Thursday, February 2, 2012

Should I be Concerned that my cholesterol seems to be gradually increasing ?

A note from a 48 y/o women. My recent lab. test show my cholesterol to be slowly increasing. My cholesterol was 128 mg/dl 20 years ago , 149 mg/dl 2 years ago and was 161 on my most recent test.  My other test , HDL is 49mg/dl , Triglyceride 84 mg/dl and LDL was 93.    Should I be concerned ?

Discussion

   Cholesterol  does go up a little as we mature and get a little stouter. The  exact cause for the slight increase with age is not known but  may be due to hormone changes as we mature.  Also your weight and activity level is probable a little different now than it was 20 years ago.

      *You don't smoke and I assume your BP is normal .

     * Your triglycerides of 84 is very good.
        Triglyceride levels  over 100 mg/dl effect the potential for LDL cholesterol to cause harm 
        by reducing the the size of LDL cholesterol particles.
       Also your low triglycerides level of 84 means that the calculation of your LDL
        cholesterol is more accurate. Your LDL is 93 . The target goal is < 100 mg/dl

      *Your LDL test is not measured it is calculated by subtracting HDL and 1/5 of your 
        triglyceride levels from  your total Cholesterol .

      *  Measuring APO- b is a more accurate method of evaluating LDL  levels. There is one
          Apo b  attached to each LDL particle.
          Generally ordering  an Apo b level is not necessary unless someones triglyceride levels 
           are over 150 mg/dl . 
            The target goals for ;
                              Apo b is 90 mg/dl if the LDL is <100 mg/dl
                              Apo b  is 80 mg/dl for LDL  = or <  70 mg/dl
   
       * Non HDL cholesterol is another way of evaluating risk .  It is  another calculated 
          number.          Cholesterol - HDL  =  Non HDL Cholesterol 
          This number represents all of the other various forms of cholesterol such as IDL ,LDL
           and VLDL that are generally up to no good. 
           The target goals for: 
                      non - HDL cholesterol is <130 mg/dl if the LDL  is  = or < 100 mg/dl 
                      non-HDL cholesterol  is < 100 mg/dl if the LDL is < 70 mg/dl
              
            your calculation is; Cholesterol 161 - HDL 49 = Non HDL cholesterol is 112 mg/dl 
         
       * Your HDL and cholesterol are in a low risk range. 

Your lab test suggest that you are low risk for cardiovascular disease now. I would suggest starting to make some lifestyle changes and repeating your lipid panel in 1 year.

Switching towards a Medaterreanean style eating habits is a good way to preserve your good health. I have attached a simplified version that I can remember and have found useful.  (Holidays are exempt ). I have difficulty including  legumes daily and 2 cups of vegetables , 4 bean salads and V8 juice has helped. I also don't care for fish and have generally stopped eating meat because I like the animals more than I like their meat . This does not mean that I will pass up an occasional hamburger or steak.

 I think the article below is from WEB MD. The dietitian who wrote this did a good job.

The Mediterranean Diet: What It Is
Some experts consider the "Mediterranean diet" -- rich in plant foods and monounsaturated fats -- to be one of the healthiest in the world. The Mediterranean diet has long been associated with heart health and longevity. Beyond that, it can also be an excellent weight loss plan, as long as you eat in moderation.
The Mediterranean coastal region stretches across Europe from Spain to the Middle East. Fifty years ago, scientists noticed that people living in this region tended to be healthy and live long lives, primarily because of their diet and lifestyle. Mediterranean cuisine varies by region, but is largely based on vegetables, fruits, olives, beans, whole grains, olive oil, and fish, along with a little dairy and wine. Additionally, the Mediterranean lifestyle includes leisurely dining and regular physical activity.
Studies show that calorie-controlled diets rich in plant foods, healthy fats, and lean protein -- like the Mediterranean diet -- are a nutritious formula for weight loss. A study in the New England Journal of Medicine found that a Mediterranean diet was as effective as a low-fat diet for losing weight and also offered some metabolic benefits.
"Research continues to demonstrate that being physically active and eating a nutritious diet of primarily whole foods that are filling and satisfying can enable people to control weight," says cardiologist Arthur Agatston, MD, creator of the South Beach Diet, which is based on the Mediterranean diet model.
Some other perks of living the Mediterranean lifestyle include a reduced risk of chronic diseases such as diabetescancerAlzheimer's and heart disease, says cardiologist Robert Eckel, MD, past president of the American Heart Association.
Mediterranean Diet: What You Can Eat
There is not a single "Mediterranean diet." Instead, it's a dietary pattern of plant foods, monounsaturated fats (mainly olive oil), fish, and limited amounts of animal products.
The basic Mediterranean diet pattern is as follows:
  • Legumes: Eat daily.
  • Fruit: 2.5 cups daily.
  • Vegetables: 2 cups daily.
  • Fish: More than twice weekly.
  • Nuts: A handful daily.
  • Meat/poultry: Less than 4 ounces daily.
  • Dairy products: 2 cups of a low-fat variety daily.
  • Wine: 1 daily serving for women, two for men.
  • Fats: Use primarily monounsaturated fats.
  • Eggs: Less than 4 per week.
Some tips for embracing the Mediterranean style of eating:
  • Select whole grains for your breads, cereals, and other starches.
  • Choose nuts, seeds, legumes, fish, low-fat dairy, and poultry to satisfy your protein needs (you can include lean meat on occasion as well).
  • Most importantly, reduce the amount of saturated and trans fats in your diet. Use olive or canola oil instead of butter or margarine.
  • If you choose to drink alcohol, enjoy it as a glass of wine with lunch and/or dinner.
"It's almost too good to be true -- a steaming pasta dish with tomato sauce and herbs, or a grilled piece of snapper drizzled with olive oil and fresh cracked pepper, or a great salad of greens, tomatoes, a crumble of Parmesan, and a drizzle of olive oil and lemon," says K. Dun Gifford, Oldways Preservation Trust president. "Scientists report these dishes are as healthy as it gets."

    1 comment:

    1. This blog is great source for Medium Chain Triglycerides information which is very useful for me. Thank you very much.


      triglycerides level

      ReplyDelete

    Your comments and questions are appreciated. David Calder,MD