Many of the forum members and IronOnline site readers are in the 50-year-old age bracket, making heart health, specifically cholesterol, a common topic around here. It’s a difficult one, too, because not only is there a good deal of money-making advertising going on, there’s honest disagreement among the research scientists.
Yet the Framingham Heart Study documenting patients since 1948 reports that 80% of cardiovascular disease patients, those with coronary arterial damage, have normal cholesterol numbers. Secondly, at least half of all clogged arteries don’t fit the standard risk factor mold. There’s simply more to this than those 30-second tv spots can tell.
Here’s an overview of cholesterol testing and treatment, and here’s a reminder how vital cholesterol is to our functioning bodies.
Several things we do know that we didn’t know just a few years ago:
~There’s a lot more to the cholesterol story than the two numbers (LDL, the low density lipoproteins, aka lousy cholesterol) and HDL, the high density lipoproteins, aka the healthy cholesterol). There are sub-particles of LDL and HDL, and it’s partly those elements that may contribute to problems. Still, the most current research conflicts with the common cholesterol thinking, and there’s more to be done before we can have confidence in medical recommendations.
~There’s some controversy over the importance of lowering cholesterol, even fairly high cholesterol. This is not to say dietary changes are not important, but it appears it’s more important for some than others; in some very important, others not important at all. You’ll have to do some research, and you’ll have to get some blood testing to find out in which category you fit. And then you may have to experiment, test and try again. This is sometimes a long process that can take a couple of years to sort out.
~Inflammation may be more damaging than cholesterol, and inflammation plus high LDL cholesterol might be the triple play. Stress inflames, bigtime, and this refers to all types of stress, stress over money and relationships… work and overwork stress… and, what I believe to be true in Dave’s case, overtraining — decades of pushing himself to the limit. You can’t go back for a do-over to see which method would have worked better, but there it is: It’s likely the demands Dave placed on himself, those that made him a champion athlete, combined with the next element to jam him up.
~The next element: Oxidation caused by iron, bad juju. Think rusty pipes. Iron causes oxidation that not even a cornucopia of anti-oxidant diets can neutralize. The main lessons here: Make sure your vitamins and food supplements do not have added iron (unless you’re a vegetarian or a menstruating woman); if you eat beef, commit to donating a pint of blood quarterly; and oh, don’t get any older. Age doesn’t help with the oxidation thing.
~High triglycerides contribute to plaque buildup in the arteries. Get a blood test and find out if this is a concern for you. High triglycerides is another danger marker when combined with high LDL cholesterol.
~High blood pressure gouges holes in the arteries by excessive force. It’s imperative to keep your blood pressure within optimal levels (120/80 or lower), either with exercise, food choices or medicine if those don’t work.
~High blood sugar damages arteries, causing more areas to be damaged by the deadly combination of inflammation, oxidation and cholesterol. Best way around that one is the Zone diet.
~Homocysteine: There’s a clear connection between it and atherosclerosis — arterial blockage — but the reasons are as yet unknown. Regardless of the whys, the fix is easy: B vitamins, specifically B6, B12 and folic acid. A B-Complex tablet should bring down homocysteine levels in the blood; plan to take a B vitamin daily for the rest of your life. Stick with the complex, individualizing the B vitamins is not recommended. Bonus point: B-complex may also lower fibrinogen and C-Reactive Protein, both factors in arterial inflammation and clotting.
~Lipoprotein(a) is a pretty clear marker for heart disease potential. There’s not a lot you can do about this genetically determined risk factor, but since it’s a good predictor — possibly the best — it does tell you of the importance of other controllable heart-health criteria. LP/a is highly susceptible to oxidation, causes blood clot problems and, in combination with high levels of LDL or even low levels of dense LDL sub-particles, is deadly.
~Menopausal women and hormone replacement: We used to take estrogen partly for heart health, we thought at the time, because pre-menopausal women are somewhat protected from heart disease. As it turns out, taking estrogen didn’t bring menopausal heart health up, and the thinking now is that iron is building up in women who don’t have a monthly period. Post-menopausal women need to do quarterly blood donations, too. Do it as a gift of life, and save your arteries as a side benefit.
~Stress causes inflammation; there’s no longer any question. Reduce all stresses. Whatever you have to do, do it. Change jobs, reduce debt, sort out troubled relationships, take a walk, pray, do yoga. Pick the one that hits home hardest and get to work. And if you train as hard as Dave does, well, either stop, get an extra day of rest between workouts, or find a way to relax fully. I dunno, get a hot tub?
~Trans fats we know to be deadly. Period. Saturated fats, that’s becoming a little less clear. At least, we’re not as sure as we used to be.
~Depression also causes blockage. If you’re depressed, do something about it, either try 5HTP for low-level, occasional or winter depression, or get a doc’s prescription for an anti-depressant. Stress and depression are absolutely, unquestionably linked to cardiovascular disease.
~Exercise, top of the list normally, but left to a lower position here only because you wouldn’t even have seen this if you weren’t already getting in your weight workouts. Still, the volume of weekly exercise seems to be preventative, 5-6 hours a week is optimum for heart health. Those of you doing shortened 30-to-45-minute training sessions or those on three-a-weeks (or less) may need to bring in more exercise. To keep overtraining at bay, cardio may be your answer… please accept my apologies in advance.
~I left off quitting smoking, which would otherwise have been at the top of the list as numero uno. You don’t smoke, do you?
We’re going to look closer at all of these puzzle pieces over the next weeks to make certain we’re each doing what we can to limit our individual risk.
Testing for heart health, how to get started
Further study material here:
More cholesterol research and commentary
More on heart health