Archive for the ‘smoking’ Category

Triglycerides

Tuesday, July 22nd, 2008

Triglyceride is a fat-like substance produced in your body. High triglyceride level can occure due to obesity, cigarette smoking, alcohol drinking, lack of physical activity and a diet very high in carbohydrates. High triglyceride level usually leads to high total level of cholesterol with high bad cholesterol level and low good cholesterol level. High triglyceride level in blood can also be a sign of diabetes mellitus and/or heart disease.

Blood triglyceride level depend on age and sex. Women tend to have higher triglyceride levels than men do, and as they get older, their cholesterol and triglyceride levels tend to rise.

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Lipitor How Much LDL

Wednesday, July 9th, 2008

Cholesterol is a lipid, a type of fat found in the body. Having high “bad” cholesterol means you have too much LDL in your blood. LDL is low-density lipoprotein, or “bad” cholesterol.

Too much cholesterol in the blood, or high cholesterol, can be serious. People with high cholesterol are at risk of getting heart disease. This can lead to a heart attack or stroke.

Only about 20% of cholesterol comes from the foods you eat. The other 80% is made by your body. Things such as age and family health history affect how much cholesterol your body makes.

Cholesterol levels tend to rise as you get older. Unfortunately, there are usually no signs that you have high cholesterol. But it can be detected with a blood test. These tests can also help your doctor predict what your risk for heart disease may be.

Total Cholesterol

Your blood test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). The total number is based on:

* LDL (”bad” cholesterol)
* HDL (”good” cholesterol)
* Triglyceride (a type of fat found in your blood) levels

Total Cholesterol Levels / What It Means

Less than 200 mg/dL / Desirable
200-239 mg/dL / Borderline high risk for heart disease
240 mg/dL and above / High risk for heart disease

The 2 Types of Cholesterol: LDL and HDL

Bad cholesterol: Low-density lipoprotein (LDL)

Too much LDL in your blood can clog arteries. This can increase the risk of heart attack and stroke.

Good cholesterol: High-density lipoprotein (HDL)

High levels of HDL can help protect you from a heart attack or stroke. HDL carries cholesterol from the body’s tissues to the liver. So, low levels of HDL can increase the risk of heart disease.

If you’re worried about high cholesterol and heart disease, make an appointment to speak with your doctor. LIPITOR is clinically proven to lower bad cholesterol 39-60%, when diet and exercise are not enough (average effect depending on dose).

LIPITOR is a prescription drug. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (”good” cholesterol) or smoking to reduce the risk of heart attack and stroke. When diet and exercise alone are not enough, LIPITOR is used along with a low-fat diet and exercise to lower cholesterol.

LIPITOR is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

LIPITOR is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

If you take LIPITOR, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before and during treatment and may adjust your dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

When diet and exercise alone are not enough, adding LIPITOR can help. LIPITOR is one of many cholesterol-lowering treatment options that you and your doctor can consider.

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Attention to Heart Health Good for the Brain

Friday, April 25th, 2008

A recent survey found that two out of three African Americans worry about developing heart disease and two out of five are concerned about developing Alzheimer’s disease, yet only one in 20 are aware that heart health is linked to brain health.

February is Black History Month and American Heart Month, and the Alzheimer’s Association and the American Stroke Association, a division of the American Heart Association, are teaming up to educate African Americans on how to manage heart health to promote brain health.

“What’s good for your heart is good for your brain,” Dr. Jennifer Manly, spokesperson for the Alzheimer’s Association, said in a statement.

“African Americans should be aware that there is building evidence that older adults whose hearts are healthy tend to live longer with healthy brain function,” Manly added in comments to Reuters Health. Manly is with the G.H. Sergievsky Center and the Taub Institute for Research in Aging and Alzheimer’s Disease at Columbia University, New York.

Compared to the general public, African Americans have a higher risk of diabetes, high blood pressure, high cholesterol and other cardiovascular complications, which could lead to a higher risk of stroke and Alzheimer’s disease.

Manly said African Americans can help to improve their heart health and cognitive function by “partnering with their doctor and watching their numbers; keep blood pressure below 120/80 millimeters of mercury, fasting blood sugar less than 100 milligrams per deciliter, cholesterol below 200 milligrams per deciliter, and maintain a body weight in the recommended range.”

Healthy lifestyle choices will also help African Americans improve their heart and brain health. African Americans who are physically and mentally active, maintain their social connections, reduce fat and cholesterol in their diet, and don’t smoke may lower their risk for stroke and Alzheimer’s disease, the researcher emphasized.

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Diabetics More at Risk for Heart Health Problems

Tuesday, April 22nd, 2008

If you have diabetes, your risk of having a heart attack is the same as a non-diabetic who has had a heart attack. So make heart health a priority.

What things can and should you do? First, make sure you have a doctor. People who have no physician are likely to have more advanced health problems than those who see the doctor regularly. This should seem like common sense, but too many people avoid seeing a doctor. Many lack health insurance. Others may see the doctor but may not follow the doctor’s recommendations.

Prevention is far better than having to treat heart disease. Maintaining a healthy blood pressure is one way to reduce your risk. Millions of Americans suffer from untreated high blood pressure, which accelerates heart damage.

Millions also smoke, which competes with high blood pressure as being the single greatest accelerant to heart disease.

So if you want to lower your risk profile for heart disease if you have diabetes, stop smoking and treat your high blood pressure.

Yes, stopping smoking is easier said than done. Most adult smokers started their habit during their teen years, when they were most susceptible to the addictive properties of nicotine. But most smokers need more than just doctor’s orders to kick the habit. Smoking cessation programs are available. If you have diabetes, no other single behavior does more harm than smoking. Make smoking a priority to stop — by whatever means possible.

Reducing risks

Diet has much to do with health. Getting a proper balance of fruits and vegetables can reduce heart disease risks, as can regular physical activity. A daily walk can do more to reduce your risk of heart disease than many prescription medications. But make sure you have proper medical clearance before embarking on an exercise program for your diabetes and heart.

Daily aspirin therapy has been shown to reduce risks to the heart in people with and without diabetes. The common dose prescribed for non-diabetic patients is 81 milligrams per day. Medical evidence shows that diabetics are resistant to that dose. Some researchers recommend that 162 milligrams would be better. But discuss this with your doctor.

By age 35, all diabetics should have yearly electrocardiograms. This painless test can reveal possible problems and may prevent a more serious one. An exercise stress test also can reveal problems within the heart. Diabetics are more likely to have silent heart disease, which further delays getting a proper diagnosis.

Controlling blood pressure is a must for diabetics. Not only is high blood pressure more common in diabetes, but its presence acts as an accelerant to coronary artery disease. Many medicines are effective for high blood pressure. Lowering salt intake also should not be ignored. We all have too much salt in our diets.

One class of blood pressure medicines is especially helpful for diabetics. These are called ACE inhibitors, short for angiotensin converting enzyme inhibitors. They are characterized by the word “pril” attached to the end of the name of the drug’s generic form.

Examples include enalapril, lisinopril and captopril. Not only do these drugs effectively lower blood pressure in diabetics, but they also lower the risk of kidney damage. This is a great bargain, given the high risk of kidney failure in persons with diabetes.

Cholesterol levels down

High cholesterol is a widespread problem. Diabetics are more prone to having high cholesterol and triglyceride levels, collectively known as lipids.

Keeping blood lipid levels as low as possible is key to preventing and even reversing cholesterol plaques within the coronary arteries, which give rise to heart attacks and strokes. While changes in diet are part of the management, it may require a combination of medications to keep the “bad” cholesterol levels (known as LDL) low. Medications known as fibrates are helpful in controlling triglyceride levels. Statins such as atorvastatin (Lipitor) help to reduce “bad” LDL cholesterol.

Good diabetes control helps to lower both triglycerides and LDL.

Conclusion

Keeping heart disease in check (or preventing it altogether) in diabetics starts with keeping your diabetes in the best possible control, as reflected in your hemoglobin A1C test (which is best kept below 7 percent).

Blood pressure and cholesterol levels must be kept in normal ranges by changes in diet and lifestyle, with perhaps some help from prescription medicines. Finally, getting regular heart checkups by your doctor after age 35 will do the most to prevent a cardiac “surprise” one day.

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How to Lower Your Cholesterol

Wednesday, April 9th, 2008

Heart disease is the UK’s biggest cause of death - and having high cholesterol puts you at significant risk. But as there are no obvious symptoms, a heart attack is often the first warning sign of the condition.

Don’t let this happen to you. Take our quick cholesterol quiz to identify whether you may have the condition - and how to slash your risk…

1. How old are you?

a) Under 24 (-1)
b) 25-44 (0)
c) 45-65 (+1)
d) Over 65 (+2)

Why it matters: Cholesterol increases with age. Only 26 per cent of men and 31 per cent of women under 25 have high cholesterol, but by the age of 50 those figures shoot up to 81 per cent of men and 79 per cent of women. “We don’t exercise as much as we get older and we tend to eat more fat,” explains Ellen Mason, cardiac nurse at the British Heart Foundation.

Whatever your age simple lifestyle changes can turn things round fast. Just adding a handful of walnuts a day to your diet can slash levels of harmful LDL cholesterol by 10 per cent in up to six months, while eating 100g of beans daily can reduce it by 20 per cent in three weeks.

2. Do your relatives have high cholesterol? Or have any close male relatives had a heart attack before 50, or any female ones before the age of 55?

a) Yes (+2)
b) No (0)
c) I have no idea (+1)

Why it matters: “Family history is definitely a risk factor for cholesterol,” says Dr Robert Finnie, a trustee for the cholesterol charity Heart UK.

“If a sibling or parent has high cholesterol you have a 50 per cent greater chance of having it yourself.” The reason is that genes can determine how your body makes and processes cholesterol. If, for example, you inherit an under-performing version of a gene called APOE-4, you won’t transport cholesterol out of your body as well as other people.

Fortunately, gene behaviour can be changed. According to Dr Jack Challam, author of Feed Your Genes Right (Wiley Books), healthy levels of vitamin E in the diet help boost APOE-4 activity. Consider taking a supplement.

3. Which of these sounds most like your exercise regime?

a) I don’t do any (+2)
b) I do my 10,000 steps throughout the day (+1)
c) I exercise for 20 minutes at least three times a week (0)
d) I exercise for more than 20 minutes at least three times a week (-1)

Why it matters: “Exercise triggers the release of enzymes that break down the harmful LDL form of cholesterol that collects in your arteries,” says Dr Marie Murphy, head of the School of Exercise Sciences at the University of Ulster. Any movement triggers this enzyme release - in Dr Murphy’s trials simply walking up stairs for two minutes up to eight times a day slashed LDL levels by seven per cent in eight weeks. But longer sessions of formal exercise create a greater effect.

Aim to do a 40-minute workout three to four times a week.

4. Which of these do you eat more than three times a week?

a) Red or processed meats (+1)
b) Butter, cheese, full fat milk (+1)
c) Cakes, biscuits, chocolate, crisps (+1)
d) Deep-fried foods (+1)

Why it matters: All of these are high in saturated fat. “This is basically the raw material your body needs to make cholesterol,” says nutritionist Dale Pinnock (www.dalepinnock.com).

Cut your intake of saturated fat and cholesterol levels fall.

A us study has shown that every one per cent of saturated fat you drop from your diet cuts your cholesterol by one per cent, too.

To cut down, limit all of the above and opt for low-fat versions. Grill, bake or steam foods and use heart-healthy sunflower or olive oil for frying.

5. How stressful is your life?

a) Very, I get stressed easily and it happens a lot (+2)
b) Very, but I do lots of relaxation/ exercise to fight it (+1)
c) I usually cope well with stress (0)

Why it matters: Dr Andrew Steptoe, at University College London, found that levels of “bad cholesterol” are three times higher in people who are stressed than those who remain cool under pressure. “Blood fats, including cholesterol, are released during stress as, in past times, we needed them to fuel our ability to flee the thing causing us stress. Today we tend not to run away from stresses so the fats are not used up and remain in our blood,” he says. Controlling stress is therefore important for controlling cholesterol levels.

6. How many of these do you have more than four times a week - tea, wholegrains, oats, beans, soy, olives, seeds, Benecol, nuts, apples?

a) None (+2)
b) 1-2 (0)
c) Over 2 (-1)

Why it matters: “These foods can all actively lower levels of cholesterol in your body,” says Dale Pinnock. High-fibre foods such as oats, wholegrains and beans absorb cholesterol in the intestine helping you pass it out of the system. Healthy fats in nuts, seeds and olives speed up how fast your liver breaks it down. Try to include one to two servings of cholesterol lowering foods every day.

7. How much coffee do you drink a day

a) Fewer than four cups (0)
b) Over four cups of espresso or cafetiere coffee (+1)
c) Over four cups of any other type (0)

Why it matters:
“Cafestol, an oil in coffee beans, activates an enzyme that inhibits cholesterol breakdown,” says Professor David Moore, of Baylor College of Medicine in Texas. Drinking five cups of high-cafestol coffee - espresso or that made in a cafetiere - can raise cholesterol by up to eight per cent in four weeks. Fortunately for coffee lovers a sensible intake of under four cups a day won’t cause major issues.

8. Measure the area around your tummy. Is it over 37ins (men) or 32ins (women?

a) Yes (+1)
b) No (0)

Why it matters: The more you weigh, the higher your cholesterol is likely to be.

Denise Armstrong, at Heart Research UK, says: “People who are overweight tend to eat higher fat diets and do less exercise.”

Changing these things will reduce weight - and cholesterol.

9. How much alcohol do you drink a day?

a) Nothing (+1)
b) Up to two units a day for women, up to three for men (0)
c) More than two units a day (women) or three for men (+1)

Why it matters: Moderate alcohol intake actually boosts levels of healthy HDL cholesterol. Excess alcohol doesn’t raise cholesterol, but it does increase the amount of harmful fats called triglycerides which damage the arteries.

10. Do you smoke?

a) No (0)
b) Yes (+1)

Why it matters: Smoking doesn’t increase cholesterol but it also raises triglycerides in your body.

WHAT THE SCORES MEANS

Under 3: You are living a low-cholesterol lifestyle so chances are your levels are within the normal range. Keep it up.

4-10: You may have health issues. Ask your GP for a cholesterol test, or try a home test (Superdrug’s Self-Check Test is £9.99).

More than 11: You are at high risk of high cholesterol. See your GP for a test rather than trying a home one. If levels are very high, you may need a course of cholesterol-lowering drugs - as well as making lifestyle changes.

I got a wake-up call before it was too late

Sarah Wade, 34, lives in East London. She’s single and works for a design agency. She says:

“I was registering with a new GP so I asked him to give me an MOT.”

“Although I’d lost an uncle to heart disease and my mum has high cholesterol, I was still shocked when he said my levels were high, bordering on very high. I thought cholesterol only affected overweight people and at 9st I certainly wasn’t that.”

My doctor explained some simple changes I could make to lower it. Now, one Sunday a month, I cook loads of pasta, lean meat and oily fish dishes (the omega 3 fats help lower cholesterol) and freeze them in batches. I work long hours and used to rely on ready-meals and takeaways, which are packed with saturated fats, but now I have my own healthy ready-meals.

“I eat more fruit and veg and have replaced squashes with fresh juice, especially pomegranate juice, which is good at lowering cholesterol. I eat more fibre and take psyllium husk supplements, a natural source of dietary fibre. I also run three times a week and have reduced my alcohol intake.”

“Thankfully my cholesterol is now normal. I’m just grateful I had a wake-up call before it was too late.”

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Cholesterol is NOT the Critical Cause of Heart Disease

Monday, February 4th, 2008

Cholesterol is not the major culprit in heart disease or any disease. If it becomes oxidized it can irritate/inflame tissues in which it is lodged in, such as the endothelium (lining of the arteries). This would be one of numerous causes of chronic inflammation that can injure the lining of arteries. However, many good fats are easily oxidized such as omega-3 fatty acids, but it does not mean that you should avoid it at all costs.

Common sense would indicate that we should avoid the oxidation (rancidity) of cholesterol and fatty acids and not get rid of important life-giving molecules. Using the same conventional medical thinking that is being used for cholesterol would lead one to believe that doctors should reduce the risk of Alzheimer’s disease by taking out everybody’s brain.

In fact, cholesterol is being transported to tissues as part of an inflammatory response that is there to repair damage.

The fixation on cholesterol as a major cause of heart disease defies the last 15 years of science and deflects from real causes such as the damage (via glycation) that sugars such as glucose and fructose inflict on tissues, including the lining of arteries, causing chronic inflammation and resultant plaque.

Insulin & Leptin Resistance

Hundreds of excellent scientific articles have linked insulin resistance and more recently leptin resistance to cardiovascular disease much more strongly than cholesterol, and they are in fact at least partially responsible for cholesterol abnormalities. For instance, insulin and leptin resistance result in “small dense” LDL particles and a greater number of particles.

This is much more important than the total cholesterol number. Because of particle size shift to small and dense, the total LDL cholesterol could still be low even though the number of particles and the density of the particles is greater. Small, dense LDL particles can squeeze between the cells lining the inside of the arteries, the “gap junction” of the endothelium, where they can get struck and potentially oxidize, turn rancid, and cause inflammation of the lining of the arteries and plaque formation.

Importantly, many solid scientific studies have shown a mechanistic, causal effect of elevated insulin and leptin on heart and vascular disease, whereas almost all studies with cholesterol misleadingly only show an association. Association does not imply cause. For instance, something else may be causing lipid abnormalities such as elevated cholesterol and triglycerides, and also causing heart disease.

This “something else” is improper insulin and leptin signaling. Similarly, sugar does not cause diabetes; sugar is just listening to orders. Improper insulin and leptin signaling is the cause of diabetes. Likewise, cholesterol does not cause heart disease, but improper metabolic signals including improper signals to cholesterol (causing it to oxidize) and perhaps to the liver that manufactures the cholesterol, will cause heart and vascular disease and hypertension.

Removing cholesterol will do nothing to improve the underlying problems, the real roots of chronic disease, which will always have to do with improper communication, and the generals of metabolic communication are insulin and leptin. They are really what must be treated to reverse heart disease, diabetes, osteoporosis, obesity, and to some extent aging itself.

Cholesterol; Wrongly Accused?

Before we can begin to talk about the real cause and effective treatment for heart and blood vessel disease, we must first look at what is known, or I should say what we think we know. The first thing that comes to mind when one hears about heart disease is almost always cholesterol. Cholesterol and heart disease has been almost synonymous for the last half-century. Cholesterol has been portrayed as the Darth Vader to our arteries and our heart.

The latest recommendation given by a so-called panel of “experts” recommends that a person’s cholesterol be as low as possible, in fact to a level so low they say it cannot be achieved by diet, exercise, or any known lifestyle modification. Therefore, they say cholesterol-lowering drugs; particularly the so-called “statins” need to be given to anyone at high risk of heart disease. Since heart disease is the number one killer in this country that would include most adults and even many children. The fact that this might add to the $26 billion in sales of statin drugs last year I’m sure played no role in their recommendations.

Or did it?

Expert Conflict of Interests

Major consumer groups think so. They found out that eight of the nine “experts” that made the recommendations were on the payroll of pharmaceutical companies that manufacture those drugs. Major scientific organizations have chastised medical journals for allowing the pharmaceutical industry to publish misleading results and half-truths. There is a major push under way to force the pharmaceutical industry (and others) to publish results of all of their studies, and not just the ones that appear positive. The studies that showed negative results would be forced to be published also.

It could be that lowering cholesterol might not be as healthy as we are being told. More and more studies are coming out showing just how unhealthy lowering cholesterol might be, particularly by the use of statin drugs. In particular, statin drugs have been shown to be harmful to muscles causing considerable damage. A common symptom of this damage is muscular aches and pains that many patients experience on cholesterol-lowering drugs, however most do not realize that these drugs are to blame.

Hmm…isn’t the heart a muscle?

Statin Drugs Actually Increase Heart Disease

Indeed, low cholesterol levels have been shown to worsen patients with congestive heart failure, a life-threatening condition where the heart becomes too weak to effectively pump blood. Statin drugs have been shown to also cause nerve damage and to greatly impair memory. One reason that statin drugs have these various serious side effects is that they work by inhibiting a vital enzyme that manufactures cholesterol in the liver. However, the same enzyme is used to manufacture coenzyme Q10, which is a biochemical needed to transfer energy from food to our cells to be used for the work of staying alive and healthy.

Statin drugs are known to inhibit our very important production of coenzyme Q10. Importantly, while many cardiologists insist that lowering cholesterol is correlated with a reduction in the risk of heart attacks; few can say that there is a reduction in the risk of mortality (death). That has been much harder to show. In other words it has never been conclusively shown that lowering cholesterol saves lives. In fact, several large studies have shown that lowering cholesterol into the range currently recommended is correlated with an increased risk of dying, especially of cancer.

No Such Thing as Good and Bad Cholesterol

Because the correlation of total cholesterol with heart disease is so weak, many years ago a stronger correlation was sought. It was found that there is so-called “good cholesterol” called HDL, and that the so-called “bad cholesterol” was LDL. HDL stands for high-density lipoprotein, and LDL stands for low-density lipoprotein. Notice please that LDL and HDL are lipoproteins — fats combined with proteins. There is only one cholesterol. There is no such thing as a good or a bad cholesterol. Cholesterol is just cholesterol. It combines with other fats and proteins to be carried through the bloodstream, since fat and our watery blood do not mix very well.

Fatty substances therefore must be shuttled to and from our tissues and cells using proteins. LDL and HDL are forms of proteins and are far from being just cholesterol. In fact we now know there are many types of these fat and protein particles. LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation. Thus, you might say that there is “good LDL” and “bad LDL.” Also, some HDL particles are better than others. Knowing just your total cholesterol tells you very little. Even knowing your LDL and HDL levels do not tell you very much.

A mistake that is rarely made in the hard-core sciences such as physics seems to be frequently made in medicine. This is confusing correlation with cause. There may be a weak correlation of elevated cholesterol with heart attacks, however this does not mean it is the cholesterol that caused the heart attack. Certainly gray hair is correlated with getting older; however one could hardly say that the gray hair caused one to get old. Using hair dye to reduce the gray hair would not really make you any younger. Neither it appears would just lowering your cholesterol.

Perhaps something else is causing both the gray hair and aging. Even if elevated cholesterol were significant and heart disease (which I question) perhaps something else is causing the elevated cholesterol and also causing the heart disease.

Let’s look little more at cholesterol or, as Paul Harvey was fond of saying, “the rest of the story.” First and foremost, cholesterol is a vital component of every cell membrane on Earth. In other words, there is no life on Earth they can live without cholesterol. That will automatically tell you that, in of itself, it cannot be evil. In fact it is one of our best friends. We would not be here without it. No wonder lowering cholesterol too much increases one’s risk of dying. Cholesterol also is a precursor to all of the steroid hormones. You cannot make estrogen, testosterone, cortisone, and a host of other vital hormones without cholesterol.

Cholesterol Is The Hero, Not The Villain.

It was determined many years ago that the majority of cholesterol in your bloodstream comes from what your liver is manufacturing and distributing. The amount of cholesterol that one eats plays little role in determining your cholesterol levels. It is also known that HDL shuttles cholesterol away from tissues, and away from your arteries, back to your liver. That is why HDL is called the “good cholesterol;” because it is supposedly taking cholesterol away from your arteries. But let’s think about that.

* Why does your liver make sure that you have plenty of cholesterol?
* Why is HDL taking cholesterol back to your liver?
* Why not take it right to your kidneys, or your intestines to get rid of it?

It is taking it back to your liver so that your liver can recycle it; put it back into other particles to be taken to tissues and cells that need it. Your body is trying to make and conserve the cholesterol for the precise reason that it is so important, indeed vital, for health.

One function of cholesterol is to keep your cell membranes from falling apart. As such, you might consider cholesterol your cells “superglue.” It is a necessary ingredient in any sort of cellular repair. The coronary disease associated with heart attacks is now known to be caused from damage to the lining of those arteries. That damage causes inflammation. The coronary disease that causes heart attacks is now considered to be caused mostly from chronic inflammation.

What Is Inflammation?

Think of what happens if you were to cut your hand. Within a fraction of a second, chemicals are released by the damaged tissue to initiate the process known as inflammation. Inflammation will allow that little cut to heal, and indeed to keep you from dying. The cut blood vessels constrict to keep you from bleeding too much. Blood becomes “thicker” so that it can clot. Cells and chemicals from the immune system are alerted to come to the area to keep intruders such as viruses and bacteria from invading the cut. Other cells are told to multiply to repair the damage so that you can heal. When the repair is completed, you have lived to be careless another day, though you may have a small scar to show for your troubles.

We now know that similar events take place within the lining of our arteries. When damage occurs to the lining of our arteries (or even elsewhere) chemicals are released to initiate the process of inflammation. Arteries constrict, blood becomes more prone to clot, white blood cells are called to the area to gobble up damaged debris, and cells adjacent to those damaged are told to multiply. Ultimately, scars form, however inside our arteries we call it plaque. And the constriction of our arteries and the “thickening” of our blood further predisposes us to high blood pressure and heart attacks.

So Where Might Cholesterol Fit Into All Of This?

When damage is occurring and inflammation is being initiated, chemicals are being released so that that damage can be repaired. One could speculate that to replace damaged, old and worn-out cells the liver needs to be notified to either recycle or manufacture cholesterol since no cell, human or otherwise, can be made without it. In this case, cholesterol is being manufactured and distributed in your bloodstream to help you repair damaged tissue and in fact to keep you alive.

If excessive damage is occurring such that it is necessary to distribute extra cholesterol through the bloodstream, it would not seem very wise to merely lower the cholesterol and forget about why it is there in the first place. It would seem much smarter to reduce the extra need for the cholesterol — the excessive damage that is occurring, the reason for the chronic inflammation.

So Why Take Cholesterol-Lowering Drugs?

The pharmaceutical companies thought that you might think that. They went back to the drawing board. They did more “research” and found (coincidentally) that statin drugs had anti-inflammatory effects. Therefore we’re currently being told to stay on our cholesterol-lowering drugs because now they work by reducing inflammation and perhaps not even by reducing cholesterol, and in fact perhaps in spite of it. Aspirin reduces inflammation for a lot less money. So does vitamin E, and fish oil, and dietary changes without the dangers of drugs and having many other benefits instead.

What About Triglycerides?

Triglycerides are just medical terminology for fat. A person with high triglycerides has a lot of fat in the bloodstream. Triglycerides are generally measured when a person has fasted overnight. High fasting triglycerides are either from manufacturing too much, or using (burning) too little. In other words, what high triglycerides are telling you is that you are making too much fat and you are unable to burn it. This indeed is a major problem. The inability to burn fat underlies virtually all of the chronic diseases of aging, and in fact may contribute to the rate of aging itself.

As such, one might think that the control all fat burning and storage might be very important in heart disease, and the other diseases of aging such as diabetes, obesity, osteoporosis, and even cancer. Indeed, this appears to very much be the case. The two hormones that to a major extent control our ability to burn and store fat, insulin and leptin, appear to play a major role in all of the chronic diseases of aging. I would call them the most important hormones, indeed chemicals in the entire body. But that is a story for next time.

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Keeping Cholesterol Down

Thursday, January 31st, 2008

There’s new scrutiny of  statins, which are the most popular prescription drug ever that’s been marketed as a cholesterol-lowering medication.

As Businessweek reports: “The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program, 40 million Americans should be taking them. Some researchers have even suggested-half-jokingly-that the medications should be put in the water supply, like fluoride for teeth.”

This week, CBS News partnered with Businessweek, which reported today that statins don’t necessarily help patients in the way they are thought to. Read our partner story from Businessweek here.

While it is possible that it is in your best interest to use cholesterol-lowering medication, medical experts suggest ways to lower your cholesterol without drugs - making simple lifestyle changes.

The American Heart Association’s Web gives simple recommendations in a checklist for lowering cholesterol. It suggests taking simple measures: exercising regularly, eating a heart-healthy diet and making certain lifestyle choices, such as avoiding tobacco smoking.

Eating healthy

The American Heart Association offers some information on cholesterol, your body and your diet.

Some of your cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol - including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.

The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.

At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.

Eat at least 25 to 30 grams of dietary fiber each day - preferably from whole grains, fruits, vegetables and legumes. To combat high blood pressure and for overall cardiovascular health, also limit sodium to 2,300 mg or less per day.

But a heart-healthy diet isn’t just about what you shouldn’t eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.

But can a bowl of cereal help prevent a heart attack? The Mayo Clinic suggests the best foods to lower your cholesterol and protect your heart. A partial list from the Mayo Clinic is below.

Oatmeal

Oatmeal contains soluble fiber, which reduces your “bad” cholesterol. Soluble fiber is also found in such foods as kidney beans, brussels sprouts, apples, pears, psyllium, barley and prunes.

Walnuts and almonds

Studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.

Fish including omega-3 fatty acids

Studies in the 1970s showed that Greenland Eskimos had a lower rate of heart disease than did other individuals living in Greenland at the same time. Analysis of dietary differences between the groups showed that the Eskimos ate less saturated fat and more omega-3 fatty acids found in fish and whale and seal meat. Research since that time has supported the heart-healthy benefits of eating fish. If you can’t dine with the Eskimos, other good sources of omega-3 fatty acids include flaxseed, walnuts, canola oil and soybean oil.

Soy

Long thought to have cholesterol-lowering effects, a recent meta-analysis by the American Heart Association’s Nutrition Committee showed soy protein actually has very little impact on reducing cholesterol levels. In January 2006, the American Heart Association issued a statement saying the cardiovascular health benefits of soy protein are minimal at best. No benefit was seen on HDL, triglycerides, or blood pressure and even with a large intake of soy, only a small impact on LDL was seen.

Stay away from smoke

The American Heart Association advises the following:
Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control. Cigarette smoking is so widespread and significant as a risk factor that the Surgeon General has called it “the leading preventable cause of disease and deaths in the United States.”

Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery.

Keep up physical activity

Physical inactivity is a major risk factor for heart disease, according to The American Heart Association, which recommends getting at least 30 minutes of physical activity, preferably every day but at least more days than not.

You don’t need to get your minutes all at once - it’s fine to break up your activity into 10-minute sessions or 15-minute sessions. For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you’ve been inactive.

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