Plant sterols might be an additional risk factor for coronary heart disease

This study was published in Metabolism 2002 Dec;51(12):1519-21

Study title and authors:
Serum plant sterols as a potential risk factor for coronary heart disease.

Sudhop T, Gottwald BM, von Bergmann K.
Department of Clinical Pharmacology, University of Bonn, Bonn, Germany.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12489060

The lead author of the study, Dr Thomas Sudhop, notes that in patients with the inherited disease of phytosterolemia, elevated concentrations of plant sterols (eg, campesterol and sitosterol) (think Benecol and Flora proactive) have been implicated as a risk factor for premature atherosclerosis.

This study examined the role of plant sterols in patients (with plant sterol levels in the normal range) admitted for elective artery coronary bypass graft surgery. The study included 53 patients of which 26 reported a family history in their first-degree relatives for coronary heart disease.

The study found:
(a) Patients with a positive family history for coronary heart disease had a significant 31% higher plasma levels of campesterol compared to patients without a family history of coronary heart disease.
(b) Patients with a positive family history for coronary heart disease had a significant 29% higher plasma levels of sitosterol compared to patients without a family history of coronary heart disease.
(c) Patients with a positive family history for coronary heart disease had a significantly higher ratios of sitosterol to cholesterol and campesterol to cholesterol compared to patients without a family history of coronary heart disease.

Dr Sudhop concluded: "These findings support the hypothesis that plant sterols might be an additional risk factor for coronary heart disease".

Plant sterols, found in Benecol and Flora proactive, are associated with an increased risk of coronary artery disease

This study was published in Steroids 2015 Mar 23

Study title and authors:
Increased plant sterol deposition in vascular tissue characterizes patients with severe aortic stenosis and concomitant coronary artery disease.

Luister A, Schött HF, Husche C, Schäfers HJ, Böhm M, Plat J, Gräber S, Lütjohann D, Laufs U, Weingärtner O.
Klinik für Innere Medizin III¸Kardiologie, Angiologie und Internistische Intensivmedizin.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25814070

Phytosterols are present in very small quantities in fruit and vegetables. The phytosterol content of plant sterol-enriched margarines (Benecol, Flora proactive etc) are higher by an order of magnitude of up to 841 times than the average vegetable (see here). Campesterol and sitosterol are types of phytosterols.

Oxyphytosterols are phytosterols that have gone rancid.

Cholestanol is a derivative of cholesterol.

The aim of the study (of 104 patients) was to evaluate the relationship between phytosterols, oxyphytosterols, lathosterol, cholestanol and cholesterol in patients with severe aortic stenosis (artery blockages), some of whom also had coronary artery disease who were scheduled for elective aortic valve replacement.

The study found:
(a) The ratio of campesterol-to-cholesterol was increased by 26% in plasma of patients with coronary artery disease compared to those without coronary artery disease.
(b) Sitosterol concentrations were increased by 38.8% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(c) Campesterol concentrations were increased by 30.4% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(d) Oxidized sitosterol-to-cholesterol ratios were up-regulated by 22.7% in the plasma of patients with coronary artery disease compared to those without coronary artery disease.
(e) Oxidized campesterol was increased by 17.1% in the aortic valve cusps (the triangular fold or flap of a heart valve) of patients with coronary artery disease compared to those without coronary artery disease.
(f) Neither cholestanol nor the ratio of cholestanol-to-cholesterol was associated with coronary artery disease.

Luister concluded: "Patients with concomitant coronary artery disease are characterized by increased deposition of plant sterols, but not cholestanol in aortic valve tissue. Moreover, patients with concomitant coronary artery disease were characterized by increased oxyphytosterol concentrations in plasma and aortic valve cusps".

Is it wise to consume margarines high in phytosterols (such as Benecol and Flora proactive) when the study suggests that phytosterols are associated with a higher risk of coronary artery disease?

Increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates

This study was published in the British Medical Journal 2013 Feb 4;346:e8707

Study title and authors:
Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.

Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, Ringel A, Davis JM, Hibbeln JR.
Laboratory of Membrane Biophysics and Biochemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23386268

The objective of the study was to evaluate the effectiveness of replacing dietary saturated fat with polyunsaturated fat, for the prevention of coronary heart disease and death in men with heart disease. The study lasted for 39 months and included 458 men, aged 30-59 years, who had had a heart attack or angina.

The men were allocated into two groups and instructed to either:
(i) Increase their polyunsaturated fat intake to about 15%, reduce their intake of saturated fat and to less than 10% and reduce their dietary cholesterol to 300 mg per day. To achieve these targets these men were provided with liquid safflower oil and safflower oil polyunsaturated margarine (high polyunsaturated fat group).
(ii) Carry on with their normal diet (saturated fat group).

The study found:
(a) After 12 months the cholesterol levels of the men on the high polyunsaturated fat diet were 8.5% lower than the men on the high saturated fat diet.
(b) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death compared to the men who consumed the high saturated fat diet.
(c) Men who consumed the high polyunsaturated fat diet had a 70% increased risk of death from cardiovascular disease compared to the men who consumed the high saturated fat diet.
(d) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death from heart disease compared to the men who consumed the high saturated fat diet.

The study shows that increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates.



Medium or high intake of margarine is associated with a 50% increased risk of a nonfatal heart attack

This post includes a summary of a study published in the European Journal of Clinical Nutrition January 1997, Volume 51, Number 1, Pages 30-32 and a recipe for carne asada.

Study title and authors:
Margarine intake and risk of nonfatal acute myocardial infarction in Italian women

Books:

A Tavani1, E Negri1, B D'Avanzo1 and C La Vecchia1,2

1Istituto di Ricerche Farmacologiche 'Mario Negri', Via Eritrea 62, 20157 Milano, Italy
2Istituto di Statistica Medica e Biometria, Università di Milano, Via Venezian 1, 20133 Milano, Italy

This study can be accessed at: http://www.nature.com/?file=/ejcn/journal/v51/n1/abs/1600356a.html

The study examined the relationship between margarine intake and nonfatal heart attacks in 429 Italian women, aged 18-74 years, in hospital with diagnosis of heart attack and 866 controls.

The study found that medium or high intake of margarine was associated with a 50% increased risk of nonfatal heart attack.

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Recipe of the day

Carne Asada

Food Mall: Flank Steak

Ingredients:

■1 1/2 pounds (grass fed) flank steak
■4 garlic cloves, finely chopped

■1 jalapeno pepper, finely chopped
■1/4 cup finely chopped cilantro
■1 teaspoon cumin
■1 teaspoon chili powder
■1 teaspoon oregano
■Pinch cayenne pepper
■2 limes, juiced
■8 to 12 ounces beef broth

Directions:
Slice the flank steak on the diagonal into thin strips.

Combine all ingredients in a large Ziploc bag or in a shallow dish (meat should be completely covered in liquid).

Marinate in the refrigerator at least 3 hours. Take out and drain off the marinade. Lightly salt the steak. The meat can be cooked in a skillet with coconut oil or grilled.

Cook 3-6 minutes on each side for medium-rare.

Carne Asada



Margarine damages the lining of blood vessels

This post includes a summary of a paper published in the International Journal of Hygiene and Environmental Health 2002 Mar;205(1-2):95-102 and a recipe for stuffed pumpkin.

Study title and authors:
PCB-induced oxidative stress in endothelial cells: modulation by nutrients.

Books:

Hennig B, Hammock BD, Slim R, Toborek M, Saraswathi V, Robertson LW.

Cell Nutrition Group, Department of Animal Sciences, University of Kentucky, Lexington, KY 40546, USA. bhennig@uky.edu

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12018021
 
Hennig finds that polychlorinated biphenyls (PCBs) can damage the lining of blood vessels (endothelial dysfunction) which can lead to heart disease, and that polyunsaturated omega-6 oils can increase this damage.

Foods rich in polyunsaturated omega-6 oils include safflower oil (78%), sunflower oil (68%) and soybean oil (51%), all of which are main constituents of margarine. 
 
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Recipe of the day

Stuffed Pumpkin

Ingredients:

Food Mall: Sausage

1 lb sausage removed from casings

1 tbs fresh sage, chopped OR 1 1/2 tsp dried sage
1 tsp allspice
1/2 tsp salt
1/2 tsp black pepper
1 small sugar pumpkin or 1 kabocha squash

Directions:
1. Preheat oven to 400. Line a baking sheet with parchment paper or aluminum foil

2. In a large skillet, brown sausage, breaking it into chunks with the spatula. Add in sage, allspice, salt and pepper. Cool.

3. Cut the top of the squash or pumpkin like you are preparing it to be a jack-o-lantern (angle the knife, so that it creates a little shelf for the top to sit on).

4. Scoop out the seeds with a spoon and discard or toast later for munching.

5. Sit pumpkin or squash on the baking sheet and fill with contents of the skillet. Replace the top.

6. Bake at 400 for about an hour or until the squash is soft and caramelizes.

7. Allow to cool for 15 minutes.

Stuffed Pumpkin



Sunflower oil and olive oil increase heart disease risk factors compared to butter

This post includes a synopsis of a study published in the Journal of Nutrition 2002 Dec;132(12):3642-9 and a recipe for lamb kebabs.

Study title and authors:
Butter differs from olive oil and sunflower oil in its effects on postprandial lipemia and triacylglycerol-rich lipoproteins after single mixed meals in healthy young men.

Books:

Mekki N, Charbonnier M, Borel P, Leonardi J, Juhel C, Portugal H, Lairon D.

Unité 476-Institut National de la Santé et de la Recherche Médicale, Human Nutrition and Lipids, National Institute of Health and Medical Research, Université de la Méditerranée, 13009 Marseille, France.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12468601

Mekki notes how excess triglyceride levels accumulated after meals are related to heart disease risk.

The goal of the study was to evaluate the effects of saturated fat (butter) , monounsaturated fat (olive oil) or (omega-6) polyunsaturated fat (sunflower oil) on post meal blood triglyceride and fat levels.

The study found that:
(a) The two unsaturated oils (olive oil and sunflower oil, found in many margarines), induced a higher post meal rise in (bad) triglyceride and (bad) chylomicron levels than the butter meal.
(b) Circulating chylomicrons were smaller after the butter meal than after the two vegetable oil meals. (So they can be eliminated more easily)

Mekki concluded that consumption of butter results in lower triglyceride and chylomicron levels in the circulation of young men than consumption of olive or sunflower oils.

High triglycerides and chylomicrons levels are implicated in heart disease. See here and here.

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Recipe of the day

Lamb Kebabs

Ingredients:

1 dried bay leaf

Food Mall: Lamb

1 inch piece ginger root chopped fine

1 inch cinamon stick

1 tsp coriander seeds

1 tsp fennel seeds

1 tsp chili powder

1 tsp garam masala

1 tsp lemon juice

1 tsp gound turmeric

1 tbsp oil

1.5 lbs lamb neck fillet

Instructions:

Using food processor, grind together first six ingredients (bay leaf through chili powder). Combine with garam masala, lemon juice turmeric and oil in a large bowl. Cut lamb into 1/4 inch slices. Add to spice mix and marinate room temp 1 hour or overnight in fridge. Spread out lamb on cookie sheet and cook in a 400F oven for 20 minutes. Serve with lemon wedges and fresh cilantro.

Lamb Kebab



Sunflower oil damages the blood vessels

This post featues a synopsis on a study published in the Journal of Nutrition 2008 Oct;138(10):1910-4 and a recipe for anchovy and mustard glazed leg of lamb.

Study title and authors:
Impaired postprandial endothelial function depends on the type of fat consumed by healthy men.
Berry SE, Tucker S, Banerji R, Jiang B, Chowienczyk PJ, Charles SM, Sanders TA.
Nutritional Sciences Division, King's College London, London SE1 9NH, United Kingdom. sarah.e.berry@kcl.ac.uk

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18806100
                                                                                                                                           Books:

The study investigated the effects of saturated fat (butter) meals and monounsaturated fat (sunflower oil, found in many margarines) meals on the function of the blood vessels in 17 men.

Berry found that:
(a) The rise in (bad) triglycerides was 66% LESS after the butter meal than after the sunflower oil meal.
(b) After the sunflower oil meal there was a DECREASE in blood flow and an INCREASE in cell damage.
(c) After the butter meal there was NO change in blood flow and NO cell damage.

The study shows how sunflower oil damages the blood vessels, which may lead to heart disease.

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Recipe of the day

Anchovy and Mustard Glazed Leg of Lamb

Ingredients:                                                                                   Food Mall: Boneless Leg of Lamb 

1.3kg/3lb lean boneless leg of lamb

4-5 garlic cloves, peeled and cut into slivers

4 large sprigs of rosemary

Cold-pressed extra virgin olive oil

15ml/1tbsp wholegrain mustard

4 or 5 anchovy fillets, in olive oil, drained and finely chopped

Large knob of butter, slightly softened

Sea salt and freshly ground black pepper

Method:

1.To prepare your lamb; place on a chopping board then stud it with the garlic and rosemary. Gently insert the tip of a knife about an inch into the flesh of the lamb and then push a sliver of garlic and a couple of rosemary leaves into the hole left behind. The more of these you do, the more highly developed the flavour. I would recommend at least 10 and up to 20. The lamb can be prepared up to this point well in advance, even the night before.

2.Preheat the oven to Gas mark 4-5, 180-190°C, 350-375°F. Rub the lamb all over with the oil and season well with sea salt and freshly ground black pepper, put it on a baking tray in the oven and cook according to how you like your lamb.

3.Meanwhile blend the mustard, anchovy and butter into a paste. About 25 minutes before the end of the cooking time smear or brush this over the skin of the lamb and return to the oven. When the glaze has taken on a golden brown colour, remove the lamb from the oven, transfer to a large warm plate, cover with foil and leave to rest for 5-10 minutes somewhere warm before serving.

Margarine intake increases the risk of heart disease

This post includes a synopsis of a paper published in Epidemiology 1997 Mar;8(2):144-9

Study title and authors:
Margarine intake and subsequent coronary heart disease in men

Books:

Gillman MW, Cupples LA, Gagnon D, Millen BE, Ellison RC, Castelli WP.

Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA 02215, USA.

This paper can be accessed at: http://www.jstor.org/pss/3702499

The study compared margarine and butter consumption on 832 men age 45-64 years and free of heart disease, with over 21 years of follow-up.

The study found that:
(a) For each increment of 1 teaspoon per day of margarine there was a 10% increase of heart disease over 21 years.
(b) Butter intake did not predict heart disease incidence.

Gillman concluded that the study offered support to the hypothesis that margarine intake increases the risk of coronary heart disease.

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Margarine increases the risk of heart disease

This post contains a synopsis on a study published in the American Journal of Clinical Nutrition Vol 53, 655-659 and a recipe for rosemary chicken.

Study title and authors:
Lowering of HDL2-cholesterol and lipoprotein A-I particle levels by increasing the ratio of polyunsaturated to saturated fatty acids
F Fumeron, L Brigant, HJ Parra, JM Bard, JC Fruchart and M Apfelbaum
INSERM U286, Faculte X Bichat, Paris, France.

This study can be accessed at: http://www.ajcn.org/content/53/3/655.full.pdf+html
 
Fumeron notes that the protective role of high-density lipoprotein cholesterol (HDL) against heart disease has been attributed to a high densities of the subfractions HDL2 and apolipoprotein A-I (LpA-I).

Books:

The study investigated the effect of a high ratio of polyunsaturated to saturated fatty acids on these subfractions in a group of young adult males. Two diets were consumed at the subjects' homes for 3 weeks each.
The diets were:
(i) 70 g butter (LOW polyunsaturated fat/saturated fat ratio) HIGH saturated fat diet.
(ii) 70 g sunflower margarine (HIGH polyunsaturated fat/saturated fat ratio) High polyunsaturated fat diet.

Significant decreases in the protective subfractions of HDL, HDL2, and LpA- I were observed in the margarine, HIGH polyunsaturated fat diet compared to the HIGH saturated fat diet.

The study reveals that the high polyunsaturated fat diet (margarine) diminishes the two highly protective HDL cholesterol subfractions, HDL2 and LpA-1, which could be detrimental and increase the risk of heart disease.

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Recipe of the day

Rosemary Chicken

Food Mall: Chicken

Ingredients:

• 1 chicken

• 1 bunch of rosemary

• 1 clove of garlic
• 1 whole onion
• 1 t kosher salt
• olive oil

Instructions:
After proper cleansing, rub chicken with olive oil inside and out.

Place rosemary inside chicken cavity with a whole peeled onion.

Crush or squeeze garlic and rub over chicken or place slices under skin of breast.

Sprinkle with salt and place in roasting pan. Cook at 300 F for 3 hours.

What has caused the rise of diseases such as cancer, heart disease and infertility?

Over the past century there has been a massive change in the type of food that people eat.

Table 1 showing consumption of butter, lard, shortening, margarine and vegetable oils from 1909 to 1985

http://www.slidefinder.net/o/oilingofamerica/3194348/p3

Table 1 shows that over the past century, butter consumption has plummeted from 18 grams per person per day to 5. Consumption of lard has gone to very little while consumption of shortening has almost tripled. And the shortening in 1909 was made of coconut oil and lard. It was actually a natural product. Shortening today is made out of partially hydrogenated vegetable oil. Margarine consumption has gone up five fold. Look at just the liquid vegetable oils –more than a fifteen-fold increase. These rancid vegetable oils are completely new to the human diet. These changes in fat-and-oil consumption patterns are the major cause of our modern diseases, including heart disease, cancer, infertility and learning disabilities in our children.

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Recipe of the day

Food Mall: Sirloin Steak

Pan-Fried Beef

Ingredients:

4 sirloin or rump steaks

15ml/2tbsp tallow
25g/1oz butter

Instructions:
Heat 15ml/1tbsp tallow and 25g/1oz butter in a non-stick or griddle pan. Season 4 beef rump or sirloin steaks and fry the steaks over a medium heat according to preference.

Pan Fried Beef