Ayako Yoneyama writes:
I think that there are 2 similarities between patient A and patient B. First, there is quite a possibility that they will suffer from heart disease, though the reasons are different. And, second, they don't do daily exercise.
These patients present some similarities,
but there are many differences between them. First, only A has the symptoms
of heart disease. Next, patient A does no exercise but, patient B does
weekend exercise. For favorite foods, there are clear differences between
them, for example, patient A likes sweet fatty foods more than B. Next,
A's LDL cholesterol level is much higher than B's. Finally, in B's family
there is a history of diabetes, so she may tend to suffer from it which
may also cause heart disease.
I advise both patients as follows:
To patient A: Though you are 20 years old, you have narrowing of the arteries.
You must change your diet and other life style habits. Your LDL cholesterol
level is very high, so you should cut down on sugar and fatty foods, for
example, ice cream and fatty meats. Please eat more fruits and vegetables
each day, and fish instead of meat. If you use oil, you should choose safflower
oil. Finally, you had better do exercise every day, because exercise may
increase "good" cholesterol levels, which is believed to remove
excess cholesterol from the body.
I don't say that you must not eat all kinds of fatty and sweet food from
now on. What I want to tell you is you need to change your ideas about
diet. If you used to eat a sweet dessert after every meal, you should reduce
your intake of sweets so that, for example, you could eat your favorite
food "ice cream" once a week. Try to think a little about your
health every day, and you may not suffer from serious heart disease in
the future.
To patient B: Now you don't suffer from heart disease, but you have some
risk factors for disease, for example, your family tends to suffer from
diabetes. You should reduce risk factors. You are overweight, so you should
lose weight, and, you can raise your good cholesterol-HDL-level by exercising,
quitting smoking, and eating more boiled or grilled fish and skinless chicken
and less fried meat. Please replace white bread with whole-grain breads
and cereals, because dietary fiber may help lower your cholesterol, and
prevent heart disease. Any way, from now on, stop smoking and do more exercise,
for instance, ride your bicycle everyday, and you will not suffer from
heart disease.
To both patients: Both patients should be checked regularly by doctors
because the prevention of illness is better than its cure. And, please
remember that the most effective prevention is your correct diet and daily
exercise. Daily and moderate exercise is recommended, because it helps
increase your HDL-cholesterol level, which is effective to reduce the LDL-cholesterol
level. You should avoid fatty sweet foods, and eat more fiber-rich food
such as vegetables. You should replace sweets with nonfat yogurt and ice
milk. But, it is important that you sometimes eat favorite fatty sweet
foods, because they are nutrition for your "heart".
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