Cholesterol is not all bad. In fact, you'd be in a bad way without it, as it's a vital part of all your cells. It's just that you have too much of it. The simplest way to measure it is through your blood, since it gives a rough approximation of the amount in your arteries, which is where the problem lies. The accepted normal range is below 200mg per 100cc of blood. Where did this watermark come from? It is clearly a statistical figure, since the blood cholesterol value of the Kalahari Bushmen (whose current lifestyle is similar to that of 2 million years ago) is 77mg per 100cc of blood. Not surprisingly, there is no hardening of the arteries noted in these people. Therefore, contemporary cholesterol values are roughly three times higher than they were in the past--no wonder we're clogged up with it. The cholesterol in your body comes and goes, which is why the amount in your arteries can be eliminated through a rigid "lowering" program. Seventy percent of your cholesterol comes from that which you yourself manufacture, mostly in the liver; only one third comes directly from the diet. This is why a low-cholesterol diet is not as important as a cholesterol-lowering diet.
An important function
As it exists in your body, most cholesterol serves as a way to dissolve fat; in essence it helps absorb and transport fat. So the more fat your liver sees, either in the diet or from the fat in your body (as with stress), the more cholesterol it makes. This phenomenon explains why accountants' cholesterol values go up in early April and med. students' levels go up at exam time.
Good vs. bad cholesterol
The cholesterol story becomes more complex with the discovery that not all cholesterol is bad for you. The high density lipoprotein (HDL) cholesterol actually seems good for you. The famous Framingham Heart Health Study has clearly shown that those of us with high HDL levels seem protected against heart disease, and those with low levels are at really high risk despite what the total cholesterol level is. For example, I would rather have a patient with a total cholesterol of 240 with an HDL of 60 than a patient with a total cholesterol of 200 with an HDL of 30. The major factors that seem to increase the HDL cholesterol levels are physical exercise and a moderate intake of alcohol. So, strange as it may sound, the drinking jogger seems to be favored.
Cholesterol and the ThirdAger
There has been much discussion, too, whether it is still advisable to try to lower the cholesterol levels in people over 65. Several strong studies suggest that it is. I welcome this perspective, as I have held to the idea that age alone should not be the criterion for development of passive attitudes about health promotion. This does not mean that older persons, particularly those 75 or older, who are always at risk for restriction of dietary diversity, should be further confined by a rigid diet aimed at getting the blood cholesterol down.
Bottom line:
I stand firm in my conviction that it is never too late to be as healthy as possible, and this means having as low a cholesterol and as high an HDL level as possible, no matter what your age.
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