Mihoko Mizokuchi writes:
Both patient A and B have some risk
factors regarding heart disease. Since they seem to favor high-cholesterol-contained
food and lack everyday basic exercise. They, however, have many differences,
and the most important differences between them are the following four
factors.
1) Cholesterol level: patient A has a high LDL cholesterol level, while
patient B has a low total cholesterol level; 2) how they feel at the moment:
A has "angina" chest pains, but B feels all right; 3) arteries'
condition: A has narrowing of the arteries, but B has normal arteries;
4) a family history of diabetes: A doesn't have a family history of illness,
while B's father died of diabetes two years ago.
I have three major suggestions to both patient A and B. First, increasing
exercise. Second, eating healthy food. Third, seeing their family doctors
to know their risk and how to cope with it.
Increasing exercise:
Exercising can raise our high-density lipoprotein (LDL) cholesterol level,
which removes cholesterol from the lining of the arteries and helps maintain
good blood flow. An HDL cholesterol level of less than 35 puts us at higher
risk for heart disease, while more than 60 reduces it. Patient A already
has narrowing of the arteries. It would be a cause of his "angina"
chest pain, for narrowing of the arteries results in high blood pressure
and insufficient oxygen to the heart. So he must be very careful about
his HDL cholesterol level. Patient B seems to have a low HDL cholesterol
level, as her total cholesterol level is only 125, therefore she needs
to pay attention to it. She also needs to try to quit smoking and lose
weight in order to get the higher HDL benefit. How about participating
in routine physical exercise?
Eating healthy food:
Eating healthy food can help lower our low-density lipoprotein (LDL) cholesterol
level, which carries cholesterol in the blood to body cells, and may protect
us from the damaging effects of cholesterol. Patient A's LDL cholesterol
level is 165, which means he has an increased risk of heart disease. (Less
than 130 is a good or desirable level.)
So these patients should eat at least five servings of fruits and vegetables
each day, for plant foods have no cholesterol, but are fiberrich. Fiber
helps prevent diabetes and keeps our weight down. So fruits and vegetables
are especially suitable to patient B, when I consider her family history
of diabetes and the fact of her being overweight. I think she needs to
replace her favorite white bread with whole-grain breads and cereals. When
we increase the amount of fiber we eat, we should not forget to drink more
fluids than usual.
Both patients ought to limit high cholesterol foods such as egg yolks that
patient A likes in particular. He should not eat egg yolks more than four
times a week or should eat egg substitutes.
And they should reduce fat, trim away all visible fat and boil, bake or
broil rather than fry meats. Patient A needs to select lean cuts of meat
although he loves fatty meat. They can limit intake of saturated fats such
as dairy fats. For example, patient A can take non-fat ice cream and patient
B can take cottage cheese. And they can replace animal fats with appropriate
substitutes. Mono unsaturated fatty acid reduces the LDL level while keeping
HDL levels the same. Mono unsaturated fatty acids are usually liquid oil
of vegetable origin such as olive, peanut and canola.
Seeing family doctors:
Usually people over 20 had better have their cholesterol level checked
at least once every five years, but because both patients A and B have
some risk factors, they need to have their cholesterol level checked more
often. They should talk to their family doctors (is it me?) about how often
they need to be tested.
Cholesterol comes from foods of animal origin and is produced by the body,
mainly in the liver. Cholesterol is not all bad, but it is essential to
human life. The best total cholesterol level is under 200. A level between
200 and 239 means we have some risk for heart attack or stroke. A cholesterol
level of 240 or more means that we have an increased risk of heart disease.
In short, seeing a doctor and checking up on their cholesterol level regularly
will be significant for both patients A and B in order to avoid serious
sickness or sudden death.
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