Cholesterol         According to the American Heart Association, 102.2 million Americans age 20 and older (almost 50 percent of American adults) have elevated blood cholesterol levels, a key risk factor for heart disease. Lifestyle changes such as improving diet, losing weight and increasing exercise are often effective. Various medications, such as the”statin” drugs and niacin, may be used to lower cholesterol, but various supplements may also be helpful as well, lowering low-density lipoprotein (LDL or “bad cholesterol”), sometimes raising high-density lipoprotein (HDL or “good cholesterol”), and improving the LDL/HDL ratio. Some supplements may also reduce triglycerides, which pose additional, although lower, risks.
As I have indicated previously, dietary changes that are useful in controlling cholesterol levels are spelled out in the following posts:
.    http://www.mortontavel.com/2015/12/07/polyunsaturated-fats-support/
After changing one’s diet, however additional measures are often needed, which can be considered before resorting to drugs. Supplement ingredients that have been used to reduce cholesterol include sterols and sterol esters (produced in the normal refinement of vegetable oils, or alternatively as a byproduct of papermaking from the oil of pinewood pulp), stanols and stanol esters (substances closely related to sterols that are derived from the same sources), red yeast rice (a yeast grown on rice), garlic, fish oil, and soy protein. Soluble fiber such as oats in the diet as well as moderate intake of alcohol can also improve cholesterol levels. :
The evidence supporting the various cholesterol-lowering supplements varies. The best evidence is for sterols, stanols and their esters, soy protein and high dose-niacin (sold as a supplement as well as a prescription drug). These are sometimes associated with certain risks, which should be understood. ..
This review will be limited to the stanols and sterols, which constitute groups of agents that are inexpensive and possess a good safety profile. It should be noted, however, that while sterols and stanols can lower cholesterol and likely cardiovascular disease risk, no study thus far has shown a direct risk reduction by this means..

Scientific studies have shown that a dose of 800 mg or more of free sterols per day is required to produce effective reductions in cholesterol, usually around 10%. According to Consumer’s Lab, most of the supplements contain their claimed amounts of sterols other than Pure Encapsulations CholestePure, which. at the dose of one capsule, would provide only 450 mg of free sterols.
• Enzymatic Therapy Cholesterol Shield also includes pantethine, which may cause a modest decrease in total cholesterol, LDL, and triglycerides. In addition, HDL will rise at a dose of 300 mg 3 to 4 times a day
• Source Naturals Cholesterol Rescue includes Sytrinol™ (300 mg per day) which, may also modestly lower cholesterol.
             Phytosterols at Lowest Cost
Comparing the cost to obtain an equivalent amount of free sterols (800 mg), the lowest cost is from Nature Made CholestOff, amounting to 33 cents, while the cost for the same amount of ingredient from other products ranges from about 40 to 60 cents. CholestOff Plus is also supported by a successful clinical trial.

List of Phytosterols: This following presents a compilation of effective products (capsule or tablet form): CholestaCare, Cholesterol Shield, CholestOff, CholestePure, Shaklee Cholesterol Reduction Complex CholestePure, and Source Naturals Cholesterol Rescue.

Butter-like spreads: Plasma total- and LDL-cholesterol concentrations are reduced by margarines enriched with free plant sterols. Results are effective at an intake of 1.5gm or more of plant sterols per day, but they have little apparent effect on HDL-cholesterol or triacylglyceride concentrations. One prime example of this group is Benecol, which is provided in the form of a spread, but it is also produced in a yogurt drink, cream cheese spread, and Dobrogea Benecol Rye Bread. Another spread that has between 0.85 to 1.3 grams of sterol esters per serving is Smart Balance HeartRite Light. Just 2-4 servings of this spread per day also can fulfill your daily recommended dose of phytosterols. In order to consume enough amounts of these spreads, try adding them to such foods as steamed broccoli and oatmeal.

Conclusion: Whether you have cardiovascular disease or are presently normal, consider including the strategies above in your diet, especially make use of the spreads on your bread or in your cooking.




During the past 25 years dietary supplements have rocketed in popularity in the U.S.A., reaching over $25 billion yearly in sales. Contributing to a misguided air of authenticity, they are offered in drugstores, supermarkets, and health-food stores. But what do we actually know about these products in terms of both safety and efficacy? In a  2013 Consumer Reports survey, 55% of respondents thought the government required supplement makers to include warnings about potential dangers and side effects on their products. They don’t, meaning that safety issues are often ignored!

   So let’s run down a list of highly popular supplements, and the pros and cons for each:

Multivitamins: Many people believe they can promote general health and ward off serious conditions such as cardiovascular diseases and cancer. But the facts don’t support these contentions. Clinical trials repeatedly fail to show benefit of multivitamin supplements to healthy people. But even worse, they can, under certain circumstances, be risky: Both vitamin A and calcium can be dangerous if taken in excess, especially when added to a normal diet. Adult males and females should not ingest a daily total of over 3,000 mg. of vitamin A. Total daily calcium intake should not exceed 2,500 mg. So check to see how much you are getting in your regular diet and avoid supplements that cause the totals to exceed these levels.

Vitamin E: Originally touted to prevent cardiovascular disease, later studies have totally debunked this premise. More recently, supplements of vitamin E were suggested in the hope of preventing prostate cancer, but actual study pointed in the opposite direction: This vitamin actually increased prostate-caner risk in men age 50 and older.

B vitamins: Often thought to promote healthy metabolism and energy, the evidence refutes this contention in most circumstances. A normal diet contains an excess of B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (Pyridoxine), B12 (cobalamin), and folic acid. Unless your diet is deficient (see below), then supplementation is a waste of money. Vegetarians, and people (especially the elderly) having difficultly with absorbing B12, may benefit from supplementation of this vitamin. Moreover, women who are or may become pregnant should consider supplementation with folic acid, 0.8 mg daily. The oral form of supplemental folic acid is usually absorbed better than that found naturally in food. One caveat, however, is that high doses of folic acid can mask B12 deficiency that can lead to serious physical problems.

Vitamin K:Believed to promote healthy blood clotting and protein synthesis and prevent cancer. The reality: Leafy greens and other vegetables provide more than enough to satisfy the body’s need for this vitamin. Moreover, the normal bacteria that inhabit the bowel synthesize vitamin K and can make up any possible shortfall. There is no evidence that supplemental doses can prevent cancer. But there is a downside risk: Too much vitamin K can make the anticoagulant (blood thinning) drug warfarin (CoumadinR) less effective, a serious potential danger.

Fish Oil:  This supplement is widely used with the intent to prevent and/or treat cardiovascular diseases. Although the evidence indicates that two or more servings of fish weekly is capable to reducing heart attacks and strokes, linking fish oil supplements to these diseases is less clear. Some evidence suggests that they may help, but the better choice is in the dietary consumption of the fish itself.

Calcium: An important mineral constituent of the body, calcium is often taken with the intent of building healthy bone, thus preventing osteoporosis and fractures. But the evidence does not support such claims. Even with supplemental consumption of over 1,000 milligrams daily, calcium has not been shown to prevent fractures in either premenopausal or postmenopausal women. Among the possible risks of high calcium intake, some studies suggest that it may increase the risk of heart disease.

Vitamin C: For many years high doses of this vitamin have been used for preventing and treating colds, heart disease, and cancer. Despite numerous studies, however, the actual evidence fails on all these counts.  Although generally safe, a possible risk of high doses of supplemental vitamin C can lead to unhealthy buildup of iron in body tissues and organs, posing a risk to the occasional individual suffering from iron storage disease


Vitamin D: This vitamin is important in bone and muscle health, nervous and immune system function, cell growth and reproduction, and moderating inflammation. Although controversial, its administration is alleged to ameliorate certain types of heart disease, hypertension (high blood pressure), diabetes, and possibly multiple sclerosis. Some research suggests it may prevent colon cancer, and—although controversial—other cancers as well. It’s also associated with a reduced rate of depression in older people, and greater immunity against some infections. So far, however, few controlled prospective trials have investigated the potential benefits of vitamin D supplementation in preventing any of these problems.

      Normally we obtain vitamin D through sun exposure and dietary intake. It is manufactured by the body, but the process requires exposure to ultraviolet light. Given the widespread use of sunscreen, however, to prevent skin cancer, up to 36 % of Americans are low on this vitamin. Food sources for this vitamin are limited, although some products such as milk are fortified. Natural sources include fatty fish such as catfish, salmon, mackerel, sardines and tuna; eggs; beef liver; and cod liver oil. Your doctor can perform a blood test to determine whether you are deficient of this vitamin. If you are found to be deficient, instead of risking sun exposure, dietary modification and/or supplemental vitamin D should be considered.  

     The latest US recommendations for the minimum daily requirement of vitamin D, or cholecalciferol—vitamin D3, the preferred formare 600 IU (international units) for those under 70, and 800 IU for those older. These quantities appear to retard bone loss. Persons infrequently exposed to the sun, especially the elderly, and postmenopausal women may need 800–1000 IU daily. From a review of available information, I conclude that people who get at least 700 IU of vitamin D daily and take calcium supplements have denser bones, have better muscle strength, and are likely to suffer fewer falls and fractures than those who don’t. The only caution is to avoid exceeding the government’s safe daily upper limit of 2,000 IU.

Glucosamine/Chondroitin:  This supplement is widely used in the effort to help repair cartilage and relieve suffering from degenerative joint disease (osteoarthritis).  After many conflicting studies, however, a recent, more definite large study showed that glucosamine was unable to relieve knee pain or cartilage loss in people with osteoarthritis. Although generally safe, this product would pose some risk to some people with shellfish allergies.


      Unless there is compelling evidence of efficacy—which is seldom the case—all supplements should be avoided. Three especially egregious products linked to serious dangers are the following: 1)  Kava, which is taken to relieve stress and anxiety, is capable of producing serious liver disease, 2) Yohimbe (yohimbine hydrochroride), used to treat erectile dysfunction, is risky because the impure ingredient present in over-the counter preparations, can cause unpredictable effects on blood pressure, rapid heart rate, and other problems,.and 3) Aconite, touted to relieve inflammation and joint pain, can cause nausea, vomiting, low blood pressure, respiratory system paralysis, heart-rhythm disorders, and even death.

                          IS ANYTHING WORTH TAKING?

    In general, normal diets contain more that enough to preclude the need for supplementation. If one has a demonstrated deficiency of any, then, upon the advice of a physician, supplementation may be justified. As noted above in the case of vitamin B12, folic acid, and Vitamin D, supplementation can be useful.





    Most of us are aware that red meat—when taken in excess—is not a very healthy choice. But what constitutes an excess of this food, and how bad is it? So, let’s take a closer look at these issues:

    First, red meat may shorten your life! In 2012 scientists at the Harvard School of Public Health evaluated results from more than 120,000 subjects in two studies and found that, after a period of 28 years, those who ate the most red meat (two or more servings per day) had a 30% higher risk of dying than those who ate only about 1/2 serving or less per day. They concluded that 8% of deaths in women and almost 10% in men could be prevented if people consumed less than half a serving of red meat per day. In their study, a single serving was roughly 3 oz. of cooked steak, hamburger, and pork chop, but only 1 oz of sausage, ham, or other processed meat, and 1/2 oz. of bacon. These results fell in line with earlier studies involving half a million people. From this I would conclude that you don’t need to stop eating such meat entirely, but curtailing your intake to about once a week can eliminate most of the risk.

   Second, red meat is not “heart or brain healthy.” This means that the arteriosclerotic process resulting from consumption of this meat can lead to heart attacks and strokes, both resulting from closure of arteries supplying blood to the heart and brain. So even if you survive, you may impair the function of your heart or brain, and with it, your life style can go out the window! The reason: Red meat is a major source of saturated fat in the average diet. This latter fat raises bad (LDL) cholesterol levels and contributes to hardening of the arteries (arteriosclerosis). But other compounds in this meat may contribute to these bad effects. These latter substances include nitrite, salt, iron from blood, and also potentially harmful compounds that are created when meats are cooked at high temperatures. Another possible culprit in meat is carnitine, a substance that may, on its own, enhance arteriosclerosis by promoting bacterial growth in the bowel that produces excessive TMAO (trimethylamine-N-exide). This latter substance is capable of producing accelerated heart disease in animals, and higher levels are found in individuals suffering from overt heart disease. These early observations are speculative and require further study for definite conclusions.

   Another threat red meat poses is a greater risk of developing type 2 diabetes, a condition further enhancing the risks of  arteriosclerosis and other bad outcomes.  Several studies have linked processed red meats to an elevated rate of this disorder, and this may also extend to unprocessed red meats as well. One example: Harvard researchers tracked more than 200,000 people for up to 28 years and found that the risk of diabetes increased by 32% for every two ounces of processed meat—and by 12% for every three ounces of unprocessed meat eaten per day. Numerous possible explanations have been advanced explain this relationship, but the meaning is clear for each person’s eating habits. 

    Third, there is a relationship between red meat and cancer. The American Cancer Society has weighed in on this issue with the following statement: “Limit consumption of processed meat and red meat. To reduce your cancer risk, eat no more than 18 oz. per week of red meats such as beef, pork and lamb, and avoid processed meat such as ham, bacon, salami, hot dogs, and sausage.” After careful analysis, they found that the risk of colon and rectal cancer rises by about 20% for every serving red or processed meat consumed daily, with additional suggestive evidence that the risk may extend to other cancers such as pancreas, prostate, or esophagus. How red meat could produce cancers is unknown, but there are two possible pathways: 1) N-nitroso compounds—capable of producing cancers in experimental animals—are created by the nitrites used to color and preserve processed meats like bacon, sausage, and lunch meats. But even unprocessed red meat seems to increase levels of these compounds, possibly through the effect of iron attached to the blood contained in red meat (as opposed to white meat).  2) When meats are cooked to well done at high temperatures, heterocyclic amines and polycyclic aromatic hydrocarbons are formed, and these compounds are carcinogenic, at least in animals. This latter danger can be reduced by cooking to less well done at lower temperatures, a measure that applies to all types of meat—red or white.

     Finally, excessive consumption of red meat is environmentally unfriendly. About two-thirds of corn and soybean production in the U.S.A. goes for animal feed rather than for humans. Since it requires about 5-8 lbs of feed to produce one lb of beef or pork, this inefficiency results in excessive use of water and fossil fuels which in turn jeopardizes our environment at a time when the world can ill-afford this burden.  Moreover, methane, a potent greenhouse gas, is produced by cattle and has 23 times the heat trapping capacity of carbon dioxide. Adding further to this burden, in order to accommodate increasing farmland to feed animals, forests must be cleared, again causing us to lose a valuable means to clear carbon dioxide from our atmosphere.

     So I can simply conclude that those cattle appearing repetitively on TV are passing along the correct advice—”Eat Mor Chikin”! (and Fish, too!)