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Dietary Research and Cholesterol Levels: Fine-Tuning Eating Habits

The connection between diet and cholesterol levels is well established, but incredibly complicated and intricate. Recent clinical trials have shed some new light on the relationship between healthy eating and cholesterol.

Whole Grains and LDL Levels
In recent years, the relationship between obesity, cholesterol levels and carbohydrate consumption has generated heated debate in the medical community. Some researchers point to the increase in American carbohydrate consumption in recent decades as the reason for the concurrent rise in obesity (the most extreme adherents of this view gave rise to numerous carbohydrate-restricted, high-protein diets). Other researchers admit to a connection between the three, but argue that refined carbohydrates are specifically to blame.

A recent report in the American Journal of Clinical Nutrition suggests that whole grain carbohydrates actually reduce both overall cholesterol levels and LDL (commonly called "bad" cholesterol) levels. The clinical trial examined the whole grain consumption of almost three thousand middle-aged adults. The study included detailed analysis of eating habits and periodic blood tests over a four-year period.

The results indicate that those who eat adequate amounts of whole grain foods, such as bran and high-fiber breads, have lower cholesterol levels than people who consume limited amounts of whole grains. Participants who ate at least nine servings of whole grains a day also had lower Body Mass Indexes (BMI) than those who did not—a low BMI decreases the risks of developing both high cholesterol and heart disease. Furthermore, a high percentage of whole grains in the diet appear to improve the body's ability to use insulin, reducing the chances of insulin resistance and type 2 diabetes.

The results of the clinical trial dispute the theory that a general increase in carbohydrate intake causes obesity and high cholesterol. Whole grains do not promote obesity: in fact, they appear to promote a healthy body weight. The true danger appears to lie in the heavily refined carbohydrates that make up a large percentage of pre-prepared, processed food.

Fish, Veggies and Leptins.
It's not often that a protein beats vegetables in a heart or cholesterol study, but fish came out on top in a recent study published in Circulation: Journal of the American Heart Association. The study examined the diets of two African tribes in Tanzania: one tribe lives inland and eats a primarily vegetarian diet, while the other lives by a lake and eats a diet rich in fish.

The tribe who ate the fish-rich diet displayed lower levels of the hormone leptin. Leptin is produced by fat cells to signal a feeling of fullness after eating. If large amounts of leptin are produced, the body becomes less sensitive to its effects. High levels of leptin have been linked to both obesity and an increased risk of high cholesterol and heart disease.

The study evaluated 279 members of the fish-eating tribe and 329 of the mostly vegetarian tribe. Men in the lakeshore area had average leptin levels of 2.5 ng/ml compared to levels of 11.2 ng/ml amongst the vegetarian men. Fish-eating women had average leptin levels of 5.0 ng/ml (women generally have higher leptin levels that men), compared with 11.8 ng/ml amongst the women eating a vegetarian diet. Daily calorie intake, BMI, age, gender and food consumption were factors included in the study.

Virond Somers of the Mayo Clinic, Rochester, Minnesota, suggests that a fish-rich diet somehow makes the body more sensitive to leptin. A faster reaction to lower amounts of leptin, means fullness will be felt earlier, decreasing the likelihood of overeating.

It should be noted that the results of the study do not determine if lower leptin levels will help prevent obesity when applied to the high-fat, high-carbohydrate American diet. While the American Heart Association recommends at least two servings of fish a week, the majority of the American population does not eat fish regularly.

Trans Fatty Acids, LDL Levels and Food Products
Recent research has suggested that trans fats may increase the risk of heart disease as much as saturated fats. Trans fats are partially hydrogenated fats that are often used in prepared foods, deep fat frying in restaurants and many types of margarine. Trans fat use became popular in the food industry after the link between heart disease and saturated fats was established.

Now, however, mounting evidence indicates that trans fatty acids raise LDL cholesterol, and simultaneously lower HDL ("good") cholesterol. This evidence is sparking a fierce argument between food producers and some health advocacy groups.

The problem is one of public awareness. Although many food producers list the amounts of saturated fats their products contain, few bother to list the amount of trans fat. Often the amount of trans fat in the product is almost equal the amount of saturated fat. The Center for Science in the Public Interest has suggested that information about trans fats be listed on food products as it is for saturated fats, and hopes that the FDA will take steps to make this a reality.

This has angered some food producers, who offer the counter argument that the level of trans fats that can be consumed safely has yet to be determined. Until adequate scientific documentation has been compiled, they argue, any FDA-imposed recommendations for trans fat consumption would be arbitrary at best.

The result is likely to be a sudden upswing in cholesterol clinical trials examining the effects of trans fats on both LDL and HDL cholesterol, with the aim of determining whether trans fats should be considered separately from other forms of fat, and whether consumption of trans fatty acids should be limited to specific daily amounts.

Resources

McCook, A. (2002). Consumer Group: Trans fat silently lurking in foods. Retrieved August 5, 2002, from http://www.nlm.nih.gov/medlineplus/news/fullstory_8717.html.

Rostler, S. (2002). Whole grains can help cut insulin, cholesterol. Retrieved August 5, 2002, from
http://www.nlm.nih.gov/medlineplus/news/fullstory_8707.html.

Winnicki, M., Phillips, B., Accuroso, V., Puato, M., Palatini, P., and Pauletto, P. (2002). Fish-rich tribal diet linked with low leptin levels. Retrieved August 5, 2002, from http://www.americanheart.org/presenter.jhtml?identifier=3003556.

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