Blood Test Results: Blood pressure, Cholesterol, and HDL

Yesterday I went to the Doctor’s for the results of the blood work I had drawn last week. After first telling me I had Chlamydia, the Doctor pulled up the correct chart (Thankfully, I don’t have Chlamydia, unfortunately there is an Anthony in Harlem who does.) the Doc began going over my numbers.

After being vegan for 6 years, my B-12 levels were perfect. The healthy range is between 200-900 pg/mL. I scored a 695. I did this by consuming a few fortified foods once in a while such as soy and almond milk but I also take a B-12 supplement every few days. It is the only supplement I take and I don’t take it every day.

In America, heart disease is currently our number one killer, but as Dr. Esselstyne boldly states in the documentary, Forks Over Knives, “if the truth be known coronary artery disease is a toothless paper tiger that need never, ever exist and if it does exist, it need never, ever progress.” Now if you’ve read Dr. Esselstyne’s book How to Prevent and Reverse Heart Disease (BYOL review pending), or Rip’s Engine 2 Diet, you’ll remember that there are a few magic numbers when it comes to blood pressure and cholesterol that nearly guarantee you’ll stand apart of the majority of Americans who currently suffer from the disease (many of whom won’t know they even have the disease until after they have died of a serious heart attack!).

First, blood pressure. Unfortunately, according to the CDC, one in three Americans have high blood pressure, many of whom are told to take medicine for the rest of their lives to artificially lower it. We consider high blood pressure, or hypertension, to be a natural part of the aging process, but this is not true. Rather it is a natural part of the Standard American Diet. Adults who consume a mostly plant-based diet typically have blood pressure levels similar to their children. I’m happy to use my Mom as a shinning example of this. She has had high blood pressure my entire life and for the last several years was on medication to control it. Last August I convinced her to switch to a plant-based vegan diet. Since the beginning of April, she has been completely off her medications!

Blood pressure is expressed in two numbers. The first number is called the systolic blood pressure and this represents the force your heart exerts on your arteries when your heart squeezes. You want your systolic pressure to be 120 or below. Mine was 106.

Next is the diastolic blood pressure, and this represents the force the blood exerts on your arteries when your heart relaxes. This number should be below 80. Mine was 60.

Cholesterol is, perhaps, America’s real greatest killer! And to think most people willing put extra cholesterol into their bodies whenever they chose to eat an animal based food! The average American’s cholesterol, again according to the CDC is around 200 mg/dL. This, by their standards is borderline risky, however the research shows that even this number is too high. Heck, just common sense can tell you that! Currently ¼ of the population will die from heart disease… something is clearly off with our numbers. Rather, Dr. Esselstyne argues from his research that to be “heart attack proof,” our total cholesterol levels should be below 150. Among others, Dr. Campbell’s The China Study concurs with this number. Mine was 88 mg/dL.

Now besides the total number, cholesterol is also made up of a few numbers. The two most commonly discussed are LDL, or low-density lipoprotein, and HDL, or high-density lipoprotein. We traditionally refer to LDL as bad, and HDL as good because LDL sticks to our arties, while HDL tends to clear them. 

If LDL is bad, we obviously want our LDL reading to be low. Most people’s LDL is around 100, but according to Dr. Esselstyne that number is still too high, and can put one at risk of heart disease, and several other chronic degenerative diseases. Instead, he recommends we should aim for 80 or below. Mine was 34.

Now HDL is a bit more tricky. Because it is the “good” cholesterol, we assume we want that number to be high; however, according to several research studies, what is far more important is to have your total cholesterol and LDL levels in check.

My HDL level was 27 mg/dL. My Doctor told me that it was way too low and it could potentially put me at risk for heart disease; however, I believe - and the science supports me - that there is an error in his thinking. Yes, 27 mg/dL is very low, however, my total cholesterol is over 100 points below average. So obviously my other levels will also be low. According to Dr. John McDougall, “When total cholesterol is lowered, all fractions of cholesterol are reduced, including HDL-cholesterol. This is not bad, but expected, and actually of no harm.”

In a study done on the Indian population, Tarahumara, a population that thrives off of a nearly complete plant-based diet and has almost zero accounts of heart disease help prove this. The researchers subbed the Tarahumara plant-based diet with an “affluent” diet high in fat, animal protein, and cholesterol, the natives total cholesterol raised 31% from an average of 121 to 159 in just five weeks. At the start of the study their HDL levels were around 32 mg/dL. Over the five weeks, those levels, on average, also jumped by 31% to 42. The study concluded they were at significantly higher risks for contracting heart disease at the end of the study then they were at the beginning even though their “good” cholesterol level rose. Essentially, labeling one form of cholesterol as “good” and one as “bad” is a classic example of the reductionist thinking that is too common when it comes to health and nutrition. A certain amount of both forms of cholesterol are needed for the body to function properly- and our bodies make both so there is no reason to increase our consumption of it with animal foods.

Worldwide (comparing people who eat different diets) those who have the lowest HDL levels (like people in rural Japan, China, and Africa) have the lowest rate of heart disease – and also the lowest total cholesterol. Those with the highest HDL levels (like people in the USA and Western Europe) have the highest rates of heart disease. 

As Dr. McDougall notes, when total cholesterol drops so too will HDL. In fact, in a study of over 500 of his patients, he found that, on average, people reduce their overall HDL levels by 19 percent (8 mg/dl – from 41 mg/dl to 33 mg/dl) in 11 days.

The Doctor told me that I should try and raise my HDL by consuming more Omega-3 fatty acids. At first he suggested fish, but then remembering that I was vegan he then offered I consume nuts and some seeds. He never specifically said walnuts, chia or flax, but those were the foods he was groping for. (As a side note, studies on cows and fish have both shown these animals get their Omega-3s from eating greens- It is not implausible to suggests humans do the same.)

Now, you might think, well, that doesn’t seem unreasonable, and until just a few days ago, I might have agreed. But we have to remember there are two essentially fatty acids that our bodies need to get through food. The first is Alpha-linolenic acid or Omega-3, which the doctor said would help raise my HDL- the second is Linoleic acid or Omega-6. According to recent studies, the ideal ratio between these two EFAs is a 1:1. A whole food, plant-based diet typically provides exactly that, a 1:1 to 3:1 (still within the safe realm) Omega 6 to Omega-3 ratio (for comparison, SAD is a 20:1 – 50:1 ratio). For someone eating the Standard American Diet, increasing their consumption of Omega-3 foods is a good idea, however for someone eating a plant-based diet it may not be. By increasing the Omega-3 intake, you could disrupt the ratio between Omega-6 to Omega-3, and this can lead to increase risk of heart disease as well as type-2 diabetes among other aliments. Both of these outcomes would be very rare with the numbers that I am dealing with, but why take the chance?

Finally, one cannot die of low HDL just as you cannot die from having a high HDL number. That said, far more people go to their graves from heart attacks believing their high cholesterol is safe because they have a lot of “good” cholesterol. We need to stop thinking about these matters in such reductionist ways. 

I hope you all have a great weekend filled with healthy foods!

As always, I am not a medically trained Doctor and this blog should not be taken as medical advice. Consult your doctor about any changes you make to your diet and all of your health concerns.

References:

Brinton EA.  “A low-fat diet decreases high density lipoprotein (HDL) cholesterol levels by decreasing HDL apolipoprotein transport rates.”  Journal of Clinical Investigation. 1990 Jan;85(1):144-51.

Kausik, et al. “Long- Chain Omega-3 Fats, Fish and Type 2 Diabetes,” American Journal of Clinical Nutrition 90, 613, 2009.

Esselstyn, C. Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure, New York, Penguin Group, 2007.

Esselstyn, R. The Engine 2 Diet: The Texas Firefighter's 28-Day Saver-Your-Life Plan that Lowers Cholesterol and Burns Away the Pounds, New York, Wellness Central, 2009. 

Knuiman JT.  HDL cholesterol in men from thirteen countries.  Lancet. 1981 Aug 15;2(8242):367-8.

McDougall J.  “Rapid reduction of serum cholesterol and blood pressure by a twelve-day, very low fat, strictly vegetarian diet.”  Journal American College Nutrition. 1995 Oct;14(5):491-6.

McDougall J. “Good Cholesterol “Worstens” with McDougall?” McDougall News Letter September 2003.

McMurry MP.  “Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet.”  New England Journal of Medicine. 1991 Dec 12; 325 (24):1704-8.

Preview of My Beef with Meat by Rip Esselstyn

A few months back, the folks over at the Engine 2 Diet posted on their facebook that they wanted bloggers help in spreading the word about Rip’s new book, My Beef with Meat. Originally, they were allowing bloggers to submit five questions for Rip to answer and also mentioned the possibility of giving away some E2 products- they now have everything from E2 shirts (I have one from when I volunteered at their plant-strong immersion last summer) to E2 crackers, cereal, and almond milks! 

However, things change, and I suspect they were overwhelmed with requests and after nearly two months I reached back out to see if the blog tour was still happening and if any of my carefully crafted questions would be answered. They replied with a template for bloggers to follow, including some recipes, a short peak into the new book, and a Frequently Asked Questions section with answers from Rip. So while I was a bit disappointed I decided to use parts of the template, what follows is far less personal than I was hoping for, but still worth sharing (and do note, I resisted the urge to cut and paste Rip's answer to make him say silly things, like in the film, Good Morning Vietnam). I’m excited for his new book to arrive and highly suggest either of his books if you are veg curious, at a cross-roads with your own health, or if you are already plant-based and looking for some new healthy recipes, need a reminder about why oil is dangerous, or if you just need some advice on how to respond to the paleo people at your Cross Fit gym, My Beef with Meat should be on your radar.

 

For those of you who don’t know, (and I really should do a full review of his first book, The Engine 2 Diet, sorry I read it before I was blogging…) Rip Esselstyn is one of the stars of the documentary, Forks Over Knives and the son of the legendary Dr. Caldwell Esselstyn, the cardiovascular doctor who has been saving thousands of lives (including President Bill Clinton’s) with the simple prescription of a strict plant-based diet. When Rip was younger, he was a three-time All-American swimmer at the University of Texas at Austin and then competed as a professional triathlete, winning the classic Escape from Alcatraz triathlon six-times and the Capital of Texas Tri a stunning eight times.

After retiring from his career as a triathlete, Rip joined a firehouse where, besides being the most popular model on the Austin Firefighter Yearly Calendar, he helped transform the health of his firefighting brothers with his trademarked Plant Strong™ diet (I was serious, it's trademarked). His success was stunning and it inspired him to write his first book. With the book published, Rip left the firehouse and teamed up with Whole Foods Market as one of their Healthy Eating Partners where he works with employees, customers, and Whole Food’s local communities. If all this sounds slightly familuar it might be because he has appeared on hundreds of radio shows as well as national television programs, including the Today show, CBS Sunday Morning Show, Good Morning America, and The Dr. Oz Show.

The Engine 2 Diet, which advocates a strict whole food, plant-based diet is proven by both science (including researchers such as his dad as well as his friend Dr. T. Colin Campbell) but also through his own anecdotal evidence as he has witnessed thousands transform their health simply by following his diet.

Following is a brief glimpse of what Rip’s newest book is all about, as well as one of the new recipes.

(Just to be clear, these are not my questions, but I thought they were worth sharing)

Why did you write this book?

I’ve discovered that there is a HUGE disconnect between what people think is healthy and what medical science knows to be healthy; for example, people have been bamboozled into believing that olive oil, Greek yogurt, chicken, and fish are healthy. Many people think the diet of the day is salmon, low fat dairy, and olive oil, washed down with a glass of red wine and a Lipitor pill for good measure. This is how confused, distracted, and off-course we have gotten--because this is NOT a good diet!

This book explains to plant eaters and meat eaters alike why a whole food, plant-strong diet rocks on a jillion different levels, hence the subtitle: The Healthiest Argument for Eating a Plant-Strong Diet. The primary driving force behind the book was to delve deeper into the major myths that keep surfacing about eating plants, such as: “You won’t get enough protein”, “You won’t get enough calcium”, “Eating plants is too expensive”, “Real men (and women) eat meat”, “Olive oil is heart-healthy”, and “Moderation in everything.”

The book shows how wrong each of these myths is. It gives the reader real science, not fad-diet talk. One of the titles we thought about was “How to Win an Argument with a Meat-eater” and believe me, after reading this book, you will never lose another argument with a carnivore again.

By the way, once you’ve won the argument, you can start cooking up any one of the 140 lip- smacking, rib-sticking outrageously good recipes to prove your point with food as well as with words.

There are some controversial things you tackle in this book, like the Paleo Diet. Why did you decide to address that specific diet?

The two big dueling diets right now are paleo and planteo. I believe that the paleo diet is just a good gimmick. The paleo people have taken the South Beach/Atkins diets and put a little spin on it.  There are some positives with paleo, such as no refined or processed foods, and no dairy products. But any diet that promotes animal products with saturated fats, and animal protein isn’t promoting health. The consensus among the researchers who have studied the diets of humans in paleo times have said that at least 80 percent of their food was plant-based. Yes, they ate some animals, but we've evolved since then, we're smarter; we do not need, want, or get healthy from animal products. Back in the day, you would do anything you could to get calories into your body--it was a matter of survival. But in this day and age, you can go down the street to any grocery store and get all that you need without resorting to animal flesh.

An interesting article in US News & World Report in 2011 reviewed many different popular diets and decided that the one people should avoid is the paleo diet.

What about the people who say that they get results from a paleo diet? That’s because the Standard American Diet (SAD) is such an abomination you will get good results when switching to any diet that is even remotely healthier. If you want to get to the next step, cut out the meat!

Do your kids like eating this way?

My kids, Kole and Sophie, do not like eating this way--they LOVE eating this way! They have no interest in eating anything from animals. If they find out that cake and ice-cream offered to them has things like eggs, butter or milk they politely decline. Kole and Sophie love mangoes, grapefruit, brown rice, baked tofu, peanut butter on whole grain bread, whole grain pasta, cheese-less whole grain pizza and banana ice-cream.  Kole was hungry, and I told him I'd give him anything he wanted. Guess what he asked for.... he asked for broccoli!

Here is a photo of a seriously good looking guy and Rip Esselstyn too! I got to meet Rip at the Farms2Forks Immersion during the summer of 2012. He is an incredibly nice guy and even let me tease him about being afraid of the word "vegan."

What about athletes--can they be plant-strong?

Yes they can and should be plant-strong. It is the absolute dope when it comes to taking your athletic performance to the next level. When I was a full time triathlete, I was guilty of taking performance enhancing…… foods. They are nature’s legal performance enhancing drugs!  Plants give you an abundance of protein, water, phytonutrients, vitamins, and minerals that support your body after training. Plants are loaded with clean, unprocessed carbs that will replace depleted glycogen stores in your muscle and liver--allowing you to train harder, adapt faster, and improve quicker.

Plants give you a dose of alkaline, and anti-inflammatory substances that protect you from the stresses of long training days.  Plants give you a clear head that will allow you to focus like a laser beam. Plants give you youthful arteries that will improve blood flow to all of your working muscles for maximin oxygen uptake. Plants strengthen your immune system and keep you healthy and free from illness.  Plants give you a lean and muscular body that doesn't carry excessive weight.

When you are eating plant-strong, you are getting unprocessed carbs, healthy fats, plant-proteins, fiber and anti oxidants -- all of the things that your body relishes and craves and takes your performance to the next level.

Thanks Rip!

And just to show that the Engine 2 recipes are more than just salads, here is a recipe for healthy, low-fat, and oil-free Banana Oatmeal Peanut Butter Cookies from the new book!

I made these last week, and have to say they are frickin' delicious! In fact, I could have eaten the entire tray, but instead I decided to bring them into work so all the T-Rex's (omnivores) I work with can get a taste of what healthy eating is all about! These guys are similar to my holiday special Peanut Butter and Oat Cookies, so you know they're good, but are still distinct enough to be a warmed and much welcomed addition to your next cookie tray!

E2 Banana Oatmeal Peanut Butter Cookies:

Ingredients:

3 ripe bananas, mashed

1 tablespoon vanilla

¾ cup natural chunky peanut butter

3 tablespoons maple syrup

2 cups old fashioned oats

½ cup whole wheat flour*

1 teaspoon baking powder

¼ teaspoon salt ((optional) I omitted the salt.)

½ cup non-dairy chocolate chips or raisins** 

Makes 30- 32 cookies

Directions:

1. Preheat oven to 350 degrees

2. Prepare a cookie sheet with parchment paper

3. Mix bananas, vanilla, peanut butter and maple syrup into a creamy consistency in a large bowl

4. In another bowl, combine oats, flour, baking powder and salt

5. Add the dry ingredients to the wet ingredients and stir until they are well combined -the batter

should be slightly sticky

6. Fold in the chocolate chips or raisins

7. Place rounded, heaping tablespoon-sized balls of the batter onto an ungreased baking sheet

8. Bake for 15-18 minutes or until lightly browned

9. Gobble these up while they are still warm

©Engine2Diet

*For wheat-free version, sub whole wheat flour with spelt flour.  

** For a less processed chocolate chip, try cacao nibs. (is it a cookie if it doesn't have some type of chocolate?) 

As a side note,  I ran the numbers on these cookies and while nutrition calculators are not perfect, each cookie has roughly 55 calories which is less than half the calories in Chips' Ahoy Chocolate Chip Cookies. Also, for those of you who are obsessed with protein, eating an entire tray of these would cover most peoples protein needs for an entire day! Yup seriously people, protein is that easy to get on a plant-based diet!

Well, a big BYOL thank you to Rip and the E2 team for everything they do and for sharing their work with us.