Network Health Dietitians July 08 Issue 36

cutting down on . . . cholesterol update
- Egg free cookery books are available:
Bakin’ Without Eggs - Rosemary Emro 1999.
Manufacturer develops
The Book of Egg Free Cakes - Cinita Stammers 2000.
- Adapt cake, mufﬁ n and other baking recipes by using
reduced cholesterol milk
either egg replacers or a teaspoon of baking powder in
A lower cholesterol alternative to regular milk is be-
place of each egg
ing developed by Alliance Enterprises. The manu-
- 12 really successful egg free Yorkshire puddings can be
facturer claims that Benelact, already a licensed
made by mixing 100g plain ﬂ our with 300mls milk (cows’/
production technique and a ﬁ nal ingredient prod-
soya etc). Then place in a greased and heated (in oven
uct on the global market, can reduce cholesterol
to 220c) 12 compartment fairy cake tin. Then cook until
without losing the taste of dairy based ingredients.
golden approx 15 minutes. For individual toad in the
Alliance Enterprises states that the patented process
holes add a part baked baby sausage to mixture in the
Benelact can cut cholesterol by 90 percent in skimmed
tin before cooking.
milk and 35 per cent in full fat milk.
They are currently developing the product to ﬁ t the
Egg allergy and medication
needs of health conscious consumers and a spokes-
Certain medicines may contain traces of egg and
person said: “One of the challenges is to create
should therefore be avoided by those with a severe allergy
un-adulterated milk that does not have any adverse
to egg. These are the yellow fever vaccine and the inﬂ u-
organoleptic effects,” the spokesperson added. “In
enza (ﬂ u) vaccine.
addition, the challenge is also to not introduce ‘un-
Many people ask if the MMR (measles, mumps and
natural’ components into a natural food.”
rubella) vaccine should be given to those with egg allergy.
According to the manufacturer, the Benelact pro-
The ofﬁ cial guidance is:
cess combines mixing and separating operations with
‘There is increasing evidence that the MMR vaccine can be
the addition of natural oils to the milk.
given safely even when the child has had an anaphylactic
During the ongoing processing, the group says that
reaction to food containing eggs.’
these oils work to ‘grab’ and then separate cholesterol
(British National Formulary).
from the actual milk under controlled temperature
conditions.
1.5 million more statin prescriptions
New national guidelines are expected to increase the number of cholesterol lowering drugs prescribed to
people in the UK, in a move to prevent cardiovascular disease related deaths.
The National Institute of Clinical Excellence (NICE) offer of a statin prescription. NICE believes this will help
estimates that another one and a half million adults will prevent 15,000 heart attacks and strokes every year. But
be prescribed statins, following the Government’s an- the British Heart Foundation (BHF) has voiced concern for
nouncement for compulsory vascular screening for all the many people that will escape through the net and
40 to 70 year olds. GPs will identify those at a high risk of miss out on the preventative care. The BHF doubts the
a heart attack or stroke within the next ten years, using screening will be attended by socially deprived people
computer software that systematically takes into ac- and those from diverse ethnic backgrounds. The BHF also
count a variety of risk factors. criticised NICE for not proposing to continue monitoring
High risk patients will be invited to check their car- the high risk patients after statins were prescribed.
diovascular risk and will receive lifestyle advice and the
ENHANCE trial: lowering LDL cholesterol
Dr Anthony Wierzbicki, Chairman of HEART UK’s Medical and Scientiﬁ c Research Committee, comments on the
ENHANCE trial.
Results of the ENHANCE trial were presented at the 57th the usual effects on other markers. The results showed that
annual scientiﬁ c sessions of the American College of Car- statin+ezetimibe therapy resulted in no beneﬁ t in terms of
diology in Chicago in March. Enhance is an imaging trial slowing thickening of the carotid arteries (carotid IMT). The
in 720 patients with heterozygous familial hypercholesterol- trial showed that ezetimibe therapy was safe.
emia (FH). It is difﬁ cult to make the leap from showing a lack of
The results and articles commenting on the trial were effect on artery thickening to making suggestions about
published on-line in The New England Journal of Medicine. what a drug will deliver in studies examining its effects
HEART UK urges patients who are prescribed ezetimibe by on rates of heart disease or stroke. Studies to investigate
their doctor to continue taking their medication. Support- the effect of ezetimibe on the rates of heart disease and
ing this recommendation, Dr Anthony Wierzbicki, Chairman, stroke in patients are still underway and will report in a few
HEART UK Medical and Scientiﬁ c Research Committee said: years: this ENHANCE trial represents the ﬁ rst of four studies
“The ENHANCE trial can be interpreted in many ways. on ezetimibe. The results of this trial do however reinforce
The trial investigated the use of ezetimibe or placebo in the ofﬁ cial advice from NICE that the ﬁ rst therapy for all
combination with a statin in patients with familial hyper- patients with high cholesterol should be a statin which
cholesterolaemia, many of whom had received intensive are proven to reduce heart disease at all doses from the
statin therapy alone for many years. The trial showed that lowest to the highest. Ezetimibe should be used in those
statin+ezetimibe caused a signiﬁ cant reduction of LDL patients unable to reduce cholesterol sufﬁ ciently by other
(bad) -cholesterol over the use of a statin alone and had means.”
NHDmag.com July ‘08 - issue 36 19
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