It’s “back to school” time! I have even seen some early leaves turning their colors. Let’s celebrate our health and wellness together this harvest season. One of the ways you can actively participate in your health maintenance is to get routine screening blood work each year (CBC, Comprehensive metabolic & lipid panel, thyroid panel). The fall is a great time to do this as the family gets back into a routine and prepares for the winter months. Bring it to your next appointment at Bambú so that your doctor can evaluate it.
Cholesterol: Truths & Myths…
These fundamental screening tests can illuminate a lot about a person’s overall health and health risks, but this month we will focus on debunking some common myths about cholesterol and lipids. In the past 20 years, cholesterol has almost become a dirty household word. The prevailing opinion is that cholesterol is always harmful, especially the BAD cholesterol. But, 90% of your cholesterol is produced inside of your own body, not absorbed from food sources. Since your body makes it, we would like you to understand its function and purpose. By learning this, you will begin to recognize when cholesterol is doing its job in a beneficial way and when its presence is harmful (and why).
There is a type of lipid, the triglyceride, which reflects dietary choices more closely than cholesterol. This number indicates carbohydrate intake. Other than that specific number, your diet can obviously impact cholesterol levels in your blood by influencing body chemistry, but very little of that effect is directly from dietary absorption. First and foremost, cholesterol has three main purposes in the body: to fight inflammation, to create fluidity in cell membranes, and to provide the backbone for the majority of our hormones. Without cholesterol, you would not have the necessary levels of crucial hormones in your system. Your sleep, menstrual cycle, energy, blood sugar regulation, blood pressure, and mood would all suffer. In fact, studies show that patients with extremely low levels of cholesterol have significantly higher rates of suicide than their counterparts with higher numbers. In addition, cholesterol embeds itself in every cell membrane and “breaks up” the tight associations between other membrane particles. This interruption gives the membrane “fluidity” and allows for items to cross the barrier more easily. This role in human physiology is VERY important because it allows essential nutrients to enter the cell and toxic waste products to exit. Without cholesterol, our cells would be much less porous and the removal of wastes would be less efficient.Perhaps most important, though, cholesterol fights inflammation in the body and, as we have discussed in earlier issues of this healthletter, chronic persistent inflammation is a primary underlying contributor to all degenerative illnesses. So, while the current wisdom is that cholesterol causes cardiovascular disease and plaques in the coronary arteries, if you consider that cholesterol fights inflammation, you will find an alternative explanation. Harmful oxidative substances cause inflammation of the arterial walls. The body produces higher levels of cholesterol to patch these irritations and reduce the inflammation. So, when the cardiologist looks, he/she sees cholesterol, but the lipid is there to help resolve the underlying issue. It is not itself the problem. Two questions, then, remain…
Q&A
- Is there an inherent problem with high levels of cholesterol? And, if so, what is the ideal range?
Ideally, total cholesterol should remain within the range between 160-200 mg/dl. But, more important than this number is the ratio between this value and the HDL level. At Bambú, the physicians feel that this ratio should be around 3 or below. So, that means it is better to have a total cholesterol of 250 mg/dl and an HDL of 80 mg/dl than it is to have a total cholesterol of 180 mg/dl and an HDL of 40 mg/dl. In addition, it is important to keep your triglyceride level (the one determined by diet) low.There is nothing inherently wrong with higher levels of cholesterol, but if your numbers do not fall within this ideal range, it is important to work with your doctor to investigate why your body is producing more cholesterol than is necessary. It might be an indicator of unresolved inflammation that you need to deal with. Or, some people have an inherited familial predisposition to high lipid levels. In this case, more aggressive prevention of cardiovascular plaques is imperative in a good health maintenance plan.
- How should one evaluate and treat this underlying inflammation?
As mentioned, the basic blood work screen includes a Complete blood count, comprehensive metabolic and lipid panels, and a thyroid panel. If you have a family history of high cholesterol, high blood pressure, stroke, diabetes, or heart disease, it might be wise to speak to your doctor about adding an evaluation of your inflammatory markers. Your risk increases if your same sex parent has had a heart attack before the age of fifty.These include… Fibrinogen, C-reactive protein, Homocysteine, and Lipoprotein A. Great Smokies lab offers a very comprehensive panel to evaluate overall inflammatory and cardiovascular risk that includes all of these tests.Treatment for chronic inflammation will vary from patient to patient and require a thorough evaluation by your doctor. But, castor oil packs, the anti-inflammatory diet, essential fatty acids, probiotics, exercise, and deep breathing are a great start to reducing your overall inflammatory burden.
The Skinny on Dietary Fats
Up to this point, we have only addressed the fats that float around in your blood. Now, we will talk about the fats that you put into your mouth. A lot has been made recently of this topic. The basic point is that saturated fats directly increase cholesterol levels in your blood, trans fats cause the inflammation of blood vessels that calls on the body to produce more cholesterol and a mixture of mono- and poly-unsaturated fats are the most protective of your cardiovascular health. So, look for oil options that integrate the flavor you are searching for with a healthy combination of unsaturated fats. Olive oil, obviously, is great to cook with or for salads. But, coconut oil is a better option to cook/bake with as it withstands higher temperatures without producing harmful residues. Other common oils include hazelnut, walnut, and sesame oils. Most nut oils have wonderful unique flavors, but are not safe to cook with. At high temperatures, they become rancid and can cause oxidative damage once ingested. To make a great spreadable fat for breads, combine ¼ cup butter with ¼ cup olive oil and mix. This solution cuts the level of saturated fat from the butter, but preserves the flavor.
We hope you found this information helpful. We strive to help our patients find a healthy way in the world. If you have topics you’d like us to address in future issues please let us know. We are always available for questions and comments.
Warm Regards,
The Physicians of Bambú Clinic