Cholesterol - WKTV Journal

By Rick Jensen, Spectrum Health Beat

The nation’s top nutrition panel may be changing its tune when it comes to an earlier recommendation of avoiding eggs and other cholesterol-rich foods, but not all doctors agree.

A preliminary report released in 2014 noted that “cholesterol is not considered a nutrient of concern for over-consumption,” meaning it might matter less how much cholesterol is in the foods we eat.

That doesn’t mean people should go wild with a pound of bacon each morning.

Thomas Boyden, MD, a Spectrum Health cardiovascular physician, said he believes diet and exercise are two of the most important components of cholesterol management.

“I am 100 percent for patients doing everything they can for themselves and ultimately taking responsibility for their own health,” Dr. Boyden said. “If patients were more focused on diet and routine aerobic activity, many would realize they have the opportunity to improve their overall health and reduce their chance of heart disease and stroke, potentially without the need for medications.”

Dr. Boyden said some people have inherent genetic risks or other illnesses and are at higher risk than others. These patients oftentimes cannot fix their cholesterol numbers with diet and exercise alone, so he advocates for medication in these cases.

If you have high cholesterol, here’s what you need to know:

Worst foods

Avoid fatty foods, but know that not all fat is bad fat. The worst are trans fats and saturated fats, which are mostly found in processed foods and fatty meats. Eating less of each of these will benefit a patient’s cholesterol levels. Beef and red meats should be consumed in moderation.

Best foods

Try to eat a balanced diet rich in fruits and vegetables and non-animal based proteins. Soy products, beans and fish (which has a better fat composition than other animal products) are all great to incorporate into your diet. Introducing fish into your diet a couple times per week can make a noticeable difference.

Activity

The more aerobic activity you can work into your routine, the better. Moderate aerobic activity is less likely to affect weight loss, but it can lower cholesterol and blood pressure, and helps control blood sugar. Exercise improves mental capacity, makes bones strong and improves mood. Any exercise is helpful, so don’t feel that you need to train like an athlete. Just 20–30 minutes per day of moderate activity has proven benefits. The key is to get your pulse and breathing elevated, but there is no need to push yourself to extremes.

Family history

It is important to know family history and whether you have a higher disposition to illnesses and risk factors. Are you overweight? Do you have diabetes or high blood pressure? And do any of these conditions run in your family? Talk to your doctor about how your genetics could affect your health now and in the future.

Treatment

If you have high cholesterol, high blood pressure and/or diabetes, it’s important to speak with a physician to create a personalized treatment plan that works for you. Your doctor can conduct an individualized risk assessment and help you determine what might work best for you.

Screenings

Learn about the effects of cholesterol on your health at a free vascular screening. To qualify for a free screening, you must have at least two of the following risk factors:

Diabetes
Age 60 or older
Hypertension
History of smoking
High cholesterol
Family history of abdominal aortic aneurysm
Family history of atherosclerosis before age 60

Reprinted with permission from Spectrum Health Beat.

Familial hypercholesterolemia can be diagnosed with a simple blood test and a look at family history. Genetic testing can confirm the diagnosis. (Courtesy Spectrum Health Beat)

By American Heart Association, HealthDay

High cholesterol is a risk factor for heart disease, but not all forms of it are the same.

An underdiagnosed genetic condition called familial hypercholesterolemia can cause dangerously high levels of cholesterol at an early age.

While scientists have determined familial hypercholesterolemia is caused by genetic mutations that affect the body’s ability to remove LDL, or “bad” cholesterol, they haven’t pinned down all the genes involved for nearly 1 in 3 people who have it.

But that may be beginning to change.

Scientists presented preliminary research at the American Heart Association’s Vascular Discovery conference in Boston this week showing more clues to the genetic roots of familial hypercholesterolemia.

National Heart, Lung, and Blood Institute researchers screened 19,114 genes and identified transgelin as one of the genes of interest. Previous studies have found this gene could be associated in LDL metabolism.

When researchers disabled the gene in cells, some cells tried to compensate.

“The cell tries to make more cholesterol because cholesterol is vital for the cell to survive,” said Diego Lucero, the study’s lead author and a postdoctoral fellow at the institute. “Understanding this is important because it might have impacts on the magnitude of the clinical presentation of the disease.”

People with familial hypercholesterolemia are exposed to chronically high levels of LDL from an early age and their risk for premature heart disease is 20 times greater than the general population, according to the Familial Hypercholesterolemia Foundation.

Over time, the condition can lead to atherosclerosis—the buildup of plaque and narrowing of artery walls. As a result, signs of heart disease can show up decades earlier in people with familial hypercholesterolemia compared to the general population.

The condition affects approximately 1 in 250 U.S. adults. Yet, it remains largely underdiagnosed and undertreated.

“Less than 10 percent of those who have (familial hypercholesterolemia) have actually been diagnosed, which leads to a lot of premature morbidity and mortality,” said Dr. Samuel Gidding, chief medical officer for the foundation.

Someone who carries the altered gene has a 50% chance of passing it on to their children.

Yet, the challenge is diagnosing familial hypercholesterolemia.

Health care providers may not understand the difference between general high cholesterol and familial hypercholesterolemia and may not screen high-risk people, said Gidding, who was not involved in the new study.

Familial hypercholesterolemia can be diagnosed with a simple blood test and a reported family history of cardiovascular disease. Doctors look for LDL levels over 190 in adults and over 160 in children, and onset of heart disease before age 60 in men and before 50 in women. Genetic testing can confirm the diagnosis.

Once identified, there are effective ways to treat the condition, Gidding said. Early treatment with medications, as well as maintaining a heart-healthy lifestyle, can lower the risk of premature heart attacks and strokes.

The new research and further work identifying new genes involved in the development of familial hypercholesterolemia could lead to better diagnosis and treatment, Gidding said.

“Anytime an individual gene like this could help explain variations in lipid level, it could be a drug target.”

Reprinted with permission from Spectrum Health Beat.