Your Cholesterol Matters

What Your Numbers Mean and How You Can Improve Them

Richard Furman

• Publisher: Revell
• Year: 2017
• ISBN:
  9781493406791
• Topic: Medicine
• Subtopic: General Health

A must-read for those on cholesterol lowering medication and those with stents in their heartsWhen it comes to our health, what we don't know can harm us most. Eighty-five percent of people over the age of fifty have significant blockage in the arteries of their hearts without any symptoms. Two-thirds of the time, the initial symptom is a full-blown heart attack. Doctors tell patients to watch their diet, get regular exercise, and lose weight--but they also increasingly prescribe cholesterol lowering drugs that patients will take every day for the rest of their lives. The problem is that a daily pill only addresses one small part of the cholesterol problem.Dr. Furman wants readers to understand what their cholesterol numbers mean, how best to change levels of both the lethal LDL cholesterol and hero HDL cholesterol, and how to adjust their lifestyles in order to stay off of expensive medications that don't address the whole problem (and often have negative health-impacting side effects). Not only will Dr. Furman's advice make them healthier in the short term, it will also enable them to have more control over the aging process, allowing them to live longer, better lives.

Part 1: Taking Charge

1.
Cholesterol Matters

We have a problem. Most people do not know what is going on in their bodies. The damage happens quietly, and most people have no idea that what they are doing is causing the damage.

Your overall health is determined in large part by the health of your arteries. Your heart is the pump, and your arteries are the conduit responsible for carrying every particle necessary to keep your body functioning properly. If you learn nothing else concerning your anatomy related to your health, take note of the importance of the health of your arteries. Your arteries are the pipeline for the nutrients that are essential to every cell in your body. If that pipeline is partially plugged, you are setting yourself up for problems, especially in your heart and brain. Keep the health of your arteries at the forefront of your thinking as you continue reading this book.

Picture in your mind small particles floating around in your blood. Some of these particles are good; some are bad. The bad particles work their way through the lining of an artery and get stuck in the wall itself. This causes a reaction in which cells and fluids mix in an attempt to get rid of the foreign particle that has invaded the wall of the artery. Over time, this reaction can lead to either a rupture or plaque buildup in the affected artery. This is a silent process. It doesn’t cause you pain. It doesn’t give you a headache or make your chest hurt. It works quietly while you order extra cheese on your hamburger and ask for extra cream sauce on your steak.

The health of our arteries is one of the greatest health problems in America and one that results in over half of our deaths every year. We all need to learn and remind ourselves what happens in our bodies as we go about our daily lives. We need to know what the numbers represent when the doctor hands us our cholesterol reports. We need to know that blood cholesterol is completely different from dietary cholesterol. One is in blood, and the other is in food. The cholesterol in our blood affects our arteries directly. The cholesterol in certain foods can cause our blood cholesterol to become elevated. You are going to learn which foods have the most profound effect on your blood cholesterol. I encourage you to avoid as many of the foods that elevate your blood cholesterol as possible.

Most people do not realize that not all cholesterol is bad. Just as there is good fat, there is also good cholesterol. You are about to learn the difference as a physician understands it, and you won’t have to go to medical school to find out.

Cholesterol: More Than Just a Number

Cholesterol is a fatty substance in the outer layer of every cell in your body that maintains each cell’s membrane. It is involved in the production of sex hormones as well as hormones released by your adrenal glands. It insulates nerve fibers. It is significant in the metabolizing of certain vitamins, including A, D, and E. It is essential to your body.

Cholesterol is carried through the bloodstream combined with a protein. The structure of the cholesterol with the protein is a molecule called a lipoprotein. There are two main types of lipoproteins. They appear on your lab report as Low Density Lipoprotein and High Density Lipoprotein, or LDL and HDL. Here is an easy way to remember them: LDL is “lethal,” and HDL is a “hero.” You want your lethal number to be as low as possible and your hero number to be as high as possible.

Your cholesterol numbers are to your body what warning lights are to your car. If you are like many people, you don’t know your numbers, or if you know them, you don’t realize the significance of abnormal numbers. If you don’t know your cholesterol numbers, get a test done today to find out what they are. You have to notice a warning light before you can take action.

By the Numbers

Let’s look at what doctors mean when they talk about cholesterol numbers. There are three important numbers: the total cholesterol, the LDL cholesterol, and the HDL cholesterol.

When your doctor tells you your cholesterol is too high, they are usually talking about your total cholesterol number. But most patients don’t realize that the total cholesterol is the sum of their bad LDL cholesterol and their good HDL cholesterol. There are some additional cholesterol particles within that total number, but they are fairly insignificant to understanding what is going on.

When your physician says your cholesterol is too high, they actually means your LDL cholesterol is too high. This is because your total cholesterol number is made up mostly of your lethal LDL cholesterol, and if it is high, your total number is high.

If you are told you must get your cholesterol down, your doctor means you should get your LDL cholesterol down. When your physician says to start on a cholesterol-lowering medication, what they should say is that they are going to start you on an LDL cholesterol–lowering medication. Your doctor should then explain that the primary cause of high LDL cholesterol is eating foods that contain the bad fats.

Lethal LDL Cholesterol

Let me give you an illustration of how LDL cholesterol affects your arteries.

Picture what happens when a splinter gets stuck in your finger. The area of the penetration becomes a battleground. The body responds initially by pouring fluid into the space around the splinter. The fluid contains numerous specialized cells that are expert at fighting the foreign body. One of two things then happens. The area either ruptures and drains, or it heals with cells that cause thick scar tissue.

The same process happens when an LDL cholesterol particle gets stuck in the wall of one of your arteries. That LDL particle is like the splinter. The LDL splinter causes your body to send out the inflammatory army to that battleground in the wall of the invaded artery. Again, one of two things happens. The area swells with inflammation that ruptures into the artery, which results in immediate clot formation and blockage of that artery, like a straw plugging up, or the battle ensues until fibroblast cells surround the enemy LDL particle and wall it off, forming a scar, which is known as plaque.

The LDL cholesterol splinters do not pick and choose which arterial wall they are going to get into, but the ones we hear about the most are the ones that cause the most dramatic symptoms and damage. These are the arteries in the heart and the brain. Heart attacks and strokes are the result.

The damage takes years to accumulate and often happens numerous times at the same places, usually where there is turbulence in the blood flow, such as where an artery divides or where a smaller artery branches off from a larger one. If there is repeated healing and scarring, plaque builds up until it finally gets large enough to cause a complete blockage of the artery.

When a splinter gets in your finger, you make sure you don’t stick your finger into the briar patch again. But the problem with cholesterol is that when the LDL splinters get in the wall of an artery, no pain is involved. You don’t realize it is happening over and over. There is no pain to warn you. You have to learn from medical research.

Hero HDL Cholesterol

The component that is often skipped when considering cholesterol numbers is that you should do everything possible to get your HDL cholesterol higher in addition to getting your LDL cholesterol down.

The cholesterol that usually gets left out of the discussion is the good, hero HDL cholesterol. However, the HDL number is as important as the LDL number in understanding how damage to your arteries comes about and what can be done to protect them. In fact, the American Heart Association lists a significantly low HDL as a cause of heart disease. It is as bad as hypertension or obesity when it comes to causing a heart attack. Therefore, physicians should educate their patients on what can be done to raise HDL even though there is no medication they can prescribe for it.

HDL cholesterol is of equal significance to LDL cholesterol because HDL cholesterol combats LDL cholesterol, which is the culprit causing problems in the heart arteries, brain arteries, or any other artery in your body. If your HDL is below 40, you are in a separate medical category of cardiac danger. Here is the way to picture how HDL particles work.

Think of HDL particles as patrol cars that cruise through your blood looking for lethal LDL cholesterol splinters. An HDL particle pulls up by an arterial wall that has several LDL splinters in it, puts them into the patrol car, and takes them to jail—the liver—which disposes of them. Then the HDL patrol car goes back to pick up more LDL splinters to take them to the liver. The more of these patrol cars you have, the better. As a matter of fact, for every point increase in HDL, there is a 2 to 3 percent decrease in your chance of having a heart attack.

There is no medication to increase your HDL. The two lifestyles that play the biggest role in controlling your HDL cholesterol are your weight and how much you exercise. The more you weigh, the lower your HDL is going to be. As you lose excess weight, your HDL will increase. Exercise does the same thing; the more intense your exercise, the higher your HDL cholesterol will get.

The Importance of the Ratio of Total Cholesterol to HDL Cholesterol

The more HDL patrol cars you have and the fewer LDL splinters you have, the better. That means you need to do all you can to avoid the foods that cause your LDL to increase. At the same time, you need to do all you can to increase the number of HDL particles in your arsenal of battleground equipment. The two biggest weapons are exercise and weight loss.

The cholesterol number that is often the least explained is the ratio of total cholesterol to HDL cholesterol. If you were to divide your total cholesterol number by your HDL cholesterol number, the more HDL cholesterol you have, the lower that ratio would be. This shows the importance of having as much HDL as possible to fight the battle and as few LDL enemies as possible to fight against.

Let’s say that in your total cholesterol number there is one unit of HDL and four units of LDL. If you add them together, you would have five units for your total cholesterol. If you divide your total cholesterol by your HDL, you would get a ratio of 5.0. Now let’s say you have two units of HDL and four units of LDL, giving a total of six units. If you divide your total cholesterol of six by your HDL of two, your ratio falls to 3.0. You want your ratio to be below 3.5. Even if your LDL stays the same, you can drop your ratio by raising your HDL.

The importance of the ratio of total cholesterol to HDL makes you realize the significance of your HDL cholesterol. Remember that statin drugs affect only the LDL cholesterol part of the picture. If you avoid foods that contribute to your LDL number while at the same time losing weight and exercising, which increases your HDL number, you will improve your ratio. There is so much more you can do to protect your arteries than take a pill to help lower your LDL cholesterol. Don’t focus on one aspect of the battle. Fight the full fight. Look at the whole picture of what is happening and go after quality health.

No medication can protect you as much as you can protect yourself by taking proper care of your body. Statins have been shown to prevent many heart attacks by lowering a person’s LDL cholesterol. If your doctor has you on such a medication, by all means take it, but be sure to talk to your physician about your commitment to make lifestyle changes that should make it possible for you to decrease or even eliminate the medicine. Your physician will keep a record of your HDL to total cholesterol ratio. Aim high and shoot for a ratio below 3.5.

Good Choices and Bad Choices

If you don’t know which foods are bad, you will continue to choose the kinds of foods that result in damage that causes over half of the deaths in America. Once you know good and bad choices and the result of each, your eating lifestyle will change.

Let me give you an example. I took a flight from Cusco, Peru, to Lima, Peru, and had a two-and-a-half-hour layover. The fellow I was traveling with had credentials to get us into the airline lounge. We went to the nicest flight lounge I had ever seen. There was a room designated as a quiet zone with large padded lounge chairs and dimmed lighting. (Most of the people in the room were asleep, and I wondered if any would miss their plane.) The food was markedly different from that of other lounges I had visited. There was a long table with a machine in the middle that produced fresh-squeezed orange juice. The attendant placed whole oranges into the top, and you could watch them being sliced in two and carried to a rounded grinder that produced juice, which fell to the bottom of the see-through box. It was entertaining to watch.

To the right of the orange juice machine were the healthy foods: a multitude of different nuts, bowls of olives, and fruits.

To the left were fried bananas, small sandwiches of processed meat mixed with some type of mayonnaise, chocolates of all shapes, at least three types of cakes with creamy icing, and some type of fried chips I didn’t recognize.

If the people in charge of the food knew about bad fats and good fats, they could not have done a better job of showing the public which foods they should eat and which they should avoid.

This food selection was going to be my dinner, because in a couple of hours I was going to board an overnight flight back to the United States. I planned to sleep the full seven hours rather than spend the first two hours waiting for dinner to be served on the aircraft.

Let me tell you what I ate because I knew which foods cause the lethal LDL to increase and which foods cause the hero HDL to increase. Three mainstay food types ran through my mind: fish, nuts, and olives or olive oil (or canola oil). These foods contain the good fats—the healthy monounsaturated fat and the good omega-3s. I didn’t see any fish, but I saw a large selection of nuts and olives as well as an orange and a banana. I filled my plate and took a seat.

I wondered what my friend would get. He didn’t understand that his eating habits were causing disease to his arteries. He got every fried item they had. He quickly ate several sandwiches with the processed meat hidden in mayonnaise globs and went back for seconds. He even had a third helping of whatever the little fried fingerlings were. Then he went back for the chocolates.

Why? I kept asking myself. Why do individuals not pay attention to what medical research shows us about how to keep our bodies at peak performance? That is my goal in this book: to condense the best medical research for you in easy-to-understand terms, to tell you what things you can control that will allow you to decide how you want to live. Then it is up to you to choose. I am hoping you will commit to quality choices for life.

Your Numbers Do Matter

In my study hangs a plaque a friend gave me that reads, “If you are going to be stupid, you’ve got to be tough.” I will admit I did some stupid things that inspired my friend to give me the plaque, but I encourage you to seek wisdom, not be tough, when it comes to protecting your most valuable possession—your health.

Money can’t buy extra years for your life. The Bible states that money can’t keep us from the grave. All must die someday. But the following information from the medical literature proves that though we can’t avoid the grave, we can add years to our lives and improve the quality of the years we have.

The Journal of the American Medical Association reported a study on the life expectancy of men who had favorable total cholesterol levels compared to men of the same age who had unfavorable total cholesterol levels. The results astounded me, and I think they will astound you too. The men who had the favorable total cholesterol levels had a life expectancy that was 3.8 to 8.7 years longer than that of those with the unfavorable total cholesterol levels. There was a continuous, proportional relationship be...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Preface
• Introduction
• Part 1: Taking Charge
• Part 2: Lifestyle 1: Weight Control
• Part 3: Lifestyle 2: Food
• Part 4: Lifestyle 3: Exercise
• Conclusion
• Epilogue
• Medical References
• About the Author
• Also by Richard Furman, MD, FACS
• Back Ads
• Back Cover