Sunday, September 27, 2009

Cholesterol: The Good, The Bad, and The Ugly

After Labor Day I go for my annual physical check up. As the years roll on inexorably, I must confess that I look forward to this ritual, and I don’t mind taking the train to Crestwood (2 stops beyond Bronxville). Actually, I must confess that I really enjoy the trek from the train station to my doctor’s office—it’s all uphill and good for the heart.

Besides the physical activity, I do a little thinking, passing in review the main events of the year just gone by, and what I should confess to the good doctor: that my prostate is acting up, that my right shoulder grates when I get up in the mornings, that my acid reflux woke me in the middle of the night, or should I omit that I’ve discovered two Cuban restaurants which serve pork chops in red sauce that’s out of this world? Wrong choice of words: let the chops be out of this world, but not me!

“Inhale,” “cough,” “ …lean over…smooth as a pebble,” “…5 pounds overweight.” And so on—the good doctor rambles on. Meanwhile, I am anticipating his next step: “ …a little blood.”

A few days later he calls me and gives me a reading of my php and cholesterol level. Php I understand well since he’s treating me for an enlarged Prostate gland, but cholesterol?

Because I don’t want to take the good man’s time, nor to show my ignorance, I simply mumble a few words and “ahems” and thank him profusely. This year, though, he said my cholesterol level was “borderline.’ That set off a few bells in my head.

Not knowing about cholesterol is bad enough, but not attempting to learn about it is even worse; so I did a little research— which I will share with you.

What is cholesterol?
Cholesterol is a soft, waxy substance found in all parts of the body. It’s a type of fat. Your body makes some cholesterol, and some cholesterol comes from the food you eat.

To work well, your body needs a little bit of cholesterol, but too much cholesterol can clog your arteries and lead to heart disease. Gulp! So what’s too much? Before we can answer this question we have to distinguish between

• HDL — "good" cholesterol
• LDL — "bad" cholesterol

Cholesterol helps the body produce hormones, bile acid, and vitamin D; and moves through the bloodstream to be used by all parts of the body.

LDL is bad because it builds up in the wall of your arteries and forms plaque, which in turn can cause a narrowing of the arteries. Right away I pictured a sand hour glass. The fact is that enough of this infamous plaque can not only slow the flow of blood but also block it, depriving your heart, brain, and other organs of that much needed blood. High LDL can cause a stroke.

HDL or “good” cholesterol keeps the bad one from building up in the arteries.

What is “borderline” level?
• Less than 200 mg/dL: Desirable
• 200-239 mg/dL: Borderline-High Risk
• 240 mg/dL and over: High Risk
• Low HDL (‘good’) cholesterol (less than 40 mg/dL for men, less than 50 mg/dL for women) puts you at higher risk for heart disease. While the “bad” cholesterol needs to be kept low, the “good” should be upped.

In general, your risk of developing heart disease or atherosclerosis goes up as your level of blood cholesterol increases.

To determine how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors such as age, obesity, family history, smoking and high blood pressure.

Food Sources
Cholesterol is found in eggs, dairy products, meat, and poultry. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish are high in cholesterol. Repeat: cholesterol is found only in foods of animal origin.

Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol.

Fat content is not a good measure of cholesterol content. For example, liver and other organ meats are low in fat, but very high in cholesterol.

• eat foods low in cholesterol and saturated fat and free of trans fat
• maintain a healthy weight
• be physically active

Since more than half of the adult population has blood cholesterol levels higher than the desirable range, and not everyone has a stroke, we can assume that there are some other factors besides cholesterol that also cause strokes.

A school of physicians do not subscribe to cholesterol as a villain, and believe that inflammation of the heart is the real cause of strokes--not cholesterol. Click this link to learn more about inflammation of the heart; you'll be surprised as I was!

Since Aspirin is an anti inflammatory, I take 1 table every other day. So, I watch what I eat, watch my weight, walk 2 miles a day, and never skip my annual checkup.
The writing techniques I employ in this article are all explained in Mary Duffy's writing manual:

Sentence Openers

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