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What diet advice do you most often recommend to clients for heart disease prevention?

A. Eating more fruits and vegetables
B. Portion size awareness
C. Consuming less saturated fat
D. Eating more high-fiber foods
E. Other

(Vote here!)

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In the March issue

Preventive nutrition using The Jungle Effect

Preserved foods and canning trends

Big changes: small grocery stores hit the scene

Increasing diversity in dietetics

According to the American Heart Association, cardiovascular diseases are our nation’s No. 1 killer. Since 1963, February has been designated as American Heart Month to urge Americans to join the battle against these diseases. This month’s E-News Exclusive focuses on cholesterol levels, one risk factor for heart disease.

Study Says: Cholesterol Levels Did Not Indicate Cardiac Risk

A new national study has shown that nearly 75% of patients hospitalized for a heart attack had cholesterol levels that would not indicate a high risk for cardiovascular event according to current national cholesterol guidelines. Specifically, these patients had LDL cholesterol levels that met current guidelines, and close to one half had LDL levels classified in the guidelines as optimal (less than 100 milligrams per deciliter).

“Almost 75% of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit,” says Gregg C. Fonarow, MD, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study’s principal investigator.

While the risk of cardiovascular events increases substantially with LDL levels above 40 to 60 milligrams per deciliter, current national cholesterol guidelines consider LDL levels less than 100 to 130 milligrams per deciliter acceptable for many individuals. The guidelines are therefore not effectively identifying the majority of individuals who will develop fatal or nonfatal cardiovascular events, according to the study’s authors.

(FULL STORY)

Researchers Find Convincing Evidence of Probiotics’ Effectiveness

Up to one in five people taking antibiotics stop their therapy due to diarrhea. Physicians could help patients avoid this problem by prescribing probiotics, according to a study by researchers at Albert Einstein College of Medicine of Yeshiva University published in American Family Physician.

Antibiotics target “bad” bacteria but may also kill the “good” bacteria in the large intestine, leading to diarrhea. Diarrhea can also result from bacterial and viral infections. Probiotics have been promoted as restoring the microbial balance disrupted by antibiotics and infections. Probiotic bacterial strains are added to certain yogurts and brands of miso and other fermented foods and are also available as powders and pills sold in health food stores.

The Einstein scientists reviewed the medical literature and found seven high-quality studies in which probiotics were administered. The researchers concluded that the studies support the use of probiotics for avoiding diarrhea resulting from antibiotic use or gastrointestinal viral or bacterial infections. In addition, the probiotics used in these studies were found to rarely cause adverse effects, even in children.

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This month’s selection:
What is the latest research and thinking about turmeric as an anti-
inflammatory postexercise to reduce soreness?

— Andrea, a dietitian from Thousand Oaks, Calif.

Response:
Turmeric, a member of the ginger family of herbs, has been used medicinally for thousands of years to treat a variety of health issues, ranging from improving energy levels to helping liver function. Most interest these days, however, regards the herb’s reported ability to reduce inflammation. One of the compounds in turmeric is a substance called curcumin, which has known anti-inflammatory properties. As such, turmeric and curcumin are sometimes used interchangeability.

Several preliminary studies find that turmeric appears to inhibit the action of the enzyme complex cyclooxygenase, which plays a key role in the generation of hormonelike substances called prostaglandins. Prostaglandins take part in a number of biological reactions, including inflammation. Turmeric also appears to inhibit the production of thromboxane, another by-product of the cyclooxygenase pathway that is a potent stimulator of platelet aggregation. In this manner, turmeric has effects similar to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).

The research on turmeric as an anti-inflammatory supplement, however, is considered preliminary at best. Currently, no head-to-head comparisons of turmeric vs. NSAIDs in humans appear to have been published. One issue worth noting is that turmeric does not appear to be absorbed well when taken orally.

Your question concerned postexercise muscle soreness, or delayed onset muscular soreness, which is muscular pain that’s generally felt 24 to 72 hours after physical activity. While it has not been well researched, one recent study did note that curcumin reduced some of the markers of inflammation in mice that were subjected to downhill running (a known producer of delayed onset muscular soreness). From this, one might infer that turmeric may have merit.

However, some research appears to caution against the use of NSAIDs in athletes because of concerns that they may reduce muscle protein synthesis, which, in theory, might decrease the speed at which muscles recover following exercise. While more research is needed, if turmeric does act as a “natural NSAID,” then the caveats for drugs such as aspirin and ibuprofen may hold true for turmeric as well. That said, for the nonathlete, these effects, if they do exist, would probably be imperceptible to most.

Turmeric is generally well tolerated by healthy adults. Because the herb appears to have a blood-thinning effect, those who take blood thinner medications such as Coumadin and supplements (eg, vitamin E) that act in a similar fashion should exercise caution.

— Joe Cannon, MS, CSCS, NSCA-CPT, is a personal trainer, an exercise physiologist, and a health educator in the Philadelphia suburbs.

Learn about using physical activity to promote cardiovascular health in this month’s issue of Today’s Dietitian. Read the “Today’s CPE” article, take the 10-question online test, and earn two CPEUs!