Body Worry : Balancing Good and Bad Cholesterol

Eric, a good friend here--who feels great, is very active and looks lean and healthy--just found out he has severe coronary heart disease. He recently entered the hospital for quadruple bypass surgery.

My friend, about 50, says he's never been sick enough to be in the hospital before. He found out about his disease because an insurance company required a resting EKG test before issuing him an additional policy.

The clogging of the arteries around his heart (that's what coronary heart disease is) was severe enough so that in two places the arteries were completely blocked, and in two other places they were 90% blocked. Arteries provide our cells with oxygen. Severe blockages like these eventually strangle the heart--a heart attack.

Eric, of course, is lucky. He didn't want to have a physical in the first place (who does?), postponed it twice and came close to putting it off for an entire year. Had he done that, the doctors believe, heart disease would have presented itself to him in a more brutal manner than an irregular EKG. He would probably have had the symptom 40% of us have: instant death.

Because Eric was such a jock, a perfect commercial for the active life style, a lot of people on this island were shocked when they learned of his disease. Because I know him well, I was not shocked. He possessed several of the leading indicators of heart disease.

Which brings me to the great irony here: Even though heart disease seldom speaks to us before it cripples or kills, we are surrounded by information that virtually always indicates the presence (or future presence) of the disease.

None of the information is hard to gather, either. For instance, do you (or does someone you care about) smoke or have the wrong cholesterol levels, or have high blood pressure? Individually, these are considered the most important risk factors in the development of heart disease.

Are you a sedentary person, or do you have high body fat, or diabetes, or a good case of tension and stress? How about a history of heart disease in your immediate family, including grandparents or aunts and uncles? I used to think physicians were wasting my time when they asked me about the death of my relatives, but heredity plays a big role in heart disease and other health problems.

But of all these things, probably the most important indicator is your cholesterol level. Cholesterol, at normal levels, isn't bad for you; it's necessary for your body's functioning. This vital chemical substance is both manufactured in our bodies and found in the animal tissue we eat.

Our bodies usually regulate cholesterol needs pretty well, but sometimes we complicate its work. Like when we eat too much animal fat. When we do that, our bodies begin to manufacture even more cholesterol. For that cholesterol to travel around, the liver produces elements that actually transport cholesterol called HDLs and LDLs (high density lipoproteins and low density lipoproteins).

Excess Cholesterol

HDLs are the good guys in this story. They return excess cholesterol to the liver for breakdown and disposal. LDLs have a different function: They like to take cholesterol to our cells, and are especially attracted to our arteries.

And here the problems begin.

When LDLs and HDLs are in balance, cholesterol travels through our arteries with little impact on the health of the arteries themselves.

Over the Ideal Balance

But when our level of LDLs to HDLs is too high (for a man, anything over the ideal balance of 3.5 LDL to 1 HDL), and especially when our arteries are already damaged by such things as smoking or high blood pressure, the artery-loving LDLs begin to attach themselves to the inner lining of the artery.

They pile up in a traffic jam of sorts, and begin to obstruct the flow of blood. At that point, you have heart disease. We all will have it if we live long enough, but we all want to avoid it if we want to lead a long and healthy life.

Knowing that ratio of good to bad cholesterols is therefore probably as important as remembering to breathe. Don't you think about that a lot? You don't? That's what I mean.

Knowing your cholesterol levels won't take much time or money, either. You can find out your total cholesterol count (but not your ratio of good to bad cholesterols) from virtually any hospital, county health department or doctor in the country for $10 to $15.

If you are not in any of the high-risk categories I mentioned earlier for heart disease, that will probably tell you enough.

But if you are in any of those high-risk categories, that one number isn't enough. Ask your doctor for a "Lipid Profile." The profile will tell you your LDL/HDL ratio and shouldn't cost more than $25 dollars plus your visit. Don't even think that you can't afford all that, either. The average hospital stay for a heart attack victim is more than $30,000.

Talking about the factors that produce heart disease doesn't exactly put any of us in a joking mood, because this monster just doesn't forgive if we ignore it. But heart disease, the great killer, does respond quickly to changes in our health patterns.

Changes in Diet, Activity

The Cooper Clinic in Dallas has seen lowered cholesterol levels in weeks with simple changes in diet and increases in activity.

The most important dietary change is to lower your fats. For instance, a switch from butter and stick margarine to soft tub margarine lowers saturated fats. Eating half the skin on your fried chicken will lower your fats; baked chicken is even better.

And a nice long walk before you eat that meal will help, too. Modest exercise lowers your appetite, eventually improves your balance of good and bad cholesterols, and also simply makes you feel good.

Feeling good is the best revenge. The original couch potato, I am proof of that. Now what is your cholesterol level, and what do you plan to do about it? Let me know.

Send any questions to Remar Sutton in care of The Times. Questions of general interest will be discussed in future columns.

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