Cholesterol and you

Cholesterol in your body comes from several sources.

One source is from the foods we eat. It can be very confusing to try and figure out what is good for you and what is not. Some of us joke that a good rule of thumb is that if it tastes good it is probably bad for you. Unfortunately, that is largely true of the foods we eat today. Processing and added chemicals make many foods taste better and added fats make them filling and rich tasting. So how can some of these foods be cholesterol-free and yet high in fat?

The key is to understand the definitions and sources of cholesterol.

Cholesterol is a constituent of animal fats. Vegetables do not contain cholesterol and neither does vegetable oil. Yet no one in their right mind would say that eating a pound of french fries, which contain no cholesterol, would be healthier than a couple of eggs and a few slices of bacon. However, neither are good for you in excess. Hence the word moderation comes into play.

By reading labels you can discern what the fat content of foods are, what the cholesterol content is as well as sodium and other ingredients of the products are (saturated, unsaturated and trans fats). By limiting the amount of fat that you ingest you can limit the amount of cholesterol, reduce the bad fats in your diet, and improve your overall health. The cleaner the fuel you give to your body, the cleaner your “engine” will run.

The other source of cholesterol in your body is from your body itself. Your body manufactures cholesterol. The amount of cholesterol your body manufactures is a product of genetics. You can blame your ancestors for the majority of the cholesterol in your body.

High cholesterol causes heart disease and strokes, among other problems. A discussion with your doctor about your family history and risk factors is the best place to start on finding out your level of risk and need for intervention.

A fasting blood test (taken on an empty stomach) will allow your doctor to measure and evaluate your cholesterol levels.

Diet is part of the treatment but will only lower your levels by 10 to 15 percent. Many people will require medication.

We often talk about “good” and “bad” cholesterol. What do we mean by this? What does it mean to you?

Bad cholesterol is called LDL. That stands for low density lipoprotein. “Good” cholesterol is called HDL or high density lipoprotein.

The bad type of cholesterol is the one that tends to stick to the insides of your arteries and clog them up. The good kind of cholesterol actually protects your arteries from this process.

If you have ever had the opportunity to look inside one of the water pipes in your house you can see the buildup of calcium and lime and other deposits over time. This same process is going on inside your arteries. If you have more calcium in your water you will have more buildup in your pipes. If you have more bad cholesterol in your blood you will have more buildup in your arteries.

What we have discovered is that by lowering the amount of total cholesterol and bad cholesterol in the blood we can significantly lower the amount of deposits on the inside of the arteries and lower the rate of heart attacks and strokes. Over time, we have developed the data to determine at what level the reduction is most effective and where our goals should be.

There are several different levels of bad cholesterol that are cut-off points, which have been established by literally looking at which levels kill people and which levels save them. After a risk assessment, we can determine which level best suits your particular risk profile.

Particular risks for heart disease are family history, being a male, high blood pressure, high cholesterol, diabetes, age, smoking, obesity, inactivity and a few other contributing factors. If you have several of these risk factors then you need a lower bad cholesterol level in order to control and decrease your risk of illness.

So where does this bad cholesterol come from?

Well, as we discussed, it is partly from diet. The major source, however, is your own body. Your own genetic makeup decides how much good and bad cholesterol you make.

There are folks that are morbidly obese and have normal cholesterol levels as well as folks that are thin as a rail and have sky-high cholesterol.

The ways in which we attack these other risk factors are to eliminate as many as possible.

Obviously, number one would be to quit smoking.

Number two would be to control your blood pressure either through low salt diets or medications or both.

Weight loss, moderate exercise (30 minutes three to five times a week) among other health promoting activities will also reduce your risk factors.

However, some factors cannot be changed. Your age, sex and family history are pretty well etched in stone.

Your cholesterol falls somewhere between these two extremes. While largely genetically determined, it can be altered.

We use diet, exercise and often medications called “statins.” These medicines work in the liver by blocking the production of bad cholesterol and actually raise the levels of good cholesterol. By and large they are safe and well tolerated. There is a small group of people that cannot take them. There are other medicines we use for people who cannot tolerate statins.

You can start on your healthy future by cutting the amounts of fat in your diet and exercising and stopping smoking. We urge you to make an appointment with your health care provider and get your risk factors analyzed and your cholesterol checked.

Good health, CNMI. (John L. Doyle, MD/Special to the Saipan Tribune)

John L. Doyle MD is the Medical Affairs director of the Commonwealth Healthcare Corp. This article is an unsolicited and unpaid contribution by the author.