Tacio: Lowering your cholesterol level

Monday, November 8, 2010

YOU may have noticed that pork and eggs have become four-letter words. It's all because of cholesterol, a substance that's gotten a reputation for breaking hearts than your loved one.

But cholesterol isn't entirely bad. The human body actually needs it - and produces it - to help protect nerves and build new cells and hormones. In fact, our bodies get all the cholesterol they need by making it on their own. The trouble starts when we add to the cholesterol our bodies produce.

Have something to report? Tell us in text, photos or videos.

Excess cholesterol settles along arterial walls, and that excess can clog arteries and restrict blood flow, leading to angina pain, heart attack or stroke. (Cholesterol is also a leading cause of gallstones.)

Unfortunately, there's a lot of confusion surrounding this substance. And it's no wonder, with similar terms like serum cholesterol, dietary cholesterol, HDL cholesterol, and LDL cholesterol being bandied around, you may have trouble telling the good from the bad and the ugly.

Serum cholesterol is the amount of this fatty substance in our bloodstream. Our serum cholesterol is what our doctor measures in a cholesterol test. A reading under 200 is desirable; a reading over 240 may be dangerous and is cause for concern.

Meanwhile, dietary cholesterol is what we eat. For instance, an egg has 213 milligrams; an apple has none. Experts recommend that we eat no more than 300 milligrams a day.

Low-density lipoprotein (LDL) is the bad cholesterol that clogs arteries. It simply means that if our LDL is lower, it is better. On the other hand, high-density lipoprotein (HDL) is the good cholesterol that scours artery walls and helps remove harmful LDL. The higher our HDL, experts say, the better.

To lower bad cholesterol, doctors usually prescribed simvastatin, atorvastatin, and rosuvastatin. All three belong to a class of drugs called the statins, which are very effective in lowering cholesterol levels.

In his book, How To Live Longer, Dr. Willie T. Ong shares this information: "For persons with total cholesterol of more than 280 mg/dl or an LDL cholesterol of greater than 190 mg/dl, drug treatment may be started after (a) an eight-week trial of diet and exercise and (b) confirmation of cholesterol levels beyond the above cut-offs.

"For those persons who have heart disease, hypertension or are heavy cigarette smokers, drug treatment is started at a much lower cholesterol level of 240 mg/dl and higher or an LDL cholesterol of more than 160 mg/dl.

"And for those who have diabetes or have already suffered a heart attack or stroke, they are the ones who would most benefit from the statin drugs, even if their cholesterol levels are just a shade over 200 mg/dl."

But before taking any drug, Dr. Ong urges that you should check the accuracy of the test. "First, cholesterol test results are notoriously inaccurate, unless it is taken from a reputable laboratory," writes the heart doctor. "Second, make sure the 12-hour fasting requirement is followed - no food and just a minimum of water before testing. For these reasons, a repeat test after 1-2 months of diet and exercise may save the patient money and needless worry."

Dr. Ong, who was named Outstanding Filipino Physician by the Department of Health in 2007, admits that drugs are "expensive and entails frequent monitoring for side effects." As such, he recommends that "lifestyle changes should be maximized."

For one, you must eat breakfast every morning. Breakfast skippers tend to have higher levels than those who start of their mornings with a bellyful, according to studies. One reason may be that breakfast skippers make up for missing the morning feast by munching on unhealthy snacks later on, suggests Dr. John L. Stanton, professor of food marketing at St. Joseph's University in Philadelphia.

For another, don't depend on decaf. Decaffeinated coffee actually raises LDL levels more than regular brew, so it's the worst beverage selection if you have high cholesterol. That's according to David Jenkins, director of the Clinical Nutrition and Risk Factor Modification Center at St. Michael's Hospital at the University of Toronto.

It may be because the coffee beans used for decaf are stronger than "regular" beans. Frequent coffee drinkers (those who drink it daily) typically have a 7 percent cholesterol increase, as shown in a study at Stanford University in California.

As stated earlier, the higher the HDL, the better. Cholesterol-cutting statins aren't very effective at raising HDL, but happily some food are. Dark chocolate, for one. In a recent study, volunteers who ate 100 grams of dark chocolate (70-percent cocoa) every day for a week raised their HDL by 9 percent. That's a load of chocolate (about 2300kJ), but Paul Gurbel of Sinai Hospital in Baltimore, the study's co-author, says eating smaller daily doses (say 15 grams) over an extended period of time should also help.

Salmon can also do the same trick. HDL reportedly rose 4 percent in adults who ate two 115 grams servings a week for four weeks, according to a study by Loma Linda University in California. Other fatty fish - mackerel, herring, and sardines - should deliver similar benefits, researchers say.

Eating soybeans and other legumes can help lower your cholesterol, according to Dr. James W. Anderson, a professor of medicine and clinical nutrition at the University of Kentucky College of Medicine in Lexington. The reason these high-fiber legumes are so effective is because they contain a water-soluble fiber called pectin that surrounds cholesterol and chaperons it out of the body before it can cause trouble.

The more of these beans you eat, the greater the benefits. In one study, Dr. Anderson asked men to eat one-and-a-half cups of cooked beans a day. The result? Their cholesterol plummeted 20 percent in just three weeks.

Carrot, Bugs Bunny's favorite entr‚e, is a boon to arteries because they have plenty of cholesterol-lowering pectin. "It may be possible for people with high cholesterol to lower it 10 to 20 percent just by eating two carrots a day," explains Dr. Peter D. Hoagland, a researcher at the US Department of Agriculture Eastern Regional Research Center in Philadelphia.

Pectin can also be found in citrus, tomatoes, potatoes, strawberries, and spinach.

There are several supplements that can counter cholesterol. Tufts University researcher Paul Jacques, found that vitamin C raised levels of HDL in the elderly people he studied. He estimates that one gram a day could increase HDL by 8 percent.

Other studies show that when extra vitamin C is added to a pectin-rich diet, cholesterol drops even lower than with pectin alone. Conveniently, many pectin-packed fruits and vegetables are also rich in vitamin C.

What about vitamin E? One study done by French and Israeli researchers showed that 500 international units of vitamin # a day for 90 days significantly increased HDL levels. "Our results support the use of vitamin C for people with high blood-fat levels," said the researchers.

If you're taking calcium supplements for the sake of your bones, you may be doing your heart a favor, too. In one study, one gram of calcium daily for eight weeks lowered cholesterol 4.8 percent in people with mildly high levels. In another study, two grams a day of calcium carbonate reduced cholesterol by 25 percent in 12 months.

Before doing all what have been suggested here, be sure to consult your doctor first. As they say, doctors know best.