The You Docs: Answers about eggs, flaxseed and funny-color sweat

I had a heart attack and had two stents inserted in my arteries. I love eggs, but limit them to one or two a week. I just read that studies found that eggs are not related to heart attacks. Are eggs really OK to eat every day?

- Lynn, via e-mail

Eggs are such a good source of high-quality protein and nutrients that we would love to egg you on. Eating more than one egg a day doesn't raise heart attack or stroke risk for healthy people, even though the yolk has more cholesterol than the average sirloin steak, which you should think of as poison because of the saturated fat in it. (Saturated fat is much worse than cholesterol in food.) But some people with heart disease - not all - have to play by different rules, depending on their response to food cholesterol. For instance, if you're a "hyper-responder," your blood LDL cholesterol levels spike disproportionately to the cholesterol you eat.

Talk to your doc about whether you need to make any diet changes to keep your heart disease in check or even reverse it. We tell our patients to avoid all saturated and trans fats, added sugars and syrups, and any grain that isn't 100 percent whole. Eggs may be part of that plan, though you may have to stay in the no-yolk zone most of the time. Here's a useful rule of thumb: When you're making an omelet or egg salad, use three egg whites for every yolk. The yolk is where the cholesterol is; the white has half of the egg's protein.

Can I get the same heart-health benefits from flaxseeds as I do from fish oil?

- Cynthia, Port Jervis, N.Y.

Nope. Fish oil has got it all over flaxseeds in terms of DHA and EPA omega-3s, the ones that studies have shown make blood platelets less sticky, reducing the risk of blood clots that can cause a heart attack or stroke and also help lower your blood pressure and triglyceride level. That's because flaxseeds, unlike fish oil, are indirect sources of omega-3s. Flaxseeds are packed with ALA (alpha-linoleic acid), which your body converts about 2 percent to EPA omega-3s, and 2 percent of EPA gets to the really effective DHA. At 2 percent of 2 percent, though, your body's about as skilled at doing this as a 2-year-old is at getting spaghetti into his mouth.

Flaxseeds do have other great things on their résumé: They contain fiber, which helps reduce cholesterol and lignans, which fight cancer. Plus, some of their ALA is converted to omega-3s, and some is better than none. However, little ALA makes it all the way to our favorite omega-3: DHA (docosahexaenoic acid), which is essential to keeping your brain sharp and your heart healthy. Those are benefits that ALA can't touch. So eat flaxseeds; just don't rely on them for your DHA and EPA omega-3s.

But here's the surprise ending: Don't rely on fish oil, either. We YOU Docs recommend taking capsules of algae-based omega-3s, which are high in DHA (aim for 900 mg a day). Algae is where fish get their DHA, so you're going directly to the source. Plus, you'll get all of DHA's perks without the fishy burps that fish oil capsules may cause.

My 70-year-old mom has a very odd problem. When she eats a couple of servings of fish, she sweats blue under her arms. I know this sounds weird, but it's true. Should I be worried about this?

- Susan, Buckeye, Ariz.

Probably not. It sounds like your mom has a rare but harmless condition called chromhidrosis, or colored sweat. Although diet usually isn't a cause, there's a simple way to test this: She can stop eating fish for a few weeks and see if that stops her from going all Smurfy. (She could take 900 mg of algae-based omega-3s to make up for the fish she's missing; see above.) If that doesn't clear up her "blues," a dermatologist can find out if she has an excess of a brownish-yellow pigment called lipofuscin, a byproduct of blood cell breakdown. Lipofuscin also is known as the "wear and tear" or "aging" pigment because it causes age-related brown spots when it accumulates under the skin. Oddly enough, when lipofuscin oxidizes in apocrine sweat glands - the kind that secrete milky fluid - sweat may turn as many colors as a small Crayola pack. There's no cure, but using a capsaicin cream or aluminum chloride hexahydrate solution (Drysol) - an antiperspirant used for excessive sweating - may help. Some docs even use Botox for this if it is such a problem that it makes her spirit blue as well. (Apologies for that, but we want you to know that there is help if the problem affects her quality of life.)

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