New England Health Advisory

As the incidence of Type 2 diabetes increases, more people are interested in learning about controlling blood sugar levels by changing their eating habits. To share an in-depth look at how blood sugar is affected by food, I first want to provide some background science on diabetes and blood sugar.

Diabetes 101: The Basics

The normal range for blood sugar is between 90 and 110. A person with a blood sugar reading of over 126 is said to be diabetic.

The key hormone responsible for regulating blood sugar levels in the body is insulin. Insulin is secreted in response to an influx of glucose into the blood stream following a meal. Type 2 diabetes develops when too much insulin is secreted because the glucose metabolism is not functioning optimally.

Insulin resistance occurs when the pancreas is required to produce more insulin to metabolize the same amount of glucose and keep the blood sugar level constant. The body’s cells are no longer able to utilize the glucose present because they are full, leading to excessive insulin and glucose in the blood stream and raising the blood sugar level.

One of the reasons diabetes is such a serious disease is the lack of early detection of insulin resistance. By the time the body has become insulin resistant and the blood sugar levels are elevated, the disease has already progressed. The blood sugar level of 126 is an arbitrary number assigned by conventional medicine to diagnose diabetes. The reality is that while blood sugar is climbing to that level, there are other warning signs that the glucose metabolism is not functioning properly and a person is on the way to becoming insulin resistant and diabetic.

These factors include: increased belly fat, sugar cravings, high triglyceride levels, low LDL levels, high blood pressure and increased inflammation. Conventional medicine using newer medication to treat diabetes now favors making the cells more insulin sensitive instead of adding insulin. Increased insulin causes you to have a raging appetite and to crave sugar. More insulin is needed to metabolize the same amount of glucose because your body is becoming insulin resistant.

The good news is that you can take charge of your health and regulate your blood sugar levels through a healthy diet and lifestyle by following the simple guidelines below. Insulin resistance can be prevented, and in some cases completely reversed, by making changes in diet and lifestyle. This is by no means a license to stop taking any of your prescribed medications, but rather to enhance your diabetes treatment and share the results of your lifestyle changes with your health care provider to see if the changes are significant enough to warrant a change in medication.

Regulating Blood Sugar Levels

The question I want to answer today is, “How does what I eat affect my blood sugar level?” Keeping a constant blood sugar level is important for everyone—people with diabetes and for those without. The more your blood sugar rises and falls, the harder your body has to work to maintain a balance. The consensus prescription for maintaining a constant blood sugar level includes regular exercise, eating small amounts of saturated fats and trans fats, and eating a high fiber diet to reduce the glycemic load on the body. So what does your body need? The three macronutrient groups the body needs to function properly are protein, fat, and carbohydrates. Protein and high-fat foods do not cause a rise in blood sugar; whereas carbohydrates do.

In order to understand the differences between carbohydrates from fruits and vegetables versus those from processed foods, it is helpful to know a little background science on carbohydrates. When consumed, carbohydrates are ultimately broken down into glucose to be used as energy for your cells and for all of the biochemical processes in your body. As you’ve probably figured out by now, not all energy is created equally.

Carbohydrates are divided into monosaccharides, disaccharides and polysaccharides. Monosaccharides are the simplest sugars. They cannot be broken down further. They include glucose and fructose. The disaccharides are carbohydrates composed of two sugars that can be broken down into their individual components, including sucrose, lactose and maltose.

The polysaccharides are long chains of monosaccharides held together with glycosidic bonds. They include cellulose and starches found in potatoes, bread, legumes and whole grains. In order for your body to break a polysaccharide down into glucose, all of the glycosidic bonds need to be broken. The longer the chain, the more bonds need to be broken and the longer it takes for the glucose to enter into the blood stream and cause a rise in blood sugar levels. The body does not digest cellulose, the fiber in a food, and it simply passes through the digestive system.

The Glycemic Index and Glycemic Load

In order to identify how the body uses carbohydrates for energy, I want to introduce the concepts of the glycemic index and the glycemic load. The glycemic index was developed to show the effects of a particular food on blood sugar levels. Each food in the glycemic index (GI) is given a score from 1 to 100, with 100 being the value assigned to pure glucose. Foods are considered to be low GI if they are under 55, medium GI between 56 and 69, and high GI over 70. It’s important to keep in mind that the values assigned are laboratory-derived values and that each person’s unique genetic makeup will allow for variations in metabolism for the same foods.

The glycemic index also takes into account the amounts of fat, fiber, total carbohydrates in a food and method of food preparation. Raw carrots have a lower GI value than cooked carrots because the cooked version has less fiber. (Fiber is broken down by cooking.) Most fresh green vegetables have a very low GI value due to the high amount of fiber they contain. Fruits also fall under the low GI category even though they contain fructose mainly due to the amount of fiber contained in the specific fruits.

Whole-wheat foods and sweet potatoes fall under the medium GI group and sugary cereals, white bread and white potatoes fall under the high GI group. Just because a food has a higher GI value does not mean that it is off limits for diabetics or anyone looking to stabilize blood sugar levels. It does however mean that you will need to balance the food with lower GI choices and monitor portion sizes.

The foods with the highest GI values are the ones that will produce the greatest increase in blood sugar levels. The foods with lower GI values will have less of an effect on blood sugar levels because glucose enters the blood stream more gradually, thus allowing the body to secrete smaller amounts of insulin slowly over time and the cells to absorb what they need without becoming overloaded.

The other concept to become familiar with is the glycemic load (GL). The glycemic load takes into account not only the GI value of the food, but also the portion size of the food. As you increase the portion size the GI value of the food stays the same, however, the GL value increases. To calculate the GL value of a food you would multiple the GI value by the amount of carbohydrates in your serving and divide by 100.

You’re probably starting to think that you need to get out a calculator just to eat. I’m certainly not suggesting that, as it would surely take the pleasure out of eating. However, if you are diabetic and you have to be conscious of the total number of carbohydrates you consume, then you are probably already counting carbs in your meals. Using the GI and the GL values as a guide will allow you to estimate the fluctuations in blood sugar that a particular food will cause.

Many readers are likely looking for a definitive answer to the question of, “If I eat chocolate cake with frosting is my blood sugar going to go up to 400?” But the answer really depends on your unique reaction to each food and the combination of other foods eaten at the same time. The glycemic index and glycemic load can be useful tools to help with meal planning, but the actual change in blood sugar in response to a specific food is unique to the person. The more insulin resistant you are the more your blood sugar will fluctuate when you stray to sweets, sugary soft drinks or other refined carbohydrate foods.

The most important rule to remember when eating is to keep your blood sugar balanced. Studies have shown a greater incidence of heart attacks when blood sugar drops suddenly from high to low than when it was stabilized. Testing and trial and error will determine what works best for you because each person is unique in their ability to metabolize glucose and in their level of insulin resistance.

How to Stabilize Blood Sugar Levels

I know that this information may sound overwhelming, but it really is crucial to preventing a host of downstream problems that stem from insulin resistance and diabetes, including heart disease, chronic inflammation, kidney disease and even some cancers. You can allow your cells to recover from insulin resistance, and become more insulin sensitive, but it won’t happen overnight.

In order to keep your blood sugar at an optimal stable level:

• Eat lean protein at each meal to help control appetite and stabilize blood sugar.
• Eat a meal or snack every four hours so that your blood sugar levels don’t drop too much and cause your body to become ravenous.
• Finish eating two to three hours before bed to allow for complete digestion so that your body can dedicate sleep time to rejuvenation and repair instead of digestion.
• Don’t eat a high glycemic index food alone. Consume it with a balanced meal to balance out the overall glycemic load. You can have dessert, but do so only after eating a protein and vegetable meal.
• Control your overall glycemic load by choosing lower GI food and watching portion sizes and total carbohydrates per serving. This will allow your blood sugar to stay more stable.
• Eat a variety of fresh fruits and vegetables at every meal. They are low GI and full of fiber and antioxidants and vitamins to help you feel full and stay healthy.
• Aim to increase your fiber intake especially in the form of soluble fiber from beans, whole grains, legumes, fruits and veggies, and nuts and seeds.
• The fiber will slow the absorption of sugar into the blood stream

Whether or not you are diabetic, keeping your blood sugar level in the healthy range is important for optimal health. By incorporating these simple suggestions for low GI value foods into your diet, you can be on your way to taking control of your blood sugar levels. Think about enjoying the high GI value foods as an addition to your meal, not as the main course and you will always be able to incorporate your favorite foods into each meal.

Yours in health,

Juliette Shimkets
Contributing Editor
New England Health Advisory

Each year, almost a billion pounds—or nearly three pounds per person—of pesticides are sprayed across the U.S. Before herbicides and pesticides were introduced 57 years ago, 37% of our crops were being lost to pest damage. Today, despite the pervasiveness of pesticide use, pests are destroying MORE than 37% of our crops.

And it’s not just in the U.S. We import heavily sprayed foods from countries that use chemicals the United States banned long ago. While pesticides have not had any significant effect on crop loss, they have definitely had an effect on our health. I think pesticide exposure levels in our food, water and environment are cause for concern today, but I am even more concerned about the effect they will have on future generations if we don’t start making some changes in the way we grow—and buy—our foods.

In my last issue, I looked at which fruits and vegetables are the most pesticide-laden and how you can make the best choices when buying fresh fruits and vegetables. Today, I’m going to discuss some of the effects these choices have on our health and look at other issues worth considering, including whether to buy food from abroad.

The Effect of Pesticides on our Health

Pesticides are toxins that can affect our nervous systems and damage our reproductive systems. (Not surprisingly, chemicals designed to prevent pests from reproducing can affect our ability to reproduce as well.) Some pesticides are more harmful to us than others and the extent of their effect on our health depends on which pesticides we are exposed to, in what amounts and at what frequency. Some, like organophosphates and carbamates, affect our nervous systems. Others disrupt our hormones and affect the endocrine system. Some are known carcinogens, while others irritate skin and eyes.

Pesticide exposure can result in both chronic and acute health concerns. Some of the chronic health concerns include shortened attention span, memory disorders and reduced coordination, early onset Parkinson’s disease, reproductive problems, hormonal disruptions and imbalance, birth defects, depression and cancer. (As far back as four decades ago, Miami University did a study on terminal cancer patients and found that in the random selection tested, they all had exceptionally high levels of pesticide residues in their liver, brain and fatty tissues.)

Some of the acute conditions pesticide exposure can trigger include blurred vision, headaches, eye problems, skin conditions, seizures, diarrhea, nausea and wheezing. Mild to moderate pesticide poisoning can even present symptoms similar to asthma, bronchitis and gastroenteritis, especially in children.

Children are particularly susceptible to these problems because of their developing body systems. CNN reported recently on new research that children across the U.S. who eat typical kid-friendly foods like frozen blueberries, fresh strawberries and celery had twice the likelihood of receiving an ADHD diagnosis. (Previous studies focused primarily on communities of farm workers and found that exposure to pesticides led to behavioral and cognitive problems in children.)

Researchers analyzed the urine of over 1,000 children and found that the kids with above average levels of one common pesticide byproduct, malathion, had double the chance of receiving an ADHD diagnosis. Since pesticides are designed to have toxic effects on the nervous systems in order to kill the pests, researchers concluded it is not a stretch to imagine that these chemicals can have an effect on the nervous systems and brain chemicals of children exposed to them.

We are all born with some pesticide exposure in our systems passed to us in utero. We add to that through our daily food and water choices and our environmental exposure. Some of us are more susceptible because of our genetic makeup or higher in utero exposure levels, but all of us can manage our pesticide exposure by making better choices.

I think our pesticide exposure through food, water and environment is so pervasive today that we should all try to minimize our exposure. If you have kids, are pregnant, have a compromised immune system or make lifestyle choices that you know place greater burden on your liver, it is even more important to pay attention to your food choices and avoid “the dirty dozen” most heavily pesticide-ridden produce and buy organic instead. (If you missed the list in the last newsletter, you can find it here.)

Buying Food From Abroad

In generations past, we ate along with the seasons, varying our diet depending on what grew at that time of year. Today, we eat much more limited diets, as many of us tend to eat from the same food groups repeatedly with little deviation. As a result, we eat our favorite fruits and vegetables year-round.

This practice not only restricts our diets and limits our exposure to the many other fruits and vegetables available each season, but it has also resulted in big business for international produce exports. The importation of fruits and vegetables raises a number of concerns about the carbon footprint of our foods, the use of pesticides illegal in the U.S. that are still being used in foreign countries and the nutritional value of food that is picked before it is fully ripe so that it can make the long journey to us before it spoils.

Though the U.S. has banned the use of some known carcinogenic chemicals in our food production process, several developing countries routinely use such chemicals in farming.

Just one example of this (and sadly there are many more) is the pesticide DBCP or Dibromochloropropane. In the late 1970s, workers at a pesticide plant in California discovered that DBCP exposure had rendered them sterile. Some companies stopped production while an investigation was undertaken, but some did not. (One company, Amvac, told its stockholders that they would continue to sell it even though it had suspected carcinogenic and mutagenic properties because a vacuum existed in the marketplace during the investigation and they hoped to take advantage of it.) After a two-year investigation, the Environmental Protection Agency concluded that DBCP does cause sterility and it was banned for use in the United States.

However, just because a chemical is banned in the U.S. does not mean there are restrictions abroad. In this case, DBCP is sold to Coast Rica, Honduras and Ecuador for use on banana plantations and then that produce is sent back to the U.S. for consumption. (Dole recently made the news with a lawsuit from banana plantation workers related to sterility from DBCP; it’s still being used in banana production today.)

One recent test indicated that bananas from Central and South America revealed 45 pesticides that are “allowable” by FDA standards as well as 25 prohibited pesticides and 37 additional poisons that the FDA does not test for. The FDA rarely refuses entry to produce or seizes any shipments, so there is little reason not to spray heavily. (One Mexican farmer stated that because Americans want blemish free produce and won’t eat items with insect marks, they spray four times as much pesticide on any produce destined for the U.S. than for any other location.)

If the FDA does test a produce sample, they remove a small section but send the rest to market while the tests are being run. So if they do in fact find excessive pesticide levels or other concerns like unknown poisons, there is little consequence because the American public has already consumed the produce by the time it is discovered.

In addition, the nutritional value of foods that travel long distances is often compromised. In order to make it to market prior to spoiling, fruits and vegetables are picked early, before they are ripe, and then sprayed to protect them from ripening too soon while still in transit. Food that is picked early before it fully ripens is not fully developed and its enzyme profile is different than that found in a mature, ripe version.

For example, unripe fruit has an insoluble form of pectin known as protopectin. But as it ripens, enzymes make the pectin soluble. In the case of fruit or vegetables from far away, they may never reach their ripe and mature nutritional state because they are sprayed to delay ripening and we consume them prior to that ever occurring or because the chemicals sprayed to prevent them from ripening on their journey effectively prevent them from ever reaching full mature development.

Buying organic reduces our pesticide exposure in foods we eat, but it also reduces the pesticide exposure in our environment. Pesticides remain in the soil—often for many years—affecting future crops, sometimes even generations later. In addition, spraying results in airborne chemicals that drift over homes, gardens and schools creating health concerns for many people—especially children and those living in rural farm areas.

There are so many great reasons to opt for organic produce, but it is also important to support our local farms and farming communities, as there are greenhouse gases emitted from airfreight to consider.  I’ve heard the argument that buying air freighted out-of-season produce is the equivalent to driving a Hummer.

So how do you decide between an organic apple from New Zealand or a conventional pesticide-laden product from a neighboring farm?

Local versus Organic

This is not an easy question to answer, and one you will have to decide for yourself based on your commitment to local agriculture, your concern about carbon footprints and your tolerance for agrichemicals in your food. I try to support local farming to the extent possible and will choose local produce, even if it’s not organic, whenever possible. (Especially if I can talk to the farmer directly at the farm stand or the farmer’s market and ask about how the produce is grown.)

The one exception to this is “the dirty dozen” fruits and vegetables, in which case the harms of the heavy pesticides outweigh any other considerations for me as I have developing children. So when buying those fruits and vegetables (and a few others toward the high end of the list that we eat regularly) organic is always my first priority.

Of course, when possible, getting something local AND organic is always ideal and I try to seek that. But in today’s world where time and money are always a consideration, that is not always possible. In the next newsletter, I’m going to talk about how to make the best choices when you can’t get fresh produce and you need to buy frozen or canned versions as substitutes. (You’d be surprised to know how much restaurant food, even at nice restaurants, comes from a can!)

To your health!

Inger Pols
Editor of New England Health Advisory

Did you know one of the best ways to lose weight is by walking?

I don’t mean going out and buying an expensive treadmill that will end up abandoned in a corner and used as a storage shelf or clothes hanger. You do not need to make an expensive purchase or join a fancy gym to lose weight.

All you need is a nice walk outside!

Many people walk outside at all times of the year, even in the winter. I admit it may sound more fun in Florida than in Maine come February, but that state’s residents aren’t called “Maineiacs” for nothing!

If weather is a problem, there are many free facilities you can use to do your winter walking. Many churches have gyms that are open to the public. There are also community centers with indoor tracks and most shopping malls open early for walkers.

Before you walk, don’t forget to warm up first by stretching and loosening up your muscles. Walking for exercise needs to become a routine. Once or twice a month will not give you the results you seek. You’ll want to do it three to four times a week to see results. Make it a part of your life.

Instant change is not going to happen.

The reality is that we don’t gain weight overnight. The changes in our bodies occurred slowly over time based on a series of decisions: Eating an extra serving of food at dinner, stopping at a fast food restaurant, taking the elevator instead of the stairs. So you’re not going to lose that extra weight overnight with a fad diet or fitness routine.

The secret is to make small changes to your diet while increasing your exercise (like starting a walking routine) over time to slowly lose those extra pounds.

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Yours for health and wellness,

Andrew Palmer
Publisher
New England Health Advisory

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By Inger Pols

On Friday, I looked at how to make healthier meat choices and today I’m going to look at how we can do the same with dairy. Humans are the only species that consumes milk past infancy. And we don’t just consume it: We inhale it! We drink milk and we eat butter, cream, cheese and ice cream more now than ever before. In 2001, Americans consumed 30 pounds of cheese per person. That is eight times more than we consumed in 1909 and more than double consumption in 1975!

While much of the cheese eaten in the early 1900s was made locally on a farm, today we are eating processed shredded cheeses out of plastic bags and we’re eating on the run: About 55% to 65% of the cheese we eat comes from commercially manufactured and prepared foods like packaged snack foods and fast food sandwiches.

Being Dutch, I consider cheese to be one of my four primary foods; I don’t think I could live without it. And because of my background and my blood type, I can handle dairy products without any digestive concerns. But over the past few years, I have reduced my dairy intake significantly and made several changes to the dairy products I do consume. Most of us are simply consuming too much dairy; making some changes can go a long way toward improving our health.

Not Your Parents’ Milk

Whenever I talk about reducing dairy consumption, I always run into someone who grew up on a farm who argues that their parents lived long healthy lives drinking milk every day. And I don’t doubt that, because when I ask about it further, they always say their diet included one glass of milk with a meal and some butter and cheese, all made locally on their farm—which means they consumed raw unpasteurized milk and milk products made freshly and untreated. In fact in 1909, 56% of all milk consumed was ingested on the farm where it was produced. By 2001, that number had dropped to 0.3%.

While pasteurization is hailed as a great invention because it kills bacteria and prevents milk from souring, the heat process also kills off many beneficial nutrients. Named after Louis Pasteur, pasteurization was developed as a means of preserving beer and wine. Pasteur never applied it to milk; that came later, in the late 1800s, when dirty urban dairies were trying to find a way to produce cleaner milk. They discovered that pasteurization allowed them to still use the dirty milk, which was easier and cheaper than finding ways to make the milk cleaner.

The idea quickly spread as profits grew. In order to market the new form of milk, producers had to convince consumers that unpasteurized milk was harmful. A smear campaign to link raw milk to diseases was undertaken and today, most people believe that raw milk is dangerous to consume. But the truth is that pasteurized milk poses far more health risks than raw milk.

Raw milk contains healthy bacteria that actually inhibit the growth of harmful organisms; once removed, the pasteurized milk is actually more prone to contamination. In addition, the pasteurization process destroys many vital nutrients in the milk. Studies show up to a 66% loss of vitamins A, E and D and a 50% loss of vitamin C. Vitmains B6 and B12 are totally destroyed by the pasteurization process, as are many beneficial hormones, antibodies and enzymes. One enzyme destroyed in the process is lipase, which impairs fat metabolism and the ability to absorb fat-soluble vitamins such as A and D.

Pasteurization also makes calcium and other minerals less available. One way they test to see if the milk is appropriately pasteurized is to look for the destruction of phosphatase. If it’s absent, the milk is considered fully pasteurized. But phosphatase is essential for the absorption of calcium. So pasteurization makes calcium insoluble. It also destroys iodine, the lack of which can cause constipation.

Pasteurization also turns the sugar of milk, lactose, into beta-lactose, which is more rapidly absorbed in the system and has been shown to make children hungrier sooner. But the dairy industry has formed a strong lobby to prevent the distribution and sale of raw milk in order to protect their profits.  They’d rather have you believe it is harmful because if you found out the truth, you probably wouldn’t want to drink pasteurized milk.

Hormones, Pesticides and Antibiotics

In addition to not being pasteurized, raw milk is produced on farms that also avoid some of the real dangers of milk and milk products today: hormones, pesticides and antibiotics.

In the newsletter on healthier meat choices, I discussed how hormones are used to help the animals to grow bigger. In addition to that injection process, some farms use an additional hormone called rBGH, which is a synthetic growth hormone. Back in the 1930s, a typical cow produced 12 pounds (or about a gallon and a half) of milk a day. By 1988, the average was 39 pounds a day. This was done primarily through selective breeding and using rBGH. Today a cow can now generate 50 pounds of milk a day.

Cows injected with rBGH are 79% more likely to contract mastitis (an infection of the udder). Those cows also suffer from reproductive difficulties, digestive problems, an increased need for antibiotics and other abnormalities. Consumer’s Union reports that milk from rBGH treated cows is more likely to be of lower quality and contain more pus and bacteria than milk from untreated cows.

But even if you find milk from farms that don’t use rBGH, other harmful hormones present in the cow remain. In addition to the ear pellet they receive as a calf containing synthetic hormones to help them grow, cows’ milk contains high amounts of estrogen because 75% to 90% of milk comes from pregnant cows. Milk from a late-stage pregnant cow can have up to 33 times as much estrone sulfate (a form of estrogen) and 10 times more progesterone. Much research ties excess estrogen to reproductive cancers such as prostate, testes, ovarian and breast cancer. Male breast enlargement has also been tied to high dairy and hormone-laden meat consumption.

Test analysis has revealed traces of 80 different types of antibiotics in milk. Animal products like milk can also contain up to 14 times more pesticides than plants If you worry about pesticides in produce, you should be even more concerned about pesticides in meat and milk.

Anyone who has been pregnant, or been around a pregnant woman, understands the effect high hormone levels can have on the body. They have likely also seen that what the mother eats is transferred to the child through the milk and has an immediate and noticeable effect on the child if there is an allergy or sensitivity issue. Consuming the milk of a perennially pregnant cow makes consuming estrogen unavoidable. As one physician/scientist from the Harvard School of Pubic Health put it, “The milk we drink today is quite unlike the milk our ancestors were drinking without apparent harm.”

A new process has been developed called ultra-pasteurization, which involves longer treatment times at higher temperatures, resulting in milk that is totally sterile. It’s not being advertised, but you can look for the word in small print on almost every national brand and even some organic brands (Horizon, the largest organic producer, now ultra-pasteurizes.)

Given all the challenges with modern milk production, it’s no surprise that many Americans are allergic or sensitive to it and that it can cause headaches, sinus and chest congestion, stomach pain, cramping, diarrhea, gas and sore, scratchy throats. Milk has also been linked to asthma, atherosclerosis, upper respiratory and ear infections, obesity and cancer. (Many doctors now think children with recurring ear infections may have dairy sensitivities.)

Many people have difficulties digesting milk even if they are not lactose intolerant. According to Dr. Walter Willett of Harvard University, “The majority of humans naturally stop producing significant amounts of lactase—the enzyme needed to properly metabolize lactose, the sugar in milk—sometime between the ages of two and five. In fact, for most mammals, the normal condition is to stop producing the enzymes needed to properly digest and metabolize milk after they have been weaned. Our bodies just weren’t made to digest milk on a regular basis. Instead, most scientists agree that it’s better for us to get calcium, potassium, protein, and fats from other food sources, like whole plant foods—vegetables, fruits, beans, whole grains, nuts, seeds, and seaweed.”

The Many Varieties of Milk

For my family and myself, traditional milk, even organic, is simply not a good health choice. Raw milk not only avoids the hormone, antibiotic and pesticide challenges of modern milk production, it also offers the nutrients and enzymes that the pasteurization process destroys. Raw milk is a complete source of protein full of beneficial bacteria and vitamins, minerals and enzymes. If you are going to consume cow’s milk, I suggest you do so sparingly and that you explore raw milk options.

In some states, you can buy raw milk in stores such as Whole Foods. In most states, however, you’ll have to buy directly from the farm. And that may not be a viable option for some. Another option to consider is goat’s milk. Much of the world consumes goat not cow’s milk, because it’s more widely available and also because many people can digest goat’s milk readily even if they cannot tolerate cow’s milk.

Goat’s milk is a great source of calcium and protein, phosphorus, riboflavin (vitamin B2), potassium and the amino acid tryptophan. It’s also been shown to enhance the metabolism of copper and iron. For those with milk allergy symptoms such as asthma, eczema, ear infections and rheumatoid arthritis, switching to goat milk may help alleviate symptoms.

The major problem with goat milk is the expense. For many people who consume moderate or large amounts of milk, it will not be financially viable. I personally consume very little milk. I put a small amount in my chai tea in the morning and I use a little when I make a risotto or a sauce that I want to have some depth or richness. I find that a small amount of goat’s milk does the trick and makes for a delicious and rich sauce. Because I use so little and a half gallon can last me more than two weeks, (and yes, it lasts that long without spoiling), I justify the expense. (I definitely noticed a reduction in bloating after switching from cow’s to goat’s milk.)

For those who can’t access or afford raw milk or goat milk, or who want a non-animal option, I recommend rice or almond milk. Almond milk can be made inexpensively at home so it’s a great option if you want a fresh milk alternative that doesn’t cost a lot.

I do not recommend soy milk because it contains a natural chemical that mimics estrogen, though it does contain nutrients and protein. As we discussed in the prostate article, these estrogens take up the hormone receptor sites intended for estrogen and leave the excess estrogen to wander around the body.

Studies show excess estrogen can alter sexual development and can lead to reproductive concerns and cancers. One study showed that two glasses of soy milk a day contained enough pseudo estrogen to alter the timing of a woman’s reproductive cycle. As a result, I suggest everyone avoid soy milk.

Choose Better Cheese

While I have focused predominantly on milk since it is the source for all dairy, cheese is a far bigger component of most people’s diets than milk. In general, we eat way too much cheese and cutting back on processed foods with cheese or hidden cheese in fast foods is a great step toward better health. When you do choose cheese, the same principles that we discussed above apply: Look for raw milk cheese (most markets carry some, especially raw milk bleu cheeses and they are delicious) and goat’s milk cheese, which are also prevalent and tasty. Experiment with these kinds of cheese and if you are a cheese lover like me, you’ll find some delicious new options in raw milk and goat’s milk cheeses.

Occasionally, I do eat traditional cheese, but I buy it from Europe because the European Union has banned all hormones. When you buy a cheese from the mountainous Alps region of France or Switzerland, you are typically getting cheese made the traditional old-fashioned way from cows or goats who have roamed free in the sunshine, eating grass and living without pesticides, chemicals or drugs.

How Much is Too Much?

So now that we have looked at milk and cheese options, how much, if any, dairy should you consume? Less is definitely more when it comes to dairy: For me, a little bit of raw milk or goat cheese makes my day and I try to eliminate eating cheese that is an afterthought rather than a primary focus in my meal. I believe in bioindividuality, which means I think that every body is different and your tolerance will depend on your own lifestyle factors and diet, as well as that of your ancestors. Some people can handle dairy without incident while others should cut it out completely. This may be due in part to the enzymes present in our blood.

Dr. Peter D’Adamo argues in his blood type diet book, Eat Right for Your Type that blood type Bs (as I am) can handle dairy. Because ABs have some B in them, they can handle a little dairy as well. But type A should significantly reduce if not eliminate dairy and blood type O should completely avoid all dairy. This may or may not ring true for you, but if you are at all curious, I suggest eliminating dairy completely for two weeks, especially if you have any symptoms like headaches, IBS, sinuses, asthma or bloating/gas, and see how you feel during that time. (That includes all milk, cheese, yogurt, butter and ice cream.) Then introduce it slowly and see how you feel as you begin to eat it again: you’ll know right away if you can handle dairy and what types affect you more than others.

To your health!

Inger Pols
Editor of New England Health Advisory

By Inger Pols

I recently had dinner with a friend who is fit, active, healthy and tries to eat well; he’s doing everything right. We got to talking about food labels and marketing claims. He told me that he reads the labels and that he thinks he’s making good healthy food choices.

It soon became apparent that he was reading the product claims on the front labels and occasionally, the nutrition facts label, but not the list of ingredients. I challenged him to read the ingredient list on the foods in his cabinets.  We pulled out the first item handy, Progresso Bread Crumbs, and I showed him the high fructose corn syrup and trans fats in the ingredient list.

We discovered 95% of the food in his house contained at least one, sometimes two or even all three, of the most harmful food additives: high fructose corn syrup, trans fats and MSG. It was a challenge to find anything in a box, bag, plastic bottle or jar that did not have one of these unhealthy additives.

Eating whole unprocessed foods is best, so I always recommend you stick to the outside aisles of the supermarket and avoid packaged and processed food.  But for many of us, it is simply not possible to avoid all processed foods. When you must buy prepared foods, how can you make the best choices?

While it’s easy to believe food manufacturers’ marketing claims, the only way to know if you’re making good food choices and know exactly what you are really eating is to read the ingredient list. Avoiding harmful additives could add years to your life.

Trans Fats or Partially Hydrogenated Oil

New York City made headlines when it banned all trans fats from foods. California then became the first state to do so.  Many European countries have done the same, or passed legislation for future elimination. What is it about trans fats that is so concerning? What led the National Academy of Science to say there is no safe level of trans fat consumption and to call for a full ban of its use at the city, state and country level?

Trans fats are made when a hydrogen atom is added to unsaturated fat. During this process, hydrogen gas bubbles through the oil in the presence of a nickel catalyst. Originally just an interesting science experiment, the result became attractive to food manufacturers looking to increase profits. Trans fats don’t spoil as readily as other oils, they don’t break down when heated repeatedly, and they can turn a liquid oil into a solid, which makes transport easier, and offer a cheaper substitute to solid animal fat.

The fast food industry saw the appeal, and almost every major chain found a use: Dunkin Donuts used them to fry donuts and McDonald’s used them to fry its french fries. (They and most others have recently eliminated trans fats due to public pressure).  Margarine, baked and snack goods benefited from increasing concern over the use of butter and lard several decades ago and the desire to shift to a vegetable-based oil product. But as trans fat consumption increased radically, researchers grew concerned about its effect on health.

Awareness of the harm of trans fats began in the 1990s, though a study done in the U.K. as far back as 1981 raised some questions.  In 1993, Harvard concluded that the intake of partially hydrogenated oils increased the likelihood of a heart attack. That study suggested that replacing just 2% of energy from trans fats with healthy unsaturated fats could reduce the risk of coronary heart disease by a third.

In 1999, a joint study by Harvard School of Public Health and Brigham and Women’s Hospital reported that  “at least 30,000 and as many as 100,000 cardiac deaths a year in the United States could be prevented if people replaced trans fats with healthier non-hydrogenated” oils.  The New England Journal of Medicine reported that same year that trans fats are directly linked to the development of diabetes, cancer and cardiovascular disease.

Today we know that trans fats increase LDL, the low-density lipoproteins, especially the smaller denser particles that we now know are more damaging to the arteries. At the same time, they reduce HDL, the high-density lipoproteins that are responsible for taking bad cholesterol and waste that needs to be returned to the liver for processing and disposal.  (For more detail, see our recent article on cholesterol.) They also create inflammation, which has been shown to lead to heart disease, stroke, diabetes and many other chronic conditions. Trans fats have also been linked to obesity and insulin resistance as well as Alzheimer’s disease.

At one point, the FDA estimated 95% of prepared cookies, 100% of crackers and 80% of frozen breakfast products contained trans fats.  They have also said that the average American consumes 5.8 grams of trans fats a day. While some companies are shifting their manufacturing processes, the majority of foods still contain some amount of trans fat.  (It breaks my heart every year when the Girl Scouts come calling because I’d love to support their cause, but their cookies all include trans fats, so typically, I make a donation and tell them to keep the cookies.)

When you eat at bakeries, restaurants, schools and cafeterias there is no way to monitor trans fat presence, so it’s likely that you’re consuming them. Trans fats do occur naturally in some meat and dairy products, so it’s hard to avoid them completely.

The American Heart Association recommends that no more than 1% of your calorie energy come from trans fats. If you eat a 2,000 calorie a day diet, that is 20 calories, or less than two grams of trans fats a day. Given what you likely ingest through your daily meat and dairy consumption, you are most likely reaching or exceeding that amount through natural sources.

Prior to 2006, when it was required to list trans fats on labels, it was hard to tell which foods contained them. Now it’s a little easier, but you still cannot depend on truth in labeling with regard to trans fats. In fact, many products claim to be trans fat free while still containing trans fats. Portion sizes under .5g per serving do not require listing on labels. (In Canada, it’s .2g.) So some manufacturers simply reduce portion sizes in order to meet the minimum requirements, but continue to process foods the same way.

The only way to know for sure is to read the label and to look for partially hydrogenated oils on the ingredient list.  It may surprise you where you find them: in addition to the obvious breads, cookies and crackers, I found them in a jar of marinated artichoke hearts!

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Monosodium Glutamate (MSG)

Almost everyone knows they should avoid MSG, so food manufacturers have gotten smart about hiding it. But it astounds me how many times I see it listed openly as monosodium glutamate in the ingredient list of a common kitchen staple.  It’s in so many foods because it’s a flavor enhancer that leads you to want to eat more, and which is exactly what food manufacturers want.

MSG is a neurotoxin that excites the brain. In addition to being toxic, it’s addictive. It can cause brain damage, lead to behavior disorders, learning disabilities, endocrine and reproductive disorders and neurodegenerative disease. It has been shown to lead to obesity regardless of caloric intake; it acts on the pancreas to secrete insulin and stimulate hunger, and if you are taking calcium blockers for high blood pressure, MSG acts as a calcium channel opener, counteracting that medication.

It’s in soups, salad dressings and dips, Hamburger Helper, frozen foods, prepared noodles and potato chips, it’s the secret ingredient at many big name fast food and chain restaurants, and it’s sold as the flavor-enhancing product, Accent. It’s not just a Chinese restaurant concern, though it gained attention after many people sensitive to its effects came down with headaches, dizziness and chest pains after eating it in Chinese food.

Glutamic acids are amino acids (the building blocks of proteins) commonly found in foods such as tomatoes, milk and mushrooms. They are also found in our cells and function as a neurotransmitter involved in a variety of brain functions. When we eat these foods, we break down the natural or sometimes called “bound” glutamic acid and it is delivered to receptors in our brain and body. It’s not harmful and in fact performs a valuable function.

But when glutamic acid is made in a factory, the “bound” glutamic acid in corn, molasses, beets or wheat is broken down by one of several processes: It is hydrolyzed, autolyzed, modified or fermented using powerful chemicals or specially engineered bacterias. (Most of the world’s production is made using bacterial fermentation, often with genetically engineered bacterias, but autolyzed and hydrolyzed processes are rampant in food products as well.)

It then becomes refined into a sugar-like white crystal form that is 78.2% glutamate, 12.2% sodium and 9.6% water. Anything 78%-79% processed free glutamic acid (MSG) will be listed as monosodium glutamate on the label. Other MSG-containing ingredients are listed in their technical form such as hydrolyzed vegetable proteins, autolyzed yeast, hydrolyzed yeast, yeast extract, soy extracts and protein isolate. Labels reveal that these forms are pervasive in the vast majority of foods we buy and eat.

So what’s the difference between the naturally occurring monosodium glutamate and the processed form?

Unprocessed glutamic acid is L-glutamic acid. When the processed version is created in factories, it is both L-glutamic acid and D-glutamic acid, along with pyroglutamic acid and a number of impurities. Several of the impurities such as mono and dichloro propanols and heterocyclic amines are carcinogenic. But even more importantly, our bodies are made to process and utilize naturally occurring L-glutamic acid, not the created D-glutamic acid that results from factory processing.

The FDA considers MSG to be naturally occurring since the basic ingredient is found in nature. But naturally occurring doesn’t mean safe. Arsenic is naturally occurring but you wouldn’t want to eat it. The factory version of MSG causes sensitivities and toxicity in people, as our bodies have never had to process this form before. Look out for all forms of monosodium glutamate including autolyzed or hydrolyzed yeast, yeast or soy extract and protein isolate on your ingredient lists and avoid them all.

High Fructose Corn Syrup (HFCS)

Because we already talked about HFCS in The Truth About Sugar report, I’ll keep this summary brief.

Research has shown that fructose inhibits our leptin signaling and directly leads to obesity, type-2 diabetes and a myriad of other conditions including heart disease. It alters our sweetness set points and interferes with satiety signals, leading us to eat more. We need to minimize fructose in our diets because fructose cannot be metabolized by the cells and must be metabolized by the liver; excess fructose consumption taxes our liver.

But high fructose corn syrup is not only a harmful form of fructose; it often contains mercury, it’s made from corn syrup that is derived from genetically modified corn, and it adds to the overload of corn already rampant in our diets as corn has shifted from a vegetable into a grain.

High fructose corn syrup is commonly found in bread and bread products, ketchup, tomato and spaghetti sauce, peanut butter, jelly, salad dressing, crackers and cookies and myriad other items including seafood cocktail sauce, barbecue sauce, sweet pickles or relish … just about everything!

When I had dinner with my friend, he wanted to make a special turkey burger recipe for me. Searching for bread without high fructose corn syrup can be quite a challenge in many traditional grocery stores. On a recent trip, I found only one offering out of 28 breads that was made without it. But finding high fructose corn syrup -free bread products such as hamburger buns and hotdog rolls is almost impossible at a traditional grocery store.

It takes a trip to the organic section of my local grocery store (I am fortunate to have access to Hannaford, which has a great selection), Whole Foods or Trader Joe’s to find products made without high fructose corn syrup. If your regular grocery store doesn’t carry non-high fructose corn syrup options, ask that they do. Or go without the bun.

Most of us consume large amounts of these three unhealthy food additives without knowing it. While we can’t control what’s in the food we eat in a restaurant or cafeteria, we can control what we cook at home. Once you start reading food labels, you’ll be surprised what’s actually in the products you’re buying. The good news is that there are healthy versions of every product out there that still taste great, if you take the time to look for them.

To your health!

Inger Pols
Editor of New England Health Advisory

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Most of us know we need to start—or increase—our fitness efforts, but many of us have difficulties getting started. In addition to weight management, exercise improves your mood, increases energy, reduces stress, helps you sleep better, boosts self-esteem, supports hormonal balance and reduces risks of chronic diseases and conditions including heart attacks, osteoporosis and breast cancer.

A recent study on mature women showed that just to maintain their current weight, the women needed to exercise for an hour a day; to lose weight would require even more time. In our busy lives, finding an extra hour can be a challenge, even if we have the desire to do so and the willpower to stick with it.

The good news is that we don’t need to work out for an hour in one session: We can break it into smaller blocks. And doing something is better than nothing, so even small efforts will make a difference in your health and well-being. This week, I’m going to give you some tips that I use when coaching that can help make your workouts work better for you.

Tip #1: Set a Goal and Measure Your Progress

Knowing what you are working toward will increase your effectiveness. As in everything else, what is measured and monitored gets done. Begin by setting an overall goal for your fitness plan. Be clear on what you want, for example, losing 25 pounds, training for a 10K or building enough endurance to be able to be comfortably active with your grandkids. The more specific you can be, the better. If your goal is to get fitter, define what that means to you.

Set a mini goal before each workout. Your first time, it may be as simple as walking without stopping for 15 minutes. That becomes your baseline and you can adjust from there by adding 5 minutes to your workout each time or running a mile a few seconds faster.

Be realistic with your goals, and yourself: If you didn’t sleep well the night before or you are fighting a cold, your goal may be just to complete the same workout you did the time before. And that’s OK. But if you are feeling good that day, decide how you can push a little.

Make a log to track your progress. When I was training to cycle from Banff to Jasper in the Canadian Rockies, my first cycling vacation, I kept a log of each training ride that included how far I rode, how long I rode, the time of day, the weather conditions and how I felt. Tracking that let me see how I was improving and how my performance was impacted by wind, time of day and my mood. This let me get smarter over time about how to train and when to push.

Tip #2: Know Yourself and Leverage Your Strengths and Passions

We all have different times of day when we feel most energetic and creative: Don’t resist your natural patterns. If you are forced to adopt new body rhythm patterns, you can do so over time, but it will take a little extra effort, so it may be harder to stick with.

Follow your passions to keep exercising from feeling like a chore. Go back to things you loved as a child like bike riding or tennis, or take up a new activity you have always wanted to try like golf or rowing. If you love watching Dancing with the Stars, try a ballroom dance or Zumba class.

But don’t feel you have to take on things that don’t appeal to you just because they are effective for others. If you hate the gym, don’t join a gym! If you don’t like exercising alone, find a class, team or group. Create a program that you will look forward to, not dread.

Tip #3: A Little Help from Your Friends

Studies show that people who join the gym with a buddy stick with their fitness efforts longer. It may be the accountability factor or the social factor, or most likely, both. If you take a class or play on a basketball team, the fun and social aspect will keep you committed and motivated beyond the pure physical benefits.

If you decide to workout on your own—at a gym, in your home, or outside—try to engage a partner or friend to either join you or to hold you accountable. For example, if you join a gym, get a friend to join too; while you may not work out “together,” you can plan to go several times a week at the same time. If you decide to walk your neighborhood after work, find someone to join you.

If you are using an exercise machine in your house and there is no way for someone to participate along with you, get creative. Find someone else that’s doing the same routine, and meet once a week to compare progress. Set some goals or challenges for each other and know that on Monday when you meet for coffee she is going to ask you if you met—or exceeded—your goal.

Tip #4: Schedule Your Workout

Life gets crazy at times and often the first thing to suffer is our workout time. Sometimes we feel selfish “indulging” in time for ourselves when there is so much else to do. Other times, people demand we prioritize other things. But taking care of yourself by working out ensures you will be around a lot longer to take care of others. And after you work out, release stress and improve your mood, you will be a better partner, parent or friend. So don’t let the workout slide.

Instead, schedule your workout just as you would a meeting or a dentist appointment. Mark the time in your calendar in ink and consider it unchangeable. If you think about everything you have to do in a day, there really is very little if anything more important than taking a little time to get or stay healthy. And you’ll feel so much better! Let it be known that you are unreachable during that time; you’ll find the world will still be waiting for you when you are done.

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Tip #5: Find Your Motivation

When you are working out and feeling like you want to stop, or you are avoiding beginning your exercise, try to remember your initial goal and motivation for starting your fitness program. The more you focus clearly on that outcome, see it in your mind and feel how good it will feel to achieve that and be living that life, the easier it will be to find the strength to continue. Also remembering how good you feel when you’re done can help get you going.

But there will be days when even that is not enough. When you are working out, it will be easier to push to new levels if you also draw on other motivation techniques. Find what works for you, whether it is just inspiring music, a bet with yourself or creating scenarios to encourage you to continue on.

As a spinning instructor, I see lots of competitive people in my classes. (Spinning, or indoor cycling, is a form of high-intensity exercise that involves using a stationary exercise bicycle in a classroom setting.) It is easy to inspire them with race situations where they are competing for the podium or to beat their best time. If that works for you, use your competitiveness to make some fun scenarios in your workout to make you work harder.

For non-competitive people, I use a lot of visualization to encourage increases in effort. As you accelerate and push for your interval, imagine a group of runners or riders ahead of you that you need to go around.

Or imagine you are in one of those charity rides/races and there are hundreds of people you need to pass because the road is full of riders. As you go around each one, ride for the cause that that race represents. Imagine yourself passing—or climbing that hill—to beat cancer or heart disease, for yourself or for the loved one you lost to them who cannot be here to ride.

It doesn’t have to be serious, though; sometimes motivation can be just pure fun. An elderly woman in one of my classes once confessed to me that every time she took an interval, she imagined racing her husband—the loser had to clean the bathrooms. In all her years in my classes, in her mind, she never lost.

For endurance situations, I often think of Terry Fox, the Canadian who decided to run across his home country to raise cancer awareness after his leg was amputated. He ran the equivalent of a full marathon for 143 days in a row until he had to end his journey because the cancer returned.

When I am tired after running a few miles, I think about that: A full marathon every day for 143 days, all on one leg. That inspires me to keep going. When Terry was asked how he kept going, he once said that he told himself just one more telephone pole. So think OK, just one more telephone pole, one more set, one more …

Tip #6: Pace Yourself and Be Realistic

We often get excited upon starting a new plan and take on too much too soon. You didn’t gain that weight overnight: In most cases it was small choices each day that built up over time. An extra 500 calories a day would net 3500 extra calories a week, or a gain of about 50 pounds in a year, assuming no change in exercise.

Most of us aren’t gaining 50 pounds a year, so more likely it’s the extra 100-200 calories here and there that just add up slowly over time. Generally speaking, you cannot escape the calories in/calories out equation, though it is really important to note that 500 extra calories of fiber and vegetables will not have the same impact in your body as 500 extra calories of cookies and bread.

You can’t lose more than a pound or two a week safely and keep it off long term. If you keep your food habits the same, to lose a pound a week, you’ll need to burn 500 extra calories a day. But physically, you can’t run an hour the first time out, nor can you serve and volley after your first tennis lesson.

It takes time, but that’s OK. Making the commitment and sticking with it is what matters. Creating a solid fitness foundation that you can build upon will serve you over the long haul: Trying to take on too much too soon will burn you out or result in injury and leave you on the sidelines.

Tip #7: Change is Good

We tend to find something that works and stick with it. And while that’s good, our bodies quickly adapt to what we do regularly. Intensity progression and cross training can yield great benefits. If you take a set of 10-pound weights (or whatever would be appropriate for your fitness level) and do three sets of 10-12 repetitions, the first time you do it, you’ll probably be sore.

If you continue to lift the same 10-pound weights in the same three sets over time, after awhile, it will not be hard any more. Eventually it will be easy. What burned the first time and built some muscle, no longer has any muscle growth because the body has adapted to it. When lifting, we know you need to progress and either increase sets or increase weight.

It is also true for your other workouts: Your body will quickly adapt to the same hour-long spin class or 18 holes of golf and it will not be a challenge anymore. Varying the intensity will allow you to continue to progress while doing the same thing, and cross training will force your muscles to work in different ways.

Throwing something new at your body through cross training has many benefits physically, including helping you get stronger, faster and fitter. But it’s also good for the soul. Trying new things and being a little uncomfortable challenges us; succeeding at them helps us grow and builds confidence and self-esteem.

Getting out of a training rut and mixing it up will keep you from burning out and will make your training fresh and new. And most of all, it keeps working out fun! And if it’s fun, you’ll stick with it longer.

To your health!

Inger Pols
Editor of New England Health Advisory

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An estimated 102.2 million Americans have cholesterol levels above 200, which is considered borderline high, according to the American Heart Association. About one-third of those have cholesterol levels over 240, which is considered by today’s test standard to be in the high-risk zone. And a new study just released showed 41% of Canadians have high cholesterol levels.

We have been told that high cholesterol is bad, that it causes heart disease (the leading cause of death in the U.S.), that we should all be tested for it, and that high levels must be treated, usually with statin drugs. With those assumptions and statistics, the problem would seem epidemic.

But today I’m going to shatter five myths about cholesterol and hopefully change the way you think about it forever.

Myth #1: Cholesterol is Bad for You

Cholesterol plays several key roles in a healthy functional body. It keeps cell membranes from falling apart and plays an integral part in cellular repair. Cholesterol is also a vital pre-cursor to many major hormones including testosterone, progesterone, estrogen, cortisol, dehydroepiandrosterone (DHEA) and is required for synthesis of vitamin D.

The body manufactures about 75% of the cholesterol it needs. The rest we must take in from foods. Without adequate dietary cholesterol, the body may divert cholesterol to where it is needed most: cellular repair and healthy function in key areas, especially the brain. When this happens, there may not be enough left for use in hormone synthesis, which can cause hormonal imbalance.

This is why some women (especially those going through perimenopause) who do not eat enough cholesterol may experience more severe hormonal reactions and symptoms.

In fact, the body has a built-in mechanism to increase its cholesterol production to override a severe shortage. In extreme cases, when cholesterol is not being consumed in appropriate levels, the liver will step in and actually overproduce cholesterol. If you were to be tested at that time, your cholesterol levels could be considered high, even though you would actually be cholesterol deficient.

But that’s not the case for most of us. So for those of us eating healthy diets with moderate amounts of fat, how concerned should we be about cholesterol in food?

Myth #2: High Cholesterol Comes from Eating Foods High in Cholesterol

Despite popular belief that it’s the cholesterol in your food that influences cholesterol in the bloodstream, according to the Harvard School of Public Health, it’s actually the mix of fats in your diet that’s important.

Saturated and trans fats (often called “bad” fats) increase the risk for certain diseases while monounsaturated and polyunsaturated (often called “good” fats), do the opposite—they are good for the body and heart, and cells need them to help manage what goes in and out of cell membranes.

Cells need fat and cholesterol to function, but fat and cholesterol can’t readily travel through the blood. So the body combines them with protein-covered particles called lipoproteins. Lipoproteins can carry a good amount of fat and travel easily through the blood. There are three types of these particles that are important: low-density lipoproteins (LDL), high-density lipoproteins (HDL) and triglycerides.

Low Density Lipoproteins (LDL)

LDL is responsible for taking the cholesterol from the liver to the body’s cells. Once the lipoprotein reaches the cell, the cell attaches to it and extracts the fat and cholesterol it needs.

High-Density Lipoproteins (HDL)

HDL then takes over and plays clean up, collecting cholesterol from the bloodstream, LDL and artery walls, and transporting it back to the liver to be recycled, an equally important role in healthy cholesterol function.

Triglycerides

Triglycerides are the body’s main method of transporting fat to cells. They make up most of the fats you eat and that your cells use. They are an important part of healthy body function, but in excess they can cause problems. If your triglycerides are high, you have a lot of fat in your bloodstream, which means you are either making too much or are unable to burn it.

Myth #3: There is Good Cholesterol and Bad Cholesterol

Despite needing LDL, it has been argued that when there is an excess of it, particles can be deposited in the walls of the arteries of the heart and elsewhere, limiting blood flow. The deposits, known as plaque, can break apart and cause a heart attack or stroke. Because of this, LDL has been called the “bad” cholesterol.

The truth is, there is no good and bad cholesterol. There is only one cholesterol: LDL and HDL are lipoprotein cholesterol carriers and they are both equally necessary for survival and wellness.

While LDL has been labeled bad because it can cause plaque development, we now know that there are many types of LDL. In fact, if we want to create labels for good and bad, we could argue there is good LDL and bad LDL. Research has shown that LDL particles come in different sizes and that the large LDL particles cause no problem. The small, dense LDL particles can be troublesome, as they are tiny enough to squeeze through the lining of the arteries.

If they oxidize, or turn rancid, they can cause inflammation, which can lead to many if not all of our chronic conditions. C-reactive protein tests measure general levels of inflammation and can be an early warning sign to take action. Inflammation can be reduced through dietary changes such as increased consumption of vitamin E and fish oil.

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Myth #4: Cholesterol Causes Heart Disease

We have known for a while that there is a correlation between cholesterol and heart attacks, but is it causal?

Research now shows that damage to the lining of arteries (such as what can occur when small dense LDL squeeze through and oxidize) causes the coronary heart disease associated with heart attacks.  The damage causes inflammation and it’s the inflammation that leads to the heart attacks.

How does this happen? Let’s look briefly at the inflammatory process.

When you cut yourself, the damaged tissue releases chemicals to start inflammation. Blood vessels constrict to slow down bleeding. Blood thickens so it can clot and cells multiply to repair damage and facilitate healing while the immune system calls on cells and chemicals to protect against viruses and bacteria from attacking the cut.

This is very similar to what occurs within the arteries. As damage occurs, chemicals are released to begin the inflammatory process. Arteries constrict, blood begins to clot, the immune system sends help, and nearby cells are told to multiply. As this process occurs over and over again in the artery lining, scars called plaque form. Over time, blood thickening and artery constriction combine to make a heart attack or high blood pressure more likely.

So remember the first step after trauma: Chemicals are released to begin inflammation and start the healing process. Enter cholesterol, whose primary function is cell repair. Cholesterol is sent to help repair the damaged tissue in the artery linings and elsewhere: it is actually helping your body heal to keep you alive.

Now if this process is occurring repeatedly, cholesterol is continually being manufactured or recycled in order to facilitate the healing process. When tested, your cholesterol levels will seem high.

Because your body needs cholesterol to heal, what effect will lower levels have on the body?

Instead of trying to deal with the symptom, the high cholesterol, we need to look at the cause: The inflammation that is being caused by excessive and/or repetitive damage, particularly from small dense LDL particle oxidation.

Pomegranate has also been shown to be highly effective as an LDL anti-oxidation agent. Subjects taking pomegranate supplements in a clinical study were able to reduce artery thickness by 35%, increase blood flow by 45% and improve markers related to LDL oxidation by up to 130%.

As you can see, the connection between cholesterol and heart attacks is correlated but not causal. High cholesterol may not be anything to worry about; it may in fact be an important component of your body’s healing mechanism. The real focus should be on reducing high LDL levels and preventing its oxidation.

If you decide that you must take action to lower your cholesterol, there are two ways to do so: Change your diet and/or take statins.

Myth #5: Statins are a Safe and Effective way to Lower Cholesterol

A January 2008 cover story in Business Week concluded that there isn’t much evidence to support taking statins.

Upon review of statin data, a leading physician and professor at the University of British Columbia found there is no benefit in people over age 65 no matter how much their cholesterol declines and that there was no benefit to women at any age. Middle-aged men who took statins saw a small reduction in heart attacks, but no overall reduction in deaths or illnesses requiring hospitalization even though their “bad” LDL cholesterol went down.

The only time the drugs were seen as effective was with patients who had already had one heart attack, as it reduced the likelihood of having another. He concluded, “Most people are taking something with no chance of benefit and a risk of harm.”

But what about the marketing hype the pharmaceutical companies put out? Let’s read the small print on Lipitor’s claim that it reduces the risk of heart attack by 36% … in patients with multiple risk factors for heart disease. It says, “That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor.”

In other words, out of every 100 people, three on placebos and two on Lipitor had heart attacks. That means that to spare one person a heart attack, 100 people had to take Lipitor for more than three years while the other 99 got no benefit. A useful statistic known as the NNT, or number needed to treat, means the number needed to treat in this case for one person to have any benefit is 100. Several recent studies have shown that the NNT for statins may be even higher: 250 or more for lower risk patients.

Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles, put it this way: “What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit? And that they could do just as well by exercising? How many would take that?”

It’s true that statins can lower cholesterol levels by (guess what?) reducing inflammation! Statins might be acceptable solutions if they were shown to be completely safe, but they are not. Statins have common side effects including muscle pain, cognitive impairments and sexual dysfunction and have been shown to increase cancer risk in rodents.

The Business Week article posed this question: What would work better?

Prescription: Change Your Diet

The answer, not surprisingly, according to Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles, is not a pill but rather diet and lifestyle changes. Several studies have shown that lifestyle changes, such as switching to the Mediterranean diet and eating more fish, brought greater declines in heart attacks than statins.

If you still want to lower your cholesterol levels, in addition to fish and omega-3s, walnuts and soluble fiber like oatmeal have been shown to be effective cholesterol reducers and most of us need more fiber in our diets anyway. Niacin (or vitamin B3) also lowers cholesterol and triglycerides and it recently outperformed Merck’s drug Zetia in arterial plaque prevention (resulting in Merck canceling the study.)

Physical fitness also plays a role with exercise and lifestyle changes such as stress reduction, diet changes and weight reduction.

Keep in mind that your doctor had little, if any, nutrition training in medical school and may not be comfortable guiding you in this regard. In addition, some physician friends tell me they are reluctant to suggest dietary changes because they find that people don’t always stick to them. So you may have to take the initiative with your physician to get the right plan in place for you.

Studies prove that the anti-inflammatory aspects of the Mediterranean diet and fish or fish oil, combined with a healthy lifestyle and reduced stress, are the most effective prescription for wellness, in the arteries as well as in the rest of the body.

To your health!

Inger Pols
Editor of New England Health Advisory

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