Several years ago, a number of researchers suggested that lecithin, which is found in high levels in egg yolk, could reduce cholesterol uptake in the gut. Though egg yolk is high in cholesterol, the research findings suggested that the lecithin inhibited the uptake of the cholesterol into the blood. This is consistent with many studies that have shown that moderate consumption of eggs generally does not increase cholesterol levels in the blood.

It is has been demonstrated that there is an increase in the amount of lutein in the body after eating eggs. Lutein is a yellow pigment that is thought to be a necessary nutrient of our diet. Low levels of lutein have been suggested to increase the risk of age-related macular degeneration, which results in loss of eyesight. Some researchers have suggested that an adequate intake of lutein in the elderly may reduce the risk of macular degeneration. In addition, to eggs, leafy green vegetables including spinach, broccoli and corn are high in lutein.

Over the years there have been indications that eggs have blood pressure lowering effects. The most researched effect seems to be inhibition of angiotensin 1 converting enzyme (ACE). There is already a widely prescribed class of drugs, developed for treatment of high blood pressure, that inhibit this enzyme. These are the ACE inhibitors.

In a recent study, both boiled and fried eggs were digested with pepsin. The stomach releases pepsin to digest food. By using pepsin with conditions similar to that found in the digestive tract, the aim was to mimic what happens when we eat cooked egg.

Interestingly, analysis of eggs digested by pepsin, showed that there was more ACE inhibitory activity in the whole fried egg, than the boiled egg.

So fried eggs are a health food?

photo credit: House Of Sims

Technorati Tags: eggs, lower blood pressure, ace inhibitor, angiotensin, pepsin, fried egg, lecithin, lutein

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Lipitor is one of a class of drugs called statins. These drugs are cholesterol lowering drugs. The inhibition of a rate limiting enzyme (HMG CoA reductase) in the synthesis of cholesterol is the main target of all the statins. There are a number of statins, each with slight differences from each other. Lipitor has been aggressively marketed and is sold as being one of the most effective of the statins.

In addition to lowering cholesterol, the statins have been shown to lower the risk of heart attack and stroke.

A new study indicates that the data presented by the manufacturer and in trials does not show a reduced risk of heart attack for women who take Lipitor.

Analysis of the data on Lipitor trials suggest that the decreased risk of heart attack applies to men but not to women.

Apparently, Pfizers advertising does not include the part of the FDA approved labeling that states there is no evidence of a decreased risk for women.

The abstract for the article ends with:

Billions of health-care dollars may be being wasted on statin use by women but the current regulatory regime does not create incentives to prevent such behavior.

Strong words!

Whether this applies to any of the other statins (lovastatin (Mevacor), simvastatin (Zocor), fluvastatin (Lescol), pravastatin (Pravachol), rosuvastatin (Crestor)), is not clear.

This difference between men and women in their response to Lipitor, is consistent with other differences that occur between men and women with regards to their hearts. For instance the symptoms of heart attack are often different between men and women. See a description of women and heart attack.

Women lose out yet again?

photo credit: Gunnar Wrobel

Technorati Tags: Lipitor, women, cholesterol, heart attack

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In the study some employees of a hospital, who had a sedentary lifestyle, were instructed to use the stairs, and not to use the elevators.

After 3 months the study participants had improved lung capacity, blood pressure and cholesterol levels. Their weight, waist measurements had decreased. Not unexpectedly their aerobic capacity had improved too.

These positive changes decreased the risk for a wide range of health problems and premature death.

It is suggested that just having a small increase in physical fitness and stamina can have a major impact on health.

I will have to think of something else, I work in a single storey building.

photo credit: ╠╣ỴρΞЯ ΔC╬ịVΞ

Technorati Tags: stairs, elevator, health

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More data from NHANES (National Health and Nutrition Examination Survey) suggests that some “normal weight” people are unhealthy and that some people considered overweight do not have signs of cardiac disease or other diseases that have been conventionally associated with obesity.

Of course being thin has never necessarily meant healthy. For instance, my mother who suffers form Crohn’s disease is thin due to her disease. However, in this analysis of the NHANES surveys, of those with normal weight there were a significant proportion who had what the authors called “metabolic markers of obesity”.

What were considered to be metabolic markers of obesity? They included high blood pressure, elevated triglycerides, high fasting blood glucose, high levels of C reactive protein (hsCRP) and low levels of HDL (the good) cholesterol.

The proportion of normal weight people with these markers increased with age, from 10.3% for ages 20 to 24 years , 16.9% between 35 and 49 years, 41.7% between 50 and 64 years, 54.7% between 65 and 79 years, and 56.2% 80 years and older.

Conversely, for those considered overweight and would be expected to have the metabolic markers, there were many who were in the optimal range. Healthy levels of the markers decreased with age, but represented a substantial proportion of the survey participants. The ranges were 47.7% between 20 and 34 years, 31.1% between 35 and 49 years, 20.4% between 50 and 64 years, 14.3% between 65 and 79 years, and 22.1% 80 years and older.

This sort of goes against what we are told. It will be interesting to see how the discussion of the data develops. The data does suggest that you need to go and get tested for cholesterol, glucose, triglycerides etc, whatever your size. Find out what your numbers are, then go from there.

photo credit: Fujoshi

Technorati Tags: weight, metabolic, obesity, NHANES

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The study was conducted at a remote nuclear facility in Israel, so there was control over the diets of the participants. There were many more men than women in the study, so the findings for women may be less general. The low fat and Mediterranean were calorie restricted, the low carb diet was not calorie restricted.

All dieters lost weight, but those on the low fat diet lost the least. Men lost most on the low carb diet, whereas women lost most on the Mediterranean diet.

HDL cholesterol (the good cholesterol) increased most on the low carb diet, closely followed by the Mediterranean diet and the worst was the low fat diet. LDL cholesterol (the bad cholesterol) decreased the most on the Mediterranean diet, the low carb diet was intermediate and there was only a small decrease on the low fat diet. Triglycerides dropped most with the low carb diet, the Mediterranean diet had a slightly small drop and the low fat diet had a much smaller drop.

These results suggest that low carb and Mediterranean diets may be more effective than a low fat diet both for weight loss and improving cholesterol and triglyceride levels.

Since the low carb and Mediterranean diets are almost equally effective, then choosing the diet that suits your tastes and lifestyle, is going to be what is most successful.

The study is published in the New England Journal of Medicine 359:229-241, 2008.

photo credit: sethschoen

[tags]low fat, low carb, Mediterranean, diet, weight, cholesterol, triglycerides[/tag]

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The globe artichoke (Cynara cardunculus) is a perennial thistle and is closely related to the cardoon. Other types of thistles have been suggested to have a range of health benefits. These include milk thistle for treatment of liver diseases and burdock, which is said to be a blood purifier.

Artichoke leaf extracts are widely available in Europe. They have been sold primarily as a treatment for indigestion, some urinary problems (hyperuricemia) and gout. Recently they have been shown to have positive effects on symptoms of irritable bowel syndrome.

Globe artichokes, of course, have antioxidants. I suspect that there is not a single plant that does not have some form of antioxidant. In particular artichokes have been suggested to protect the liver from oxidative stress. Artichoke leaf extract has also been shown to limit damage form oxidative stress in high intensity physical activity.

The most recent study looked at the effects of the leaf extract on moderately increased cholesterol levels. Those that consumed 1280 mg of artichoke leaf extract for 12 weeks saw a decrease in total cholesterol. I wonder how many artichokes I would have to eat to get the equivalent amount. Probably all the butter and mayo would counteract the good effect.

photo credit: Dylan Parker

[tags]artichoke leaf, artichoke leaf extract, ALE, globe artichoke, cholesterol, antioxidant[tags]

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What makes the perfect parasite? For those that want to survive in the body, it is stopping the body responding and attacking you, or trying to get rid of you. A happy parasite wants a happy host.

Further some organisms end up in a symbiotic relationship. Symbiosis is often defined as a relationship where there is benefit to both participants.

So what do immune-dreived health problems have to do with worms?

In order to stay in the digestive tract many worms suppress parts of the immune system. This way the body does not try to attack the worms. So when infected with worms the body will turn down some (but not all) immune responses. This is not a new idea, it has been known for quite a while.

What is new is the suggestion the body got used to having the worms and was in balance with them. So that in modern times with improvements in sanitation and medication, when we lost our worms our immune systems got out of whack and in some people got revved up. In other words perhaps it was of a symbiotic relationship, beneficial to all.

Why has this new idea been proposed?

One thing that everybody agrees on is that in recent times there has been a huge increase in immune diseases ranging from hay fever to inflammatory bowel disease. These are all diseases where the immune system becomes more active.

So, of course, this leads to the question, why has there been this very sudden increase in a wide range of immune diseases?

There are all kinds of theories. One is the hygiene hypothesis. The idea is that being no longer exposed to certain bacteria, fungi, worms etc., that our immune systems are not trained properly, and may in many people get out of control.

One of the first demonstrations of role of worms was the experimental infection of 29 patients with active Crohn’s disease (an inflammatory bowel disease) with pig whipworm. An amazing 23 patients showed improvement, with 21 of these going into remission. Gut 54:87-90, 2005 (PubMed). Later studies have shown good results with ulcerative colitis, another inflammatory bowel disease.

Are we going to be getting worm egg prescriptions in the future? Unlikely. There is now a push to find the range of mechanisms that the worms use to suppress the human responses. It is very likely that drugs based on this knowledge will be tested for use on many diseases that have an inflammatory component. These will include hay fever, asthma, eczema, multiple sclerosis and the inflammatory bowel diseases. It will also include diseases that you might not realize involve immune responses such as diabetes and atherosclerosis (blocking of arteries).

photo credit: moneydick The image is of Caenorhabditis elegans a harmless roundworm that lives in the soil.

Technorati Tags: worms, helminths, parasite, allergy, inflammatory disease, Crohn’s

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It is important to remember that your body has to have cholesterol. The major uses are; as part of the membranes of cells, and in the formation of a number of hormones.

No matter how much cholesterol you eat, your body (mainly the liver) will always make some cholesterol.

LDL (low density lipid) cholesterol contains cholesterol that is made by, or reprocessed by the liver. It is transported by the blood throughout the body, and cells that need some cholesterol will take what they need from the blood. So you need to have LDL cholesterol circulating in your blood. It is just that when there is too much that there may be problems.

Currently, the standard for treating high LDL cholesterol levels are the statins. The statins include lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor) and rosuvastatin (Crestor). The first name of each pair is the name of the drug, the second name in brackets is the commercial name for that drug. Yesterdays post about red yeast rice involves lovastatin.

These drugs are all inhibitors of the enzyme HMG CoA reductase. This enzyme is a major enzyme in the process of making of cholesterol by cells. When the enzyme is inhibited, cells in the body make less cholesterol. Then, when the cells get short of cholesterol they start to take up cholesterol from the blood to meet their requirements, then the level of LDL cholesterol in the blood drops.

(Statins are thought to have a number of other good effects too, independent of their cholesterol lowering ability. These are wide ranging and the subject of much research and controversy.)

To summarize, statins decrease the amount of cholesterol that the body can make, so then to meet requirements cells take up LDL cholesterol from the blood, which cause the level of LDL cholesterol in the blood to decrease.

photo credit: tellumo The sign is in Sausalito.

Technorati Tags: cholesterol, LDL cholesterol, drug, statin, lovastatin, atorvastatin, Lipitor

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What is red yeast rice?

This is rice that has been mixed with red yeast (Monascus pupureus) and allowed to ferment. The resulting fermentation products include a group of substances that have cholesterol lowering ability. One of these substances is the compound known as monacolin K, also known as lovastatin (Mevacor). Lovastatin was the first of the prescription statins available for lowering cholesterol. The commercial synthesized statins also include Zocor, Lipitor, Pravachol, Lescol and Crestor.

What are the potential problems with taking red yeast rice?

Some brands do not control (or measure) the amount of the active ingredient. Different batches may have almost none, or huge doses of monacolin K. Almost none is obviously not going to be any help with lowering cholesterol. Too much can result in muscle damage, also known as myopathy. (PubMed)

If the red yeast rice fermentation is not properly controlled there can be harmful products made too. When a number of red yeast rice preparation were tested some of them contained citrinin, which is a toxin that will damage your kidneys. (PubMed above)

Red yeast rice can have interactions with other medications. Some which will increase the risk of muscle damage or other side effects. This list of medications that potentially may result in side effects includes all drug interactions and cautions listed for lovastatin. As with the commercial cholesterol lowering statins Mevacor, Zocor and Lipitor, no grapefruit or grapefruit-containing products should be consumed. Grapefruit, also, increases the risk of muscle damage. If you are taking any other medications fully investigate whether combined with red yeast rice there may be side effects.

The FDA has banned some brands of red yeast rice products. However, it is likely in the future that products with strict manufacturing guidelines and extensive analysis will eventually be available.

As always caveat emptor (buyer beware).

photo credit: artonice

Technorati Tags: red yeast rice, lovastatin, citrinin, cholesterol lowering

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It has long been known that there is a subpopulation of people who even though they have borderlinel or slightly elevated LDL cholesterol are at a high risk for heart attack, stroke etc. Elevated LDL cholesterol definitely puts people at a higher risk for cardiovascular disease, but what about those with borderline or moderate elevations who develop heart and vascular disease?

Generally LDL cholesterol is not actually measured when standard blood lipid panels are done. It is calculated by a formula using measurements of total cholesterol, HDL cholesterol (the “good” cholesterol) and triglyceride. So the calculation just estimates how much cholesterol is in the LDL fraction in blood.

Cholesterol is not free in the blood; it is contained in particles. There are LDL particles, HDL particles etc. LDL particles in the blood are not all the same size or density. They have a size range, with the smallest being the most dense, and the biggest being the least dense. An analogy is comparing lead shot with a Styrofoam packing peanut. The lead shot is smaller but heavy; the Styrofoam is bigger and less dense.

The standard calculation of the amount of LDL cholesterol does not give an indication of the numbers of LDL particles. If there are lots of small dense particles, then the LDL cholesterol measurement might not be very high even though there are lots of LDL particles.

The smallest densest particles are thought to be most atherogenic (most atherosclerosis causing) and most likely to cause cardiovascular disease, while the biggest and “fluffiest” are the least atherogenic.

So, considering LDL cholesterol measurement. If there are lots of predominantly small dense particles in the blood, the calculated LDL cholesterol may not be really high since the small particles do not have very much cholesterol. However, the risk of cardiovascular disease may be significant, since there are actually lots of small dense LDL particles.

Since each LDL particle has one ApoB (apolipoprotein B100) on its surface, then the amount of ApoB can be used to estimate the number of LDL particles. So particularly if LDL cholesterol is borderline or slightly elevated then the amount of ApoB can give an estimate of the number of particles and from this the percentage of atherogenic small dense particles can be calculated.

The measurement of ApoB will therefore be particularly beneficial for predicting which patients with borderline or slightly elevated cholesterol are at risk of cardiovascular disease. Those who have relatively high ApoB would then be candidates for more aggressive cholesterol lowering treatments and could be monitored for early detection of the development of cardiovascular disease.

photo credit: kygp

Technorati Tags: LDL cholesterol, ApoB, cardiovascular disease, atherosclerosis

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