Diet, Nutrition and SupplementationPost here for supplement reviews or nutritional advice. If you're trying to get "ripped abz" THIS is where you should be.
Location: Philly on one side, Pittsburgh on another, the Green Between...
Posts: 5,857
The bad news: I have high cholesterol and they want to put me on a diet to lower it.
The situation: I am going to visit a nutritionist next week and would like to go in asking intelligent questions. I have this overwhelming fear she is going to walk in with the food pyramid and begin from there....
The question: Is it still possible to eat the protein I need (almost 200g) and still keep my cholesterol down. The "guidelines" I have read thus far, indicate I need to keep my cholesterol intake at about 200 per day. That seems a little tough to do, given a chooter is about 130 by itself.
Any help, in the form of advice, web links, suggested reading or anything other resources would be very much appreciated.
I don't really like cholesterol guidelines. My understanding is that dietary cholesterol doesn't increase cholesterol levels. In fact, some new thinking suggests to limit cholesterol intake will increase your body's production of it. Most experts will tell you that the combination of high saturated fat and high cholesterol is what you have to watch out for.
Eggs, for instance, are "high" in cholesterol, but have a relatively low amount of saturated fat. So they're just fine, but because of their cholesterol content alone they were bastardized for years.
I would recommend having a look at your entire metabolic profile. For instance, what are your triglycerides, HDL, ratio of total cholesterol to HDL (perhaps a bigger determinant of heart disease risk than LDL), and insulin levels?
Just eating a low cholesterol diet most likely won't solve the problem. I mean, look at the research on low-carb diets and the effect they have on the overall metabolic profile, yet they could be classified as a high cholesterol diet I suppose (depending on the individual person's eating habits).
I'm not necessarily suggesting a low-carb approach, but if you have metabolic syndrome, then it might be a good option, although counterintuitive. I've posted some of the stuff that follows below, but here's some information on cholesterol and low-carb diets and metabolic syndrome. Hopefully, something here will be of some use. Regardless, simply eating a low-glycemic diet (which you may eat all ready) should have a lot of benefits as well. Also, none of this addresses the problem of genetics.
Cholesterol
Very-low carbohydrate diets generally result in small increases in total cholesterol, which can be prevented or reversed if significant weight loss occurs. Part of the reason for the increase in total cholesterol is that there are also usually small increases in LDL and small to moderate increases in HDL. So the overall effect is that the ratio of total cholesterol to HDL actually decreases, which is a positive response and lowers the risk for heart disease. Furthermore, there are changes occurring within the LDL cholesterol. We have consistently shown that a very low-carbohydrate diet results in an increase in the larger diameter LDL, which is less harmful, and a decrease in the small diameter LDL, which is more atherogenic and related to heart disease.
Metabolic Syndrome
This is a highly prevalent cluster of cardiovascular disease risk factors. Its key features are abdominal obesity, insulin resistance, lipid disorders—which include increased fasting triglycerides, low HDL-cholesterol, and a predominance of small LDL particles— and high blood pressure, as well as chronic inflammation, procoagulation, and impaired fibrinolysis. (We’ll explain all of these in the book.) Basically, it’s a complicated, nasty myriad of health disorders. Although the precise definition varies, it’s estimated that almost one quarter of Americans over the age of 20, and 40 percent over the age of 40 have metabolic syndrome. It’s been described as a health care crisis of epidemic proportions.
The basis of therapies at this time are interventions promoting weight loss and physical activity, but diet represents another behavioral aspect that could have an important impact on the risk factors associated with metabolic syndrome. That’s because a very-low carbohydrate improves all of the lipid disorders associated with metabolic syndrome, in addition to improvements in glucose and insulin, even without weight loss.
Interestingly, while a low-carbohydrate diet improves all aspects of this disorder, a low-fat, high-carbohydrate diet exacerbates metabolic syndrome if the person doesn’t lose weight or increase his or her activity level. This explains to some extent why there has been a sharp rise in the prevalence of metabolic syndrome that has paralleled the rise in overweight and obesity in the US.
I'm eating the food pyramid right now. Yesterday I had nine servings of grains, four of veggies, three of fruit, three of dairy, plus meat. For "meat" I had 1/2 c refried beans, 3 oz. turkey, and 3 oz. chicken. That's it! The beans count as 1 oz. of meat, for a total of 7 oz. I usually eat that in one sitting. Think about that. One can of tuna puts you pretty much DONE for the day in the meat category.
You'd think that means I didn't get much protein, but tracking on Fitday, I had 160 g from the above diet. OK, I cheated and took another 50 g from protein powder for a total of 210, but I think you get my point. If you HAVE to eat the pyramid, it IS possible to get enough protein. Choose your foods wisely, my friend.
I'll let you know about body composition changes in a few weeks, if you're interested. I'm testing whether low fat (~50 g) is better than low carb (<50 g) for me. Just for kicks [img]smile.gif[/img]
Sorry you're having to deal with this stuff. When you say "high," I don't know how high you mean so my story may not be relevant. I apologize if you've heard this story too many times before because I know I've posted it a lot.
The way I got into all this fitness stuff in a serious way was because several years ago I had gone into my doctor's office for routine stuff and they told me that I needed to go on cholesterol lowering meds. I had already been on blood pressure lowering drugs for about 11 years at the time so I was resistant to going on yet another one for the rest of my freakin life! It was 241 total at the time. I asked if I could see if I could get it down on my own and they gave me three months. I didn't know s*%t about diet or exercise (although I had been physically active most of my life) so, as I started trying to figure out what to do, I freaked out and lost 40 lbs in two months. Yeah, I got my cholesterol down to 180 and avoided the meds... losing LOT of LBM in the process. That's when I stated to hang out at MH forum and learned a LOT about diet and exercise.
Last year on my birthday, I got my annual physical and my total cholesterol was 140 even though I'd gained weight from my lowest... and I wasn't really even focusing on the cholesterol any more. My HDL's were still over 50, however. I was actually shocked. I attribute it to exercise and cutting out trans and saturated fats wherever I can. I have changed a lot of other things but I think those were key. I used to buy grass fed beef (very low fat, less chemicals and TASTIER!) a lot but tend to just eat a lot of grilled salmon and chicken these days whereas I would have eaten fatty beef from the grocery store in the past.
I don't know if that will help you or not but that's what worked for me. Although I'm not an expert, I tend to agree with Adam that the whole cholesterol intake thing was blown way out of proportion as was the fat intake. I eat LOTS of fat every day (almonds particularly) but, judging by my last blood test, it's not causing my blood cholesterol to go up... maybe just the opposite!
I, also, eat oatmeal everyday for breakfast, which is supposed to help...? I work with a lot of Hispanic guys and they eat nopalitas (prickly pear cactus) and take it in pill form which is supposed to work...???
That's my $.02 worth. I do think that, if you go to a nutritionist, you will definitely get the old USDA food pyramid treatment!!! The ones I've talked to from school here defend it vehemently... I think they are endoctrinated in school with this mindset and they would be shaking the foundations of their profession to say anything too far off base from that.
As for readings, I'll check when I get home!
P.S. I've been off the BP meds for going on two (?) years now, too!!!
Really, I agree with Q. I think your best bet is probably to follow a diet that's low in high-glycemic carbs, but adequate in everything else--plenty of vegetables, lean meats, and healthy fats. And nothing wrong with oatmeal (he's right, it has been shown to reduce cholesterol) and other whole grains, assuming they're eatin in moderation.
I will say that beef has gotten a bad wrap for being unhealthy. According to a USDA analysis, about 50 percent of the fat in steak is monounsaturated, 10 percent is poly, and the remainder is saturated. However, of the amount that's saturated a high percentage of it (I can't remember how much off the top of my head) is stearic acid, which is the "good" kind of saturated fat (hasn't been shown to have a negative impact on cholesterol levels).
So beef isn't really a concern, especially if you're eating reasonably lean cuts (anything that's 90 percent lean).
I really don't think dropping your fat intake below 30 percent or boosting carbohydate intake above 50 percent is beneficial. Of course, everyone's different--some may thrive on that type of diet. I'll be interested to hear about Dan's results.
The AHA is a little behind the times. However, a couple of years ago they started recommending a "higher fat" diet as heart healthy option for people who preferred it--basically, low glycemic with lots of healthy fats--a Mediterranean type diet. I don't know if they're still recommending that or not.
Location: Philly on one side, Pittsburgh on another, the Green Between...
Posts: 5,857
Thanks sooooooooooooooo much, guys. I really appreciate your thoughts and your time. I am going to take this home this weekend and "digest" it, then formulate a plan of attack. Thanks again for everything!
There's a book titled Eat, Drink and Be Healthy by Walter Willet, chairman of the Dept of Nutrition at the Harvard School of Public Health, that I bought in 2001 when it came out. I devoured it (pun intended) back then, haven't looked at much lately but still think it is a good reference because the author has access to lots of long term studies (due to his position) and he uses them for support of what he says in the book.
For example, one that isn't that long a term but is given as "one of the most compelling pieces of evidence to challenge the emphasis on cutting back on all fat and eating more carbohydrates" - it goes on to say - " comes from an experiment by two Dutch scientists. They recruited forty-eight volunteers for an eight-week study. For the first seventeen days, all of the volunteers ate a typical Western diet with about 40% of calories from fat. For the next thirty-six days half of the volunteers were assigned to a diet rich in olive oil and lower in saturated fat, while the other half got a low-fat, low-carbohydrate diet. In both groups, total cholesterol levels plummented. But in the high-carbohydrate group, the levels of HDL cholesterol also fell, while triglycerides rose - both changes that increase the chances of having a heart attack or developing some oter form of heart disease. In the olive oil group, the same healthy trend was seen for total cholesterol with the unhealthy changes in HDL and triglycerides."
In another study that lasted a year, the two (out of four) groups with diets with lower fats dropped HDL's and raised triglycerides.
The author has been involved with the Nurses Health Study, an on-oing study of 121,700 female RN's since 1978, total fats were not linked to heart disease but specific fats did; replacing 5% of total calories as saturated fats with unsaturated fats reduced heart health risks by 40 and replacing just 2% of total cals from trans fats with the same no. of calories from unsaturated fats would cut the risk by 50%.
There's a pretty good primer on fats, blood cholesterol and the relationship so you might check it out.
Also, despite what I said before about nutritionists, he also proposes a totally new food pyramid! The base (biggest portion) is "daily exercise and weight control" with the next level being "whole grains and plant oils." "White rice, white bread, potatoes and pasta" are at the TOP (smallest portion) of his pyramid whereas they are the foundation of the USDA pyramid.
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