Lowering blood cholesterol- do statins have side effects?

I was asked to comment about the safety and side effect of statins– Lipitor, Pravacol, Zocor and others– drugs that are very effective at lowering blood cholesterol and preventing death from heart attacks. I’m not an M.D., but my impression is that these are pretty good drugs as far as safety and efficacy goes.

However, they can occasionally be toxic to the liver and to muscles, and if you are taking a statin your doctor is probably checking for liver toxicity (ALT/AST) and should be checking for muscle toxicity (creatine kinase). Your job is to note any muscle weakness or pain that might indicate dangerous muscle breakdown, which might eventually be fatal.

If you are concerned, there are two things you can do– one is to take supplements of coenzyme Q and vitamin D along with your statin. I can’t say that the evidence for benefits of these supplements is unequivocal, but I would take them if it were me.

The other thing you can do is to work with me to lower your cholesterol without statins. I’ve had great success with nutritional strategies that go far beyond the pretty useless low-fat recommendations you’ve probably given up on. Look on the testimonials page of my website (healthyfat.com) or search my name on Yelp for clients bragging about their low cholesterol numbers.

Does whte bread do any harm?

Although I talk about the merits of whole wheat flour all the time, I don’t think having a little white flour or bread made with a mixture of whole and refined flours is all that bad.

You will be missing out on the fiber, potassium, magnesium, calcium, etc. that are removed when grains are refined. But if the starches you eat are mostly whole foods, like oats or kasha for breakfast, corn tortillas with lunch and potatoes with dinner, then you can afford to add in some white flour.

I like Beckmann’s German Farm Bread even though the first ingredient is white flour. Good nutrition is all about moderation- people who eat whole wheat and not much else become zinc deficient because the fiber binds zinc and you can’t absorb it.

Does evening-eating cause weight gain?

People seem to think that food is metabolized less efficiently when it’s eaten at night rather than earlier in the day, and that because of this eating at night causes weight gain. I don’t believe this.

Eating in the evening only causes weight gain if you eat too much. Frequently people try hard to ‘be good’ during the day only to end up hungry at night, when it’s all too easy to get more calories than you need from desserts and high calorie snacks. Face it–when you’re hungry at 10 or 11 p.m., do you make a salad or do you have a bowl of ice cream?

Try having more healthy food during the day until you find the right balance and aren’t uncontrollably hungry at night. It’s not just your weight you’ll control but the types of foods you end up eating also.

How much fruit is too much?

Yesterday I sent out an Email asking for questions about nutrition that I could answer in this blog and the response was huge–I got some great questions. I’ll try to answer one a day and I’ll Email whomever wrote that question to make sure they see my answer.

For today I’ll talk about fruit–I’m always saying that fruit is “free”–that you can eat as much as you want even if you are trying to lose weight, because it is so low in calories, so filling and high in vitamins, minerals and fiber.

The question was: “How much fruit is too much? (Too much sugar?)
My answer: I would not restrict fresh fruit at all. When you want it, eat it (this doesn’t include fruit juice or dried fruit). The kind of sugar you want to avoid is refined or concentrated sugars that no longer look like a plant.

See how this works for you– how do you feel? I’m not advising you to eat only fruit– fruit alone provides such a short-term energy boost, that you may end up with low blood sugar (weak, headachy) if you don’t get some healthy protein and fat.

Have oranges, banana or berries with your breakfast of eggs or oatmeal & walnuts. Have mangoes and apples for snacks and desserts. And see my blog below for a mango salad recipe.

My favorite fruit is in season

If you aren’t already addicted to Champagne (or Manila or Ataulfo) mangoes, now is the time to begin your love affair. These yellow mangoes are smaller than the usual green and red variety–and they are superior in every way. Champagne mangoes are tart and sweet and smooth- kind of like a peach.

Wait until the mangoes are a little soft–they may have some small black spots too–peel them, cut the flesh off of the large pit, and eat it plain or in almost any salad.

The other day I made a salad with Manila mango slices, avocado, chopped roasted almonds, lime juice and salt–yum. For protein you could add some small cubes of tofu fried in olive oil, cooked shrimp or some chick peas, and to make it even more satisfying a little roasted walnut oil is good.

Right now these mangoes an incredible bargain for $1 each at Sigona’s Market and Whole Foods Market. Like any fruit they are a great source of the potassium and magnesium that we need for heart and muscle health so this is a win-win food choice.

Hot Dogs To Love

I love hot dogs and will eat a Hebrew National All Beef Frank at Costco a couple of times a year, but I’m happy to report that I’ve found a better option for a yummy beef hot dog. The butcher at Whole Foods recommended hot dogs made by Fork In The Road and they are delicious and much healthier than most.

Ounce for ounce, Fork In The Road Honest Dogs With Pasture-Raised Beef have less saturated fat and fewer calories compared to Hebrew National Franks. And you can feel good that the cows were raised sustainably on family farms (that you can trace by a farm code on the package). I ate mine with a Golden Sheaf Potato Roll- okay it didn’t fit too well- but it tasted fantastic.

What do farmed salmon and old fluorescent lights have in common?

PCBs (polychlorinated biphenyls) are chemicals that were used in the past to make fluorescent lights, paint, transformers, pumps, and much more. Unfortunately they are toxic and they stick around in the environment very persistently. Reading this morning about PCBs leaking from old fluorescent light fixtures in schools* reminded me of another common route of exposure- eating salmon.

Many toxic chemicals including PCBs are found in farmed salmon at levels 10 times as high as in wild salmon. If you eat more than ½ meal of farmed salmon per month, your toxin intake may be too high according to EPA estimates.**

So, try to eat wild salmon, but also think about the bigger picture. Manufacturing is always going to use chemicals, and they are going to end up in our environment- and not just when you throw the product away. Leftovers from the manufacturing process end up somewhere, and it’s all too frequently in the water and the air.

Say no to buying new gadgets. In addition to recycling, reduce and reuse. Recycling old appliances and plastic bags is good, but the new ones you buy were made in factories that generate all sorts of chemical waste so reusing is better. Help make sure that there will still be some fish around clean enough for your grandchildren to eat and with all the money you save, you’ll be able to afford local, organic food.
*New York Times 2/4/11 A17; **Science 1/9/04 303:226