Dr. Kyle: Diet Do’s and Don’ts for 2019

 

Looking to start a new diet in 2019? Here are a few tips on what to avoid and what to incorporate into your nutritional regime this year.

FATS ARE GOOD

The human body is designed to process and burn fats as one of its primary energy sources. Fat enhances food digestion and nutrient absorption. Accompany sides of vegetables with a fat source to increase nutrient bioavailability.

Try cooking with animal fats, organic grass-fed butter and coconut oil. Avoid trans fats and poly-unsaturated vegetable oils like canola oil.

Add some wild-caught salmon into your diet to balance out the ratio of omega-3’s to omega-6’s. The typical western diet has an abundance of omega-6’s so eating salmon 1-2 per week will boost your levels of anti-inflammatory omega-3’s.

DON’T SHY AWAY FROM CHOLESTEROL

Cholesterol is vital for the synthesis of hormones and vitamin D. It also helps form cell membranes and other structural components.

Eat whole foods and at least 1 yolk with your egg whites. This will give you a better nutrient profile and a healthy dose of cholesterol.

RED MEATS

Red meats have almost everything you need to not only survive but thrive. They are one of the most micronutrient dense fuel sources on the planet. Red meats are high in b-vitamins, iron, zinc, magnesium, and creatine.

Red meat also includes Lamb! It is an excellent source of heme-iron as well.

GET YOUR PROTEIN

It is most commonly recommended that daily intake should be 1g of protein per pound. Older athletes will need more due to less efficient protein absorption.

Keep in mind that dietary needs will fluctuate based on physical demands and training goals. Athletes trying to put on mass should eat 40g before bed to maintain protein synthesis throughout the night.

20g per meal will provide 90% of muscle protein synthesis. 40g will provide 100%.

Carbohydrates

Some carbs are better then other! So, we want to pick the right ones.

Avoid refined sugars (obviously). Include variation and eat 2 forms of carbs at a time for faster absorption. I recommend sweet potatoes, spinach, red peppers and carrots. These foods have plenty of micronutrients and produce low levels of gas.

Add a side of white rice to your meat and vegetable dish. White rice is easy to digest, and can help supplement your macronutrient intake. Oats on the other hand can be hard to digest – soak them in warm water overnight or add yogurt.

Remember, carbohydrates are used to fuel workouts! Getting adequate carbs to sustain your athletic performance will protect against muscle tissue breakdown.

As always, ask a healthcare professional for dietary recommendations that best suit you. Some foods that work well for others may not sit well for you. Listen to your body.

Stay healthy and good luck achieving all your health and wellness goals for 2019!

Cholesterol: The New, the Tried and the Natural

Lower Cholesterol

Let’s take a moment to remember what cholesterol is all about, take a look at the traditional statin drugs, some newer medications on the market and talk a little about natural therapies that can provide valuable service to your cardiovascular health.

I want help now

The big push over the last few decades has been to lower cholesterol to lower the risk cardiovascular events such as pulmonary emboli, myocardial infarction, and stroke. Sometimes we get so caught up in lowering one marker, we loose sight of the bigger picture. Cholesterol is only one component to cardiovascular health, however it is one that can be easily targeted with medication and tracked through blood analysis.

Cholesterol is a necessary component and building block for many of our hormones, Vitamin D and substances that help with digestion. We could not survive without it. The trouble comes when excessive cholesterol populates our blood stream, it is easily oxidized and creates deposits called plaques in our arteries.

Excessive cholesterol comes from our diet (cholesterol, trans fat, saturated fats or even if we consume too many carbohydrates) or from hereditary factors that affect cholesterol production. The plaques take up space and narrow the path that our blood flows through. When the plaque builds up enough it can block our blood supply, starving off the tissue it is designed to feed – this is an infarction.

The word infarction means “plug up or cram”.  Sometimes a piece of the plaque can break off (emboli) and float through our blood stream and get caught in areas where the vessels are narrowed like our brain or lung and lead to a restriction of blood supply (another type of infarction).  A myocardial infarction (MI) is when an area of the heart is starved of oxygen and the muscle tissue subsequently dies. A transient ischemic attack (TIA) is where there is temporary interruption of blood flow in the brain. A hemorrhage is where the integrity of the blood vessel wall fails and blood escapes.

Ok, so it makes sense to pay attention to excess cholesterol!

The Stats on Statins

 HMG Co-A Reductase Inhibitors (i.e. atorvastatin/Lipitor, Fluvastatin/Lescol, lovastatin/Mevacor, pravastatin/Pravachol, simvastatin/Zocor, rosuvastatin/Crestor)

Cost at most $300/year CND

Generally: statins reduce LDL by 20-60%, increase HDL by 5-15% and reduce Triglycerides by 7-30% Statins are prescribed more to reduce cardiovascular event risk, rather than to reduce cholesterol levels.

Evidence of being able to treat to target levels doesn’t exist. Research has found that less than half of patients on 80mg per day will achieve at target LDL of <2mmol/L.

Most will find if they have no benefit at 10mg, they will not have any increased benefit at 80mg. Also, on the note of dosage, higher dosed statins affect HbA1c, a factor measuring your blood sugar and risk of type II diabetes. In a pooled analysis of data from 5 statin trials, intensive-dose statin therapy was associated with an increased risk of new-onset diabetes compared with moderate-dose statin therapy.

Women:  For women, unless they have existing cardiovascular disease there is no evidence that lowering their lipids will decrease their risk of coronary heart disease related death.

 Men: For primary prevention in men, the absolute benefit of statins use over 5 years (the reduction of major coronary events) is around 1.5%. That means if their risk of cardiovascular disease was 8 or 9% with no statins, while on statins, their risk is 7%. For secondary prevention in men (meaning they have already had one coronary event) their absolute benefit is 4%. This means if they have had a stroke, heart attack, heart failure, angina, TIA in the past, if they take the statin their risk is 16% where as if they didn’t it would be 20%.

Simvastatin is a first line of therapy. In one study, for every 12 people treated, one life was saved. Another study showed over 5.4 years of therapy for every 31 people treated, 1 death is prevented. Simvastatin will reduce LDL by 35% and usually the prescribed amount is 20-40mg daily.

Most common side effect: Often induces muscle pain (myopathy or at extreme rhabdomylosis).

About 50% of people will stop taking statins after 3 years due to their adverse effects.

Muscle pain aggravated by alcohol, advanced age (>80), chronic renal insufficiency, grapefruit juice, small body frame, liver health, untreated hypothyroidism, gender (women more affected than men), infections, perioperative periods, vigorous exercise, vitamin D deficiency. Drugs that will increase the muscle aches: Amiodarone, Azole antifungals, Calcium channel blockers, Cyclosporine, HIV protease inhibitors, Fibrates, Macrolide antibiotics (clarithromycin, erythromycin), and occasionally Nicotinic acid. If there is potential for drug interaction, the best choice is pravastatin.

 

What about the new drugs?

Alirocumab (Praluent ) about $14,600/yr USD

Evolocumab (Repatha ) about $14,100/yr USD

Benefit is there is no muscle pain however these are at a much higher cost and are self-injected every two to four weeks rather than taken orally. They work by blocking PCSK9 inhibitors, (monoclonal antibodies) and the medication is able to lower the LDL cholesterol circulating in the blood. Research is limited however so far it shows to lower LDL levels by about 60 percent. It also lowers the risk of heart attack and mortality related to heart disease over about a one to two-year follow-up.

What is available naturally?

Limit dietary cholesterol intake to <300mg per day

Restrict transfats and saturated fats

Limit carbohydrate intake

Eat more vegetables and fruit

Increase plant sterol intake to 1g 2x/day

Include up to 40g of fibre per day (most North Americans get <8g per day!)

Limit alcohol to 1 drink per day for women and 2 for men – have some days alcohol free

Regular Exercise

A Good Night Sleep

Supplements to help regulate blood glucose & incorporate healthy fats

There are numerous cardiovascular supplements you may wish to consider with your healthcare practitioner. Too many to mention here and they are specific to an individual’s overall need and one must be careful to have the right dose, duration and be sure there is no interaction with other medications or supplements.

 See Dr. Laura M. Brown ND for your personalized cholesterol lowering treatment plan

Fish Oil

One universal supplement that has been well studied is Fish Oil. Omega 3 and now new to the market Omega 7 has shown to be of benefit for many health factors. Omega 3 is well researched and there are over 20,000 published scientific reports that support its health benefits, including that are cardiovascular health. Fish oil has been shown to reduce serum triglyceride levels. A recent report on Omega 7 shows in a double blind placebo controlled study with 60 subjects and a baseline C Reactive Protein (inflammatory marker) at 2-5mg/L showed a 44% drop in CRP. You can look for Omega 3’s and will find them in most health food stores. On a side note, Metagenics has some serious research behind the Omega 7 and has combined the 3+7 in a formula rightfully called Mega 10. You can find Mega 10 at Forward Health.

 From the heart and mind of your local naturopathic doctor, Dr. Laura M. Brown ND.

References available upon request.