AAAAARRRRRRGGGGGGHHHHHH!!!!

[r.mines]

Got my blood test results this morning. The good news is, my blood sugars are normal (diabetes in the family). The bad news is, my cholesterol is high (arteriosclerosis in the family).

7.72 (That's 298 for our neighbours south of the border). Ideally, it should be below 5.19 (that's 200 for USA'ers). :(

Well, I know I shouldn't panic yet. Next comes the test to look at the ratio of HDL, LDL, and triglycerides. I know the ratio's more important than total cholesterol, and it could be fine. Also, I suppose it's possible the reading could be a one-off. I had the blood test done right after an hour-long workout - could that be a factor, I wonder? :confused:

I shouldn't be upset. I've had pap tests come back looking scary. I've had a mammogram come back looking scary. False alarms.

Oh, BTW, I had the test done before I started my four-day reversal diet, so they are my values after a year of low-carbing. Now I wish I'd had the test done before I started this WOE, then I could see if they've gone up or down.

I suppose I should add that my blood pressure is low-normal (110 over 70, I think). Normal BP, normal blood sugar, my weight's not too high - why the high cholesterol? :confused:

I've posted this in my journal, too, in case anyone thinks they're seeing double!

Rachel

[doreen T]

but my 'puter is trying to crash again.

There are some insights and suggestions around the board .... I'll try to amalgamate them for you. Plus other info.

You're going to live

Do

[jomil]

Sorry to hear about your cholesterol results.

That was the first concern I had before I went into the LC WOE.

I have Angina and am taking beta blocker to keep my pressure down.

My blood test last October (before starting the LC diet in March this year) showed to be on the high side, 5.74. The optimal is 5.2

I was eating all low fat and low cholesteral foods until March/01.

I will keep you appraised as to the blood test results within a month. This will dictate my future participation of LC WOE.

If your blood pressure is as low as 110/70, I would say that you don't have much to worry about. You have the pressure of a teen- ager

Regards
Joe

[r.mines]

Originally posted by jomil


If your blood pressure is as low as 110/70, I would say that you don't have much to worry about. You have the pressure of a teen- ager.

Thanks, Joe. I'm working on the BODY of a teenager! :D

No, wait, that didn't come out right..... :o

No, seriously, thanks for sharing, Joe. Hope your tests come out well!

And thanks, Doreen. I've done some searching around the board already - after firmly telling myself I would NOT get upset about this, and WOULD do the work I have piled up, I spent the whole day surfing for info! But I know you'll dig up the really really good stuff - you're an angel!

[doreen T]

Rachel, you're quite right to wait and see what the HDL is, and the triglyceride levels. High total cholesterol in and of itself is not an indicator of heart disease or heart disease RISK as far as that goes.

Since you did a search yesterday, then you've likely already read these articles, the links to which have been posted several times in this forum. But, at the risk of being repetitive, I'll put them here anyway.. ;) The Cholesterol Myths (http://www.ravnskov.nu/cholesterol.htm), by Uffe Ravnskov, MD, PhD. Especially check out item #2. Blood cholesterol has nothing to do with atherosclerosis. "One of the most surprising facts about cholesterol is that there is no relationship between the blood cholesterol level and the degree of atherosclerosis in the vessels. If a high cholesterol really did promote atherosclerosis, then people with a high cholesterol should evidently be more atherosclerotic than people with a low. But it isn´t so ........."

Ravnskov's comments (http://www.ravnskov.nu/ncep_guidelines.htm) to the New Cholesterol Guidelines, recently published by the National Cholesterol Education program (May 2001) ... there's a link to the guidelines in Ravnskov's article. "It is not true either, that cholesterol has a strong power to predict the risk of a heart attack in men above 65. In the 30 year follow-up of the Framingham population for instance, high cholesterol was not predictive at all after the age of forty-seven, and those whose cholesterol went down had the highest risk of having a heart attack! To cite the Framingham authors: ”For each 1 mg/dl drop of cholesterol there was an 11 % increase in coronary and total mortality.”

It is not true either, that high cholesterol is a strong, independent predictor for other individuals.

In most studies of women and of patients who already have had a heart attack, high cholesterol has little predictive power, if any at all.

In a large study of Canadian men high cholesterol did not predict a heart attack, not even after 12 years, and in Russia, low, not high cholesterol level, is associated with future heart attacks.

Most interesting is the fact, that in some families with the highest cholesterol levels ever seen in human beings, so-called familial hypercholesterolemia, the individuals do not get a heart attack more often than ordinary people, and they live just as long.".

THE CHOLESTEROL MYTH (http://medicaltruth.com/pdf-files/cholesterolmyth.pdf), by T.J. Moore. The author goes into a lot of detail about the Framingham study, which is the most often cited in cholesterol vs. heart disease discussions. He points out that the study showed that yes, people with high cholesterol got heart disease. But what usually gets omitted from arguments is that the study showed that people with LOW cholesterol also got heart disease, and at the SAME RATE. " ... Cholesterol, however, is far from being a simple and universal explanation for what causes coronary heart disease. For example, high blood-cholesterol levels generally do not increase the risk of coronary heart disease among women. ...... The link between high blood-cholesterol levels and increased risk of coronary heart disease in both men and women weakened at about age fifty and then disappeared entirely."

THE CHOLESTEROL MYTH (http://www.second-opinions.co.uk/cholesterol_myth_1.html) by Barry Groves, author of Eat Fat, Get Thin! " ... But there are a number of significant points that the cholesterol theory overlooks. For example, there is a marked difference between the build-up found in those with familial hypercholesterolaemia and those with coronary heart disease: hypercholesterolaemia causes large deposits at the mouths of the coronary arteries, often leaving the arteries themselves unblocked, and so does not reproduce the type of obstruction found in coronary heart disease ..... It has also long been known that simple events, such as putting a cuff around the arm prior to taking a blood sample, or fear of the needle, can result in raised cholesterol values. And, even where these are avoided, large fluctuations are known with peak to nadir variations of as much as twenty-three percent. Lastly, cholesterol is only one of the constituents of an atheroma and, if you think about it, cholesterol is so necessary and so widespread in the body, it would have been surprising if it had not been found."

Page 2 (http://www.second-opinions.co.uk/cholesterol_myth_2.html) of this article is a very worthwhile read, on the myths of dietary fat and heart disease. Page 3 (http://www.second-opinions.co.uk/cholesterol_myth_3.html) discusses a few things yer grandma didn't tell you about BRAN, especially wheat bran, and the harm that it can do.

Ah, but Page 8 (http://www.second-opinions.co.uk/cholesterol_myth_8.html), A Question of Ethics, sums it up nicely " ... Some will say that we do know the cause of coronary heart disease; it is high cholesterol, or too much fat in our diets, or not enough exercise. Or it could be something else. In 1981, two hundred and forty six 'risk factors' for heart disease were listed. That number is now well over three hundred. These so called risk factors include having English as a mother tongue, having a diagonal crease in the left earlobe, not taking siestas, not eating mackerel, snoring and wearing tight underpants. What a list of this size really tells us is that we have little idea what causes coronary heart disease. And it is certain that if all the 300 plus do play a part, we have no chance of defeating the disease." ...........

Cholesterol testing
Imagine it is 2.00 a.m., you are lying in bed when you hear a noise downstairs that you know is caused by a burglar. You know how quickly your heart starts to race. Well, that is how quickly your cholesterol level can rise - and for the same reason. One of the effects of the 'fight or flight' reflex is to raise blood cholesterol. Any form of physical or mental stress has this effect. So if you run to your doctor's, your cholesterol level will be higher than if you walked; if you have been standing it will be higher than if you sat. If you are anxious, or your doctor looks worried, it will be higher. If your blood cholesterol were tested hourly throughout a day, or daily over a month, it would not be unusual to find a wide variation in values.

Blood cholesterol levels also rise naturally as you get older so that while a reading of 9 mmol/l is high at the age of twenty, it is perfectly normal if you are fifty.

Cholesterol measurements are not very accurate - less than eighty percent - even when conducted in a laboratory. A survey showed that on the same sample, laboratories could differ by as much as 1.3 mmol/l. When it is tested with a doctor's desktop machine the accuracy will inevitably be lower.

To put it in perspective, let us assume that you are around thirty years old and your cholesterol level is a perfectly respectable 6.0 mmol/l. You hurry to the surgery and are anxious about the result. This could raise it by twenty-five percent to 7.5. If it is sent to a laboratory giving the high readings it could be raised by a further 1.3. Your perfectly normal 6.0 is now a high 8.8!

In fact, so many variables affect cholesterol levels that a one-off test is a waste of time, and an unnecessary worry for the patient that can do more harm than good. Bear that in mind if you are subjected to a cholesterol test."Ok, there's a lot of opinion expressed in that last article, but it's well-researched opinion (that's likely why his website is called Second Opinions ;)). Some very good reading there too about the perils of vegetarianism as well.

In DANDR, Atkins also discusses cholesterol at length in chapter 15, Good Protection for Your Heart. On pp. 186 - 189, he lists some nutritional supplements you might consider as well.

If you can get your hands on Protein Power Lifeplan, by the Drs. Eades, pub. 2000 ... chapter 4, Cholesterol: The Good, The Bad and the Ugly ... pp 86 - 109, explains it perfectly. And also explains how an increased total cholesterol, combined with a decreased triglyceride level is actually cause for celebration. They differ from Atkins a bit on the use of supplements, especially antioxidants, which they claim are a double-edged sword.

Phew, lots of reading!!! Lots of typing too, I think I'm going to rest for a bit... :p

Take care of yourself, and don't worry too much. It's like scale phobia ... sometimes the numbers don't tell the whole picture, especially since you've been feeling well and fit otherwise.

{{hugs}}

Doreen

[r.mines]

:angel:

I can't thank you enough - but I'll try - thanks, THANKS, THANKS!!!!! Mmmmwahhh! (kiss)

What a lot of work you've done for me! I've printed out your posting and will be making lots of references to it in the time to come.

You know, it's not the high cholesterol in itself that bothers me so much - it's the risk of being 'medicalized.' I can't stand the idea of someone telling me what to eat, or what medications I 'have to' take. Well, I'm not going to let that happen. IF it's a problem, I'm going to take charge of it myself, if it means home monitoring and 'tweaking' my diet, supplements, etc. in all sorts of ways until I get it right. I'm certainly not going to be put on medication!

The annoying thing is, my doctor doesn't know I'm on Atkins - it's never been an issue, I just see her once a year for my physical and otherwise go my own merry way. Well, I certainly wasn't about to break the news right after a high cholesterol test! NOT the best way to get a sympathetic hearing!

I hate, HATE, HATE screening tests. I've had 'suspicious' pap tests and mammograms that turned out to be false positives, and now this. Every time, I'm upset, anxious, and depressed for days afterward. I'm seriously considering saying 'enough' and not having any more screenings.

Having said that, I've been reading about the link between high cholesterol and low thyroid. If my next test comes back unfavourable, I'm going to ask for a thyroid check - I might ask for it anyway. I'm going to monitor my temperature religiously for the next couple of weeks. I know some days it's very low - around 97 or even below! Maybe that's the reason for often feeling tired and run down, especially in winter?

I wonder if rushing to the lab right after a fairly strenuous morning workout might have increased my readings. For the repeat test, I won't do that again!

So here's the plan of action:

1) Back to low-carb tomorrow, with an emphasis on olive and omega oils, and severely cut back on processed meats (Atkins recommends this for high cholesterol). Try to eat fish one meal per day. Psyllium daily. Look into Atkins recommended supplements for cholesterol; lecithin is one.

2) Bookstore to pick up Atkins's book on supplements, PP Lifestyle Plan, and whatever else looks relevant.

3) Monitor body temperature several times a day.

4) Have my follow-up test in a couple of weeks, NOT immediately after exercising! Bus, don't walk, to the lab!

5) If lab results are not great, talk to my doctor about screening for thyroid.

6) Look into buying a home-testing kit for cholesterol.

Well, that's all I can think of for now. Lots of work to do!

Rachel

[Natrushka]

Originally posted by r.mines
3) Monitor body temperature several times a day.


Sorry you're having such a rough time of it, Rachel. One question and one suggestion. What was your cholesterol a year ago when it was tested? Has it changed dramatically from then or was it high then as well? The comment is for taking your temp. To get the most accurate reading be sure to do it before you even get out of bed in the morning... first thing.

Nat

[jomil]

Congratulations to Doreen on your usual comprehensive and efficient study on Cholesterol. I found it execeptionally educational.

Rachel, please slow down on your concern about medications. I would be really surprised if you received any medication for lowering cholesterol based on that incomplete test and especially with your low blood pressure readings.

Regards
Joe

[r.mines]

Nat, this is the first time I've had my cholesterol measured in about 20 years! I know Atkins recommends testing before starting his eating plan, but I never volunteer for tests - getting the results upsets me too much! (I'm even paranoid about GOOD results! Is it a false negative? Did I get someone else's results by accident? I'm a bit 'Woody Allen-ish' about my health!)

I have high cholesterol in my immediate family, which is why my doctor wanted to have me tested, 20 years ago (different doc - normal results) and now.

As for the temperature thingie ... yes, I'll do it first thing, and then I think also at intervals throughout the day. I bought a thermometer a couple of weeks ago - I never get sick, so I haven't owned one in years! - and it's electronic, so I had to 'test' it. For five days running, my basal (first thing) readings were: 97.1, 97, 97.2, 96.8 (yikes!), 97.6.

I think that's pretty low, don't you? I think it should be around 97.6, though of course there's individual variation, so my lower readings may not mean anything.

Thanks for checking!
Rachel

[r.mines]

Originally posted by jomil
Rachel, please slow down on your concern about medications. I would be really surprised if you received any medication for lowering cholesterol based on that incomplete test and especially with your low blood pressure readings.

Thanks so much, Joe. I only mention it because my doctor already has! "First the follow-up test...then dietary changes....then medication." I don't think I like what she has planned for me!

So I just have to do it my own way, right?

Rachel

[Natrushka]

Originally posted by r.mines
For five days running, my basal (first thing) readings were: 97.1, 97, 97.2, 96.8 (yikes!), 97.6.

I think that's pretty low, don't you? I think it should be around 97.6, though of course there's individual variation, so my lower readings may not mean anything.


Yes thats pretty low, Rachel. Having the thyroid checked might be a good bet.

Nat

[doreen T]

Rachel, the article by Ravnskov ... contains some up-to-date information on cholesterol-lowering drugs. His paper commenting on the New Cholesterol Guidelines, recently published by the National Cholesterol Education program (May 2001) ... has some disturbing and eye-opening facts. You might even want to print out a copy to have handy if your dr. is getting a bit hasty with the prescription pad. Check out the NCEP guidelines too (the link is in the article) ... they've declared abnormal cholesterol at such a low level, that 40% of North Americans are walking around with their arteries ready to clog at any moment ... and that includes children.. :rolleyes:

On monitoring basal body temp ... yes, first thing in the morning before rising .. is the generally accepted time. If you want to monitor trends during the day .. here's what to look for

- first thing in the morning the temp will be lowest
- late afternoon is when it normally peaks at its highest
- then drops back down again into the evening.

How it could be significant for thyroid ... if your afternoon temps are consistently low, or not increased at all from the early a.m. reading ... especially if you often feel chilled or have cold hands & feet that occur late afternoon.

Doreen

[Natrushka]

Originally posted by doreen T
How it could be significant for thyroid ... if your afternoon temps are consistently low, or not increased at all from the early a.m. reading ... especially if you often feel chilled or have cold hands & feet that occur late afternoon.


Wow, Doreen, you just described me in detail prior to LC. I am having my thyroid retested in a few weeks, I think i'll start taking the morning and afternoon temps now for reference. Thx

Nat

[r.mines]

Yes, thanks, Doreen. I'll check regularly, morning, late afternoon (3-4ish) and evening for a couple of weeks at least.

Rachel

[Natrushka]

Just curious, how is the temp monitoring going, Rachel? I bought a thermometer this afternoon to start my own little study and was a bit shocked when my temp came out as 97.1 Of course this doesnt mean much as I have no waking temp yet to compare it to. Have you noticed any trends yet?

Nat

[doreen T]

If you're checking your temp orally .... make sure you take it no less than a half hour away from hot or cold food, as these will alter the temperature of the lining of the mouth and tongue. Make sure you haven't been talking a lot, or mouth-breathing (such as during strenuous exercise) ... as the air flowing over the tongue will also alter the temperature in the mouth. Don't laugh, it's true ;). That's why many hospitals have now switched to using the ear-thermometers, which are much more accurate and constant.

WARNING -- just to clarify ... do NOT use the long thermometers intended for oral use in the ear canal. You must use a specially designed thermometer for this purpose. Ya, I know you knew that, but I had to put the warning here anyway .. :exclm:

[Natrushka]

So that's one thermometre, left ear.... ;)

Ok. No ear. I did have some water before the reading, hope that's part of the reason it was so low. I have noticed that I am no longer cold all the time (especially at night) like i used to be since starting LC.

thx Do.
N

[r.mines]

Originally posted by Natrushka
Just curious, how is the temp monitoring going, Rachel? Have you noticed any trends yet?
Nat

Not really, no. Actually, I haven't been measuring the past week - I've been out at UBC every day and just not thinking about much but work. (Haven't been on the board much, either.) I'm just getting into a really busy period and expect to be working solidly through till Xmas.

But I measured daily between Oct. 13th and 16th (4 days), and my temps seem to have gone up a degree or so over the previous ones posted - hormonal variations maybe - 97.9 or so first thing in the morning, and closer to 'normal' by afternoon. But I've noticed that when I'm hungry, or right after exercise (they usually coincide!) my temperature drops again to the low 97's.

Rachel
PS Don't worry, Doreen, I won't stick it in my ear!!!

[r.mines]

Well, I've decided to give this whole thing a rest for the next couple of months. I'm going to be working solidly, including weekends, pretty well up until Xmas, and I just don't have the time or mental energy to agonize over my health. I'm supposed to go in for my second blood test, but I've decided to wait till January. I'm more pissed off about the process of TESTING than I am about the RESULTS. It's the emotional turmoil I can't deal with.

In the meantime, I've introduced dietary changes that make me happy, regardless of whether or not I have high cholesterol (and regardless of whether that's a Bad Thing, which I'm not convinced of).

-less red meat and whole eggs
-more fish, chicken (sometimes skinless) and 'Breakfree' (egg substitute, made with less yolk, more white - tastes fine)
-more soy products, including tofu
-less butter, cheese, and saturated fat in general; found a great 'spread' made with organic cold-pressed oils, tastes yummy, and am experimenting with soy cheese (I have my doubts, but it's OK melted)
-more fibre in the form of psyllium and veggies, of course
-a few more supplements: soy lecithin, garlic, and antioxidant vitamins
-I bought a bottle of wine so I can have a glass daily, but I don't like wine much, so I haven't got to that yet. An unusual problem, eh?

I actually feel better eating this way than I do eating a lot of red meat and animal fat. It might be slightly carbier eating tofu and soy products instead of meat products, but probably not that much more, since I'm cutting down eggs and dairy at the same time.

I'm also collecting evidence to show my doctor should my second test come out unsatisfactory (whatever that is). Again, it's a slow process.

Rachel

[doreen T]

... a few things I thought of while reading this red meat will still be ok if it's quite lean .. you can use olive oil for cooking/marinating to keep it from being dry. Or, your home-made jerky would be good .. it's so lean, what with any fat being blotted away during the drying process.

beware the soy cheese. Many of these contain casein and other milk ingredients anyway, unless they say strictly vegan on the label. Otherwise they just boast "lactose-free". They aren't always lower in fat either, and some brands use hydrogenated soy oil products. I've found some of the "light" natural cheeses to be delicious, 40% lower in fat and consequently higher in protein. No-name light cheddar (from Superstore) has 5g fat/9g prot. per 30g ... as opposed to 9g fat/7g prot. for regular. (just so's ya know there are options ;))

from back in the Group Study days, a favourite recipe I still make ... is a tofu/egg custard ... it could be considered a dairy-free version of the infamous Mock Danish ... ¼ pkg lite silken tofu (for some reason the lite has fewer carbs than the regular) and 1 egg (or substitute) .. blend till creamy, add vanilla, nutmeg, dot o' sweetener, lemon rind or other desired flavours ... pour in ramekin and nuke or I prefer to use a greased dish and bake in the toaster oven for 10 minutes on high. It puffs up nicely and has a yummy custardy taste and texture. Or, use savoury seasonings - a little onion powder, s & p, a portion of leftover cooked veggies, some canned mushrooms, chopped leftover cooked meat, a teensy bit o' grated lowfat cheese ... voilà, breakfast quiche-thingy, superfast to blast you out the door in the a.m.

I posted a couple recipes for low-fat, dairy-free whipped cream and sour cream using lite silken tofu .. http://forum.lowcarber.org/showthread.php?s=&threadid=470 You are wise to carry on and not get stressed out ... probably the stress itself is just as harmful, with the rise in serum cortisols ;) ... and besides, a high cholesterol reading in an otherwise healthy person is not an indicator of disease. Which you already know ... but I hear ya on the "process" of going through the tests, and waiting ... and the doctor with prescription pad in hand. You are within your rights to say NO.

Take care, and grab those moments of R & R whenever they come your way!!

Doreen

[Ka3n]

Rachel,
Recent research has shown more of a correlation between high homocystien level and heart disease than high cholesterol levels and HD.
Our WOE can cause some people to not get enough B vitamins (including folic acid) which will cause high homocystien levels. Check how much B-complex you're getting and make sure you get enough Folic Acid.

This website has lots of information that you'll be interested in.
http://www.heartinfo.com
-----------------
Homocysteine and Folate: New Implications for Heart Attack Prevention

The observation that many heart attack victims have normal cholesterol levels underscores the need to identify other risk factors for atherosclerosis. Of several substances in the blood that are now thought to predict odds for vascular disease, the amino acid, homocysteine, is the one for which the case is strongest. The findings suggest a simple way to prevent heart attacks because homocysteine levels can be lowered by taking the B vitamin, folic acid. In a 1995 review of work exploring the relationships among homocysteine levels, folic acid and blood vessel disease (JAMA, vol. 274, pp.1049-1057), University of Washington researchers proposed that increasing folic acid intake might prevent as many as 50,000 heart attack deaths a year.

Homocysteine was first named as a suspect in vascular disease over 25 years ago by Dr.Kilmer McCully, then a Harvard pathologist. McCully, who observed severe atherosclerosis in two young children with rare diseases marked by very high homocysteine levels, speculated that minor elevations might account for atherosclerotic disease in adults. Despite early resistance to this startling new theory, subsequent investigations linked homocysteine to an estimated 15 percent of heart attacks.

Among 27 studies of homocysteine and vascular disease cited by the University of Washington review was a Harvard project involving 15,000 physicians (JAMA, vol. 268, pp.877 -81). The research, reported in 1992, showed that although relatively few of the doctors had coronaries, those in the five percent of the group with the highest homocysteine readings had a 3.4 fold increase in heart attack risk. Also cited was a 1995 Tufts University study of over 1,000 elderly men and women, which showed that high homocysteine levels raised odds for significant carotid artery obstruction. (New England Journal of Medicine, vol.332, pp.286-291). A carotid blockage is considered a warning sign of above-average risk for both stroke and coronary artery disease.

The Washington researchers concluded that a 5 u.mol/L increment in homocysteine level raises coronary artery disease risk as much as a 20 mg/dL rise in cholesterol. No one has yet proven how homocysteine causes atherosclerosis, but scientists suspect it may do its harm during one or more steps in the process that transforms a healthy blood vessel into the site of a heart attack. The arteries of animals injected with homocysteine showed changes that may lay the groundwork for the buildup of atherosclerotic plaques. There is also evidence suggesting that homocysteine stimulates proliferation of blood vessel cells that help form plaques and that it encourages clotting.

Folic acid is thought to protect against heart disease because it breaks down homocysteine and allows it to be cleared from the blood stream. The University of Washington review referred to 11 studies of folic acid's effects on homocysteine levels. Among these was the Tufts research, which showed for the first time that inadequate intake of the vitamin is the main determinant of the homocysteine-related increase in the risk of carotid blockage.

New studies suggesting a protective role for folic acid continue to appear. In 1996, Canadian investigators reported that among more than 5,000 men and women who participated in a national nutrition survey, those in the quarter of the group with the lowest folic acid levels were 69 percent more likely to die of a coronary problem than those in the quartile with the greatest stores of the vitamin (JAMA, vol.275,pp.1893-95). There is even evidence that high risk patients have the most to gain. In 1995, a University of Utah study compared over 160 men and women who had evidence of early familial coronary artery disease with a comparable group who did not have the disease. The patients, who had already had either a heart attack, bypass surgery or balloon angioplasty, showed "a considerably greater sensitivity" to the blood's concentration of the B vitamin, according to the researchers (Arteriosclerosis, Thrombosis and Vascular Biology).

Growing evidence that folic acid may prevent heart attacks has led to recommendations that people consume 400 mcg. a day. This amount has been shown to maintain low homocysteine levels and also to prevent neural tube defects in the unborn. But, although 400 mcg. used to be the recommended daily allowance (RDA) for folic acid, the RDA was cut by half several years ago. According to data cited by the University of Washington review, an estimated 88 percent of Americans get less than 400 mcg., providing "ample scope for intervention," say the authors.

One way to insure adequate folic acid intake is to eat five daily servings of fruits and vegetables. People consuming this amount are unlikely to benefit from supplements, according to a JAMA editorial published in 1993 (JAMA, vol.270, pp. 2726 - 27). Among the best natural sources of folic acid are green leafy vegetables, beans and citrus fruits. Because of a government mandate to fortify grain products with the vitamin, as of 1998, it will also be available in foods like bread, pasta and cereal. According to the University of Washington researchers, fortification offers the greatest potential for reducing coronary artery disease. However, other researchers (JAMA, vol 275, pp. 1929 -30) point out that fortification is expected to increase intake of the vitamin by only 100 mcg. and may still leave about three quarters of the population getting less than the desired 400 mcg.

Whether or not to prescribe supplements continues to be debated. Several scientists have called for clinical trials to determine whether giving folic acid actually reduces heart attack risk. An editorial accompanying the Canadian study suggests including vitamins B6 and B12 in the trials, since these vitamins also influence homocysteine levels. An additional reason for giving vitamin B12 is that folic acid supplements can mask vitamin B12 deficiencies, which are not uncommon in the elderly and may cause neurologic damage if left untreated.

While some scientists argue against prescribing supplements before there is direct proof of their benefits, others say that delays may not be desirable for some patients. At a symposium on homocysteine and heart disease, sponsored by the Federation of American Societies of Experimental Biology, Meir Stampfer, M.D., Ph.D. of Harvard, pointed out that "public health considerations often require taking protective action even before all proof is in." The implications of the existing evidence about homocysteine and folate were stressed by the co-chair of the symposium, M.Rene Malinow, of the Oregon Regional Primate Research Center. "Scientists are on the threshhold of the most important extension of the diet/health hypothesis since the discovery of the relationship of cholesterol to heart disease," he said.

Best wishes,
Katherine

[r.mines]

Thanks for the recipes, Doreen. I'll try them. It seems like the only way I can eat tofu is if it's whipped or blended beyond recognition. I've made some salad/veggie dressing thingies that are bearable, and the recipes you've just given me sound good too.

I also hear you on the soy cheese...I bought some that looked OK (it has cassein, but is unhydorogenated, low-fat and ultra-low-carb) but it tastes kinda yicky. It seems to be OK with eggs so far, and maybe in a few other recipes. One good thing is, I'm not tempted to munch it!

I'm still eating red meat, I've just cut down from three times a day to maybe once. I figure the jerky ought to be OK too, in fact I just made a new batch.

Kathryn, thanks for all the info on folic acid...I've printed it out...it's going to take a while to wade through it, in addition to the website. Lots o' reading there!

Now I'm going to totally laugh if I go back for my retest and it turns out to be perfectly normal! I still think that having a cholesterol test done right after an hour-long workout might not have been the greatest idea. Like I'm fat-burning, right? I think it makes sense that I'd have some extra in my bloodstream.

Duh!

Rachel

[Sheldon]

For more information on the failure of the cholesterol-heart-disease theory, see Dr. Kendrick's (http://www.redflagsweekly.com/kendrick.html) articles here.

It will change your whole way of thinking about this subject.

What's wrong with red meat and eggs?

Sheldon

[Lisa N]

Sheldon...

generally there's nothing wrong with red meat and eggs unless you have a sensitivity to arachidonic acid which is highest in those two items. According to the Eades' if you have a sensitivity to AA, it could cause your cholesterol readings to be elevated and generally not make you feel well. The "fix" that they suggest is to either cut out those items or take fish oil with any meal that contains them.