From: abulsari@aton.abo.fi (A. Bulsari)
Subject: Cholesterol
Organization: Abo Akademi University
Date: Sat, 7 Nov 1992 09:55:07 GMT


I got this from: Michael Traub <traub@btcs.bt.co.uk> a few months back.
It probably originates from Ferrell Wheeler.


CONTROLLING CHOLESTEROL

     Almost every adult  in the  industrialized  nations develops some
degree  of  atherosclerosis,  commonly  known  as  "hardening  of  the
arteries." In the United States, many children have  fatty streaks, or
"pre-atherosclerosis,"  in their  arteries. Atherosclerosis  leads  to
strokes,  heart attacks, and other  serious problems. But food choices
can  greatly  reduce  one's risk of heart problems.  Heart  disease is
linked  to  risk  factors.  The  principal   risk  factors   are  high
cholesterol levels,  smoking, and high blood  pressure.   Others  risk
factors  include: diabetes, obesity,  family history of heart disease,
and stress. Here is an overview of  how food choices can  affect one's
cholesterol level:
     Every   animal  cell,   both   human  and   non-human,   contains
cholesterol.  Cholesterol is important in some cell functions, and the
liver produces all of the cholesterol the body needs. There is no need
to consume any in one's diet.
     Cholesterol and fats  move through  the body in  protein packages
called lipoproteins. Low density lipoproteins (LDLs) carry cholesterol
to  the  organs through  the arteries. The  LDLs  deposit  their loads
through the inner  walls of  the arteries. This process encourages the
growth of deposits, called plaques, on  the  artery walls which narrow
the artery and obstruct the flow of blood. This is atherosclerosis. If
the blood flow to the  heart is blocked, a heart attack can occur.  If
the blood flow to the brain is blocked, a stroke can occur. Since LDLs
promote  atherosclerosis, they are known  as  "bad  cholesterol."  The
higher the LDL level, the higher the risk of heart problems.
     "Good cholesterol," found in  high  density  lipoproteins (HDLs),
moves  back to the liver where it is disposed of. People who exercise,
don't smoke, and stay at their ideal weight tend to have higher levels
of HDLs.  Since  the majority of cholesterol is in the form of LDLs, a
high blood cholesterol level means high  LDL levels. Blood cholesterol
levels are affected by many factors. But even people with a hereditary
tendency toward heart disease can do something about their cholesterol
levels.  This  is  very  important  because  with  every  one  percent
reduction  in total blood cholesterol  there  is about  a  two percent
reduction in  the risk  of  heart  attack.1 Population groups  with an
average  cholesterol  level  of  150  or  less  are  largely  free  of
atherosclerosis. For cholesterol levels above  150, the  risk of heart
disease increases.2 The  following are some  guidelines  for  lowering
blood cholesterol:

* Decrease Fat Intake, Especially Saturated Fats
     Saturated fats  raise cholesterol levels, but  they  are easy  to
avoid.  Saturated fats are solid at room temperature.  Saturated  fats
are found predominately in animal products but are also found in a few
vegetable  oils  such  as  palm  oil,   coconut  oil,  chocolate,  and
hydrogenated oils.

* Decrease Cholesterol Intake
     Cholesterol in foods increases  levels  of  LDLs.3 Cholesterol is
found  only in animal  products.  Meat, fish, poultry, dairy products,
and  eggs  all  contain  cholesterol, while  plant  products  do  not.
Choosing lean cuts of meat is not enough; the cholesterol is mainly in
the  lean  portion. Many people are surprised to  learn  that  chicken
contains  as much cholesterol as beef.   Every  four-ounce  serving of
beef or chicken contains 100 milligrams of cholesterol. Most shellfish
are very high in cholesterol.  There is  no  "good cholesterol" in any
food. Cholesterol  in  foods  raises the cholesterol  level  in  one's
blood. The best thing to do  is to keep one's  fat intake very low and
to avoid all animal products.

* Go Vegan
     As suggested  above, basing one's  diet  on plant  foods--grains,
beans,  vegetables, and fruits--is the best way to keep saturated  fat
intake low and to avoid cholesterol  completely. A vegan diet is  free
of all animal products and  yields the lowest  risk  of heart disease.
One  study has  shown  that people who adopt  a vegetarian diet reduce
their  saturated fat intake by 26 percent  and achieve  a  significant
drop in blood cholesterol levels in just  six weeks.4 Besides the very
low  levels  of fat eaten  in  a typical  vegetarian  diet,  vegetable
protein also helps decrease risk for heart disease. Studies have shown
that   replacing  animal  protein  with  soy   protein  reduces  blood
cholesterol levels even when the total amount of fat and saturated fat
in the diet remain the same.5

* Fiber, the Added Advantage of a Vegetarian Diet
     Soluble  fiber  helps  to   slow  the  absorption  of  some  food
components such as  cholesterol. It  also acts to reduce the amount of
cholesterol the liver makes. Oats, barley, beans,6 and some fruits and
vegetables are all good sources of soluble fiber. There is no fiber an
any animal product.

* Maintain Your Ideal Weight
     Losing  weight   helps  to   increase   HDL  levels  (the   "good
cholesterol").  But also where  one  carries  excess weight can affect
one's risk for heart disease.  People  who are thick around the middle
("apple-shaped") are at  a higher risk than  those  who  carry  excess
weight  around  the hips and buttocks ("pear-shaped").7 "Apple-shaped"
people should lose weight through a low-fat diet and aerobic exercise.

* Eat Lots of Small Meals
     People  who   eat  frequently  throughout  the  day   have  lower
cholesterol levels. In  one study, men  consumed  either three meals a
day or seventeen snacks a day. The snackers experienced a reduction in
cholesterol levels in comparison to the three-meal-a-day group.8

* Reduce Stress
     Mental stress causes an increased release of adrenaline which may
elevate  blood  cholesterol  levels.  Relaxation  techniques  such  as
stretching,  deep breathing,  or  meditation  help  in lowering  blood
cholesterol.

* Exercise
     Aerobic  exercise  raises levels  of HDL-cholesterol and may also
reduce levels of LDLs. Exercise also has other benefits for the heart:
it strengthens the heart  muscle,  promotes  weight  loss,  and lowers
blood pressure. Exercise  can  also help reduce stress. Exercise  does
not have to be terribly vigorous. A daily half-hour walk is helpful.

* Avoid "Miracle Cures"
     Some  people have been promoting fish oil  supplements as a means
to reduce blood  cholesterol. However, studies show  that they do  not
lower cholesterol levels. While they may affect triglycerides (fats in
the blood), they also may  change the overall pattern of  lipoproteins
in one's blood in a way that is not beneficial.9 A diet including fish
is not so beneficial as a pure vegetarian diet.
     There have also  been reports that alcohol raises one's levels of
HDLs. But recent  studies have shown that alcohol  does  not raise the
type of  HDL that  protects  against  heart disease. Alcohol does  add
extra  calories to  the diet and increases the risk  for some forms of
cancer.

* Avoid Tobacco
     Tobacco poisons one's heart as well as one's lungs.

* It's All Tied Together
     In order to  stop and to reverse atherosclerosis, it is important
to take all  of these guidelines to heart.  Making only modest changes
yields  only modest results.  A low-fat, vegetarian diet coupled  with
exercise,  stopping smoking, and stress reduction programs is the best
way  to  lower  one's  cholesterol  levels  and can even reverse heart
disease for many people.10 Well-documented information can be found in
Dr. Dean Ornish's Program for Reversing Heart Disease, by Dean Ornish,
MD.

References:
1. National Institutes of Health Consensus Development Conference Statement.
Lowering Blood Cholesterol to Prevent Heart Disease.
2. Pooling Project Resource Group. Relationship of blood pressure, serum
cholesterol, smoking habit, relative weight and ECG abnormalities to
incidence of major coronary events: final report of the Pooling Project. J
Chronic Dis 1978;31:201-306.
3. Johnson C, Greenland P. Effects of exercise, dietary cholesterol, and
dietary fat on blood lipids. Arch Intern Med 1990;150:137-141.
4. Masarei JRL, Rouse IL, et al. Vegetarian diet, lipids and cardiovascular
risk. Aust NZ J Med 1984;14:400-404.
5. Carroll KK, Giovannetti PM, et al. Hypocholesterolemic effect of
substituting soybean protein for animal protein in the diet of healthy young
women. Am J Clin Nutr 1978;31:1312.
6. Swain JF, Rouse IL, et al. Comparison of the effects of oat bran and low-
fiber wheat on serum lipoprotein levels and blood pressure. N Engl J Med
1990;321:929-34.
7. Krotkiewski M, Bjorntorp P, et al. Impact of obesity on metabolism in men
and women: importance of regional adipose tissue distribution. J Clin Invest
1983;72:1150-62.
8. Jenkins DJA, Wolever TMS, et al. Nibbling versus gorging: metabolic
advantages of increased meal frequency. N Eng J Med 1989;321:929-34.
9. Grundy SM, Denke MA. Dietary influences on serum lipids and lipoproteins.
J Lipid Res 1990;31:1149-72.
10. Ornish D, Brown SE, et al. Can lifestyle changes reverse coronary heart
disease? The Lancet 1990;336:129-33.

From Physicians Committee for Responsible Medicine
P.O. Box 6322
Washington, DC 20015
(202) 686-2210