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Front Page » December 5, 2002 » The Business Journal » The case for cholesterol control
Published 4,157 days ago

The case for cholesterol control


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By RICHARD SHAW
Staff reporter


This view of a normal artery shows the red blood cells and cholesterol that floats amongst the serum. Cholesterol comes in good and bad forms, with the amounts in a bloodstream affected by many factors including heredity, diet, exercise and other chemical and fat substances in an individuals body.

There are a lot of unknowns and disputed facts when it comes to why certain people can eat anything they want and keep their cholesterol low, while others work on exercise programs and closely watch their diets, yet have extremely high levels of bad cholesterol in their bodies.

But one thing is for sure: high cholesterol is a quiet killer, with few or no symptoms before it's diabolic affects on the heart and arteries can destroy a human life.

Most people know something about cholesterol, but few know a lot, even when they have the problem. Cholesterol is a soft and waxy substance that occurs in all parts of the body including the organs, nervous system, skin and muscles. It is made by the liver and is vital to human life because it is needed to produce hormones and bile acid.

But as with most things in life, too much of it can be bad for anyone. That is because the risk of developing heart disease or atherosclerosis increases dramatically with the increase in cholesterol levels.

Heart disease, is the leading cause of death in the United States. Nearly 530,000 people died of the malady in 1999, and that number will only increase as the large baby boomer population goes up and the average Americans intake of fats continues to rise. The fact is that, while other factors often affect the heart and cause heart problems, in the average population, cholesterol seems to be the biggest problem.

But myths about cholesterol abound and one doctor has even written a book called about the myths but not everyone agrees about what they are.

That is one of the problems with understanding cholesterol. It's somewhat like losing weight: there are many ideas and plans, enough to confuse many people.

First of all, one myth that exists is that all cholesterol is bad. Not true. To much of what is called LDL cholesterol is what is bad. LDL cholesterol has a high ratio of cholesterol to protein, as compared with HDL cholesterol that has a high ratio of protein to cholesterol. If that sounds like mumbo jumbo, then the better way to look at it is this.

LDL cholesterol is like the kids messing up the house. They go through and leave dirty dishes here and there, soiled clothes in the laundry room and on their bedroom floor, track mud all over the place and just generally deposit stuff all over the place. In the case of LDL cholesterol it drops all kinds of cholesterol along arteries, and the stuff builds up and builds up finally restricting and then blocking blood flow. Studies have shown that those amongst those with low LDL, the risk of heart attack is also the lowest.

HDL cholesterol is just the opposite. It cleans up the mess by collecting the cholesterol off the artery walls and depositing it in the liver where it is finally put into a package and eliminated from the body.

Another is that diet will eliminate the problem. First of all, almost all experts agree that cholesterol problems are to a certain, maybe a large degree, based on heredity. That is the reason the heavy set gentleman who sits down and eats fast food everyday can keep a low cholesterol count while a skinny fellow who eats little fat has a hard time controlling his LDL.

However, it's not just as simple as that, just as most things in this complicated world are not. The amount of exercise a person gets, their weight (and it seems to some experts that the "spare tire weight" an individual has even more affect on it), their age and high triglyceride levels are all factors too.

Triglyceridess are another type of fat in the blood that seems to affect the build up on the walls of peoples arteries. Some evidence hints that high triglycerides are a risk factor for heart attacks on their own, but studies have definitely linked high triglyceride levels with a decline in HDL. It may also be a big factor in weight gain as well as the onset of type 2 diabetes.

While there are home testing kits for cholesterol levels, the fact is that it is best to go to a doctor to find out the problems that may exist. The tests that physicians have done are reported in numbers.

Brent "Olie" Olson works out on a treadmill at the fitness center at the BDAC. Exercise plays a role in the levels of cholesterol an individual may have.

Most physicians will want a total cholesterol level to be under the 200 level, although some even like it much lower than that. The 200-239 level is a borderline reading and anything over 240 is considered high.

In the case of LDL cholesterol less than 100 is the optimal level. A person is borderline if their level is 130-159. High levels are regarded as anything that tests 160 and above with some people exceeding 200.

However, as is common people do not go to the doctor unless they are sick, but in the case of cholesterol, without these tests no one can tell if damage is being done.

That damage comes in the form of angina (chest pains) and/or heart attacks. The buildup on the arteries is called plaque. Plaque is formed when white blood cells are attracted to inflamed areas caused by the cholesterol buildup. In a process know as oxidation LDL is modified and the bodies immune system reacts to what it sees as harmful molecules. As this closes off the artery, which has also usually become inelastic as well based on the calcification, blood flow to the heart is restricted, thus the critical problem of destroying heart tissue due to inadequate oxygen supplies.

Not only does the plaque cause blockage directly, it can also cause ruptures in the arteries which will cause blood clots further blocking blood flow.

But regardless of all the ramifications, most people have a hard time dealing with high cholesterol. The fact that they have to change life long habits or start new ones makes it difficult. But the commitment to do so can have other benefits besides lowering cholesterol levels.

First of all, losing weight is a major factor in lowering cholesterol levels. Individuals need to find out what their ideal body weight is and then work with a physician on a diet that will work for them. Part of the diet thing is also to exercise. Just changing eating habits doesn't do enough. Most people need one half hour of exercise three times per week to get good benefits. More exercise is helpful, but be careful not to over do it either.

As most doctors will advise, the diet should be a low fat and low cholesterol diet. People need to pay attention to the saturated fats they eat. Foods that are high in that type of fat are fatty types of red meat, butter, tropical oils (such as coconut oil) fried foods and whole milk. Low fat items to eat include vegetables and fruits, whole grains, skim milk, fish and low fat cuts of meat.

Most physicians also feel that other parts of a diet or habits can hurt cholesterol levels. Smoking and alcohol consumption are also contributing factors to high cholesterol. In addition, many people who have hardened arteries also have high blood pressure. Caffeine can add to a persons blood pressure as well, so not only would it be good to cut out caffeinated drinks such as coffee (with sugar) and soda pop for the sugar levels, but it also would eliminate large amounts of caffeine from an individuals diet. In addition, soft drinks also often have lots of sodium in them, which is a factor in high blood pressure as well.

Sometimes diet and exercise don't do much. Because of this physicians will sometimes prescribe medication to control cholesterol. There are basically four kinds of medications.

The first is a group of drugs called statins. These type of drugs change the way the liver handles and produces cholesterol. Side affects come with most of these, but for the most part doctors can find one that will give minimal problems.

Another remedy is niacin. This is a B vitamin, which has been proved to lower LDL cholesterol levels in various subjects. It can also raise HDL levels and alter triglycerides as well. But just because it is a vitamin, doesn't mean it shouldn't be administered under the care of a doctor.

Another group of remedies is the fibric acid drugs. These lower the triglycerides and increase the HDL.

Finally there is a group of drugs called resins. These drugs fool the liver by keeping the bile acid in the intestines from traveling to the liver. The liver then thinks there is a shortage of bile so it produces more. This is good because it takes cholesterol for the liver to produce it. This means the liver cleanses the blood of more cholesterol, lowering the individuals overall level.

High cholesterol is called a stealth disease because it sneaks up on it's prey, the human being. But people can beat it with early detection, before it does damage if they are just willing to take the steps to do so.


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