Copyright 2002 by Nikicj5/ and  Medical Madness Newsletter@

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Cholesterol is a waxy substance made in the body and found in some foods. Diet and family history contribute to high blood cholesterol. Too much cholesterol may collect on artery walls, possibly blocking blood flow to the heart and other organs and tissues. High blood cholesterol is a major risk factor for heart disease. Cholesterol levels are measured by a blood test given by a doctor or other healthcare professional. Treatment may include proper diet, exercise, and medication.





Cholesterol and Heart disease


We hear a lot about high cholesterol today and how it can increase the risk of heart disease. But the truth is, most people don't really know what that means. The information here will help you get the facts straight. High cholesterol is a major risk factor for heart disease...Cholesterol is a fat like substance produced by your liver. You also get cholesterol from many of the foods you eat. Although it is needed by your body to function properly, too much cholesterol can be hazardous to your heart. That's because excess cholesterol can clog coronary (heart) arteries, making it hard for blood to bring in oxygen and nutrients. And if an artery becomes completely blocked, blood flow stops and a heart attack may occur.

Two main components of total serum cholesterol are:

*Low-density lipoprotein (LDL) cholesterol - the "bad" cholesterol

*High-density lipoprotein (HDL) cholesterol - the "good" cholesterol The reason for "bad" LDL cholesterol's nickname is its link with heart disease. HDL cholesterol is "good" because it helps clear LDL cholesterol out of your arteries. Many studies have proven that high levels of LDL cholesterol increase your chance of heart attack and other heart diseases, such as atherosclerosis (hardening of the arteries) and angina (chest pain). Furthermore, studies also show that every 1 percent reduction in serum cholesterol results in about a 2 percent reduction in the incidence of heart disease. Lowering LDL cholesterol can help reduce a major risk factor for heart disease.
More men and women in the United States die of heart disease than any other condition, including cancer. Since we know that heart disease is strongly related to high LDL cholesterol, lowering this type of cholesterol should be an important goal. In fact, a number of studies have shown that reducing LDL cholesterol may slow atherosclerosis, a disease in which fatty deposits build up in the coronary arteries and block blood flow. These fatty deposits are made up mostly of LDL cholesterol, so lowering blood LDL cholesterol levels may prevent new deposits from forming and even cause the existing blockages to shrink.Because of this important information, the National Cholesterol Education Program (NCEP), a group of physician experts, established guidelines for managing high cholesterol and set an LDL cholesterol goal for everyone.If you have high cholesterol, getting to your LDL cholesterol goal will eliminate a major risk factor for heart disease.
Make low LDL cholesterol your goal
A simple blood test will tell you your LDL cholesterol level. With that information, you and your doctor can determine your LDL cholesterol goal, how to get to it and how to maintain it. It's a lifetime commitment.Your risk of heart disease is related to your LDL cholesterol goal

Certain conditions or behaviors are strongly related to an increased incidence of heart disease. You already know an important one, high (LDL) cholesterol, but there are others that must also be considered. The number of risk factors you have determines your risk of heart disease AND your LDL cholesterol goal.

"Modifiable" and "fixed" risk factors include:

*Gender and age: Female 55 years or older or past menopause

*male 45 years and older

*Family history of heart disease

*High cholesterol

*Diabetes

*Smoking

*High blood pressure

*Low HDL (good) cholesterol

The first two, which cannot be changed, are called fixed risk factors. Because the others can be controlled or modified, they are called modifiable risk factors. Take control of risk factors and the risk of heart disease Controlling these risk factors has been proven to reduce the chances of heart disease developing or worsening.

Cholesterol Tracking Chart

Cholesterol levels, and their meanings
High levels of cholesterol in your blood may increase your risk of developing coronary heart disease or stroke. The higher your blood cholesterol, the greater your risk. Blood carries oxygen, and cholesterol clogged arteries can deprive the heart of oxygen, causing angina (chest pain), heart attack, or even death. All adults 20 years of age and older should have their cholesterol measured at least once every five years. The most useful kind of cholesterol measurement measures not only the amount of total cholesterol in your blood but also the amount of LDL ("bad" cholesterol), HDL ("good" cholesterol),
  
*Total blood cholesterol levelsLess than 200 mg/dL Desirable

*200-239 mg/dL Borderline-high

*240 mg/dL and over High

Your LDL
LDL cholesterol levelsLow-density lipoprotein, abbreviated "LDL," is what's known as "bad cholesterol." LDL is responsible for carrying cholesterol from the liver through the arteries; in other words, LDL brings clogging cholesterol into your arteries.LDL

Cholesterol Level LDL Cholesterol Category

*Less than 100 mg/dL Optimal

*100-129 mg/dL Near optimal/above optimal

*130-159mg/dL Borderline high

*160-189 mg/dL High

*190 mg/dL and above Very high

*You should always check with your doctor or other health care professional about what cholesterol measurements are good for you, and what steps should be taken to prevent and control high cholesterol levels.


You can control your cholesterol

There are all kinds of ways to get exercise, but most fall into two main categories: aerobic exercise and strength training.
Aerobic activities, which are motion exercises that can be sustained over an extended period of time, may help make your heart and lungs work more efficiently. They also may help you lose weight, as your body burns off fat for energy. Good aerobic exercises include
walking, running, swimming, bicycling or dancing. *If you haven't exercised in a while, a good goal to aim for is doing some form of aerobic exercise for 20 minutes a day, at least three days a week, preferably more. If 20 minutes feels too long, try fitting in two 15-minute sessions of exercise, three days a week.
If you are already in pretty good shape, you can also vary your exercise routine with strength training - exercises in which your body works against resistance, such as lifting weights, working out on weight machines or calisthenics like pushups or sit-ups. Strength training helps you develop and condition muscles, making it easier for you to perform tasks. And, since strength training puts stress on bones, it may also help keep bones strong and healthy, possibly fighting against osteoporosis. Remember, before starting any exercise program or embarking on a more strenuous exercise regimen, it's important to talk to your health care practitioner.

High cholesterol can sneak up on you
High cholesterol. You can't see it or hear it. You may feel just fine. But when your cholesterol sneaks up above a desirable level, it puts you at increased risk for heart attack, heart disease, stroke and other cardiovascular diseases. Combine high cholesterol with other heart risks (such as having a family history of heart disease, being a man 45 years old or older or a woman 55 years old or older, being a smoker or having high blood pressure or diabetes), and your risk for heart disease is even higher.
What can you do? Keep cholesterol under control by learning all you can about cholesterol and following a healthy lifestyle


Do you have a high-cholesterol lifestyle? If you're living a high-cholesterol lifestyle, your cholesterol level may be too high or it may become high in the future, increasing your risk of heart disease.

Cholesterol lowering drugs

*Extra Help -- Taking Medication*
Perhaps you've already made some lifestyle changes in order to try and lower your high blood cholesterol levels. You've cut the fat in your diet, you're eating more fruits and vegetables and you've tried to work more exercise into your day. You're probably feeling younger and healthier already! But perhaps your cholesterol levels didn't drop as much as you and your doctor had hoped, so together you've decided to give your cholesterol-lowering program an extra boost -- with medication.
Cholesterol-lowering drugs
There are several drugs shown to be effective in decreasing cholesterol. Depending on your cholesterol profile and your history, your doctor may prescribe any of the following medications to help lower your cholesterol: NIACIN, or NICOTINIC ACID
Lowers LDL ("bad") cholesterol, and raises HDL ("good") cholesterol. However, many people cannot tolerate this medication. STATINS
Statins block a key step in the process the liver uses to make cholesterol, lowering the LDL in the process. Statins may also raise HDL. Statins are the most widely used medications and are usually well-tolerated and effective. BILE ACID SEQUESTRANTS, or RESINS
These cause cholesterol to be lost in stools, thus lowering LDL. Side effects, such as constipation, may limit the use of these medications. Some people may take another type of medication, or switch to it later: FIBRIC ACID DERIVATIVES
Fibrates raise HDL, lower triglycerides and may lower LDL. Fibrates are not as effective as the statins in lowering LDL cholesterol. You might take these medications by themselves, or in combination with each other. You might be taking a statin and niacin for example.
Other medications to help your heart
Like many people with a risk of developing heart problems, you may also be taking other medications to reduce your risk of heart disease. Many people with high cholesterol also have high blood pressure, for example, so you may be taking antihypertensive drugs such as diuretics, beta-blockers or ACE-inhibitors. In addition, your doctor may recommend aspirin daily in a low dose to help prevent heart attack and stroke. It's important to remember that each one of these medications works to help your heart and blood vessels in different ways, so taking one type doesn't mean you can stop taking the other. If you think you are taking too many medicines or your daily regimen seems too complicated, speak with your doctor or pharmacist. They can help. The more you take ...Remember, virtually all medications have the potential for side effects. Your chances for developing side effects increase with each medication you add. Luckily, there are plenty of things you can do to prevent problems: Keep your doctor and pharmacist informed of any medications you take, including "over-the-counter" medications that don't need a prescription, like cough syrup, allergy and pain medications, as well as vitamins, minerals and herbs.
No short cuts
Cholesterol-lowering medications can make a major difference in your cholesterol levels, particularly when they are added to a heart-healthy diet and exercise program. Notice we said when they're added to the program, not replacing it. That's because cholesterol-lowering drugs are most effective when they're combined with a heart-healthy lifestyle, eating a low-fat, fiber-rich diet and exercising regularly.

The right dose at the right time
Know the schedule for each medication you're taking. Have your doctor or pharmacist write out a plan for taking your different medications throughout the day. Keep your plan in a convenient place -- like your bathroom cabinet or on the refrigerator door. Always take your medication exactly as it is prescribed. Keep your medications safely out of reach of children. If you're not clear about the directions, ask your doctor or pharmacist to explain it fully. It's your right as a patient and customer! Remember, taking several pills a day may be the most effective way to treat you and is not an indication of how sick you are.

Just forgetting -- or denying?
Many people have a hard time accepting that they have an illness that needs to be treated and may unconsciously deny that they're sick, especially since having a high blood cholesterol level doesn't make us feel any different. Some may feel embarrassed about having a medical condition and these feelings can show up as forgetfulness. Remember that taking medication is an important way to stay healthy and it may produce dramatic results. When you made the decision to take medication, you joined millions of people all over the world who are reducing their risk for health problems and leading longer, healthier lives with the help of medications to reduce blood cholesterol.
so TAKE YOUR MEDICINE.
Q and A about cholesteral

Q. What about cholesterol levels in children?

A: Most children do not need to have their blood cholesterol checked. But, all children should be encouraged to eat in a heart-healthy way, along with the rest of the family. Children who should be tested at age 2 or older include those who have any of these conditions:

*at least one parent who has been found to have high blood cholesterol (240 mg/dL or greater),
or
*a family history of early heart disease (before age 55 in a parent or grandparent).
*Also, if the parent's medical history is not known, the doctor may want to check the child's blood cholesterol level, especially in children with other risk factors like obesity.

Q. How high is a child's "high" blood cholesterol?

A: If your child does need to have a cholesterol test, it can be part of a regular doctor's visit. Your doctor will likely measure your child's total cholesterol level first. However, if your family has a history of early heart disease, the doctor may measure the LDL-cholesterol level right from the start. Otherwise, your child's LDL-cholesterol level should be measured if his or her total cholesterol level was checked and found to be 170 mg/dL or greater.

Q. Should you know your cholesterol ratio?

A: When you have your cholesterol checked, some laboratories may give you a number called a cholesterol ratio. This number is your total cholesterol or LDL level divided by your HDL level. The idea is that combining the levels into one number gives you an overall view of your risk for heart disease. But the ratio is too general: It is more important to know the value for each level separately because LDL- and HDL-cholesterol both predict your risk of heart disease.

Q. What are triglycerides?

A: Triglycerides are the form in which fat is carried through your blood to the tissues. The bulk of your body's fat tissue is in the form of triglycerides. Your triglycerides are measured whenever your LDL-cholesterol is checked. Triglyceride levels less than 200 mg/dL are considered normal.

It is not clear whether high triglycerides alone increase your risk of heart disease. But many people with high triglycerides also have high LDL or low HDL levels, which do increase the risk of heart disease.

Q. Will lowering my blood cholesterol help me live longer?

A: Many studies show that lowering cholesterol levels reduces the risk of illness or death from heart disease, which kills more men and women each year than any other illness. If you have heart disease, lowering your cholesterol level will probably help you to live longer. If you don't have heart disease, the studies so far do not show that you will live longer, but you will definitely reduce your risk of illness and death from heart attack.

Q. Is it safe to eat in a heart-healthy way?

A: Eating in a way that is lower in saturated fat and cholesterol is safe and can be more nutritious than an eating plan higher in saturated fat and cholesterol. It will even meet the higher needs that women, children, and teenagers have for nutrients like calcium, iron, and zinc, and an eating pattern lower in total fat will reduce the risk for other chronic diseases, such as cancer. And an eating pattern lower in saturated fat, total fat, and cholesterol can still provide enough calories for the proper growth and development of children ages 2 and above. Children younger than 2 years have special nutrient needs for fat.

Q. How much will your cholesterol levels change?

A: Generally your blood cholesterol level should begin to drop a few weeks after you start eating the heart-healthy way. How much it drops depends on the amount of saturated fat you used to eat, how high your high blood cholesterol is, how much weight you lose if you are overweight, and how your body responds to the changes you make. Over time, you may reduce your cholesterol level by 5 to 35 mg/dL or even more.


Q. Do I need to worry about lowering my blood cholesterol now that I'm over 65?
A: Yes. Older Americans (over 65) have the Nation's highest rate of coronary heart disease (CHD) and can benefit greatly from lowering elevated cholesterol. Cholesterol lowering also has been shown to reduce the risk of strokes. For seniors who do not have heart disease, cholesterol lowering may reduce the risk of developing CHD. Older Americans should have their total cholesterol and, if possible, their high density lipoprotein (HDL, the "good" cholesterol) tested once every 5 years. Older Americans should keep their cholesterol low by following an eating pattern containing foods lower in saturated fat, total fat, and cholesterol, being physically active, and maintaining a healthy weight.

Q. What is a heart-healthy diet?
A: A heart-healthy diet emphasizes foods low in saturated fat, total fat, and cholesterol to help lower blood cholesterol. This is the recommended eating pattern for Americans older than two:
*Less than 10 percent of calories from saturated fat;

*An average of 30 percent of calories or less from total fat; and
*Less than 300 mg a day of dietary cholesterol.
Saturated fat increases blood cholesterol more than anything else you eat, so choose foods low in saturated fat to help reduce blood cholesterol. If you are overweight, losing weight is important for lowering blood cholesterol. Being physically active also helps improve blood cholesterol levels because it can raise HDL ("good") cholesterol and lower LDL ("bad") cholesterol, as well as help you lose weight, lower your blood pressure, and improve the fitness of your heart and blood vessels.

Q. Is margarine better than butter in a cholesterol-lowering eating pattern?

A: Yes. Butter is high in saturated fat, which raises blood cholesterol more than anything else you eat. Most margarines are made from vegetable oils that are hardened through a process called "hydrogenation." Hydrogenation forms a type of unsaturated fat called "trans" fat that appears to raise blood cholesterol more than other unsaturated fats but not as much as saturated fats. There are now margarines available that contain no "trans" fats. You can also read food labels and choose margarines that contain liquid vegetable oil as the first ingredient (rather than hydrogenated or partially hydrogenated oil) and the least amount of saturated fat.

Q. My last cholesterol level was within my goal. Does that mean I do not have to worry about my cholesterol any more?

A: High cholesterol and heart disease are not cured but are only controlled by diet and drug therapy. Stopping your treatment quickly returns your cholesterol to the level that existed before therapy was started.

Q. How does smoking affect my cholesterol?

A: Smoking has several harmful effects on cholesterol. Smoking reduces HDL ("good") cholesterol and in all likelihood changes LDL ("bad") cholesterol to a form that promotes the buildup of deposits in the walls of the coronary arteries. In addition, smoking has harmful effects on the heart and blood vessels. In these ways, smoking substantially raises the risk for coronary heart disease if you are healthy and multiplies that risk many more times if you have other risk factors such as high blood cholesterol. All in all, smoking is the leading preventable cause of death.

Q. How can I raise my HDL ("good") cholesterol?

A:Quit smoking. The more you smoke, the lower your HDL cholesterol is likely to be.
Lose weight if you're overweight. Being overweight is often associated with low HDL levels.
Increase physical activity. This has a slow but steady elevating effect on HDL, which tends to rise in direct proportion to the amount of physical activity per week.
In addition, postmenopausal women taking estrogen replacement therapy may also experience an increased HDL level.

Q. Is lowering my cholesterol safe?

A: Yes. Cholesterol lowering itself is safe, as is the diet used to lower cholesterol. Like all medications, drugs used to lower cholesterol can have side effects, but when used by people who have a high risk of developing coronary heart disease (CHD), the benefits usually outweigh the risks. Four recent studies, three in patients who already had CHD and one in people free of CHD, showed that, over a period of 5 years, large reductions in total and LDL ("bad") cholesterol substantially reduced the chances of having a heart attack or dying from heart disease, reduced overall death rates, and produced no increase in any noncardiovascular causes of death, such as cancer, suicide, homicide, or accidents. These results have been confirmed by a combined analysis of 16 recent studies.

Q. I'm young and healthy. Do I need to have my cholesterol checked?

A: Yes. Young adults 20 years of age and older should have their cholesterol measured. Studies have shown that the buildup of plaque in the arteries that supply the heart begins in late adolescence and early adulthood, and a cholesterol level measured at age 22 predicts the risk of a heart attack over the following 30 to 40 years. Waiting until midlife to measure and lower cholesterol reduces the benefit that can be obtained. Checking your cholesterol and discussing it with your doctor can help you make lifestyle changes-eating right, being physically active, and controlling weight-to maintain good health now and prevent heart disease later in life.

"what u can do"

*Choosing foods that are low in fat

Changing your diet and losing excess weight to reach or maintain a desirable cholesterol level begins with making changes in the food you buy. Shopping for the right food doesn't have to be confusing or overwhelming. With a little practice, you can develop skills for reducing fats, reading labels and making good selections at the market.

*Pick your fats wisely
The fats you eat can be divided into three types: monounsaturated, polyunsaturated and saturated. Your goals are to choose less saturated fats and to eat less fat overall. Use very small portions of monounsaturated and polyunsaturated fats instead of saturated fat.
Choose monounsaturated fat from vegetable sources such as olive and canola oil. Monounsaturated fats lower LDL (bad) cholesterol without lowering HDL (good) cholesterol.

Choose polyunsaturated fat from vegetable sources such as safflower, sunflower or corn oil. It may lower both LDL (bad) and HDL (good) cholesterol. Many margarines are high in polyunsaturated fat.

Avoid saturated fat from animal sources such as butter, lard and fatty meats. Vegetable sources are coconut, palm and "partially hydrogenated" oils, which are found in many processed foods. Too much saturated fat can raise your cholesterol level. Shop for the best foods
Poultry, fish, seafood and lean cuts of meat (such as beef sirloin tips, pork, tenderloin or leg of lamb) are good low-fat choices. When buying meat, ask your butcher to trim off excess fat.

Fresh fruits and vegetables are practically fat-free and contain no cholesterol.

Starchy foods such as potatoes, yams, grains, breads and cereals are all good choices.

Beans and oats can help lower your cholesterol. Choose low-fat food products containing these ingredients.

Frozen entrees made with a little cheese or sauce and frozen desserts such as ice milk, low-fat frozen yogurt or light ice cream can be good low-fat choices.

Nonfat or skim milk, cheeses made with part-skim milk (such as part-skim mozzarella) and nonfat yogurt are good dairy choices.

Spreads made with liquid oil, such as tub margarine or light mayonnaise, are good choices when used in moderation. Read the labels The best way to find the fat and cholesterol in processed foods is to read the labels. You can ask yourself these four questions to help you choose products that are low in fat, especially products low in saturated fat.

Do too many calories come from fat?
Ideally, less than 30 percent of your day's total calories should come from fat

Is the serving size appropriate?

When keeping track of fat, be sure to use a serving size that is close to what you would really eat.

Is fat a major ingredient?

If high-fat ingredients like butter, cheese and hydrogenated oil are listed among the first four ingredients, the product is likely to be high-fat.

Are there several fats in the product?

When you see several high-fat ingredients listed on the label (such as butter, cheese, hydrogenated oil and cream), then the product probably contains too much fat.


Lifestyle modifications to improve cholesterol levels


Even modest lowering of cholesterol in those whose levels are high, whether through drug therapy or lifestyle changes, reduces the risk of disability and death from heart disease. Although most studies that prove that lowering cholesterol saves lives are done using drug therapy, the absolute mandate for improving cholesterol levels is to first make changes in lifestyle. Like those suffering from high blood pressure, people with high LDL-cholesterol levels do not experience symptoms until dangerous heart disease develops. Changing one's daily patterns is like breaking through a wall; it seems impenetrable at first, but once the patient has broken through, the rewards of these good, new habits are a sense of energy and physical freedom that few will want to relinquish. Diet Currently, there is much controversy over the best balance of carbohydrates, fats, and protein.

The three major cholesterol reduction diets are the following:
*the Step 1 and Step 2 diets recommended by the American Heart Association (AHA),
*the Mediterranean Diet
*very low-fat diets, such as the Ornish Program. AHA Diet

The Step 1 diet requires that daily fat intake represent less than 30 percent of calories, saturated fats less than 10 percent, and cholesterol intake less than 300 mg. (Simply switching to low-fat or skimmed milk may help people achieve the recommended dietary goal of 30 percent or fewer calories from fat and also help provide calcium.) Additionally, the daily diet of most people should consist of 50 percent to 65 percent complex carbohydrates, although this might be too high for some. A low-fat, high fiber diet appears to be safe and healthy for older children and adolescents as well.

The Step 2 diet is recommended for people with existing heart disease or unhealthy cholesterol levels. This diet requires that fat intake represent 20 percent of calories, saturated fats less than seven percent, and dietary cholesterol intake less than 200 mg.

Mediterranean Diet. The Mediterranean diet, with its emphasis on whole grains, fish, olive oil, garlic, and moderate, daily intake of wine, is rich in heart-healthy fiber and nutrients, including omega-3 fatty acids and antioxidants. Studies are increasingly reporting its health benefits. The diet calls for a relatively high fat intake (about 35 percent to 45 percent of daily calories), primarily composed of monounsaturated fats (MUFA). It recommends the same protein intake as the AHA, although fish is the primary source. Carbohydrate intake is reduced and emphasizes not only fresh fruits and vegetables, but higher amounts of nuts, legumes, and beans than standard American recommendations.

Ornish Diet. For people with severe heart disease associated with cholesterol abnormalities who cannot or do not want to take cholesterol-lowering medications, the Ornish program may be the best option if they can maintain it. It is a very demanding regimen, however, that excludes all oils and animal products except nonfat yogurt, nonfat milk, and egg whites, limits saturated fats as much as possible, reduces total fat to 10 percent and increases carbohydrates to 75 percent of calories. In addition to following strict dietary rules, people in the program exercise 90 minutes at least three times a week, use stress reduction techniques, do not smoke, and do not drink more than two ounces of alcohol per day.

Resolving the Differences. Some experts believe that either the Step 1 or the Mediterranean diet is probably adequate for people with no coronary artery disease and normal LDL levels and for those with low LDL levels with only one or two risk factors for heart disease, such as low HDL levels and smoking.

For those with higher cholesterol levels, either the Step 2, Ornish, or Mediterranean diets may be effective depending on individual conditions. The major questions concern fats: how much and what kind. In general, most patients find it difficult to comply even with fat restrictions recommended under the Step 2 diet, which calls for fat intake being 20 percent of daily calories. The Ornish program is far stricter. Of some comfort was a study reporting that restricting fat intake only to 26 percent of calories reduced LDL levels as effectively as restricting fat intake to 18 percent. Indeed, experts are increasingly saying that the type of fat is more important than the amount. Low-fat diets, in fact, have been associated with a higher risk for stroke. The Mediterranean diet has great appeal, then, because of the foods allowed, including olive oil (rich in monounsaturated oil) and wine. However, of great concern with any diet high in fats, even healthy ones, is the risk for weight gain, and it is recommended only for people who are reasonably lean. Although all these dietary approaches differ in important aspects, they have some recommendations in common: all stress the value of fiber-rich whole grains, legumes, and fresh fruits and vegetables, and when fats are recommended, they are monounsaturated and polyunsaturated. Experts agree that everyone should avoid saturated fats (found in animal products) and transfatty acids (hydrogenated, or solidified, fats, found in commercial baked goods and fast foods). In choosing proteins, soy protein and fish should be emphasized over meat.
Weight control and exercise are essential companions of any diet program. After embarking on a healthy diet, it generally takes an average of three to six months before a noticeable reduction in cholesterol occurs, although some people have reported better levels in as few as four weeks.

Exercise

Peoplewho maintain an active lifestyle have a 45 percent lower risk of developing coronary heart disease than do sedentary people. Studies report that people who change their diet in order to control cholesterol and lower the risk for coronary artery disease are successful only when they also follow a regular aerobic exercise program.
Brisk walking, jogging, swimming, biking, aerobic dance, and racquet sports, are the best forms of exercise for reducing triglyceride levels (harmful fat molecules) and raising HDL (the so-called good cholesterol) levels. It may take up to a year of sustained exercise for HDL levels to show significant improvement. Because women tend to have higher HDL levels start with, it may take longer for them to see improvements than men. Aerobic exercise also appears to open up the blood vessels and, in combination with a healthy diet, may improve blood clotting factors. Favorable changes in HDL appear to occur gradually as exercise increases and reaches significance at about seven to 10 miles a week or when burning 1200 to 1600 calories. Exercise duration (60 minutes two to four times a week) may be an important factor in increasing HDL level in the elderly, who usually do not exercise as intensely as younger people. Even moderate exercise reduces the risk of heart attack, but in terms of raising HDL levels, more is better. Resistance (weight) training offers a complementary benefit by reducing LDL (the so-called bad cholesterol) levels. Triglycerides, which rise after a high-fat meal, can be lowered either with a single, prolonged (about 90 minutes) aerobic session or by several shorter sessions during the day. Before engaging in any strenuous exercise, it is advisable to consult a physician.

Quitting Smoking Cigarette smoking lowers HDL-cholesterol levels and is directly responsible for approximately 20 percent of all deaths from heart disease. The importance of breaking this habit cannot be emphasized enough.

Alcohol The effects of alcohol on heart disease vary depending on consumption. Evidence strongly suggests that light to moderate alcohol consumption (one or two drinks a day) protects the heart. The benefits are strongest in people at high risk for heart disease and may be fairly small in those at low risk. Light to moderate alcohol intake may even reduce the risk of sudden cardiac death and also protect against coronary heart disease in people with adult-onset diabetes. Moderate consumption of alcohol, equal to or less than one drink a day, may produce a slight increase in the risk for breast cancer in women. Large amounts of alcohol can raise blood pressure, trigger irregular heartbeats, and damage the heart muscle. Binge drinkers have a significantly higher risk for a cardiac emergency. Pregnant women or those at risk for alcohol abuse should not drink alcohol.

The feel-good prescription...exercise

Okay, so you've seen it on the news, you've heard it from your doctor and probably even from your friends and family: You need to get more exercise. If you think it means doing endless jumping jacks or running miles every day, you're mistaken. In fact, exercise is simply being physically active - and it can take all kinds of forms, from dancing to washing your windows. Add some more activity to your day, and you've already made a big start towards becoming fit. What's more - you might actually enjoy it! And, remember, before starting any type of exercise program, consult with your doctor to make sure it's safe.
 

A "wonder" drug
If exercise could somehow be formulated into a pill, it would truly be the wonder drug of all time. Nothing else can do so much to keep you healthy and energetic - and help protect your heart. Regular exercise can help you lose weight, since activity helps to burn calories. With your weight lower from exercising, your heart has less work to do. For some people, that can mean lower blood pressure. What's more, exercise can raise your levels of HDL ("healthy") cholesterol. All of these steps can lower your risk for heart disease. It is recommended that those not accustomed to regular exercise begin with a plan of 30 minutes of exercise a day or ten to fifteen minutes of exercise twice a day, three times a week.

The feel-good prescription
One of the most important benefits of exercise is how it makes you feel. Think about "the good old days," when you were a kid and full of energy. One reason you felt so great was that you were probably much more active than you are today. You can't turn the clock back, but you can boost your stamina and energy by exercising regularly. Soon, you'll find yourself able to do things you thought you were "too old" to do. You'll see your mood improve, especially if you're feeling depressed, and your self-confidence will rise as you feel yourself become stronger. And you'll sleep more soundly, too.If you have too much stress in your life (and who doesn't?), exercise can help you cope. Studies have shown that people who exercise regularly are better able to handle life's stresses - job changes, saving for retirement, loss of loved ones, and so on - than people who don't. Exercise can help relieve the muscle tension stress causes and it gives you some time to yourself - to spend in thought, reflection and planning. Before you start ...First check with your doctor. Remember to begin slowly. Don't try to do more than you can handle. If you have questions or doubts, speak with your doctor. And, if you have angina or any type of heart disease, consult your doctor before starting any exercise program.

Links

* Obesity, 'spare tire' up stroke risk in older men
* Smoking + chronic infection = artery trouble
* Public defibrillators offer small survival boost
* Study finds reciting poetry calms the heart
* Aneurysm linked to connective-tissue disorder
* Doctors not sure why elders halt cholesterol drugs
* Women can 'walk away' from cardiovascular disease
* Finding may yield safer way to fight blood clots
* Patients halt aspirin, despite ability to cut risk
* Study shows better results with early angioplasty
* Not all narrowed arteries are diseased arteries, study shows
* Impotence from beta-blockers partly psychological
* Injectable contraceptive may affect vessel function
* Light drinking may lower 2nd heart attack risk
* Cholesterol drug may cut stroke after heart attack
* Obesity alone may not up risk of heart disease
* Study explores genes, heart disease and alcoholism
* McDonald's to cook with healthier oil
* Magnesium therapy doesn't help heart attack: study
* Study: birth weight, blood pressure not linked
* Exercise could wipe out effect of stress on heart
* Heart attack risk very low with latest Pill version
* Heart attack does not always cause chest pain
* Women could need antioxidants more than men
* Duration of type 2 diabetes tied to impotence risk
* Sex of fetus may influence pregnancy complications
* Crossing the legs can prevent fainting spells
also
eDiets.com: Are You Deathly Afraid Of Fat?
The American Anorexia Bulimia Association
Support, Concern and Resources for Eating Disorders
The Something Fishy Website on Eating Disorders
Frankford Hospitals - Binge Eating Disorder
Anorexia Nervosa
Bulimia Nervosa
Wellness Web About Bulimia
Introducing Bulimia Nervosa
Salon Health & Body | Unhappy meal
Zoloft Effective In Treating Binge-Eating Disorder
Binge Eating Disorder from MICHAEL D. MYERS M.D. Inc.
Treatment Issues For Binge Eating Disorder
links on eating disorder above seen in Daily Diet Diary
 

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