Sunday, June 22, 2008

The Cholesterol Connection

The Cholesterol Connection

Cholesterol counts. Make no mistake about it. If you have high cholesterol levels in your blood, you have a greater chance of having a heart attack; eat a lot of calories, saturated fat, and cholesterol, and you're very likely to have a high blood cholesterol count.

And, according to a consensus conference held by the National Institutes of Health in December 1984, "The blood cholesterol level of most Americans is undesirably high." The experts said that high levels are due largely to too many calories and too much cholesterol and saturated fat in the diet. (Saturated fat, usually hard at room temperature, is found more often in animal products--such as meat, milk and egg yolks--than in plant products.)

Men usually have higher cholesterol counts than women. Women have more of a desirable type of cholesterol called HDLs (for high-density lipoproteins), as opposed to the villainous LDLs (low-density lipoproteins), the kind associated with heart problems. In part because of their higher HDL counts, women have about one-third the chance of developing heart disease compared to men.

Blood cholesterol levels are measured in milligrams per deciliter (a tenth of a liter, or about three ounces). Blood cholesterol levels tend to rise with age in this country, perhaps because of the large amounts of saturated fats we consume. Generally speaking, any count below 200 milligrams is considered safe; and persons 40 years and older with blood cholesterol above 260 are at high risk and should be treated.

The National Heart, Lung and Blood Institute says that people with blood cholesterol over 260 have four times the risk of developing heart disease as those with a level of 190 or lower.
Public health officials are concerned that the public hasn't taken the warning about the cholesterol connection to heart, so to speak.

The NIH consensus statement recommends that all Americans over the age of 2 adopt a diet that reduces fat and cholesterol intake. Health experts note that few people bother to have their cholesterol and triglyceride levels checked regularly. They would like people to know their current cholesterol levels as well as, or (for those poor in arithmetic) better than, their checkbook balances, and they would like physicians to make measuring blood cholesterol a regular practice with their patients.

Cholesterol and triglyceride levels can sometimes be controlled by drugs. However, the side effects from the drugs are often quite bothersome. Further, an American Medical Association report recommends diet therapy be tried first, saying it is more effective.

And, the report adds, "Diet therapy is generally safer than drug therapy and, when successful, may preclude it."

While diet therapy seeks to lower LDL levels in the blood, studies show that exercise helps to increase the ratio of HDLs in the bloodstream. It is believed that HDLs help rid the body of cholesterol. HDL levels are expressed in proportion to LDL levels; a ratio of at least 1 to 3 is considered desirable.

The National Heart, Lung and Blood Institute is launching a multi-million-dollar, long-term public education program to help Americans become more familiar with their blood cholesterol levels and reduce their fat and cholesterol intakes. Americans consume some 300 to 500 milligrams of cholesterol a day, down from 700 milligrams a few years ago.

The experts would like to see us cut that average to no more than 300 milligrams a day. A reduction in total fat consumption is also recommended. Today we consume about 40 percent of our calories in fat. The experts want us to reduce that intake to 30 percent fat and to decrease the amount coming from saturated fat.

An analysis of diet information compiled between 1976 and 1980 by the National Center for Health Statistics gives some indication of where we get our cholesterol. The study, headed by Gladys Block, Ph.D., of the National Center Institute, found that one-third comes from eggs (the average egg has 270 milligrams).

Other leading sources were: beef steaks and beef roasts, more than 8 percent; hamburgers, cheeseburgers and meatloaf. more than 7; whole milk and whole milk beverages, more than 5; hot dogs, ham and lunch meats, over 4 percent; and pork chops and roasts, better than 3 percent of our daily cholesterol intake.

Block and her associates figured that ground beef meals (hamburgers, cheeseburgers and meat loaf) contributed the most saturated fat to the diet (9.3 percent of the total saturated fat consumed in a day), followed closely by whole milk and whole milk products (9.1 percent).

Slightly less than half the saturated fat in the diet, they calculated, came from the following foods: ground beef; milk; beef steaks and roasts; hot dogs, ham and lunch meats; doughnuts, cookies and cake; eggs; pork, including chops and roasts; and butter.

Some trade-offs are involved in a heart-healthy diet. Beef liver, for example, is high in cholesterol--440 milligrams for a 3-1/2-ounce serving, but the American Heart Association recommends eating it at least once a month because of high levels of beneficial nutrients