Health News • Too Much Cholesterol

Recent news about cholesterol can be very confusing and scary. We have all heard that too much cholesterol can cause heart attacks, hypertension and strokes. Perhaps some straight talk will help clear the air.

Cholesterol is a lipoprotein which is a fat molecule attached to a carrier protein molecule. These chemicals usually travel via the bloodstream from the liver and digestive tract to wherever it is needed in the body. Not only is cholesterol absorbed by the body from food. It is also produced by the body for some very important functions. Lipoproteins are the building block for fat chemistry, the nervous system and hormone production. Thus we need fat (lipids) to live but we must take these lipids in moderation. More intake of cholesterol than the body can use up will cause diseases associated with over indulgence.

Total cholesterol is divided into high density lipoproteins (HDL), low density lipoproteins (LDL) and very low density lipoproteins (VLDL). A desirable lab value of this profile goes as follows. The total cholesterol should be less than 190mg/dl while the breakdown of its components, HDL should be more than 40. LDL should be less than 99 and VLDL should be less than 40. This is usually seen on a blood lipid profile which your doctor tests when he is ordering a fasting lipid profile.

Additionally your physician may want to study triglycerides to further evaluate your fat metabolism. Triglyerides should never exceed 149mg/dl. Because children’s metabolism is directed to their growth and development, all of these values are somewhat higher in the pediatric setting.

Fortunately there is much we can do to rid ourselves of excess cholesterol. The most obvious, of course, is to limit the intake. Dietary manipulation is directed to limiting fat in the diet to 30 percent of the total caloric intake with no more than 10 percent of this fat taken from saturated fat. Additionally, the total daily cholesterol should be limited to 300 milligrams. Cardiologists refer to this as the Step I diet. Sometimes a more stringent diet call the Step II is required to reduce very high cholesterol levels. Your doctor can recommend a dietitian to help you learn how to eliminate the saturated fats from your diet.

Exercise greatly enhances HDL’s and lowers seems to reduce the bad effects of total cholesterol. Women tend to have higher HDL’s then men but with advancing age this gender bias seems to dissipate.

If cholesterol levels are dangerously high you should see a cardiologist or internist. This especially true for those who have a strong family history with arteriosclerosis and its associated hypertension, heart attacks and/or strokes at an early age. Your pediatrician will quiz you on your family history, and if it is positive for hypercholesteremia, you will be advised to restrict fat intake as early as 24 months of age. Additionally, your child’s fasting lipid level will be monitored regularly as early as ten years age when he comes in for his/her health check-up visits.

If exercise and diet changes do not bring the cholesterol down, than drug therapy may be necessary. Cholestyramine, niacin and zetia reduce the absorption of cholesterol but sometimes have side effects, which range from unpleasant to severe, as nausea and diarrhea. A new class of powerful drugs, called statins, block the production of cholesterol. Because StepI and II diets are very effective in reducing cholesterol in children, most drugs are not used in children.

Arteriosclerosis and its associated hypertension (high blood pressure) is also recognized as an inflammatory disease, whereby the cholesterol buildup inside the blood vessels creates a nidus for clot formation. Some of these clots can be massive causing a stroke if it occurs in a major artery of the brain. Other patients suffer mini-strokes when these clots happen to flake off the nidus of a clot. If this blockage is in the arteries that feed the heart muscle, the patient suffers a heart attack.

Because cholesterol metabolism so influences life span and the quality of life, most physicians are now doing routine cholesterol screening as part of health maintenance, especially, for those patients with strong family histories. This is particularly true for children in their teens with strong family histories because early intervention may mean a longer quality of life if that stroke or heart attack can be prevented.