Last week you learned about postprandial disorders and why they pose a significant risk for heart attack, stroke, and other types of heart disease. As you learned then, very often doctors fail to consider the possibility that their patients may be suffering with postprandial disorders, especially if cholesterol panel blood tests are normal. That's because such tests do not provide direct indications of whether or not postprandial disorders are present.
But that doesn't mean that the tests don't have value in helping detect postprandial disorders. They do. But only if you know what to look for.
It Starts With Your Triglycerides
Triglycerides is the name given to a group of substances that are the main component of fats and oils. Triglycerides are also one of the primary substances found in postprandial lipoproteins, which you learned in Part 1 of this article are the main culprits behind the increased risk of heart disease caused by postprandial disorders.
Although cholesterol panel blood tests do not screen for postprandial disorders directly, they do provide your Health Coach with a measurement of your body's triglyceride levels. Because triglycerdies are the primary components of postprandial lipoproteins, triglyceride measurements can provide an indirect reading of postprandial lipoproteins levels, as well. Therefore, what you need to remember is this:
Doctors and other health officials who pay attention to the dangers of postprandial disorders generally agree that fasting triglyceride levels at or above 100 mg/dL also indicate elevated levels of postprandial lipoproteins. You need to remember this, because this triglyceride level is much lower as a marker for postprandial lipoproteins than the level of 150 mg/dL or above found in the guidelines of the National Cholesterol Education Adult Treatment Panel. As a result, if your Health Coach goes by the National Cholesterol Education Adult Treatment Panel, he or she may consider triglyceride readings between 100 mg/dL to 150 mg/dL to be normal. That simply isn't the case.
Here is another thing you need to remember: Triglyceride readings cannot provide indications of elevated postprandial lipoproteins with 100 percent accuracy. In fact, elevated postprandial lipoproteins can still be present even when triglyceride readings are below 100 mg/dL. For this reason, you also need to know about another type of lipoprotein known as intermediate-density lipoprotein or IDL.
The Relationship Between Intermediate-Density Lipoprotein and Postprandial Lipoprotein Levels
Intermediate-density lipoproteins are another class of protein carriers of fats that are found in the bloodstream when postprandial lipoproteins are present. Like postprandial lipoproteins, IDL also contributes to the formation of plaque in the arteries, and is also a risk factor for aneurysms of the aorta, your body's largest artery.
Under normal conditions, the level of IDL in the blood after patients fast should be zero. IDL is present in any amount above zero then this is a strong indication that the patient has some type of postprandial disorder.
IDL levels can be measured accurately using what is known as the Vertical Auto Profile lipoprotein test (VAP test). Like the cholesterol panel blood test, the VAP test is performed after the patient has fasted for eight to 12 hours and is used to measure IDL levels directly.
Unlike postprandial lipoproteins, which dissipate in the bloodstream during the eight to 12 hour fats, IDL can persists for up to 24 hours, making it easy for the VAP tests to detect. If the test shows that IDL is present to any degree, then you can be certain that a postprandial disorder is affecting the patient.
Since the VAP test is often not included as part of a standard annual checkup, while the cholesterol panel blood test is, you can opt for having the cholesterol test first to see what your triglyceride levels are and then, if they are 100 mg/dL or above, you can request that your Health Coach provide you with the VAP test. Or you can ask for the VAP test to be included as part of your annual checkup. Either way, now you know how to determine if postprandial disorders are affecting you.
If they are, here's what you can do about it.
Reducing and Eliminating Postprandial Disorders
As with most everything else related to cardiovascular health, postprandial disorders can be caused or made worse by the consumption of fried foods and foods containing unhealthy saturated fats. Therefore, your first step in dealing with postprandial disorders should be to eliminate all sources of unhealthy saturated fats from your diet. Hydrogenated and partially-hydrogenated oils should also be avoided. Such oils are found in most processed foods, as well as many breakfast cereals, so be sure to check food labels before buying such foods. (Ideally, you should avoid processed foods altogether.)
In addition, you should also eliminate or significantly reduce your intake of foods containing omega-6 fatty acids. Foods high in omega-6s include most processed foods, egg yolks, and meats (especially organ meats), well as cooking oils, including sunflower, safflower, corn, cottonseed, and soybean oils.
At the same time that you are reducing your intake of foods and oils rich in omega-6s, you also need to increase your intake of omega-3 fatty acids, which have been proven to significantly reduce not only postprandial lipoproteins, but a number of other important risk factors for heart disease, including inflammation. The primary food sources of omega-3s are cold-water fish such as sardines and salmon, as well as walnuts. Fish oils and flaxseed oils are other rich sources of omega-3s.
In addition to the above measures, you should also increase your intake of monounsaturated oils, such as olive oil, which is also one of the best oils to use for your cooking needs.
Overall, your diet should be one that contains plenty of fresh, organic vegetables, free-range lamb and poultry, wild-caught fish, and organic low-fat dairy products, including yogurt and cottage cheese. Complex carbohydrates in the form of whole grains can also be included. (Avoid starchy carbohydrates such as breads and pasta, as well as all simple carbohydrates and sugars, as these types of foods can spike insulin levels, which is another trigger for postprandial lipoproteins.) Fresh fruits and raw nuts, such as almonds and walnuts, can be eaten as snacks. Also be sure to drink plenty of pure, filtered water each day and avoid soda and commercial teas and juices. Organic green tea has also been shown to reduce postprandial lipoproteins, as well as providing many other health benefits.
In addition to the above dietary measures, you should also be sure to exercise for 45 to 60 minutes at least three to four times a week. Research has shown that regular exercise alone can reduce postprandial lipoproteins by as much as 30 percent. In addition, if you are overweight, consult your Health Coach to create an effective weight-loss program, because being overweight has also been shown to increase the risk of postprandial disorders, and therefore heart disease, as well as other diseases.
Finally, be sure to work with your Health Coach so that he or she can monitor your progress and make any necessary adjustments to your healthy lifestyle program.