;40:137-145.

Marteau PR, de Vrese M, Cellier CJ, Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr. 2001;73(2 Suppl):430S-436S.

Meydani SN, Ha WK. Immunologic effects of yogurt. Am J Clin Nutr. 2000;71(4):861-872.

Michetti P, Dorta G, Wiesel PH, et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans. Digestion. 1999;60(3):203-209.

Pradhan A, Majumdar MK. Metabolism of some drugs by intestinal lactobacilli and their toxicological considerations. Acta Pharmacol Toxicol (Copenh). 1986;58(1):11-15.

Rani B, Khetarpaul N. Probiotic fermented food mixtures: possible applications in clinical anti-diarrhea usage. Nutr Health. 1998; 12(2): 97-105.

Reid G. Probiotic agents to protect the urogenital tract against infection. [Review]. Am J Clin Nutr. 2001;73(2 Suppl):437S-443S.

Rembacken BJ, Snelling AM, Hawkey PM, Chlamers DM, Axon ATR. Non-pathogenic Eschericia coli versus mesalazine for the treatment of ulcerative colitis: a randomized trial. Lancet. 1999;354:635-639.

Rolfe RD. The role of probiotic cultures in the control of gastrointestinal health. J Nutr. 2000;130(2S Suppl):396S-402S.

Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006;6(6):374-82.

Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach. [Review]. Chemotherapy. 1995;41 Suppl 1:48-81.

Schiffrin EJ, Brassart D, Servin AL, Rochat F, Donnet-Hughes A. Immune modulation of blood leukocytes in humans by lactic acid bacteria: criteria for strain selection. Am J Clin Nutr. 1997;66(2):515S-520S.

Shalev E, Battino S, Weiner E, Colodner R, Keness Y. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med. 1996;5(10):593-596.

Shanahan F. Probiotics and inflammatory bowel disease: is there a scientific rationale? Inflamm Bowel Dis. 2000;6(2):107-115.

Sheih YH. Systemic immunity-enhancing effects in health subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus HN001. J Am Coll Nutr. 2001;20(2):149-156.

Szajewska H, Kotowska M, Mrukowicz JZ, Armanska M, Mikolajczyk W. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr. 2001;138(3):361-365.

Szajewska H, Mrukowicz JZ. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr. 2001;33 Suppl 2;S17-S25.

Tejada-Simon MV, Lee JH, Ustunol Z, Pestka JJ. Ingestion of yogurt containing Lactobacillus acidophilus and Bifidobacterium to potentiate immunoglobulin A responses to cholera toxin in mice. J Dairy Sci. 1999;82(4):649-660.

Van Niel CW, Feudtner C, Garrison M, Christakis DA. Lactobacillus thearpy for acute infections diarrhea in children: a meta-analysis. Pediatrics. 2002;109(4):678-684.

Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135(5):564-568.

Review Date:
6/7/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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Hypercholesterolemia

FitSugar — Wed, 08 Oct 2008 17:34:56 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment Approach
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Hypercholesterolemia, or high cholesterol, occurs when there is too much cholesterol in the body. Cholesterol is a soft, waxy, fat-like substance that is a natural component of all the cells of the body. Your body makes all the cholesterol it needs. Any added cholesterol, which comes through the foods you eat, can cause harm.

High cholesterol raises your risk for heart disease, heart attack, and stroke. When there is too much cholesterol circulating in the blood, it can create sticky deposits (called plaque) along the artery walls. Plaque can eventually narrow or block the flow of blood to the brain, heart, and other organs.

The normal range for total blood cholesterol is between 140 and 200 mg per decilitre (mg/dL) of blood (usually just expressed as a number). However, the total number doesn't tell the whole story: There are two types of cholesterol -- HDL (high-density lipoproteins, or "good" cholesterol) and LDL (low-density lipoproteins, or "bad" cholesterol). The amount of HDL relative to LDL is considered a more important indicator of your risk for heart disease. There is a third kind of fatty material, triglycerides, found in the blood, that also plays a role (generally as triglyceride levels rise, HDL or "good" cholesterol falls). High cholesterol is characterized by high levels of LDL cholesterol, normal or low levels of HDL cholesterol, and normal or high levels of triglycerides.

More and more Americans have high cholesterol. While heredity may be a factor for some people, lack of exercise plus diets high in saturated fats appear to be the main culprits. High cholesterol can be prevented, often with lifestyle changes (diet and exercise) alone. If these do not work, your doctor may recommend medications to bring down your cholesterol levels.

Signs and Symptoms

High cholesterol generally occurs without any symptoms, especially in early stages. The only way to tell if your cholesterol is high is through a blood test.

Causes

In some cases, high levels cholesterol may be inherited -- your liver may make too much cholesterol, or your body may not remove LDL from your blood as efficiently as normal. High cholesterol or triglycerides can also be associated with other diseases, such as diabetes. In most cases, however, high cholesterol is the result of a diet high in saturated fat and a lack of regular exercise. High cholesterol is more common in people who are overweight or obese, a condition that is true of as much as half of the adult U.S. population.

Risk Factors

There are certain factors that put a person at increased risk of having high cholesterol. While some factors cannot be altered by changes in lifestyle, many can be changed. The most important risk factors for high cholesterol are:

Obesity
Eating a diet high in saturated fat and trans fatty acids (found frequently in processed and fried foods)
Not getting enough exercise
Family history of heart disease
High blood pressure
Smoking cigarettes
Diabetes

Diagnosis

Since most people have few if any symptoms of high cholesterol, a blood test is the only way to check levels of cholesterol in your blood. If your levels are above 200 mg/dL or your HDL below 40, your doctor may do a fasting lipid profile (a test performed after you abstain from food for 12 hours).

Although cholesterol levels above 200 are generally considered high, the optimal level for LDL cholesterol depends on whether you are at risk for or have heart disease.

Total cholesterol levels:

Desirable: Below 200 mg/dL
Borderline high: 200 - 239
High: Above 240

LDL cholesterol levels:

Optimal for people with heart disease or at high risk: Below 70 mg/dL
Optimal for people at risk of heart disease: Below 100
Optimal: 100 - 129
Borderline high: 130 - 159
High: 160 - 189

HDL cholesterol levels:

Poor: Below 40 mg/dL
Acceptable: 40 - 59
Optimal: 60 or above

Triglyceride levels:

Optimal: Below 150 mg/dL
Borderline high: 150 - 199
High: Above 200

Adults with normal total and HDL cholesterol levels should have their cholesterol checked every 5 years. If you have high cholesterol, you should be checked every 2 - 6 months and have liver function tests as well if you are on cholesterol-lowering medication.

Preventive Care

Most people can lower cholesterol levels by eating a well-balanced diet, getting regular exercise, and losing any excess weight.

Diet

A healthy diet can help you lose any excess pounds. Even losing just 5 or 10 pounds may help you lower your cholesterol. To eat a healthy diet:

Cut down on saturated fats and trans fats. No more than 10 percent of your daily calories should come from saturated fat, and you should avoid trans fats completely. Choose unsaturated fats, such as olive oil and canola oil, instead.
Eat whole grains -- whole wheat bread and pasta, oatmeal, oat bran, and brown rice.
Eat more fruits and vegetables, which are high in fiber and can help lower cholesterol levels.
Limit cholesterol in your diet. The highest amounts are found in egg yolks, whole milk products, and organ meats.
Eat fatty fish. The American Heart Association recommends that people eat at least 2 servings of fatty fish (such as salmon or herring) each week.

The American Heart Association (AHA) has developed dietary guidelines that help lower fat and cholesterol intake and reduce the risk of heart disease. The AHA does not recommend very low-fat diets, because new research shows that people benefit from unsaturated ("good") fats, such as those found in olive oil, in their diet.

Many fad diets are popular, but they may not help you lose weight and keep it off -- and in some cases, they may not even be healthy. Any healthy diet will include a variety of foods. If a diet bans an entire food group (such as carbohydrates), it's probably not healthy.

The AHA recommends the following for healthy eating:

Grains: 6 - 8 servings per day (half should be whole grains)
Vegetables: 3 - 5 servings per day
Fruits: 4 - 5 servings per day
Fat-free or low-fat dairy: 2 - 3 servings per day
Lean meat, poultry, seafood: 3 - 6 oz. per day (about the size of a deck of cards)
Fats and oils: 2 - 3 tbsp. per day (use unsaturated fats such as olive oil or canola oil)
Nuts, seeds, legumes: 3 - 5 servings per week
Sweets, sugars: 5 or fewer servings per week (the fewer, the better)

In addition, the AHA also recommends eating 2 servings of fatty fish (such as salmon, herring, or lake trout) per week; holding sodium (salt, including salt already added to food) to less than 2,400 mg per day; and limiting alcohol intake to one drink a day for women and two for men.

The Mediterranean style diet concentrates on whole grains, fresh fruits and vegetables, fish, olive oil, and moderate, daily wine consumption. This diet is not low-fat. Instead, it is low in saturated fat but high in monounsaturated fat. This diet is naturally rich in fiber, antioxidants, and omega-3 fatty acids. It appears to be heart-healthy: In a long-term study of 423 patients who had a heart attack, those who followed a Mediterranean style diet had a 50 - 70% lower risk of recurrent heart disease compared with people who received no special dietary counseling.

Losing Weight

Being overweight increases risk of high cholesterol and heart disease. Even a 5- to 10-pound weight loss can lower LDL twice as much as diet alone. Weight loss often results in lower triglyceride levels and increased HDL, too. To maintain a healthy diet, you should aim for a gradual, weekly weight loss of 1/2 to 1 pound.

Getting Exercise

Regular exercise both reduces the risk of death from heart disease and helps lower LDL cholesterol levels, especially when combined with a healthy diet. Thirty minutes of moderate exercise three to five times per week can help you lose weight or maintain a proper weight, reduce LDL and triglyceride levels, and increase levels of HDL. Exercise may also lower blood pressure. Talk with your doctor before starting a new exercise plan.

Treatment Approach

Lowering your cholesterol level reduces your risk of heart disease and stroke. Studies have shown that for every 1% reduction in cholesterol levels there is a 2% reduction in the rate of heart disease. People who already have heart disease or are at higher risk benefit most from lowering their cholesterol.

Changes in lifestyle -- better diet, more exercise -- are the most effective means of both preventing and, in less severe cases, treating high LDL cholesterol levels. In addition to lifestyle changes, specific cholesterol-lowering medications are often prescribed.

Medications

If, after making adjustments to your diet and exercise habits, your LDL cholesterol remains high, your doctor may prescribe medications to lower it. If your cholesterol is extremely elevated (more than 200 mg/dL), you may start drug therapy at the same time you make lifestyle changes. Drugs commonly used to treat high cholesterol include:

Statins (such as lovastatin, pravastatin, simvastatin, atorvastatin, and fluvastatin) -- These are usually the drugs of choice as they are easy to take and have few interactions with other drugs. Side effects can include myositis (inflammation of the muscles), joint pain, stomach upset, and liver damage. People who are pregnant or have liver disease should not take statins.

Niacin (nicotinic acid) -- In prescription form, niacin is sometimes used to lower LDL cholesterol and can be more effective in raising HDL cholesterol than other medications. Side effects may include redness or flushing of the skin (which can be reduced by taking aspirin 30 minutes before the niacin), stomach upset (which usually subsides in a few weeks), headache, dizziness, blurred vision, and liver damage. Dietary supplements of niacin should not be used instead of prescription niacin, as it can cause side effects. Only take niacin for high cholesterol with your doctor's supervision.

Bile acid sequestrants (such as cholestyramine, colestipol, and colesevelam) -- These are used to treat high levels of LDL. Common side effects include bloating, constipation, heartburn, and elevated triglycerides. People who have high levels of triglycerides (fats in the blood) should not take bile acid sequestrants.

Fibric acid derivatives (such as gemfibrozil and clofibrate) -- These medicines are effective at lowering triglyceride levels, and moderately effective at lowering LDL. They are used to treat high triglycerides and low HDL in people who cannot tolerate niacin. Side effects include myositis, stomach upset, sun sensitivity, gallstones, irregular heartbeat, and liver damage.

Probuchol -- This medicine lowers both LDL and HDL. Its use is generally limited to certain types of hereditary high cholesterol or when other cholesterol-lowering medications have been ineffective. Side effects include diarrhea, bloating, nausea, and dizziness

If you do not respond to one class of drugs, you doctor may use a combination of drugs from two classes.

Nutrition and Dietary Supplements

In addition to eating a healthy diet -- low in saturated fat, with plenty of whole grains, fruits, and vegetables -- some specific foods and supplements may help lower cholesterol.

Fiber -- Several studies have shown that soluble fiber (found in beans, oat bran, barley, apples, psyllium, flaxseed, and glucomannan) lowers LDL cholesterol and triglycerides. Fiber can also help you lose weight because it makes you feel full faster. Your doctor will encourage you to get more fiber in your diet. You may also take a fiber supplement. Men should get 30 - 38 g of fiber per day. Women should get 21 - 25 g.

Soy -- Many studies have shown that eating soy protein (tofu, tempeh, miso) rather than animal meat helps lower blood cholesterol levels, especially when you eat a diet low in saturated fat. One study has shown that as little as 20 g of soy protein per day is effective in reducing total cholesterol, and that 40 - 50 g shows faster effects (in 3 weeks instead of 6). One study has shown that soy can help reduce triglyceride levels. The AHA recommends that people with elevated total and LDL cholesterol add soy to their daily diet, and that soy is safe when consumed as part of your regular diet. Before you take soy supplements, however, talk to your doctor. Soy isoflavones may have estrogen-like effects on the body, which might lead to an increased risk of breast and other cancers.

Omega-3 fatty acids, found in fish oil -- There is good evidence that omega-3 fatty acids (namely EPA and DHA) found in fish oil can help prevent heart disease, lower blood pressure, and reduce the level of triglycerides (fats) in the blood. However, fish oil can also raise levels of both HDL and LDL slightly. When taken as a supplement, it can also act as a blood-thinner, so people who already take blood-thinning medication should only take a fish oil supplement under their doctor's supervision. The AHA recommends that people eat at least two servings of fatty fish (such as salmon) per week, and that fish is safe when consumed as part of your regular diet. If you have high cholesterol, talk to your doctor before taking a fish oil supplement.

Alpha-linolenic acid (ALA) -- ALA is another omega-3 fatty acid that may protect the heart against heart disease. However, studies have shown conflicting results about its ability lower LDL, and it does not appear to lower triglyceride levels.

Vitamin C (100 - 200 mg per day) -- Several studies suggest that eating a diet high in vitamin C can help lower cholesterol levels, but there is no evidence that taking extra vitamin C through a supplement will help.

Beta-sitosterol (800 mg to 6 g per day in divided doses about 30 minutes before meals) -- Beta-sitosterol is a plant sterol, a compound that can stop cholesterol from being absorbed by the intestines. Several well-designed scientific studies have shown that beta-sitosterol does lower LDL ("bad") cholesterol levels in the body. Beta-sitosterol may lower the amount of vitamin E and beta-carotene absorbed by the body, so you may want to ask your doctor if you need to take extra vitamin E or carotene.

Policosanol (5 - 10 mg two times per day) -- Policosanol is a mix of waxy alcohols usually derived from sugar cane and yams. Several studies have indicated it may lower LDL ('bad") cholesterol and possibly even raise HDL ("good") cholesterol. One study found that policosanol was equivalent to fluvastatin (Lescol) and simvastatin (Zocor) in lowering cholesterol levels. It may also inhibit blood clots from forming. However, almost all the studies have been conducted in Cuba or Latin America using a proprietary form of policosanol, so it is hard to evaluate the evidence. Policosanol may increase the risk of bleeding, and should not be taken by people who also take blood-thinning medication.

Coenzyme Q10 (CoQ10) -- Researchers believe that CoQ10 may inhibit blood clot formation and boost levels of antioxidants. One study found that people who received daily CoQ10 supplements within 3 days of a heart attack were much less likely to experience subsequent heart attacks and chest pain and were also less likely to die of the condition than those who did not receive the supplements. Still, more research is needed to say whether CoQ10 has any role in preventing or treating atherosclerosis. People who take statins may have low levels of CoQ10. If you take statins you may want to ask your doctor about taking a CoQ10 supplement.

Polyphenols -- Polyphenols are chemical substances found in plants that have antioxidant properties. Test tube, animal, and some population-based studies suggest that the flavonoids quercetin, resveratrol, and catechins (all found in high concentration in red wine, and in grape juice) may help reduce the risk of atherosclerosis by protecting against the damage caused by LDL cholesterol. However, more studies in humans are needed to confirm these findings.

Resveratrol -- A recent study of resveratrol in mice found that it protected against age-related damage to vital organs, including the heart and liver, even when the mice ate a high-fat diet. Although this study is promising, researchers need to confirm its findings and to determine whether resveratrol would have the same effect in humans. To equal the rate at which the mice were given resveratrol, humans would have to consume enormous quantities. In addition, resveratrol may have estrogen-like effects, and researchers don't yet know whether it would pose the same risks as estrogen supplements.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a healthcare practitioner.

Hawthorn ( Crataegus monogyna, 900 - 1,800 mg per day in two or three divided doses) -- Hawthorn contains the polyphenols rutin and quercetin, and was used traditionally to treat cardiovascular diseases. Animal and laboratory studies show that hawthorn has antioxidant properties that may help lower high cholesterol and high blood pressure. Talk to your doctor before taking hawthorn, as it can interact with other drugs taken for heart disease and high blood pressure.

Garlic ( Allium sativum, 900 mg per day of garlic powder, standardized to 0.6% allicin) -- Previous clinical trials have shown that fresh garlic and garlic supplements may lower cholesterol levels, prevent blood clots, and destroy plaque. However, more recent studies show no effect on cholesterol. Garlic can increase the risk of bleeding and should not be taken if you are also taking blood-thinning medication.

Red yeast ( Monascus purpureus , 1,200 mg two times per day with meals) -- Several studies indicate that a proprietary form of red yeast (Cholestin) can lower cholesterol levels, and that the herb acts like prescription statin drugs (See "Medications" section). For that reason, you should not take red yeast without a doctor's supervision, especially if you already take statins to lower cholesterol.

Psyllium ( Plantago psyllium, 10 - 30 g per day in divided doses taken 30 - 60 minutes after meals) -- Taking psyllium, a type of fiber, helps lower cholesterol levels as well as blood sugar levels. If you take medicine for diabetes, talk to your doctor before taking psyllium.

Guggul (Commiphora mukul, 3 - 6 g per day) -- Guggul is used in Ayurvedic medicine to treat high cholesterol levels. Scientific studies have found mixed results -- guggul appears to work in Indian populations, but not in people who eat Western-style, high-fat diets.

Other Considerations

Pregnancy

Cholesterol-lowering medications should be avoided during pregnancy.

Prognosis and Complications

Several complications may occur if high cholesterol is left untreated. These include:

Heart disease -- elevated cholesterol levels more than double the risk of heart attack. Lowering cholesterol by 1% reduces the risk of coronary artery disease by 2%.
Stroke -- low levels of HDL cholesterol have been associated with an increased risk of stroke.
Insulin resistance -- 88% of people with low HDL and 84% with high triglycerides also have insulin resistance (which leads to high blood sugar levels). Many people with insulin resistance go on to develop diabetes.

Maintaining the proper weight, eating a diet low in saturated fat, and exercising can lower cholesterol levels and improve long-term prognosis.

Supporting Research

Ackermann RT, Mulrow CD, Ramirez G, Gardner CD, Morbidoni L, Lawrence VA. Garlic shows promise for improving some cardiovascular risk factors. Arch Intern Med. 2001;161:813-824.

Al-Habori M, Raman A. Antidiabetic and hypocholesterolemic effects of fenugreek. Phyto Res. 1998;12:233-242.

Anderson JW, Davidson MH, Blonde L, et al. Long-term cholesterol-lowering effects on Psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr. 2000a;71:1433-1438.

Anderson JW, Allgood LD, Lawrence A, et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr. 2000b;71:472-479.

Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. New Engl J Med. 1995; 333:5:276-282.

Arsenian, MA. Carnitine and its derivatives in cardiovascular disease. Progr in Cardiovasc Dis. 1997;40:3:265-286.

Baber R, Bligh PC, Fulcher G, Lieberman D, Nery L, Moreton T. The effect of an Isoflavone dietary supplement (P-081) on serum lipids, forearm bone density & endometrial thickness in post menopausal women [abstract]. Menopause. 1999;6:326.

Birketvedt GS, Aaseth J, Florholmen JR, Ryttig K. Long-term effect of fibre supplement and reduced energy intake on body weight and blood lipids in overweight subjects. Acta Medica. 2000;43(4):129-132.

Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinal) and fenugreek (Trigonella foenumgraecum) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins, Leukotrienes and Essential Fatty Acids. 1997;56(5):379-384.

Bravo E, Napolitano M, Lopez-Soldado I, Valeri M, Botham KM, Stefanutti C. Hypercholesterolaemia alters the responses of the plasma lipid profile and inflammatory markers to supplementation of the diet with n-3 polyunsaturated fatty acids from fish oil. Eur J Clin Invest. 2006 Nov;36(11):788-95.

Calderon Jr. R, Schneider RH, Alexander CN, Myers HF, Nidich SI, Haney C. Stress, stress reduction and hypercholesterolemia in African Americans: a review. Ethn Dis. 1999;9:451-462.

Castillo-Richmond A, Schneider RH, Alexander CN, et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African Americans. Stroke. 2000;31:568-573.

Clarkson P, Adams MR, Powe AJ, et al. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest. 1996;97:8:1989-1994.

Davidson MH, Maki KC, Kalkowski J, Schaefer EJ, Torri SA, Drennan KB. Effects of docosahexeaenoic acid on serum lipoproteins in patients with combined hyperlipidemia. A randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 1997;16:3:236-243.

de Logeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779-785.

Ellegard LH, Andersson SW, Normen AL, Andersson HA. Dietary plant sterols and cholesterol metabolism. Nutr Rev. 2007 Jan;65(1):39-45. Review.

Frei B. On the role of vitamin C and other antioxidants in atherogenesis and vascular dysfunction. Proc Soc Exp Biol Med. 1999;222(3):196-204.

Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007 Feb 26;167(4):346-53.

Ginsberg HN, Goldberg IJ. Disorders of Lipoprotein Metabolism. IN: Fauci A, et al. eds. Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill; 2000: 2138-2149.

Hallikainen MA, Sarkkinen ES, Uusitupa MIJ. Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner. J Nutr. 2000a;130:767-776.

Hallikainen MA, Sarkkinen ES, Gylling H, Erkkila AT, Uusitupa MIJ. Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations of hypercholesterolemic subjects on a low-fat diet. Euro J Clin Nutr. 2000b;54:715-725.

HarrisWS. Omega-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65:1645S-1654S.

Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VLW. Cholesterol-lowering effects of a proprietary Chinese red-yeast rice dietary supplement. Am J Clin Nutr. 1999;69:231-236.

Hosobuchi C, Rutanassee L, Bassin SL, Wong ND. Efficacy of acacia, pectin, and guar gum-based fiber supplementation in the control of hypercholesterolemia. Nutr Res. 1999;19(5):643-649.

Howes JB, Sullivan D, Lai N. The effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of postmenopausal women with mild to moderate hypercholesterolemia. Atherosclerosis. 2000;152(1):143-147.

Human JA, Ubbink JB, Jerling JJ, et al. The effect of simvastatin on the plasma antioxidant concentrations in patients with hypercholesterolemia. Clin Chim Acta. 1997;263(1):67-77.

Jenkins D, Kendall C, Vidgen E, Agarwal S, Rao AV, Rosenberg RS et al. health aspects of partially defatted flaxseed, including effects on serum lipids, oxidative measures, and ex vivo androgen and progestin activity: a controlled crossover trial. Am J Clin Nutr. 1999;69:395-402.

Keenan JM, Wenz JB, Myers S, Ribsin C, Huang ZQ. Randomized, controlled, crossover trial of oat bran in hypercholesterolemic subjects. J Fam Pract. 1991;33(6):600-608.

Knopp RH, Superko R, Davidson M, et al. Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am J Prev Med. 1999;17(1):18-23.

Knox J, Gaster B. Dietary supplements for the prevention and treatment of coronary artery disease. J Altern Complement Med. 2007 Jan;13(1):83-96.

Kokkinos PF, Fernhall B. Physical activity and high density lipoprotein cholesterol levels. Sports Med. 1999;28(5):307-314.

Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al. AHA Scientific Statement: AHA Dietary guidelines Revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation. 2000;102(18):2284-2299.

Kris-Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzare TL. AHA Science Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I Dietary Pattern on Cardiovascular Disease. Circulation. 2001;103:1823.

Kurowska EM, Spence JD, Jordan J, Wetmore S, Freeman DJ, Piche LA, Serratore P. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr. 2000;72(5):1095-1100.

Laplaud PM, Lelubre A, Chapman MJ. Antioxidant action of Vaccinium myrtillus extract on human low density lipoproteins in vitro: initial observations. Fundam Clin Pharmacol. 1997;11(1):35-40.

Lopez-Miranda J, Gomez P, Castro P, et al. Mediterranean diet improves low density lipoproteins' susceptibility to oxidative modifications. Med Clin (Barc) [in Spanish]. 2000;115(10):361-365.

Marz W, Wieland H. HMG-CoA reducatse inhibition: anti-inflammatory effects beyond lipid lowering. Herz. 2000;25(6):117-25.

Miller AL. Botanical influences on cardiovascular disease. Altern Med Review. 1998;3(6):422-431.

Miyake Y, Shouza A, Nishikawa M, Yonemoto T, Shimizu H, Omoto S, Hayakawa T, Inada M. Effect of treatment with 3-hydroxy-3methylglutaryl coenzyme A reductase inhibitors on serum coenzyme Q10 in diabetic patients. Arzneimittelforschung. 1999;49(4):324-329.

Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med. 1997;18Suppl:S137-S144.

National Cholesterol Education Program. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.

Nestel PJ, Pomeroy S, Kay S, et al. Isoflavones from red clover improve systemic arterial compliance but not plasma lipids in menopausal women. J Clin Endocrinol Metab. 1999;84(3):895-898.

Nutrition Committee of the American Heart Association. AHA Dietary Guidelines. Revision 2000: A Statement for Healthcare Professionals. Circulation. 2000; 102:2284-2299.

Ornish D, Scherwitz LW, Billings JH, Brown SE, Gould KL, Merrit KL, et al. Intensive lifestyle change for reversal of coronary heart disease. JAMA. 1998;280(23):2001-2007.

Pereira IR, Faludi AA, Aldrighi JM, Bertolami MC, Saleh MH, Silva RA, Nakamura Y, Campos MF, Novaes N, Abdalla DS. Effects of soy germ isoflavones and hormone therapy on nitric oxide derivatives, low-density lipoprotein oxidation, and vascular reactivity in hypercholesterolemic postmenopausal women. Menopause. 2006 Nov-Dec;13(6):942-50.

Plat J, van Onselen ENM, van Heugten MMA, Mensink RP. Effects on serum lipids, lipoproteins, and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Euro J Clin Nutr. 2000;54:671-677.

Qin S, Zhang W, Qi P, et al. Elderly patients with primary hyperlipidemia benefited from treatment with a Monacus purpureus rice preparation: a placebo-controlled, double-blind clinical trial. Paper presented at: American Heart Association 39th Annual conference on Cardiovascular Disease Epidemiology and Prevention; March 1999; Orlando, Fla. Abstract.

Raitakari OT, McCredie RJ, Witting P, Griffiths KA, Letter J, Sullivan D, Stocker R, Celermajer DS. Coenzyme Q improves LDL resistance to ex vivo oxidation but does not enhance endothelial function in hypercholesterolemic young adults. Free Radic Biol Med. 2000;28(7):1100-1105.

Redlich CA, Chung JS, Cullen MR, Blaner WS, Van Benneken AM, Berglund L. Effect of long-term beta-carotene and vitamin A on serum cholesterol and triglyceride levels among participants in the Carotene and Retinol Efficacy Trial (CARET). Atherosclerosis. 1999;143: 427-434.

Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med. 1993;328(20):1450-1456.

Ripsin CM, Keenan JM, Jacobs Jr. DR, et al. Oat products and lipid lowering: a meta-analysis. JAMA. 1992;267:24:3317-3325.

Shintani TT, Beckham S, Brown AC, O'Connor HK. The Hawaii diet: ad libitum high carbohydrate, low fat multi-cultural diet for the reduction of chronic disease risk factors: obesity, hypertension, hypercholesterolemia, and hyperglycemia. Hawaii Med J. 2001;60(3):69-73.

Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs and Therapy. 1994;8:659-664.

Sirtori CR, Pazzucconi F, Colombo L, Battistin P, Bondioli A, Descheemaeker K. Double-blind study of high-protein soya milk v. cow's milk to the diet of patients with severe hypercholesterolaemia and resistance to or intolerance of statins. Brit J Nutr. 1999;82:91-96.

Spiller GA, Jenkins DAJ, Boselloo Gates JE, Cragen LN, Bruce B. Nuts and plasma lipids: an almond-based diet lowers LDL-c while Preserving HDL-c. JAm Coll Nutr. 1998;17(3):285-290.

Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med. 1993;328(20):1444-1449.

Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. Effectsof diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. New Engl J Med. 1998;339(1):12-20.

Stephens NG, Parsons A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996; 347(9004):781-786.

Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia. Ann Intern Med. 2000;133(6):420-429.

Sum CF, Winocour PH, Agius L, et al. Does oral L-carnitine alter plasma triglyceride levels in hypertriglyceridemic subjects with or without non-insulin dependent diabetes mellitus. Diabetes Nutr Metab Clin Exp. 1992;5:175-181.

Teixeira SR, Potter SM, Weigel R,Hannam S, Erdman Jr. JW, Hasler CM. Effects of feeding 4 levels of soy Protein for 3 and 6 wk on blood lipids and apolipoproteins in moderately hypercholesterolemic men. Am J Clin Nutr. 2000;71:1077-1084.

Tofler GH, Stec JJ, Stubbe I, Beadle J, Feng D, Lipinska I, Taylor A. The effect of vitamin C supplementation on coagulability and lipid levels in healthy male subjects. Thromb Res. 2000;100(1):35-41.

Verhaar MC, Wever RM, Kastelein JJ, et al. Effects of oral folic acid supplementation on endothelial function in familial hypercholesterolemia. Circulation. 1999;100(4):335-338.

Williams JC, Forster LA, Tull SP, Wong M, Bevan RJ, Ferns GAA. Dietary vitamin E supplementation inhibits thrombin-induced platelet aggregation, but not monocyte adhesiveness, in patients with hypercholesterolaemia. M J Exp Path. 1997;78:259-266.

Wang J, Lu Z, Chi J, et al. Multicenter clinical trial of serum lipid-lowering effects of a Monascus purpureus (red yeast) rice preparation from traditional Chinese medicine. Curr Ther Res. 1997;58(12):964-978.

Wong WW, Smith EO, Stuff JE, Hachey DL, Heird WC, Pownell HJ. Cholesterol-lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men. Am J Clin Nutr. 1998;68(suppl):1385S-1389S.

Yang TTC, Koo MWI. Chinese green tea lowers cholesterol level through an increase in fecal lipid excretion. Life Sciences. 1999:66:5:411-423.

Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr. 1999;69:632-646.

Zambón D, Sabate J, Munoz S, et al. Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women. Ann Intern Med. 2000;132:538-546.

Zhao G, Etherton TD, Martin KR, Gillies PJ, West SG, Kris-Etherton PM. Dietary alpha-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects. Am J Clin Nutr. 2007 Feb;85(2):385-91.

Review Date:
3/23/2007
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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