Yuko Takei writes:
Mr Tanaka has problems which may lead him to lose his health, especially with regard to the heart disease. The issues to talk with him about and answers to his question are below.
The clinical problems are 1. his LDL level is 172; 2. he has a family history of DM -- diabetes; 3. he may have a family history of heart disease; 4. he is a male.
About 1. LDL is cholesterol carrier in the blood to cells. High levels of LDLs are usually associated with elevated blood cholesterol. Extra cholesterol may be stored in arteries and cause them to become narrow, that is arteriosclerosis. It develops to a heart attack or a stroke. His LDL level indicates that his artery may have been narrow and he has an increased risk for above disease. (The best LDL level is less than 130. High risk is above 160.)
About 2. DM is considered that there is genetic factor. So he might have DM in the future. DM itself is serious disease that develops many kind of diseases and limits life span and lessens the quality of life. Heart disease is one of the diseases which is developed from DM. So he has a genetic risk of heart disease.
About 3. and 4. That means that he may be likely to develop heart disease genetically or he has a life style which could lead to heart disease. In addition, males are more likely to have coronary heart disease than females according to some date.
To deal with the above issues, there are two approaches. One is medical approach, the other is his changing life style. The former is concerned with Tanaka presently checking LDL level regularly and continuing to consult with doctors about health condition and also being informed about a heart disease and DM. The latter is concretely having proper knowledge about balanced diets -- low cholesterol diets, taking them and doing exercise. The reasons for his need to take the latter approach is to be discussed below.
The life style problems and his questions 1. He is confused and has misinterpretation about nutrition and diets: 1) his taking foods high in cholesterol and saturated fats; 2) his shortage of vegetables and fiber intake; 3) "getting nutrients from the vitamin supplements" with four or five cups of coffees and colas; 4) he does not eat breakfast; 5) his questions about RDA of vitamins and minerals, about protein and minerals, and about the difference between fats and carbohydrate; 6. he feels lots of pressure at work and finds it difficult to relax; 7. he does not like to exercise.
About 1-- His taking foods high in cholesterol and saturated fats He eat fast foods to get energy and eat lots of meat-"beef and pork mostly". Generally, fast foods and meat (especially beef) (even if the meat is "red meat") are rich in cholesterol and include saturated fats. The saturated fat-( butter, bacon, cheese, solid shortenings etc) turns into cholesterol at liver. So, those kinds of foods raise the amount of cholesterol in blood. Then cholesterol carrier-LDLs also rise. That is why his LDLs level rise even if he doesn't eat sweet foods. By the way, cholesterol is an important component of cells and the coating of nerve tissues and is needed for digestion of fats and for producing sex hormone, the excess of it, as mentioned the above, might lead to the heart disease. So, he should limit high cholesterol food. For example, he should stop or limit to eat fast foods and cut down the amount of meat or not eat broiled or grilled fish and skinless too much. Additionally, fast foods are mostly heavy taste. There are possibility to use too much sodium. Sodium can also increase the risk of heart disease. In this sense, he should also cut first food.
About 2 -- His shortage of vegetables and fiber intake Vegetables,fruits and fiber help to reduce cholesterol level.They are also rich in many kinds of vitamins. But he hates vegetables. So let him start to eat plenty of fruits or vegetable juice or to find vegetables which he can eat or to take different tasty way of vegetable cook. About fiber intake, he said he takes them from udon and white rice. But in fact, fiber is not rich in those foods. He should take real fiber rich foods-oats, whole grain breads, multiple-grain cereals, vegetables and fruits. And if he starts to eat more fiber rich foods, he need plenty of water-six glasses of water a day to work it effectively.
About 3 -- "getting nutrients from the vitamin supplements" with four or five cups of coffees and colas As he recognized, vitamins are essential to the normal functioning of our bodies. They are necessary for our growth, vitality and general well-being. For Mr tanaka, especially vitamin B1 taking is important. Because it is essential for the normal functioning of heart and being free from nerve irritability. But there is problem in his way to take vitamins-get them only from supplements. That is because vitamins can not be assimilated without ingesting food. So he need take them with meals.
About 4 -- He does not eat breakfast. Skipping meals can lead to out of control hunger, that is over eating. If he becomes overweight,his risk for heart disease increase. So he should take regular meals. But he doesn't have much time to eat breakfast in the morning, then how about taking multiple-grain cereals with low fat or skim milk, or bran muffins, whole-wheat bread with vegetable-fruit juice. Those meals do not take too much time to prepare.
About 5 -- His questions about RDA of vitamins and minerals, about protein and mineral and about the difference between fats and carbohydrate. It is in need to explain about above questions. When the explain is done, remember to that the explanation includes the relationship between diet and heart disease. For example, fats and carbohydrates are both macronutrient which generates energy. Although fats pack more energy than carbohydrates, and include vitamins, one kind of the fats-saturated fats turned to cholesterol. So he should limit it. The saturated fats are animal and dairy fats which remain solid at room temperature- butter, bacon, cheese. Then he should take another kind of fat for essential fats intaking. Those are polyunsaturated and monounsaturated fats (especially former one). Those are usually liquid oils of vegetable origin, such as corn, safflower, soybeans, sunflower, and sesame seed oils. They tend to reduce high levels of certain fats in the blood. By the way he is computer specialist. Nowadays there are computer soft which has clear information about what is nutrient and each nutrient function, about RDA, of course about mineral and protein. To provide him information about those soft is one possible effective way which he gets those knowledge. Moreover, although he gets information about nutrients, recognizing them does not always means taking them properly. It is to be explain that taking balanced diet after all lead him to take balanced nutrients and to become good condition -low risk of heart disease. To take balanced diet, it is convenient to use the Guide Pyramid provided from Natural health magazine. It is a figure which shows him how much should he take each kind of foods -- vegetables, fats, etc. to get essential vitamins, minerals and energy sources etc.
About 6 -- Feeling lots of pressure at work and finding it difficult to relax This problem may partly caused by his improper vitamins taking and too much caffeine taking. Vitamins especially vitamin B1, B2, B6, D take their role on nerve system. So he should take them from low fat milk, skim milk and whole grains. There are much caffeine in coffee and colas. Caffeine is a drug that stimulates the central nervous system and works as a diuretic. He might loose not only water but also his relaxed feeling. He should limit intake of caffeine to under three cups.
About 7 -- He does not like to exercise. He can keep his weight down by exercise as he thinks. But exercise is also thought to increase the level of HDL. It is referred to as good cholesterol, because it helps remove bad cholesterol from the blood. He should do more exercise to increase HDL levels. But he is too busy to do exercise. So first. how about using the stairs, not the elevator or escalator where he works?
All of above are first steps to avoid heart disease;
continuous consultation with doctors is needed.
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