Cholesterol
AFTER your doctor has read the result of your laboratory test, you walk out of the doctor’s office with a piece of paper in your hand and it has a number on it: 240, 250 or even 300. It’s your cholesterol count and it’s too high! Before you panic, start mulling over cholesterol drugs or race out out to buy more life insurance, stop! Breathe in, breathe out. Now relax, because you have some work to do.
About half of us have cholesterol count that is high (240 or above) or borderline high (200 to 239). This may put us at risk for heart disease and possibly a handful of other health problems including stroke and impotence. But numbers alone don’t tell the whole story. The important thing to remember is that one’s cholesterol count can be lowered with the right plan. Here’s what you should do:
Look at the numbers
The blood test that measures total cholesterol is also designed to measure high-density lipoprotein or HDL. This is the good form of cholesterol that scours road block-forming plaque out of your system. If your HDL reading is 35 or above, that is good news. However, if your HDL level is below 35, you could be in potential danger even if your total cholesterol is less than 200. If your HDL is low, you could have a coronary risk tremendously higher than a person whose total is elevated. But it’s still not time to worry. There’s more figuring out to do.
Count risk factors
What you will do next depends on circumstances outside of your cholesterol status. Give yourself a pop quiz:
•Do you smoke?
•Do you have high blood pressure?
• Do you have diabetes?
•Do you have a family history of heart attack or sudden death striking a father or brother before age 55 or a mother or sister before age 65?
•Are you over age 45?
Saying yes to any of these questions suggests a risk of coronary disease. Also, being overweight or not getting enough exercise can increase the risk from any of these factors.
Take a new test
What you want is more precise information about a substance called low-density lipoprotein or LDL. That’s the bad cholesterol which leaves waxy deposits all along your circulatory system. You particularly need to be tested for LDL if your total cholesterol is in the borderline range (200 or 239), or higher and you answered yes to at least two of the risk-factor questions in step two. Schedule an appointment with your doctor for an LDL test. It will require drawing blood and you need to fast beforehand. The number to hope for is something under 130. If your LDL count is below the range there is a lot less to be concerned about. You still need to cut down on dietary fat particularly the saturated kind and cholesterol. A little more exercise would not hurt either. You are also in immediate risk for cholesterol-related disease but plan on being rechecked in four or five years. If your measurement is over 130, however, it’s time to look seriously at your individual risk factor again.
Plot your course
If your LDL is 160 or above, that is too high. You’ll be put on a strict diet and exercise program. You will also need to be under your doctor’s care. Your first goal is to bring LDL down to below 160. If your LDL is between 130 and 159, your course of action depends on your risk factors. If you answered yes to one or none of the risk-factor questions in step two, you probably won’t need to be under a doctor’s care. You can take charge of the situation by reducing your
intake of saturated fat and cholesterol, controlling your weight and exercising regularly. Your goal is to bring LDL below 130.
If your LDL is between 130 and 159 and you have two or more risk factors, you are in the same boat as the 160 and over group and are looking at an
increased risk of heart disease. The difference is that your goal will be to bring your LDL under the 130 line. If you have ever had a heart attack, angina (chest pain) or heart surgery, no matter how high your LDL is now you will need to work to bring it down to 100 or below.
Change your diet
A good diet is the most important line of defense against the effects of cholesterol. Sixty-four percent of your risk for heart disease is from diet alone. And simple changes can give you dramatic results fast. One review of different cholesterol-lowering studies found that dropping total cholesterol by 10 percent and sustaining that level can cut risk of heart disease by an average of 25 percent at age 40. That kind of reduction is possible in a more two to four weeks through diet changes alone especially when cholesterol levels are very high. Your priorities in order are:
Cut back on foods high in saturated fats like whole-fat dairy products and fatty cuts of red meat. This is the big one, the single move you can make that will change your cholesterol level and lower your risk. You should know too, that there is an added benefit to cutting back on saturated fat. It may help you lose weight. And that’s the most important thing. Dropping five to 10 pounds and keeping them off can double the LDL reductions you get from reducing saturated fat and cholesterol alone.
Boost your fiber intake. Studies by nutrition
experts show that having a diet high in soluble fiber reduces LDL and additional 4.8 percent in people who were already eating a low-fat diet. And that’s the key! Soluble fiber did not do the job by itself. it
enhanced the drop in LDL that came from eating less fat. Foods high in soluble fiber includes beans, whole-wheat pastas and oat and wheat cereals, fruits such as apples (with the skin on) and oranges (eat the white stuff) and most vegetables such as broccoli and carrots.
Take your vitamins. Especially antioxidants. People who get plenty of vitamin C also have high levels of HDL. The effect appeared strongest in older men. The best dietary sources of C are oranges, grapefruit and other citrus fruits and juices as well as green and red peppers and broccoli. Research in Finland has
also determined that artery clogging progressed more slowly in men with high LDL who had the highest blood levels of beta-carotene (found in carrots and sweet potatoes) and vitamin E (found in wheat germ and mangoes). Make sure your diet includes plenty of antioxidant-rich foods, such as broccoli and carrots and consider taking a daily multivitamin supplement.
Eat seafood. Plenty of studies suggest that fish-eaters are less prone to heart disease. A low-fat diet that included a daily serving of fish increased the
subjects’ HDL and decreased their LDL. Subjects ate salmon, tuna and sardines. These and other cold-water fish are your best bets. Opt for boiled or baked food, not fried ones.
Add exercise
Physical activity directly affects cholesterol by
lowering LDL and raising HDL. In my gym, I usually prescribe 30 to 45 minutes of cardiovascular exercises and 20 minutes of strength training three to five times a week. People who undergo intensive training can raise HDL by 5 to 10 percent over a period of three to six months. Clients who spent eight weeks on a combined diet and exercise program reduced heart disease risk by 30 percent from cholesterol changes alone.
Medication
As a rule, doctors are slow to prescribe cholesterol-lowering drugs for a number of reasons. First, diet and exercise need about six months to kick in.
Beyond that, drugs add cost to treatment, can have side effects and usually need to be taken long term or perhaps for the rest of your life to be effective. So taking medication is the last step. But if you have
already tried diet therapy and exercise but they have not worked, medication can save your life. You are a candidate for medication if your LDL score is 190 or higher, if it is 160 or higher and you have two or more of the risk factors mentioned in step two or if it is 130 or higher with heart disease. What drug you will have to take depends on what your doctor thinks is best for you.
With little effort, you can take steps to lower your cholesterol without drugs. As you see, much of this starts as soon as you open your mouth to eat or strap on those running shoes for a walk or jog. Our genes predispose us to certain cholesterol levels but what we eat and what we do can have a tremendous impact.
