Archive for cholesterol
What do you consider most important health factor that will enable you to continue to live life the way you want?
For some of us, it is to have a sharp mind to continue with the creative pursuits we want to engage. Our brains and creative process are the most part to us. We then hope our bodies are healthy enough to carry those minds around for a while.
For others it is to have the energy and strength to be as physically active as we want.
There is no doubt however, a healthy heart is needed for both types ways of living. It turns out that quite possibly striving for a healthy cholesterol profile may not be enough for menopausal women!
A recent study out of the Univ. of Pittsburgh School of Public Health reveals that having a high HDL cholesterol can cause cholesterol plaque, just as the bad LDL can. This study followed 225 women in their mid to late 40′s for 9 yrs. They were determined to be clear of cardiovascular disease at the beginning of the study. It was noted that the women with higher HDL levels as they transitioned through menopause had a greater number of cholesterol plaques formed that the other participants. The researchers theorize that the changing levels of estrogen affects cholesterol metabolism, but they admit they do not know more than that.
We have been taught for years that having a high HDL, or “good cholesterol”, is protective against heart disease. We do not know all there is about cholesterol and how it is metabolized, but this small study would indicate that a lot more has to be determined before we have a clear picture or the final word on cholesterol and aging.
What can we women do in the meantime to protect our hearts?
We can improve all the other potential risk factors we may have for heart disease.
- Consume a diet low in animal fats, trans fats and saturated fats. Increase healthy plant based fats
- Decrease and eliminate processed starches, sweets and packaged foods. Studies have suggested that when saturated fat is consumed with processed starch (think chicken biscuit, pastries, fast food meals) more harm is done than consuming saturated fat by itself. Having said that, you still need to LIMIT the saturated fat you consume.
- Stop smoking or using nicotine products. Nicotine basically inflames the walls of blood vessels, allowing cholesterol particles to adhere and gather.
- Exercise in any way that is enjoyable and tolerable for you. Moving helps metabolize food energy so it is used, not floating around looking where is will live.
Talk with your medical provider about your cholesterol profile and how it may impact your health. There is a relatively new way of analyzing cholesterol called the NMR lipoprotein. This technology looks at the particle size and count of both good and bad cholesterol. We all make different sized cholesterol particles, and the more yours are large, the less likely they can stick to the walls or arteries and create plaques.
Until we know more about cholesterol, do what you can with your habits. This way you can be more active, creative, influential, involved, thought provoking and connected for many more years!
Last week I gave you all some links sent to me by the NIH to help women come to terms with the possibility of heart disease. What is it you need to know about to determine if you need to be worried?
Here are some of the basics.
1. What is your blood pressure, glucose, and cholesterol? These 3 things are the early warning signs of potential harm to your heart and blood vessels.
An elevated blood pressure occurs for a variety of reasons but basically the blood vessels are too narrow and the heart has to work harder as a pump to get the blood to flow through and make it to the organs. The heart over time can enlarge, and not work as effectively.
An elevated glucose causes problems with the walls of the blood vessels, making them less healthy, inflamed and eventually not effective as conduits for the blood flowing through.
Elevated bad forms of cholesterol can infiltrate into the lining of the blood vessels, causing blockages. These can eventually rupture, causing a complete blockage. When this happens in the brain, it is a stroke; in the coronary blood vessels it is a heart attack.
2. What are your genetics for heart disease? In other words, have many family members had early heart attacks and strokes?
Having a strong family history of heart disease indicates there is a tendency to inflammation in your blood vessels that contributes to poor health of arteries. This genetic predisposition may include diabetes, high cholesterol, high blood pressure.
Having a family history does not mean you are fated to have an MI or stroke, but it does mean you need to be very careful what you do in terms of lifestyle and habits. You can avoid the fate of your genes with careful living.
3. What are your health habits? Yes, yes; this is what we medical people preach about day in and day out!
It is the one most important modifiable action you can take however, which is why we stress healthy habits so much. You have the power to change the fate of your genes!
Exercise helps the heart get a good work out, it exercises the muscle and gets the blood flowing all over your body. It uses up the excess calories you may have eaten. It lowers cortisol levels that are elevated in most of us due to the stress of our lives. This lower cortisol following exercise causes the muscle layer around the outside of the blood vessel to relax a little, making the tube a little wider and easing the heart from having to pump so hard. The idea is for your heart to work hard during exercise, and not all the time. Additionally, exercise helps your liver make more of the good cholesterol which then helps the body get rid of the bad cholesterol.
A healthy diet low in animal fats, trans fats, and saturated fats that come from fried foods, packaged and processed baked foods; helps to keep cholesterol lower and inflammation in the blood vessels lower. Then the cholesterol flowing through your blood stream doesn’t have as much inflammation to latch onto, creating a plaque or potential blockage.
Lowering sugar in the diet also helps reduce inflammation, avoid diabetes with its’ destructive actions; and helps with weight.
Sodium is a major contributor to high blood vessel for many people through retention of fluid and tightening to the blood vessel walls, making them more narrow.
Maintaining a health weight reduces the amount of blood vessels your heart has to pump blood too, as fat needs blood vessels also. There is less mileage that the heart has to pump blood through. The actions that it takes to maintain a healthy weight also helps the heart, and is described above.
Do you smoke cigarettes or use nicotine products? Nicotine contributes to heart disease mostly through the inflammation and disease to blood vessel walls. Nicotine also contributes to tightening of the blood vessels, making them more narrow. The inflammation and narrowing then helps cholesterol do its’ bad thing with blockages.
Do you get enough good quality sleep? Hey, everything has to rest! Sleep helps aid in repair of the body, lowering of inflammation, mobilizing excess fluid.
OK, quick tips:
- Instead of frying foods, saute in a little olive oil or other healthy oil
- Add very little salt to food, use other seasons like pepper and herbs, spices
- Get out and move every day, figure out a way this will work for you
- Get a good nights sleep, work on sleep habits to aid this occuring
- ditch the sodium, nicotine products, fast foods, fried foods, fatty meats. Make them a rare occurrence
- decrease sugar, white starches like bread, pasta, potatoes, rice; as they basically act like a big dose of sugar in the body
- limit alcohol and caffeine products to a healthy consumption
- have your glucose, cholesterol and blood pressure monitored regularly and talk to your provider about what to do to reduce them if they are elevated.
Think about it, the only rest your heart gets is between each beat. Not to scare you, but that muscle keeps going, all the time. Why would you not be kind to it, protect it, pay attention to it?
The question of the benefit of cholesterol medication is a much talked about topic of discussion these days in health and medicine. There are two camps; those who follow the guidelines produced by experts after analysis of medical studies, and those who believe that these guidelines are polluted by the influence of pharmaceutical companies. There are traditional medical providers in both groups, but most nontraditional practitioners would opt for the second group.
You may wonder which group your medical provider belongs to. Many patients believe that physicians who prescribe these medications get a kick back from the drug companies for prescribing these medications.They are therefor leery of the actual need or benefit for themselves.
While it is true that many prescriptions for statin drugs, the class of drugs that can lower cholesterol, are written yearly; this is not because of a financial incentive.
Why so many statin drugs prescribed?
In 3 short words: the American diet! As a medical provider who regularly checks the cholesterol levels of patients, I am disheartened on how many abnormal lab results I see. I am convinced the number one reason for these elevations is the food choices people make. It is true that genetics play a role, but what you put in your mouth plays more of a role.
Not everyone with high cholesterol will have illness from this elevation. Medical research is trying to figure out what the differences are between people who develop heart disease from their elevated cholesterol and those that do not. Researcher do not have all the answers, and sometimes they argue amongst themselves as see with the newest guidelines and risk calculator tool!
What we do know is that a diet high in sugar and fatty meats, as well as highly processed foods, raises cholesterol. A diet low in these items and high in fruits and vegetables tends not to raise the cholesterol. Some people are more genetically predisposed to have high cholesterol. A bad diet can make this happen, whereas a more vegetarian or Mediterranean diet, will help to prevent cholesterol elevations.
We all need some degree of cholesterol, as this is used in cell repair and nerve health. Too much however, collects along the walls of the arteries as it has to go somewhere. Some cholesterol can be broken down and taken out of the body, but not all. Exercise can help with this breakdown, thereby lowering the cholesterol.
It is strongly felt and supported in medical research that cholesterol plaques in the artery walls are capable of growing until they rupture, causing a heart attack. This happens in many people but not all, and unfortunately we do not have the capability of predicting with accuracy who will have this happen. In some people it is a given, others it is more elusive a risk. So for now, medical providers have to go by the odds with their suggestion and recommendations regarding statin therapy.
But you do have some choices. You can decide to ignore the advise to take statins, and take a chance that you will not have a cardiac event; play the odds in other words. If you are wrong however, you may lose big time.
You can chose to address your lifestyle instead of take medication, or do both. Changing your diet profoundly and for good, as well as exercising may make the need for statins a moot point. For me, as a patient and medical provider, is the approach I recommend regardless of whether statin therapy is also used. A healthy diet can do so much more than just lower cholesterol.
So for now, if your medical provider is recommending statin therapy; it is not so they can get a kick back from the drug company. Most likely your cholesterol level is high enough and your risk factors numerous enough that you are at risk for a cardiac event. And now you have a choice: take the medicine, change your diet, do both or do neither and take your chances.
It would seem incredible that one meal could cause a heart attack, but that actually could be the case! You may already grasp the concept that fatty foods can harm your health in addition to causing weight gain.
But did you know that a meal high in fat can potentiate coronary artery disease?
Researchers have long understood this and have done study after study to associate the two. A recent research project done at University of California at Davis has possibly shown the correlation between these two events. They took a group of volunteers with varying waist circumferences and triglyceride levels and measured their blood levels of a substance-triglyceride rich lipoprotein (TRGL) after these volunteers had consumed a high fat breakfast from a major fast food chain. They exposed lab created endothelial tissue to this TRGL and measured the inflammatory response. It is this inflammatory response that can cause and lead to heart disease and stroke. Not all of us have much systemic inflammation or high TRGL levels. The endothelial cells which had the highest inflammatory response also had an immune trigger which helped to cause this response. These factors were more plentiful in people with larger waist circumferences, and did not occur to the same degree in people with normal waist circumferences.
So what exactly does this mean to you?
If you are overweight or even normal weight, and your waist is disproportionately larger; then you are at risk for developing heart disease. You have systemic inflammation and difficulty with fat and glucose metabolism. This could lead to higher levels of triglycerides and TRGL. When the TRGL is flowing through your blood stream after consumption of a high fat fast food meal, it will attach to your blood vessel walls and trigger inflammation. The body then sends out white blood cells to deal with this inflammation and that is how atherosclerosis occurs.
When the atherosclerosis is in coronary arteries, that can lead to a heart attack.
When the atherosclerosis is in blood vessels leading to or contained in the brain, a stroke can occur.
When the atherosclerosis occurs in arteries leading to your kidneys, intestines or liver; these organs do not work well.
And when it occurs in the blood vessels supplying your legs, you can have pain with walking, ulcers or even loss of extremities.
So is the fast food meal really worth all that damage and illness?
What is Heart Disease?
The heart is a pump for blood. Blood carries the nutrients we need to our cells and hauls waste products away for elimination mainly through the liver and kidneys. The heart starts beating in our chest while we are in the uterus and if we live to age 75 our heart will beat about 2.7 BILLION times. It is tough and
resilient but it can be injured. Sometimes because of an accident, poisoning whether accidental or self-inflicted like too much alcohol, genetics and other reasons outside our control, it doesn’t beat that long or that well. The heart disease that killed over 430 thousand U.S. women in 2006 and continues to do so each year is not well understood.
Heart disease causes inflammation of the lining of the circulatory system. After a certain point that is poorly understood right now, the body begins to loose that battle and resorts to plan B. It uses small dense particles of cholesterol to shore up the inflamed weakened lining of the arteries. This is usually a slow process but it eventually closes some of those arteries. The inflammation itself causes other problems in other organs but none so insidious as in the arterial lining.
When the inflammation reaches a certain point, the body begins to calcify these cholesterol deposits. This creates hard plaques and circulation troubles. When plaques rupture inside arteries, clots cut off blood flow to brain, heart muscle, skeletal muscle as in peripheral vascular disease or intestines. This causes pain, sometimes death of some of the muscle and maybe death of the person.
What is a risk factor?
It is a measurable fact that taken together with your total risk factors, indicates the level of risk for a certain health problem. RISK FACTORS are not DISEASES. They do not predict you will have heart disease, they indicate a level of risk, a percentage chance that a disease, in this case heart disease, will occur.
What risk factors can I control?
Risk factors over which you have no control are:
- your sex
- your age
- your family history
- your own history of heart attack, stroke or TIA previously.
Risk factors you do control are:
- Use of tobacco products
- Your level of activity
- Your cholesterol particle size
- Your blood pressure
- Your weight
- Your control of your blood sugar
- Your Triglyceride level
- Your response to Stress
- Good Dental Health
What do we really know about preventing heart disease?
We know a lot about heart disease but our knowledge isn’t perfect. We like gadgets, operations, pills and the latest thing when the oldest thing really matters.
We know when we are fit, trim and eating a healthy diet we are less likely to have any disease. We are less likely to respond negatively to stress when we exercise regularly. What is it that we can do that will reduce our response to disease onset within our body?
Don’t eat too much, eat as much local food as possible and avoid processed food. Pay attention to your body and keep some records. Be aware of how much you eat and its affect on your energy, weight and thinking. Be proactive but not obsessive.
Have a large group of friends, read instead of watch TV and screen out the negative junk in movies, TV shows and the news. Get enough sleep. Your body is made to do work long and slow. Investigate various kinds of activity that mimic work if you don’t have land to work or activities that are fun. I favor for myself Nordic Walking, Swing dancing, the “Shovel Glove” workouts you can find on YouTube.com and some light weight lifting along with lifting my Grandfather’s Blacksmith Anvil I inherited. What are your favorites?
As far as eating and supplements go – grass fed beef has an omega 6 to 3 ratio of 4-1. This is similar to ideal in our own muscles. Grain fed beef have a ratio of 16 or 20 to 1. This is a cause of inflammation. I supplement with a krill oil capsule (500mg) daily to boost my omega 3 fatty acids which help brain, joints, reduce triglycerides, raise HDL cholesterol and help decrease inflammation. Put a live bacteria back into your gut with a probiotic supplement ( I use Jarrow products). I don’t take it daily but will share a bottle of 100 and we each take 3 at bedtime for a couple of weeks a couple of times a year. I take vitamin D3 made from sheep wool lanolin about 1000IU most days of the year since I am inside most days.
Don’t forget to laugh a lot and be a source of laughter.
I can’t say you should do these things. I do them because my research has indicated that they are beneficial. Talk to your doctor, chiropractor, naturopath etc… Consider their motivation for giving you great advice.
I hope you will come back, become a subscriber , leave comments and tell your friends about us. So, I have a motive. Some people want to tell you something and others just like to be right. What do you think mine is?
Tell me your thoughts. Ask me a question. What have I missed? Where do you think I am wrong? If you think it is the meat thing and want me to be a vegetarian like you I am for it. I just want the animal to eat them first and I will eat the animal.
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What is cholesterol?
The definition provided by a National Institutes of Health site is:
Cholesterol: A lipid unique to animal cells that is used in the construction of cell membranes and as a building block for some hormones.
What does cholesterol do in my body?
Cholesterol for the body is produced in the liver. The brain produces its own cholesterol. Cholesterol is very important to our health since all cell membranes (think of them as the hardware for the cell) incorporate cholesterol membrane. Cholesterol is essential to the functioning of our nervous system thus the brain produces its own. It is also used as the base (main ingredient) for many essential hormones.
When you think of hormones think of Estrogen, Progesterone, Thyroid etc..
How is cholesterol measured?
When most people have their cholesterol measured, three blood fats are being measured and the rest calculated. Why is this important? I will answer that after I explain the lab test. The three fats that are measured are:
- Total Cholesterol
- HDL or high density lipoprotein
The measured cholesterol is produced by the liver. We can measure the result of brain production but that is not considered essential to the development of heart disease. Cholesterol is probably not essential either but we will get to that in a minute. The TC or total cholesterol measured in the blood is the total amount produced by the liver.
Triglycerides are stored energy. They are made by the liver when energy consumed exceeds energy expenditure. When you eat too much, you store fat! The type of fat is triglycerides.
Triglycerides: The major form of fat stored by the body. A triglyceride consists of three molecules of fatty acid combined with a molecule of the alcohol glycerol. Triglycerides serve as the backbone of many types of lipids (fats). Triglycerides come from the food we eat as well as from being produced by the body.
Triglycerides would be produced by the liver if we did not eat them. When we consume large amounts of fats and sugars then the excess energy is used to produce triglycerides which are then stored as fat with the abdomen, near the liver so they can be quickly converted to energy in times of starvation which for most of us in western society never happens. So, we get fatter and fatter! Some fat is a good thing but too much is harmful.
When we measure triglycerides, we do it after at least an 8 hour fast so that we are at the lowest level in our blood. This number is very important in the usual way cholesterol is “measured”.
HDL or high-density lipoprotein is the last measurement. We all know oil and water do not mix. Cholesterol is made in the liver and has to be transported through the blood to places where it is needed. Cholesterol is a fat, meaning a solid at room temperature. Oil is a fat that is liquid at room temperature. Fats do not dissolve in water. To transport HDL cholesterol through the blood, the body wraps it in a special coating of protein called APO-A. APO-A is soluble in water allowing cholesterol to go through the blood to the cells. HDL has been called “good cholesterol”. There is no good or bad cholesterol. Cholesterol has a job to do and it always does it. If you have lots of inflammation on the lining of your arteries, then the body uses cholesterol to line the arteries. This is reversible until the cholesterol is calcified. This is a final step in the inflammatory process and when the calcified plaque breaks, clotting inside a vessel occurs. This leads to death of the cells depending on blood from that artery. In the brain we call it a stroke or a heart attack if it happens in the heart circulation.
LDL cholesterol is not usually measured, it is calculated. The formula is (Total cholesterol – HDL) – Triglycerides divided by 5. The answer is the calculated LDL. If the LDL is high and it is recommended you take a drug to lower it ask for a direct measurement of LDL called a VAP or an NMR.
If the LDL is large particles then they are not associated with heart disease. If they are small particles, they are associated with heart and brain circulation problems and talking a medication while you make changes to your life-style is advisable. Cholesterol can not usually be lowered much through diet but LDL particle size can be changed by diet, exercise and body fat loss.
What are the right numbers for ME?
You need cholesterol! You do not want it too low. Higher levels in women are associated with longevity. Larger particle sizes are associated with health. What you want is a total cholesterol in the low 200′s and an HDL and LDL particle size that is large.
These three things (total cholesterol <250 and large HDL/LDL particle size) are associated with low heart disease if you are not drinking more that 3 ounces of an alcoholic beverage a day, are at an ideal weight and body fat composition and do not have other underlying diseases.
It isn’t just about cholesterol but about your level of stress, how much exercise you get, what you eat and drink and your genetics. There is no right answer for everyone. Much of the current research centers around how much medication or which medication you should take to prevent heart disease. You need a thinking physician and good information to help YOU make decisions about your health.
What is your opinion? Do you take medication for your cholesterol? Why? Do you agree or disagree with what is written here? Leave us a comment. Lets have a dialogue.
Women and Heart Disease Risk, part 2
Anne and I continue our discussion answering questions like:
What is a risk factor?
What blood tests really help predict my risk?
What should I do about my risk?
These sessions are called Ask An Expert Anything and my guest was Anne Vaillancourt PAC “the Menopause Mentor”. Anne is a
practitioner in Chapel Hill, NC and specializes in women’s health. In session one she talks about the statistics for cardiovascular disease in menopausal women. We discuss what a risk factor is and what you should know about them. The second part of this discussion will be in the next blog post here on Female Menopause Mentors.
To the right you see an artists rendering of a complex plaque within an artery. These occur as a result of genetics, lifestyle, diet and exercise habits. If I asked you what kind of diet caused this, would you say a diet high in fat? Maybe would be my cautious answer. It appears that inflammation may have more to do with it along with sedentary lifestyle. That inflammation may have more to do with the kind and amount of carbohydrates you consume. I would like you to watch this 5 minute video and then ask us a bunch of questions.