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Self Care Pharmacy Blog

Posts Tagged ‘Cholesterol’

 

Darker Isn’t Always Better

Thursday, October 29th, 2015

By: Maame Debrah-Pinamang, PharmD Student

ChocolateFor years, the scientific world has been shouting to the masses about the benefits of eating dark chocolate. The health benefits of dark chocolate have been extensively studied to provide us with the knowledge that habitual consumption of dark chocolate will lead to lower risk of cardiovascular disease, raise your high density lipoprotein levels (good cholesterol), as well as provide antioxidant properties to keep you looking younger, longer.1 Evidence such as this has led people to choose dark chocolate over regular milk chocolate. What if that’s not necessarily the case? Recently, there was an article stating that milk chocolate provides the same benefits of dark chocolate, as well as an increase in research on what the health benefits of dark chocolate come from, and whether the heart benefits that dark chocolate has is present in other types of chocolate.2 Besides color and taste, there is very little difference between dark and milk chocolate. Different companies include different levels of sugar and cocoa powder in their formulations, although the FDA sets standards for what cocoa levels constitute each type of chocolate. In order to be considered milk chocolate, the piece of chocolate must not contain less than 10% chocolate liquor, and at least 12% milk ingredients. For dark chocolate, the required amount of chocolate liquor is greater than or equal to 35%.3

A recent study analyzed the chocolate consumption of over 20,000 people for a period of 11 years, on average. Participants consumed a median of 4.6 grams (about 1.25 individual squares on a standard bar of Hershey’s chocolate) of chocolate per day, and had their cardiovascular health assessed.4 The data used in the first study looked at the effects on HDL and LDL with the participants self-reporting their consumption of chocolate. Participants that consumed a higher amount of chocolate had an increase in cardiovascular health, a lower body mass index (BMI), as well as lower blood pressure. However, the self-reporting of chocolate consumption leads to errors in reporting and inconsistent measurements. The study also failed to report the specific type of chocolate the participants consumed, making it difficult to pinpoint the exact cause of the reduced health risks. In order to produce a more reliable study, the researchers should have produced a specified amount of chocolate to each participant as well as recording the specific kind of chocolate.

Of the more common types of chocolate, dark chocolate is more extensively studied for the benefits that it may provide, but that kind of chocolate may be irrelevant. In a similarly conducted study in Japan, researchers gave participants 13, 19.5, and 26 grams of chocolate per day.5 Similar to the first study, those who ate more chocolate saw a greater increase in cardiovascular health. Those who ate at least 13 grams of chocolate per day found approximately 3.23 mmol/L decrease in LDL cholesterol. Some limitations of the study was that the study participants were given cocoa powder, which is not readily available to most people, as well as the cocoa powder being added to hot water, and not taken as a piece of chocolate that is easily available to all people.

In order to gain all the heart benefits of chocolate, each person should attempt to get approximately 1.5 grams of chocolate per day. Although a consistent consumption of chocolate could provide an increase in heart health, the benefits may not apply to everyone. Different health conditions may not allow for self-care with chocolate consumption. Given the results of the research, it is inconclusive that the impact of dark chocolate on heart health is greater than milk chocolate. The studies performed in the articles allow a safe assumption that either kind of chocolate would provide the same benefits.  The health benefits stemming from cocoa powder and not from the color of the chocolate allow for a greater range of chocolate that will provide heart healthy benefits. The recommended daily amount of chocolate from The Cleveland Clinic Wellness is 1.5 to 3 ounces to ensure maximum heart benefits from chocolate (Godiva sells chocolate in 1.5 ounce size).6 The small amount of chocolate provides us with right correct amount of chocolate to ensure heart health, without the excess sugar that comes with eating too much chocolate. Although it is important to take self-care measures to reduce your risk of heart disease, do not rely solely on chocolate as your cardiologist. Before beginning any self-care regimens, contact your primary care provider to ensure that the measures you are starting are safe and the best options for your needs.

 

References

  1. Kwok, C. S. et al. Habitual Chocolate Consumption and Risk of Cardiovascular Disease Among Healthy Men and Women. British Medical Journal. 2015.
  2. Wanjek, Christopher. “Even Milk Chocolate is Good for you, According to new Study” Huffington Post. June 16, 2015. Accessed October 14, 2015.
  3. Hershey’s. Types of Chocolate. Available at: http://web.archive.org/web/20090126124820/http://hersheys.com/nutrition/chocolate.asp Accessed October 28, 2015.
  4. Smit, H. J., Gaffan, E. A., Rogers, P.J. Methylxanthines are the psycho-o Kondo. pharmacologically active constituents of chocolate. 2004; (176)3-4:412-19.
  5. Baba, S, et al. Plasma LDL and HDL Cholesterol and Oxidized LDL Concentrations Are Altered in Normo- and Hypercholesterolemic Humans after Intake of Different Levels of Cocoa Powder. The Journal of Nutrition. 2007;137(6): 1436-1441.
  6. Cleveland Clinic Wellness. Eating Chocolate can be Healthy. Available at: http://www.clevelandclinicwellness.com/Promos/Pages/Chocolate.aspx#. Accessed October 28, 2015.

Could your phone be used for more than games?

Friday, October 16th, 2015

By: Abigail Savino

Nowadays, it seems as if everyone has a cell phone – from kids to our grandparents, they are commonplace.  So why not design an application for the phone that could help improve our health? There are fitness tracking apps and calorie counting apps that are designed to help develop healthy lifestyles, but some suggest using text messages as forms of encouragement.1 One research study tested out the power of a text message in helping people become healthier over a period of six months.256px-Texting_closeup

Researchers from Sydney, Australia studied the effectiveness of text messaging on health in patients with coronary heart disease, a cardiovascular disease where plaque builds up in the arteries slowing the flow of blood to the heart.2,3 One group of patients received a typical intervention such as modifying diet and exercise at the suggestion of their doctor.3 The other group received four text messages each week providing advice, encouragement, and support for lifestyle changes. Text messages that the participants received were selected from a bank catered to the participant’s chronic condition. Participants who were smokers received a message similar to: “Try identifying triggers that make you want a cigarette and plan to avoid them.” Those who were trying a modified dietary approach received messages such as: “Try avoiding adding salt
to your foods by using other spices or herbs.” Others told to increase physical activity received messages like: “Don’t forget physical activity is good for you! It reduces your risk of diabetes, heart attack, stroke, and their complications.” Investigators also sent texts containing information about the cardiovascular system, for example, “Studies show that stress…can increase the risk of heart disease. Please talk to a health professional if you need help.”

The primary outcome of the study was to determine the text messaging effect on cholesterol levels. After six months, the participants who partook in the text messaging intervention had an average LDL cholesterol level of 79 mg/dL which was lower than the typical intervention group who had an average of 84 mg/dL.3 The study also monitored blood pressure, body mass index (BMI), active smokers, and physical activity levels.4 These were all positively affected by the intervention – average blood pressure for the text message intervention group was 128/81 vs 136/84 for control, BMI was lower at 29 vs 30.3, and more physical activity was completed at 936.1 minutes per week compared to 642.7 minutes per week. The study also started off with 184 smokers in the text message intervention group and ended with only 88 people still smoking. Since cardiovascular disease can be managed by lifestyle changes (diet, smoking, physical activity), it is significant that the text messages focused on those areas and help explain why these results were observed.2 One limitation to the study is the small scale, which may not allow representation of the full effect of clinical outcomes. This study was conducted through a hospital facility so it is not known how generalizable this will be to the overall population. Additionally, the messages were only sent in English excluding non-English speakers, the final results were recorded through self-reporting, cost-effectiveness of the intervention was not studied, and the study was not completely blinded.

Similar ideas have been popping up in other places in healthcare. Medicaid uses this system to give more individualized attention to their patients.5 They do this by sending appointment reminders, medication reminders, and also educational material that relates to them specifically.5 Also a study has been done with patients that have had a stroke in which the text messages were sent to remind them to take their medications, dietary and lifestyle changes, and to be in contact with a health care provider.6 This study increased appointment and medication adherence by 40%.5

Data from the research study above shows that text messaging could help to improve your health, and almost everyone has a phone so your motivation comes straight to your fingertips. If your doctor recommends you to be a part of a program like this then I suggest you strongly consider becoming a participant. If you don’t think a typical intervention approach is going to benefit your health, using this text message system could help to improve your health on your own time. It is great that they send little reminders to help motivate and remind you why it is important to follow through. Participating in something similar to this would be beneficial to improve your health as a whole. With today’s technology, this will likely become a bigger thing in the near future. Would you be willing to try using text messages as encouragement or as reminders? I know I would, everyone needs a little bit of motivation to get the ball rolling with whatever you are battling.

 

References

  1. Macfarlane S. Can A Simple Text Lower Your Cholesterol?. Diabetes Insider. 2015. Available at: http://diabetesinsider.com/can-a-simple-text-lower-your-cholesterol/39648. Accessed September 29, 2015.
  2. Heart.org. What is Cardiovascular Disease? 2015. Available at: http://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovascularDisease/What-is-Cardiovascular-Disease_UCM_301852_Article.jsp. Accessed October 1, 2015.
  3. Chow CK, Redfern J, Hillis GS, et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: A randomized clinical trial. JAMA. 2015;314(12):1255-1263.
  4. University Herald. Texting Patients Could Lower Cholesterol, Blood Pressure. 2015. Available at: http://www.universityherald.com/articles/23954/20150923/texting-patients-could-lower-cholesterol-blood-pressure.htm. Accessed September 30, 2015.
  5. Comstock J. RCT: Text message-based program boosts adherence to appointments, medication | MobiHealthNews. Mobihealthnewscom. 2014. Available at: http://mobihealthnews.com/34749/rct-text-message-based-program-boosts-adherence-to-appointments-medication/. Accessed September 29, 2015.
  6. 6. Kamal A, Shaikh Q, Pasha O et al. Improving medication adherence in stroke patients through Short Text Messages (SMS4Stroke)-study protocol for a randomized, controlled trial. BMC Neurology. 2015;15(1). doi:10.1186/s12883-015-0413-2.