0:04

Hello,

0:04

and welcome to the nutrition dealer

0:07

podcast This is Monica Rheinigle.

0:09

And this week, we're going to take look at handful

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of non prescription supplements that claim

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to reduce your cholesterol levels. Are

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any of these effective enough to perhaps

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replace prescription medications? Or

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could they possibly be used in combination

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with one another? But before

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we dig into all that, nutrition divided

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listener Ramsey asked me to clarify

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the difference between fermented and

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cultured foods, what exactly

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is the difference between them?

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And do they have the same benefits?

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Well, this

0:41

is kind of a tricky answer, Ramsey,

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because cultured and fermented foods

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is a very broad category. It

0:47

encompasses everything from yogurt to

0:50

kimchi, to beer, wine,

0:52

and cheese. Culture

0:54

foods are a subcategory of

0:57

fermented foods, in which a culture

0:59

of bacteria and or yeast

1:01

is used to jumpstart that

1:03

fermentation process and also

1:05

to provide just a bit more control over

1:08

which microbes are dominant. Yogurt,

1:12

kaffir, kombucha, and

1:14

vinegar are all examples of

1:16

fermented foods that are made by adding

1:18

microbial cultures to fresh

1:20

foods. Now, another option

1:22

is wild fermentation and that

1:25

relies on microbes that are naturally

1:27

present in or on the

1:29

foods themselves or even just floating

1:31

around in the air.

1:33

sour dough, traditional

1:34

sauerkraut, kimchi, and

1:37

pickled vegetables are all examples

1:39

of wild fermentation. if

1:42

you've ever had a little dish of

1:44

fruit salad or coleslaw get

1:46

fizzy in the fridge when you kept it

1:48

for too long, well, and you've experienced some

1:50

wild fermentation in your own kitchen.

1:54

Cheese is an especially confusing category.

1:57

Some cheeses like blue cheese

1:59

and

1:59

cheddar cheese are cultured with

2:02

various strains of bacteria

2:03

and they're fermented, but others

2:06

such as ricotta or paneer

2:08

cheese are not fermented. They're

2:10

simply curdled with some sort of

2:12

acid. Cottage

2:13

cheese is traditionally made by

2:15

curdling and not culturing However,

2:18

some brands of cottage cheese now have

2:20

probiotic bacteria added to

2:23

them, and these are usually labeled

2:25

as containing live and active cultures.

2:26

It's

2:28

really difficult to make

2:31

blanket statements that apply to

2:33

all fermented and cultured foods.

2:36

Labeling conventions such as whether

2:38

or not they say live and active cultures

2:40

are somewhat inconsistent not

2:43

all back bacteria that are involved in

2:45

fermentation are considered to be probiotic

2:48

bacteria. That designation is

2:50

reserved for bacteria that have been shown

2:52

to have specific beneficial effects

2:54

in the body. And then we also use

2:56

that same term to talk about foods that contain

2:59

those bacteria. and even for

3:01

foods that are considered to be probiotic

3:03

foods, the specific benefits

3:06

are going to depend on the nutritional aspects

3:08

of the food that is being fermented,

3:11

as well as which yeast and bacteria are

3:13

involved in that fermentation. So

3:16

for example, yogurt is

3:18

going to provide protein and calcium

3:21

from the milk in addition to

3:23

probiotic bacteria. fermented

3:25

cabbage on the other hand will contain

3:27

vitamin c, k, folate,

3:30

and other nutrients that are found in the cabbage.

3:33

And of course, some foods also contain

3:35

elements that we may be trying to limit

3:37

in our diets, such as the alcohol

3:39

in wine and beer, or

3:41

the saturated fat in cheese

3:44

or the sodium in sauerkraut or

3:46

kimchi. So if you're trying

3:48

to maximize your gut health and your

3:50

overall nutrition, My best advice

3:52

is to try to incorporate a variety

3:55

of different cultured and fermented foods

3:57

into your diet and just be mindful

3:59

of any specific aspects such

4:01

as sodium or alcohol that

4:03

you may wish to limit. And

4:06

now let's talk about cholesterol

4:08

lowering supplements. I recently got

4:10

an email about this from Debbie who

4:12

wrote, I consider myself very

4:15

healthy and fit, but my cholesterol

4:17

keeps going up every year and it's

4:19

now high enough that I can

4:21

no longer ignore it.

4:23

At seventy one, Debbie isn't

4:26

on any prescription

4:26

drugs Go Debbie, and

4:29

she really didn't want to start taking

4:30

a cholesterol lowering medication. So

4:33

she started looking around online and

4:35

she found three nutritional supplements

4:37

that all claimed to lower cholesterol,

4:39

but each one of them featured a different

4:42

active ingredient. One of them had cocoa

4:44

flavonols Another contained

4:46

phytospirals, and the third

4:49

was an extract from red yeast

4:51

rice. Is there any

4:53

research as to which of these is the most

4:55

effective that we ask me, since

4:57

they're all different

4:58

ingredients, maybe I should take

5:00

more than one.

5:07

Red

5:09

yeast rice extract is a traditional

5:11

Chinese medicine. It's made by fermenting

5:13

a certain variety of rice

5:16

with a specific strain of yeast.

5:18

and some studies indicate that its cholesterol

5:21

lowering effects are comparable

5:23

to that of statin drugs. Those are the

5:25

most commonly prescribed cholesterol

5:27

lowering medications. And there's

5:29

a good reason for that. Red

5:31

Rice East extract contains

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a naturally occurring compound called

5:35

monocolin k. which is

5:38

chemically identical to a prescription

5:40

cholesterol lowering medication known as

5:42

lobastatin. Unlike a

5:44

prescription medication, however, The

5:46

potency of red yeast rice

5:48

extract supplements may vary,

5:51

which obviously creates some concerns

5:53

about dosing and safety. In

5:55

fact, the FDA has attempted to

5:57

block the sale of ready rice

5:59

extracts in the U. S. but it hasn't

6:01

entirely succeeded at removing them

6:03

from the marketplace. especially the

6:06

online marketplace. But

6:08

look, if your goal is

6:10

to stay off statin medications, then

6:13

I think a red yeast rice extract

6:15

isn't a very good solution because it's essentially

6:17

the same thing. And if

6:19

a statin drug does turn out to be

6:21

necessary in your case, I really

6:23

think you'd be better off with a prescription

6:26

version of the drug because that's going

6:28

to be better regulated in terms of its

6:30

potency better monitored in

6:32

terms of possible adverse effects

6:34

or side effects, and also

6:36

more likely to be covered by your insurance.

6:39

But what about those

6:40

other two supplements? COCOVIA

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CardioHealth is

6:44

a heart health supplement that contains cocolaflavanals.

6:47

Now you could get cocoa flavonols from

6:49

eating chocolate, of course, but

6:51

you wouldn't get quite as concentrated a

6:53

dose as you get from this supplement. and

6:55

it's been put to the test in double blind

6:58

placebo controlled studies.

7:00

The Flavanah supplement was found to improve

7:02

a number of

7:02

aspects of cardiovascular health.

7:05

subjects taking the cocolaflavanals had

7:07

improved endothelial function.

7:10

That's basically how well the

7:12

blood vessels

7:12

contract and relax.

7:14

as well as modest reductions in their blood

7:16

pressure and their cholesterol levels.

7:19

Total cholesterol levels fell by

7:21

about five percent on average

7:24

and that may not be enough to

7:26

bring high cholesterol levels into a

7:28

low risk range, which

7:30

brings us to the phytosterol supplements.

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and these are sold under a variety of branch

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names. Phytosterals are

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compounds that are found in plants and

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they're very similar in

7:40

structure to cholesterol. which

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is found in animal foods. In fact, they

7:45

are so similar that

7:46

they can actually occupy the cellular

7:48

receptors for cholesterol, thereby

7:51

preventing it from being absorbed in

7:53

the intestine. Studies have shown

7:55

that phytosterol supplements can lower

7:57

your LDL cholesterol,

7:58

that's your

7:59

bad cholesterol by eight

8:02

to ten percent and for some

8:04

people this could allow them

8:06

to control their cholesterol without

8:08

medication. But here's an interesting

8:10

thing. It can also be taken together

8:12

with statin medications to

8:14

improve their efficacy. Adding

8:16

a phytocero supplement can be

8:18

comparable to doubling the dose

8:20

of a statin medication. And

8:22

unlike statins or Red Use

8:24

Rice Extract, phytospherals do

8:26

not have serious side effects or safety

8:29

concerns. The effective

8:31

dose of phytocerals for lowering

8:33

cholesterol is eighteen hundred to

8:35

two thousand milligrams a day.

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And there doesn't appear to be any

8:40

additional benefit to taking

8:40

any more than that. In

8:42

addition to nutritional supplements,

8:45

phytosteroids are also available in

8:47

functional food products such as butter

8:49

replacements. Benacol is one

8:51

popular brand of these. and you'd

8:53

need to eat about four tablespoons

8:55

a day to get that recommended

8:57

dose and that would obviously also add a few

8:59

hundred calories to your diet. but

9:01

of course, phytosterils are also available

9:04

just in regular old foods.

9:05

The

9:06

primary sources of phytosterils in the typical

9:09

diet are nuts seeds,

9:11

soybeans, and other legumes, avocados,

9:14

as well as nuts seed

9:16

and olive oils. and

9:18

the typical intake of dietary

9:20

phytocerals is estimated to vary from one

9:22

hundred and fifty to four

9:24

hundred and fifty milligrams per

9:26

day. Vegetarians and vegans

9:28

tend to be at the upper end of that

9:30

range, probably because of their higher

9:32

intake of legumes and nuts. And

9:34

I would also wager that users

9:36

of the nutrition GPA app, you've

9:39

heard me mention this before in the podcast,

9:41

that they would also probably tend

9:43

toward the higher end of that range

9:45

because the foods encouraged by that app

9:47

include a lot of those foods that are higher

9:49

in phytosterols. So

9:51

you could always take an approach similar

9:53

to the one that I recommend for calcium

9:56

supplementation. Instead of

9:58

taking the higher recommended amount

10:00

as a supplement, you

10:02

could use a supplement or a

10:04

functional food product or some

10:06

combination of those just

10:08

to close the gap between

10:10

the target and what

10:12

your healthy diet already provides.

10:14

And finally, because the covalvenols

10:17

and the phytosterols work through different

10:19

mechanisms, you could

10:21

potentially take them both. But

10:23

in the interests of getting the biggest bang

10:25

for your buck and minimizing

10:27

the number of supplements you're taking,

10:30

I think I'd be inclined if

10:32

cholesterol is your primary

10:34

concern to see how far you can get

10:35

with the phytospirals first. Now,

10:38

of course, you'd want to run all

10:40

of this past your doctor. Depending

10:43

on your situation and your other

10:45

risk factors, They may be willing to let

10:47

you try a phytosteril supplement for

10:49

a few months to see whether it's

10:51

enough to get your levels into a

10:53

safe range. But

10:55

if despite all your efforts with

10:57

diet, lifestyle, and maybe

10:59

nutritional supplements, you do

11:01

end up having to take a statin medication

11:03

to control your cholesterol, I

11:05

don't want you to feel like this is

11:07

a personal or a moral

11:09

failure. Sometimes our

11:11

bodies just need a little help,

11:13

especially as we get older. And

11:15

even though we may prefer to be

11:17

drug free, The benefits

11:20

of taking a medication may well

11:22

outweigh the risks. And also,

11:24

rest assured that even

11:26

in that case, Your efforts with

11:28

diet and lifestyle were not

11:30

wasted. You will likely get much

11:32

better results and need

11:34

less medication as a result of

11:36

those efforts. Do you have a nutrition

11:38

question you'd like me to answer? You can email it

11:40

to me at nutritionquickanddirty tips

11:42

dot com or leave it on the

11:44

nutrition to give a listener line at 4439616206

11:49

and you might hear your question featured in

11:51

a future episode. And also,

11:53

I wanted to let you know about a special

11:55

program that I'm offering later this

11:57

month. It's on overcoming

11:59

stress and emotional eating.

12:01

If this is something that you struggle with,

12:04

believe me, you are not alone. It's one of the

12:06

things that people most frequently ask

12:08

for my help with. And right

12:10

now, before we get into the holidays, it

12:12

just seems like the perfect time.

12:14

You can learn more about that at

12:17

wayless dot life.

12:17

slash stress. That's

12:19

way less dot life slash stress.

12:23

Nutrition diva is a quick and dirty

12:25

tips podcast It's audio engineered by Nathan

12:27

Sims with script editing by Adam

12:28

Sessel. Thanks also to Morgan

12:31

Christiansen, Holly Hepkins,

12:32

Devina Tomlin and our Internet camera and

12:35

racing. That's all for this episode. I'll see you

12:37

next week. Remember to eat something good twenty.