Cardiovascular Health Improvements in US May Be Slowing-Possibly Reversing

The number of American adults considered 'low risk' for heart disease has fallen below 10 percent, according to a new study, which places the spotlight on the growing need to address the risk via nutrition.

Published in the American Heart Association journal Circulation, the paper reveals that the progress in heart health that had been made during the 1970s and 1980s has now been reversed. According to the authors, only 7.5 percent of Americans between the ages of 25 and 74 were in the low risk category in 1999-2004. The figure for adults rated low risk was 10.5 percent in 1988-94.

The study, Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States Adults, created a low-risk index based on the following five factors:
• Not currently smoking• Total cholesterol below 200 (mg/dL) and not using cholesterol-lowering drugs• Blood pressure (systolic/diastolic) below 120/80 millimeters of mercury (mmHg) without using blood pressure-lowering medication• Body mass index (BMI) less than 25 kg/m2• Never diagnosed with diabetes.

Nutrition: Quantity & Quality

Adults at low risk of heart disease are those unlikely to develop cardiovascular disease or the associated risk factors. The researchers said that from a preventive health point of view, it was disappointing that less than 10 percent of Americans are meeting all the low-risk factors.
"Our analysis suggests that achieving low risk status for most US adults remains a distant and challenging goal. Unfortunately, the limited strides that were made towards this goal during the 1970s and 1980s were eroded by the increases in excess weight, diabetes and hypertension during more recent decades," said lead author Earl Ford of the US Public Health Services at the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga.

The report found that while fewer adults are smoking, an increasing proportion are developing high blood pressure or diabetes or becoming overweight or obese.

While excessive weight continues to be a rising challenge, the quality of nutrition continues to play an important role in heart health promotion and disease prevention. Diets incorporating the right types of fibers, fats and other nutrients such as plant sterol and potassium can actively work to reduce blood levels of cholesterol, hypertension or the onsight of Type II diabetes. Yet, there remains tremendous confusion over nutrients and diets whose benefits are supported by strong science.

Source: Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States AdultsCirculation. 2009 Published online before print September 14, 2009doi: 10.1161/CIRCULATIONAHA.108.835728Authors: Earl S. Ford MD, MPH, Chaoyang Li MD, PhD, Guixiang Zhao MD, PhD, William S. Pearson PhD, and Simon Capewell MD

Walnut Basil Pesto -- Lighter, Healthier

We grow a variety of herbs ---oregano, parsley, rosemary and basil-- in the Kardea garden. The oregano and rosemary retain wonderful flavors when they are dried, but the parsley and basil lose their zest. Pesto offers a great way to enjoy these herbs. The pesto also freezes well and can be enjoyed throughout the winter.

We have refined a standard pesto recipe to improve its heart healthy qualities. Sauteed walnuts replace the parmesan cheese, reducing both the sodium and saturated fat levels. The walnuts are a good source of L-arginine and ALA omega-3 fatty acids. Both these nutrients have been found to improve arterial function and blood flow. Moreover, the walnuts help maintain the great pesto consistence.

Both the basil and the parsley are a good source of anti-oxidants, particularly beta-carotene. Fatty acid ratio is a healthy 4:2:1 of monounsaturated: polyunsaturated: saturated.

Use over your favorite pasta or on sandwiches. A small dollop also can be used when serving a hearty soup.

Ingredients
4 Cups Fresh Basil Leaves, loosely packed
1 Cup Fresh Parsley, loosely packed
1 Cup Walnut
2/3 Cup Extra Virgin Olive Oil
4 Large Cloves Garlic, Chopped

Heat a pan over low heat. When hot, add 1/3 cups of olive oil, 3 cloves of chopped garlic and all the walnuts. Sautee 3-4 minute or until garlic is soft but not browned. Set aside and let cool.

In a food processor, add the second 1/3 cup of olive oil, the basil, the parsley and 1 clove of the fresh, chopped garlic. Blend with the sautéed walnuts.

Makes about 2 cups pesto. To freeze, place about .5 cup (enough for about a pound of pasta) in a small container. Cover with a thin coat of olive oil and freeze.

Admittedly, when serving with pasta, a bit of parmesan cheese brightens the dish, but keep it to a sprinkle. You will find that this pesto dish is far lighter than some of the more traditional pesto recipes.

Middle-Aged Cholesterol & Golden-Years Dementia

Even moderately elevated cholesterol levels in midlife are strongly associated with later risk of Alzheimer's disease (AD) and vascular dementia (VaD), new research suggests [1].

Lead author Dr Alina Solomon (University of Kuopio, Finland) and colleagues used data from the Kaiser Permanente Northern California Medical Group to investigate the relationship between midlife cholesterol and dementia and found that cholesterol defined as "borderline high" of 200 to 239 mg/dL increase risk.

"Both physicians and patients need to know that elevated cholesterol increases the risk not only for heart disease, but also for dementia," Solomon said. "The most important finding was that even moderately elevated cholesterol at midlife can increase the risk of both AD and VaD later in life."

The study is published in the August 2008 issue of Dementia and Geriatric Cognitive Disorders.
The study included 9844 subjects who had undergone detailed health evaluations during 1964 to1973, when they were ages 40 to 45 years.

Comparing those with cholesterol below 200mg,dL, the analysis showed Alzheimer's disease hazard ratio for midlife borderline cholesterol (200-239 mg/dL) and 1.57 for high cholesterol (>240 mg/dL).

The risk of vascularr dementia hazard ratios were 1.50 for borderline cholesterol and 1.26 for high cholesterol.

Dr Robert Stewart (King's College London, UK) said that the Solomon study data are "convincing." "In general there is now a large body of evidence that indicates that what is bad for the heart is bad for the brain—that is, that the well-known risk factors for coronary heart disease and stroke are also risk factors for dementia (whether this is classified as Alzheimer's disease or vascular dementia)," Stewart said. [2]

"So the real message for clinicians is not to do anything differently, but to be aware that what they should be doing already—identifying and treating high cholesterol, high blood pressure, and diabetes and promoting healthy diet and active lifestyles—is likely to have more benefits than originally envisaged and should reduce risk of dementia as well as reducing risk of cardiovascular disease."

Kardea Nutrition enables cholesterol lowering and heart healthy diets.

[1] Solomon A, Kivipelto M, Wolozin B, et al. Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later. Dement Geriatr Cogn Disord 2009; 28:75-80
[2] Kelly, Janis Elevated cholesterol in midlife increases dementia risk. The Heart.Org August 11, 2009.

More Than an Apple-A-Day: Multiple Portions of Fruits & Vegetables Heart Healthy

A number of studies have linked higher fruit and vegetable consumption and reduced risks of coronary heart disease and stroke. The findings are based on the epidemiolgical studies of large groups of people. Epidemiological evidence remains open to strong challenge as the causal relationships can be difficult to support. Are the nutrients in fruits and vegetables working directly to reduce the risk of disease? Or is it that people who eat more fruits and vegetable simply reduce their intake of the foods containing heart unhealthy nutrients---saturated fats, trans fats, salt? Or is there yet some other factor involved.\? The American Heart Association (AHA) has found the result sufficiently signficant to recommend increasing fruit and vegetable consumption as part of a heart healthy diet.

A new clinical study, published in Circulation (volume 9, no 16 april 28 2009, pp2153-2160) has identified a causal relationship. Specifically, the study found improvements in arterial health with 6% increase blood flow response for each additional portion of fruit and vegetables consumed daily.

In responding to the efforts to identify the active compounds in fruits and vegetables, the study's authors comment that rather than searching for the single magic bullet micronutrient, a more practical approach is likely to consider whole foods and associated dietary patterns. Thus, increasing fruit and vegetable consumptions is likely to have numerous beneficial effects due to synergistic effects of bioactive compounds.

So look beyond the apple-a-day to keep the doctor away. Multiple portions of fruits and vegetables--- each with different compounds that may work together to improve heart health---is recommended.

Cholesterol Lowering Videos-Web MD & Kardea Nutrition

Two videos --- one at Web MD and one at Kardea Nutrition --- offer insight into the power of nutrition to lower cholesterol. This power extends beyond avoiding foods high in cholesterol; it looks to nutritions that actively affect your body chemistry to improve (and lower) how you absorbs and metobolizes the cholesterol naturally produced by your body. These active nutrients include plant sterols, selected soluble fibers and selected fatty acids. Click on the links below to view.

Kardea Nutrition Video
Web MD Video

Lifestyle Changes Before Statins for Individuals wiith High CRP

Recent studies, notably the JUPITER study published in the New England Journal of Medicine, reinforces the evidence that reducing the level of inflammation in the arteries as measured by C-Reactive Protein (CRP) levels may reduce the development of arterial plaque. The Jupiter study also was focused on the role of cholesterol-lowering medication (the statin, Crestor) to reduce both LDL (bad) cholesterol and CRP. The positive results of the study suggested that many more people --- even those with otherwise good cholesterol levels but with high CRP levels---be prescribed these medications.

Not so fast, suggests Doctor Roger Blumenthal, director of the Johns Hopkins Center for Prevention of Heart Disease. In an online interview, Dr Blumenthal emphasizes that lifestyle changes, including dietary changes, are the appropriate course of action.

Kardea Nutrition-Heart Healthy & Inspired-enabling cholesterol management, naturally and nutritionally.

Report to Doctors: Dietary Interventions for Cholesterol Lowering Effective but Underutilized

Dietary intervention to lower serum LDL-cholesterol (LDL-C) is effective, yet underutilzsed in general family practice, reports a June 2009 article published in the Australian Family Physicians journal.

A year long trial showed an average LDL cholesterol lowering of 13%, with about one-third of subjects achieving a reduction greater than 20%. An important difference in the results related to the individual's adherence to dietary advice. The most effective dietary strategies are replacing saturated and trans fatty acids with poly- and monounsaturated fats and increasing intake of plant sterols. Losing weight and increasing soluble fibre and soy protein intake can also lower serum cholesterol and may be considered when recommending a nutritionally balanced, cholesterol lowering diet.

Plant Sterols & Omega-3s Combine To Boost Heart Health

A combination of fish oil and plant sterols demonstrated over a 22% reduction in overall cardiovascular risk. In the September 2008 publication in Atherosclerosis, the researchers reported that they failed to demonstrate similar result for individuals taking fish oil alone.

The study's authors', Michelle A Micallef, University of Newcastle, and Manohar L, Garg, Hunter Medical Research Institute, write, "to date, this is the first study to investigate the combined cardioprotective effects of these two functional foods" in individuals with high cholesterol but without history of heart disease. The authors' conclude that the combine use of fish oil and plant sterol therapy is "an ideal alternative or adjunct to pharmacological treatments, for maximum cardioprotection ih high risk individuals."

Kardea Nutrition delivers a system of products that enable combination therapy, offering delicious foods and quality supplement. The Kardea system extends beyond fish oils and plant sterols to include cholesterol-lowering fiber and monounsaturated-rich extra-virgin olive oil.

Kardea Gourmet Bars: What Dietitians Are Saying

Here at Kardea Nutrition, we are on a mission to enable cholesterol management through a nutritional, natural approach. For some, this approach allows the individual to avoid the need for prescription medications. For others, it allows for sharply lower doses of these medication to achieve targeted cholesterol levels. For all, it offers an opportunity to optimize our longer term health.

While we are here to provide the products that better enable this lifestyle, the dietitians and nutritionists are in the field working with individuals each day to change lifestyles and create healthful eating habits. We are reaching out to these health profressionals across the country. Here are some responses that we have received:

"Thanks so much for sending the samples of the Kardea bars. The bars are great and the breakdown is just perfect - especially since I've been trying to find more products we can carry here with sterol esters."—Susan, MS, RD, LDN, Urbana, IL.

"They are fantastic! Love the fiber content and that you are using psyllium. … Many thanks." Stacey RD, CPT, Santa Monica, CA

"I love the bars. Thanks."---Jennifer MS, MPH, RD, Massachusetts (Corporate Wellness Manager)

"I received your samples, and tried one myself. It was very good. Will recommend to my patients. Thank you."---Vickie , MS, RD, CDE, Maryland

"I spoke with you earlier about your great product. I work for in the Employee Wellness Department at a major insurance company and we are actively seeking better for you products for our cafeteria. Additionally, we offer cholesterol screenings, health fairs, diabetes classes, etc. I am sure you will find great opportunities for both you and our company." ---Judith RD, LDN, CDE, Texas

"We are selling your bars like hot cakes."--Sarah, RD, LD, Iowa, In-store dietitian.

"Hi-I am a registered dietitian working for a company whose mission is to personalize the treatment of patients threatened with cardiovascular disease. A colleague of mine in NY mentioned she had sampled your product and was recommending it to her patients. I wondered if you might supply me with a sample as well. Thank you."--Stacey, RD, LD, Alabama

"Even as I write this I am preparing a presentation on the ‘role of foods and a sensible diet to manage cholesterol and heart health’ for an elite group of ADA spokespersons. I intend to showcase Kardea bar and oil in my presentation."---Kantha, PhD, Illinois.

Maximizing Sterol Effectiveness: Study

A recent study, published in Food & Nutrition Research (January 2009), found that while sterols uniformly worked to lower LDL cholesterol, their power is affected by a number of factors. The study assessed 59 randomized clinical trials published from 1992 to 2006. Maximum results were found where patients:

• Consumed 2.5 grams of sterols or stanol per day. The FDA allows a health claim for products containing as little as .4 grams of plant sterols or .65 grams of plant sterol esters. As such, individuals will often need to take multiple servings of plant sterol products to attain the optimum daily intake. Consumption beyond 2.5 grams did not lead to further reductions ( Foods with Plant Sterols).
• Took plant sterols over the course of the day. Multiple servings were generally found to be more effective than a single serving.

Not surprising, sterols lowered LDL cholesterol by more among individuals with high or very high cholesterol levels, but sterols also proved effective among individuals with optimal to borderline-high LDL cholesterol. The authors also sought to assess the power of sterols across different types of foods. While they generally found that foods with some fat content (greater than 3 grams per serving) and low-fat milks and yogurts may be somewhat better, the evaluation does not appear to control for other elements of diet, lifestyle and medications. More research in the role of plant sterols coupled with a broader approach to therapeutic nutrition for cholesterol management is merited.

Foods with Plant Sterols

Plant sterols are an effective nutritional tool for lowering LDL cholesterol by 10-15%. As part of a diet that is both low in saturated fats, trans fats and cholesterol, and high monounsaturated fats and soluble fiber from oats, beans, barley or psyllium, individuals can achieve cholesterol reduction of 30%+.

In nature, small quantities of plant sterols can be found in a range of foods, particularly vegetable oils. The average plant sterol intake is about 250 milligrams. Vegetarians consume in a range of 400 to 750 milligrams. Plant sterol intake in traditional diets has been estimated to be about 1g (1000mg). Medical studies have concluded that 2-3g (2000-3000mg) effectively lower cholesterol. Fortified foods or supplements are typically required to obtain these levels.

Click for Chart of Foods with Plant Sterols

kardea - gourmet nutrition for cholesterol management

Foods with Plant Sterols

In nature, small quantities of plant sterols can be found in a range of foods, particularly vegetable oils. In the American diet, the average plant sterol intake is about 250 milligrams. Vegetarians consume in a range of 400 to 750 milligrams. Plant sterol intake in traditional diets has been estimated to be about 1g (1000mg). Medical studies have concluded that 2-3g (2000-3000mg) effectively lower cholesterol. Fortified foods or supplements are typically required to obtain these levels.


At our sister site, Kardea Gourmet, you can find a listing of a variety of foods with plant sterols --- naturally-occurring and fortified. You also can find (and contribute) great recipes for foods that actively work to improve cholesterol levels.