Re: LDL cholesterol and diet question

Sat, 17 Dec 2005 05:00:01 +0200 in article
<17r6q1dr710p2ln9vefh2ofs8baju97l5g@xxxxxxx> Matti Narkia <narkia@xxxxxxxxx>
wrote:

>Fri, 16 Dec 2005 18:26:59 -0500 in article <40h0prF1aa3taU1@xxxxxxxxxxxxxx>
>Susan <nevermind@xxxxxxxxxx> wrote:
>>
>>miscellaneousmedia@xxxxxxxxx wrote:
>>> I have to drop by LDL by 40 points in 60 days. I can do it. I'm going
>>> strict veggie and working out. But I wonder if adding salmon or
>>> benecore (rather than strict vegan and/or no butter, marginine or
>>> benecor) to the diet will help drop the LDL
>>
>>Adding salmon and reducing starch and sugars may do it. Also, you may
>>want to research the supplement pantethine, it lowered my LDL 70 points,
>>and I eat a low carb/highish fat diet, which doubled my HDL.
>>
>I agree with Susan. After I reduced my carbohydrate intake by leaving out
>potatoes, rice and grain products, and increased my intake of extra virgin
>olive oil and fatty fish, and started taking daily 1-2 glasses of red wine
>and half a teaspoon cinnamon powder, my HDL has risen 100%.
>
Why cinnamon? See

Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA.
Cinnamon improves glucose and lipids of people with type 2 diabetes.
Diabetes Care. 2003 Dec;26(12):3215-8.
<http://care.diabetesjournals.org/cgi/content/full/26/12/3215>

"OBJECTIVE?The objective of this study was to determine
whether cinnamon improves blood glucose, triglyceride,
total cholesterol, HDL cholesterol, and LDL cholesterol
levels in people with type 2 diabetes.

RESEARCH DESIGN AND METHODS?A total of 60 people with
type 2 diabetes, 30 men and 30 women aged 52.2 ± 6.32
years, were divided randomly into six groups. Groups 1,
2, and 3 consumed 1, 3, or 6 g of cinnamon daily,
respectively, and groups 4, 5, and 6 were given placebo
capsules corresponding to the number of capsules consumed
for the three levels of cinnamon. The cinnamon was
consumed for 40 days followed by a 20-day washout period.

RESULTS?After 40 days, all three levels of cinnamon
reduced the mean fasting serum glucose (18?29%),
triglyceride (23?30%), LDL cholesterol (7?27%), and total
cholesterol (12?26%) levels; no significant changes were
noted in the placebo groups. Changes in HDL cholesterol
were not significant.

CONCLUSIONS?The results of this study demonstrate that
intake of 1, 3, or 6 g of cinnamon per day reduces serum
glucose, triglyceride, LDL cholesterol, and total
cholesterol in people with type 2 diabetes and suggest
that the inclusion of cinnamon in the diet of people with
type 2 diabetes will reduce risk factors associated with
diabetes and cardiovascular diseases."

(Commented in the article

"Cinnamon spice produces healthier blood"
<http://www.newscientist.com/news/news.jsp?id=ns99994413>

So perhaps cinnamon does not significantly raise HDL, but it may lower LDL.

Cocoa powder and dark chocolate instead may raise HDL:

Mursu J, Voutilainen S, Nurmi T, Rissanen TH, Virtanen JK, Kaikkonen
J, Nyyssonen K, Salonen JT.
Dark chocolate consumption increases HDL cholesterol concentration
and chocolate fatty acids may inhibit lipid peroxidation in healthy
humans.
Free Radic Biol Med. 2004 Nov 1;37(9):1351-9.
PMID: 15454274 [PubMed - in process]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15454274>

"... Cocoa polyphenols may increase the concentration of
HDL cholesterol, whereas chocolate fatty acids may modify
the fatty acid composition of LDL and make it more
resistant to oxidative damage."

Cocoa powder and dark chocolate may have multiple cardiiovascular benefist.
A few examples:

Alonso A, de la Fuente C, Beunza JJ, Sanchez-Villegas A, Martinez-Gonzalez
MA, Alonso A, Sanchez-Villegas A, Grassi D, Blumberg JB, Ferri C.
Chocolate Consumption and Incidence of Hypertension.
Hypertension. 2005 Dec;46(6):e21-e22. Epub 2005 Nov 14. No abstract
available.
PMID: 16286580 [PubMed - as supplied by publisher]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16286580>

Heiss C, Kleinbongard P, Dejam A, Perre S, Schroeter H, Sies H, Kelm M.
Acute consumption of flavanol-rich cocoa and the reversal of endothelial
dysfunction in smokers.
J Am Coll Cardiol. 2005 Oct 4;46(7):1276-83.
PMID: 16198843 [PubMed - in process]
<http://content.onlinejacc.org/cgi/content/abstract/46/7/1276>

Grassi D, Necozione S, Lippi C, Croce G, Valeri L, Pasqualetti P, Desideri
G, Blumberg JB, Ferri C.
Cocoa reduces blood pressure and insulin resistance and improves
endothelium-dependent vasodilation in hypertensives.
Hypertension. 2005 Aug;46(2):398-405. Epub 2005 Jul 18.
PMID: 16027246 [PubMed - in process]
<http://hyper.ahajournals.org/cgi/content/abstract/46/2/398>

Grassi D, Lippi C, Necozione S, Desideri G, Ferri C.
Short-term administration of dark chocolate is followed by a significant
increase in insulin sensitivity and a decrease in blood pressure in healthy
persons.
Am J Clin Nutr. 2005 Mar;81(3):611-4.
PMID: 15755830 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/abstract/81/3/611>

Fraga CG.
Cocoa, diabetes, and hypertension: should we eat more chocolate?
Am J Clin Nutr. 2005 Mar;81(3):541-2.
PMID: 15755820 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/81/3/541>

Keen CL, Holt RR, Oteiza PI, Fraga CG, Schmitz HH.
Cocoa antioxidants and cardiovascular health.
Am J Clin Nutr. 2005 Jan;81(1 Suppl):298S-303S. Review.
PMID: 15640494 [PubMed - indexed for MEDLINE
<http://www.ajcn.org/cgi/content/abstract/81/1/298S>

Kurosawa T, Itoh F, Nozaki A, Nakano Y, Katsuda S, Osakabe N, Tsubone H,
Kondo K, Itakura H.
Suppressive effect of cocoa powder on atherosclerosis in Kurosawa and
Kusanagi-hypercholesterolemic rabbits.
J Atheroscler Thromb. 2005;12(1):20-8.
PMID: 15725692 [PubMed - indexed for MEDLINE]
<http://www.jstage.jst.go.jp/article/jat/12/1/12_20/_article> (abstract)
<http://www.jstage.jst.go.jp/article/jat/12/1/20/_pdf>
<http://www.jstage.jst.go.jp/article/jat/12/1/12_20/_cit> (references)

Stoclet JC, Chataigneau T, Ndiaye M, Oak MH, El Bedoui J, Chataigneau M,
Schini-Kerth VB.
Vascular protection by dietary polyphenols.
Eur J Pharmacol. 2004 Oct 1;500(1-3):299-313. Review.
PMID: 15464042 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15464042>

Engler MB, Engler MM, Chen CY, Malloy MJ, Browne A, Chiu EY, Kwak HK,
Milbury P, Paul SM, Blumberg J, Mietus-Snyder ML.
Flavonoid-rich dark chocolate improves endothelial function and increases
plasma epicatechin concentrations in healthy adults.
J Am Coll Nutr. 2004 Jun;23(3):197-204.
PMID: 15190043 [PubMed - indexed for MEDLINE]
<http://www.jacn.org/cgi/content/abstract/23/3/197>

Fisher ND, Hughes M, Gerhard-Herman M, Hollenberg NK.
Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in
healthy humans.
J Hypertens. 2003 Dec;21(12):2281-6.
PMID: 14654748 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14654748>

Innes AJ, Kennedy G, McLaren M, Bancroft AJ, Belch JJ.
Dark chocolate inhibits platelet aggregation in healthy volunteers.
Platelets. 2003 Aug;14(5):325-7.
PMID: 12944249 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12944249>

Murphy KJ, Chronopoulos AK, Singh I, Francis MA, Moriarty H, Pike
MJ, Turner AH, Mann NJ, Sinclair AJ.
Dietary flavanols and procyanidin oligomers from cocoa (Theobroma
cacao) inhibit platelet function.
Am J Clin Nutr. 2003 Jun;77(6):1466-73.
PMID: 12791625 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12791625&dopt=Abstract>

Steinberg FM, Bearden MM, Keen CL.
Cocoa and chocolate flavonoids: implications for cardiovascular
health.
J Am Diet Assoc. 2003 Feb;103(2):215-23. Review.
PMID: 12589329 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12589329&dopt=Abstract>

"... Applications of this knowledge include recommendations by
health professionals to encourage individuals to consume a wide
range of phytochemical-rich foods, which can include dark
chocolate in moderate amounts."

Mathur S, Devaraj S, Grundy SM, Jialal I.
Cocoa products decrease low density lipoprotein oxidative
susceptibility but do not affect biomarkers of inflammation in
humans.
J Nutr. 2002 Dec;132(12):3663-7.
PMID: 12468604 [PubMed - indexed for MEDLINE]
<http://www.nutrition.org/cgi/content/full/132/12/3663>

Holt RR, Schramm DD, Keen CL, Lazarus SA, Schmitz HH.
Chocolate consumption and platelet function.
JAMA. 2002 May 1;287(17):2212-3.
<http://jama.ama-assn.org/cgi/content/full/287/17/2212>

Kris-Etherton PM, Keen CL.
Evidence that the antioxidant flavonoids in tea and cocoa are
beneficial for cardiovascular health.
Curr Opin Lipidol. 2002 Feb;13(1):41-9. Review.
PMID: 11790962 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11790962&dopt=Abstract>

>As for LDL reduction with diet, see for example
>
>Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam
>A, Parker TL, Vidgen E, Lapsley KG, Trautwein EA, Josse RG, Leiter LA,
>Connelly PW.
>Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin
>on serum lipids and C-reactive protein.
>JAMA. 2003 Jul 23;290(4):502-10.
>PMID: 12876093 [PubMed - indexed for MEDLINE
><http://jama.ama-assn.org/cgi/content/full/290/4/502>
>
[snip]
>
>The LDL reducing items of the diet in the above study included eggplant,
>okra, soy protein, almonds, margarine containing plant sterols, barley and
>psyllium.

Cinnamon may be added to the list of LDL-reducing food items.


Some probiotics may also improve serum lipid profile. The review article

Gill HS, Guarner F.
Probiotics and human health: a clinical perspective.
Postgrad Med J. 2004 Sep;80(947):516-26. Review.
PMID: 15356352 [PubMed - indexed for MEDLINE]
<http://pmj.bmjjournals.com/cgi/content/full/80/947/516>

has a brief summary about these effects, the direct link is

<http://pmj.bmjjournals.com/cgi/content/full/80/947/516#SEC7>

According to this summary the results have been conflicting with
Lactobacillus acidophilus and Lactobacillus bulgaricus, but perhaps somewhat
better with Enterococcus faecium and Lactobacillus plantarum 299v. Below
some references about cholesterol reducing effects of Lactobacillus
acidophilus L1, Enterococcus faecium M-74, and Bifidobacterium longum:

Anderson JW, Gilliland SE.
Effect of fermented milk (yogurt) containing Lactobacillus acidophilus L1 on
serum cholesterol in hypercholesterolemic humans.
J Am Coll Nutr. 1999 Feb;18(1):43-50.
PMID: 10067658 [PubMed - indexed for MEDLINE]
<http://www.jacn.org/cgi/content/full/18/1/43>

Hlivak P, Odraska J, Ferencik M, Ebringer L, Jahnova E, Mikes Z.
One-year application of probiotic strain Enterococcus faecium M-74 decreases
serum cholesterol levels.
Bratisl Lek Listy. 2005;106(2):67-72.
PMID: 16026136 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16026136>

"CONCLUSIONS: In our study, the administration of E. faecium M-74
probiotic strain was associated with reduction of serum cholesterol
concentration by 12% after 56 weeks. The crescent amount of facts on
this issue gives a solid reason to assume that probiotics will find
their place as a therapeutic alternative in human medicine. (Tab. 4,
Fig. 4, Ref: 36.)"

Xiao JZ, Kondo S, Takahashi N, Miyaji K, Oshida K, Hiramatsu A, Iwatsuki K,
Kokubo S, Hosono A
Effects of milk products fermented by Bifidobacterium longum on blood lipids
in rats and healthy adult male volunteers.
J Dairy Sci. 2003 Jul;86(7):2452-61.
PMID: 12906063 [PubMed - indexed for MEDLINE]
<http://jds.fass.org/cgi/content/full/86/7/2452>


Gill and Guarner also mention in their review article that L casei TMC 0409
and S thermophilus TMC 1543 and L acidophilus 145 and Bifidobacterium longum
913 combination can increase HDL. One reference about this:

Kiessling G, Schneider J, Jahreis G.
Long-term consumption of fermented dairy products over 6 months increases
HDL cholesterol.
Eur J Clin Nutr. 2002 Sep;56(9):843-9.
PMID: 12209372 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12209372>

"CONCLUSIONS: The long-term daily consumption of 300 g
yoghurt over a period of 21 weeks (control and synbiotic)
increased the serum concentration of HDL cholesterol and
lead to the desired improvement of the LDL/HDL
cholesterol ratio."


In a clinical study

Naruszewicz M, Johansson ML, Zapolska-Downar D, Bukowska H.
Effect of Lactobacillus plantarum 299v on cardiovascular disease risk
factors in smokers.
Am J Clin Nutr. 2002 Dec;76(6):1249-55.
PMID: 12450890 [PubMed - indexed for MEDLINE]
<http://www.ajcn.org/cgi/content/full/76/6/1249>

with smokers Lactobacillus plantarum 299v reduced several CVD risk factors,
for example decreased systolic blood pressure. A citation from the abstract:

"Results: Significant decreases in systolic blood
pressure (P < 0.000), leptin (P < 0.000), and fibrinogen
(P < 0.001) were recorded in the experimental group. No
such changes were observed in the control group.
Decreases in F2-isoprostanes (37%) and interleukin 6
(42%) were also noted in the experimental group in
comparison with baseline. Monocytes isolated from
subjects treated with L. plantarum showed significantly
reduced adhesion (P < 0.001) to native and stimulated
human umbilical vein endothelial cells.

Conclusion: L. plantarum administration leads to a
reduction in cardiovascular disease risk factors and
could be useful as a protective agent in the primary
prevention of atherosclerosis in smokers."


Finally, a couple of references about decreasing LDL oxidation with
probiotics:

Kullisaar T, Songisepp E, Mikelsaar M, Zilmer K, Vihalemm T, Zilmer M.
Antioxidative probiotic fermented goats' milk decreases oxidative
stress-mediated atherogenicity in human subjects.
Br J Nutr. 2003 Aug;90(2):449-56.
PMID: 12908907 [PubMed - indexed for MEDLINE]
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12908907>

"... Consumption of fermented goats' milk improved anti-
atherogenicity in healthy subjects: it prolonged
resistance of the lipoprotein fraction to oxidation,
lowered levels of peroxidized lipoproteins, oxidized LDL,
8-isoprostanes and glutathione redox ratio, and enhanced
total antioxidative activity. The consumption of
fermented goats' milk also altered both the prevalence
and proportion of lactic acid bacteria species in the gut
microflora of the subjects. We conclude that the goats'
milk fermented with our special antioxidative
lactobacilli strain Lactobacillus fermentum ME-3 exhibits
anti-atherogenic effects."

Terahara M, Kurama S, Takemoto N.
Prevention by lactic acid bacteria of the oxidation of human LDL.
Biosci Biotechnol Biochem. 2001 Aug;65(8):1864-8.
PMID: 11577730 [PubMed - indexed for MEDLINE]
<http://www.jstage.jst.go.jp/article/bbb/65/8/65_1864/_article/-char/en>
<http://www.jstage.jst.go.jp/article/bbb/65/8/1864/_pdf>
<http://www.jstage.jst.go.jp/article/bbb/65/8/65_1864/_cit>

--
Matti Narkia
.

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