THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Wednesday, May 29, 1996 TAG: 9605250055
SECTION: FLAVOR PAGE: F1 EDITION: FINAL
SOURCE: BY PAT DOOLEY, STAFF WRITER
LENGTH: 172 lines
WATCHING OUR cholesterol used to be easy.
We went to the doctor. He tested our blood. If our cholesterol was more than 200, we cut back on fat and ate more fruits, grains and vegetables.
If our cholesterol was under 200, we went out for fries and a burger and didn't think much more about it.
Cholesterol, we figured, was just another fad.
Oh, how wrong we were.
High cholesterol is a major cause of heart disease, the nation's No. 1 killer. Almost a half-million Americans die of heart attacks each year.
Those who survive face strict doctor's orders to reduce the risk of future attacks: quit smoking, exercise, slash dietary fat and monitor cholesterol.
``They're simple things but they're things people neglect,'' says Dr. William DeLacey, cardiologist at Lakeview Medical Center in Suffolk and a spokesman for the American Heart Association.
For those who haven't had a heart attack, the prescription remains the same.
Doctors today preach prevention: Control cholesterol to reduce the risk of heart attack, stroke and even cancer.
It's something of a new attitude, and one DeLacey likens to the treatment of high-blood pressure beginning in the 1970s.
``The incidence of stroke, heart disease and kidney disease were all reduced by the control of blood pressure,'' he says. Giving heed to high cholesterol now, he adds, may one day reap similar results.
Scientists are learning much about cholesterol. But, for the consumer, reports of the multitude of studies can be daunting.
``There's a lot of talk about cholesterol today,'' says a heart association pamphlet, ``and lots of misunderstanding.''
We've been told about ``good'' cholesterol and ``bad'' cholesterol.
We've been bombarded with scientific terms such as lipids, lipoproteins, saturated fatty acids and triglycerides.
We've been advised to exercise, rid our diets of fat - the wrong fat, but not all the fat. We've even heard that a little alcohol may be good for us - unless we don't drink, or we have a drinking problem. We might even know of heart patients who've been told to supplement with vitamin E.
``I've seen some confusion,'' says Joan Sechrist, a registered dietitian and health educator with Sentara Alternatives Delivery Systems in Virginia Beach. ``Sometimes you lose people who don't have a scientific background.''
So Sechrist keeps her initial advice simple: Have your total cholesterol tested.
Drugstores, supermarkets and community health programs often offer screenings for a small fee. Usually, they use a basic test, with blood from the prick of a finger.
``They're designed to cull out people who need to be treated,'' says cardiologist DeLacey.
Anyone with a reading of 200 or more should consult a physician for detailed readings that measure high-density lipoproteins, or HDLs, the so-called ``good'' cholesterol; low-density lipoproteins, or LDLs, the ``bad'' cholesterol; and blood fats called triglycerides.
Health professionals look for LDLs of 130 or less, and HDLs of 35 or higher; HDLs can help flush the body of cholesterol.
Some people have high total cholesterol. If their HDLs also are high, the levels may be acceptable. ``You really need somebody to help you interpret the results,'' DeLacey says.
We make it
Everyone's body makes cholesterol, a soft, fatlike substance that helps form cell membranes, some hormones and other tissues. We also get cholesterol from animal-based foods such as meat, poultry, fish, cheese and eggs.
Too much cholesterol can accumulate in the arteries that feed our heart and brain. When cholesterol combines with plaque - a thick, hard deposit that clogs arteries - the result can be stroke or heart attack.
The heart association recommends we limit dietary cholesterol to 300 milligrams a day. But, more adamantly, it advises us to cut fat.
``There is one universal bad thing and that's saturated fat,'' says Babs Carlson, a registered dietitian and consultant for Chesapeake General Hospital and Norfolk's Eastern Virginia Medical School.
Saturated, or solid, fat is the chief culprit in raising blood cholesterol. It, too, is found in animal-based foods such as beef, cheese and eggs. Unlike cholesterol, it also is in some plant-based foods, such as coconut and palm oils.
Unsaturated fats - polyunsaturates and monounsaturates - are less harmful because they are not solids. Some monounsaturates, such as olive oil, can even help raise our good cholesterol.
The heart association advises limiting fat to less than 30 percent of daily calories, and our saturated fat to 10 percent of that.
Some health professionals recommend even less - as little as 10 percent of calories, especially for heart patients.
``Most people assume a small change toward a 30 percent diet is what they're supposed to do,'' says David P. Swain, director of the Wellness Institute and Research Center at Norfolk's Old Dominion University. He advocates a diet as low as 10 percent fat ``for anybody, but certainly for anybody with elevated cholesterol.''
Most people in the United States consume 40 to 42 percent of their calories from fat, Swain says.
Beyond diet
Controlling cholesterol doesn't end with diet.
``The No. 1 thing people can do beyond modifying their diet is to stop smoking,'' DeLacey says. Not only is smoking ``highly associated'' with heart disease, it also lowers our good cholesterol, he says.
Doctors also prescribe exercise. ``It's one of the few things anyone is aware of that will raise HDL levels,'' says ODU's Swain. Beginners should strive for an hour of moderate daily walking, he says.
Maintaining a sensible weight also is key. Some doctors prescribe vitamin E, an antioxidant, which prevent LDLs from sticking to artery walls.
Some heart patients are advised to drink red wine or other alcohol, which also is thought to raise HDLs.
The use of alcohol is controversial, DeLacey says, and must be ``balanced with the ravages of alcoholism. . . . I don't prescribe it.''
Back in the spotlight is fiber, for its apparent cholesterol-lowering power. It is found in oats, beans, apples and other grains, fruits and vegetables.
For some people, high cholesterol is genetic, DeLacey notes. Along with a low-fat diet and exercise, they may need cholesterol-lowering medicine.
But for most of us, prevention is the best medicine. And the benefits, DeLacey says, are dual. ``A low-fat diet, in general, will reduce both your risk for heart disease and cancer.'' MEMO: LOWERING YOUR CHOLESTEROL
The American Heart Association reports that about 31 percent of
American adults have cholesterol levels from 200 to 239. Their risk of
heart attack is twice that of people whose cholesterol is below 200.
Here are some tips for lowering your overall cholesterol, from the
heart association:
Eat fewer than 30 percent calories from fat. Some health
professionals recommend as little as 10 percent calories from fat.
Choose polyunsaturates - such as safflower, sesame and sunflower seeds,
corn and soybeans - and monounsaturates - such as canola, olive and
peanut oils and avocados.
Eat less than 10 percent calories from saturated fat, such as butter,
lard and tropical oils including coconut and palm.
Other foods high in saturated fat include beef, veal, lamb, pork,
poultry fat, cream, milk and cheese. These foods also are high in
cholesterol.
Consume no more than 300 milligrams cholesterol daily.
Eat no more than four egg yolks a week. One egg yolk contains about
213 milligrams cholesterol. Egg whites do not contain cholesterol.
Eat fish, poultry without skin and lean meats. Use low-fat or skim
dairy products.
Consider that shrimp and crayfish are higher in cholesterol than most
fish, but lower in fat and saturated fat than most meats and poultry.
Avoid processed meats, such as sausage, bologna, salami and hot dogs.
About 70 to 80 percent of their calories come from fat. Buy ``choice''
or ``select'' grades of beef, instead of ``prime.'' Read labels.
Trim fat from meat before cooking. Use a rack to drain fat when
broiling, roasting or baking.
Hamburger adds more fat to the American diet than any other food.
Broil rather than pan-fry meats such as hamburger and steak.
Other cooking methods that require little or no fat are boiling,
poaching, steaming, sauteing and microwaving.
Occasionally snack on nuts and seeds. Though high in fat and
calories, most of the fat is unsaturated. Nuts and seeds contain
protein, but no cholesterol.
Choose complex carbohydrates for about 50 percent of your daily
calories. They include whole grains, fresh fruits and vegetables, beans,
rice and pasta. Many of these foods are high in fiber, which helps flush
our bodies of ``bad'' LDL cholesterol.
Starting at age 20, have your total cholesterol and HDL checked.
Exercise, maintain a healthy weight and quit smoking.
For more information about cholesterol, call the American Heart
Association's toll-free hot line: 1 (800) HEARTLINE. Or, call the
American Heart Association Tidewater Council at 671-8636. You also can
write: National Cholesterol Education Program, Information Center, 4733
Bethesda Ave., Suite 530, Bethesda, Md. 20814-4820. Ask for the
pamphlets ``Facts About Blood Cholesterol''; ``Eating To Lower Your High
Blood Cholesterol''; and ``So You Have High Blood Cholesterol.'' ILLUSTRATION: Color drawing by SAM HUNDLEY, The Virginian-Pilot
Photos by CNB