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Cholesterol - watch saturated fats or carbs? or both?
So I got more information today from my doc about my high cholesterol (posted a vent yesterday). She said to get at least 1000mg of fish oil and 500mg of niacin a day. Right now I'm taking 2800mg fish oil and 50mg of niacin, so I can up the latter. She also said to eat less than 9g of saturated fat a day. Looking at MyFitnessPal, I'm consistently in the 20s on sat fat. Sometimes less and sometimes more.
(She also said exercise 30mins 3-5x a week. I've got that more than covered right now.)
But in reading I've been doing, carbs and sugar affect cholesterol too. I'm getting about 200g of carbs every day and we'll say 60g of sugar. That one seems to be all over the place and range from 50-130.
I'm more tempted to watch carbs and sugar, but I also want to be smart about the saturated fat. My sources of it are largely healthy, very rarely fast or fried food.
Gah. Despite progress, I clearly have a lot left to learn and do.
Re: Cholesterol - watch saturated fats or carbs? or both?
Here are links to him discussing the book and concepts. The three parts total about and hour and a half (I streamed them on my iPod during my commute).
http://journal.crossfit.com/2011/12/garytaubesfull.tpl
I've read WWGF. I've been considering the primal diet, or at least heading in that direction, but that would probably be contrary to my doc's advice of <9g sat fat a day. I have a good friend who's eating primal and having good success on it.
I'm generally struggling about the conventional science vs. new writing on the topic. I work in public health, so it's a bit difficult for me to completely ignore it.
I've got high cholesterol too, thanks to genetics (thanks Dad!). my total cholesterol was 250 when I was FIVE years old. it got up to 280-something with an HDL of 20-something when I was 23 and I got on Lipitor to both bring the LDL down and the HDL up. I take 40 mg of Lipitor daily and have been for 4.5 years and my lipid numbers were finally within normal range this January. we also monitor my CBC and comprehensive metabolic (includes a liver profile) to monitor for adverse side effects and those have been perfect. I get my blood tested every 6 months.
I'm also a cardiac care nurse, so between my own health, my dad's, and my job, this is something that I've been studying for several years now. the studies are now showing that diet doesn't have *that* great an effect on your total cholesterol level if it is indeed genetic. your triglycerides, sure. those will swing up and down based on the amount of saturated fat you're eating. but not the total. if you get your HDL up, it will take care of clearing out your TRGs, since that is the job of HDL.
as far as carbs go, it depends on what studies you're reading. basically, it depends on how well the studies are run and what exactly they are testing for. but a bunch of literature is coming out regarding diet, cholesterol, and its effects on the heart and vascular system and they're all saying something different. even the cardiologists, and my own doc, are just going with the old standby to "watch your diet and exercise" because they're covering their asses in case diet *does* have an effect. but they aren't sure. however, watching your simple carbs and sugars is not a bad idea since type 2 diabetes (even borderline) and cardiovascular damage go hand in hand. complex carbs, like oatmeal, bran, etc are EXCELLENT in lowering cholesterol and highly recommended in a heart healthy diet, so I wouldn't cut out carbs completely. I try to eat something with oatmeal or bran daily.
all of this to say that while I do *try* to watch what I eat, I don't monitor it too closely because I know that my medication and exercise had more of an effect than diet ever did. if my total cholesterol was 250 at five years old, you know I wasn't eating a bunch of junk food then and running around like crazy, thus diet had no effect on me. but that's just me. everyone is different, even those with high cholesterol. even my dad is different than me because he's allergic to statins, bile acid sequestrants, and niacin. so the only method for him is diet (which he doesn't follow) and exercise (which he can't do after 4 knee surgeries on his left and 3 on his right and there's no pool for him to swim in).
Glenna Harding Photography
I'd add Robert Lustig's lecture "Sugar: The Bitter Truth" to the must-see/hear list. He details fructose metabolism and its negative effects on health:
http://www.youtube.com/watch?v=dBnniua6-oM
UCSF is posting a series about obesity with similar content, narrated by Lustig but much easier to follow:
http://www.youtube.com/watch?v=h0zD1gj0pXk&list=PLB9BC165392E146AC&index=1&feature=plpp_video
You could start by cutting out the added sugars. It won't harm you and can only help. Even the AHA's current upper limit for women is 6tsp/100 cals. per day (about 25g):
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Sugars-and-Carbohydrates_UCM_303296_Article.jsp . The daily minimum requirement is 0g. Refined sugars are there for our entertainment
My personal strategy is to have fructose in the form of fruit/veg only, little bit of very dark chocolate and good desserts at special occasions outside of home.
You could keep the sat. fat steady during that time to better isolate the effect of sugar intake on your lipid profile. Try to get it from good quality sources like omega 3 enriched eggs and/or grassfed meats, grassfed butter like Kerrygold, etc. and that way you'll get other valuable nutrients at the same time like vitamin K2 and CLA.
For info on saturated fat, check out Dr. Jeff Volek. He argues that saturated fat restriction is not necessary and may even be harmful in the context of a carb. controlled diet. Here's one interview with him:
http://www.askthelowcarbexperts.com/2012/03/11-saturated-fat-is-good-for-you-dr-jeff-volek/
If I'm remembering correctly, recommendations to limit saturated fat are faulty in that trans fats were lumped in with saturated fats in studies and we know those man-made fats are pretty terrible? something to look into.
Finally, the fish oil is supposed to be anti-inflammatory and adds a bit of omega 3. A more potent strategy to balance your omega 3 to 6 ratio is to cut back on the omega 6 content. Save omega 6 content for things like nuts and poultry and avoid most plant-based oils (except for olive and coconut): corn, soybean, canola/grapeseed/rapeseed, etc. Here are some nifty guides to fats and oils:
http://www.balancedbites.com/PDFs/BalancedBites_FatsAndOils.pdf
http://www.balancedbites.com/PDFs/BalancedBites_CookingFats.pdf
exactly. much more succinct and well-worded than I can say.
Glenna Harding Photography
Thanks for this information, ladies. Good stuff.
I'm another with genetically high chol. Total = 275; HDL = 103 and LDL = 158. Tri = 69. I exercise 6 days a week (cycling, boot camp, spin, hiking) and eat well. Not perfect, but I don't eat a lot of crap. My adenosine stress test came back perfect, as did the echocardiogram. My cardiologist didn't put me on chol meds because the ratios are good. I'll never be below 200 total chol no matter what I do.
WOW. that's pretty awesome, actually. mine hovers in the 40s. it's not bad, but it's not at preventative levels like yours is.
Glenna Harding Photography
It covered one visit last year because I had high cholesterol AND high blood pressure. Now that my BP is normal, I'd have to pay OOP. Still might though. The RD I saw last year actually called me today (to tell me about the ins stuff), and she was so proud of my 70lb loss. She gave me a few tips over the phone -- VERY in line with responses in my 'critique my eating' post and told me to try "chloestoff" or something. Have to research that now...