From the office of Robert S. Grimshaw Jr MD FACP Internal Medicine 3535 Hill Blvd Yorktown Hts NY 914 962-3180 NEWS Recognized Provider  “With Distinction” by the American Diabetes Association/National Committee for Quality Assurance 2/99-2/02

Cholesterol Info Page 2 9/99

    The following supplement recommendations are well regarded by top cardiologists and internists and supported in the literature:

    Antioxidants to prevent the oxidation of the LDL cholesterol that you have: Vitamin E 400 IU, Vitamin C 500 mg timed release in the morning (do not take C with calcium, take calcium in the afternoon and before bed).

    If your homocysteine level comes back higher than 9, you*ll need a prescription for 1 mg of folic acid. In the interim, 400 mcg (available over the counter) is fine along with 50 mg B 6 and 100 mcg of B 12. These nutrients decrease homocysteine, making the interior walls of the arteries Teflon like and more resistant to the adherence of oxidized LDL.

    No-flush or timed release niacin, 250 mg with food, helps convert pattern B to pattern A and is also available by prescription by the name of Niaspan in order to consume higher doses without the flush.

    Soluble fiber found primarily in oatbran and legumes (peas, beans and lentils). Daily oatmeal is OK, but doesn’t really make a big difference. I usually advise 500-1000 mg oatbran tablets with each meal. It binds with bile acids in the colon so you excrete them. This prevents their reabsorption by the body which then uses the bile to manufacture its own LDL cholesterol. So, you can dramatically cut down on what your body is making.

    Omega 3 fatty acids from fish oils, found supplementally in MAX EPA 1000 mg - take with food, or in fatty fish such as salmon, halibut, sardines, tuna steak, swordfish twice a week. Omega 3's are especially effective in preventing the damage from excess circulating triglycerides. They, like Vitamin E are also natural blood thinners. Omega 3*s are also natural anti- inflammatories.


    Olive oil is rich in monounsaturates, a good fat,  and red wine and red wine vinegar are also good for their natural antioxi-dant compounds.

    Benecol and TakeControl spreads are now available in supermarkets. These use a natural plant sterol to decrease LDL. Benecol also comes as a salad dressing. Three servings a day can decrease LDL by 14% they say--it*s pricey, about $8 for 2 weeks for 3 servings a day.


    Stay away from saturated fats, partially hydrogenated vegetable oils (found in most commercial baked goods and convenience products), simple sugars and late day eating. Anything that is more than 30% fat calories is usually a no. However, nuts, which are a fat, do contain monounsaturates which are good along with a host of other great nutrients. So, 1 to 3 oz of nuts at 4 PM for 200-400 cal to take the edge off of overeating at dinner is OK.
-- Geri Merante, RD,MPH,CDN