Wednesday, 4 May 2016

Diet and Blood Cholesterol, Statins and COQ

Cholesterol has been a leveler. It was considered a cause of concern, especially for people living a comfortable life style, making them forgo some nice food and regularly swallow tablets to keep it under control, thus making them feel a little uncomfortable. Good and Bad cholesterols were identified and there were a number of claims by various food products about how they promoted Goodies and check Baddies.

It was said, probably by a rival lobby, that the fear of cholesterol was fanned by manufacturers of a family of drugs called Statins. These drugs controlled Cholesterol levels, but caused weakening of muscles. Another set of drugs or rather food supplements called CoEnzimes were promoted to counter the effects of Statins. This expensive therapy evoked a mixed response.

This topic again started making headlines as some notification from US Govt is reported to have accepted that Cholesterol is not a cause of concern.

Various sets of opinions, real life experiences and advice were expressed on this topic.

 Some related articles are given on these links
Cholesterol Myths ... ???
http://abghare.blogspot.in/2012/12/cholesterol-myths.html
All about Cholesterols - Good and Bad
http://abghare.blogspot.in/2013/07/all-about-cholesterols-good-and-bad.html
How to Reduce Your Cholesterol Levels!
http://abghare.blogspot.in/2013/06/how-to-reduce-your-cholesterol-levels.html
Cholesterol, Alcohol, Heart and Brain

http://abghare.blogspot.in/2014/10/cholesterol-alcohol-heart-and-brain.html

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S Dayal : Date: Feb 3 2016

Cholesterol is finally officially removed from Naughty List

The US government has finally accepted that cholesterol is not a 'nutrient of concern', doing a U-turn on their warnings

In the meantime of 40 years US Drug Industry in connivance with Health Department made over 1.5 trillion US Dollars by selling cholestrol lowering drugs. This fear probably caused death of a million gulliable citizen who believe the US drug industry.

comment by Nikki Barri

Cholesterol has been on the "naughty" list of nutrients for nearly 40 years, with health officials warning us to stay away from high-cholesterol foods since the 1970s to avoid heart disease and clogged arteries.

"Full-fat dairy products and advocados are high in good fats."

But US officials have finally given the green light for a U-turn on previous warnings, which means eggs, butter, full-fat dairy products, nuts, coconut oil and meat have now been classified as "safe" and have been officially removed from the "nutrients of concern" list.

The US Department of Agriculture, which is responsible for updating the guidelines every five years, stated in its findings for 2015: "Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day.

"The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol, consistent with the AHA/ACC (American Heart Association / American College of Cardiology) report.

"Cholesterol is not a nutrient of concern for overconsumption."

"Eggs are no longer on the 'naughty list'. "

The Dietary Guidelines Advisory Committee will, in response, no longer warn people against eating high-cholesterol foods and will instead focus on sugar as the main substance of dietary concern.

The 70s, 80s and 90s were the 'non fat' years, with the government warning people to limit the amount of high-cholersterol foods in their diets to avoid heart disease and strokes.

But nutritionists and scientists have long been campaigning for the U-turn, which started with introducing "good cholesterols" back into the 'safe zone'.

US cardiologist Dr Steven Nissen said: "It's the right decision. We got the dietary guidelines wrong. They've been wrong for decades."

He esitmated that about 20 per cent of cholesterol levels in your blood come from your diet, which means the rest is produced by your liver and is actually needed by the body.

Dr Chris Masterjohn added:“Since we cannot possibly eat enough cholesterol to use for our bodies’ daily functions, our bodies make their own.

"When we eat more foods rich in this compound, our bodies make less. If we deprive ourselves of foods high in cholesterol - such as eggs, butter, and liver - our body revs up its cholesterol synthesis."

"Nuts were previously thought to contain too much cholesterol."

Sugar has now been identified as the "worst" food culprit for health problems, with GPs now focusing on weaning patients off the sweet stuff.

Cardiologist Dr Aseem Malhotra, who works with group Action On Sugar, says a clamp-down on the food industry is next.

He said: "It's very clear that added sugar has absolutely no nutritional value whatsoever and, contrary to what the food industry want you to believe, the body doesn't require any carbohydrate for energy from added sugar.

"And we know the food industry have been spiking our food with added sugars. We also know that carbohydrates and particularly refined carbohydrates - so carbohydrates that lack fibre, sugar being one of them - have the biggest impact on insulin in terms of surges of insulin in our body. And insulin is a fat storing hormone." So, in summary, ditch your skinny latte for a full-fat latte and get some avocados down you.

The Real Truth about Cholesterol

The majority of the cholesterol in you is produced by your liver. Your brain is primarily made up from cholesterol. It is essential for nerve cells to function. Cholesterol is the basis for the creation of all the steroid hormones, including estrogen, testosterone, and corticosteroids. High cholesterol in the body is a clear indication
which shows the liver of the individual is in good health.

Dr. George V. Mann M.D. associate director of the Framingham study for the incidence and prevalence of cardiovascular disease (CVD) and its risk factors states: "Saturated fats and cholesterol in the diet are not the cause of coronary heart disease. That myth is the greatest deception of the century, perhaps of any century"
Cholesterol is the biggest medical scam of all time.
There is no such thing as bad Cholesterol! Men of science have abandoned truth for money. Attempting to control cholesterol is a very, very dangerous practice that occurs in every hospital and medical clinic daily.

By Ron Rosedale, MD
"Statin Drugs Actually Increase Heart Disease"

So you can stop trying to change your Cholesterol level. Studies prove beyond a doubt, cholesterol doesn't cause heart disease and it won't stop a heart attack. The majority of people that have heart attacks have normal cholesterol levels.
THE GREAT CHOLESTEROL SCAM
By K.L. Carlson, MBA
Cholesterol guidelines have been created to increase pharmaceutical profits, not to improve peoples’ health. I know from my experience as a pharmaceutical sales representative for a statin drug. We were trained to emphasize to physicians the new lower LDL guidelines that were ostensibly created by health experts. The truth is the majority of the experts who created the lower guidelines have multiple financial ties to pharmaceutical companies. One expert was found to have ties to ten drug firms

OUR BODY NEEDS 950 mg OF CHOLESTEROL FOR DAILY METABOLISM AND THE LIVER IS THE MAIN PRODUCER.
ONLY 15% OF CHOLESTEROL IS BEING DONATED BY THE FOOD WE EAT. If the fat content is less in our food we eat, our liver
Got to work more to maintain the level at 950 mg. If the cholesterol level is high in our body, it shows the liver is working perfect. Experts say that there is nothing like LDL or HDL.
…………..
….. Cholesterol is not found to create block any where in human body. Why does it create block only in heart, where as calcium sediments create
Block all over the body .. for example kidney, pancreas. Urinary bladder, gall bladder etc etc

JNC VIII 2014 has also relaxed the BP target. Let live simple and stress free...
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Taswir Singh :
Thanks for the information.
But now on wards, if this is  true people will loose faith in world leader of science and capitalism.
It is actually shame on the part of USA pharma industry, which has been exploiting gullible citizen for so many years at a stretch.
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Thottappilly Premachandran :
More strange is that no one in the group(perhaps many may be using cholesterol medicines in this group!) is not picking up this subject. I am sure it is a very critical subject and not mundane.
I am requesting our honourable members from USA to look in to this topic and enlighten us. What I heard is that the origin of this discovery is from there.
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N P Sharma :
It is still very difficult for the doctors to stop cholesterol medicines. Last month my wife's cholesterol was within normal range , so I asked the nephrologist if we can stop the medicine now as it is anyway not a critical parameter. But he advised to continue the medicine.
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Anand Ghare :
As I have understood From Googling, Cholesterol in Blood and that in food are two different things, somewhat loosely connected. It is not necessary that all the cholesterol you eat gets converted in to or is directly added to your blood stream. It is also possible or rather common that body produces its own cholesterol from Carbohydrates eaten in excess.
Actually Cholesterol is also very much essential for proper functioning of our body, but if the bad cholesterol is in excess, it gets deposited at unwanted places and the good cholesterol tries to remove it from them. Appears funny but true!
So if you have a tendency of high cholesterol levels in blood either burn it with exercise or use drugs to control. It is also not necessary that the cholesterol in blood will get deposited in arteries and cause blockages. That may depend on other factors and which artery is affected when is statistical in nature. We have seen very healthy looking people suddenly fall ill and when checked by Angiography they are found to have 70-80% blockages. So as a precautionary measure, doctors keep advising medication, not necessarily under influence of Drug trade.
There are conflicting opinions about cholesterol in Ghee and Coconut oils, many people advocating their use. I think if we are used to it, let us only have some moderation. However, keeping a watch on total food consumption is must, especially in old age.
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Mohan Rao :
Cholesterol is a fat substance naturally present in blood and cells.  There are two types: LDL and HDL. High cholesterol usually refers to high LDL (“bad”) cholesterol. The target level is 2.0 mmol/l. It can increase the risk of cardiovascular disease. The goal is to lower it. One should check with the physician if you should be on medication to achieve this. On the other hand, HDL (“good”) can reduce the risk of cardiovascular diseases if it present at higher levels. Triglyceride is also a form of fat that the body makes from sugar, alcohol and other food sources. Healthy eating habits, regular physical activity can help you manage cholesterol and reduce the risk of cardiovascular diseases.
Healthy eating tips: choose lower fat foods, limit saturated fats avoid trans fats, limit food sources of cholesterol and choose high fiber foods. To lower LDL (“bad”) cholesterol, replace saturated fats and trans fats with small amounts of unsaturated fats such as vegetable oils (canola, peanut, olive), use nuts and seeds such as peanuts, almonds and ground flax or soft non-hydrogenated margarine. Choose lower-fat milk (skim) or milk products (yogurt) or soy or rice-based substitute products. Use whole grains, high fiber grains with soluble fiber (barley, brown rice, multi-grain pasta). Choose low-glycemic index foods. Choose unprocessed fruits for more fiber. Choose fresh vegetables, with a variety of colors, and high fiber. Choose fatty fish (salmon, trout, sardines), plant proteins (Vegetarians note: legumes, lentils, Tofu), lean meats (visible fat trimmed, skin removed from poultry. Choose lower-fat cheese (less than 20% milk fat).
People with diabetes have an increased risk of cardiovascular diseases even if their LDL-cholesterol is normal and even higher risk if LDL cholesterol is elevated.
The info is summarized from Canadian Diabetes Association literature.
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SUBBARAO CHIVUKULA :
I am attaching an article which Mr.Dayal or somebody else circulated in the NPCIL retirees group, written by a well known correspondent Nikki Barr either in Washington Post or another Newspaper. Review of various health advises was done once in every five years by the US government authorities and the latest was done in January this year. Similar articles were written in various newspapers in the first week of January on this U-turn policy by the US Government. My brother-in-law is a practicing Cardiologist here in the US for the last 25 years. I asked my wife, who is right now visiting him, to check with him on this, since she and myself take Lipotor, brand name for Atorvastatin 5mg every day. He is aware of the developments and advised us to discontinue the medication.

We have to make a clear distinction between diet-cholesterol and blood cholesterol. As written in the article, most of the cholesterol requirement by the body is made in the body by Liver. If there is any deficiency in the body's requirement Liver makes it up. It is known that Liver makes about 80% of the body requirement and if diet supplies more than 20% of the requirement, Liver makes what is deficient. Like the article says correctly, Trans-fats and Saturated fats in the diet have to be avoided, since they get deposited anywhere including the coronary arteries.

I am writing this because somebody opined that nobody residing in the US has written on this important subject. Hope I am not contradicting any opinion expressed by anybody and offending him.
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Mohan Rao :
 The general wisdom seems to be that cholesterol has to be controlled by healthy eating habits and regular exercise. But there seem to be cases where cholesterol is stubborn including people who already had heart attacks/strokes etc and sometimes even younger people. Physicians should be consulted and go with their recommendations for lowering cholesterol with drugs. I cannot comment on whether there has been some abuse by the US drug industry in this regard.
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Mohan Rao :

The dialectic of the cholesterol debate captured by Shri Sudhakar Dayal in his email was doubly interesting: on the one hand, it was demystifying cholesterol which had captured public opinion as the culprit for heart attacks for so long and on the other it described new medical opinion of the related agencies in the US as to the so-called naughty list of food nutrients in this debate in the light of new opinions.

Cholesterol does not have to be in the so-called naughty list (personally I think such a list is misleading) since as Ghare Saab has pointed out that cholesterol has a job to do in the body and is produced by the body as well as contributed to by the food-chain. There is a problem of controlling excess cholesterol in the body for the well-known reasons and the pharmaceutical research for the cholesterol lowering drugs was necessitated on that account. The expenses reported (1.5 trillion dollars) seem to be huge but justifiable given that what has emerged in terms of treatment is not snake oil but a range of useful pharmaceutical products in market world-wide which are saving lives every day. I  do not have the personal knowledge to judge the reported deaths of a million ‘gullible’ citizens from  the use of cholesterol drugs directly attributable to the drugs.

It was known that cholesterols are needed for the body and what was missing perhaps in the debate was how much is appropriate and a yardstick for moderation such that excess cholesterol does not become a problem instead of a nutrient. The earlier limit of 300 mg/day seems to be now discounted and perhaps reflects need of a revision of this number. The report talks about scientists and nutritionists moving cholesterol limits to the ‘safe’ zone but how safe is safe is not made known. Without limits, cholesterol consumption will swing from the previous levels to no levels at all and given the gumption of food, dairy and meat industries, the debate will have to swing back at some point to some level of rationality given that cholesterol is needed but not in excess. Dr, Masterjohn’s statement that we cannot possibly eat enough cholesterol and the body has to makes its own does not seem credible to me without some limit on what we can consume.

Consuming unlimited amount of cholesterol-containing foods such as eggs, dairy products and meats will only exacerbate the problem and unduly stress the natural systems in the body in controlling cholesterol. I would imagine that even if the new research is trying to correct the old understanding to remove the unnecessary stigma attached to high cholesterol foods, certain degree of moderation in the consumption of saturated fats would be prudent if nothing else.

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Taswir Singh :
Some deaths might have occurred because people were weaned away from good foods like eggs animal fats coconut oil and desi ghee.
As these products provide good amount of energy for sufficient long time person eats less and instead of gaining weight looses weight.
However in the absence of such foods public started taking fast food along with lot of coke and other energy providing drinks and started gaining lot of weight.
This is one of the reason for increase in the population of OBESE people in  USA and other countries like Australia etc.
It led to all type of problems like diabetes, B.P and joint pains.
Eating eggs and desi ghee in moderate qty. reduces weight.
Taking coke bakery products like cakes sweets etc increase weight and many a times lead to obesity.
Taking statins etc for controlling cholesterol is required definitely if ones body is prone to producing high amount.
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B.B Narang :

I would like to add following points on cholesterol:

Studies carried out in U.S.A if involves white race will not be applicable to Indians(brown race) since Indians have more tendency for formation of cholesterol and their arteries are relatively narrower.

Doctors,to start with suggest preventive measures like change in food habits and going for walk/exercise to bring down levels of bad cholesterol( LDL and VLDL which is equal to Triglecerides/5) and increase good cholesterol,HDL. If these measures fail,only then they prescribe statins which have side effects.

After a certain age,one has to go for regular checkups as a preventive measure.If problem has started ,go to a good doctor,have faith in him and follow his instructions strictly.

One point which is missed by many doctors is role of mental stress on formation of certain hormones which get converted into bad cholesterol.Many persons could get rid of statins by doing meditation and breathing exercises etc.In this regarding I am forwarding an article on role of mental stress in mental and physical health.
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Nandkishore Agarwal
What Shri Narang has said is right. Unfortunately, once you develop some cardiac problem leading to an angioplasty or balooning even, no doctor wants to take the risk of avoiding statins for the patient. No doctor wants to take it out of his prescription the statins even though knowing fully well that long term use of statins lead to muscle weakness and various other problems. Their principle is simply" you have to chose between the two known devils. Problem with heart or with muscles". And the use of statins contiue.
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S. Nanda kumar' :
I have undergone bypass surgery in1998 and I am taking statin for past 18 years. I have not experienced any side effects. But I also take co-engyme Q-10 supplement to off set statin
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S k chadda
co-engyme Q-10 supplement to off set statin
Is it the full name of priscription and what is the dose and how many times a day.

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N.k.Agarwal
I had discussed this with our doctors some times back. They are either not aware or at leaast told me that it is not required. I am not really sure about its availability and if under any trade name in India. I have also read about it in the american medical files but nobody in India seems to be talking about it. This is considered to be a good substitute for statins minus the later's side effects.
To add about what shri nandkiumar says, I hv myself been taking statins since my first angioplasty in 2006. Only thing is when there used to be pain in my calf muscles, some times the doctors used to subscribe it to statins but with the immediate rider that you have to choose between the two evils what is good for you.
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Anand Ghare :
Different brands of COQ are available in Indian market, from a few mgs to a few hundred mgs per tablet. They are not substitutes to Statins. They are rather expensive food supplements and are supposed to strengthen muscles to counter the weakening effect of statins. I used to have cramps in my legs in my sleep or when I was getting up in the early mornings and was advised to take them. I have taken them on and off, but did not come to know whether they actually worked and to what extent. I reduced the dose of Rosuastatin in consultation with my doctor from 10 mg to 5 mg and the problem of cramps almost stopped. I stopped taking COQ thereafter.
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Krishan Chopra :
I took statins for almost 22 years and left a year ago when I could no longer tolerate the side effects.I am now in the process of expeimenting with herbal medecines and other natural treatment like taking salad and fruits 15 minutes before food. My total cholestrol has not gone up much but in the process of coming down but still little above 200 .Next blood test will give me a better confidence and there after I would put the details .
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Ravi Rustagi :
In such a situation of deaths and calamity, attributable directly to cholesterol drug use, there would be class-action law suits, recalls and what not. I have not seen anything like this yet. Remember, America is a capitalist society, the goal is to make or save as much money as possible, within legal framework.
Still the question remains- why the pharmaceutical industry didn’t publish the cholesterol knowledge earlier? I would think it may be like a mega-movie release in Diwali time, the goal is to maximise profit.
In conclusion, what you summarised in terms of moderation in diet makes sense. More the merrier has been unfortunately, the approach of the past century, causing steep rise in obesity and sickness in the land of prosperity. Let us hope the ancient sattvik-endued Wisdom prevails in 21st century. For this, the lead must come out of Bharat. A step was taken on June 21, 2015.
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Puran Sharma:
I did not have cholestrol/ sugar problem when I had heart attack in tennis court in 2008. I was put on Statin 40mg that was reduced to 10 mg. BARC doctor explained that it also helps in avoiding deposits in veins. I now regularly get pain in the biceps area. Presently it is tolerable. Could it be because of side effect of Statin? I underwent By-Pass surgery in 2008. My Cholestrol/ Sugar levels are under control.
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Nandkishore Agarwal :
As per my understanding after my earlier discussions with our cardios, the muscle pain due to Statins is not restricted to only one set of muscles. It will effect a number of muscles in various parts of the body. The pain in biceps is probably due to some over stretched muscles in the specific area due to some physical stress or lifting some weights. By the way, are you playing tennis these days? In any case, even if you are playing, my suggestion would be to go on a slower pitch.
Best thing would be to consult our doctors to be sure about the cause.
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Mohan Rao :
The link provides a Q&A about statins by the British Heart association.( https://www.bhf.org.uk/heart-matters-magazine/medical/drug-cabinet/statins). The way I understood it was that it may be easier to deal with the side effects (such as muscle aches) rather than not taking statins if you have stubborn cholesterol problem. One should consult doctors who may monitor your cholesterol and adjust statin dose if the side effects are severe.
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B.B Narang :
Following is some information on coenzyme Q10:
1.       It is a natural substance produced by body. It is also concentrated in many foods including nuts and oils. It has become a popular dietary supplement in some countries and is being used to maintain general health and treat heart diseases and a number of other serious conditions. Some clinicians believe it is so important for normal body functioning that it should be dubbed ‘Vitamin Q’
2.       It acts as a catalyst for metabolism for conversion of foods to energy .As it acts in conjunction with enzymes, it is named as coenzyme. It is found in every cell in the body and is especially abundant in the energy-intensive cells of the heart. Like vitamin E, it acts as an anti-oxidant to prevent cell damage from free radicals.
3.       It is claimed that it improves heart function, treat variety of heart problems, treat gum diseases, prevents some cancers, and protects nerves to slow down progression of Alzheimer and Parkinson disease and other age related degenerative changes.
4.       In some countries, doctors recommend coenzyme supplement after the age of 40.It is a complement to conventional medicines-not a replacement for prescribed medicines. The doctor only can decide about the dosage depending upon whether being taken for heart, Alzheimer or other specific complains.
5.       It is quite popular in advanced countries and available as an OTC supplement. In India it is not so popular because of high cost. Typically in Japan, 10% of adult population takes it regularly.
6.       Typically for any medicine or health supplements views/counter views keep on appearing based on experience of users. This is true for coenzyme Q10 also. It is found to be overall safe.
7.       CHSS doctors may not be prescribing it because it is a supplement not a medicine and also due to high cost.
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S Nanda kumar :
Some  more information regarding COQ 10.
This is a vitamin supplement and supposed to improve  heart function. Commecial name of the tablet
is Ze - Q which has strength of 100mg.. one strip of 10 tablet cost Rs 420. Statin medicine depletes COQ in your body and therefore it is recommended.but not proved. Japanese are the biggest consumer and they think it improves longivity.

After my heart attack my ejection fraction ( efficiency of the heart ) was 50%. with this condtion you can run marathon, and your heart is very fit. but this factor fell down recently to 40% and no one knows the reason why it happened. To improve this fraction I am taking 2 or 3 tablets a week.This is recommended not by doctor ( some doctors agree ) but appeared in TOI health capsule!!! If Ejection fraction is less than 30 %, one may find brisk walking impossible. To reduce my BP, I am doing brisk walking every day hoping that ejection fraction does not fall below 30 %
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B.B Narang 
I  agree with Sh. Nanda Kumar that Q10 increases efficiency of heart.In a major study carried out in Italy,2500 patients with congestive heart failure were given daily dose of 100 mgs of Q10 in addition to their other treatment.80% showed improvement and after taking it for 90 days,they had less ankle swelling and shortness of breath and began to sleep better. Q10 plays vital role in providing energy to heart muscle.
In some persons statins lead to reduction of Q10 in the body and also break down of muscles. Q10 help decrease muscle break down and reduce pain and discomfort.In some persons who take beta blockers for controlling high blood pressure,level of Q10 decreases leading to some complications.So they have to take Q10 as supplement.In Shri Puran Sharma's case muscle pain could be due to use of statin as 40 mg is rather high.

Following are the food items which contain Q10. Non-vegetarian foods have higher Q10 compared to vegetarian foods.Level of Q10 reduces if the foods are overcooked or fried.

1.Red Meat(Particularly heart and liver)
2.Oily Fish( Salmon, Tuna,Mackerel)
3.Oils(Soybean,Rapeseed,Sesame)
4.Nuts(Walnuts,Peanuts)
5.Vegetables(Spinach,Broccoli,Cauliflower)
6.Grains(Whole grains, Wheat Germ)

As Shri Ghare stated in his mail that he was experiencing cramps in the legs due to use of statins. I have personal experience with cramps in the legs early in the morning.The cramps started in August and continued in September last year when I shifted to Delhi.I also got lower back pain.I  found that lack of calcium could be cause of cramps as well as backache.The doctor gave me vitamin D+ calcium and within 10 days cramps as well as backache disappeared.I got blood test done for vitamin D and it was 24 nmol/L which falls in deficient range of < 50(high risk of developing bone disease).For the last 2 month I am taking vitamin D once a week and will be getting blood test done next month to avoid excess of vitamin D.Sufficient range is 75-250 nmol/L(optimal concentration for maximal health benefit)
As stated in my earlier mails 80% of Indians have vitamin D deficiency but do not realize its importance until they get serious health complications.Body can not assimilate calcium from foods due to lack of vitamin D and calcium deficiency further aggravates the problems.

I had been taking statin 10 mg for the last 20 years as my cholesterol level continued to be high despite following Dr. P.T.V.Nair(BARC Hospital) advice to reduce cholesterol by diet control and long walks.I also consulted Dr. Vishwanathan,a very good cardiologist in Chembur who said that Indians in general have higher cholesterol levels despite all precautions.I have not experienced any side effects of statins. However the cardiologist in Delhi hospital has  reduced dose to 5 mgs daily and my cholesterol level remains within limit.
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Anand Ghare :
Thanks Narang for sharing your personal experience in so much details. Vitamin D, especially D3 and B12 have suddenly assumed great importance in last few years. Pathological tests for their determination are very expensive and to my knowledge whoever has done this test is a candidate for their deficiency leading to their consumption as a routine. Mercifully they themselves are not very expensive. Most calcium tablets are fortified with vitamin D3 to facilitate the absorption of calcium by the body. However, excess of calcium or vitamin D is also harmful. So you get into the cycle of repeating the expensive  pathological tests again and again.
Some times I feel ignorance is really bliss. My parents and their ancestors never got their blood tested and lived a carefree life.
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Nandkishore Agarwal :
Deficiency of Vitamin D3 is best made up from taking atleast 15 minutes of sunshine. It is very difficult to make up vitD3 from medicines although it is claimed that it can be so. It is also not true that anybody who goes in for pathological tests will end up with deficiency of D3. In my personal case, I had developed sciatica pain in my left leg. This was treated for quite some time but ultimately the pain in the calf muscles would not go. Doctors tried to make up the D3 with medicines. Pathlogical tests showed very satisfactory results for D3. Not getting relief, the wise doctor did not want to keep on stuffing medicines in the system. Instead, I was referred to Medical division who in turn after some trails sent me to Jaslok for Neuropathy tests. This is where it was revealed that the calf muscle pain  was due to peripheral and sensory neuropathy for which the line of treatment is totally different.
The whole idea in writing the above is that problems in the body at times may be due to some other reasons other than deficit of D#.

Reg CQ10: Most doctors in India seem to be totally unaware of this coenzyme. Particularly, when I specifically asked some of our cardio people in the hospital, they said it is not necessary and not required even to monitor it. Even some of the consultant (visiting vardiologists) also had the same opinion). Under the circumstances, irrespective of its cost, there being no guideline for its dosage for an individual, it becomes a difficult proposition to take it and derive its intended benefits.

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Nandkishore Agarwal :
As per my recent discussions with our visiting Cardiologists on the issue of use of Statins for Cholestrol control, it was pointed out by him that a lot of reports are floating around on the subject. However, he opined that where ever a person has a history of cardiac problems like angioplasty or by-pass surgey etc, the use of Statins is lifelong and can not be compromised. The problems associated with it like muscle pain etc have to be compared with the intended benefits and accepted. Use of Statins in other cases where one is found to have high cholestrol, but otherwise normal with no cardiac history, has to be restricted as it really does not have much effect nor does it contribute in any way to control the cholestrol. This is primarily produced by the Liver in the human body which controls it also depending upon the requirement of the body.
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Ravi Rustagi :
As a regular practitioner of yoga, and your senior mentor enjoying excellent health in retirement days, it is my request that you also consider introducing yoga/pranayam as part of your daily exercise regimen.

The following precautions and asanas would help in controlling cholesterol.
- Yoga is an alternate approach to health benefits, so you must consult your physician before giving up any current medication
- Learn yoga the right way and under the guidance of a trained yoga expert; mere bookish reading or watching TV is not a substitute to learning

- I regularly perform
 i)  kalpabhati pranayam (skull shining breathing)
ii) Shalabhasan (locust pose)
iii) Sarvangasan (shoulder stand)
iv) Paschimottanasan (two-legged forward bend)
v) Ardha Matsyenasan (sitting half- spinal twist)

- The above practices help increasing the metabolic rate by stimulating the abdominal organs and improves functioning of digestive track), plus cures constipation without any powder etc
- Lastly, healthy eating habits, and
- skipping one meal a week: fasting for body as well as mind(no food + no worry). Body and mind cooperate best.

These are doable by everyone, and with no side effects.
PLEASE START IN RIGHT EARNEST ON THE ABOVE MENU, till you can meet a trained yoga therapist.
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Krishan Chopra :
In my case doctors recommended cq10 when the side effects of statin which I was taking for 20 years  ,became intolerable .It did not help me and  I  had to stop statins. I am now using herbal Medcines and my cholestrol levels are within limits.
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'KM Shirolkar' :
I have seen many people claiming that , they perform either yoga or meditation. And still they face serious cardiac problems.
What i have observed that those who are only practising only meditation are more prone to such problem. Because to avoid angiana
, basically , what you require is an aerobic exercise.
AND generally most of the people avoid aerobics, saying it is not right at my age, it is very hectic, it can cause some serious damage etc. And resort to yoga or meditation as an easy way out.

Ok,  i understand that , and agree that yoga , pranayam and meditation can also keep  you fit.  BUT The question is how much of these exercise is done?
One should know that to derive a righe benifit, have an excellent physical fitness, you have to devote and practice it for minimum one and half of hour per day.
Now another observation: Most of the people who claim that they have an excellent knowledge of yoga and pranayam, and practice it regularly....... practice it for only 15 minutes to 40 min max....AND LAND INTO SOME OR OTHER HEALTH PROBLEM.
Because the duretion is not enough. Also they practice only preliminary asanas and pranayam.
How many of them can perform 'Shirsasan' ?
Haredly 1%.

Different benifits are derived from different practices. That means,  YOGA, PRANAYAM, AEROBICS AND MEDITION each happen to  provide a  different type of benifit.
Hence it also necessary to practice all type of exercises turn by turn to keep you absolutely fit.
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B.B Narang :
Most of the age related/lifestyle health problems are caused due to following factors:
1.Lack of physical activities.Walking or physical exercises increase blood circulation to the organs and remove toxins from the body. Ayurveda methods like steam bath,massage and enema also remove toxins from the body.
2.Air pollution,water and food contamination also generate toxins in the body.
3.Taking junk foods instead of healthy foods on a regular basis loads the organs.
4.Not taking balanced diet like optimum mix of proteins-carbohydrates-fats causes variety of problems.
5.If there is family history of a particular disease,there are more chances of getting the disease.However the onset can be delayed if other precautions are taken.
6.Mental stress plays an important part.When a person is under stress,hormones are released from the body to counter the stress.However the hormones get converted into cholesterol and toxins.That is why meditation and breathing exercises  play an important role.
7.Taking drugs,tobacco,too much alcohol etc. loads the body organs beyond their capacity leading to accumulation of toxins.

So a single factor can not prevent a disease as toxins have to be removed using all means.A person gets in to health problem whenever acid-alkali ratio in the blood shifts in favour of acid.As the age advances capacity of organs to remove toxins reduces so one has to be more careful.

An example of longevity are the people in Hunza located in Gilgit-Baltistan area of North Pakistan.There are many centenarians and the reasons given for their long life is taking items like dried apricot and almonds,taking fresh air and exercise.They are example to the world for using preventive means for healthy lifestyle.

Continuing discussions on Coenzyme Q10,doctors in Government hospitals can not prescribe because these are considered supplements and are quite costly.Typically one capsule costs about Rs.24/- in India.However these are not so costly as the same will cost about 40 cents in U.S.Doctors in Japan,Italy,Sweden and Canada commonly prescribe Q10 to treat heart diseases.Typically in Japan 10% of adult population takes it regularly.I found that near my house all the chemists store Q10.That means that some of the private cardiologists must be prescribing Q10.
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Ravi Rustagi:

We all agree that good health is top priority in life, more so in retirement years.
Recently, I was in India, and had an occasion to attend an annual event of Rustagi community in my hometown in Haryana. I was honoured with a momento.
One gentleman over 80 years in a wheel chair, said 'my two sons were letting me stay in their apartments turn by turn till my health was good. Forcibly, in this final stage, I have moved to live in my daughter’s home, while I had not had a meal in her home all my life. What a shame, he felt. He advised, we should read less, talk less about food, health, medicines etc but get on with exercise asap.

I have been doing regular yoga/pranayam/meditation lasting 90 minutes. I have tailored it myself according to what I have found suits me most, and based on the knowledge acquired from accredited teachers.
I am glad I am doing it intensively.
Sh Narang writes about the Baltistan-Gilgit mountain folks in N Pakistan. I am sure they do not have even 5% knowledge on health matters than most of us have, yet they enjoy 100 fold better health. Sometime, less is more There is a saying Aam khao, patte na gino.

Most well- retired people in America in my valve company plan to buy RV, tour around the country, spend lavishly, buy goodies, visit casinos and overindulgence for instant gratification.  I wish they would instead first join a yoga school after retirement. The fundamental benefit is not just better bodily health, but a better balanced life overall. You learn how to act better, how to think better, how to feel better, how to face difficult situations better, and finally self-realise, learn about your own self better. There is no substitute to yoga, believe me.

One good turn deserves another- good retired life is knocking please answer the door bell. Do not delay, or procrastinate. It is never too late. If you begin practise with just one of the 5 yamas, other 4 come by too.

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Krishan Chopra :
Reg source of Chollest off. . I buy Cholest off  in USA and is made by an American company and distrbuted by   " Nature made nutrtional products " ( www.Nature Made .com ) Available in all Pharmacies cheaper In costco.I believe it can be replaced by Louki Juice.  
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From: Rustagi
 I am pleased to put forth the following for your consideration, then you can decide yourself.
1. From Allopathic pills to Yoga/ meditation is like switching from Newtonian physics to Quantum physics, i.o.w. from atomic level of matter to subatomic energy/holistic level. It is not an easy switch, but it can be managed. These are drastically two different approaches. The western science is finally realising effectiveness of the new approach, as most Nobel prizes in sciences are now awarded on quantum physics and quantum mechanics. Coming from India, you are aware that energy related healing practices of acupressure, yogaasans, pranayams, meditation and prayer therapy have been performed since millennia in the East- China and India. There must be some truth in it.

2. You said that you have heard or known about people performing yoga/meditation, and still they face cardiac problems. Why don’t you believe there are many more cases of people who have successfully overcome cardiac problems? You will find such examples/differences in all branches of knowledge- nuclear energy for example. When Dr. Bhabha and Pt. Nehru decided in 1948 that India should embark in nuclear research, they must have received tons of opposition from local as well as overseas folks.
To cut the matter short, please do visit an accredited yoga therapy centre( I know a couple of such reliable and trustworthy places in India), talk to them and decide yourself. You do possess the wisdom of decision making, I have full faith in you and other retirees in our group.

3. My request is: we should get personally involved in whatever we do. Believing in hearsay is like idle curiosity. A nuclear professional can go above and beyond……….I attended a 31 days residential course in Santacruz east at The Yoga Institute. I do not suffer from any ailment, aches, pains/distress etc, yet I wanted to learn the techniques directly from the right teachers. I am glad I did. It was worth making a special trip from New York to Mumbai.

4. Chopraji, you will meet many more people in such places who are serious about their health, and have been cured already. Since you like to avoid junk food for your body, please also avoid junk thoughts for your mind. Then junk emotions and junk feelings …….A sort of chain reaction in healing the body, mind and spirit. I call this out-of-the-box approach, and not the traditional in-the-box approach.

Trust the above will serve a good start. Believe me, it is not too late yet.
One hour of Yoga, Pranaam, Meditation regime increases our life span by 7 hours- 700% ROI.

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