Your Guide to Conquering High Cholesterol

I. Introduction:
Cholesterol is a white, waxy fat found naturally in the body and is used to build cell walls and make certain hormones. Too much of it can clog the arteries and cut off the supply of blood to the heart, thus high cholesterol is the leading risk factor for heart disease. The three main factors that increase your risk for heart disease include high blood cholesterol/low HDL (> 200 milligrams per deciliter total cholesterol, <40>130 LDL) &/or high triglycerides (> 150 mg/100 ml blood), high blood pressure (> 140 systolic and 90 diastolic, below 120/80 =normal), and cigarette smoking. People who smoke a pack of cigarettes a day have more than twice the risk of a heart attack compared to people who’ve never smoked. In turn, blood cholesterol levels can be elevated by cigarette smoking and two other risk factors - obesity and an inactive lifestyle.

The important steps towards a healthy heart:
¨ Exercise regularly
¨ Utilize stress management techniques
¨ Have an eating pattern that is-

1. Low fat (<30% serving =" (<" 3 =" 10.5," over =" 105," serving =" low" food =" greater">5 grams dietary fiber). The American Dietetic Association recommends 25 to 30 grams of fiber per day.

IV. Soy-The Multifaceted Food:
Using soy products are an easy way to get a variety of protein sources in your day and simultaneously decrease your risk for heart disease and other chronic diseases. The soybean seed is 13 to 25% oil, 30 to 50% protein, and 14 to 24% carbohydrate.
¨ Soy protein, likely the genistein present in soy, lowers cholesterol levels 1. Soy decreases LDL-cholesterol levels and increases HDL, rather unique, since oat bran or decreased saturated fat intake decreases HDL levels.
2. Soy isoflavones, plant chemicals unique to soybeans, have antioxidant properties which protect LDL from oxidation and has favorable effects on blood vessel function.
3. Research studies using an average intake of ~40 grams of soy protein per day with a low fat (30% of calories), low cholesterol (<300 mg) diet was associated with a 12.9% reduction in LDL, 10.5% reduction in triglycerides, and an increase in HDL by 2.4%. One percent reduction in cholesterol decreases heart attack risk by two to three percent.
4. Soy protein compared to casein (cow’s milk protein), decreases LDL and increases HDL in individuals with normal lipid levels.

Bottom Line:
The FDA has recommended 25 grams or more of soy protein a day to reduce risk of coronary heart disease (reduce total and LDL cholesterol level). A sample day with soy:
Breakfast: Oatmeal made with soy milk and add ¼ cup soy milk on top = 6.5 g
AM Snack:
Dr. Soy California Blend Trail Mix (1 ounce) = 7 g
Lunch: ½ cup cooked soy pasta with ½ cup of your favorite marinara sauce with a mixed green salad = 6.3 g
Afternoon Snack: Whole-wheat crackers with 1-ounce part-skim milk cheese
Dinner:
Sushi with ¼ cup of edamame (fresh soybeans) = 5 g
Total = 24.8 g soy protein

V. “Five A Day” For Better Health:
Have 2 to 4 servings of fruit a day and 3 to 5 servings of vegetables a day for better health. One serving is 1 small fresh fruit (2 inch across/4 oz.), 1/2 cup of canned/fresh fruit or unsweetened 100% fruit juice, or 1/4 cup dried fruit (choose natural dried fruit without sulfur dioxide added), 1/2 cup cooked vegetables or vegetable juice, or 1 cup of raw vegetables. Add green leafy vegetables, such as spinach or kale which provide omega-3 fatty acids.

VI. Exercise helps increase your truck-loading cholesterol (HDL)!
Do aerobic exercise 30 minutes a day, it’s better to exercise more days for less time than less days for more time to strengthen the arterial vessel wall, increase collateral circulation and increase HDL.

VII. Conclusion:
Walk your talk! Go to the grocery store today and implement heart healthy eating into your long-term lifestyle.

Selected Grocery Items and Recipe:

1. Featured Products from the Livetician’s Grocery Shopping List:
Tea - Traditional Medicinals Organic Golden Green Tea
Bread/Cereals/Crackers - Whole Foods Organic Ezekial (3 g dietary fiber), Food For Life Ezekiel 4:9 Sprouted Grain Tortillas, 365 Organic 5 Grain Cereal with Soy, Kashi Heart to Heart/Go-Lean Crunch Cereal, Mother’s 100% Natural Oat Bran, Ak-Mak 100% Whole-Wheat Crackers
Beans/Grains/Nuts - Health Best Dried Organic Beans/Quinoa/Amaranth, Westbrae Natural/Eden Canned Organic Beans, Arrowhead Mills Whole Grain Amaranth, Lundberg Wild Blend Long Grain Brown Rice, Casbah Organic Whole-Wheat Couscous Original, 365 Organic Whole Wheat Pasta, Food For Life Sprouted Grain Pasta, Health Best Dry Roasted Soy Nuts/Raw Almonds, Dr. Soy/Genisoy Soy Nuts
Soy Products - Mori-Nu/Nasoya Organic Silken Tofu, Edamame (fresh-in deli), 365 Organic Soymilk, Whole Soy & Co. Yogurt
Supplement - Barlean’s Forti-Flax or Spectrum Essentials cold-milled organic flaxseeds
Condiments/Oils - Madhava/Sweet Cactus Farms Agave Nectar, Hain Pure Foods Canola Mayonnaise, Robbie’s Barbeque/Sweet and Sour Sauce, Bragg Liquid Aminos, 365 Organic Canola Oil/Organic Extra-Virgin Olive Oil
*Deborah creates a list of recommended foods available at Whole Foods customized for each client based on his or her dietary needs.

2. Recipe:
Livetician’s Energizer Shake! By: Deborah A. Klein, MS, RD
Ingredients:
4 ounces of tofu (“Mori-Nu” Firm) or ¼ cup nonfat dry milk powder
1/2 cup low fat or non fat plain yogurt
1 banana
1/2 cup of frozen strawberries (~5 strawberries), or frozen mixed berries
2 to 3 cups of 1% milk or soy milk (try Whole Foods Brand vanilla soy milk) {for a thicker shake, add ¾ of the blender full with milk}
1/2 cup filtered/bottled water/ice - optional (don’t need water if you use more milk)
Optional –For omega-3 essential fatty acids and fiber, stir in a Tablespoon of ground flaxseed to the cup you drink, so flaxseed doesn’t get rancid, need to drink it right away.
Directions: In a blender, put 4 ounces of tofu, yogurt, a banana, a handful of strawberries (about a 1/2 cup), and milk. If you like thicker shakes, instead of using water, fill the blender up with milk ¾ full. Put the top on the blender, chop, blend, and whip. You’re all set for an energizing breakfast or snack. Add a piece of high fiber toast or a small bowl of cereal with the shake for even more sustainable energy. Make this shake the night before, keep it in the blender and store in the refrigerator. The next morning, just press whip, and you’ve got a quick and easy “on- the-go” energizer.
Serving size: 1 cup
Total servings: 5 Nutrition Analysis per serving:
96 calories, 4.6 g protein, 15 g carbohydrate, 2.5 g fat, 1.4 g fiber

Kale as a Source of Calcium

Dairy products, such as milk and cheese, provide about 70% of the calcium in North American diets. These products are great sources of calcium. In fact fat-free milk is the most nutrient dense( milligrams per kilo calorie) source of calcium. However, leafy greens, such as kale also provide a great source of calcium without the extra calories and fat that whole milk and most cheeses provide. Some leafy greens contain calcium but it is not absorbed in the body because of the presence of oxalic acid. This effect is not as strong in kale. For those of you that are lactose intolerant this leafy green vegetable is a great way to get your calcium for the day.



Add kale to your dinner plate tonight by trying this quick recipe.

Ingredients:

1 bunch of kale, washed and chopped into bite-size pieces
1 yellow onion, sliced
1-2 cloves of garlic, minced or finely chopped
2-3 tablespoons of extra virgin olive oil
Juice of 1/4 lemon
1/2 cup of vegetable broth or water
Sea salt and pepper, to taste (optional)

Directions:

Warm olive oil over medium heat in a large pot or pan. Add onions and cook for 3-5 minutes or until slightly translucent. Be sure to stir the onions around once in a while so that they don't burn.

Add garlic and kale and mix them together with onions. Allow garlic, kale and onions to cook for one minute, then add vegetable broth and cover pot or pan for 4-6 minutes. Check kale from time to time starting at the 4 minute mark for tenderness.

Once kale is tender, add sea salt and just a few drops of lemon juice. Give it one last stir and serve.

Be sure to taste as you add lemon juice. Adding too much can turn the whole dish sour.

We enjoy this dish with avocado and a bowl of brown rice or quinoa.

Recipe by: Dr. Ben Kim

Migraine Headache Tips!

MIGRAINE HEADACHES AND TRIGGER FOODS

Patients are walking into my office frequently with migraine headaches. So, here's some information that will hopefully help for all of you who want to get these headaches out of your life.

Migraine = severe head pain, plus one or more symptoms, including nausea, vomiting, and increased sensitivity to light, sound, and smells; lasting 4 to 72 hours.

Possible General Triggers:

• Certain Foods
• Hunger or missed meals
• Changes in weather
• Some physical activities
• Emotions and stress
• Medications
• Hormonal Changes
  

Specific Food and Beverage Triggers:

• Alcohol: Red wine, vermouth, champagne, and beer
• Beverages with caffeine: Coffee, tea, soft drinks
• Dairy Products: Aged cheeses, such as cheddar
• Breads: Sourdough, fresh yeast, homemade
• Vegetables and Fruits: Some types of beans (broad, Italian, lima, lentil, fava, soy), sauerkraut, peas, avocados, and overripe bananas
• Snacks: Peanuts, peanut butter
• Meats: Salted and cured meats (ham, corned beef, sausage, bacon, lunch meats), dried meats, pickled herring, chicken livers
• Soups: Canned or from mixes
• Desserts: Chocolate-based
• Food Additives and Flavorings: Monosodium glutamate, sodium nitrite, soy sauce, marinades, and meat tenderizers
  Recommendations:
  1. Keep a diary of what you eat to determine your possible trigger foods. Depending on how often your attacks occur, you may need to keep the diary for a few weeks.
  2. Drink water throughout the day, keep a water bottle with you at all times and keep sipping.
  3. Eat foods that are high in fiber and protein, and low in simple carbohydrates.
  4. Include almonds, watercress, parsley, fennel, garlic, cherries, and fresh pineapple in your eating plan.
  5. Get regular moderate exercise.
  6. Massage the neck and back of the head daily.
  7. Choose baked, broiled, or steamed rather than fried foods, have anti-inflammatory foods and seasonings: fish, flaxseeds (grounded), organic eggs with omega-3's, legumes, ginger, turmeric. Stay clear from red meat as much as you can-it's the most inflammatory food available.
  8. Eat small meals, within an hour after waking, and every 3 to 4 hours throughout the day, try not to go longer than 5 hours without eating.
  9. Please stop smoking. Enroll in a smoking cessation program or try seeing a hypnotherapist, every patient from our practice who enrolled in a hypnotherapy program for smoking cessation, quit smoking by the end of the program.
  10. See your dentist for treatment of any tooth problems or grinding, that may contribute to the migraines.
  11. Relax, take hot baths, and listen to calming music.

12. VERY IMPORTANT: Supplement with Magnesium- key muscle relaxant, try: Phytotherapy liquid gel caps, available at Whole Foods: it contains Calcium Citrate Malate with Vitamin D and Magnesium.

Also, have fish oil capsules, great anti-inflammatory supplement, order EPA-DHA Extra Strength enteric coated capsules from Metagenics: http://www.livetician.meta-ehealth.com/

Health and happiness to you!

Your Livitician,

Deborah A. Klein, MS, RD
deborah@livitician.com