The World's Healthiest Foods

Elevated Cholesterol 5: Recent research studies confirm the importance of eating healthy foods on healthy cholesterol levels

Tomato-rich Diet Significantly Improves Cholesterol Profile

A high dietary intake of tomato products significantly reduced total and LDL cholesterol levels, while also increasing LDL's resistance to oxidation (damage by free radicals) in a study involving 21 healthy subjects published in the British Journal of Nutrition.

Study volunteers followed a diet free of tomato products for 3 weeks, followed by a high tomato diet (13.5 ounces tomato juice and 1 ounce tomato ketchup daily). At the end of the high tomato diet period, study participants' total cholesterol levels had dropped an average of 5.9%, with LDL cholesterol levels reduced by 12.9%. Blood samples also showed increases in lycopene, beta-carotene and gamma-carotene-antioxidant carotenoids found in tomatoes-plus a 13% increase in the ability of circulating LDL cholesterol to resist oxidation. Br J Nutr. 2007 Dec;98(6):1251-8. While drinking 13.5 ounces of plain tomato juice every day may seem a bit challenging, enjoying a cup of tomato juice with lunch, a cup of hot tomato juice into which an ounce of tomato ketchup has been stirred along with some freshly ground pepper as an afternoon "soup" break, and/or a Virgin Mary before dinner would provide some taste diversity along with the amount of tomato products effective in the research.

High Cholesterol Blocks Cardio-protective Benefits of Estrogen

Research published in Nature Medicine has revealed why women are better protected than men from cardiovascular disease until they reach menopause and a mechanism for the damaging effects of high cholesterol on the heart.

Estrogen binds to receptors in the blood vessels of the heart, helping its blood vessel walls to remain elastic and dilated, so any damage can be more easily repaired.

David Mangelsdorf and colleagues from UT Southwestern Medical Center, Dallas, TX, have shown that a by-product of cholesterol metabolism, 27-hydroxycholesterol (27HC), competitively binds to the same receptors in the blood vessels of the heart as estrogen, blocking estrogen's protective effects on the cardiovascular system.

The primary effect of 27HC in blocking out estrogen is that this results in the inhibition of nitric oxide production. Nitric oxide promotes smooth muscle relaxation in blood vessels, aids in blood vessel cell growth and repair, and prevents blood clot formation. Manglesdorf's team found that 27HC's damaging effect was predominantly on estrogen receptors in the cardiovascular system. When 27HC binds to estrogen receptors in other tissues, such as reproductive tissues, it has no effect on their reproduction-related functions. Nat Med. 2007 Oct;13(10):1185-92. Particularly for postmenopausal women, who have less estrogen to compete against 27HC, a healthy way of eating that lowers cholesterol is essential to help maximize estrogen's heart-protective effects. To learn which of the World's Healthiest Foods are especially effective in lowering cholesterol, click What Foods and Nutrients are Good for Healthy Cholesterol Levels?

Soy Nuts Lower Blood Pressure and LDL Cholesterol, plus Decrease Menopausal Symptoms in Postmenopausal Women

Soy nuts have a lot to offer postmenopausal women, suggest two studies conducted by Francine Welty and her team from the Beth Israel Deaconess Medical Center, Boston.

Enjoying a half-cup of soy nuts as one source of protein in a healthy diet can reduce blood pressure and LDL cholesterol levels in postmenopausal women by as much as 10% in just 8 weeks, discovered Welty's team in research they published in the Archives of Internal Medicine (Welty FK, Lee KS, et al.)

High blood pressure (hypertension) is defined as having blood pressure higher than 140/90 mmHg, and is a major risk factor for cardiovascular disease, a leading cause of death in postmenopausal women.

In this 16-week study, 60 postmenopausal women (average age 56), 12 of whom had high blood pressure, followed two different diets, each for 8 weeks: a Therapeutic Lifestyle Changes (TLC) diet or a TLC diet in which soy nuts (roasted, unsalted soybeans) were used as one source of protein. Blood samples and blood pressure measurements were taken at the beginning and end of each 8-week diet.

The TLC diet derived 30% of its calories from fat (with 7% or less from saturated fat), 15% from protein and 55% from carbohydrates. The diet delivered 1,200 mg of calcium and less than 200 mg of cholesterol daily. Two meals of fatty fish, such as salmon or tuna, were included weekly.

The TLC with soy diet contained the same calorie, fat and protein, calcium and cholesterol content, but 25 grams of its protein were delivered in the form of one-half cup of unsalted soy nuts.

When eating the soy nuts as part of their TLC diet, the women with high blood pressure

experienced systolic and diastolic blood pressure reductions of 9.9% and 6.8%, respectively, and even those with normal blood pressure experienced reductions and 5.2% and 2.9%, respectively.

Not only was blood pressure lowered in all the women, but in those who began the study with high blood pressure, LDL cholesterol and apoB levels also dropped, 11% and 8% respectively, compared with the TLC diet without soy. (LDL, sometimes called "bad" cholesterol is a major risk factor for cardiovascular disease, and apoB is a carrier for LDL, so lower levels mean that less LDL is being carried in the bloodstream.)

"A 12-millimeter of mercury decrease in systolic blood pressure for 10 years has been estimated to prevent one death for every 11 patients with stage one hypertension treated; therefore, the average reduction of 9.9 milligrams of mercury in systolic blood pressure in hypertensive women in the present study could have significant implications for reducing cardiovascular risk and death on a population basis," wrote Welty.

Triglyceride levels also dropped in all the women when eating soy nuts, 7% in those with normal and 11% in those with high blood pressure. (High triglycerides, a form in which fat is carried in the bloodstream, are another cardiovascular disease risk factor.)

"Although these reductions were not statistically significant, their magnitude is similar to reductions in triglyceride levels observed in other soy studies and may have clinical relevance, especially since triglyceride levels are stronger predictors of cardiovascular risk in women than in men," noted Welty.

The researchers speculate that soy isoflavones work synergistically with other compounds in soy nuts, which are roasted whole soy beans, to produce the blood pressure lowering effects. In other studies, in which isoflavones were given in isolation in the form of supplements, no such benefits were observed.

"This study was performed in the free-living state; therefore, dietary soy may be a practical, safe and inexpensive modality to reduce blood pressure. If the findings are repeated in a larger group they may have important implications for reducing cardiovascular risk in postmenopausal women on a population basis," concluded the researchers.

In a similar 16-week diet crossover study, this one looking at menopausal symptoms, Welty's team again gave 60 healthy postmenopausal women two 8-week diets, the TLC diet and a TLC diet with similar calorie, fat, and protein content in which one-half cup soy nuts divided into three or four portions spaced throughout the day (containing 25 g soy protein and 101 mg isoflavones) replaced 25 grms of non-soy protein. (Welty FK, Lee KS, et al, J Women's Health).

Once again, compared with the TLC diet alone, women did much better on the TLC diet with soy nuts. While eating soy nuts, hot flashes dropped 45% in women beginning the study with at an average of at least 4.5 hot flashes a day, and 41% in those who began the study with an average of less than 4.5 hot flashes daily.

Eating soy nuts also resulted in significant improvements in the women's scores on the menopausal symptom quality of life questionnaire: a 19% average decrease in vasomotor symptoms score, 12.9% reduction in psychosocial symptoms score, 9.7% decrease in physical symptoms score, and a 17.7% reduction in sexual symptoms score.

Practical Tip: If you're postmenopausal or heading towards menopause, including a half-cup of unsalted soy nuts in your healthy way of eating is an easy, delicious way to lower your blood pressure and LDL cholesterol, while greatly reducing hot flashes and other menopausal symptoms. Divide your soy nuts into 3 or 4 handfuls and use as a snack or a crunchy topping for soups, salads and steamed vegetables.

An Egg a Day May Be Okay

Although eggs are well-known for containing cholesterol, in two recent studies, participants' blood levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were not affected by eating an egg a day.

Enjoying a daily egg-whose yolk is a rich source of vision-protective carotenoids, including not only lutein but also zeaxanthin-may reduce the risk of developing age-related macular degeneration (AMD) without increasing cholesterol levels, according to the results of these two studies, published in the October 2006 Journal of Nutrition.

Conducted at the University of Massachusetts, these studies show that, in addition to keeping hunger at bay longer (eggs' satiety index is 50% than that of most breakfast cereals), an egg a day boosts blood levels of lutein and zeaxanthin, thus reducing the risk of AMD-without increasing cholesterol or triglyceride levels.

In AMD, the macula, the central part of the retina which controls fine vision, deteriorates, greatly limiting eyesight or even resulting in blindness in those afflicted. The leading cause of blindness in people over age 50, AMD afflicts more than 10 million people in the United States, plus an additional 15 to 20 million worldwide.

In the first study, a randomized cross-over trial, Elizabeth Goodrow and her team investigated the effects of eating one egg a day on blood levels of lutein, zeaxanthin, cholesterol and triglycerides in 33 men and women over age 60.

After a no-egg start up week, volunteers ate either an egg or egg substitute daily for 5 weeks, then again ate no eggs for a week before crossing over to the other intervention for a second 5 weeks.

After the 5-week period in which they ate a daily egg, participants' blood levels of lutein and zeaxanthin significantly increased by 26 and 38%, respectively, compared to their levels of these carotenoids after their no-egg week.

And although eggs are well-known for containing cholesterol, participants' blood levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were not affected by eating an egg a day.

In the second study, researchers led by Adam Wenzel looked at the effect of a 12-week egg intervention on lutein and zeaxanthin levels in both the blood and the retina of the eye (the macular pigment optical density or MOPD) of 24 women ranging in age from 24 to 59.

The women were randomly assigned to eat 6 eggs every week containing either 331 micrograms (Egg1) or 964 micrograms (Egg2) of lutein and zeaxanthin per yolk, or a placebo (a sugar-filled pill).

No changes in cholesterol levels were seen in the women eating eggs, but in those given the placebo (the sugar pill), increases in total cholesterol and triglycerides were recorded.

Unlike the first study, only blood levels of zeaxanthin, but not lutein, increased in both Egg1 and Egg2 groups; however, carotenoid levels in the retina (MPOD) increased in both egg intervention groups, a result that suggests a daily egg offers protection against AMD.

Although egg yolk contains less lutein and zeaxanthin than some other foods-spinach, for example-when supplied by eggs, these carotenoids appear to be especially well absorbed into the retina. "Increasing egg consumption to 6 eggs per week may be an effective method to increase MPOD," wrote lead study author Wenzel.

So, enjoy a quick and easy, appetite-satisfying, vision-sustaining poached or soft boiled egg for breakfast. Take an egg salad sandwich to work or add a hard boiled egg to your luncheon salad. On the weekend, treat yourself to our Healthy Breakfast Frittata or Egg Crepes filled with veggies, one of the delicious egg recipes featured in The World's Healthiest Foods Essential Guide.

We suggest choosing organic omega-3-rich eggs if available. Produced by hens fed a diet rich in flaxseed, these eggs are an exceptional source not only of lutein and xeaxanthin, but cardio-protective anti-inflammatory omega-3 essential fatty acids as well.

Combining Cholesterol-Lowering Foods as Effective as Statin Drugs

If you have high cholesterol, chances are your physician has suggested a statin drug to reduce your blood levels of LDL (bad) cholesterol. Statin drugs work by blocking the enzyme HMG-CoA reductase, which is involved in the body's production of cholesterol. Although statins are effective in lowering LDL, they have numerous side effects.

Well-known lesser side effects of statin drugs include nausea, diarrhea, constipation, muscle aches, pains and weakness. In some individuals, statin use causes an increase in liver enzymes, indicating abnormal liver functioning. If the increase is only mild, your doctor will likely tell you to continue taking the drug; if it is too abnormal, you'll be told to stop, which usually reverses the liver problem.

More serious potential side effects include rhabdomyolysis-severe muscle pain accompanied by the destruction of muscle cells. When this occurs, the muscle cells release a protein called myoglobin into the bloodstream. Myoglobin can impair kidney function and lead to kidney failure.

Lesser known side effects include changes in memory, attention, or concentration, irritability and depression, and a higher risk of suicide and accidents.

Perhaps the most important side-effect of statin drugs, which is likely a contributor to many of the above noted side effects, is that all statins deplete the body of CoQ10, a critically important antioxidant enzyme in our cells' energy production process. Our bodies produce CoQ10 using the same biochemical pathway that creates cholesterol, including the enzyme HMG-COA reductase, which statin drugs block.

Since muscle cells, especially heart muscle cells, and brain cells are those that use the most energy, adequate supplies of CoQ10 are essential for health. It's not surprising that statin drugs are accompanied by an increased risk of muscle pain, wasting and heart failure.

Fortunately, a study published in the February 2005 issue of the American Journal of Clinical Nutrition shows that dietary approaches combining cholesterol-lowering foods offers another option to statin drugs.

In this study, 34 patients with high cholesterol underwent three 1-month treatments in random order: a very-low-saturated-fat diet (the control diet), the same diet plus 20 mg lovastatin daily (statin diet), and a diet high in plant sterols, which included soy-protein foods (soy milks and soy burgers), almonds, oats, barley, psyllium, okra and eggplant (portfolio diets).

During each of the three diets, fasting blood samples were taken at weeks 2 and 4.

The results? All 3 diets lowered total cholesterol, which dropped an average of 8.5 on the control diet, 33.3 on the statin diet, and 29.6 on the portfolio diet after 4 weeks. However, the portfolio diet lowered LDL cholesterol as well as the statin diet, and nine study participants (26%) achieved their lowest LDL cholesterol level while on the portfolio diet.

Given the risks-and expense-associated with statin drugs, if you have high cholesterol, ask your doctor about a month's trial to see if a dietary approach combining cholesterol-lowering foods can lower your LDL cholesterol as well as a statin drug.

Flaxseeds Cholesterol-Lowering Effects Comparable to Statins

In a study involving 40 patients with high cholesterol (greater than 240 mg/dL), daily consumption of 20 grams of ground flaxseed was compared to taking a statin drug. After 60 days, significant reductions were seen in total cholesterol, LDL cholesterol, triglycerides and the ratio of total to HDL cholesterol-in both groups. Those receiving flaxseed did just as well as those given statin drugs!

Body mass index, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and the ratio of total cholesterol/HDL-cholesterol were measured at the beginning of the study and after 60 days.

In those eating flaxseed, significant reductions were seen in total cholesterol (-17.2%), LDL-cholesterol (-3.9%), triglycerides (-36.3%) and the ratio of total cholesterol/HDL-cholesterol (-33.5%) were observed in the diet+flax group, compared to baseline.

Similar reductions were seen in those taking the statin. Benefits did not significantly differ between the two groups.

LDL Cholesterol Lowered by a Whole Foods Diet

In a landmark study, the effects of consuming a diet high in vegetables, fruits, soy foods and nuts were compared to either a control diet that was very low in saturated fat and based on milled whole-wheat cereals and low-fat dairy foods or the same diet plus the statin drug, lovastatin. Study participants, a group of 46 adults (25 men and 21 postmenopausal women with high cholesterol whose average age was 59) were randomly assigned to follow one of these three diets for one month. At the end of the month, all three groups showed a decrease in LDL (bad) cholesterol and C-reactive protein (a marker of inflammation that is a risk factor for cardiovascular disease).

In those on the control diet, LDL dropped an average of 8%, and C-reactive protein dropped an average of 10%.

In those on the whole foods diet, LDL dropped an average of 28.6%, and C-reactive protein dropped an average of 28.2%.

In those on the control diet plus lovastatin, LDL dropped an average of 30.9%, and C-reactive protein dropped an average of 33.3%.

No matter your age, education, smoking status or physical activity, the more fruits and vegetables you eat, the lower your blood level of LDL (potentially harmful) cholesterol, suggests research from the National Heart, Lung, and Blood Institute published in the February 2004 issue of the American Journal of Clinical Nutrition. Researchers used data from the Family Heart Study to compare the amount of fruits and vegetables consumed to LDL levels in 4,466 men and women ranging in age from 37 to 66. The higher participants¡¯ intake of fruits and vegetables, the lower their LDL levels. Participants who ate the most produce (4 or more servings a day) had LDL levels about 7% lower than those who ate the least (0 to 1.9 servings daily).

Mediterranean Diet Boosts Antioxidant Levels, Protects LDL Cholesterol

Following a Mediterranean diet has been linked to lower incidence of cardiovascular disease and cancer. A study published in the September 2005 issue of the American Journal of Clinical Nutrition, reveals one reason why: people who enjoy a Mediterranean diet have much higher levels of protective antioxidants.

During 2001-2002, Greek researchers studied a random sample of 1514 men and 1528 women aged 18-89 years. Those most closely adhering to a Mediterranean diet had, on average, 11% higher antioxidant levels than those not following this healthy way of eating.

The beneficial effects of enjoying a Mediterranean diet were directly reflected in study participants' levels of oxidized LDL cholesterol (LDL damaged by free radicals, which contributes to the development of cardiovascular disease). Those most closely following a Mediterranean diet had, on average, 19% less oxidized LDL cholesterol than those whose diets least incorporated the olive oil, fruits and vegetables for which the Mediterranean diet is renowned.

Additional analysis revealed that higher antioxidant levels were directly linked to consumption of olive oil, fruits and vegetables. Consumption of red meat, however, was associated with lower antioxidant capacity.

Mediterranean Diet Lowers Heart Disease Risk More than Low-Fat Diet

In just 3 months, eating a Mediterranean-style diet can reduce risk of heart disease by 15%--almost twice as much cardiovascular risk reduction as that seen on a low-fat diet-shows the Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms (Medi-RIVAGE) study.

Published in the November 2005 issue of the American Journal of Clinical Nutrition, this is the latest in a string of studies to affirm the benefits of this healthy way of eating.

French researchers assigned 212 men and women at moderate risk for heart disease to either a Mediterranean diet or a low-fat diet for 3 months.

Mediterranean diet participants were instructed to base their meals around whole grains, fruits, vegetables, nuts, and olive oil, and to eat fish 4 times a week, but red meat only once a week.

Those on the low-fat diet were told to eat poultry rather than beef, pork and other mammal meats, to eat fish 2-3 times a week, to stay away from animal products high in saturated fat, and to eat fruit, vegetables, low-fat dairy products and vegetable oils.

Among those on the Mediterranean diet, total cholesterol dropped by 7.5% compared to 4.5% in the low-fat diet group.

Overall cardiovascular disease risk fell 15% on the Mediterranean diet compared to 9% on the low-fat diet.

The Medi-RIVAGE study suggests that the healthy fats found in a Mediterranean-style diet-such as the healthy way of eating espoused at the World's Healthiest Foods-not only do not promote heart disease, but lower cardiovascular disease risk.

And these fats-the monounsaturated fats in olive oil, omega 3 fats in fish, and mono- and polyunsaturated fats in nuts-not only lower your risk of heart disease but greatly improve the flavor and taste of your food while also increasing satiety (feeling satisfied after eating, so you are much less likely to eat more than you need)

Olive Oil, Super Food for the Heart

A review of the research by noted olive oil researcher Maria Covas strongly suggests that diets in which olive oil is the main source of fat can be a useful tool against a wide variety of risk factors for cardiovascular disease. (Covas MI, Pharmacology Research)

On November 2004, the Federal Drug Administration (FDA) of the U.S.A permitted a claim on olive oil labels concerning: "the benefits on the risk of coronary heart disease of eating about two tablespoons (23 g) of olive oil daily, due to the monounsaturated fat (MUFA) in olive oil."

But recent studies have shown that olive oil contains much more than MUFA. Olive oil is a functional food that is also rich in antioxidants and phenolic compounds with a variety of protective effects.

The cholesterol of a person whose diet is high in olive oil will primarily contain oleic acid, the fatty acid that predominates in olive oil, and oleic acid is more resistant to free radical or oxidative damage. And not only will the LDL of a person whose dietary fat is primarily olive oil produce LDL that is more resistant to free radical damage, but that individual's LDL will be firther protected by olive oil's supplies of vitamin E and phenols with antioxidant activity, further lessening the likelihood of its being oxidized.

By reducing both inflammation and free radical damage to cholesterol, dietary olive oil protects the endothelium, the lining of our blood vessels, helping to maintain its ability to relax and dilate (thus preventing high blood pressure).

By protecting LDL against oxidation, olive oil short circuits the process through which atherosclerotic plaques form. (Only once oxidized does LDL adhere to the endothelium, attracting immune cells (monocytes) that try to clear it out, turn into foam cells and begin plaque formation.)

The anti-inflammatory effects of a virgin olive oil-rich diet also result in a vascular environment in which platelets are less likely to clump together and form blood clots. Not only do olive oil's antioxidant compounds lessen the inflammation initiated by free radical damage, but olive oil is rich in inhibitors of a compound called platelet activating factor (PAF). PAF begins the clotting process by causing platelets to aggregate and is also involved in the activation of immune cells and their binding to the endothelial wall.

Compared to diets high in saturated fat and low fat, high carbohydrate diets, a number of studies have shown that olive oil-rich diets not only reduce LDL cholesterol levels, but also lower blood sugar levels and decrease insulin requirements in persons with type 2 diabetes.

Practical Tip: Rely on delicious, flavorful virgin olive oil as your first choice for dressing salads. Put a little olive oil and balsamic vinegar on your bread plate and use it to add flavor to crusty whole wheat bread and rolls. Drizzle olive oil over potatoes, beans, grains, steamed vegetables, and soups. You will not only enhance the flavor of your food, but greatly reduce your cardiovascular disease risk.

Olive Oil Cardio-Protective - But Don't Overdo It

It's the Mediterranean version of the French paradox: in the REGICOR Study, conducted in Spain, researchers found a lower incidence of heart attacks despite a high prevalence of risk factors for cardiovascular disease. Olive oil-which accounts for nearly 35% of calories and is the main source of fat in Mediterranean countries-was a likely explanation.

To investigate this, Maria-Isabel Covas, PhD, Head of The Research Group in Oxidative Stress and Nutrition at the Lipids and Cardiovascular Epidemiology Unit, Institute Municipal dìInvestigació Mèdica, Barcelona, Spain, brought together an international team with partners from Denmark, Finland, Germany and Greece to collaborate in the EUROLIVE Project.

In addition to studies on the bioavailability of polyphenols from olive oil in humans, the EUROLIVE Project has conducted 6 clinical trials in which 3 olive oils, similar except for differences in their polyphenol content (low, 2.7 mg/kg; medium, 164 mg/kg; and high, 366 mg/kg), were given to healthy male volunteers in intervention periods of 3 weeks at doses of 25 mL/day.

Results of the EUROLIVE studies have shown that:

The higher the polyphenolic content of the olive oil, the higher the increase in levels of HDL "good" cholesterol. Average increase in HDL was 0.025 mmol/L for low, 0.032 mmol/L for medium, and 0.045 mmol/L for high phenolic olive oil, respectively. (Extra virgin olive oil contains the most polyphenols, followed by virgin olive oil, olive oil and a highly refined olive oil called "pomace.")

Subjects' atherogenic index (their ratio of total cholesterol to HDL cholesterol) and the oxidative (free radical) damage of cholesterol and other lipids decreased as the polyphenolic content of the olive oil increased. (Lipid oxidation--free radical damage to cholesterol and other fats-is considered a high risk factor for coronary heart disease development.

In men from Northern and Central Europe who do not typically eat a Mediterranean diet, daily consumption of 25 mL of olive oil resulted in a 3% decrease in systolic blood pressure.

Consuming 25 mL/day of olive oil, in replacement of other fats, did not cause weight gain.

A moderate amount of olive oil-a 25 mL dose (1.7 tablespoons)-did not promote postprandial (after meals) oxidative stress (free radical damage to cholesterol) whereas a single olive oil dose of 40 mL (2.7 tablespoons) did.

Practical Tip: Olive oil, particularly extra virgin olive oil, provides a number of heart-healthy benefits-increasing HDL "good" cholesterol, improving the ratio of LDL:HDL, and, if you aren't already following a Mediterranean diet, may lower your systolic blood pressure as well. But don't overdo it. Consuming more than a couple of tablespoons at a meal can increase free radical damage of cholesterol.

Pterostilbene, in Cranberries, Blueberries and Grapes, Lowers Cholesterol

Pterostilbene (pronounced TARE-oh-STILL-bean), a powerful antioxidant compound found in grapes, cranberries and blueberries, which is already known to fight cancer, may also help lower cholesterol.

In a study using rat liver cells, scientists at the USDA Agricultural Research Service compared the cholesterol-lowering effects of pterostilbene to those of ciprofibrate, a lipid-lowering drug, and resveratrol, another antioxidant found in grapes with a chemical structure similar to pterostilbene that has been shown to help fight cancer and heart disease.

They based their comparison on each compound's ability to activate PPAR-alpha (short for peroxisome proliferator-activated receptor alpha). The PPARs are a family of receptors on cells all throughout the body that are involved in the absorption of compounds into cells for use in energy production. PPAR-alpha is crucial for the metabolism of lipids, including cholesterol.

Pterostilbene was as effective as ciprofibrate and outperformed resveratrol in activating PPAR-alpha. The take away message: turn up your cholesterol burning machinery by eating more grapes, blueberries and cranberries.

Grape polyphenols lower key factors for coronary heart disease in women

Consuming a drink made from adding just 36 g (1.26 ounces) of a powder made from freeze-dried grapes to a glass of water daily for 4 weeks resulted in a wide variety of cardioprotective effects in 24 pre- and 20 postmenopausal women, shows a study published in the August 2005 issue of the Journal of Nutrition.

  • Blood levels of LDL cholesterol and apolipoproteins B and E dropped significantly. (These apolipoproteins are involved in the binding of LDL and VLDL cholesterol to blood vessel walls, one of the beginning steps in the development of atherosclerosis.)
  • Triglycerides dropped 15 and 6% in pre- and postmenopausal women, respectively.
  • Cholesterol ester transfer protein activity dropped 15%. (Inhibition of this protein has been shown to increase levels of HDL while decreasing LDL levels.)
  • Levels of urinary F(2)-isoprostanes (a marker of free radical damage in the body) dropped significantly as did blood levels of TNF-alpha (tumor necrosis factor-alpha, which plays a major role in the inflammation process).

The rich mixture of phytonutrients found in grapes-which includes flavans, anthocyanins, quercetin, myricetin, kaempferol, as well as resveratrol-is thought to be responsible for these numerous protective effects on cholesterol metabolism, oxidative stress (free radical activity) and inflammation.

Grapefruit lowers cholesterol, heart disease risk

Both blond and red grapefruit can reduce blood levels of LDL (bad) cholesterol, and red grapefruit lowers triglycerides as well, shows a study published in the March 2006 issue of the Journal of Agricultural and Food Chemistry.

Israeli researchers from the Hebrew University in Jerusalem first tested the antioxidant potential of blond and red grapefruits and then their cholesterol-lowering potential in humans. The test tube research showed that red grapefruit contains more bioactive compounds and total polyphenols than blond, but both grapefruits are comparable in their content of fiber, phenolic and ascorbic acids, and the flavonoid, naringinen, although red grapefruit contains slightly more flavonoids and anthocyanins.

When consumed daily by humans, both grapefruits appear to lower LDL cholesterol in just 30 days. Blood cholesterol levels were measured at the outset of the trial period and after 30 days in 57 patients, aged 39-72 years, with high cholesterol. These subjects were randomly divided into three equal groups. Those in the first group added red grapefruit to their daily diet; those in the second group supplemented their diet with blond grapefruit, and the third group, acting as a control, ate no grapefruit.

After 30 days, cholesterol levels in both the red and blonde grapefruit groups had dropped significantly: total cholesterol by 15.5% in those eating red grapefruit and 7.6% in those eating blond grapefruit; LDL cholesterol by 20.3% and 10.7% respectively; and triglycerides by 17.2% and 5.6% respectively. No changes were seen in the control group.

Both red and blond grapefruits both positively influenced cholesterol levels, but red grapefruit was more than twice as effective, especially in lowering triglycerides. In addition, both grapefruits significantly improved blood levels of protective antioxidants. Red grapefruit's better performance may be due to an as yet unknown antioxidant compound or the synergistic effects of its phytonutrients.

Almonds Provide Double-Barreled Protection against Diabetes and Cardiovascular Disease

Lessening after-meal surges in blood sugar helps protect against diabetes and cardiovascular disease, most likely by lessening the increase in cholesterol-damaging free radicals that accompanies large elevations in blood sugar. This is one reason why low- glycemic index diets result in lower risk of diabetes and heart disease.

Almonds appear to not only decrease after-meal rises in blood sugar, but also provide antioxidants to mop up the smaller amounts of free radicals that still result. (Jenkins DJ, Kendall CW, Journal of Nutrition)

Researchers fed 15 healthy subjects 5 meals providing a comparable amount of carbohydrate, fat and protein: 3 test meals (almonds and bread, parboiled rice, and instant mashed potatoes) and 2 bread control meals. Blood samples, taken before each meal and 4 hours afterwards, showed levels of protective antioxidants increased after the almond meal, but decreased after the other meals.

And not only did the almond meal increase antioxidant levels, but unlike the other foods, almonds also lowered the rise in blood sugar and insulin seen after eating.

Practical Tip: So, don't just enjoy almonds as a between-meal snack. Spread a little almond butter on your toast or down the center of a stalk of celery. Add a handful of lightly roasted almonds to your salad or chop and use as a topping for pasta, steamed or healthy sautéed vegetables.

Cranberry Juice Increases Cardio-Protective HDL Cholesterol

Having low blood levels of "good" HDL cholesterol has long been recognized as a factor that increases risk of cardiovascular disease, but something as simple as enjoying a daily 8-ounce glass of low-calorie cranberry juice may significantly increase blood levels of cardioprotective HDL cholesterol, suggests a study published in the British Journal of Nutrition (Ruel G., Omperleau S, et al.)

In this trial, 30 abdominally obese men, averaging 51 years in age, drank increasing amounts (4 ounces, 8 ounces and 12 ounces daily) of low-calorie cranberry juice during three successive 4-week periods.

While no changes in the men's HDL were noted after drinking 4 ounces of cranberry juice each day, a large increase (+8.6%) in circulating levels of HDL was noted after the men drank 8-ounces of cranberry juice daily, an effect that leveled out (+8.1%) during the final 12-ounce phase of the study.

After drinking 8 ounces of cranberry juice daily, the men's triglyceride levels also dropped, while their levels of total and LDL cholesterol remained unchanged, which means that overall, their overall lipid profile significantly improved.

The researchers chose abdominally obese men because, in other research (Farnier M, Garnier P, et al., Int J Clin Pract), abdominal obesity, high triglycerides and being male, have been strongly linked to low HDL and cardiovascular disease.

Abdominal obesity, high triglycerides and low HDL cholesterol are also key symptoms of the metabolic syndrome, a condition which greatly increases one's risk of developing type 2 diabetes. And type 2 diabetes is well known to be a primary risk factor for cardiovascular disease, which remains the leading cause of death not only in the U.S., but throughout the developed world. So, the subjects in this study were men whose health was greatly at risk.

Isn't it wonderful that something as simple, affordable and delicious as a daily 8-ounce glass of cranberry juice offers such potential beneficial impact on our health?

Instead of buying the "low-calorie" cranberry juice, which is usually sweetened with aspartame or comparable chemicals, look for unsweetened cranberry juice concentrate. It will be less expensive and healthier to simply add a little concentrate to a glass of water, then sweeten to taste with honey or stevia.

Garbanzo Beans (Chickpeas) Lower Cholesterol

Including garbanzo beans in the diet significantly lowered both total and LDL "bad" cholesterol, found research published in the Annals of Nutrition and Metabolism (Pittaway JK, Ahuga KD, et al.)

In this study, 47 adults participated in two eating plans of at least 5 weeks duration. Each food plan provided sufficient calories to maintain participants' weight, but one plan was supplemented with garbanzo beans and the other with wheat.

The garbanzo-supplemented diet, which provided slightly less protein and fat, and more carbohydrate than the wheat-supplemented diet, resulted in a significant 3.9% drop in total cholesterol, which was largely due to a 4.6% drop in LDL "bad" cholesterol.

For even more cardio-protection, team garbanzo beans with garlic or turmeric:

National Health and Medical Research Council (NHMRC) Level III-3 evidence shows that consuming a half to one clove of garlic daily may have a cholesterol-lowering effect of up to 9%. For a quick, tasty hummus, just combine pre-cooked garbanzos in the blender with lemon juice, olive oil, garlic and/or onion, salt and pepper to taste.

In other research, when 10 healthy volunteers consumed 500 mg of curcumin per day for 7 days, not only did their blood levels of oxidized cholesterol drop by 33%, but their total cholesterol droped 11.63% , and their HDL "good" cholesterol increased by 29%! (Soni KB, Kuttan R, Indian J Physiol Phartmacol.) Healthy sauté onions with turmeric for 2-3 minutes then add pre-cooked garbanzos and heat until warmed through.

For the most curcumin, be sure to use turmeric rather curry powder-a study analyzing curcumin content in 28 spice products described as turmeric or curry powders found that pure turmeric powder had the highest concentration of curcumin, averaging 3.14% by weight. The curry powder samples, with one exception, contained very small amounts of curcumin. (Tayyem RF, Heath DD, et al. Nutr Cancer)

Practical Tip: Enjoyed regularly, garbanzo beans can help lower LDL "bad" cholesterol. Add garbanzos to tossed salads, enjoy them as a dip or spread in the form of hummus or baba ganoush, or let them take center stage as the main ingredient in a spicy curry.

Increase garbanzos' cardio-protective effects by spicing them with garlic, which also lowers cholesterol, and turmeric, which not only lowers LDL "bad" cholesterol, but also increases HDL "good" cholesterol.

Be sure to use turmeric rather than curry powder; turmeric contains more of the protective compound, curcumin, than does curry powder.

For more information on cholesterol see:


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