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Daily Dose

A list of foods to lower your cholesterol

By Deborah Kotz
Globe Staff / August 29, 2011

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For decades, those with high cholesterol have been given a list of don’ts when it comes to their diet: Don’t eat cholesterol-rich eggs; don’t eat butter; don’t eat red meat or regular ice cream. Well, now researchers have identified a list of do's for the diet that may work to lower cholesterol levels better than avoiding those don’ts.

In a study published last week in the Journal of the American Medical Association, researchers found that eating cholesterol-lowering foods like nuts, soy protein, and certain fiber-rich items result in bigger drops in “bad’’ LDL cholesterol than avoiding high-fat meat, eggs, and dairy foods.

“Doctors tend to focus on telling patients what to avoid instead of what to add,’’ said study coauthor Cyril Kendall, a research scientist at the University of Toronto.

In the study involving 345 participants, one group was randomly assigned to get dietary advice on cholesterol-lowering foods such as oats, barley, soy milk, tofu, nuts, and legumes; they were also instructed to eat margarine enriched with plant sterols, which are plant chemicals that have been shown to reduce cholesterol. People in a control group were told to reduce their fat intake by eating low-fat dairy products, whole-grain cereals, and fruits and vegetables, advice endorsed by the American Heart Association.

The first group had nearly a 14 percent drop in LDL cholesterol - the average level dropped from 171 milligrams/deciliter to 145 mg/dL - while the control group had only a 3 percent decline, a drop from 171 to 163. (A level above 160 mg/dL is considered high.)

The study didn’t address whether health outcomes, like heart attack prevention, would be affected by this level of decline, and it was partly funded by a manufacturer of plant sterol-fortified margarines.

Here’s the diet that brought the biggest drop in cholesterol levels. (The researchers didn’t test to see whether supplements worked, so stick with whole foods.)

Soy products. Eat four servings a day; each serving is equivalent to 4 ounces of firm tofu, 1 cup of soy milk, one-half cup of soybeans, three-quarter cup of soy yogurt, or one-third cup roasted soy nuts.

Nuts. Eat about 1.5 ounces per day of any kind of nuts, including almonds, peanuts, and cashews.

Foods fortified with plant sterols. Eat four servings a day of products fortified with plant sterols, including an 8-ounce glass of orange juice, cup of yogurt, and tablespoon of margarine. The US Food and Drug Administration allows such fortified foods to be labeled “cholesterol-lowering.’’

Fiber-rich foods. Eat four to five 4-ounce servings a day of foods rich in viscous fiber, a kind of sticky fiber found in beans, legumes, oats, barley, and cereals that contain psyllium. Wheat bran and produce rich in insoluble fiber - for all their nutritional benefits - don’t contain much viscous fiber.

lgmoney wrote: I was not aware of the soy benefits; thanks for this. I have focused on the other three categories and noticed a 10 percent drop in weight, 30 percent drop in body fat, and an LDL drop from 196 to 112.

doctordick wrote: Just as many people with low or normal cholesterol levels suffer from cardiac events as do people with high cholesterol levels. The following from Deb’s post sums it up best. “The study didn’t address whether health outcomes, like heart attack prevention, would be affected by this level of decline.’’

TheKidsRAllRight wrote: Interesting topic and comments. Genetics play a role in this, no?

Deborah Kotz responds: Yes, genetics and aging play a strong role in determining cholesterol levels. It’s not solely about diet.

Coaching with Alzheimer’s

Legendary basketball coach Pat Summitt revealed last week that she had been diagnosed with early onset Alzheimer’s disease three months ago. That’s a devastating diagnosis for the 59-year-old University of Tennessee women’s basketball coach, but one framed with a glimmer of optimism. Summitt said she would continue coaching during the upcoming season with the aid of her assistant coaches.

“I’ve got a great staff and great support system, and I’m going to stick my neck out and do what I always do,’’ Summitt told The Washington Post.

Work can be extraordinarily beneficial for those in the initial stages of the disease, said Dr. Dorene Rentz, co-director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital.

“My guess is that her most salient symptom is her memory loss,’’ said Rentz. “Returning to work with help from assistants is exactly what we encourage early-onset folks to do.’’ Summitt’s professional responsibilities will not only give her a psychological boost but could actually slow the progression of the disease by keeping her brain agile.

Work decisions, however, can be much more difficult for those in life or death jobs like firefighters, pilots, or surgeons, Rentz added. Patients in those types of professions would probably need to alter their professional responsibilities so that they wouldn’t be putting others at risk during memory lapses.

bobbydelray wrote: Pat is sending a wonderful message to the Alzheimer’s community - there is life after a diagnosis of Alzheimer’s.

Shifting kids back to their school-year sleep schedule

Like many parents, I’m wondering what I should do to get my kids back to their earlier sleep schedules during the days before the school year starts. Dr. Dennis Rosen, associate medical director of the center for pediatric sleep disorders at Children’s Hospital Boston, gave me some helpful advice.

First off, he told me, I have to progressively march back their wake-up time rather than howling at them to go to bed earlier. “Give it at least a day for every hour that their bedtime is off,’’ Rosen advised. “If they’ve been waking up at 9 a.m. on a regular basis and they need to wake up at 6 a.m. for school, you’ll need three days to get them back on track,’’ waking them an hour earlier each morning for three consecutive days.

Kids will be less cranky if you shift them even more gently, by 15- to 30-minute increments each day - if you have the time before the school year starts. “Consistency is really important,’’ said Rosen. “Don’t . . . fall into the trap of letting teens go to bed late and sleep in on the weekends’’ after the school year starts.

In setting an earlier wake-up time, parents need to make sure their kids are really awake - not lying in bed in a half-groggy state or dozing in front of the TV in a darkened den. “They need bright light exposure in the morning to give their brains a wake-up cue,’’ said Rosen. Morning light passes through the eyes and shuts down the brain’s production of the sleep-inducing hormone melatonin.

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