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IHOR MAGUN, M.D., F.A.C.P. ANSWERS YOU ALWAYS WANTED TO KNOW ABOUT CHOLESTEROL A substantial amount of information exists on cho lesterol and this information can become confusing. Questions as — what is considered a good cholesterol level, what are the HDL and LDL levels are always asked. We will address these questions and make cer tain recommendations. Cholesterol is a colorless, waxy substance and a necessary component of every body cell. Its attachment to certain proteins in the blood make it dissolve. These protein-cholesterol complexes are called lipoproteins. Cholesterol is carried on three different lipoproteins — very low density lipoproteins VLDL, low density lipopro teins LDL, and high density lipoproteins HDL. LDL is the major carrier of cholesterol and when elevated deposits cholesterol on the walls of the blood vessels. This is frequently referred to as the “bad” cho lesterol. HDL is the ’’good” cholesterol in that it removes cholesterol from tissues and arteries and then carries it to the liver for removal from the body. Hence, a high level is desired. VLDL mostly transports triglycerides, another fat, and increased blood triglycerides are usu ally associated with high VLDL levels. The VLDL levels are usually not obtained. It is important to know your cholesterol level. The ideal cholesterol level for everyone over age twenty is 200 mg/dl or less. If it is high, the LDL and HDL and triglycerides need to be measured as well. The National Cholesterol Education Program (NCEP) sets recommendations and classifies risk fac tors other than LDL cholesterol. Positive risk factors include: (1) age-males greater than 45 years old or females greater than 55 years old or premature meno pause without estrogen replacement treatment, (2) fam ily history of heart disease, usually before age 55 in first-degree male relatives or before age 65 in first- degree female relatives, (3) cigarette smoking, (4) dia betes, (5) hypertension (blood pressure above 140/90 mg Hg) or on hypertension medication, (6) low HDL (less than 35). Negative risk factors include a high HDL cholesterol, and if it is greater than 60 mg/dl, subtract one risk factor because high HDL cholesterol levels are associated with low coronary heart disease risk. The guidelines are as follows: (A) For individuals with no heart disease and with fewer than two other risk factors, the goal of LDL should be less than 160 mg/dl. (B) For individuals with no heart disease with two or more risk factors, the goal of LDL should be less than 130 mg/dl. (C) For individuals with heart disease the goal of LDL should be less than 100 mg/dl. The reason the cholesterol levels should be known and addressed is that it is one factor that will reduce the risk of heart disease and heart attacks. Dietary control is often necessary as well as weight control, however, proper diet along with medications is usually needed and must be evaluated and prescribed by a physician knowledgeable in the treatment protocol. If you are motivated to do something positive for your health, start by avoiding foods rich in saturated fat and cholesterol (read the labels). Some foods actually help lower the cholesterol level. These include soluable fiber food such as oat bran. Being overweight often keeps the cholesterol level elevated, so weight loss is recommended. One final note — many people have a genetic pre disposition to high cholesterol and need close medical attention. These include individuals who eat correctly and are not overweight. Cholesterol control is a team effort — the medical team and the patient must work together. Play an active role in your life and make it a positive difference. time, building columned temples, a theater, a parliament building, even a bath house. When Constantine became emperor, he considered making the place his capital. But, when all was said and done, he decided that an earthquake-prone and malaria infested Troy number X just wouldn’t do. He made his name and his own history elsewhere. And so, all the Troys were abandoned and forgotten by everyone except a few nomadic sheepherders until the enterprising Schliemann decided to make his fame and fortune by proving that Homer was not just a good storyteller. And then the Turks discovered tourism. Now the buses roll between Canakkale and Troy on a more or less regular schedule. The visitor is casually advised to take the three o’clock bus back to Canakkale because the five o’clock bus may not come until the fol lowing day. Not far from where Achilles fell there is a little cafe-bar that serves good Turkish tea and muddy Turkish coffee. And just next door, almost an after thought, one finds a little gift shop with ticky-tacky knick-knacks vying for space with exquisite handwoven rugs. The best sellers, of course, are the little statuettes of the wooden horse, or, for those, who like to travel light, postcards of the same (Originally published in Four Quarters) Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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