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In the News

Combating Cholesterol – A Mixed Arsenal

By Dr. Victor Gong, Medical Director of 75th St. & 126th St. Medical, Ocean Pines Medical & Doctors Weight Control & Wellness centers, Ocean City, MD.

The waxy buildup in our blood vessels is a leading cause of fatal heart disease.

A disturbing fact about American health; we're becoming dangerously overweight. We eat too much of the wrong foods, and as we do, cholesterol builds up in our blood vessels, setting us up for the country's leading killer: heart disease.

An estimated l00 million Americans now have high cholesterol. Many are not even aware they have a problem, Fortunately; it's not hard to bring your cholesterol level down. The challenge comes in figuring out how to launch the attack: Diet and exercise? Prescription drugs? Nutritional supplements? Or some combination?

Your body needs small quantities of cholesterol to help produce hormones and maintain cell membranes. The problem occurs when too much accumulates, usually as a result of a diet rich in saturated fat. LDL, or low-density lipoprotein, is the "bad" cholesterol that threatens your heart. HDL is the "good," high-density lipoprotein that can protect against coronary disease. Current recommendations are that your total cholesterol should be under 200, your LDL under l30 and your HDL over 35. Some experts advocate even more ambitious standards-LDL under l00 and HDL over 45-especially for people who have already had a bypass or a heart attack or who have other coronary risk factors, such as smoking, diabetes or high blood pressure.

The first course of action should be lifestyle changes a program of daily exercise and a diet low in saturated fat-less meat, fewer fatty baked goods and dairy products, more fruits, vegetables and whole grains. The American Heart Association's diet, which allows 30 percent of calories to be derived from fat, can bring on modest (5 percent to l0 percent) LDL reduction over several months.

If your cholesterol levels still don't reach a desirable number after several months of better eating and greater fitness, you may need stronger medicine. Of the four classes of cholesterol-lowering drug, the most widely prescribed are the "statins," which include Baycol, Lescol, Lipitor, Mevacor, Pravachol and Zocor. Statins, found to lower LDL cholesterol by 28 percent and reduce the risk of a heart attack by 3l percent. In rare instances, the medications can cause muscle pain and liver abnormalities.

Resins work in the intestines to the help eliminate LDL. Niacin, which is available over the counter and by prescription, raises HDL. Fibrates are effective in lowering triglycerides fats. It may also help raise HDL. Natural options include red yeast rice which is a naturally occurring statin that can reduce LDL by 15 %. Soy protein, about 25 grams ( 2 glasses of soy milk) or whole oats ( 3 grams a day) can reduce cholesterol by 10 % and 2 % respectively.

Which route you choose should depend on a combination of factors, most important your cholesterol levels and your risk factors. Diet and exercise changes should always be tried first. Lowering saturated-fat intake and adding soy protein and margarine with stern, for example, could give you total LDL reduction of l0 to l5 percent.

Be sure to tell your doctor if you're taking supplements. And if you're on prescription drugs, don't assume you can go off once your levels drop. However you go about it,the important thing is to know your cholesterol level and take charge. You've got a variety of options-but only one heart.

Attacking the Enemy

Diet and exercise are key in keeping bad cholesterol in check, but there are many additional options.

Pharmaceutical Options

Statins:

The most widely prescribed, they interrupt cholesterol formation.

Resins:

They work in the intestines to help eliminate LDL.

Niacin:

Available both over the counter and by prescription. Raises HDL.

Fibrates:

Effective in lowering triglyceride fats. May also help raise HDL.

Natural Options

Red Yeast Rice:

Its naturally occurring statins can reduce LDL by l5%

Sterols:

Margarine fortified with them can cut LDL by l4%

Soy Proteins:

25 grams a day (2 glasses of soy milk) can cut LDL by l05.

Whole Oats:

The soluble fiber in oats, found in some cereals, can reduce LdL.

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