A Reader’s Question about Cholesterol
“I read in your book about cholesterol and I think I understood it. Now my doctor says my cholesterol is too high. Am I supposed to be worried about that?”
The cholesterol information in my book is accurate but a bit incomplete in view of cardiovascular research done since my book went to press. I usually avoid talking about cholesterol in my newspaper articles because it is a topic of hot debate among the experts that I follow.
Some experts say cholesterol isn’t important as long as triglycerides (TGL) and HDL cholesterol are in range (TGL under 150, HDL at or above 50). The perfect combination of both would be 1/1.
Others agree about the importance of triglycerides and HDL but feel very strongly that other cholesterol measurements are critical and steps should be taken to lower the numbers. For most doctors this usually means take a medication.
I am not qualified to give medical advice. But I can help fill in the blanks so you can decide for yourself if you should worry.
Imagine you are on an island with no roads, just a river as the only source of transportation. Some things like fish just swim along in the river and sticks float along nicely on the top.
But people and other heavy stuff have a bit of a problem because they tend to sink. So there are boats to accommodate these troublesome people. Most, although not all, of the boats have the same capacity.
People arrive at a main station to go to work or shopping. And they also bring chairs, refrigerators and such to be delivered along the river. All day long the station master orders up the number of boats required for all the people and material gathered at the station. Take note, there is just so much room on a boat. The more stuff to be carried, the more boats required.
The boats stop at points along the river banks to drop off people and material, getting lighter and lighter until eventually only the pilot and other crew members are left on the boats. The main station master sends out other boats to pick up undeliverables material from damaged boats and bring them straight back to the main station.
Sounds perfect, right? Well, there can be problems with this seemingly efficient process.
Boats can have more people than other material, and vice versa. Sometimes the drop off points are full and people get stuck on their boat – which really ticks them off. The weather just can’t be trusted so sometimes the river bank and drop off stations get damaged, and the boats get tossed around and bounce off the bank.
On occasion a boat crashes and gets stuck on the bank. Its a mess. And the more boats bouncing off the bank, the more likely this is to happen.
The number of boats and condition of the river bank define the problems, The people and material on the boats aren’t really at fault. But the number of people and amount of material to be moved does determine the number of boats.
You as the Island
Your liver is the main station and your blood stream is the river. Cholesterol and triglycerides (both of which are forms of fat) cannot just be tossed into the river, so the liver creates boats (lipoproteins) to carry them through your blood stream and deliver both to body cells (drop off stations) as needed.
HDL is the lipoprotein sent out empty to pick up undeliverables and damaged material (from boats) and return them to the liver.
A lipid blood test your doctor prescribes measures the amount of cholesterol and triglycerides inside the lipoproteins. But the amount of cholesterol is much less important than the number of lipoproteins (boats) required to carry it. This number is easily measurable but usually isn’t.
Complicate that with the condition of your blood stream. The amount of excess glucose (sugar) and insulin hanging around along with high blood pressure, various toxins (like smoking), and other stuff cause inflammation and damage the walls of the blood stream. The more boats (lipoproteins) banging against the damaged walls the greater the potential that some will get stuck.
So the famous plaque and blood clots develop which can create blockage and heart attacks. This is the thing your doctor and you are really worried about.
Your genes can create structural and operational issues but you are not in control of those. You are, however, largely in control of damage to the walls of your blood stream and the number of lipoproteins in your blood. You are in control of your diet.
Damage can be healed and the number of lipoproteins can be reduced with diet and lifestyle correction over time.
Should you be worried? It depends on your history. If you know there are things to be corrected, repair needs to start as soon as possible. In the meantime, only you and your doctor can decide what medical interventions would be appropriately protective now.
Do you have questions? Send them to email@example.com
Pat Smith is the author of “It’s All about the Food,” a book available on Amazon and Bob’s Food City (Mt. Ida) that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Proceeds from her book benefit the Montgomery County Food Pantry. Her website is http://www.allaboutthefood.org/ She can be contacted at firstname.lastname@example.org, 501-605-3902. Her Facebook page is www.facebook.com/patsmithbooks.