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T H E D E TR OI T J E W I S H N E W S

Henry Gordon chooses to ignore his problem.

04

Good HDLs,
bad HDLs,
cholesterol counts
they all add up
to forcing
individuals
to watch out for
their health.

RUTHAN BRODSKY
SPECIAL TO THE JEWISH NEWS

t's a good bet that conversations
centering on diet, weight, and
nutrition eventually focus on
'cholesterol.
Most of us know our own cho
lesterol count. We may not know
what the count means but we
can recite the numbers. Patient
education programs of hospitals
and health organizations have
made sure that we understand
cholesterol level is important be-
cause if it's too high we're more
at risk for a heart attack or a
stroke.
Heart and blood vessel (car-
diovascular) disease is the No. 1
killer of Americans. The simple
fact is that study after study
points to elevated blood choles-
terol levels as a major contribu-
tor to the problem. The good
news is that the number of
deaths from cardiovascular dis-
ease has been decreasing due to
improved treatment and modi-
fication of cardiovascular disease

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cholesterol sometimes confusing
is that you can't live without it,"
says Dr. Jeffrey Krakauer, M.D.,
endocrinologist and director of the
Osteoporosis Program at Beau-
mont Hospital.
"Cholesterol is a fat-like sub-
stance (lipid) that is essential to
the body's cell membranes, to the
insulation of nerves and to the
production of hormones. It's used
by the liver to make bile acids
which help digest foods.
"The liver makes about 80 per-
cent of a person's blood cholesterol
and only about 20 percent (diet
cholesterol) comes from diet."
Cholesterol is transported
throughout the bloodstream just
like the nutrients from digested
food. To make this happen, the
body coats cholesterol with a pro-
tein; this cholesterol-protein pack-
!
age is lipoprotein.
Lipoproteins carry both cho-
lesterol and triglycerides (also a
lipid or fat-like substance) in the
blood. Low-density lipoproteins
(LDLs) contain lots of cholesterol
and are called the "bad" choles-
terol because they correlate with
deposits of plaque in the blood ves-
sels.
High-density lipoproteins
(HDLs) contain mostly protein
and are the "good" cholesterol.
Triglycerides are the fat in the
blood stream which haven't been
yet made into LDL or HDL, but
they're on the way. The higher the
triglycerides, the greater the
chance of heart disease, stroke
and blockage because the behave
like T .DL.
According to Dr. Krakauer, if
there are too many LDL
particles in the blood, or the
liver isn't functioning cor.
rectly, the body's cells be-
• Diabetes — can increase come saturated with
‘ , .*‘Smoking damaffes walls of
cholesterol, which is then
• blood vessels making them prone
triglycerides and decrease HDL in
• to accumulate fatty deposits. May many people.
deposited in the artery
walls. That's when the
also lower your HDL by as much as
high-density lipoprotein
Risk factors you can't change:
15 percent.
• High blood pressure -- dam-
• Age the level of LDL choles-
(HDLs) do their part and
ages the walls of arteries and can
terol increases as a person ages. The pick up cholesterol and car-
increase can be caused by aging or ry it to the liver where it's
accelerate the development of ath-
erosclerosis. Some medications for an increase in body fat.
disposed.
The problems arise
high blood pressure increase LDL
• Gender — Until age 45-50, men
when there's just too much
levels and decrease HDL levels.
have higher total cholesterol levels
than women and up to this age
cholesterol from LDL par-
• Inactivity -- decreases HDL
women usually have higher HDL
ticles and they remain on
levels.
• Overweight — increases
levels. After menopause, women's the artery walls.
total cholesterol rises and the HDL
Doctors often report one
triglycerides and lowers HDL lev-
or two cholesterol ratios.
level drops.
els.
The first is the patient's ra-
tio between total choles-
bumps called plaques and cause
risk factors, including choles-
terol (TC) and HDL. The lower
terol.
the interior of arteries to narrow,
the TC to HDL the better. The
The bad news is that there's
reducing blood flow.
second ratio is between LDL and
still close to 1 million Americans
As a plaque enlarges, silently
HDL. Again, the lower the LDL
dying each year from cardiovas-
and painlessly, a tear or rupture
to HDL the better.
cular disease according to the
in the plaque may cause a blood
Example of bad ratios: Total
clot to form and block the flow of
American Heart Association.
Cholesterol/HDL=250/40+6.25;
Many of these deaths occur be- blood or break free and plug an
LDL/HDL =190/40+4.7.
artery. If the flow of blood to a part
cause of narrowed or blocked ar-
Example of good ratios: Total
of the heart is stopped, this is a
teries (atherosclerosis) in which
cholesterol/HDL = 250/90 = 2.7;
heart attack. If blood flow to the
cholesterol-containing fatty de-
LDL/HDL = 140/90 = 1.5.
posits accumulate in the walls of brain stops, this is a stroke.
Weight loss, a low-fat diet, ex-
arteries. These accumulate as
"What makes talking about