Jul 29, 2009

Our genetic code should be no big secret

We should be less frightened of wider access to our DNA profile — those in the know are offering theirs up for public view

The 1997 movie Gattaca sets out one of the great dystopias of science fiction. Genetic technology has divided humanity. Social class is determined by DNA. The “valids”, with sound genetic profiles, dominate the top jobs and political power. The “in-valids”, with flawed genomes, form a genetic underclass.

The film’s vision highlights a deep concern about the coming genomic age: that as science reveals more about the human genetic code it will not only herald new approaches to medicine but also create new ways to discriminate and invade privacy. Employers might select candidates according to genetic aptitude. Health insurers could refuse cover to people with high-risk genomes. And personal information about our health and personalities might be revealed for all to see.

Such fears have built a consensus that ethical use of genetic information must be founded on strict privacy. If DNA profiles are to improve treatment and prevention of disease without compromising liberty, access must be controlled. They belong to individuals and should not be disclosed without their consent. The prevailing assumption is that we should guard such data closely.

It is far from clear, however, that this assumption is correct. True genetic privacy may be impossible to achieve — and many of the scientists whose work is driving the DNA revolution believe that the costs of trying will outweigh the benefits. Some are even backing their words with action, by publishing their own genetic data on the internet.

The fantasy that it is possible to prevent unauthorised access to a person’s DNA was exposed in March by Peter Aldhous and Michael Reilly, of New Scientist. Aldhous drank from a glass and gave it to Reilly, who used commercial services to extract his colleague’s genetic profile. It is illegal in Britain to test DNA like this without consent. But the process is so cheap and simple, and the chance of detection so slim, that this offers little practical protection. We leave so much DNA wherever we go that we cannot expect to keep it to ourselves. Legislation might be a deterrent, but it will not prevent unauthorised use.

Even if genetic data could be comprehensively protected, it doesn’t automatically follow that it should be. In making a fetish of DNA, we may be limiting its usefulness. If science is to unravel the medical implications of genetic variations between individuals, to personalise and improve healthcare, it will be necessary to compare the DNA sequences of hundreds of thousands of people. A culture of privacy will hold this back while secreting information that may be less sensitive than it seems.

Certainly, the great and the good of human genetics do not feel that they have much to lose by sharing this data. Some are challenging the privacy assumption by example. When the genetics pioneer Craig Venter became the first person to have all six billion DNA letters of his genome sequenced he published the lot. James Watson, the co-discoverer of the double helix, has done likewise, redacting only the status of a gene linked to Alzheimer’s because he did not want to know the information himself. Kari Stefánsson, of deCODE Genetics, which sells personal DNA tests, allows his customers to compare their data with his.

George Church, of Harvard University, has gone a stage further. The founder of the Personal Genome Project (PGP), and its first participant, has published not only his complete genome sequence but also his medical records and other physical details. He aims to recruit 100,000 volunteers to do the same.

The nine other recruits to the PGP’s pilot phase are all people who know their stuff: they include the psychologist Steven Pinker, John Halamka, Dean of Technology at Harvard Medical School, and Misha Angrist, a geneticist at Duke University in North Carolina. Another 13,000 have joined a waiting list to take part. By putting their information in the public domain, participants hope to exploit “crowd-sourcing”, the notion that allowing anyone to work on a problem will lead to it being solved more swiftly. The phenomenon underlies the success of Linux open-source software and Wikipedia. It could soon be driving genetic discoveries as well.

This will have individual benefits as well as social ones. When Church placed his medical records on the internet he was contacted by a doctor who suggested a useful change to his cholesterol medication. Interpretations of open data are more likely to help than harm.

The prophets of open-source genomics are unruffled because the perceived need for absolute secrecy is also based on a misunderstanding of heritability. While most people think of genetics as a deterministic science, this is rarely so. Most genes that influence health have a probabilistic effect, raising or lowering risk by small margins. Most people with the Alzheimer’s risk gene , for example, will not get Alzheimer’s. It would not only be wrong to judge somebody’s intellect, skills or good health by their ownership of particular genetic variations — it would be profoundly misleading.

All of us carry risky variants: there is no such thing as a perfect genome. That should help to prevent discrimination: if insurers were to exclude everyone with a raised genetic risk of this or that they would rapidly go bankrupt. If the market fails, companies can be banned by law from demanding genetic test results; the US has already done this, and the UK has a voluntary moratorium.

Nobody should be forced to reveal genetic data, which should be published only with the informed consent of the owner; the PGP takes the “informed” part so seriously that it requires participants to pass a genetic literacy test. But it is instructive that so many of those who best understand the mechanics of the genome see so little to fear. Given wider understanding of the probabilistic nature of genetics, their choice to go public is one that many more of us could emulate.

Jul 27, 2009

NHS not ready to take advantage of breakthroughs in genetic sequencing

The health service is not ready for an impending genetic revolution in medicine and requires urgent reform to turn scientific advances into better patient care, a parliamentary inquiry declares today.

The NHS needs to revamp its provisions for genetic testing, the training of doctors and nurses, and its IT and laboratory services, if understanding of the human genome is to deliver health benefits to its patients, according to a House of Lords report.

Medical advances stemming from the sequencing of the human genetic code are already starting to improve healthcare, and could transform it over the next decade, the influential Lords Science and Technology Committee said. Widespread genetic testing could aid the diagnosis and prevention of disease, and allow doctors to prescribe targeted drugs according to patients’ individual genetic profiles.

This opportunity, however, could easily be missed without significant changes to NHS infrastructure, training and practice, the committee found. It called on ministers to prepare a new White Paper on genomic medicine, to address the challenges ahead. “The use of many types of genomic tests is increasing rapidly, both in the NHS and in tests sold directly to consumers, and the availability of these tests will, in time, have a dramatic impact on disease diagnosis and management,” the report said. “This is already placing strain on the expertise of doctors, nurses and healthcare scientists, who at present are poorly equipped to use genomic tests effectively and to interpret them accurately, indicating the urgent need for much wider education of healthcare professionals and the public in ‘genomic medicine’.

Jul 25, 2009

ILMN -Biotech firm Illumina will sequence your entire genetic code -- and throw in a Mac - for $48,000.- Sourced WhisperFromWallStreet.com

Illumina Inc.ILMN Price competition is coming to the rarified world of genome sequencing.
For $48,000, San Diego-based Illumina (ILMN) will sequence your genome -- in other words, your entire genetic code. Until now, the only other company offering personal genome sequencing services is biotech startup Knome. It charges $99,500.

Genome sequencing can alert individuals if they have inherited genes that cause illnesses like diabetes, Alzheimer's or cancer. Using the information as a guide, people could alter their lifestyles in an attempt to dodge potentially latent diseases. They also could find out the probability of passing along a genetic disease like cystic fibrosis to their children, or uncover interesting details about their ancestry.

Illumina is tossing in an iMac computer loaded with a customer's genetic data to round out the deal. But spending nearly $50K on a genetic code will not fit most people's budgets, even though that pricetag is hundreds of millions of dollars cheaper than sequencing the first human genome in 2003. Illumina says it expects just tens, perhaps hundreds, of people to sign up for the service within the next year.


Illumina, Inc. engages in the development, manufacture, and marketing of integrated systems for the analysis of genetic variation and biological function. Its instrumentation products include Genome Analyzer II, an instrument for high-throughput sequencing using Illumina sequencing by synthesis technology; iScan System, a high-resolution imaging instrument to scan BeadArray based assays; and BeadXpress Reader, a low- to mid-multiplex, high-throughput instrument for readout of assays. The company?s consumables comprise Standard Sequencing Kit, a reagent used for sequencing by synthesis chemistry on the Genome Analyzer; Paired-End Genomic DNA Sample Prep Kit, a streamlined library preparation kit to generate 200?500 kb insert paired-end reads; InfiniumHD Whole-Genome BeadChips comprising Human1M-Duo, Human610-Quad, Human660W-Quad, and HumanCytoSNP-12, which are multi-sample DNA analysis microarrays that interrogate up to 1.2 million markers per sample; iSelect Custom Genotyping BeadChips that are customer designable SNP genotyping arrays for 6,000 to 200,000 markers; and Whole-Genome Gene Expression BeadChips, which are multi-sample expression profiling arrays with up-to-date content for human, mouse, and rat. Illumina was founded in 1998 and is headquartered in San Diego, California.

Jul 23, 2009

Susceptibility Locus in Neurokinin-1 Receptor Gene Associated with Alcohol Dependence.

Substance P (SP), a neurotransmitter in stress pathways, exerts its effects mainly through the neurokinin-1 receptor (NK1R). Genetic and pharmacological studies show that binding of ligands to NK1R decreases anxiety-related behaviors, and therefore, self-administration of alcohol in mice and craving for alcohol in humans.

As genetic variants may result in differential expression of the receptor through various molecular mechanisms, we examined whether allelic variations in the NK1R gene are associated with alcohol dependence (AD) by genotyping 11 single-nucleotide polymorphisms (SNPs) across NK1R in alcoholic (n=271) and healthy control (n=337) participants of Caucasian descent. The AD was diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Associations of the SNPs with AD were assessed at both the individual SNP and haplotype levels.

We found that genotype and allele frequencies of rs6715729, a synonymous SNP in exon 1, differed significantly in alcoholics and in controls (p=0.0006; OR (odds ratio)=6.13; 95% CI=4.06, 9.23). Haplotype analyses indicated two risk haplotypes for AD in the 5' end of the gene, formed by the three-SNP combinations rs6715729–rs735668–rs6741029.

Taken together, we conclude that polymorphisms of NK1R are significantly associated with the development of AD in Caucasian individuals. Additional studies are needed to replicate these results in other samples and to elucidate the mechanism(s) by which these polymorphisms affect NK1R function in the brain.

Neuropsychopharmacology advance online publication 24 June 2009

Jul 21, 2009


Scegliere di sottoporsi a un test genetico rappresenta una presa di coscienza verso se stessi, un’opportunità per migliorare il proprio stato di salute e la qualità di vita. “Chi decide di eseguire un test genetico per la valutazione del proprio rischio di sviluppare la malattia di Alzheimer” dichiara il dott. Giuseppe Di Fede, “sta compiendo un passo in direzione della prevenzione. Vivere a lungo è infatti un’opportunità vuota di senso se alla quantità di anni non si associa la possibilità di vivere una vita di qualità, in autonomia fisica e psichica. ” Chi deve sottoporsi al test? Il test genetico si rivolge ad un segmento di popolazione di età compresa tra i 35 anni e i 75 anni. La vera prevenzione si realizza tra i 40 ed i 65 anni, periodo in cui se è presente il rischio genetico di sviluppare la patologia, è alta la possibilità di bloccarne lo sviluppo, attuando protocolli e percorsi diagnostici, terapeutici e preventivi. “Tra i 50 e i 65 anni è ancora possibile instaurare una terapia medica adeguata per rallentare la manifestazione della patologia, ma, in questo caso, non si può parlare di prevenzione ma di diagnosi precoce di Demenza o pre-Demenza. ” Il test genetico ha una indicazione mirata verso quelle persone che hanno una familiarità per il Morbo di Alzheimer, con parenti stretti, padre, nonno, cugini, zii, ma si rivolge anche a tutti coloro che vogliono prendere coscienza del proprio stato di salute per poterlo mantenere o migliorarlo. “Eseguire un test genetico è una scelta libera e personale” afferma il dott. Di Fede “che in genere, però, vede coinvolte sia la persona che si sottopone al test, sia la famiglia. Infatti, soprattutto in caso di referto che indichi rischio elevato a sviluppare la malattia, la famiglia acquista un ruolo importante di sostegno nelle fasi di follow-up e di coinvolgimento dell’adottare stili di vita preventivi. La partecipazione è spesso così importante che tutti i famigliari di un soggetto ad elevato rischio iniziano percorsi di prevenzione, favorendo quindi lo svilupparsi di una cultura di promozione della salute”. Il referto personalizzato contiene una determinazione del profilo di rischio pro infiammatorio associato al Decadimento Cognitivo e alla Demenza Senile, espresso in rischio Basso, Medio, Alto. Il referto è semplice da comprendere, non necessita di un genetista per la sua lettura, ma di un medico che conosca i passi e i protocolli da mettere in atto, quali esami richiedere e quali percorsi preventivi attuare. “Non si deve pensare che il test genetico crei malati o situazioni di vita da malati. Anche nei casi di rischio medio o alto gli esami diagnostici si effettuano una volta l’anno, proprio come sottoporsi ad un normale check up”. Gli esami che rientrano nel protocollo annuale sono: - la Tomografia Computerizzata dell’encefalo, - valutazione neurocognitiva, - determinazione dei fattori favorenti l’infiammazione. Ogni valutazione viene accompagnata da un’accurata anamnesi per determinare la presenza o meno di demenza o decadimento cognitivo nei familiari, controllo dello stile di vita, dell’attività fisica e dell’alimentazione, e se necessario vengono consigliati anche controlli per la determinazione di eventuali incompatibilità alimentari.

Jul 19, 2009

Uno studio per diagnosticare il diabete attraverso gli occhi

In Italia si stima che quasi 2 milioni di persone sono diabetiche e questa cifra tende a salire.

L’Università di Birmingham in Inghilterra sta portando avanti uno studio per scoprire l’insorgenza del diabete partendo da un analisi fatta sugli occhi.
Molto spesso si scopre di essere diabetici solamente quando si fanno le analisi del sangue di routine. Ci sono invece dei segnali certi che anche senza analisi possono farci pensare a un diabete.

* Una continua sete molto forte tipo arsura
* Si va in continuazione in bagno a fare la pipì
* Un dimagrimento improvviso
* Continua sensazione di stanchezza
* La tendenza a soffrire spesso di infezioni, specie ai genitali

Se avete questi sintomi allora è meglio fare un controllo approfondito dal vostro medico di famiglia.

L’Università di Birmingham sottoporrà i volontari a un test cardiovascolare, un test della vista e della pressione oculare ed un analisi del sangue.

Maggiori informazioni le trovate sul sito della Aston University.

Jul 17, 2009


July 9, 2009 — An international study of genetic variations involved in glioma, the most frequently occurring type of brain tumor, has identified 14 common gene variants in 5 genes associated with the occurrence of glioma.

Published online July 5 in Nature Genetics, the international investigation, led by researchers at the M.D. Anderson Cancer Center in Houston, Texas, analyzed data from 2 genomewide association studies from the United States and the United Kingdom. Together, the studies included 1878 patients with glioma and 3670 control individuals whose genotypes were obtained. "It's the first time we've had a large enough sample to understand the genetic risk factors related to glioma," said one of the senior authors, Melissa Bondy, PhD, professor, Department of Epidemiology, M.D. Anderson Cancer Center, University of Texas, in an M.D. Anderson press release.

The study contributes to understanding the possible cause of this common type of brain tumor, which constitutes approximately 80% of all primary brain malignancies. The only contributing factor identified previously was ionizing radiation. However, an increased familial risk had been recognized, leading to the US and UK genomewide association studies of glioma in populations with Western European heritage. Beginning with the genotyping of more than a half-million single nucleotide polymorphisms (SNPs), the researchers found 34 SNPs demonstrating strong evidence of association with glioma (P <>−5). Replication studies were carried out in 3 case-control groups from French, German, and Swedish populations, totaling 2545 patients with glioma and 2953 control individuals.

Combined results from genomewide association and replication studies pointed to 14 SNPs in 5 genes that qualified for genomewide significance (P <>−7). Among these 14 SNPs, the 95% odds ratios (ORs) ranged from 1.18 to 1.36, with respective Pvalues ranging from 1.07 × 10−8 to 2.34 × 10-18. The 5 genes implicated were TERT,CCDC26, CDKN2A/B, PHLDB1, and RTEL1. The strongest association was found for a SNP in CCDC26, a gene on chromosome 8 that influences retinoic acid, thus reducing telomerase activity and increasing programmed cell death. A SNP in TERT showed the next strongest association with glioma (P = 1.50 × 10−17). TERT is necessary for telomerase activity and maintaining telomeres.

The third strongest association (P = 7.24 × 10−15) was for a SNP in CDKN2B. TheCDKN2A/B region activates p53, a well-known tumor suppressor. Interestingly, half of all brain tumors have lost at least 1 copy of this gene — a deficit that usually indicates poor prognosis. The fourth-ranked SNP (P = 2.52 × 10−12) was located inRTEL1, a gene on chromosome 20 that normally functions to stabilize the genome. The fifth strongest signal (P = 1.07 × 10−8) was demonstrated for a SNP in PHLDB1— a gene previously implicated in neuroblastoma, but not in glioma. The only interactive effects detected in the study were between SNPs in CDCC26, and analysis of other pairs showed that their effects on glioma were independent. As rank-ordered here by their strength of association with glioma, the 5 genes increased the risk for glioma by 36%, 27%, 24%, 28%, and 18%, respectively.

Because their effects are largely independent, the variants' contributions to glioma risk are additive: "Individuals with eight or more risk alleles have an approximately fourfold increase in glioma risk compared to those with a median number of risk alleles," the report stated. However, this may be a low estimate because the model weighted the SNPs equally, which is unlikely in reality. At present, the authors caution against using the results of their study for individual screenings. Not only is more research needed on the function of the individual genes, but factors such as demographics, environmental factors, and lifestyle should be included when identifying at-risk individuals.

The investigators will begin an even more comprehensive study next year, enrolling 6000 patients with glioma and 6000 control individuals. "We will be able to look at all of the potential risk and protective factors we've identified in much smaller studies over the years," said Dr. Bondy, "such as exposure to ionizing radiation, allergies, infections, and use of nonsteroidal anti-inflammatory drugs." Dr. Bondy is also optimistic about the future: "Our findings give reasons for hope for those who might be affected and an incentive for a more comprehensive investigation of what has been a mysterious disorder."

Nat Genet. Published online July 5, 2009.

Jul 15, 2009

Breakthroughs in DNA medicine to revolutionise doctors’ training

Doctors are to be given more specialised training in genetics to prepare the NHS for a revolution in DNA-based medicine, The Times has learnt. A review of medical education in genetics is to examine what doctors need to know about the influence of DNA on common diseases and patients’ response to drugs, so they can exploit science’s growing understanding of the human genome in clinical practice.
In an interview with The Times, Professor Peter Farndon, director of the National Genetics Education and Development Centre, said recent advances in genetic science made it essential for doctors to have more access to information. Though the last genetics syllabus for medical students and junior doctors was introduced in 2006, so much has changed since then that the centre was already working to update it, he said. It was also developing guidelines for professional education in the field.
Over the past three years, costs of reading DNA have fallen so sharply that many scientists predict that it will be possible to sequence any individual’s entire genetic code for less than £1,000 within a year or two. Research has also revealed hundreds of genetic variations that affect an individual’s risk of disease or response to medicines. Companies such as 23andMe and deCODEme have started to sell genome scans directly to consumers, assessing their genetic risks of developing a range of diseases for between £300 and £600. Last week a report from the House of Lords Science and Technology Committee said that these developments required urgent reforms to medical training and NHS infrastructure so they could be translated into benefits for patients. The importance of genetic tests was “placing strain on the expertise of doctors, nurses and healthcare scientists, who at present are poorly equipped to use genomic tests effectively and to interpret them accurately, indicating the urgent need for much wider education of healthcare professionals and the public in genomic medicine”, the report said. While doctors learn about genetics in undergraduate and postgraduate training, the focus is on rare disorders caused by mutations in single genes, such as Huntington’s disease and cystic fibrosis.
More recent genetic research has identified hundreds of DNA variants with more complex and subtle effects on a wide range of much more common conditions, such as heart disease, cancer and rheumatoid arthritis. Each raises or lowers a patient’s predisposition to disease only slightly, but can combine to create a significantly raised risk, and their influence can be difficult to interpret.Family doctors, in particular, need an understanding of this area so that they can give appropriate advice to patients, Professor Farndon said. Scientists have also started to discover genetic variants that affect whether drugs are likely to be effective, or the safe dose that a patient can take. This practice, known as pharmacogenomics, is forecast to become increasingly important to more personalised medicine, but currently it is not highlighted as an important teaching subject. “It definitely needs to go into the main syllabus now, absolutely,” Professor Farndon said. “Suppose there’s a set of eight DNA variants that predispose a woman to a high risk of breast cancer. Even though she has no family history, you might target her for screening much sooner than the current recommended age.”

Jul 11, 2009

A Doctor’s Vision of the Future of Medicine

It's June 2018. Sally picks up a handheld device and holds it to her finger. With a tiny pinprick, it draws off a fraction of a droplet of blood, makes 2,000 different measurements and sends the data wirelessly to a distant computer for analysis. A few minutes later, Sally gets the results via e-mail, and a copy goes to her physician. All of Sally's organs are fine, and her physician advises her to do another home medical checkup in six months.

This is what the not-so-distant future of medicine will look like. Over the next two decades, medicine will change from its current reactive mode, in which doctors wait for people to get sick, to a mode that is far more preventive and rational. I like to call it P4 medicine—predictive, personalized, preventive and participatory. What's driving this change are powerful new measurement technologies and the so-called systems approach to medicine. Whereas medical researchers in the past studied disease by analyzing the effects of one gene at a time, the systems approach will give them the ability to analyze all your genes at once. The average doctor's office visit today might involve blood work and a few measurements, such as blood pressure and temperature; in the near future physicians will collect billions of bytes of information about each individual—genes, blood proteins, cells and historical data. They will use this data to assess whether your cell's biological information-handling circuits have become perturbed by disease, whether from defective genes, exposure to bad things in the environment or both.

Several emerging technologies are making this holistic, molecular approach to disease possible. Nano-size devices will measure thousands of blood elements, and DNA sequencers will decode individual human genomes rapidly, accurately and inexpensively. New computers will sort through huge amounts of data gathered annually on each individual and boil down this information to clear results about health and disease.

Medicine will begin to get more predictive and personalized (the first two aspects of P4 medicine) over the next five to 10 years. First, doctors will be able to sequence the genome of each patient, which together with other data will yield useful predictions about his or her future health; it will be able to tell you, for example, that you have a 30 percent chance of developing ovarian cancer before age 30. Second, a biannual assessment of your blood will make it possible to get an update on the current state of your health for each of your 50 or so organ systems. These steps will place the focus of medicine on individual patients and on assessing the impact that genes and their interactions with the environment have in determining health or disease.

In preventive medicine (the third P), researchers will use systems medicine to develop drugs that help prevent disease. If, say, you have a 50 percent chance of developing prostate cancer by the time you're 50, you may be able to start taking a drug when you're 30 that would reduce substantially reduce that probability. In the next 10 to 20 years the focus of health care will shift from dealing with disease to maintaining wellness.

Participatory medicine acknowledges the unparalleled opportunities that patients will have to take control of their health care. To participate effectively, though, they will have to be educated as to the basic principles of P4 medicine. New companies that can analyze human genome variation, like 23andMe and Navigenics, are already planning to provide patients with genetic information that may be useful in modifying their behavior to avoid future health problems. In the future, patients will need not just genetic data but insight into how the environment is turning genes on and off to cause disease—just as smoking often causes lung cancer and exposure to sunlight can cause skin cancer.

By Leroy Hood (NEWSWEEK)

Jul 7, 2009

Ethical, Legal, and Social Issues in Genetic Testing

Information from genetic testing can affect the lives of individuals and their families. In addition to personal and family issues, genetic disease or susceptibility may have implications for employment and insurance. Therefore, careful consideration in the handling of this information is very important. Critical issues include:

  • Privacy - the rights of individuals to maintain privacy. Some genetic tests are required or strongly encouraged for developing fetuses and newborn babies. If an infant is found to be a carrier or likely to develop or be affected by an inherited disease, these findings may affect the future employability or insurability of the individual.

  • Informed consent - obtaining permission to do genetic testing. One must have knowledge of the risks, benefits, effectiveness, and alternatives to testing in order to understand the implications of genetic testing.

  • Confidentiality - acknowledgment that genetic information is sensitive and access should to limited to those authorized to receive it. Future access to a person's genetic information also should be limited.

Jul 5, 2009

The TLC Diet - Lowering Your Cholesterol

There are a number of ways your health care provider can help you to lower your LDL level enough to decrease your risk of developing heart disease or having a heart attack including Therapeutic Lifestyle Changes (TLC) which is a special cholesterol lowering diet that includes physical activity and weight management. 
Some patients may require cholesterol-lowering drug treatment in addition to TLC.
The TLC diet is a low-saturated-fat, low-cholesterol diet that includes less than seven percent of calories from saturated fat and less than 200 mg of dietary cholesterol daily. The number of calories allowed on the TLC diet is individualized based on the number of calories needed to lose weight or maintain weight while avoiding weight gain. Sometimes reducing saturated fats and dietary cholesterol is not enough to lower your LDL enough and increasing the amount of soluble fiber may be necessary. Other foods that contain plant stanols or plant sterols such as cholesterol-lowering margarines and salad dressings can be added to the TLC diet to further help boost the effectiveness of the TLC diet.

Foods low in saturated fats include:
fat free or one percent dairy products
lean meats
poultry with the skin removed
soft margarines either liquid or in tubs--read the labels to find the ones that are low in saturated fats, as well as ones that contain little or no trans fat

Foods, high in cholesterol, that should be limited include:
liver and other organ meats
egg yolks
full-fat dairy products

Sources of soluble fiber include:
fruits such as oranges and pears
vegetables such as brussel sprouts and carrots
dried peas and beans

Jul 3, 2009

High Blood Cholesterol - what you need to know

According to the American Heart Association approximately 102.3 million American adults have total blood cholesterol values of 200 mg/dL and higher, and of these about 41.3 million American adults have levels of 240 or above. In adults, total cholesterol levels of 240 mg/dL or higher are considered high risk, and levels from 200 to 239 mg/dL are considered borderline-high risk.

Cholesterol is important because your blood cholesterol level is a major factor in determining your risk of developing heart disease. The higher your blood cholesterol, the higher your risk of developing heart disease or having a heart attack. Heart disease is the number one cause of death among both women and men in the United States. Every year more than one million U.S. residents have heart attacks and about half of those heart attacks are fatal.

Cholesterol is a waxy, fat-like, substance in your blood that builds up in the walls of the arteries; eventually, this build up of cholesterol causes a narrowing of the arteries and restriction of blood flow to the heart can become slow or blocked. Oxygen is carried through the blood to your heart; if your heart does not receive enough blood or oxygen you may experience chest pain. If there is a complete blockage in your arteries then a heart attack occurs.

If you have high blood cholesterol, you may not be aware of the potential problem since high blood cholesterol alone does not cause symptoms. This lack of symptoms makes it imperative that everyone (recommendations are for those 20 and over) is tested and knows their blood cholesterol numbers. If you have high blood cholesterol, lowering your numbers will significantly reduce your risk of heart disease and heart attack. High cholesterol can affect both males and females of all ages; my teenage son has very high (over 400) cholesterol levels, as well as triglycerides, which is quite scary for a parent.
To find out what your blood cholesterol numbers are you need to have a blood test called a "lipoprotein profile." You must fast for nine to 12 hours before your test. The lipoprotein profile provides information about your:
total cholesterol 
LDL or bad cholesterol -- LDL cholesterol is the primary source of cholesterol build up and blockage in your arteries.
HDL or good cholesterol -- HDL cholesterol helps to keep LDL cholesterol from building up in your arteries.
triglycerides -- Triglycerides are another type of fat in your blood.

Total cholesterol levels that are under 200 mg/dL are the most desirable; blood cholesterol levels from 200 to 239 mg/dL are indicative of borderline high cholesterol; levels of 240 mg/dL and above indicate high blood cholesterol levels.
FYI: Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. 
What LDL cholesterol category am I in? 
Less than 100 mg/dL = Optimal 
100-129mg/dL = Near optimal/above optimal
130-159 mg/dL = Borderline high
160-189 mg/dL= High
190 mg/dL and above= Very high

The good HDL cholesterol provides protection against heart disease; the higher your HDL number is, the lower your risk of developing heart disease or having a heart attack. However, if your HDL cholesterol number is lower than 40 mg/dL your risk is considerably higher than someone whose HDL is 60 mg/dL or higher.
Heart disease risk also increases in people who have high triglyceride levels. Some people may need treatment for high triglycerides if their level is borderline high (150-199 mg/dL) or high (200 mg/dL or more).

Jul 1, 2009

More Than Just Diet - Your Cholesterol Factors

Many factors affect your cholesterol level; some are under your control, while others such as age, gender, and heredity are not. Things that you can control include:Your diet. While saturated fat in your diet is the main source that may cause your blood cholesterol levels to raise, cholesterol in food sources is also important; reducing theses dietary sources of cholesterol can help to lower your blood cholesterol levels.

Your weight. If you are overweight, your risk for heart disease and high blood cholesterol is greatly increased. If you lose weight you can lower your LDL and total cholesterol levels and help to increase your HDL and reduce your triglyceride levels.

Being physically inactive. Another risk factor for heart disease, as well as a contributing factor in being overweight is a lack of regular physical activity. Regular physical activity helps to lower LDL and raise HDL cholesterol. According to a report on a new study of diet and exercise by the National Academy of Sciences, Institute of Medicine one hour of physical activity is now recommended to reduce health risks.Because other factors such as age, gender, and heredity are things you cannot change, controlling your diet, weight, and amount of physical activity are even more important. The fact is that the older we get the higher blood cholesterol levels will rise. Women are particularly susceptible to the age factor since before menopause total cholesterol levels are lower than men of the same age; however, post menopausal women often see an increase in LDL levels. You may also be genetically predisposed to high blood cholesterol levels since high cholesterol can run in families.Your risk for developing heart disease or having a heart attack depends on the number of risk factors you have in addition to high blood cholesterol; generally, the higher your LDL level the higher your risk of developing heart disease or having a heart attack. If you already have heart disease, your risk is significantly higher than someone who does not have heart disease. If you have diabetes, you risk is greater as well. Other major risk factors that have an impact on your LDL levels include:Smoking cigarettes. If you smoke, stop; if you don't smoke, don't start!

High blood pressure. If your blood pressure is 140/90 mmHg or higher or if you are already taking blood pressure medication, you are at increased risk for heart disease or heart attack.

Low HDL cholesterol. HDL levels of less than 40 mg/dL increase your risk; while HDL levels of 60o mg/dL or higher do not increase your risk of heart disease or heart attack.

Family history. If your family history includes heart disease in your father or brother before age 55 or heart disease in mother or sister before age 65, your risk is increased.

Age. Men who are 45 and older and women who are 55 and older face significant risk of developing heart disease or heart attack if their cholesterol levels are high.Although being overweight and/or physically inactive are not included in this list they are factors which must be considered and corrected.