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Dr. Jim Painter PhD, RD University of Texas ?Houston, School of Public Health

@DrJimPainter

Outline

Heart Healthy Portfolio diet 1. Plant sterols 2. Soluble fiber 3. Soy 4. Nuts Additional Supplements 5. Garlic 6. Chocolate Supplements for Type 2 Diabetes 7. Berberine 8. Cinnamon

1. Stanol/Sterol Esters

(Sterols) (Stanols) Stanol/Sterol esters work by increasing cholesterol

output into the bile and by transferring cholesterol back into the intestinal track.

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Plat & Mensink, 2002; FASEB J 16:1248-1253

Products

Recommendations

? Usual dose is 800 mg ? 6.0 grams/d ? Divided equally and given before meals ? Doses above 2.0 g/day do not appear to add additional benefits.

Nies, 2006. Complimentary and Alternative Therapies for the Management of Dyslipidemias

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2. Soluble (Viscous) Fiber

Effects: Reduces total and LDL cholesterol Reduces CHD risk

Psyllium or Oat Bran and LDL Cholesterol in Normal and Hypercholesterolemic Men

66 participants (normal= 36, hypercholesterolemic=30) consumed 0.6g, 1.7g, or 2.8g soluble fiber from wheat bran, psyllium, or oat bran respectively

8 wk controlled clinical trial

Romero,AL, Romero,JE, Galaviz, S et al. (1998). Cookies Enriched with Psyllium or Oat Bran Lower Plasma LDL Cholesterol in Normal and Hypercholesterolemic Men from Northern Mexico . Journal of the American College of Nutrition, 17, (6)601-608.

Changes between baseline and 8 weeks in plasma triglyceride hypercholesterolemic (cholesterol>220mg/dL) subjects

60

50

40

Control

30

Psyllium

Oat bran 20

10

0 Baseline

8 Weeks

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Changes between baseline and 8 weeks in LDL

cholesterol of hypercholesterolemic

(cholesterol>220mg/dL) subjects

160

140

120

100

Control

80

Psyllium

60

Oat bran

40

20

0 Baseline2

8 Weeks

Wei et al., 2009, Euro J Clin Nutr, 63: 821-827.

Mechanism: Soluble Fiber

LDL

Receptor LIVER

Hepatic Portal Vein

Bile Salt Psyllium

Bile Duct

Duodenum

Ileum

Anderson, et al., Am. J. Clin. Nutr. 71:472, 2000

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Sources: Fiber

oatmeal, cooked peas kidney beans potato, baked with skin whole wheat bread bran flake cereal

spinach certain fruits

apples bananas oranges pears psyllium (grain found in some cereal products)

3. Soy/ legumes

Low in saturated fat

Contains protein and other compounds that help lower blood cholesterol

Effect = reduced risk of heart disease

Reduction of Total Cholesterol by Soy

Initial Cholesterol (mg/dl)

>335 259-332 201-255 127-198

0

20

40

60

Average Total Cholesterol Reduction

(mg/dl)

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