The American diet is too high in calories, saturated fat, cholesterol and salt and too low in fruits, vegetables and whole grains. In my opinion one of the most important hidden culprits contributing to the obesity epidemic is high fructose corn syrup. Just visit the center isles of your local grocery store, pick up a few products and read the labels. You will be surprised at how many products contain high fructose corn syrup.

The problem is that high fructose corn syrup gets quickly converted into glucose. The glucose enters your bloodstream and is either used as a fuel for producing energy or is converted into fat. In order for the glucose to be used as energy you need to be exercising rather vigorously (aerobically). Since most of us don't exercise continually the glucose gets stored as fat.

The other problem with high fructose corn syrup and high levels of glucose in our bodies has to do with insulin. The pancreas secretes the hormone insulin to allow the cells to use glucose as a fuel. The cells contain insulin receptors that allow the cells to use glucose. After long periods of high blood glucose these receptors don't work as well. This leads to high levels of glucose in the blood, a condition known as type 2 diabetes.

Your genetics also play a role in the development of type 2 diabetes. If your family has a history of obesity or diabetes you may be at an increased risk for developing it.

This doesn't happen overnight. It generally takes years to develop type 2 diabetes. Before developing diabetes many people develop a condition known as metabolic syndrome or syndrome X. Eating foods high in sugar can lead to this. People first develop metabolic syndrome and this eventually develops into diabetes.

Here are some of the signs of metabolic syndrome:

High blood pressure (135/85 or greater)

Central obesity--waist circumference 40 inches or more for men and 35 inches or more for women.

Low HDL levels (good cholesterol) less than 40 mg/dL.

High fasting blood glucose levels of 110 mg/dL or greater.

High triglycerides (150 mg/dL or greater)

According to the National Cholesterol Education Program if you have any three of the above signs you have metabolic syndrome.

Source: National Cholesterol Education Program, Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), National Heart, Lung, and Blood Institute, National Institutes of Health, May 2001.
It turns out that too many simple carbohydrates mess up our cells. To be more specific that high fructose corn syrup tends to down regulate our cells' insulin receptors. This leads to what is called insulin resistance. Insulin is what helps to regulate the amount of glucose in our bodies. If our receptors aren't responding the insulin can't work and we end up with more glucose in our system that is stored as fat. This leads to weight gain--middle aged spread and eventually to type II diabetes. It also contributes to the buildup of plaque in arteries.

It is better to choose foods that get converted into glucose at a slower pace. Bacon n eggs fit the bill but are too high in cholesterol. What's left are lower fat foods like most fruits, veggies, soy protein, nuts, bran.

The key is the glycemic index of foods. The glycemic index tells how fast the food gets converted into glucose. You need to choose foods with a low (less than 10 is ideal) glycemic index.

Exercise also helps decrease the glucose and fat in our bodies. We don't have to get in shape to run that marathon, but 30 minutes of brisk walking can provide some nice benefits. If you need a treadmill or exercise bike just go to any neighborhood rummage sale. Walking in your local mall works too but this can get expensive.

It is important to watch your cholesterol levels but it turns out that cholesterol is not the whole story when it comes to plaquing up the arteries. For years the medical establishment touted that we get our total cholesterol under control, first below 220, then 200. Now in some cases cardiologists are comparing cholesterol lowering to the limbo game; "how low can you go?"

What may be more important than total cholesterol are those little packages of fat that your liver makes to send it around your body. There are good packages (HDLs) and bad boys (LDLs). Also, those bad LDLs can be big or small and it's the small ones that can deposit on the inner walls of the arteries and build up. This is kind of the like the plumbing in an old house. We used to live in one and you couldn't flush the toilet when taking a shower without reducing the comforting warm embrace of the water to a cold trickle.

So how can we keep the pipes from blocking up short of hiring Roto Rooter (in cardiology language that spells angioplasty) or rebuilding the plumbing. Well statins are a start but there is more we can do by taking some important nutritional substances. Hey I know this is more pills but nutrition is good, right?

There are a few and I will start with one superstar for the heart--Co enzyme Q10 or CoQ10. This is a biggie and can lower blood pressure as well as reduce the muscles aches and pains associated with statins. The recommended form is an oil-based pill and the dose is 100mg-300mg daily.

Fish-fish-fish. Yes, fish are full of those amazing omega 3 fatty acids. Now there are also omega 3 eggs, cooking oils and spreads for those who are not akin to eating those scaly creatures. You have to take a pretty good dose of a high-quality capsule--3000 to 4000 mg/day with at least 30% of the capsule containing EPA and DHA.

Get in the sun, or, take vitamin D. VItamin D is experiencing a kind of resurgance in popularity in the nutrition world these days as some newer studys tout its cancer fighting abilities. Vitamin D helps by reducing inflammation in the plaque. There is a marker of inflammation called C-reactive protein and vitamin D has been shown to lower this. The recommended dose depends on how much sunlight you get but can range from 1000-6000 units per day for those with coronary artery disease.

Lastly, there is a nutrient that helps to increase the chemical nitric oxide in the vascular system. Yes, that's what Viagra and the plethora of ED drugs do in a certain part of the male anatomy, but guys need vasodilation in their arteries too. The recommended dose is large --3000-6000mg, twice per day. Better to use a powder for this one.

There are a few more but these seem to be the main nutritional weapons that help in the fight against coronary artery disease.

As always, you need to consult with your healthcare practitioner before using nutritional or herbal substances.