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(HealthNewsDigest.com) – Watching you cholesterol is important. Your total cholesterol number is an indicator to your doctor about what is going on regarding your risk for heart disease. But your total cholesterol number alone is not the entire story. If your number is high, it is a warning to you and your doctor to dig a little deeper into your risk profile. Heart disease is still the number 1 killer of men and women in the US, 60% will have a heart attack or stroke and one-third will die of a heart attack or stroke.
All that being said, there is a good deal you need to know beyond your total cholesterol number. For decades Americans have been cautioned not to eat too much cholesterol and they have been told to work at lowering both their total cholesterol and LDL cholesterol. And, you are told to fast after midnight on the day you get your cholesterol tested. A good deal of this information has changed and you may not be up-to-speed on the latest advice by the experts.
Let’s start with getting your cholesterol tested. There is no need to fast to get accurate values. Fasting can be difficult when you have diabetes or an appointment later in the day. A study just published in the European Heart Journal involving more than 300,000 people in the US, Canada and Denmark showed that you do not need to check your cholesterol on an empty stomach. In fact, all values – total cholesterol, HDLs, LDLs, triglycerides – were similar whether the person fasted or not. Denmark has been using non-fasting blood samples since 2009 and now 21 medical experts from Europe, Australia and the US agree with this approach.
Should you watch how much cholesterol you eat? Most countries do not put a value on how much cholesterol to eat daily. The 2015 Dietary Guidelines for Americans finally agree with this consensus and no longer recommend that American eat 300 milligrams of cholesterol or less daily. Why? We now know that dietary cholesterol does not directly translate into blood cholesterol. Cholesterol is made in the liver and the driver of this production is the amount of saturated fat and trans fat we eat, not the cholesterol in food.
The latest approach to preventing heart disease is to focus on lifestyle changes first – maintaining or achieving a healthy weight, not smoking, being active daily, and controlling blood pressure. Ideally, young and middle-aged adults are the best targets for a healthy lifestyle approach. Achieving a healthy lifestyle could prevent the use of medications to reduce heart disease risks. However, when medications are needed they should not be considered a cure. They are simply a part of the total prevention pyramid for heart disease.
Who is at the greatest risk for heart disease and how do you know where you stand? The American College of Cardiology and the American Heart Association have developed an online risk calculator (http://tools.acc.org/ASCVD-Risk-Estimator/) which you and your doctor can use to begin a discussion about whether you need medication and which would be most effective for you. The calculator takes into account well-established risk factors for heart disease and stroke, including age, sex, race, blood pressure, diabetes, smoking status, and total and HDL cholesterol.
For those who have already suffered a heart attack or stroke, with diagnosed cardiovascular disease, with a genetic predisposition to elevated LDL cholesterol, or those with diabetes and elevated LDL cholesterol appropriate medication such as statins are warranted. For others, lifestyle changes might be a first step in prevention with drugs as a backup if goals cannot be achieved through healthy habits alone.
This new approach to risk assessment and treatment gives lifestyle changes a chance to work. Often when someone is given a realistic estimate of their risk for heart disease or stroke they are willing to take the steps needed to make changes.
For more information on evaluating your risks and making healthy lifestyle changes to lower your risk for heart disease you might want to take a look at one of my latest eBooks, the Fat and Cholesterol Counter available from iTunes and Amazon/Kindle.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of 30 books. Available as eBooks from iTunes and Kindle/Amazon:
Diabetes Counter
Calorie Counter
Protein Counter
Healthy Wholefoods Counter
Complete Food Counter
Fat and Cholesterol Counter
Available in print from Gallery Books:
Most Complete Food Counter, 3rd Ed.
Your Complete Food Counter App: http://itunes.apple.com/us/app/your-complete-food-counter/id444558777?mt=8
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com.
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