All about Diet

Mankind fills no container worse than he fills his stomach.

In the past most illness was mostly the result of a lack, such as warmth, food etc. Now it is mostly due to excess and in particular excess of the wrong food or food in general.


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TLC Diet

Although there are several diets that will result in lowered LDL cholesterol, the National Cholesterol Education Program (NCEP) set forth guidelines for medical professionals to follow when instructing patients on a medical nutrition option for lowering cholesterol. Termed the TLC diet or the Therapeutic Lifestyle Changes Diet it emphasizes heart healthy lifestyle choices.

The Therapeutic Lifestyle Changes diet (TLC) is a cholesterol lowering diet that refers to a cholesterol-lowering treatment that lowers a person's low-density lipoprotein (LDL) level and raises their high-density lipoprotein (HDL) level enough to reduce their risk of a heart attack or other chronic disease caused by hardening of the arteries.

The TLC diet follows these dietary guidelines

  • Less than 7% of the day's total calories from saturated fat.
  • 25-35% of the day's total calories from fat.
  • Less than 200 milligrams of dietary cholesterol a day.
  • Limit sodium intake to 2400 milligrams or less per day.
  • Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level.

The NCEP classifies blood cholesterol levels as:

  • Total Cholesterol less than 200 mg/dL, desirable; 200-239 mg/dL borderline-high; 240 mg/dL and above high.
  • HDL Cholesterol less than 40 mg/dL as a major heart disease risk factor; 60 mg/dL and above gives some protection against heart disease.

The three cornerstones of the TLC lifestyle modification diet are:

  • Dietary Changes. Reduction of saturated fat, trans-fat, and cholesterol within the diet. Addition of plant stanols and sterols. Increased consumption of soluble fiber.
  • Weight Management. Weight loss can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels. For those with a large waist measurement (more than 40 inches for men and more than 35 inches for women) it is important to lose weight to decrease the risk for developing heart disease.
  • Physical Activity. Regular physical activity, at least 30 minutes on most, if not all, days is recommended every day of the week. Physical activity can help raise HDL and lower LDL and is important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement

The TLC eating plan is one that advises less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. There should be no more than 25-35% or less of total daily calories coming from total fat intake. A limit of 2400 mg of day of sodium is recommended. The TLC diet recommends weight maintenance and avoidance of weight gain through caloric homeostasis. If LDL cholesterol is not lowered through reduction of saturated fat and cholesterol intakes, then it is suggested that the amount of soluble fiber in the diet be increased.

The TLC Program is adjusted using a set of four categories that are based on ones heart disease risk profile to set LDL goals and treatment steps. For a person who has heart disease or diabetes, they are considered a category I, carrying the highest risk. For persons free of those conditions, their needs are based upon their personal risk of having a heart attack in the next 10-years based upon the Framingham Heart Study. The higher a persons risk category, the more important it is for them to lower their LDL and control any other heart disease risk factors (including smoking and high blood pressure) they have.

Function

The TLC diet is prescribed for people who need to reduce their risk for heart disease. The main goal in treating high cholesterol via the TLC program is to lower a persons LDL level. Research has proven that a lowering of LDL levels can prevent or decrease the risk of heart attacks and reduce deaths from heart disease in both men and women. The TLC program can decelerate, stop, or reverse the buildup of plaque. When followed, it can also lower the cholesterol content in unstable plaques, making them less likely to burst and cause a heart attack. For those who have already experienced a myocardial infraction, the diet can reduce the risk of another heart attack, possibly prolonging life.

Precautions

Along with a qualified physician, making sure that qualified professionals who can assist with safe dietary and lifestyle changes should include registered dietitians, doctors, nurses, psychologists, and exercise physiologists.

Risks

According to the NCEP Guidelines, all adults 20 years of age and older should have their total cholesterol as well as HDL-cholesterol measured every five years.

Positive Risk factors for heart disease:

  • Male greater than 45 years of age
  • Female greater than 55 years of age
  • Female with premature menopause without estrogen replacement
  • Family history of premature coronary heart disease having definite myocardial infarction or sudden death before age 55 in father or other first-degree male relative, or mother before age 65 years of age
  • Currently smoking or history of cigarette smoking
  • Blood pressure greater than 140/90 mmHg or on antihypertensive medications
  • HDL cholesterol less than 35 mg/dl
  • LDL cholesterol greater than 130 mg/dl
  • Diabetes Mellitus

Research and general acceptance

Scores of research articles support a direct relationship between LDL cholesterol levels and the rate of coronary heart disease (CHD) in a person. Within-population studies such as the Framingham and MRFIT studies and between-population studies, most notably the Seven Countries study support this research as well. Studies on familial Hypercholesterolemia, a genetic disorder characterized by high levels of LDL cholesterol, have an exceedingly high rate of premature atherosclerosis. The majority of research from experimental animals, laboratory investigations, epidemiology, and genetic forms of hypercholesterolemia indicate that elevated low-density lipoprotein (LDL) cholesterol is a major cause of CHD. In addition, clinical trials demonstrate a reduction of coronary heart disease risk when low-density lipoprotein-lowering therapy is instituted. For these reasons, the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood cholesterol in Adults (Adult Treatment Panel III) continues to identify elevated low-density lipoprotein cholesterol as the primary target of cholesterol-lowering therapy.

 

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