University of Virginia Health System

The "Low Down" on High Cholesterol Counts

New American Heart Association program aims to tame this health threat

< December 3, 2002 > It is called "Cholesterol Low Down," and it is the American Heart Association's new offensive to defeat one of the top public health enemies—high cholesterol counts.

The free national education program offers brochures; newsletters; a Health Risk Assessment, which helps you determine your risk for heart disease; healthy living cookbooks; and a range of fitness tips to get you exercising.

All of these tools are available on the American Heart Association's Web site, via e-mail or regular mail.

"It's more focused, targeted information that people can use," says program spokesman Dr. Roger Blumenthal, who is also director of preventive cardiology at Johns Hopkins University in Baltimore.

"We're trying to do things that are more practical. We can use this program and get people to realize that there are a lot of the things they can control," he adds.

High cholesterol is one of the leading risk factors for heart disease and stroke, which are the number one and number three killers in the United States. According to the American Heart Association (AHA), some 102 million US adults have total blood cholesterol levels at or above the recommended level of 200 milligrams per deciliter.

Cholesterol is a soft, waxy substance that is present in all parts of the body including the nervous system, skin, muscle, liver, intestines, and heart. There are two types of cholesterol: high density lipoprotein—or HDL, the so-called "good cholesterol"—and low density lipoprotein—LDL, the "bad cholesterol."

A recent AHA survey found that most people over the age of 40 recognized the importance of healthy cholesterol levels in their blood, yet more than half did not know their own levels or even what the recommended levels are.

"The nation is not doing well in terms of cholesterol levels, even in high-risk individuals," Blumenthal says. "Study after study shows that a minority of individuals are being treated with medication who should be. We also know that of the people being treated, only a minority are at their target level for cholesterol and the same applies for blood pressure."

So what is the best strategy to conquer this insidious enemy?

First, by recognizing that combating cholesterol is a two-pronged issue, says Dr. Christopher J. White, chairman of the department of cardiology at the Ochsner Clinic Foundation in New Orleans. Cholesterol is a product not only of what you eat, but also of what your liver makes.

"A patient can be perfectly compliant in everything you tell them to do diet-wise and still churn out a ton of bad cholesterol," White says.

When that happens, a variety of medications—such as statins—can stem the flow. However, drugs should only enter the picture after patients have done everything they can to lower their cholesterol levels through diet and exercise, White emphasizes: "The drugs are toxic. There's no such thing as a non-toxic medicine."

Diet, medication, and cholesterol are part of what Blumenthal calls the "ABC's" of cardiac care:

• A, as in Aspirin.
  Discuss with your physician whether the benefits outweigh the risks and whether you should take this medicine, which may prevent the occurrence of heart attacks and strokes.
  
  
• B, for Blood Pressure.
  Again, talk to your physician about ways to improve your lifestyle and possible medications to optimize your blood-pressure levels.
  
  
• C, as in Cholesterol.
  Determine what your cholesterol levels are and whether you need treatment. If your score is high, your physician may prescribe medication.
  
  
• C is also for Cigarettes, a known risk factor for heart disease.
  "If you smoke, you may want to have your head examined," Blumenthal says. And you should talk to your physician about ways to quit.
  
  
• D is for Diet and Weight, as well as for Diabetes and Blood Sugar Control.
  Weight and high blood sugar levels are also risk factors for cardiovascular disease. As White says, you do not have to be a saint when it comes to a healthful diet, but you should be reasonable.

• E, as in Exercise.
  The Cholesterol Low Down Program has tons of information regarding how to improve exercise levels and get your heart rate up. "When it comes to cholesterol, it's not just eating, it's also exercise," White points out.

What Blumenthal did not mention was the final letter: F as in Family.

This year, the AHA is emphasizing that heart disease is a family affair because it runs in families. So the AHA has brought in actress and comedienne Vicki Lawrence as a national spokeswoman. Lawrence recently found out she had elevated cholesterol.

"What we're trying to do with this year's campaign is emphasize that heart disease is a family affair and, if one person is at risk, the whole family should do their part," Blumenthal says.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Journal of Clinical Nutrition

American Heart Association

National Heart, Lung, and Blood Institute

For more information on cholesterol in the blood, please visit the Cardiovascular Diseases information module on this Web site.

In Other News About Your Health:

Don't Let the Holidays Go to Waist

How to nibble away at overeating

It is time to start planning how to avoid packing on the pounds as you are tempted to pack in all that delicious holiday food.

The holiday season extends about six weeks, starting with Thanksgiving and lasting through New Year's, and you need to work out a game plan to ensure your waistline stays under control, says Purdue University foods and nutrition expert Olivia Bennett Wood.

You can counter weight gain by adding 10 or 15 minutes to your exercise routines or by putting some extra thought into your holiday meal preparations, Wood says.

Before you go to a holiday party or dinner, eat some small nutritious snacks. That will help moderate your food intake at the party or dinner. When you are at a party, beware of unconscious eating where you keep reaching for food without even thinking about it.

Wood offers some advice for people hosting a holiday function. Rather than a buffet, have a single menu. It does not have to include numerous entrees or desserts. Have one main dish and two side dishes. Skip a side dish if you include an appetizer or dessert.

Desserts should be simple or light—fresh pineapple with pomegranate seeds, for instance.

Here are some other hosting suggestions:

• Include low-calorie items such as fresh vegetables and fruit with low-calorie or no dip.
  
  
• Provide low-calorie beverages.
  
  
• Do not push food on people. They know when they have had enough to eat.
  
  
• Do not equate the amount of food eaten with the success of your recipes or your party.
  
  
• When you prepare the food, read labels carefully. Some items that are labeled low fat may actually have almost the same number of calories as the regular product.

Always consult your physician for more information.