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The ABCs of Cholesterol

August 11, 2002|by KEVIN CLAPP
(Page 2 of 2)

Kuhn stresses that there is no greater risk from taking cholesterol medication as there is for any other treatment.

But like the benefits of exercise, which disappear once activity is halted, cholesterol reducing drugs will not keep levels from rising again if patients stop taking their medication.

Sometimes it takes a life-shaking event to make a difference.

Ever since childhood, fast food had been a staple of Ron Pike's diet. Caught in the bustle of life, running here or there for work or with the kids, the 59-year-old probably ate fast food five or six times a week.

The last week of May, a routine physical exam of the relatively slim (175 pounds, 5'10") Hagerstown man included a cholesterol test. The result was nothing out of the ordinary for Pike, a level of 220 mg/dL, including an HDL of 37 mg/dL.

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A little high, but in keeping with past tests. A week later, on June 1, Pike had a heart attack.

"People have got to be aware of this," he says now. "And take it seriously, watch the fat intake."

Following his attack, Pike was put on a cholesterol reducing medication, Zocor, he takes once a day. He also was began a regular exercise regimen.

"Before, my exercise principally consisted of golfing and a little walking, but I didn't do enough to consider it exercise," the clinical social worker says. "You delude yourself into thinking you're in shape but you're not."

He also revamped his diet, opting for more salads, fruits and vegetables, plus making recipes at home that are more heart healthy. Surprisingly, Pike says, the new menu doesn't taste too bad.

Six weeks after his heart attack, the exercise, diet and medication did their job. His total cholesterol level had dropped 107 points, to 113 mg/dL.

And he doesn't miss the greasy indulgences commonplace just a few months ago. Pike hasn't been to a fast food restaurant since his attack, doesn't intend to return.

Not everyone is as proactive.

"There are some people who would never make a change if not for a heart attack or a heart bypass operation," says Pam Peitz, cardiac rehab coordinator at Washington County Hospital, who adds that eating saturated fats is a prime source of external cholesterol.

The American Heart Association recommends diets include only about 16 grams of saturated fatty acids each day.

"You eat one bacon cheeseburger, you're over that and people don't realize," Peitz says. "You've got 14 by the end of breakfast and you're only allowed 16 a day."

Saturated fats, because of their similarities to cholesterol molecules, are most easily converted to cholesterol, Kuhn says, but other fats aren't immune. It's just that converting fatty acids and hydrogenated fats takes a bit longer, and can be used for other purposes before the liver gets around to turning them into cholesterol.

"The body is very amazing in its ability to convert one thing into another," Kuhn says. "Saturated fats, they're just sitting there and are easy targets for the liver to gobble up and convert."

As is often the case when controlling diabetes, obesity - even, Libby wrote in May, inflammation - and cholesterol, the debate circles back to eating right, exercising regularly and shedding excess pounds if necessary.

Peitz usually tells her patients they can expect to lower their overall cholesterol reading by adjusting their diet. American Heart Association guidelines bear her out.

They recommend men eat less than 300 milligrams of cholesterol daily, less than 200 for those with heart disease. Average intake for American men is about 337 milligrams a day; for women, 217 milligrams.

Admittedly, it's easier said than done given the relative ease of consuming fast food or pre-processed snacks and a lack of adherence to dietary guidelines advocating heavy intake of fruits and vegetables.

"It's all coming back to the same common denominator. Eat plenty of fruits and vegetables," Higgins says, also pointing to intake of vitamins B6 and E, folate and fiber. "All these are connected to preventing the bad effects of cholesterol."

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