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Keeping Cholesterol in Check : Why Acting Now to Reduce Your Fat Levels Just Might Keep You From Paying Later

Times Staff Writer

So the surgeon general says fried foods are bad for you. But they taste so good. And a flaky croissant every morning--well, who could resist? Anyway, you’re young, active and lean. There’s time enough when you’re middle-aged, sedentary and plump to worry about whether cholesterol is setting up house in your arteries.

But making a few small changes in your diet now could keep you out of cholesterol trouble for years beyond the norm, according to a ground-breaking analysis by scientists at the U.S. Centers for Disease Control.

Increases With Age

By charting information from two national studies, Dr. Gerald Cooper and statisticians Samuel Caudill and S. Jay Smith found that an American’s blood cholesterol level increases consistently with age. For men, the annual increase is about 2 milligrams per deciliter of blood between ages 20 and 30, and 1 mg. per year from ages 30 to 60. For women, the higher increases come later in life: 1.5 mg. per year between ages 20 and 40, and 2 mg. per year between 40 and 60.

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The resulting graphs allow people to see the age when their cholesterol levels can be expected to reach what doctors call the “borderline high-risk” level of 200 mg. of cholesterol per deciliter of blood and the level considered at high risk of developing heart disease, 240 mg. or above.

This kind of concrete information demonstrates for the first time how foregoing those French fries today can keep a person in the safety zone for several years beyond what would otherwise be the case.

For example, a 30-year-old man with a cholesterol level of 185 who continued to eat a standard American diet containing 36.5% fat could expect his cholesterol level to reach 200 mg. at age 38, according to the Centers for Disease Control charts. However, by lowering his cholesterol level by 10 points now--by cutting his fat intake to 30%--his time below 200 could be extended to at least age 51.

For a 30-year-old woman at the same 185 level, dropping by 10 points would be even more immediately beneficial. She could expect to reach 200 mg. at age 36 if she made no dietary changes. With a leaner diet, her time below 200 mg. would extend at least until age 42.

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Shape Could Change

Furthermore, an individual’s actions today could change the shape of his age-related cholesterol curve altogether, said Dr. James I. Cleeman, coordinator of the federal government’s National Cholesterol Education Program.

“It is possible that not only are you dropping the starting point of the curve but that you’re affecting its shape as well,” he said. “That is, it may not rise as this set of curves rises if you take action--the curve should be flatter. So the news could be even better than this chart shows.”

The chart “can be helpful in motivating people at any age, but certainly in young people who are not yet at high (cholesterol) levels,” he said. “This will tell them they might get there.”

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“It is much easier to get somebody’s attention when they are ill or facing some kind of life crisis,” said Dr. Edward N. Brandt, executive dean of the University of Oklahoma College of Medicine and a nationally recognized cardiovascular disease expert. “The question is, how can you get people’s attention if they’re pretty healthy and everything is OK? This may be one way to do that.”

The figures are based on tests conducted on more than 11,000 Americans for the 1976-80 National Health and Nutrition Examination Survey. The graphs then were checked against actual results of long-term cholesterol monitoring on individuals in the Framingham heart study, which has been running since 1948.

Experts Don’t Know

The researchers and other cholesterol experts point out that it’s impossible to say whether the increases charted in the graphs are a result of the body’s natural aging process or whether they resulted from the traditional fat-rich diet of Americans.

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But the experts agree that Americans can assure themselves of a healthier future if they change their eating habits today.

The ultimate reinforcement for changing one’s diet now is not as quantifiable as points on a cholesterol scale, Cooper points out.

“The big thing about cholesterol is that if a person really maintains it, they can look forward to a better quality of life for many years,” he said.

HOW MUCH FAT? Fast food can quickly use up the total allowable in the 30%-fat diet, as table below shows. A 120-pound woman needs about 55 grams of fat per day, and a 160-pound man about 75 grams. So if you must eat a burger or fried chicken, make up for it by keeping other fats to a minimum that day.

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Item Grams of fat Burger King Whopper with cheese 36 McDonald’s Big Mac 33 Jack-in-the-Box Jumbo Jack 29 Wendy’s Single 26 McDonald’s Quarter Pounder 22 Kentucky Fried Chicken wing, extra crispy 13.5 Kentucky Fried Chicken wing, original recipe 9

THE 30%-FAT DIET You’ll have a healthier tomorrow if you choose a diet today that takes no more than 30% of its calories from fat, health experts say. As shown in the sample menus below, this means smaller meat portions, less fried food and greater emphasis on fruits, vegetables and grains.

WOMEN

An 1,800-calorie-per-day diet for the average woman, with a fat content of approximately 30%.

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In grams Carbohydrates Fat Protein Breakfast 1/2 cantaloupe 30 -- -- 1 cup cereal(approx.1 1/2 oz.) 22 1 4 1 cup 2% milk 12 5 8 Lunch 2 slices whole-grain bread 30 tr 4 2 oz. turkey -- 6 14 lettuce, tomato 4 -- 2 mustard -- -- -- 2 tsp. mayonnaise -- 10 - Soda water -- -- -- Raw carrot & celery 8 -- 4 Snack 2 med. fruits (chop 1 1/3 cup) 40 -- -- Dinner 3 oz. broiled fish -- 9 21 1 cup steamed brown rice 30 tr 4 1 cup broccoli 8 -- 4 Salad 8 -- 4 2 tbsp. Italian dressing -- 15 -- 1 slice bread 15 -- 2 1 tsp. margarine -- 5 -- 1 cup 2% milk 12 5 8 Snack 1 med. fruit (chop 2/3 cup) 20 -- -- Total 239 56 79

This is 956 calories from carbohydrates, 504 from fat and 316 from protein. (Each gram of protein or carbohydrates provides 4 calories. One gram of fat provides 9 calories.)

MEN

A 2 , 400-calorie-per-day diet for the average man, with approximately 30% fat content .

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In grams Carbohydrates Fat Protein Breakfast 1/2 cantaloupe 30 -- -- 2 cups cereal (approx. 3 oz.) 44 2 8 1 1/2 cup 2% milk 18 7 12 1 slice toast 15 -- 2 1 tsp. margarine -- 5 -- Lunch 2 slices whole-grain bread 30 tr 4 3 oz. turkey -- 9 21 lettuce, tomato 4 -- 2 mustard -- -- -- 2 tsp. mayonnaise -- 10 -- Soda water -- -- -- Raw carrot & celery 8 -- 4 Snack 2 med. fruits (chop 1 1/3 cup) 40 -- -- 3 oz. broiled fish -- 9 21 1 1/2 cup steamed brown rice 45 tr. 6 1 cup broccoli 8 -- 4 Salad 8 -- 4 2 tbsp. Italian dressing -- 15 -- 1 slice bread 15 -- 2 1 tsp. margarine -- 5 -- 1 cup 2% milk 12 5 8 Snack 1 medium fruit (chop 2/3 cup) 20 -- -- 4 cups popcorn 20 -- 3 2 tsp. margarine -- 10 -- Total 317 77 101

This is 1,268 calories from carbohydrates, 693 from fat and 404 from protein. (Each gram of protein or carbohydrates provides 4 calories. One gram of fat provides 9 calories.)

SOURCE: Janice Shigehara, R.D., clinical dietitian at Scripps Clinic, La Jolla.

THE ABCs OF CHOLESTEROL Recent studies indicate that high blood cholesterol results from an interaction between what foods you eat and how your body reacts to them. Problems in the former can affect the latter.

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For instance, a diet high in saturated fats not only raises the cholesterol level but also in time can turn off the body’s natural defense against too much cholesterol in the blood, some researchers feel.

‘GOOD’ AND ‘BAD’ CHOLESTEROL--HDL and LDL in the bloodstream are combination fat/protein molecules that serve as carriers for cholesterol. High levels of HDL are associated with lower risk of heart disease. High levels of LDL are considered the primary sign of impending atherosclerosis, or fat-clogged arteries, and resulting heart disease.

ALL FATS ARE NOT CREATED EQUAL--In people who do not have a family history of high blood cholesterol, saturated fats are considered the primary reason for too much “bad” cholesterol in the blood.

Both polyunsaturated and monounsaturated fats lower LDL levels, so both are recommended as alternatives to saturated fats. However, recent research indicates that polyunsaturated fats also decrease “good” cholesterol and has led some nutritionists to prefer monounsaturated fats.

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WHERE IT COMES FROM--Saturated fats: fatty meats, dairy products and hydrogenated oils, especially palm and coconut oils. Polyunsaturated fats: corn, safflower, sunflower, sesame, soybean and cottonseed oils. Monounsaturated fats: Olive oil and canola (rapeseed) oil.

THE EGG ISSUE--The standard medical advice is that people with cholesterol levels above 200 mg per deciliter of blood should eat no more than 3 egg yolks per week; above 240 mg, the limit is one egg yolk a week.

The National Research Council Committee on Diet and Health recommends limiting cholesterol intake to less than 300 mg a day; one egg yolk has about 250 mg. But how you prepare the eggs--fried in butter versus poached or boiled--is as important as how many you eat. That is because the body’s own mechanisms for limiting cholesterol in the blood appear to be influenced more by saturated fat consumption than they are by cholesterol consumption.


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