TriVita Asks, “Is Cholesterol Bad?”

Summary: Cholesterol and Your Heart: Where Do We Stand?
by Dr Brazos Minshew

Cholesterol. This article will explain the relationship between high cholesterol and heart disease, describe the different types of cholesterol, and review several ways to lower a high cholesterol level, including exercise, a low-fat diet, and medication.

What is Cholesterol?
Cholesterol, judging from the thousands of food labels and TV commercials boasting “zero cholesterol” has quite a bad reputation. Cholesterol is a vital component of all cell membranes. Unfortunately, too high a concentration of cholesterol in the blood is associated with an increased risk of heart disease. A high cholesterol level is one of many risk factors for developing heart disease.

Where Does Cholesterol Come From?
Most of the cholesterol circulating in your blood is made in the liver from fat metabolism. Dietary cholesterol comes from animal products such as meat, milk, cheese and butter.

Cholesterol and fat are transported through the bloodstream in particles called lipoproteins, which are so named because they contain different proportions of lipid (fat) and protein molecules. Chylomicrons carry triglycerides (fat from the foods you eat) from the intestine to body tissues, where they are used for energy or stored as fat.

LDLs (Low Density Lipoproteins) are stuffed full of cholesterol. They hold about two-thirds of all the cholesterol in the blood. These particles, nicknamed “bad” cholesterol, are partially responsible for forming plaque (debris) along blood vessel walls. The more LDLs you have, the greater your risk of getting coronary artery disease or a heart attack.

HDLs (High Density Lipoproteins) are known as “good” cholesterol. Cholesterol and Heart Disease
Increased levels of cholesterol in the blood can contribute to atherosclerosis, which is the gradual build-up of cholesterol, fat, and fibrous debris along the walls of your arteries. In the heart arteries called coronary arteries this can lead to chest pain or angina when someone exerts themselves.

What’s Your Risk?
A high level of blood cholesterol is associated with an increased risk of heart disease. But unlike other risk factors for heart disease that you can’t change or modify, such as age, sex, or a family history of heart disease, you can lower a high cholesterol level. The more risk factors you have, the greater your chances of developing heart disease.

Know Your Numbers
Cholesterol levels can be measured with a simple blood test. The higher the ratio (high total cholesterol, low HDL cholesterol), the greater your risk for coronary heart disease. Your doctor can help assess the degree of risk associated with your particular cholesterol values:

Lab Test	Desirable	Borderline	High Risk
Total Cholesterol	less than 200 mg/dL (5.2 mmol/L)	200-239 mg/dL (5.2-6.1 mmol/L)	more than 240 mg/dL (6.2 mmol/L)
LDL Cholesterol	less than 130 mg/dL (3.4 mmol/L)	130-159 mg/dL (3.4-4.0 mmol/L)	more than 160 mg/dL (4.1 mmol/L)
HDL Cholesterol	More than 39 mg/dL (1.0 mmol/L)	n/a	less than 40 mg/dL (1.0 mmol/L)
Triglycerides	less than 250 mg/dL (2.8 mmol/L)	n/a	more than 250 mg/dL (2.8 mmol/L)
Ratio of total Cholesterol:HDL	less than 3.5	3.6-4.9	more than 5

Ways to Lower Cholesterol
Is your cholesterol or ratio of cholesterol to HDL too high? The most effective ways to lower cholesterol and reduce your risk of heart disease include exercise, a low-fat diet and medication.

Exercise keeps your heart and blood vessels healthy. Exercise raises HDL, the “good” cholesterol.

The National Cholesterol Education Program’s (NCEP) dietary guidelines for lowering cholesterol have focused on lowering total fat, which often ends up increasing carbohydrate in the diet. Some nutrition experts have demonstrated that certain people on this diet may actually lower their HDL cholesterol, the “good” cholesterol. This often leaves the ratio of cholesterol to HDL unchanged. Other dietary guidelines include lowering cholesterol intake, changing the type of fat you eat, and increasing fiber.

General Tips for a Cholesterol-Conscious Diet

Reduce Total Fat
Depending on your cholesterol profile, a reduction in total fat may be beneficial. Less fat in the diet means that there is less “raw material” for the liver to use in making cholesterol. Reduce Saturated Fat
The type of fat you eat is just as important as how much you eat. Since the liver makes cholesterol more efficiently from saturated than unsaturated fat, changing the type of fat you eat can help to lower your cholesterol. Reduce Partially Hydrogenated Fats or Trans Fats.

To prolong the shelf life of foods, particularly margarine, snack foods and baked products, manufacturers use liquid vegetable oils, which have been partially hardened to form trans fats. Eating a diet containing these products has been associated with an increased risk of cardiovascular disease. Many foods now specify their content of trans fats; reading food labels can help you avoid these substances

Increase Polyunsaturated Fats
The type of fat found in fatty fish like salmon, mackerel and tuna is particularly healthful. Since bile, a substance that helps digest fat, is made primarily of cholesterol, excreting it will help lower total cholesterol levels. Intriguing research has shown that the vegetable protein in soy may be able to lower blood cholesterol.

A registered dietitian (RD) can help you plan a cholesterol-modifying diet that’s appropriate for your weight, height, activity level, and blood cholesterol profile.

Source: TriVita Article Cholesterol and Your Heart: Where Do We Stand?

Cholesterol-Lowering Drugs: Do They Help?

Healthcare professionals continue to debate the benefits of statin drugs

Statin drugs have become big business. The use of these cholesterol-lowering drugs increased by 156% between 2000 and 2005, rising from 15.8 million people to 29.7 million people.

Statins are currently the best-selling medicines in history, used by more than 13 million Americans and more than 12 million additional patients around the world, producing $27.8 billion in sales in 2006. Half of that amount went to Pfizer alone for its leading statin, Lipitor.North Americans are bombarded with messages from doctors, pharmaceutical companies and the media saying that high levels of bad cholesterol are the ticket to an early grave and must be brought down now. Yet, many respected healthcare professionals question the benefits of these drugs. They point out that different clinical trials were biased or only showed marginal benefits. Some researchers even have doubts about the need to drive down cholesterol levels in the first place. The debate about the effectiveness of statins continues and each side offers statistics to support their position. Statin proponents point to studies that suggest these medications may prevent heart attacks and strokes among people who don’t already have cardiovascular disease or elevated cholesterol levels. And there are even studies that claim statins can help protect against dementia or Alzheimer’s. However, there are just as many respected healthcare professionals who feel that statin drugs are unnecessary and possibly even dangerous. Some of these people question whether cholesterol automatically is the culprit in most heart diseases. “Cholesterol is just one of the risk factors for coronary disease,” explains Dr. Ronald M. Krauss, director of atherosclerosis research at the Oakland Research Institute, in a Business Week article. “Higher LDL levels do help set the stage for heart disease by contributing to the buildup of plaque in arteries. But something else has to happen before people get heart disease. When you look at patients with heart disease, their cholesterol levels are not that much higher than those without heart disease.” Still others point to the ever-growing body of evidence that shows potentially serious side effects from statins. The most common side effect is muscle pain and weakness, most likely due to the depletion of CoQ-10, a nutrient that supports muscle function. Some healthcare providers suggest taking a CoQ-10 supplement to help protect against statin side effects. To find out more about TriVita’s CoEnzyme Q-10 product, call a Wellness Consultant at 1-800-991-7116. Other potential side effects from large statin doses may include anemia, acidosis, frequent fevers, cataracts and lessening of mental acuity. Now there’s even more controversy about statinsJust recently the American Academy of Pediatrics (AAP) started recommending cholesterol-lowering statin drugs to obese children as young as age eight. Statins have long played a role in the fight against a childhood disease called familial hyper-cholesterolemia. However, the AAP is now making widespread recommendations for a whole generation of eight year olds. The AAP has been strongly criticized for its statement by the food and nutrition industries. Some say that no studies have been performed to show that this course of action is both necessary and successful. They suggest that doctors should emphasize the value of dietary approaches. An article in Nutraingredients.com states, “The lifestyles of these children have got them into this state; their lifestyle must get them out of it. And that means changing their diet.” How to lower cholesterol naturally Here are a variety of ways to lower your cholesterol naturally without any potentially dangerous side effects: • Make sure you get plenty of high quality, Omega-3 fatty acids • Reduce grains and sugars in your daily diet • Include soluble fibers containing psyllium seed • Eat plenty of fruits and vegetables: five servings for children, seven for women and nine for men • Try to eat a good portion of your food raw • Get the right amount of exercise – this will help increase blood flow throughout your body and also raise HDL, the protective “good” cholesterol • Avoid smoking and drinking excessive alcohol • Don’t become overwhelmed by emotional challenges – use prayer, meditation or relaxation techniques to lower stress level being overused and oversold to the wrong people. Source VitaJournal October 2008 pg 29 For more on this subject visit TriVita for more information.