HEALTH

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Artwork by Kevin Kreneck of the Roanoke Times & World-News. Copyright 0 1989. Kevin Kreneck. Distributed by Los Angeles Times Syndicate.

Cholesterol Debate

RUTHAN BRODSKY

Special to The Jewish News

M

ichael was lucky. He
managed to bring
his cholesterol down
before the storm brought on
by Thomas J. Moore, author of
Heart Failure (Random
House, 1989), who claims that
lower cholesterol levels do not
reduce the risk of heart at-
tacks or lengthen lives.
Excerpts from the book
published in the September
issue of The Atlantic made na-
tional headlines as the former
Washington correspondent
from the Knight-Ridder
newspapers charges that a
few researchers and inac-
curate data have fooled
Americans into believing that
their blood cholesterol levels
are too high. Eating less fat
and cholesterol won't protect
you from heart disease, Moore
says. In fact, it could actually
raise your risk of colon cancer
and stroke.
French fry freaks, Baskin
Robin regulars, ground beef
gourmands and cream cheese
connoisseurs came out of the
closets en masse, grins across
their faces.

But before you reach for the
schmaltz and sour cream her-
ring, the word is out that
Moore is not entirely correct
either; he tells only half the
story. Indeed, most experts
agree that scientific opinions
have long differed about the
degree of risks posed by
elevated cholesterol and the
appropriate levels at which
treatment should begin.
However, scientific evidence
continues to make a strong
case that cholesterol and fat
do increase your risks for
heart disease.
"Just lowering your
cholesterol levels doesn't
necessarily mean that we're
all going to live a lot longer,"
explains M.R.S. Nair, M.D.,
staff cardiologisst at Pro-
vidence Hospital. "There are
a lot of people with low
cholesterol levels who smoke
a pack of cigarettes a day and
are at a high risk for a heart
attack."
He points out that the
Helsinki Heart Study, con-
ducted in the mid-1980s on
males below the age of 55,
showed that most of the men
in that study, treated or not
treated, did not have a heart
attack although their

Local experts
make the case
for lowering
cholesterol levels.

cholesterol levels were high.
Yet current U.S. guidelines
call for treating everyone
with a LDL level of 190 or a
total cholesterol level of 285.
Nair believes that studies
like these are sometimes
misleading because they
generalize too much. The
Helsinki study, for example,
included no women.
Moreover, it doesn't say that
although some men lowered
their LDL levels with medica-
tion, some still became sick
with other diseases, had
cataracts, gallstones and even
died.
"We know that a high
cholesterol level for some in-
creases their risk for heart at-
tacks," Nair states. "And we
also know that exercise helps
reduce the risk for heart at-
tacks. People spend a lot of
money on junk food. They'd be
a lot better off taking that
money and correcting their

eating behavior, keeping
away from sweets and in-
cluding more fruits and fiber
in their diet."
Nair says we should be
practical about our life style
and use moderation for our
eating habits. He thinks too
many people make
themselves and their family
unnecessarily miserable
while lowering their
cholesterol level.
"Cholesterol is not the on-
ly risk factor for coronary
heart disease, but one of
several important factors,"
Charles Lucas, M.D., Chief of
the division of Preventive and
Nutritional Medicine, Beau-
mont Hospital, explains.
"The famed Framingham
Heart Study shows that high
levels of high-density lipopro-
tein (HDL) and low levels of
low-density lipoprotein (LDL)
put people at less risk for
heart attacks."
LDL's (the bad kind) deliver
cholesterol to tissues, blood
vessels and artery walls. The
higher the number of LDLs,
the greater the risk for heart
disease. HDL's (the good kind)
are believed to help remoe
cholesterol from artery walls.
The higher the number of

HDLs, the lower the risk of
heart disease.
Lucas says that even with
total cholesterol levels under
200, 20 percent of the popula-
tion would probably develop
coronary heart disease due to
other factors such as a low
HDL level or to the fact that
they smoke. In other words, a
person who smokes and has a
low cholesterol level may be
at greater risk of a heart at-
tack than a person with high
cholesterol levels who doesn't
smoke. It's all in the genes.
"Five percent of people who
are underweight develop cor-
onary heart disease," Lucas
reports, "whereas half of the
people who are 40 percent
overweight develop heart
disease which shows that if
you're thinner you have less
of a risk. What's interesting,
however, is a more recent
study at the Cooper. Clinic in
Dallas which clearly
demonstrates that physically
fit persons also lower their
risk of heart disease and
cancer."
According to Lucas, factors
which contribute to high
cholesterol levels besides
smoking are genetics
(parents), obesity and lack of

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