If you have said that you are like many other Americans who share a concern about the risk of coronary heart disease. But if you’ve never managed to do something about it, read on. You will find the answers to some of the most common questions people have about cholesterol and what you can do to control it. Happily, you will find that controlling your cholesterol is much easier and tastes better than you thought!
Why is cholesterol suddenly so important?
If you’ve noticed that cholesterol has received increased attention in recent decades, you’re right. In 1985, the National Heart, Lung, and Blood Institute of the National Institutes of Health launched the National Cholesterol Education Program (NCEP). The goal of the program is to reduce illness and death from coronary heart disease (CHD) by reducing the number of Americans with high blood cholesterol. The impetus behind the NCEP was strong proof that lowering high blood cholesterol reduces the risk of coronary heart disease. In fact, a one percent decrease in cholesterol produces a two percent decrease in the chance of a heart attack.
Surveys also indicated that neither physicians nor the general public were adequately informed about the relationship between cholesterol and heart disease. This led to an aggressive public and professional education strategy. So yeah, you’ve heard more about cholesterol, because there’s so much more to hear.
What is coronary artery disease?
Over time, cholesterol and other blood substances settle on the inside walls of the coronary arteries. When this buildup restricts the flow of blood through the arteries, very little oxygen reaches the heart. At best, coronary heart disease victims suffer from chest pain (angina); at worst, a fatal heart attack, the kind that accounts for 30 percent of nearly two million deaths in the United States each year.
While high blood cholesterol levels seriously increase a person’s risk of coronary heart disease, adding smoking and high blood pressure, the other major risk factors, multiplies that risk.
How many Americans have high cholesterol?
The American Medical Association published these figures based on NCEP estimates: Thirty-six percent of Americans have cholesterol levels high enough to justify being under the care of a physician. Approximately 102 million Americans age 20 and older are candidates for medical advice and intervention for high blood cholesterol levels.
On top of that, there are millions more who should take immediate action to bring their blood cholesterol levels into the “desirable” range.
In other words, if your cholesterol level can take a few tweaks, you have something in common with more than one in two Americans!
What role does age play?
If you are between the ages of 20 and 39, the chance that your cholesterol level is too high is one in five. That rate increases to one in two between the ages of 40 and 59. Over age 60, there is a 60 percent chance that you have a problem.
Should You Get A High Cholesterol Test?
If you are over 20 years old, you should! The NCEP suggests that you get tested at least once every five years.
Your initial evaluation will determine your total cholesterol level and evaluate risk factors such as smoking, blood pressure, and your personal and family medical history. Often, cholesterol screening is carried out during the course of a routine physical exam, but advances in finger-stick testing procedures (where the finger is pricked to draw a small amount of blood) mean that widespread initial screening in non-clinical settings is a problem. practical and convenient alternative. Your GP should confirm high or high blood cholesterol levels with the fingerstick method.
The important thing is that you know your cholesterol level. Blood cholesterol is measured in milligrams per deciliter (mg / dl). Levels below 200 mg / dl are classified as “desirable blood cholesterol”, those between 200 and 239 mg / dl are “borderline-high blood cholesterol” and above 240 mg / dl are “high blood cholesterol. “. At 200 and above, the risk of coronary heart disease increases steadily.
In general, the NCEP recommends that people with blood cholesterol levels between 200 and 239 mg / dl adopt heart-healthy eating habits and be retested annually. If there are additional risk factors, more tests will likely be required.
People with blood cholesterol levels above 240 mg / dl should undergo additional tests to determine a course of treatment to lower their blood cholesterol level.
Should children be screened?
The Committee on Nutrition of the American Academy of Pediatrics believes that children with a family history of early coronary heart disease or high cholesterol should be evaluated. “Early” means before the age of 50 for men and 60 for women.
For various reasons, the Academy does not believe in universal tests for children, but its opinion is not shared by all. Cory Servaas, MD, director of the Children’s Better Health Institute, says that between 20 and 30 percent of children under the age of 12 that her organization tests “have higher cholesterol levels than we think they should be … 180 mg / dl. “And he adds,” Since the screen test is cheap and easy to do, why not do it? We often don’t know what the family history is to know if a child should be tested. “
Is there really “good” and “bad” cholesterol?
Absolutely! But first, it’s important to understand that everyone, regardless of age, needs cholesterol. It is vital for the formation of cell membranes and for the manufacture of bile acids. It is also the chemical precursor for hormones such as progesterone, testosterone, and estrogen. All cells in the body can make cholesterol (the liver makes 80 percent), and there is no known physiological reason to supplement the body’s cholesterol with dietary cholesterol.
In order for cholesterol to get from where it is made (in the liver, for example) to where it is needed to support metabolism, it is transported as a lipoprotein. (Lipoproteins are substances that allow insoluble fats like cholesterol to travel in the blood based on water). Low-density lipoproteins (LDL) carry cholesterol from where it is made, while high-density lipoproteins (HDL) carry it to the liver. At this point, cholesterol can be further metabolized or passed into the intestine for elimination. Because HDL limits the amount of cholesterol in the blood, it provides protection against dangerously high cholesterol levels. High HDL levels have been associated with a lower incidence of coronary heart disease.
If your cholesterol tests are in the “high” range, or if you are “borderline high” with additional risk factors for coronary heart disease, your doctor will perform additional tests to establish the relationship between LDL and HDL.
What can you do to maintain a heart-healthy diet?
You don’t need to be a professional dietitian or eat a boring diet to lower or maintain a desirable cholesterol level. Nor is it necessary to carry a calculator to add milligrams of this or that. What you need to know are some basic principles.
- Eat less fat! There are three types of fat: saturated, polyunsaturated, and monounsaturated. A heart-healthy diet requires you to reduce your intake of saturated fat.
They are found in meat and dairy products, as well as commercially prepared baked goods made with coconut oil and cocoa fat. Read the labels!
Instead of eating foods high in saturated fat, shift your emphasis to complex carbohydrates (whole grains, fruits, and vegetables), seafood, and skinless poultry. If you eat meats, select lean cuts and trim as much fat as possible before cooking. By cutting fat, you will also drastically cut calories, as fat contains twice the number of calories as protein or carbohydrates.
- Replace saturated fats with polyunsaturated and monounsaturated fats. Polyunsaturated and monounsaturated fats can help you lower your cholesterol. And recent studies conducted at the University of California San Diego Department of Medicine indicate that monounsaturated fats lower LDL (bad cholesterol) levels while leaving HDL (good cholesterol) levels intact. Canola oil is a wonderful source of monounsaturated fats. It is one of the top cooking oils in Japan, a country widely recognized for its low rate of heart disease.
- Reduce dietary cholesterol. Avoid organ meats altogether and eat less egg yolks.
- Increase dietary fiber. Never before has fiber been so easy to introduce into your diet. We’ve been hearing a lot about oat bran as a source of fiber lately, and for good reason. Studies indicate that oat bran, when consumed regularly, can lower cholesterol by up to 19%.
- Exercise! Exercise has been shown to reduce the risk of coronary heart disease by increasing the level of good HDL cholesterol in the blood.
- Stop smoking! Exercise raises HDL levels, but smoking lowers them. Smokers are at additional risk for coronary heart disease.
Do school lunch programs support heart-healthy dietary standards?
Jayne Newmark, a national spokesperson for the American Dietetic Association, cautions that school lunch programs are self-sufficient and therefore sell foods that children are more likely to buy. “Our job is to get kids to like foods that are healthy for the heart. You see a lot of hamburgers and fries these days because that’s what kids like. We have a sales job to do. That’s why we’re trying to get nutrition into the curriculum. But education really starts at home and it can’t start too early, “says Newmark.
What are the additional benefits of a heart healthy diet?
A high-fat, low-fiber diet has been linked to colon and breast cancers, as well as diverticular disease, stroke, diabetes, high blood pressure, and even osteoporosis. And if that is not enough, there is always obesity to appeal to the vanity that we all carry within.