Cholesterol: the good, the bad and the ugly

There’s been much talk of cholesterol in recent years with regards to different types, where it comes from and what are the best ways of lowering it? Conflicting information has left most of us a little confused in knowing what we should be doing in order to address this common health concern.

Cholesterol is an integral component of every cell and plays a vital role in hormone production, digestion and brain & nerve function. It travels through the blood stream attached to carrier proteins called lipoproteins. LDLs (low density lipoproteins) are the major carriers of cholesterol and as they encourage cholesterol deposits in the arteries, they are known as “bad cholesterol”. HDLs (high density lipoproteins) carry unneeded cholesterol from the cells back to the liver to be broken down for elimination and this is known as “good cholesterol”[1].

Confusion about cholesterol exists because many people don't understand there is a difference between blood cholesterol and dietary cholesterol. Blood cholesterol is the cholesterol that circulates in your blood. About 80 per cent is produced by your liver. Dietary cholesterol is found in foods from animal sources such as meat, fish, poultry, eggs and dairy products. Only about 20 per cent of the cholesterol in your blood comes from eating foods that contain it.

A high blood cholesterol level, especially high LDL, is a major risk factor of heart disease. If you have high blood cholesterol or have a history of heart disease in your family, reducing your cholesterol to a healthy level is important for long-term good health.

What causes high cholesterol levels?

Dietary cholesterol is often blamed for high cholesterol levels, but for most people, cholesterol from foods has little effect on blood cholesterol levels. Other contributing factors to consider are:

• Genetics: influences how fast LDL is made and removed from the blood.
• Weight: excess weight may increase LDL levels. Weight loss especially helps to lower LDL & triglycerides and raise HDL levels. If you have tried to lose weight in the past with no success, you may have an underlying hormonal imbalance that needs to be addressed.
• Exercise: regular physical activity may lower triglycerides and raise HDL.
• Age & gender: before menopause, women usually have lower total cholesterol levels than men of the same age. This reverses after about age 50.
• Alcohol use: moderate (1-2 drinks daily) alcohol intake increases HDL cholesterol but does not lower LDL cholesterol. Drinking too much alcohol can damage the liver and heart muscle, may contribute to high blood pressure and raise triglyceride levels.
• Stress: stress can raise blood cholesterol levels over the long term. One way it may do this is by affecting your habits. For example, when some people are under stress, they console themselves by eating sweet and fatty foods or by having a comforting bottle of red.
• Insulin resistance: seen in conditions such as PCOS and diabetes is closely linked to high cholesterol levels, weight gain and obesity.

Treatment strategies

Statin drugs have been the drug of choice to treat elevated cholesterol levels but these potent drugs have serious side effects that need to be taken into consideration. Statins have a demonstrated ability to lower Coenzyme Q10 (CoQ10), which leads to fatigue, muscle weakness, soreness and cardiac weakness. When you treat high cholesterol with a drug you are in no way, shape or form treating the cause and it should come as no surprise that artificial drugs can cause serious side effects.

Following are some natural strategies to implement:

Dietary control: dairy products, meat and eggs all contain cholesterol but avoiding these foods could prevent you from getting some important nutrients such as calcium, protein, iron, zinc or B vitamins. Choose lower-fat dairy products such as buttermilk or skim milk. Enjoy fish more often, choose lean cuts of meat, have poultry without skin and limit serving sizes to about the size of your palm.

Normalize insulin levels: by eliminating sugar and processed grains, which will also normalize weight, increase your energy and lower blood pressure and triglycerides.

Increase fiber: helps eliminate excess cholesterol - include whole grain breads and cereals, fruits & vegetables and include more meat alternatives such as beans, peas, lentils andtofu.

Reduce saturated and trans fats: found in meat, egg yolks, dairy products made from whole milk and foods that contain hydrogenated fat, including palm or coconut oils, margarine, fries, doughnuts, fried chicken and fish, crackers, chips, cookies and bakery products.

Increase cholesterol lowering fats: monounsaturated fats are found mostly in canola, olive and peanut oils, nuts (especially almonds and walnuts) and seeds. Polyunsaturated fats are found in oils made from sunflowers, safflowers, corn, soybeans, nuts, flaxseed and sesame seeds. Good quality fish oil can also help regulate cholesterol levels

Policosanol: a supplement containing sugar cane wax has been found to significantly lower cholesterol.

Chromium: lowers total cholesterol, improves HDL to LDL ratio, and stabilizes blood sugar levels to reduce cravings & mood swings.

Reduce caffeine intake: coffee can elevate blood cholesterol levels, more than doubling the risk of heart disease[2] and puts undue strain on the adrenal system.

Exercise regularly

The bottom line is you need to take charge of your cholesterol, no one can do it for you. The answer is not as simple as “popping a pill”, synthetic, natural or otherwise; diet & lifestyle changes are your first lines of defense – so what are you waiting for!

Emma Scasni is a qualified naturopath at MassAttack Health Clinic and has a keen interest in women’s health. Emma is passionate about all aspects of natural health and is happy to offer support and advice to new and existing MassAttack members. MassAttack specializes in natural treatment programs for women with hormonal imbalances such as PCOS, Fibroids, Endometriosis & thyroid imbalance. Narelle Stegehuis, CEO of MassAttack, is the recipient of the Australian Naturopathic Excellence Award 2006 and can be contacted at narelle@massattack.com.au

Feeling tired and sluggish?

Our lives are so hectic these days that it really is difficult to find harmonious balance in our daily living. Commitments are many and varied and it seems more often than not, work and family get more of our time than we do. With not nearly enough time in the day to get everything done, we push ourselves to do a million and one things and in the mean time, rarely spare a thought for our own needs. It’s not hard to understand why imbalances occur and the thyroid gland is a main area that is often affected. Weight gain and lethargy are common symptoms of an underactive thyroid but this can just be the tip of the iceberg.

The thyroid gland is a major endocrine gland in the body and is located in the neck, around the same area as the Adams apple. It is a major regulatory gland and is responsible for metabolism, energy and heat production and also communicates with other major hormonal systems in the body. The thyroid, reproductive and nervous systems are closely linked and it is estimated that approximately 10% of the population have a thyroid imbalance diagnosed by abnormal blood test results[1].

Common symptoms seen with an underactive thyroid can include:

• Stubborn weight gain
• Slow metabolic rate
• Continuous fatigue
• Muscle cramps & tremble
• Cold intolerance
• Dry skin
• Hair loss
• Depression
• Mental slowness
• Menstrual irregularities
• Infertility and miscarriage
• Low blood pressure
• Constipation

Medical causes of hypothyroidism include surgery and radioactive iodine treatment. The lesser known contributing factors of poor thyroid function are closely related to an overstimulated immune system (Hashimoto’s thyroiditis), compromised adrenal function (which also features heavily with weight gain, insulin resistance and nutritional deficiencies) and the effects of stress within the body, called oxidative stress. This initiates the production of free radicals, which has the potential to damage thyroid tissue. As the thyroid tries to compensate for this damaged tissue, it can become inflamed and a goitre may develop. Post partum hypothyroidism is yet another contributing factor, which may be brought on by an immune disorder, traumatic birth or excessive blood loss during labour.

Nutritional deficiencies also contribute to poor thyroid function. Selenium, along with zinc, are necessary to activate thyroid hormone and also important to control oxidative stress. Due to poor farming practices, our soil has become selenium deficient, which affects the level of this mineral in our food[2]. Iodine is the central component of thyroid hormone and a deficiency of this mineral is one of the leading causes of hypothyroidism world wide[3]. Reasons for this are believed to be due to reduced use of iodised salt in food manufacture and from the replacement of iodine containing sanitisers for chlorine based chemicals in the dairy industry[4].

So what can be done to treat an underactive thyroid? A blood test for thyroid function may be necessary to identify the level of imbalance of TSH, T3 and T4 and if autoimmunity is present. This will show up as a positive thyroid antibody reading. Thyroid hormone replacement is a common first line of defence but often exacerbates stubborn weight gain regardless of the amount of exercise undertaken or how healthy one’s diet is. Weight will often increase from eating less and doing more! Even if your levels come back “within normal range” your thyroid may still need support.

Naturally, other factors to consider are:

• Stress reduction: hit the gym, try some deep breathing exercises or join a yoga class. Not only will this support your thyroid, it will also help with weight loss, oxygenation and elimination of toxins
• Reduce oxidative damage: stop smoking, moderate your alcohol intake, eliminate trans and saturated fats from your diet, include moderate exercise
• Herbal treatment: herbs such as Withania, Bladderwrack, Bacopa and Coleus can all be effective in supporting thyroid function
• Avoid yo-yo dieting: this will further slow your metabolism contributing to weight gain. Make sure you eat small but regular meals throughout the day, concentrating on good sources of protein
• Limit goitrogens: these are foods that can interfere with thyroid hormone production and include broccoli, cauliflower, spinach, cabbage, brussel sprouts and soy products. Limit but DON’T eliminate
• Antioxidants: include goji berries, dark skinned berries, fresh fruit and vegetables
  Warming herbs: such as ginger and chilli help the body burn energy for heat production and increases the metabolic rate. Add these to your cooking or grate fresh ginger and drink as a tea
• Selenium: found in foods such as brazil nuts, vegetables, wholegrains, meat and seafood. Selenium is toxic in high doses so if using a supplement, do not exceed a daily dose above 100mcg
• Iodine: good sources include sea salt and seaweed

With thyroid function having a strong link in many areas of general health and well-being, it is important that this area that receives sufficient support and nourishment.

Emma Scasni is a qualified naturopath at MassAttack Health Clinic and has a keen interest in women’s health. Emma is passionate about all aspects of natural health and is happy to offer support and advice to new and existing MassAttack members. MassAttack specializes in natural treatment programs for women with hormonal imbalances such as PCOS, Fibroids, Endometriosis & thyroid imbalance. Narelle Stegehuis, CEO of MassAttack, is the recipient of the Australian Naturopathic Excellence Award 2006 and can be contacted at narelle@massattack.com.au

[1] Thyroid Disorders & Infertility Seminar notes, Metagenics 2008, pg 4
[2] http://www.usyd.edu.au/su/agric/acpa/people/budi/selenium.htm
[3] Thyroid Disorders & Infertility Seminar notes, Metagenics 2008, pg 5
[4] Thyroid Disorders & Infertility Seminar notes, Metagenics 2008, pg 6

The trouble with PMS…

At one stage or another, the majority of us will have experienced some form of PMS during our menstruating years. Cramps seemed to be the common symptom during high school days and whether this conveniently happened just before our P.E. class or not, it was usually severe enough to dread the oncoming months of pain our period would bring. Later on down the track, emotional turmoil may have ensued and the fluid retention and weight gain some experienced could rival the Michelin man. Most women put up with PMS as’ just a part of life’ but there is quite a lot that can be done to reduce the severity of this all too common condition.

PMS relates to a plethora of physical and psychological disturbances that occur during the first half of the cycle, known as the luteal phase. The timing of these disturbances is important in diagnosing PMS. They must be absent in the first week after menstruation and before ovulation, and the onset of the period must result in a reduction in the severity of symptoms[1]. If symptoms last outside of this pattern, other causes may need to be investigated.

The symptoms related to PMS are many and varied and can occur with varying degrees of severity. For some, PMS can go by with very little bother but for others, the severity of symptoms can be so severe that they have a negative impact on work and personal relationships. For ease of grouping and listing these symptoms, there are 5 separate categories that we can look at in terms of symptomatology. These categories are not fixed and overlapping often occurs.

PMS A (anxiety) PMS C (cravings)

anxiety dizziness or fainting
nervous tension headache
mood swings fatigue
irritability palpitations

PMS D (depression) PMS H (hyperhydration)

depression fluid retention
forgetfulness weight gain
crying swelling of extremities
confusion breast tenderness and swelling
insomnia abdominal bloatin

PMS P (pain)

aches & pains
lowered pain tolerance[2]

The exact cause of PMS is not completely understood but it is believed to be influenced by hormonal imbalances, neurotransmitter abnormalities, nutritional deficiencies and/or poor diet and lifestyle[3].

Hormonal influences:

Oestrogen/progesterone ratio imbalance: both hormones are required to regulate the cycle and when this balance is tipped, oestrogen can dominate the environment. This may bring about mental and emotional changes commonly seen in PMS such as feelings of irritability, aggressiveness and anxiety. Heavy and prolonged bleeding may also feature. An oestrogen dominant environment can predispose conditions such as endometriosis, fibroids and cysts, which can then go on to contribute to unnecessary weight gain.

Progesterone deficit: Progesterone levels themselves may be sufficient but there may be problems with signalling this hormone into the cell. This could be due to faulty cells or from an increase in stress hormones, which block receptors and make them unavailable to progesterone. Progesterone receptors are found throughout the body including the brain, respiratory tract, uterus, skin, eyes and breasts and these are all common areas affected by PMS[4].

Adrenal hormones: Not only can stress hormones interfere with receptor responsiveness, they can also interfere with the overall communication between other major hormonal systems. The adrenal gland secretes a hormone responsible for maintaining fluid balance. Stress can increase the production of this hormone which can contribute to fluid retention[5]. Long term stress can also deplete the body of important nutrients and can cause unwanted weight gain.

Neurotransmitters

Both oestrogen and progesterone interact with the neurotransmitters serotonin, noradrenalin and dopamine. Fluctuations in any of these neurotransmitters can contribute to feelings of anxiety, difficulty concentrating, depression, irritability and mood swings. Blood sugar levels can also be affected resulting in increased appetite and sugar cravings.

Dietary imbalances

May be caused by the following factors

• high carbohydrate to protein ratio
• high dairy intake
• caffeine
• alcohol
• high sugar intake
• high animal and saturated fat intake
• prolonged stres

With so many possible contributing factors, where on earth does one start with the whole treatment process? This is where a number of different approaches may be of benefit to cover as many relevant factors as possible. Each treatment plan needs to reflect the needs of the individual and target the main presenting symptoms. This can be done in a number of ways.

• Herbs: there are a wide range of herbs to address the many PMS related symptoms such as fluid retention, sugar cravings, irritability, fluid retention, cramping and heavy bleeding
• B Group Vitamins: nourishes the nervous system and assists with liver clearance of oestrogens, dampening the oestrogen rich environment in PMS, fibroids, cysts and endometriosis
• Magnesium: nourishes the nervous system, may assist with correct fluid balance, regulates blood sugar levels to reduce cravings and excessive hunger, relaxes muscles that may be affecting cramps and headaches
• Bitter foods: to aid liver clearance of oestrogens. Include foods such as endive, chicory, silverbeet, radicchio, outer leaves of cos lettuce, dandelion root, and grapefruit
• Exercise: crucial for oxygen transport which may relieve cramps, will assist with liver clearance of hormones, fantastic way to lower stress levels and increase endorphins to help stabilise moods & emotions
• Stress reduction: yoga, meditation, massage and counselling are all useful tools to help relieve the pressures of daily life
• Dietary modification:
  

# increase protein, especially fish rather than dairy and red meat
# decrease poor quality carbohydrates
# reduce or avoid caffeine and alcohol
# reduce sugar intake and avoid excess fruit and juices
# avoid salt: watch for hidden salt in processed foods
# increase vegetable intake
# eat small, frequent meals to balance blood sugar levels
# increase fibre to assist with bowel clearance

It seems likely that the interaction between ovarian hormones, stress hormones, neurotransmitters, nutrient deficiencies, poor diet and lack of exercise are all factors that need to be considered when focusing on the potential causes, and treatment, of PMS. The important thing may not be to rely solely on treating just one area of imbalance as more often than not, an imbalance in one area will soon spread to another. Taking a holistic approach to treating PMS may well be the only way to achieve long term results. Your MassAttack program will assist in identifying these imbalances and will initiate a treatment plan that will help you remember PMS as a thing of the past.

Emma Scasni is a qualified naturopath at MassAttack Health Clinic and has a keen interest in women’s health. Emma is passionate about all aspects of natural health and is happy to offer support and advice to new and existing MassAttack members. MassAttack specializes in natural treatment programs for women with hormonal imbalances such as PCOS, Fibroids, Endometriosis & thyroid imbalance. Narelle Stegehuis, CEO of MassAttack, is the recipient of the Australian Naturopathic Excellence Award 2006 and can be contacted at narelle@massattack.com.au

[1] Ruth Trickey, (2003) “Women, Hormones & the Menstrual Cycle”, Allen & Unwin NSW, pg 115-116
[2] Suzie O’Donohue, Gynaecology: Approaches to Treatment with Natural Therapies, SSNT, 2003 pg 42
[3] Ruth Trickey, (2003) “Women, Hormones & the Menstrual Cycle”, Allen & Unwin NSW, pg 116
[4] Ruth Trickey, (2003) “Women, Hormones & the Menstrual Cycle”, Allen & Unwin NSW, pg 118
[5] Ibid

Maybe just one more?

It happens to the best of us. We’ve just worked a monster day, barely having time to stop for lunch and the end of the day just won’t arrive quickly enough. When we finally get home, we kick off the heels and open a bottle of red. “I’ll just have one glass” we mutter. But then no dinner cooking experience is complete without a glass of wine so we pour another. Dinner without wine just wouldn’t seem right so another is poured and before we know it, the bottle is empty. This is an all too common occurrence and even if you aren’t polishing off a bottle a night, do you really know the effect alcohol is having on your system?

Alcohol has been consumed by humans since pre-historic times[1] and is commonly used for a number of different hygienic, dietary, medicinal, religious, and recreational reasons. Ethanol, commonly known as alcohol, is a psychoactive drug that acts primarily upon the central nervous system altering brain function. The result of this promotes temporary changes in perception, mood, consciousness and behaviour. This is probably why most of us enjoy it so much. It provides a release from the day to day things we get caught up in and allows us to escape for a short space of time.

Recent studies suggest that drinking in moderation can have a range of positive health benefits such as a lower risk of heart attack[2], lower risk of diabetes[3], lower risk of Alzheimer's disease[4], reduced risk of stroke[5] and an increase in overall longevity[6]. The key to the benefits of alcohol is moderation. All of the above reported benefits have the potential to be reversed with excessive alcohol consumption. But does anyone really know what’s classified as moderate? US dietary guidelines defines moderate drinking as no more than 1 drink per day for women and no more than 2 drinks per day for men. And for all you clever thinkers, this does not mean that if you haven’t had a drink for 4 days that you can safely have 4 in one night.

It’s important to remember the role of the liver when it comes to alcohol consumption. A healthy liver should be able to process moderate amounts of alcohol with very little fuss. But when the liver is compromised (due to excessive alcohol, poor diet, stress, medications/drugs), it only makes sense that its capacity to function will also be compromised. Poor liver function can affect our health in a number of ways including hormonal imbalances, impaired digestive function, emotional disturbances and reduced energy levels. Sound familiar?

In order to maintain hormonal balance, the liver must process our hormones to be converted into other substances or, if no longer needed in the body, prepared for elimination. Speaking specifically of oestrogen, if the liver is not functioning at full speed, it can re-enter the circulation and cause an oestrogen dominant environment. This is where things like weight gain, fibroids, endometriosis, PMS, fluid retention, low libido, infertility and breast and uterine cancers can develop. Looking at this list, is that extra glass of red really that necessary?

Drinking has long been associated with weight gain and it is the effect alcohol has on blood sugar levels that is a major concern. Alcohol does not supply any essential nutrients and our body uses the calories alcohol provides as energy. In small amounts this is fine but what is not immediately used for energy production will be stored as fat. If you haven't eaten for a while, your body uses its liver stores of glucose for energy. When these stores are used up, the liver makes glucose from other sources. However, alcohol inhibits the liver from making glucose, so if you haven't eaten, you run the risk of low blood glucose (hypoglycemia). In fact, the glucose-lowering action of alcohol can last 8 to 12 hours after you had your last drink[7]. When our blood sugar levels get too low, we start craving carbs and sweet things to boost those levels back up. So begins the vicious cycle of snacking on the wrong foods, which further alters blood sugar regulation and contributes to weight gain.

Dietary factors need to be taken into consideration when looking at the effect of alcohol. Alcohol inhibits the breakdown of nutrients into beneficial molecules by reducing the secretion of digestive enzymes from the pancreas. It impairs nutrient absorption by damaging the cells lining the stomach and intestines and disabling transport of some nutrients into the blood. All that hard work we put into making sure we eat the right foods is suddenly coming undone.

While it may not be possible to remove all toxic substances from our diet and environment, making a conscious effort to limit alcohol consumption is a great start. Set a goal and stick to it. It might be to not have more than 2 drinks a week or better still, plan to have an alcohol free month. The difference in how you feel and how your body functions will be amazing. Seriously, when was the last time you went that long without a drink? Feel empowered by proving that you can do it and reward your self with a massage once you have made it through the month. Because, you deserve it.

[1] http://e85.whipnet.net/ethanol.history/index.html
[2] http://www.aheartylife.com/
[3] http://www.ncbi.nlm.nih.gov/pubmed/15161790?dopt=Abstract
[4] http://www.serials.cib.unibo.it/
[5] http://stroke.ahajournals.org/
[6] http://ije.oxfordjournals.org/cgi/content/full/34/1/199
[7] http://www.abbottdiabetescare.com/