Food for a lifestyle change part 2 - the early days!

Well, it's been a hell of a month for me. I've had to organise a funeral for a family member, and help my daughter with her new baby, as well as supporting my son with his three month old. All of this has played havoc with my diet! And that's the main problem I can see at the moment- if I am stressed my portion control and my ability to choose good food goes out the window. I obviously haven't conquered my change in life style yet! 

I found the change in diet easy initially. More dried fruit, nuts and seeds, less wheat and dairy, soya margarine for cooking, more whole foods like brown rice and oats. Simple, especially as on special occasions like a Saturday morning, I'll join my partner in a delicious bacon baguette or eggs and soldiers. It's all about my diet fitting in with our life style.

However, the stress has taken it's toll. I find myself with an inexhaustible appetite, constantly going through the kitchen cupboards for more nuts or dates or rye bread or oat cakes to fill my seemingly empty tummy. I drink water by the bucket but still I am hungry! Portion control is a nightmare, I still find myself eating huge platefuls, and healthy though the food is, it does still contain calories- so I need to eat less not more if I am to lose this weight and keep it off!

I know I have bad patterns round food. I eat too fast and don't give my tummy time to send a message to my brain that it's full- by the time that happens I have already eaten seconds. And I don't concentrate on what I am eating, instead I ladle it in while playing on the computer, or working or driving. So I don't notice what I am eating and thus don't feel satisfied. And I eat because the food is in front of me, without checking that I am actually hungry. In fact, I eat as if tomorrow there may not be any food- and if you could see inside my kitchen cupboards you would know that there's no chance of that happening! And I have tried to change these things in the past, but there's never been any long term change in my eating habits.

I noticed something the other day that really got me thinking. I met a woman at a party, she was in her mid forties and had a great figure- you know, flat on the tummy and boobs in the right place! At first I was convinced that she had no children, and hence her body, but no, she had three. We carried on drinking and were both a bit tipsy. And then it happened. The crisps and dips came out. So me, drunk, throws all caution to the wind and starts chowing down. Honestly it must be quite a sight, me drunk with crisps around because I literally hoover them up! But not this lady. She had a few and then stopped. She'd had supper she said, and was still full. I was bemused by this - after all, I had had supper too, and am on a diet, but give me a few drinks, or some stress, and it's literally all over! I have no control, and I want it, like I want a good figure.

But I know that I can change, and I know that it's all about finding the right information at the right time. For example, I finally gave up cigarettes for good last year. How did I do it? It was the right book (Allen Carr's Easy Way to Stop Smoking: Be a Happy Non-smoker for the Rest of Your Life by Allen Carr) at the right time - when I felt I needed to stop because of my age, and was truly fed up with stopping and starting again and again. I had read Carr's book before, but only once and I hadn't thought about it much. Last year I really read it. I read it slowly, I paid attention, and I re-read the parts that I had trouble banging into my thick skull. Carr didn't tell me anything I didn't already know. I knew that smoking would shorten my life, and I knew that I hated the smell and the taste. But Carr helped me take that knowledge and apply it to my life. It stopped being theory, and became practice instead.  And if I ever feel tempted to smoke again, all I have to do is open Carr's book and remind myself of what a disgusting, life destroying habit it is. I have to remind myself of the theory, to make my practice better. 

Anyway, back to my lifestyle change re food. So what I was looking for was the right information, because it surely is the right time. I am sick and tired of dieting and putting on weight, and again I am too old for this! I need to lose weight, and I need to keep it off. I need to become aware of eating, aware of what I eat, of when I need to stop.

So I have been reading MindFullness: The No-Diet Diet Book by Elaine Fairman.

For those of you that don't know, if you have an I-phone or I-pad, you can down load a Kindle app that enables you to read this, and the book is a steal at £1.99. There are plenty of books like this out there if you need a real, paper version. Go to a good bookshop and look in the diet section and the self help section. Look for a book that tells you how to eat properly, and how to get food into perspective in your life.

The MindFullness book is very readable, and at the moment I am reading a chapter called 'The simple rules', which is about eating consciously and slowly and stopping when you are full. The theory is obvious, and the practice is difficult!

I want to consider here my latest mantra, which is 'don't put energy into negativity'. Or 'don't feed conflict' or 'try not to think bad thoughts'. As Fairman says 'All moods will pass if you stop poking them'. The same can be said about appetite or greed. If I find myself thinking about food, I consider whether I am hungry or just obsessing. If the latter, then I turn my mind to something else. If the former, I will eat something, but I will focus on stopping everything else, sitting quietly, and eating slowly, enjoying each mouthful. It seems to work. And I don't feed negativity if I slip either. This weekend was a family one, with babies all over the house, lots of visitors and lots of cooking. Inevitably I ate more than I needed to, but I am refusing to give myself a hard time about it. Instead I am back to concentrating, eating slowly and controlling my portion size. This change is a big one, and it will take a long time, with a lot of relapses on the way. But I know it can be done, and that it is worth doing. Wish me luck!

Cholesterol and statins

Cholesterol and statins

Let’s start at the very beginning, as they say. Pin your ears back and concentrate, because although I have tried to put all this in sensible language it’s all a bit technical and difficult!

Let’s start with cholesterol.

Cholesterol is...

A sterol found widely in animal and plant tissues. It is a main component of blood plasma and cell membranes, and it is an important precursor of many steroid hormones (such as the estrogens, testosterone, and cortisol), vitamin D₂, and bile acids. In vertebrates, cholesterol is manufactured by the liver or absorbed from food in the intestine. Higher than normal amounts of cholesterol in the blood are associated with higher risk for developing coronary artery disease and atherosclerosis. Chemical formula: C₂₇H₄₆O. (The Free Dictionary n.d.)

Cholesterol is very important, and our bodies produce between 800-1500 mg each day. This is used in a variety of metabolic processes:-

• ·         Cholesterol strengthens all our cell walls and helps in the exchange of nutrients and waste across membranes
• ·         Nearly a quarter of the body’s store of cholesterol is contained in the central nervous system, It is essential for the conduction of nerve impulses.
• ·         Bile acids are formed from cholesterol, and help us to digest fat.
• ·         Cholesterol assists in the formation of some of our hormones.
• ·         In the skin, cholesterol helps us to convert sunlight to vitamin D, and makes our skin resistant to chemicals and disease organisms (Segala & Life Extension Foundation. 2003).

So, we need it but there is good and bad cholesterol.

So-called ‘good cholesterol’ is high density lipoproteins or HDL, and helps reduce cardiovascular disease. To do this there needs to be between  50-70 mg/dL in your blood  (Segala 2003).

‘Bad cholesterol’  is low density lipoprotein or LDL, and this is the stuff that builds up in your arteries and increases your risk of cardiovascular disease or CV (American Heart Foundation n.d.).

Triglycerides and Lp(a) cholesterol are two other components of your cholesterol blood test, and for more information on these please check out the American Heart Foundation site.

LDL cholesterol is the focus of this article, along with statins, a group of drugs that lower LDL in the blood.

Lipoproteins are also known as lipids, and an abnormal amount of lipids, or a disordered lipid metabolism, is known as dyslipedemia. So, if your doctor gives you a cholesterol test and tells you that your levels are too high and you need statins, then you have dyslipidemia. And this puts you at risk of cardiovascular disease, particularly if you have diabetes or or any of the other risk factors, such as  tobacco use, alcohol use, obesity, hypertension, high cholesterol, physical inactivity and unhealthy diet  (World Heart Federation 2013; Mooradian 2009) . Dyslipidemia is found in 70-90% of patients with coronary heart disease (Neely 2012; Agoşton-Coldea et al. 2007) and in 50% of cases of early heart disease has been found to be due to inheritance, a.k.a familial dyslipidemia. In the other 50% of cases the dyslipidemia was due to some pre-existing disease such as kidney disease, hypothyroidism, obesity and cholestasis. And the drug. of choice for treating lipid disorder are the statins.

There’s a lot of scare stories about statins out there, a lot of them put about by people who sell so-called (unproven) cures. This is why this article only cites good research and findings by reputable bodies. Beware what you read on the internet!

So- a meta analysis of the trials of statins has shown that they do confer benefit on patients at increased risk of cardio vascular disease, mainly in men and women over 65 with increased risk factors, and particularly when combined with exercise (Brugts et al. 2009; Greenhill 2012). The benefits exceed the risks in most cases, although some patients with active or chronic liver disease may need a different approach (Calderon et al. 2010).

Side effects have been shown to be memory loss and confusion ,and  raised blood sugar levels leading to type 2 diabetes, particularly in postmenopausal women (FDA 2011; Culver 2012).  The benefits of statins are still seen as outweighing the risk of diabetes (Ridker et al. 2012). Severe muscle problems can also be caused by statins  (FDA 2012)and lovastin in particular  can interact with other medication and lead to muscle damage (FDA 2011).

There are some alternatives to statins for the treatment of dyslipedemia:-

• ·         ‘Functional foods’, i.e. foods that either increase health and well being or reduce health risks. For lipid disorders, soluble fibre (from oats and psyllium), soya protein and dark chocolate have all been shown to have a positive effect (Sirtori et al. 2009).
• ·         Fish oil has a positive effect on dyslipedemia, more precisely omega 3 at 4 g daily (Goldberg & Sabharwal 2008).
• ·         Fenofibrate has been found to be effective, with or without statins (McKeage & Keating 2011), as has gemfibrazil (Fazio 2008) and niacin (Jellinger et al. 2012).

I hope this has been helpful. Personally, at nearly 60 I am approaching the danger zone. My solution already encompasses a healthy diet (see January’s blog ‘Food for a lifestyle change’) but I am happy to add more oats, soya protein and dark chocolate, as well as a straightforward Omega 3 supplement.  Hopefully that will keep my cholesterol levels down!

Bibliography

Agoşton-Coldea, L. et al., 2007. Prevalence and particularities of dyslipidaemia in subjects with coronary heart disease. Romanian journal of internal medicine = Revue roumaine de médecine interne, 45(4), pp.341–347.

American Heart Foundation, Good vs bad cholesterol. Available at: American Heart Organisation.

Brugts, J.J. et al., 2009. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ, 338(jun30 1), pp.b2376–b2376.

Calderon, R.M. et al., 2010. Statins in the Treatment of Dyslipidemia in the Presence of Elevated Liver Aminotransferase Levels: A Therapeutic Dilemma. Mayo Clinic Proceedings, 85(4), pp.349–356.

Culver, A.L., 2012. Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative. Archives of Internal Medicine, 172(2), p.144.

Fazio, S., 2008. Management of mixed dyslipidemia in patients with or at risk for cardiovascular disease: a role for combination fibrate therapy. Clinical therapeutics, 30(2), pp.294–306.

FDA, 2012. Consumer Updates - Controlling Cholesterol with Statins. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048496.htm [Accessed February 18, 2013].

FDA, 2011. Consumer Updates - FDA Expands Advice on Statin Risks. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm [Accessed February 18, 2013].

Goldberg, R.B. & Sabharwal, A.K., 2008. Fish oil in the treatment of dyslipidemia. Current opinion in endocrinology, diabetes, and obesity, 15(2), pp.167–174.

Greenhill, C., 2012. Dyslipidaemia: Exercise reduces mortality in patients receiving statins. Nature Reviews Endocrinology, 9(2), pp.66–66.

Jellinger, P., Smith, D. & Mehta, A., 2012. AACE Lipid and Atherosclerosis Guidelines. , 18(Supplement 1).

McKeage, K. & Keating, G.M., 2011. Fenofibrate: a review of its use in dyslipidaemia. Drugs, 71(14), pp.1917–1946.

Mooradian, A., 2009. Dyslipidemia in type 2 diabetes mellitus. Nature Clinical Practice, 5(3), pp.150–157.

Neely, D., 2012. How can we improve clinical diagnosis of dyslipidemia? British Journal of Cardiology, 19.

Ridker, P.M. et al., 2012. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis from the JUPITER trial. The Lancet, 380(9841), pp.565–571.

Segala, M., 2003. Disease prevention and treatment. 4th ed., Ft. Lauderdale  FL: Life Extension Foundation.

Segala, M. & Life Extension Foundation., 2003. The Life Extension Foundation’s disease prevention and treatment : scientific protocols that integrate mainstream and alternative medicine Expanded 4th ed., Hollywood  Fla.: Life Extension Media.

Sirtori, C.R. et al., 2009. Functional foods for dyslipidaemia and cardiovascular risk prevention. Nutrition research reviews, 22(2), pp.244–261.

The Free Dictionary, cholesterol. The Free Dictionary.

World Heart Federation, 2013. Cardiovascular disease risk factors.