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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