Lots of good info here! Very well said and described, MJ, Bucky, mouse and Mudbug! And your suggestion on remembering the difference in the two is very helpful, bug!
ITK, FIRE your doctor and find a new one!! That is one blessing the US offers us as an option to incompetence, which some of our neighbors in this world would give anything to possess. Doctors, secretaries, chefs are all first people. Some are captivated by their professions and strive constantly to learn more and do better, and others have a capacity to become apathetic. They’re just people. It's too bad you have to endure the trial and error process until you find one that "fits," but you do.
By no means am I an expert in nutrition or cardiology, but I do know a thing or two, especially about the aftermath of a few years of high cholesterol and its effects upon this body of ours. So here are a few facts for you guys to “chew” on…
Cholesterol does three very bad things to us humans:
1. Cholesterol is what forms the lipid core of the plaque that gets deposited on the interior walls of our arteries, narrowing them down, day after day, making our hearts work that much harder to supply blood to our entire body. Over the course of a few years, that heart gets pretty tired of working harder and harder each successive day.
2. Cholesterol also plays a role in what we call “foam cells” that tend to destabilize chunks of the plaque and cause them to dislodge from arterial walls, float into a chamber or valve and directly lead to a heart attack.
3. High levels of lipids in the blood after a single fatty meal cause platelet aggregation, meaning they stick together into dense clusters, along with some other blood products naturally attracted to the nasty lipids, which can and do get snagged upon scaly plaque lining an artery and cause an obstruction. This is referred to as a thrombosis, which is a lot like a clot, but different because of its specific cellular composition. Thromboses are most unpleasant and cause a lot of problems, to say the least.
As MJ pointed out, these spectacular machines known as our bodies produce their own cholesterol naturally, and this amount is all that our bodies need or want based upon the kind of diets we eat and the amount of regular exercise we get that consumes fat, which is merely a fuel source, if you will. All the extra cholesterol, whether we eat it or produce it ourselves, gets deposited in the bloodstream to wreak havoc within the cardiovascular system. Either you are a closet Nutritionist, MJ, or you have one in the family because your list of foods was right on the mark! Ironically, game meat, be it elk, moose, deer, bear, whatever is exceptionally low in fat, as I understand it. I would certainly appreciate some of our experts in game meat to comment on that before the weekend’s up and the keyboard is pried from my DiscussCooking fingers!
MJ, I would amend those road mark levels you cited a wee bit, if I may. The risk from cholesterol begins to rise after a serum cholesterol (LDL) level of 160 in men, and 190 in women. The MEDIAN serum cholesterol of the average person with a Myocardial Infarction (heart attack) in the US, before the attack happens, is 240. (You can’t look at cholesterol levels during or shortly after an MI, of course, because the MI itself causes levels to go down for a while.)
Again, half of the people who are going to have heart attacks this month in the US will have a serum cholesterol level BELOW 240, and a great number of those will be dancing just under and just above the 200 mark! Anytime I hear some nut chirp about how people have heart attacks with no risk factors (LDL below 150, doesn’t smoke, semi-vegetarian diet, regular exercise, unremarkable family history) makes me want to swat them for the misinformation! There is another critter known as a homocysteine that is a reknown culprit. But I’m getting a little over-technical here. Suffice it to say cholesterol alone is a very large part of an incredibly huge picture in heart health.
Generally speaking though, most people are much more likely to die of cancer than an MI or Coronary Artery Disease (CAD) if their serum cholesterol level remains below 150. Rarely, very rarely are MI's seen in that neighborhood and people in that range almost always have great plumbing, too.
It is true that the major determinant of cholesterol blood levels is saturated fat intake. However, dietary pre-formed cholesterol, and particularly pre-formed oxidized cholesterol, also raises cholesterol blood levels, but nothing to the extent that saturated fats do.
Vegetables, as a rule, have zero cholesterol, yet many a 100% VEGAN has high cholesterol. Why? GENETICS!! Those DNA road marks called genes control precisely how your individual body deals with cholesterol and everything else, which is why family medical histories are so very important to maintain. In the case of a total vegetarian, it is quite possible for one to have bad enough genes to make too much cholesterol. The extra overflows into the blood stream and whamo, plaque! Also, there was a study done on a African tribe of hunters (I believe) that consumed some 1500-1800 grams of fat daily and had LDLs below 100. Why? GENETICS and EXERCISE! No cars or even electricity in their world. These are extreme examples, but I hope you understand my point in making them.
For a little light reading on the subject, go to http://www.framingham.com/heart/
and read a little of the Framingham Study, one undertaken over the course of 50 years. It is a required course of study for any medical student because it completely redefined heart health and was the impetus behind the very birth of common day cardiac care in the US and far, far beyond. Another worthy of review, for those of you so inclined, is the China Health Study, a massive study completed about 12 years ago of a very large semi-vegan population whose “average” total cholesterol was only 150 mg/dl and with data down to 90 mg/dl or so, and you see something interesting: no coronary disease deaths, but a strong correlation with infectious diseases like pneumonia. I don’t have a link to that one, but I’d bet it would be found easily with google.
In a perfect world, I would want someone to keep their serum levels between 150 and 160, but that’s almost impossible in the common American lifestyle. To do it, you need a balanced low-fat diet with a predominance of vegetables and fruits and grains, utilizing some poultry, fish and game meat, and much less beef and pork especially, coupled with exercise...REAL rounded, structured exercise, not just a daily walk around the neighborhood. Because of this, it’s just easier and more achievable for most folks to be given meds, usually statins, to reduce cholesterol levels. Despite the controversy with Baycol’s recall (which I call a “me-too statin” that was rushed onto the market without the long, multi-year study done on its predecessors), death is the greatest side-effect of high cholesterol and we have meds that successfully reduce that death rate. Most cardiologists I know stick to the better-tested statins like Mevacor, Zocor and Pravachol. I long for the day when Diabetics have such a handy tool available!!!
ITK, a glass of red wine a day has been strongly supported in good clinical trials as very helpful to the cardiovascular system. Part of this could be the alcohol that somewhat reduces plaques in atherosclerosis (hardening of arteries). And red wine has an extra large effect, probably from the bioflavonoids (the stuff in the wines that makes them red) that inhibit platelet aggregation, which is an important step in atherogenesis. That's the presumed mechanism, but nobody knows for certain yet (I don't think...).
Sorry to take up so much real estate, folks! I hope you find some of this helpful…