Case Studies

Conquer Cholesterol: The Bad with the Good

| November/December 2005

Monty — a memorable name for a memorable person. Monty was a big guy, and when it came to cholesterol, he had big numbers. His total cholesterol was more than 325, and the other numbers — LDL cholesterol (so-called “bad” cholesterol) and triglycerides followed suit.

These days, thanks to the media, most people understand the significance of these numbers, at least somewhat. And although medical science can’t tell you exactly what the numbers mean, it has become clear that high values for total cholesterol, LDL cholesterol and triglycerides are not good for your health. Along with blood pressure, these numbers are early indicators of a patient’s risk of developing chronic heart disease, and of experiencing, or even dying from, a heart attack or stroke.

What the media often does not mention is that the high cholesterol and hypertension that often lead to coronary artery disease (CAD) also can play a major role in producing many symptoms associated with aging (at least in many developed countries) — especially sexual dysfunction in men and women, poor memory (and eventually Alzheimer’s), inability to walk very far without pain, and nerve pain (neuropathy).

Cleaning Up Monty’s Act

Monty and I talked for nearly an hour at our first meeting. He had a lot of questions — he had just been told by his doctor to “clean up his act” or suffer the consequences. Other tests from his doctor showed that some of his coronary arteries were already partially blocked. Monty did not know much about a healthy lifestyle. He loved fast foods, but told me, “My wife and doc are both pushing me to change my diet, or else. The thing is,” he continued, “my wife also has high cholesterol and high blood pressure. She’s about 50 pounds overweight. I want to bring her in next time. We have a plan to clean up together.” Before menopause, women have only about 40 percent the incidence of heart attack as men, but after menopause, and the decline of estrogen, the comparative risk rises to 70 percent or higher.

I gave Monty a handout that rates common foods and drinks for their potential to promote heart disease and, eventually, serious cardiovascular symptoms. Major benefits come from eating as high on the “heart-friendly scale” as possible every day. A problem with heart disease is the slow and persistent damage to all of our body’s vital vessels that happens silently — we often aren’t aware of the damage until a major symptom or sign occurs. No matter what kind of symptom patients come in for, I always ask them about their heart-healthy plan. It’s my job as a health-care provider to encourage all my patients to have a 10- and 20-year plan for their heart. Studies have shown that even some teenagers already have significant damage in their cardiovascular system.

Best and Worst Foods for Heart Health

This scale shows the best and worst choices of foods for heart health. In this chart, a rating of 10 is the most beneficial; 1 is the least. In general, when it comes to heart-friendly foods, think fiber!

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