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Cholesterol Kills

Every year, heart attacks strike roughly 1.1 million Americans, and just less than half the time, they¡¯re fatal. Strokes strike millions more with similar results. Though the causes of each are complicated and wide-ranging, a single culprit can put one at risk for both; a high blood cholesterol level.

Estimates from the American Heart Association are that over 102 million American adults have blood cholesterol levels that are higher than they should be, while over 41 million of those have levels that are dangerously high. It's alarming, but in a complicated way. Complicated because cholesterol isn't inherently unhealthy. Cholesterol is a naturally occurring substance found in many types of foods and oils. The body can use certain types of cholesterol to digest normal dietary fats, build cell walls and make steroid hormones. Further complicating the matter, there isn't just one type of cholesterol - there are two; one is harmful and one isn't. The helpful cholesterol is known as high-density lipoprotein (HDL cholesterol). HDL cholesterol is believed to carry cholesterol deposited in blood vessels to the liver, where it's used or safely eliminated. Low-density lipoprotein (LDL cholesterol) is dangerous because instead of being circulated back to the liver it builds up throughout the body's circulatory system.

Eventually, the cholesterol - and other protein elements in the blood, collectively known as plaque - accumulates to the point where it can block the flow of blood through the vessel - just like a clog can block the flow of water in a sink. When these blockages occur in the blood vessels in the heart, called the coronary arteries, the lack of blood flow will cause the heart to become starved for oxygen and trigger a heart attack. If the blockages occur in arteries leading to or inside the brain, a stroke may result.

While heart attacks have become less fatal over the past 30 years, due mainly to improved post-heart attack care, prevention is the safest course. Prevention means maintaining a healthy cholesterol level by way of maintaining a healthy lifestyle. Screening is the first step. Anyone over the age of 20 should have their cholesterol levels checked by blood test at least once every five years. Self-testing kits are available at most pharmacies, and can be useful to get a sense of what one's level is, but they aren't a substitute for the detailed data that a full blood test can provide and a doctor can help you interpret. What's considered a healthy cholesterol level varies with age, and other risk factors for heart disease (such as obesity, high blood pressure and smoking) but generally, one should aim for an overall level of between 160 and 200 mg/dL (milligrams of cholesterol per deciliter of blood).

Keeping levels within a safe range requires two things; a cholesterol conscious diet and an active lifestyle (30 to 60 minutes of exercise a day has been found to reduce LDL blood cholesterol).

To get started on a heart friendly diet, there are a number of steps you'll need to take;

- First and foremost, stay away from foods that are high in fat - and especially those high in saturated fats. Saturated fat is the main source of cholesterol in most people's diets. No more than 25% to 35% of your daily calories should come from fat - fewer than 7% should come from saturated fats. To make sure you can stay within this range, get into the habit of reading food labels. If you're serious about it, keep a diary of your eating habits you can use to evaluate your cholesterol intake.

- Make sure you get at least five servings of fruit and vegetables and six servings of cereals, breads and other whole grain foods a day. When selecting meat, stick to fish, poultry (both fish and poultry without the skin is healthier than with) and lean cuts of most other meats. Heavier meats - such as beef and pork - are high in saturated fats.

- Many of the oils and fats in processed foods are hydrogenated; that is, put through a chemical process that adds hydrogen as a preservative. These hydrogenated oils raise blood cholesterol. Try to avoid prepared, deep fried foods and when cooking, try to use natural, non-hydrogenated oils - such as canola or olive.

- Get into the habit of drinking non-fat or 1% milk rather than whole. Where you can, substitute margarine for butter. Soft margarines - such as the kind that come in liquid form, or in tubs - are the best (harder, stick varieties are often hydrogenated to give them their shape and texture). Look for margarines that have less than 2 grams of fat per tablespoon, or which list their primary ingredient as vegetable oil.

- Many processed foods on the market today feature "fat substitutes" such as Olestra, which cause them to have all the tempting qualities of fatty foods, but less cholesterol; don't be fooled. While the occasional "fat-free" treat is all right, people will often make these foods a major part of their diet, believing they're healthy. Doing so usually leads to over consumption, which can lead to obesity - another risk factor for heart disease.

- Maintain a healthy weight; as just mentioned, obesity is a risk factor for heart disease, as carrying excess weight on the upper half of your body can decrease your HDL levels and increase your LDL levels.

- Include foods that have a high-soluble fiber content in your diet. As part of a low-fat diet, the soluble fibers that come in foods like oat bran, oatmeal, beans, peas, rice bran and citrus fruits (among others) can lower your cholesterol.

- In addition to soluble fibers, include soy products in your diet. Soymilk can easily replace certain dairy products, and tofu goes with nearly everything. Certain compounds in soy tend to act like cholesterol regulating hormones in the human body, and can lower your LDL levels while increasing your HDL levels.

- Finally, always consult with a doctor about which diet and lifestyle changes would be most effective for you. Working with someone who's familiar with your health and your lifestyle can give you a leg up in starting and sticking to a cholesterol lowering routine.

Make these changes, and follow them up with steps to reduce other risk factors for heart disease (such as smoking, diabetes, hypertension, obesity and physical inactivity) and you can steer yourself clear of high cholesterol.

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