Dear Dr. Gourmet,

Q: Can you lower your cholesterol without exercising?

A: I love this question. Even though Dr. Gourmet is about food I believe that exercise is key to being healthy.

You can certainly lower your cholesterol without exercise. The research shows this to be the case. That said, you will do better to exercise regularly. Regular activity has clearly been shown to help lower your total cholesterol, improve the HDL (good) cholesterol and lower LDL (bad) cholesterol. Cholesterol and Exercise

Q: I wondered if there’s too much of a good thing: can salmon more than 4 times per week raise cholesterol levels or otherwise pose risks? Is there an upper limit? I’m referring to canned Pacific salmon, mackerel, or sardines.

I’m a lacto vegetarian, am likely deficient in omega-3 and omega-6 fatty acids, and don’t have qualms incorporating fish into my diet – just wondered about an upper limit.

A: Salmon is a safer choice as are mackerel and sardines. All three are higher in Omega-3 fatty acids and there’s less risk of contamination with mercury or other industrial pollutants than some other fish. A 3 1/2 ounce serving of each of these choices comes in at about 1,000 mg of Omega-3 fats but not more than 0.5 parts per million of mercury. Too much fish?

Q: I have had four attacks of AFib in the past 3 years, so I am on Coumadin. I have read many of your postings on Coumadin and caffeine and Coumadin and cranberries. Caffeine probably does not cause AFib but if one has had AFib attacks will Caffeine bring on another attack?

Regarding cranberries, all of the data I have seen relates to cranberry juice. Would the same opinion that there is no credible evidence that moderate intake of juice affects Coumadin therapy apply to cranberries in a salad or other recipe or eaten alone? I would think they are more potent than the juice.

A: I don’t see that there’s evidence one way or the other about whether caffeine will provoke further episodes of atrial fibrillation in those who have already had issues. The evidence we have about the lack of a link comes from large epidemiologic trials. These have not shown any association between caffeine and heart rhythm problems. However, the only way for us to know for certain would be to perform a randomized, prospective trial where one group with atrial fibrillation drinks coffee and the other doesn’t. Comparing the two would offer us definitive evidence. Coumadin, A-Fib, Cranberries and Caffeine

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