I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Transplant Discussion => Topic started by: donnia on July 23, 2008, 04:20:32 PM
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I just got a copy of last weeks labs and this weeks labs.
My cholesterol, Triglycerides LDLC and LDH are all high?? I dont even know what the Triglycerides and LDH are telling me.... anyone know??
These are the results of my last 3 labs.
07-04-08
Cholesterol 304 (normal range 121-208) (High risk greater than 240)
Triglyceride 585 (normal range 42 -159) ??? what is this telling me
LDLC 173 (normal 49-107) (Moderate risk 130-159, High risk 160)
LDH 273 (normal 100 - 190)
07-07-08
Cholesterol 298
Triglyceride 733
LDLC 146
LDH 214
07-21-08
Cholesterol 272
Triglyceride 570
LDLC 130
LDH 216
I was taking 40 mg Lipitor and my neph upped it to 80 mg Lipitor after my 07-04-08 labs. My cholesterol is coming down. These labs are pretty scary! I am just 7 weeks post tx... can my meds already have this effect on these labs???
On a positive note, my creatinine for 7-21-08 was 1.0!!! Even after all that yucky sickness... I thought maybe my creatinine would go up because I got dehydrated, but it didnt It was 1.2 on 07-07-08 and went down tot 1.0 YAY!
Okay, any of you smart folks got any information for me??? Also... I have been pretty tired lately... could these labs have something to do with it??? My hemoglobin is 12.0 and Hematocrit 35.3 so it isnt that.
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I don't know if immunosuppressants can change your cholesterol that quickly. What were your numbers before the TX?
Here's some more info:
http://ihatedialysis.com/forum/index.php?topic=7252.0 Immunosuppressant drugs can contribute to high cholesterol
http://ihatedialysis.com/forum/index.php?topic=221.0 Do any of you have cholesterol problems?
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I'm not sure what my numbers were before tx Karol... I know my choelseterol was high... but I was never really fasting to get accurate results. Even when I did my labs I had to take my Bactrim, Valcyte, Myfortic and Protonix..... so I wonder if that had any effects on the results. I will ask the tx team tomorrow while I am there for clinic.
Thanks for the info Karol!
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Blood lipid elevation is a standard side-effect of immunosuppressive drugs. My cholesterol level doubled from its value three days before my transplant to two weeks after my transplant. Usually your nephrologist will prescribe some statin class medications to try to reduce the hyperlipidemia, since dietary management is incapable of handling the size of the lipid problem generated by immunosuppressives.
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My cholesterol went up post transplant but it took about 15 years to do it. Mine was super good prior to trx and there's no genetic component for me. I still take only 10 mg of prevastatin. I exercised a lot while I had the trx and because my husband does have a genetic predisposition for high cholesterol we seldom if ever eat deep-fried things or high fat stuff either. If it's genetic, diet and even a lot of exercise won't be enough. The only times that Lee's cholesterol was controlled by diet and exercise was when we'd be canoeing 8 hours a day for three weeks or so and eating beans and fish. No one can keep that up as a lifestyle so of course he takes the statins.
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I like this site for understanding the various tests:
http://labtestsonline.org/understanding/analytes/ldl/test.html
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Good site Pelagia. So, am I correct in thinking that Donnia's HDL looks pretty high and that might help to balance out the ratio somewhat?
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Donnia, do you list HDL or LDH?
HDL is high density lipoproteins. LDH is a different thing altogether (see below)
For HDL, I found this statement on the American Heart Association website:
"recommend using the absolute numbers for total blood cholesterol and HDL cholesterol levels. They're more useful to physicians than the cholesterol ratio in determining the appropriate treatment for patients.
But they also state: "Some physicians and cholesterol technicians use the ratio of total cholesterol to HDL cholesterol in place of the total blood cholesterol. The ratio is obtained by dividing the HDL cholesterol level into the total cholesterol. For example, if a person has a total cholesterol of 200 mg/dL and an HDL cholesterol level of 50 mg/dL, the ratio would be 4:1. The goal is to keep the ratio below 5:1; the optimum ratio is 3.5:1."
LDH is lactate dehydrogenase. Levels in the blood can be influenced by many things. Here's the NIH's Medline link:
http://www.nlm.nih.gov/medlineplus/ency/article/003471.htm
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Ahh, I posted on the other website board you posted this question on. Not sure what I posted was what you are looking for.
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Hmm, of course I was thinking HDL where Donnia posted LDH.
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I was listing LDH.
I just got back to the hotel from my doctors appointments. My nephrologist said that the meds of course do cause all the problems I am having. He suggested that I talk to my nephrologist at home about taking me OFF the Lipitor because my SGOT and SGPT (liver levels)levels are high. He suggested 1G fish oil 3 times daily instead of the Lipitor. He said it should bring my cholesterol down AND he said it does wonders for the Triglycerides. I will be talking to my doctor about that when I get home. He also suggested I talk to my doctor about taking me off Diovan (BP). He said Beta blockers are better for the kidney, so I will look into that further.
Had my stent taken out. Humm... it was a little (well, more than a little) worse than a cath., but it was over before I knew it.
Are any of yall taking Lasix? I am still retaining a little fluids and my BP is high (even with meds)... 170/100!!!!! He thinks that with the Lipitor and my fluid retention, my BP is being affected. He wants me to take 20 mg Lasix as needed when I am retaining fluids. My transplant coordinator has been very weary of telling me to take Lasix.... he said it tends to make your kidney become 'lazy'. Anyone heard of this?
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I don't have an answer for you Donnia, but has it been 7 weeks since you transplanted???? OMG! Time flys!!!
Doctor recommended in-center hemo. I may be starting the end of next week or the beginning of the following week. I"m nervous. Any thoughts?
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Hey Kelly. Yes, 7 weeks!!! You are correct, time does fly!!!!
As for in center hemo Kelly, I highly recommend you go to the dialysis center and meet the nurses and techs. It will really help put your mind at ease. It helped me alot. Do you already have a fistula or are you going to have to use a permcath?
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Hey Donnia, I also take fish oil and have for about ten years. It was prescribed by my naturopath but then approved by my neph. I take Ascenta, Nutra Sea hp. The hp means high powered I think and also on the bottle it says 3:1 EPA. This is apparently a very good brand and I was told to be a bit careful because they aren't all created equal. Some contain pollutants l guess but I take this one because it was recommended specifically although I'm sure there are other excellent brands out there.
DHA
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Is that over the counter fish oil tablets?
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Yes they are but not everywhere here carries that brand. I get them from a pharmacy that carries many good quality naturopathic preparations as well as pharmaceuticals. You can look it up on line too but remember that there's a difference between the regular and the hp capsules. I take two in the morning and two at night.
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The quality matters in fish oil because fish oil can concentrate oil-soluble pollutants.
Do you like fish? Really fishy, fish? I try to eat kipper snacks, sardines or canned salmon at least once a week because they are loaded with fish oils, calcium and other minerals. This isn't a good idea for someone on dialysis, but post-transplant is okay. I learned this from some "old salts" I used to spend time with at sea a long time ago.
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We just saw Jenna's transplant team. Her cholesterol was 230 6 months ago, a little high.
They are checking it again. The doc said he thinks the omega 3 oils, like flax seed oil or fish oil, are a much better way to start treating it, and they don't interfere with the immunosuppressants.
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Thanks Karol. I am very excited about this avenue of treating this. Seems like Lipitor is not such a great drug for us to take anyway.
Thanks for all the help.... give me a few years and I just might become a nurse with all the knowledge we gain!!!
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Thanks Donnia. I'll do that!
I buy my fish oil capsules at Costco. They are MUCHO cheaper than a vitamin store like GNC. The first time I bought some it was at a GNC type stire and they were $25+ for 250. I was taking 9, yes 9, capsules a day at that time. I found the at Costco and they are like $12 for 250. Now I only take 1 b.i.d. whew!
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I love canned salmon, sardines all those things but of course they're "renally impossible". In Jamaica we used to eat all kinds of dried, salted fish. Everything from herring to cod, makerel to chinese dried shrimp. Saltfish and ackee iis the national dish of Jamaica. Those salt cured fish are delicious to me for cooking purposes but there's enough salt for a couple of lifetimes so I banned them. One of my favorites was salted herring diced up finely, marinated in vinegar with finely chopped onion. Let sit in the fridge and eat on crackers. OOps, no wonder my kidneys wore out.
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My cholesterol is fine, my good cholestrol is low though. My triglycerides are 233. That is the highest yet.
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I am not much of a fish person. I do like tuna and I like salmon patties.... but to just eat fish.... nope! My husband does make a good talapia. I don't like fishy fishy fish.
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I love most types of fish!!! I called the pharmacist this morning and asked about fish oil pills for hubby because his triglyerides are really high. She said the Omega 3 capsules would really help. She looked it up and told me it was ok for renal patients. I called our dialysis nurse then and she got the ok from the neph for him to take them. Have to buy some this weekend.
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I didn't get back in town early enough to call my nephrologist so I have to wait until Monday to call and get the okay from him. :thumbdown;
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Be careful of one thing. Do not do as I did and put the fish oil capsule in your pocket to "take later" then forget and they get washed! Your clothes will stink to high heaven! I'm embarrassed to say I've done this more than once! :shy; I had to soak the load of laundry in vinagar and wash multiple times to get the fish smell out! yuk!!! :puke;
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Ewwwww.... I will definately not put them in my pocket... LOL......
:flower;
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If they smell that bad when you wash them, there is no way I am gonna put them in my mouth :puke; I don't want to taste anything of fish.
I dislike fish food and smell very much. Don't expect me to go to any Aquariums or seafood restaurants.
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Ewww.... do they taste fishy when you take them?
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You can get ones that are flavoured. Lemon or strawberry I think. They don't taste fishy to me, as they're gelatin capsules but I'm the far far extreme of non-picky around tastes. Prednisone and all the other crap we swallow every day tastes way nasty and I just throw back the whole lot and it's done.
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Flax seed oil capsules will provide the Omega 3 that you need but don't have the taste problem.
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Looked at the pharmacy today, no flavored fish oil capsules nor is flax seed on the shelf. There was something mixed with flax and cod oil.
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Looked at the pharmacy today, no flavored fish oil capsules nor is flax seed on the shelf. There was something mixed with flax and cod oil.
My health food store keeps the flax seed oil in the refrigerator.
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You should keep flax seed oil, or even ground flax seed or whole in the fridge and same goes for fish oil in whatever form. The quality of the fish oil is crucial and cod liver oil is not recommended. Fish oil is high in EPA and DHA while flax seed oil is high in ALA (which if you get enough can make EPA and DHA in the body). I was told that good fish oil is best but I also used to add ground flax seed to my cereal for fiber as well as the other benefits. A good health food store is your best bet on the fish oil front and Costco type stores are probably the worst in terms of the quality of the fish involved. These fatty fish can contain significant contaminants so it's wise to be cautious about brand.
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When I was a child mom made me take liguid cod liver oil. A teasspoon of the oil and a round red sugary candy after. it tasted AWFUL!! I still can't stand to look at the candy that she used to give me after. I can taste the cod liver oil when I see the candy :puke; The pills I bought have a coating and are lemon scentd so no smell or aftertaste at all!! I love fish anyway but not the cod liver oil I used to have to take. later in the fall we will catch our own mackeral. Nothing like a nice fresh mackeral cooked!!
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There is a bit of controversy about whether or not most folks can turn the ALA from flax oil into DHA and EPA. Vegetarians will probably want the flax oil, but others may prefer the fish oil, keeping in mind the possibility of contaminants. Many of the oily fish that are used for oil extraction (e.g. menhaden by the company Omega Protein), grow fast and are harvested young. As a result, they are not as likely to accumulate contaminants as something like a halibut or shark. One last consideration is that fish harvest for oil is increasingly controversial from an environmental standpoint as it may not be sustainable.
I like the mayoclinic site for rating the health benefits of various supplements. They give grades at the bottom of each page that make it really easy to understand the "state of the science." This link will take you to the page on fish oil:
http://www.mayoclinic.com/health/fish-oil/NS_patient-fishoil
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Totally confused now on what to take that is not fish based. Sorry, but just the thought of or reading the ingredient of something that contains fish makes me think of the smell and not want to take it. I may have a fishphobia, or that I just can't stand the taste and smell of it.
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Totally confused now on what to take that is not fish based. Sorry, but just the thought of or reading the ingredient of something that contains fish makes me think of the smell and not want to take it. I may have a fishphobia, or that I just can't stand the taste and smell of it.
If you can't take the fish oil, take flax oil, or try some of the foods that are high in ALA and see if it helps. You can get it flax oil in capsules, just like the fish oil.
Here's an excerpt from the American Heart Association page on fish oil and other foods rich in Omega-3 fatty acids for fighting heart disease. (DHA, EPA and ALA or LNA are all omega-3 fatty acids)
"Fish and Omega-3 Fatty Acids
AHA Recommendation
Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease.
We recommend eating fish (particularly fatty fish) at least two times a week. Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
To learn about omega-3 levels for different types of fish — as well as mercury levels, which can be a concern — see our Encyclopedia entry on Fish, Levels of Mercury and Omega-3 Fatty Acids.
We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA), which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha-linolenic acid and heart disease."
There's also a table of recommended doses:
http://www.americanheart.org/presenter.jhtml?identifier=4632
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The omega 3 pills I bought have absolutely no fishy smell or taste. They are called Omega 3 MD and you only have to take one a day!!!
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Professor Gregory Danovitch in his book, "Handbook of Kidney Transplantation," also recommends omega-3 fatty acids, flax, and ginger as supplements which may, in principle, help contain the inflammatory processes which constitute graft rejection, thus functioning as a supplementary sort of immunosuppression that lacks the normal toxicity of these drugs.
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I had an appointment with my cardiologist. I mentioned my trigylcerides. When they tried to pull up my labs for July, nothing was there. June's labs were not there. The last labs were May. I am so happy to know that I am being closely monitored. :sarcasm; I thought I had this taken care of. I have complained to the lab as well as the transplant center. My previous coordinator would call the lab if she didn't get my results. All he said about my trigylcerides was exercise more and lose weight. I worked out 4 days this week and 5 last week as well as walking. I wonder how much exercise is considered enough.
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Donnia-
Having FSGS and hereditary issues, I had extremely high lipids. Cholesterol 425 & triglycerides 1300!!! I am now on Crestor 20mg and cholesterol is 110 and I have to have a liver function panel test done every 3 months. My triglycerides are down to an amazing 225 now and I take a drug called Lovaza, which is the Omega-3 fatty acids with something else in it. The greatest thing about that drug, is there is no toxicity to any organs, so no blood testing is needed. They are liquid capsules, so no taste either. I take 2 in the morning and 2 at night....they are big though. I asked about OTC fish oil and they said I would have to take a lot more pills if I went that route.
M brother also had high triglycerides and he cut out all of the sugar and his is now normal, but was 550. The triglycerides put you at high risk for diabetes and pancreatitis.
Hope this helps :)
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Thanks lruffner~
My best friend is coming to town next week for my birthday. She does not use ANY sugar at all.... she sweetens with fruits and something else... cant remember what she called it. I am going to get her to help me with ideas on how to lower my sugar intake.
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I don't use any sugar either. I sweeten with fruit and splenda. I use splenda in all my recipes that said sugar. I find it doesn't change the taste at all.
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My guys won't go for the all Splenda substitution, but if I go 50/50 or even 25 sugar/75 splenda, they can't tell the difference. You can also try agave, which is sweet, but has a low glycemic index. The downside is that it's expensive.
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I tried the agave this week and loved it! My best friend was in from out of town and brought me some. You are right tho, it is expensive. I am going to look online and see if I can find it any cheaper than she found it.
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Here's an relatively new article about how diet can affect your heart health (and kidney health since the transplanted kidney needs good blood flow). It follows on the heals of the news stories about the benefits of the Mediterranean Diet and South Beach Diet compared to some of the other popular diets:
Mediterranean diet: Choose this heart-healthy diet option
If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet incorporates the basics of healthy eating — plus a splash of flavorful olive oil and perhaps a glass of red wine — among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.
Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet remain tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.
Benefits of the Mediterranean diet
The Mediterranean diet is thought to reduce your risk of heart disease. In fact, a 2007 study conducted in the United States found that both men and women who consumed a Mediterranean diet lowered their risk of death from both heart disease and cancer.
Key components of the Mediterranean diet include:
Eating a generous amount of fruits and vegetables
Consuming healthy fats such as olive oil and canola oil
Eating small portions of nuts
Drinking red wine, in moderation, for some
Consuming very little red meat
Eating fish on a regular basis
Fruits, vegetables and grains
The Mediterranean diet traditionally includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables. The Mediterranean diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol that's more likely to build up deposits in your arteries.
Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten without butter or margarines, which contain saturated or trans fats.
Healthy fats
The focus of the Mediterranean diet isn't to limit total fat consumption, but to make wise choices about the types of fat you eat.
The Mediterranean diet is similar to the American Heart Association's Step I diet, but it contains less cholesterol and has more fats. However, the fats are healthy — including monounsaturated fats, such as olive oil, and polyunsaturated fats, which contain the beneficial linolenic acid (a type of omega-3 fatty acid). These fat sources include canola oil and nuts, particularly walnuts. Fish — another source of omega-3 fatty acids — is eaten on a regular basis in the Mediterranean diet. Omega-3 fatty acids lower triglycerides and may improve the health of your blood vessels. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans-fatty acids), both of which contribute to heart disease.
Choosing oils and fats
Olive oil. All types of olive oil provide monounsaturated fat — a type of fat that can help reduce LDL cholesterol levels when used in place of saturated or trans fats. "Extra-virgin" and "virgin" olive oils are the least processed forms, meaning they contain the highest levels of the protective plant compounds that provide antioxidant effects.
Nuts. Nuts may be high in fat (80 percent of their calories come from fat), but tree nuts, including walnuts, pecans, almonds and hazel nuts, are low in saturated fat. Walnuts also contain omega-3 fatty acids. Nuts are high in calories, so they should not be eaten in large amounts — generally no more than a handful a day. For the best nutrition, avoid honey-roasted or heavily salted nuts.
Wine
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, light intake of alcohol has been associated with a reduced risk of heart disease in some research studies.
Red wine has an aspirin-like effect, reducing the blood's ability to clot, and also contains antioxidants. The Mediterranean diet typically includes some red wine, but this should be consumed only in moderation. This means no more than 5 ounces (148 milliliters) of wine daily for women (or men over age 65), and no more than 10 ounces (296 milliliters) of wine daily for men under age 65. Any more than this increases the risk of health problems, including increased risk of certain types of cancer.
If you're unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol. Also keep in mind that red wine may trigger migraines in some people.
Putting it all together
Adopting a Mediterranean diet is easy if you're a smart shopper. Choose plenty of fresh fruits and vegetables, limit your intake of red meat, and eat fish at least once a week. Though avoid fish that's fried or laden with butter or heavy sauces. Use healthy fats, such as olive oil and canola oil, when cooking — but only in moderation because of their high calorie content. Consider nuts as a snack or an addition to a salad. Finally, reduce or eliminate saturated fat and trans fats (also known as hydrogenated or partially hydrogenated oils) from your diet.
Read food labels to see what you're really buying and putting into your body. Here are some specific steps you can take:
Eat natural peanut butter, rather than the kind with hydrogenated fat added.
Use butter sparingly. "Low fat" or "cholesterol-free" on the label doesn't mean a product is necessarily good for you. Many of these items are made with trans fats.
Eat a variety of whole fruits and vegetables every day. Ultimately, strive for seven to 10 servings a day. Keep baby carrots, apples and bananas on hand for quick, satisfying snacks. Fruit salads are a wonderful way to eat a variety of healthy — and tasty — fruit.
Use canola or olive oil in cooking. Try olive oil for salad dressing and as a healthy replacement for butter or margarine. After cooking pasta, add a touch of olive oil, some garlic and green onions for flavoring. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter.
Substitute fish and poultry for red meat. Avoid sausage, bacon and other high-fat meats.
Limit higher fat dairy products such as whole or 2 percent milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.
Eat fish once or twice a week. Water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it's sauteed in a small amount of olive oil.
Keep walnuts, almonds, pecans and Brazil nuts on hand for a quick snack.
If it's OK with your doctor, go ahead and have a glass of red wine at dinner with your pasta or fish. If you don't drink alcohol, you don't need to start. Drinking purple grape juice may be a healthy alternative to wine.
Once you experience the delicious and healthy choices the Mediterranean diet has to offer, it just might become your favorite diet.
By Mayo Clinic Staff
June 20, 2008
http://www.mayoclinic.com/health/mediterranean-diet/CL00011