Saturday, April 06, 2013

Cholesterol Guidelines from the Cleveland Clinic!

The following is from The Cleveland Clinic Cholesterol Guidelines

Nutrition - Cholesterol Guidelines

The National Heart, Lung and Blood Institute's
 National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP III) guidelines for cholesterol reduction include the latest information known to date on how to optimally reduce your risk for coronary heart disease.Bringing the Science to your Dinner Table

It is estimated that millions of people are at much greater risk for heart disease than previously realized. This means more and more people will be walking away from their doctor’s office with a cholesterol-lowering drug prescription in hand (it is estimated prescription drug needs will increase from 13 to 36 million). Medications aside, what these new guidelines also so vividly illustrate is the growing epidemic of poor dietary habits, obesity, hypertension, hyperlipidemia and sedentary lifestyles that lead to the number one killer in America today.
Because of this the ATP intensified the use of nutrition, physical activity and weight control in the treatment of elevated cholesterol and titled it the "Therapeutic Lifestyle Changes" (TLC) treatment plan. Even if you come out with a gold star on your cholesterol level and overall risk for coronary heart disease, most of us would surely benefit from implementing these guidelines.
The following table can help you implement the guidelines into practical terms you and your family can enjoy and reap heart-healthy benefits:

New TLC guidelines:

Saturated Fat – less than 7% of total calories
  • Why? What does this mean?: Diets high in saturated fats are linked to increased risk of coronary heart disease. Saturated fats are thought to have the most potent cholesterol raising potential.
  • Examples: Fatty cuts of meat, skin on poultry, egg yolks, lard, butter, whole milk dairy products, palm kernel oil, palm oil, coconut oil, desserts and sweets, fried foods and most snack foods and fast foods made with hydrogenated or partially hydrogenated fats. These fats are generally solid at room temperature.
Trans Fat – as little as possible
  • Why? What does this mean?: Trans fatty acids are formed when a liquid fat is turned into a solid one; a process called hydrogenation. Research indicates that trans fat have the same cholesterol-raising effect that saturated fats do. Therefore we recommend keeping your trans fat intake as low as possible.
  • Examples: To keep your trans fat intake down, limit foods with the following ingredients: partially hydrogenated oil, hydrogenated oil, stick margarine and shortening. Limit your intake of fried foods, cakes, pies and other foods containing the above. Foods containing trans fat are also solid at room temperature.
Polyunsaturated Fat – up to 10% of total calories
  • Why? What does this mean?:Diets moderate in polyunsaturated fats are generally recommended. Substituting polyunsaturated fats for saturated fats will reduce both total and LDL (bad cholesterol) but do have the potential to also lower HDL (good cholesterol) levels when consumed in large amounts. That is why they should be consumed to no more than 10% of total calories each day.
  • Examples: Margarine, soybean, safflower, sunflower, cottonseed and corn oils, pumpkin and sunflower seeds, most salad dressings and mayonnaise. These fats stay liquid at room and refrigerator temperatures.
Monounsaturated Fat – up to 20% of total calories
  • Why? What does this mean?: Most desirable source of fat in the diet. Substituting monounsaturated fats for saturated fats will reduce both total and LDL cholesterol while sparing the reduction of HDL cholesterol.
  • Examples: Olive and canola oils, nuts, nut butters and oils (e.g. peanut butter, almond oil), avocados and olives. These fats stay liquid at room temperature but solidify slightly when placed in the refrigerator.
Total Fat – 25% - 35% of total calories
  • Why? What does this mean?: All of the fat you consume on a daily basis should not exceed 35% of total calories. Research to date indicates that the lowest incidence of heart disease in many regions and cultures such as the Mediterranean region consume approximately 25%-35% of total fat from calories each day. But keep in mind these diets contain the greatest percentage of fat calories from mono and polyunsaturated fats.
  • Examples: All of the sources of fat noted above.
Dietary Cholesterol – less than 200 milligrams each day
  • Why? What does this mean?: Excesses in dietary cholesterol have been linked to increases in coronary heart disease. Consuming less than 200 milligrams per day is a prudent attempt at lowering your risk.
  • Examples: Cholesterol comes from two sources – that which your body creates and that which is found in animal products (meat, poultry, fish, egg yolks and dairy contain dietary cholesterol). Choose reduced fat or lean sources of animal products to help reduce your dietary cholesterol intake.
Carbohydrates – 50% - 60% of total calories
  • Why? What does this mean?: Carbohydrates are the building blocks of a heart-healthy diet. Choose complex carbohydrates (instead of refined ones with white flour) to get the maximum nutritional benefit from these foods.
  • Examples: Whole grain or oat based breads, crackers, pastas and cereals, other whole wheat/grain based flour products; brown or wild rice; couscous, quinoa, barley, buckwheat; lentils, split peas and beans; fruits and vegetables.
Fiber – 20-30 grams per day
  • Why? What does this mean?: Dietary fiber, specifically the viscous (soluble) form, is associated with a decrease in cholesterol and contributes to a host of other health benefits.
  • Examples: All of the above complex carbohydrate food sources. Aim for a minimum of 10 or more grams of viscous (soluble) fiber each day by increasing oats, barley, lentils, split peas, beans, fruits and vegetables. Aim for 8 or more servings from fruits and vegetables daily, eat legumes like beans or lentils at least 3 times a week and choose only unrefined flour based products.
Protein – Approximately 20% of total calories
  • Why? What does this mean?: Dietary protein can come from both plant and animal sources and is an essential nutrient to good health. The problem is, many protein sources (especially animal sources) contain a lot of saturated fat and cholesterol so choose your protein sources wisely.
  • Examples: Major sources of protein in the diet: beef, veal, pork, fish, chicken, legumes like lentils and beans, dairy products, nuts, seeds and soy foods.
Total Calories – balance energy intake with output to achieve or maintain a desirable body weight
  • Why? What does this mean?: Excessive calories, regardless of the source, results in weight gain. Excessive weight gain over time can result in obesity, diabetes, hyperlipidemia, hypertension, joint problems and a host of other debilitating diseases including heart disease.
  • Examples: Aim to consume 4-6 small meals and snacks daily. Avoid skipping meals and eating late at night for optimal weight maintenance.
Margarine enriched plant sterol/stanol esters
  • Why? What does this mean?: Plant sterols are substances naturally occurring in plants. They are similar in structure to the cholesterol molecule and when ingested, inhibit the cholesterol molecule from being absorbed in the small intestine, resulting in a net decrease in overall cholesterol.
  • Examples: The NCEP recommend incorporating margarine enriched with stanols as an enhancement to therapy prescribed by your physician, NOT as a replacement for diet, lifestyle change or prescribed lipid-lowering medications. Currently, two stanols are available on the market- Benecol® and Take Control®.

You may wonder how it is you can incorporate these guidelines into your and your families hectic lifestyle. Take the following steps one day at a time and focus first on the foods in your diet that are high in saturated fat and cholesterol. Start making simple substitutions for saturated fats with mono and polyunsaturated fats, couple this with a focus on fruits, vegetables and whole grains, some physical activity and you are well on your way towards reaching your nutritional goals. Below is an example of how the TLC guidelines would be implemented for someone on a 1,800-calorie diet. You may require more or less calories for weight loss or maintenance, see your registered dietitian or physician for more information on your caloric needs.
NutrientFor a 1,800-calorie diet
Saturated fat, <7% of calories14 grams or less per day
Polyunsaturated fat, up to 10% of caloriesUp to 20 grams per day
Monounsaturated fat, up to 20% of caloriesUp to 40 grams per day
Total fat, 25% to 35% of caloriesBetween 50 and 70 grams per day
Carbohydrate, 50% to 60% of caloriesBetween 225 and 270 grams per day
Protein, about 15% of caloriesAround 67 grams per day
CholesterolLess than 200 milligrams per day
Fiber20-30 grams per day with a focus on viscous (soluble) fiber

Tuesday, January 29, 2013

Is it Anxiety or is it Low Blood Sugar??? My Constant Dilemma

One of the biggest issues I have with being a T1D and taking insulin is that


Okay, that's not entirely true.  When I start shaking and get lights flashing before my eyes, I know it's low blood sugar.  But the a-l-m-o-s-t too lows can be quite confusing.

Take today for example.  I went to my acupuncturist and I was feeling hyper.  I told him I was stressed by work and family issues and I wanted him to focus on stress today.  He was wonderful, as usual, and I did breathing and meditation during my treatment.  I walked out of there feeling much, much better.

But by the time I'd made the gas station detour and was heading home, that hyper-stressed-anxious feeling was back.  I walked in my front door, took an anti-anxiety pill, and then realized, a few minutes later, that nothing was happening.  I grabbed my Ping meter and sure enough, it registered a 65.  That's not terribly low (I have been MUCH lower) but it's low enough to make me feel anxious.

Half a glass of OJ later, and I'm good to go!

Have you had this experience?

Monday, January 28, 2013

Rampant Diabetes--in the US and in my ancestry

I am not certain how diabetes runs in different families.  I wonder:  does every family have at least one person with Type 2 diabetes?   The statistics are difficult to figure out, especially because organizations such as the American Heart Association keep their numbers by age (child versus adult) rather than by diagnosis (Type 1 versus Type 2). The 2012 American Heart Association Statistical Fact Sheet. for example, says that there were 18.3 million American adults with diagnosed diabetes, 81 million with pre-diabetes, and over seven million adults who are running around undiagnosed.  Nearly 200,000 American children under age 20 had diabetes in 2012.

What we don't know from the AHA figures is how many of those kids had Type 2 because they were heavy and not eating properly, and how many were Type 1, with genetic predispositions and antibodies.

What we also don't know from the AHA statistics is how many of the 18 million grown-ups with diabetes are us Type 1's who are surviving and living normal or near-normal life-spans.  We don't.

So there is no way I can see from these stats to figure out how many of us are living in families with a predisposition toward diabetes.

What I can tell you is this:

I have two antibodies for Type 1.  I was diagnosed as an adult, around age 30, which means I don't fit properly into the AHA categories -- an adult Type 1 doing well.  I am Caucasian and non-Hispanic, so I am from a population that generally is not as predisposed to diabetes.

I can tell you that one of my ancestral lines--specifically my maternal grandmother's mother's line--has family members with Type 1.  My third cousin here in Seattle, a descendant of my grandmother's first cousin, got Type 1 diabetes at about the same age as I.  We have also been told that my grandma had twin cousins with Type 1.  We do not know much beyond that.  The Jewish diaspora, you know...

My maternal grandpa had Type 2 diabetes.

My father's family is a complex story.  Lots of Type 2 diabetes and lots of deaths due to complications of diabetes.  My first cousin Carl, my dad's nephew, has Type 2, and several of his half siblings died of Type 2, including many years ago my cousin Clara, who was morbidly obese.  There were three different mothers, so it's probably a pretty good indication that the diabetes comes from the Bradleys or perhaps my dad's mom's family.  We don't know.

What I do know is that the cards are stacked against these genes of mine.

But from my perspective, it seems that everyone I know has somebody somewhere in their family with diabetes.  It's usually Type 2, but it's there.

Sunday, January 27, 2013

The Girl's Guide to Diabetes

I would like to share with you the link to an art exhibit called The Girl's Guide to Diabetes. The artwork is by "Ana," a Type 1 diabetic who had her showing on January 13.  She is a student at James Madison University.  The website was created by her sister.

One of Ana's pieces. I am guessing it is on neuropathy. Permission to post this received from Ana's sister.  Please visit their exhibit website!

I don't know if Ana is a bike rider or if she's going to participate in the JDRF Ride to Cure Diabetes, but I am, and I'm doing it for people like Ana--and for me.  Today I hit 10 percent of my goal, five days into the campaign.

Thank you Ana!

Saturday, January 26, 2013

The Ride: Getting Started on Fundraising!

Susan Horst
I met with Susan Horst yesterday at Soul Food in Redmond to walk through the specifics of my fundraising campaign for the Ride.  Susan is the JDRF NW Ride Event Manager.  She is a joy to be around and an absolute bundle of energy!   

I showed Susan the Microsoft Access project file I've been putting together listing potential donors and planned fundraising tasks.  She made a couple of suggestions, for example, to create some additional categories for my donor file.  My immediate assignment from Susan is to plan where I estimate the $4,000 in donations for my pledge will come from.  That's what I started in the Access file, but now that's been refined with Susan's help.  

Friday, January 25, 2013

A New Campaign! The JDRF Ride for the Cure 2013!

I'm back to blogging here again, talking about my life with Type 1 Diabetes!

Now, the focus is a new goal:  In September, I'm doing a century bike ride with the JDRF Ride to Cure Diabetes.  I'll be participating with upwards of 30 fellow Northwest riders, nearly each one of us working toward bringing in $4,000 in donations!

I started this blog page mid-decade to raise money for JDRF through Blogathon.  At that point, I blogged nonstop for 24 hours, twice an hour, and brought in a few hundred dollars.  That was fun, but this is a much greater undertaking, and I'm going to need a lot of help.

I'll be posting about my progress as well as that of my fellow riders and teammates.  Please subscribe and join us for the daily adventure!