Screening for the Primary Risk Factors of Cardiovascular Disease

By James P. Meschino, DC, MS

In previous articles, I have highlighted evidence showing that eating foods high in saturated fat and/or cholesterol, as well as trans fats and deep-fried foods, are main culprits in promoting high blood cholesterol levels (total cholesterol and LDL cholesterol).

Many studies have shown that consuming foods lower in these fats, and higher in soluble fiber, help to reduce blood cholesterol and improve outcomes for cardiovascular disease patients. Although certain saturated fats raise cholesterol more than others, the principle saturated fats found in the North America and Western European diet appear to raise cholesterol to the greatest degree.^1-6

That said, overconsumption of carbohydrates can also contribute to higher cholesterol and triglyceride levels. Excess carbohydrate calories are converted into fat within the liver (some of them saturated fat), which activates cholesterol production in order to transport the fat to adipose tissue and muscle tissue, which store and burn fat, respectively. Thus, overconsuming carbohydrates also raises cholesterol, albeit to a lesser degree than saturated fat consumption, also raises triglyceride levels and may lower HDL cholesterol. (HDL cholesterol is capable of reversing arterial plaque.)⁷

In the final analysis, it is a combination of dietary, genetic, inflammatory, lifestyle and other factors that must be analyzed as a whole to establish the patient's overall risk for cardiovascular morbidity and mortality. Click to download the Cardiovascular Risk Factor form I developed and use with patients in the primary prevention of cardiovascular disease. If the patient scores outside of the ideal range, then I address with dietary, exercise and supplementation interventions that can help them improve their profile, in concert with any concurrent medical interventions that are being applied. I hope you find it helpful.

References

1. Jenkins D, Kendall C, Marchie A, Faulkner D, Wong J, et al. Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr, 2005;81:380-7.
2. Shils ME, et al. Modern Nutrition in Health and Disease, 10th Edition. Lippincott Williams & Wilkins, 2006; pages 96-110 (Lipids, Sterols and Their Metabolites).
3. Esselstyn Jr. CB. Resolving the coronary artery disease epidemic through plant-based nutrition. Preventive Cardiology, 2001;4:171-177.
4. Grundy SM. Dietary fat: at the heart of the matter. Science, 2001;293:801-2.
5. "Meals High in Saturated Fat Impair "Good" Cholesterol's Ability to Protect Against Clogged Arteries." Science Daily, Aug. 8, 2006.
6. Your Guide to Lowering Cholesterol With TLC. U.S. Dept. of Health and Human Services, National Institutes of Health; National Heart, Lung, and Blood Institute. NIH Publication No. 06–5235, December 2005.
7. Chapman J, et al. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J, 2011 June;32(11):1345–1361.

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