Cholesterol treatment guideline

The new Cholesterol guideline was published in November and is the result of a joint task force of the American College of Cardiology and the American Heart Association. The report was published in the journal Circulation.

Cholesterol moleculeFirst, a couple of caveats: Dietary supplements by law cannot claim to treat or prevent any illness. So to some degree, it makes sense that clinicians would not turn to them first to help patients who already have high cholesterol. Also, it should be noted that the guideline would be aimed first and foremost at specialists, who likely would be consulted only after a patient has been referred with a treatable condition.

Paucity of information on Cholesterol prevention

Nevertheless, it is telling that so little effort is spent in the guideline on discussing how to help patients to keep from crossing over the line into the treatment category, rather than spending page after page on how to fix the boat after it has sprung a leak. In the 120-page document, which includes 69 pages of actual text, only two short sections were devoted to lifestyle factors in the prevention of development of hyperlipidemia.

“Patients should consume a dietary pattern that emphasizes intake of vegetables, fruits, whole grains, legumes, healthy protein sources (low-fat dairy products, low-fat poultry (without the skin), fish/seafood, and nuts), and nontropical vegetable oils; and limits intake of sweets, sugar-sweetened beverages, and red meats,” the guideline states.

One other section of the guideline addresses prevention specifically.

“Primary prevention of ASCVD over the life span requires attention to prevention or management of ASCVD risk factors beginning early in life,” the guideline states. It then refers the reader to a table that includes one statement about encouraging a healthy lifestyle and then devotes the rest of the information on statin therapy, starting as early as age 8.

Lipid ingredients, polyphenols shown to have effects

A number of dietary ingredients have been researched for their positive effects on blood lipid profiles including lipid ingredients and many plants and fruit extracts rich in phytochemicals.

Omega-3s, for example, have been shown to have positive effects on high triglyceride levels, but the effects on LDL cholesterol specifically are less clear-cut. Levels can actually increase slightly, but the size of the LDL particles changes as well, which is a good thing. And HDL (the “good” cholesterol) goes up, too, indicating a generally positive overall trend.

Extra virgin olive oil, which is rich is some polyphenolic compounds such as hydroxytyrosol, has been suggested to benefit blood lipid profiles via a multifaceted action that includes both anti-inflammatory aspects and the promotion of cholesterol efflux. Olive is, of course, one of the main components of the Mediterranean diet, which is frequently recommended for heart health.

Drug hits one target –  supplements hit many

But this multifactorial approach doesn’t fit neatly into the mostly drug-focused paradigm of the new guideline, said James Kennedy, Ph.D. president of ingredient supplier Polyphenolics, which has a line of grape seed extracts which are among the more comprehensively researched polyphenol-based ingredients on the market.

“There is no question that statins can dramatically reduce your blood cholesterol levels,” Kennedy told NutraIngredients-USA. “They absolutely can reduce cholesterol much further than any polyphenol from a fruit or vegetable.”

“But for me it’s about lifestyle first. It just struck me as odd that here is a group concerned about our heart health and they were pretty much exclusively recommending drugs,” he said.

Kennedy said that cardiovascular disease is a multifaceted condition. Statins target one aspect of this situation and hits that nail squarely on the head. But natural ingredients, perhaps especially when offered in combination, take a more comprehensive approach to the problem.

Polyphenolics offers a line of grape seed extracts that includes MegaNatural BP, which has been researched for its effect on supporting blood pressure in the healthy range. That effect takes into account the healthy flow dynamics of the circulatory system, something that a myopic focus on cholesterol numbers glosses over.

Evidence backing many polyphenols

Grape seed extracts are just one of many polyphenol-based ingredients on the market that have been researched for their benefits in ameliorating the risk factors of CVD.

grapes are recommended in low cholesterol diets

“If you look at cardiovascular disease as a whole, a lot of polyphenols – and grape seed extract in particular – address the various areas including blood pressure and blood glucose as well as hypercholesteremia. Our industry offers a food-first approach which makes sense to consumers. They look at supplementation as a complement to everything else they are doing to address all aspects of heart disease, not just one piece of it” Kennedy said.

The entourage effect implied by the research backing polyphenols (they all appear to do slightly different things) is now starting to be borne out by research. A recent study in the journal Nutrients showed that just two weeks on a polyphenol-poor diet could alter vascular biomarkers in a group of healthy men.

And a recent review article in the journal Molecules had this to say: “Consumption of polyphenols from plant extracts and fruits increases antioxidant levels in plasma which protect vasculature and improve anti-inflammatory and lipid profiles, blood pressure, HDL-C, and vascular function.”  The review focuses on a number of polyphenols and other naturally occurring compounds, including gallic acid and punicalagin from pomegranate.

Combo products increasing in popularity

Kennedy said there is increasing interest among supplement product formulators in taking advantage of the evidence supporting the multifactorial effects of polyphenols.

“We do come into contact with customers who say they want to put together a heart health formula and want to know what they can combine our grape seed extract with,” he said.

“Recently we had a customer who wanted to combine our grape seed extract with a blueberry extract and a bergamot extract. When you go into the store you frequently see our extract in formulation with other ingredients,” Kennedy said.

The beauty of the natural approach to heart health is these ingredients can be combined with virtually no concern about antagonistic interactions, Kennedy said. Polyphenolics has continually worked on its GRAS dossier, with higher and higher dosages proven to be safe, he said.

“For the most part these are natural products and they are not known to have any cross indications. With statins, you have to dial the dose in and the patient has to be monitored very carefully.”

 

Peanut butter benefits

Benefits of peanut butter are enormous. Peanut butter is a firm favorite among adults and children alike. Although tasty, many people still wonder about the health benefits of peanut butter.

Peanuts and peanut butter contain nutrients that may boost a person’s heart health and improve blood sugar levels.

Depending on how people use peanut butter in their diet, it can help them lose weight, or put on pounds during weight training or bodybuilding.

However, the benefits of peanut butter should be carefully evaluated because peanut butter is high in calories and fat, so people should enjoy it in moderation.

In this article, we look at the benefits of eating peanut butter and explain the risks associated with consuming it.

Nutritional benefits of peanut butter

Peanut butter in a jar from above
Peanut butter is a good source of protein and vitamin B-6.

Peanut butter provides a good amount of protein, along with essential vitamins and minerals, such as magnesium, potassium, and zinc.

Most notably, each 2-tablespoon (tbsp) serving of smooth peanut butter provides the following nutrients, minerals, and vitamins:

  • Protein. Peanut butter contains 7.02 grams (g) of protein per 2-tbsp serving. This counts toward the recommended dietary allowances (RDA) for women of 46 g and 56 g for men, which varies by age and activity level.
  • Magnesium. With 57 milligrams (mg) of magnesium, each serving helps towards the RDA of 400–420 mg in men and 310–320 in women. Magnesium is essential for health, playing a role in over 300 chemical processes in the body.
  • Phosphorous. Each serving contains 107 mg of phosphorus, which is about 15.3 percent of the RDA of 700 mg for adults. Phosphorus helps the body to build healthy cells and bones and helps cells to produce energy.
  • Zinc. A serving of peanut butter provides 0.85 mg of zinc. This is 7.7 percent of the recommended daily intake of 11 mg for men, and 10.6 percent of the RDA of 8 mg for women. Zinc is necessary for immunity, protein synthesis, and DNA formation.
  • Niacin. Peanut butter contains 4.21 mg of niacin per serving, which makes a useful contribution towards a person’s recommended intake of 14 to 16 mg. Niacin benefits digestion and nerve function and helps produce energy.
  • Vitamin B-6. With 0.17 g of vitamin B-6 per serving, peanut butter provides almost 14 percent of an adult’s RDA of 1.3 mg. Vitamin B-6 plays a role in over 100 enzyme reactions in the body and may be necessary for heart and immune system health.

However, there are also nutritional disadvantages if a person eats more than the recommended amount of peanut butter.

Peanut butter is high in calories, saturated fats, and sodium.

Each serving contains 3.05 g of saturated fats, which is 23.5 percent of the American Heart Association’s maximum recommended daily intake of saturated fat for those consuming 2,000 calories a day. People should aim for less than 13 g of saturated fat per day.

It also contains 152 mg of sodium, which is 10.1 percent of an adult’s ideal daily upper intake of sodium of 1,500 mg.

Health benefits of peanut butter

Eating peanut butter in moderation and as part of an overall healthful diet may provide the following benefits:

1. Weight loss

Several studies suggest that eating peanuts and other nuts can help people maintain their weight, or even help with weight loss.

This may be because peanuts improve satiety, which is the feeling of fullness, thanks to their protein, fat, and fiber content.

A 2018 study suggests that eating nuts, including peanuts, reduces a person’s risk of being overweight or obese. This study compared the dietary and lifestyle data for over 373,000 people from 10 European countries over 5 years.

Earlier research based on data gathered from over 51,000 women suggested that those who ate nuts twice weekly or more experienced slightly less weight gain over an 8-year period than women who rarely ate nuts.

2. Boosting heart health

Peanut butter contains many nutrients that can improve heart health, including:

  • monounsaturated fatty acids (MUFAs)
  • polyunsaturated fatty acids (PUFAs)
  • niacin
  • magnesium
  • vitamin E

The proportion of unsaturated fats (PUFAs and MUFAs) to saturated fats in the diet plays a particularly important role in heart health. Peanut butter has a similar ratio to olive oil — which is also known as a heart-healthy option.

A high intake of nuts may have links to a reduced risk of mortality from heart disease or other causes. The researchers recommend peanuts in particular as a cost-effective way to improve heart health for some people.

Research also suggests that including 46 g per day of peanuts or peanut butter into an American Diabetes Association (ADA) diet plan for 6 months could benefit the heart, improve blood lipid profiles, and control weight for people with diabetes.

However, as peanut butter is high in calories, it is crucial that a person limits their intake if they do not want to put on weight. Eating more than the recommended amount will also increase fat and sodium intake, which does not benefit the heart.

3. Bodybuilding

Senior lady working out at the gym
Peanut butter is an easy way to increase calorie intake.

Many bodybuilders and fitness enthusiasts include peanut butter in their diets for various reasons.

Although calorie amounts will vary based on stature, activity level, and metabolic rate, the typical daily recommended calorie intake ranges from around 1,600–2,400 calories per day for women and up to 3,000 calories per day for men. However, active adult men should consume up to 3,000 calories daily, while active women need up 2,400 calories per day.

Thanks to its high-calorie content, peanut butter is an easy way to increase calorie and unsaturated fat intake.

Nut butter is also a source of protein, which is essential for building and repairing muscles. Although peanut butter is not a complete protein — meaning it does not contain all of the essential amino acids the body needs — it does count toward a person’s daily protein intake.

Spreading peanut butter on whole-grain bread makes a more complete protein meal, as the bread contains the amino acid methionine, which peanut butter lacks.

4. Managing blood sugar levels

Peanut butter is a relatively low-carbohydrate food that contains good amounts of fats and protein, as well as some fiber.

These characteristics mean that peanut butter, with no added sugar, does not have a significant impact on blood glucose levels. This means it can be a good option for those with diabetes and confirm the benefits of peanut butter.

The ADA recommend that people replace saturated fats with monounsaturated fats in their diets. They suggest peanut butter, peanuts, and peanut oil as good sources of monounsaturated fat.

A small 2013 study suggests that eating peanut butter or peanuts for breakfast could help women with obesity and an increased risk of type 2 diabetes to manage their blood glucose levels. According to the survey, the women who added nuts to their breakfast had lower blood sugar levels and reported less hunger compared to women who ate a breakfast that contained the same amount of carbohydrates but no nuts.

Peanut butter is a good source of magnesium, which is an essential nutrient for people with diabetes. Continuous periods of high blood sugar may reduce magnesium levels in the body. Low magnesium levels are linked to prediabetes and type 2 diabetes.

5. Reducing the risk of breast disease

Eating peanut butter, especially from a young age, may reduce the risk of benign breast disease (BBD), which increases the risk of breast cancer.

A study in the journal Breast Cancer Research and Treatment, reports that eating peanut butter and nuts at any age may result in a lower risk of developing BDD by age 30.

The researchers examined the data for over 9,000 schoolgirls in America. Other types of pulses, such as beans and soy, along with vegetable fats and other nuts, may also offer protection from BBD.

Even those with a family history of breast cancer had a significantly lower risk if they ate peanut butter and these other foods.

Peanut butter benefits and nutritional profile

The table below provides a detailed nutritional profile of 2 tbsp of smooth peanut butter:

Calories 188
Protein 7.02 g
Saturated fats 3.05 g
Monounsaturated fats 6.63 g
Polyunsaturated fats 3.63 g
Carbohydrates 7.67 g
Fiber 1.80 g
Sugars 2.08 g
Calcium 17 mg
Iron 0.69 mg
Magnesium 57 mg
Phosphorus 107 mg
Potassium 189 mg
Sodium 152 mg
Zinc 0.85 mg
Niacin 4.21 mg
Vitamin B-6 0.18 mg
Vitamin E 1.90 mg

Peanut allergies

Peanuts and other nuts are common allergens, with a peanut or tree nut allergy affecting over 3 million Americans, according to the National Institutes of Health (NIH). Those with a known peanut allergy should avoid peanut butter and foods containing the nuts.

The NIH also note that just 20 percent of those with an allergy will eventually outgrow the allergy and stop having reactions to nuts.

Which peanut butter is best?

When selecting a peanut butter product, look for one that contains just peanuts and few or no other ingredients.

Some peanut butter brands will contain other ingredients, such as sugar, salt, and added oils. Avoid these where possible. Try adding a little honey to peanut butter dishes as a sweetener instead.

It is normal for pure peanut butter to separate into solid and liquid form. Stir the contents thoroughly, and the consistency will return to normal.

People can buy natural peanut butter in health food stores and online.

To stop the peanut butter going off, store it in the refrigerator.

How to add peanut butter to your diet

Peanut butter, rice cakes and banana
Peanut butter is a healthful option when enjoyed as part of a balanced diet.

Eating more peanut butter is easy. Sometimes, it can be too easy — so be sure to be mindful of your intake to avoid eating more calories than you may need in a day. Remember 2 tbsp of peanut butter is close to 200 calories.

People can include peanut butter in their diets by:

  • Making a classic peanut butter and jelly sandwich, using whole fruit, low sugar jelly, and whole-grain bread.
  • Spreading peanut butter on rice cakes and top with banana slices.
  • Whipping up a Thai peanut dressing for salads, using lime juice, rice vinegar, soy sauce, and honey.
  • Adding a spoonful of the nut butter to smoothies to make them more filling.
  • Dipping apple and pear slices into peanut butter for an easy snack.
  • Stirring peanut butter into yogurts or warm oatmeal.

Summary

The benefits of peanut butter indicate at that peanut butter can be a healthful option when people enjoy it as part of a balanced diet. It is rich in several nutrients, including protein and magnesium, which may help protect the heart and manage blood sugar and body weight.

However, eating too much peanut butter can increase a person’s daily intake of saturated fat, sodium, and calories.

Those who have a peanut allergy should avoid peanut butter as it could trigger a potentially deadly reaction.