5 Steps To Lowering Your Cholesterol

[Music] [Music] [Music] [Music] [Music] welcome to the exam room live brought to you by the physicians committee hi i am the weight loss champion chuck carroll and this is the healthiest half hour anywhere online today we appreciate you joining us right here on facebook and on youtube coming up today we're going to be talking all about cholesterol you know we all need it but too much of it can turn out to be just an artery clogging disaster and who wants that millions of us have high cholesterol though and it's so easy to happen so today we're going to learn five easy ways that you can lower your cholesterol naturally and giving us those tips is the one and only dr vinita rahman thank you so very much for being here today looking forward to getting those tips from you thank you all right and dr rahman she's taking your questions as well so if there's something on your mind about cholesterol that you would like to ask the doctor go ahead and post that in the comments or the chat box you can also tweet it to us using that hashtag exam room live also today there are big big big happenings down in washington where the fda has approved a pilot program that would dramatically reduce the number of animals that are used in drug development our own elizabeth baker is here to tell us all about this extraordinary program and give us the details on that elizabeth thank you so very much for being here today okay plus we're working on some stories at the exam room news desk when we get a check on health headlines you're gonna love this one if you're big on social media because it turns out the next person to slide into your dms might just save your life we'll give you details on that story in a little while but let's start with cholesterol nearly 100 million americans have it and it's largely preventable and it's not just an adult problem now either it's seven percent of children between the ages of seven and 19 have it as well and a lot of that probably has to do with that standard american diet so how can we reduce this how can we reverse this unhealthy trend for that we welcome dr vinita ramon to the exam room live dr vermont thanks so very much for being here this is super concerning you hear that number 100 million americans and true or false this really is high cholesterol is largely a preventable problem for the most part that's true we believe that for the majority of people their cholesterol levels are determined by their diet and lifestyle there are a small minority of people for whom they may have a genetic mutation that's causing high levels of cholesterol that may not respond to diet and lifestyle but the good news is for the majority it can be controlled all right before we get into the tips let's go ahead and do kind of a cholesterol reset a cholesterol 101 as it were first of all what is cholesterol and do we actually need it yeah so great question so what is cholesterol it's a fat soluble molecule if you will that's found in our bodies and we absolutely need it our cells use it to build cell walls it's used to make various vehicles in our blood that carry things so we need it but here's the problem too much can cause significant issues and predominantly the concern with high levels of cholesterol is cardiovascular disease which remains the leading cause of death in the united states and worldwide and we know that high cholesterol levels are a big contributor to that so it's really important to manage our cholesterol levels a lot of us know that the high blood pressure mark is anything over 120 over 80. i think a lot of us though may not know what the high level mark is for cholesterol so what would be considered an elevated cholesterol number yeah so uh generally speaking i like to use the data from the framingham study which has been going on for decades and decades and what we know from that is a total cholesterol of 150 or less is protective that people who maintain their cholesterol levels below 150 are at much lower risk for cardiovascular disease now the other number to keep in mind is it gets a little confusing but when you get your cholesterol levels you see generally many different numbers but the ones we look at are total cholesterol ldl cholesterol hdl cholesterol and triglycerides and another thing you can look at and a lot of labs are now giving it to us is the ratio of total cholesterol to hdl cholesterol and we want that to be under four that is also protective so try to aim for one of those at least a total less than 150 or that ratio of total cholesterol to hdl cholesterol less than four and what is the difference between hdl and ldl cholesterol yeah so this is very confusing um what hdl and ldl actually refer to are the vehicles that are carrying cholesterol in our blood so ldl are these cars if you will imagine them they're traveling in our blood they're carrying cholesterol to the rest of our body and hdl is the vehicle that's removing it and taking it back to the liver where it can then be removed so an easy way to remember this is ldl is sort of the lousy cholesterol we want to keep it as low as possible so l for ldl lousy keep it low all right go ahead yeah and then hdl is the opposite it's helpful h for helpful and we want to keep that high as possible that's helpful all right now so you said anything total cholesterol under 150 is optimal i pulled some numbers from the national health and nutrition examination survey before the show nhanes study here um and for americans the the mean dietary cholesterol intake is 293 milligrams every day for for men it's almost 350 women it's less than that but my goodness gracious as a doctor you hear that number knowing that the optimal intake is so much lower than that that has to be kind of alarming to you yeah so we really want uh you know our cholesterol levels tend to run high in the us uh predominantly due to our diet and lifestyle and and and that's actually in a way good news because that's something we can control unlike our genes so there this is uh relatively good news we can change our diet we can change our lifestyle and bring this under control and uh and it looks like uh well one we've lost my camera so let me just do the the voice off screen here for a second um according to this study 96 percent of cholesterol actually came from meat eggs grain products and milk and when i looked at that initially i was like grain products really well it turns out that they were including a lot of processed foods and processed bread in there and those could also have butter and eggs and things like that in there so 96 based off of what it was you were just saying that seems pretty accurate right yeah yeah so you know it's really important for everyone to know that cholesterol while we need it we don't need to consume it our body can make all the cholesterol it needs and when we consume it it only serves to elevate our cholesterol levels and the the reason this is important is that cholesterol is found in all animal based foods uh whether it's fish or poultry or red meat or dairy products they are all rich in cholesterol whereas plants are naturally cholesterol free so if we are consuming animal foods we're likely to have higher levels of cholesterol all right well now let's see what we can do about those higher levels of cholesterol you've got five ways to lower your cholesterol naturally what is the first tip that you have for us you know first is to really cut out those foods that have cholesterol in them so uh you know again red meat uh and dairy are leading contributors to high cholesterol levels and people um often turn to fish because they've heard fish may be healthier but here's the problem fish is also very high in cholesterol especially shellfish like lobster or crabs or shrimp they can have very high levels of cholesterol and even chicken and eggs so it's really important to cut those out start by eliminating foods that are elevating our levels and what are the kinds of foods for tip number two then what are the types of foods that we should be eating so anything plant-based will be naturally cholesterol-free and so really aim for high-fiber plant food so this one is easy you know the four basic plant food groups fruits vegetables whole grains and legumes so legumes are things like beans and lentils like black beans are packed with not only protein but also fiber and these fiber rich foods help eliminate cholesterol from the body so really important to get that fiber in all right i want you to take your time talking about this third tip because tis the season where this next one may break a lot of hearts you're talking about something in particular what is your third tip so avoid tropical fats now what do i mean by that so within the plant-based family some foods are healthy and some aren't so great for us so fruits vegetables legumes whole grains are great but these tropical fats now this is these are foods that are really high in fat particularly saturated fat which raises our cholesterol level so there are three basic food groups here and i'm so sorry to break this to our audience but chocolate is one of them especially solid chocolate will be really high in saturated fat so if you crave chocolate go for cocoa powder less saturated fat and then coconut is naturally very high in saturated fat especially coconut oil so i recommend if you're trying to lower your cholesterol just avoid all coconut products and coconut oil is not a health food despite a lot of popular uh pro you know proclamations out there that it can lower this or lower that there's no evidence and then the third is not used so much in the u.s but palm oil which is used in many tropical countries so avoiding these three is key while you may not be cooking with palm oil it will sneak into processed foods so some of those vegan meats or cheeses will either be made with palm oil or coconut oil and that will bring a lot of saturated fat with it yeah that's a good tip it's just because it's vegan doesn't necessarily mean that it's healthy i think a lot of the plant-based butters might also use that um and certainly the desserts as well do all right tip number four less on the food front and more about getting up off of the couch yeah so exercise is so important we know that regular aerobic exercise has a slew of benefits including lowering our cholesterol level so regular aerobic exercise which is where we're rhythmically moving our arms and legs for a prolonged period of time like 20 to 30 40 minutes such as walking jogging biking swimming hiking these can all help improve our hdl the helpful cholesterol and lower our overall cholesterol so really important to get out there and move even though we're in this pandemic um maybe getting outside can be really helpful let's go ahead and bring it home with tip number five what do you have for us yeah and this is one we don't want to forget if you smoke it's really important to quit smoking we know that tobacco has no health benefits and it is fraught with health hazards and one of them is it will worsen our cholesterol levels so if you smoke really important to stop smoking and not only will you help improve your cholesterol levels you will reduce your overall risk of cardiovascular disease interesting that tobacco would factor in there i mean you wouldn't naturally associate that with the cholesterol but that's that's a good connection there so all five tips we'll go ahead and tweet those out for you as well a little bit later on from chuck carroll wlc let's go ahead right now dr ramon while we have you here and open up the doctor's mailbag we have a great question here from debbie who is writing about statins cholesterol medication she writes that what if you have been following a strict esselstyn quote unquote plan for one and a half years but got off of statins nine months but now you start to see that cholesterol rebound so what is happening there what advice can you offer debbie yeah so uh you know debbie a couple of things come to mind so let's go through the five things we just talked about so you're following the strict esselstein plan so you're not consuming any animal foods so we can mark that off um and then making sure you're getting plenty of fiber-rich foods so i say three to five servings a day of fruits vegetables legumes and whole grains and do try to keep them whole grains because they will have more fiber in them and then really making sure you're not consuming those tropical fats because as we discussed those do sneak in especially in restaurant food or commercially prepared food so look for the words coconut oil or palm oil and in the nutrition label look for the amount of saturated fat in food even things like avocado can have a fair amount of saturated fat so if your cholesterol has rebounded maybe cutting back the avocados could be helpful and then other things regular exercise and then maintaining a healthy bmi is also important because at higher levels of bmi our cholesterol levels can rise all right if we didn't get to your question today have no fear we will save it and do our best to get you an answer on an upcoming episode and i'd be remiss if i didn't also mention that dr ramon is available to see patients via the wonders of telemedicine at the barnard medical center and so to schedule your appointment with dr ramon head over to barnardmedical.org or call 202-527-7500 for full list of states where services are available and you can inquire about insurance as well uh dr rahman i assume you've worked with a number of patients on lowering their cholesterol yeah you know this is such a common issue that we see in our patients and many of us come to us specifically for this because they they know they can take a statin but they would prefer to try to reverse it naturally with diet and lifestyle and we work on that with them outstanding dr ramon thank you so very much happy holidays happy holidays chuck thank you let's switch gears now and turn to some extraordinary news out of the nation's capital here in washington the fda recently announcing a pilot program that would reduce the number of animals being used in drug testing potentially sparing tens of millions of lives every single year so as we shift over to these new human relevant methods we want to learn more about this pilot program what is it and what the effect will be as we move forward for that we welcome our pharmaceutical policy program director here at the physicians committee attorney elizabeth baker thank you so very much for joining us hey chuck great to be here back i'm back to chat with you before we get going on this program i think that it's important that we begin by addressing how these animals are actually being used in the test and can you talk to us a little bit about that um sure for every single new drug that comes to market there is extensive animal testing that is done at the non-clinical phase so that is done prior to clinical trials in human sometimes concurrently as well the animals as you imagine they live in laboratories most of their interactions that they'll have with humans are the people who are feeding them or experimenting on them and then at the end of the experiment generally they are they are killed and we see the a ton of different animal species are used in drug development um most common and and i think every drug that i've ever looked into you'll see monkeys mice rats and dogs but you also see cats rabbits guinea pigs pigs hamsters and other animals as well so basically you name it there's a good chance that it's it's being tested there i'm curious though when i think well i hear a lot of those animals i don't even think that there's a close association with us as humans and i'm kind of wondering well how in the world would testing being done on them in any way translate to the effect that the drug would potentially have on us yeah so isn't that isn't that quite the question so uh the use of animals in drug testing started a long time ago and really at the time that's the science that we had um since then science has evolved quite a bit and now we have methods that are based on human biology and that are much better for predicting human outcomes we now have the data we know that the animal studies are not very good at predicting what happens in humans because it depends on the species you use and even the fda and the national institutes of health say that the vast majority of drugs over 90 percent that do appear safe and effective in animals will fail when they move into human clinical trials and that goes to underscore the importance of this program so let's talk a little bit more about it can you walk us through the details yeah i'd love to so um i find it so exciting this is something that at pcrm we have been working for um for a number of years and it was just last monday that fda launched it it's called i stand or innovative science and technology for new drugs and what it does is it provides a pathway for companies to work with the food and drug administration to be able to gain broad acceptance of a non-animal method and this is so important because prior to i stand there really was not a pathway for non-animal and human biology-based approaches to be accepted in a way that all drug sponsors or all drug developers could use them so you have the traditional animal studies that have been used for years drug sponsors could use those confidently and know that the agency will accept them but the the methods that have been developed more recently that are non-animal that are based on human biology they are just accepted on a case-by-case basis and so what this means is that a company that wants to use one of these approaches needs to go to the agency make a pitch for using it do all sorts of additional work to provide extensive evaluation studies every single time that they want to use that approach so for every product and as you can imagine this adds a lot of time a lot of work to an already length really lengthy and costly process and it also really dissuades companies from using these approaches because they can just go ahead and use the animal test confidently and know that the fda will accept it without having to do all of that additional work and perhaps delay um delayed development and so this istan program is so important because it removes those extra hurdles that companies have to go through in order to use a non-animal method for these approaches that are qualified under the program and not only does it provide this qualification pathway it also just provides a much needed pathway for companies to be able to interact with the agency so not every method is at the point of acceptance right now but they certainly could benefit from fda input and so this program allows um allows that as well well let's talk about some of those methods we've discussed previously on the show something called organ on a chip which i thought was just fascinating i mean essentially my takeaway from that was like it literally is like a chip about the size of a usb device that can give researchers almost all the data that they need as far as safety and efficiency and human relevancy but what are some of the other methods that may become under consideration with eyestand sure well um so this is a broad iceland is a broad program it covers all the drug development tools that are not eligible under an existing program at fda and so it really would provide a pathway for all these in vitro and computational approaches that utilize human biology i do want to just jump into organ chips a little bit in case anyone viewing isn't familiar but what they are is they are about the size of the usb they're developed to mimic the structure and function of um of organs and they can be used either on their own for testing but they're also great because they can be linked with other organs into what are called microphysiological systems they are really exciting because they you can use human cells that are easily obtained from a scrape of the skin these cells are reprogrammed and they are grown into different organ cells that can be used in these different organ chips for testing new medicines and so they're so exciting because they use human biology to help us understand human disease and predict human outcomes um but i also think it's really exciting that they that organ chips specifically have been um have been described by fda as one of the methods that may utilize this program because the fda and our national institutes of health have done a lot of work already on these organ chips so at national institutes of health there is a center called the national center for advancing translational sciences they are managing many programs with so many companies who are who have developed these programs and now they're working on evaluation but also the fda has brought several of these organ chips in-house for evaluation and i've worked closely with some really great fda staff on a think tank for microphysiological systems or organ chips where we really are working to identify what needs to happen in order for these to be accepted and i think um so that part is really exciting but it also um lists non-clinical toxicology assays and those are the in-vitro computational approaches that um that are our um hear about so often from us it's so cool that something you know this size can contain so much data and do so much good in the world like that is just extraordinarily amazing to me mind-blowing even i mean that is technology at its finest right there uh really quickly as we kind of wrap this up i mean just super exciting details with this program here um i want to learn more about the physicians committee's involvement in this you mentioned it briefly um a little bit earlier in the interview but this is something you've been working on since 2016 right yeah that's correct so i came to physicians committee in 2016 and i was tasked with integrating human biology-based and non-animal approaches into drug development um in order to do that i worked very closely with my boss christy sullivan um and then others came on board after that but very early on in 2017 we decided to bring together uh stakeholders so we had fda national institutes of health pharmaceutical companies technology developers all to come together so we could identify what needed to happen in order to overcome barriers to using non-animal methods and one of these this path this lack of a pathway is something that came up very early and was very clear to us that needed to happen in order for us to really move things forward for these approaches that don't use animals so we worked on a manuscript um just kind of outlining our our recommendations for how we would move the field away from relying so heavily on animal studies and toward greater use of non-animal human biology based approaches we kept having these meetings and it eventually formed into a coalition of drug development stakeholders called the non-clinical innovation and patient safety initiative pcrm really leads all of the activities but we do work with other stakeholders on different projects so not everybody works on the same things we just do it they we just engage with other groups where it makes sense with the goals of their organization but we really have focused on policy changes as you said i'm an attorney so my big interest is how can we ensure that the policies um that the policies support using the most predictive science that doesn't use animals and so that's what we've been focusing on we've been looking at the regulations at guidance and we have other projects going on there to change to change the these rules that govern and guide drug development but this pathway has been a central part of our work for the past several years um and you asked how we work on it there's a there's a few different things that we have going on kind of all at the same time first is working with the food and drug administration directly so we provided input to the fda at every chance that we got in order to let them know that the stakeholder community is saying this is needed and to provide all the justification so fda hosts a lot of stakeholder meetings and any meeting that they hosted that would have relevance to this program or uh we were there presenting on it and so that there was a drug development tools qualification program that the fda has initially we wanted that to just be expanded to cover these in vitro and computational approaches the fda has a predictive toxicology road map that was launched several years ago and we thought this should be a part of implementation also the office of new drugs at the fda was being reorganized and so we put this forth as a policy initiative that they could undertake we worked with different committees that influenced the fda and in which the fda participates we met with we really worked on growing industry partners who would use these technologies to be able to come with us to the fda and say uh and and provide justification from a different perspective for why the program is needed so that's kind of like all the fda work that we were that we were doing but at the same time we were meeting with congress congress is really important because congress can put pressure on the agency can help set the agency's agenda provides funding to the agency and so congressional action is taken very seriously by the agencies so we started with hosting a briefing on capitol hill to educate offices and get get people interested in this and the idea of this program then we supported members of congress in sending a congressional inquiry to the fda commissioner asking them to establish the program and then we also supported the senate and the house of representatives in um in appropriations funding language so all of that was happening at congress and then we it was that we were obviously making progress um like i said i was part of this think tank here i am part of this think tank on microphysiological systems and organ chips and we were working on a manuscript highlighting really what needs to happen to get these methods to be used in drug development and i i did bring to the group that we need this kind of pathway to evaluate them and the group agreed and we put that into a manuscript and then also fda put together their own manuscript on their perspectives on toxicology where they acknowledged the need for this program as well and so all of that was really exciting and i was just so happy to see last monday that this program was indeed launched and really quickly we're about out of time here so in 30 seconds or less can you tell us what's next when do we go beyond this pilot program what's the time frame there that we can hopefully graduate this thing into a full-blown well-funded permanent program well it's hard to say because it's you know it's just launched but what we are doing now is helping companies with submissions we're having discussions with fda to see how we can support the agency because of course we do want to move it beyond this pilot phase right now it's likely to be limited to a handful of methods that are accepted through it so we want to do everything we can to make sure the pilot is successful that it is well funded so that it it does become its own permanent stand-alone program at the fda all and i think a lot of people watching right now may also be thinking reducing is great but i would really like to eliminate so that i think is going to be the goal for a lot of people moving forward and elizabeth i know that that is certainly something that we would love to see at the physicians committee as well and the only way that we can make that happen is with support from our members and donors and people who want to push this pilot program forward as well so i would encourage everybody watching right now if you support this message if you support ending or reducing animal testing with drug development go ahead please if you can give what you can to the physicians committee we would greatly appreciate that i do believe we are matching dollar for dollar now thanks to one of our generous donors matching dollar for dollar through the end of the year and you can get in on that right now by heading over to pcrm.org donate elizabeth baker thank you so very much for your time you're welcome thank you chuck let's go ahead and take a trip now to the exam room news desk and get a check on health headlines today we begin with heart disease we spoke about that with dr rahman earlier today well there is new data out now that shows that heart disease accounts for one out of every three deaths worldwide that was the statistic from last year china had the most cases followed by india and russia while the us came in fourth most alarmingly cases of heart disease have doubled globally since 1990 but experts do say this is also one of the most preventable chronic illnesses out there and a plant-based diet has been shown to reduce the risk or even in many cases reverse heart disease all right final story of the day and this is a doozy uh tease this one at the top of the show man do i love it uh the next person to slide into your dms might just save your life that is the findings of a new study where researchers sent direct messages to people twice a day for two weeks on facebook encouraging them to eat healthier and what they found was specific to red meat the people who were receiving these dms actually cut their red meat consumption by almost half and then naturally what researchers at cardiff weren't expecting was that people then also naturally began to become more interested in their health and actually reduce the amount of dairy they were consuming as well so they slid into the dms and their health changed forever pretty interesting stuff right all right coming up on the show tomorrow we will be joined once again by dr neil barnard and lee crosby the fiber queen they will be teaming up to do a doctors and dietitians mailbag all episode long so go ahead and load us up right now with your questions send them on over to at chuck carroll wlc or at pcrm just make sure when you send them you use that hashtag exam room live you can also post them right now in the comments section that's all the time that we have for today i want to say thank you one more time to dr vinita rahman for joining us as well as elizabeth baker and to the crew behind the scenes that makes the magic happen thank you guys as always and to you my exam roomies appreciate you raising your health and nutrition iq right alongside of us for everyone here at the physicians committee i am the weight loss champion chuck carroll thanks so very much for watching until tomorrow stay safe take a stand and keep it plant-based

Channel: Physicians Committee

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Length: 35min 14sec (2114 seconds)

Published: Thu Dec 10 2020