Controlling Cholesterol For Dummies®, 2nd Edition
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Library of Congress Control Number: 2008924088
ISBN: 978-0-470-22759-6
Manufactured in the United States of America
10 9 8 7 6 5 4
Carol Ann Rinzler is the author of Nutrition For Dummies, now in its 4th edition, as well as Heartburn and Reflux For Dummies, and more than 20 other books on food and health. A former nutrition columnist for the New York Daily News, Carol lives in New York with her husband Perry Luntz, author of Whiskey and Spirits For Dummies, and their amiable cat, Katy.
To my husband, Perry Luntz, for all the usual reasons.
Every For Dummies book is a work of many hands, so I have many people to thank for this one.
First in line, Michael Lewis, my Acquisitions Editor, who moved this new edition of Controlling Cholesterol For Dummies from an idea to a reality. Then there’s my wonderful project editor, Natalie Harris, whose scientific intelligence and editorial diligence kept things on track. My many thanks to Copy Editor Carrie Burchfield whose keen eye and fine-point blue pen are a writer’s delight. And let’s not forget Wiley’s hardworking proofreaders and page layout technicians.
Like others who write about health and medicine, I am enormously grateful to Martin Graf, MD, and Bonnie Taub-Dix, the experts who’ve generously taken the time to read the manuscript for accuracy. I also appreciate the assistance of the professionals at the American Heart Association: Aaron Talent, Tagni McRae, and Taylor Morris.
Finally, I would like to put in a word of appreciation for all the anonymous folks at the Food and Drug Administration, the U.S. Departments of Agriculture and Health and Human Services, the Centers for Disease Control and Prevention, and the similar agencies up there in our neighbor to the north, Canada. Without their efforts, you and I would be left without the numbers we need to construct intelligent guidelines for a healthy life. So let’s hear it for these guys: Hip! Hip! Hooray!
We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/.
Some of the people who helped bring this book to market include the following:
Acquisitions, Editorial, and Media Development
Project Editor: Natalie Faye Harris
(Previous Edition: Tonya Maddox Cupp)
Acquisitions Editor: Michael Lewis
(Previous Edition: Natasha Graf)
Copy Editor: Carrie A. Burchfield
(Previous Edition: Mike Baker)
Editorial Program Coordinator: Erin Calligan Mooney
Technical Editors: Martin W. Graf, MD; Bonnie Taub-Dix, MA, RD, CDN, Director of BTD Nutrition Consultants, New York
Editorial Manager: Christine Meloy Beck
Editorial Assistants: Joe Niesen, David Lutton, Leeann Harney
Cover Photos: Daniela Richardson
Cartoons: Rich Tennant (www.the5thwave.com)
Composition Services
Project Coordinator: Erin Smith
Layout and Graphics: Carl Byers, Reuben W. Davis, Alissa D. Ellet, Melissa K. Jester, Christine Williams
Proofreaders: David Faust, Penny Stuart
Indexer: Cheryl Duksta
Special Help Sarah Faulkner, Alissa Schwipps, Jennifer Tucci
Publishing and Editorial for Consumer Dummies
Diane Graves Steele, Vice President and Publisher, Consumer Dummies
Joyce Pepple, Acquisitions Director, Consumer Dummies
Kristin A. Cocks, Product Development Director, Consumer Dummies
Michael Spring, Vice President and Publisher, Travel
Kelly Regan, Editorial Director, Travel
Publishing for Technology Dummies
Andy Cummings, Vice President and Publisher, Dummies Technology/General User
Composition Services
Gerry Fahey, Vice President of Production Services
Debbie Stailey, Director of Composition Services
Title
Introduction
About This Book
Conventions Used in This Book
What You’re Not to Read
Foolish Assumptions
How This Book Is Organized
Icons Used in This Book
Where to Go from Here
Part I : Getting Up Close and Personal with Cholesterol
Chapter 1: Mapping the Heart Land
Ladies and Gentlemen, Meet Your Heart
Attack of the Killer Heart Disease
Getting to the Point of This Book
Chapter 2: Comparing Cholesterol’s Risks and Benefits
Shaking Hands with Cholesterol
Believe It or Not, You Need Cholesterol
Breaking the Bad News
Focusing on Other Blood Baddies
Warning! Heart Attack in Progress!
Chapter 3: Rating Your Cholesterol-Related Risk
Categorizing Cholesterol as a Risk Factor
Adding Up Your Basic Cholesterol Numbers
Defining Higher, Lower, Medium — and Just Right
Listing Other Risk Factors
Evaluating Your Own Risk Factors File
Heart Attack Risk Factors at a Glance
Checking for Plaque Buildup
Calculating Your Heart Attack Risk
Part II : Eating Your Way to Lower Cholesterol
Chapter 4: Writing Rules for a Cholesterol-Lowering Diet
Being Prudent
Doing the Diet Two-Step
Adding TLC
Finding Diet Aids
Chapter 5: Building a Cholesterol-Lowering Diet
Making Your Game Plan
Choosing the Fat That Fits
Factoring in the Fiber
You Know the Deal: Everything in Moderation
Chapter 6: Pinning Down the “How-To’s” for a Cholesterol-Lowering Diet
Avoiding Certain Foods (Or At Least Eating Them in Very Small Portions)
Plant-Produced Foods That Help Control Cholesterol
Slicing the Cholesterol from Your Dinner Plate
Part III : Leading a Cholesterol-Lowering Lifestyle
Chapter 7: Weighing Weight’s Weight on Cholesterol
Presenting the Health Risks Posed by Extra Pounds
Figuring Out Who’s Fat
Making Lifestyle Changes
Tossing Out the Scales
Chapter 8: Exercising Options to Control Your Cholesterol
Sweating the Definition: Exercise
Pairing Exercise and . . .
Riding the Stationary Bike into the Sunset
Chapter 9: Weeding Out Tobacco’s Role in High Cholesterol
Enumerating Smoking’s Health Hazards
Identifying the Smokers
Breaking the Habit
Choosing How to Quit
Chapter 10: The Grape, the Grains, and Your Cholesterol
Toasting to Your Heart
Identifying Alcohol’s Heart-Healthy Compound
Drinking in Moderation
Checking Out the Risks, Too
Rating Alcohol Beverages as Food
Part IV : Cutting Cholesterol with Nutrients and Medicine
Chapter 11: Vitamins, Minerals, and Other Good Stuff
Identifying Supplements
Popping a Vitamin and Mineral Pill May Help Lower Cholesterol
Fighting Cholesterol with Dietary Fiber
Phabulous Phytochemicals
Waiting for the Next Study
Chapter 12: Prescribing Lower Cholesterol
Introducing Cholesterol-Lowering Medicines
Comparing the Benefits of Cholesterol-Buster Drugs
Picking the Perfect Pill Candidate
Chapter 13: Identifying Meds That Raise Cholesterol
Hankering for Hormones
Lowering Fluids with Diuretics
Sabotaging Cholesterol Therapy
Narrowing Your Options
Getting the Last Word
Chapter 14: Mouth-Watering Morsels for Special Occasions
Little Bites a Cardiologist Would Love
Tasty Recipes to Impress Your Guests
Cinnamon and Spice Almonds
Citrus-Scented Marinated Olives
Skewered Scallop Seviche with Avocado
Crudités with Mango Salsa and Creamy Avocado Dip
Mango Salsa
Creamy Avocado Dip
Mushroom Pâté
Part V: The Part of Tens
Chapter 15: Ten Clicks to Reliable Cholesterol Information
The American Heart Association
Brand Name Cholesterol-Lowering Drugs
Center for Drug Evaluation and Research
Centers for Disease Control and Prevention (CDC)
The Mayo Clinic
MedicineNet.com
MedlinePlus.com
National Cholesterol Education Program
National Heart, Lung, and Blood Institute
Stedman’s Online Medical Dictionary
WebMD
Chapter 16: Ten Nutrition Web Sites
The American Cancer Society
American Council on Science and Health, and the Center for Science in the Public Interest
The American Dietetic Association
The American Heart Association
The Food Allergy & Anaphylaxis Network
The Food and Drug Administration
Food and Nutrition Information Center
The U.S. Department of Agriculture Nutrient Database
The Weight Control Information Network
Chapter 17: Ten Cholesterol Myths
Most of the Cholesterol in Your Body Comes from Food
All Fatty Foods Raise Your Cholesterol
Women Never Have to Worry about Their Cholesterol
Children Have No Cholesterol Problems
Eating More Dietary Fiber Lowers Blood Cholesterol
Cholesterol Is the Only Thing That Leads to Plaque in Your Arteries
Red Meat Has More Cholesterol Than Chicken or Turkey
A Heart Attack Is the Only Health Risk Associated with High Cholesterol
Changing Your Diet Is the Only Way to Control Your Cholesterol
You Can Never Be Too Rich or Too Thin, and Your Cholesterol Can Never Be Too Low
Chapter 18: Ten (Okay, Eleven) “Eureka!” Cholesterol Moments
1957: The Prudent Diet
1958: Introducing Cholesterol Busters
1971: Naming Cholesterol an Official Risk Factor for Heart Attack
1971: MRFIT Gets Going
1984: Indicting Hypercholesterolemia
1985: Recognizing the Risk from LDLs
1985–1987: Establishing the National Cholesterol Education Program
1986: Unveiling Statins
1988, 1993, 2001: ATP I, ATP II, ATP III
2001: Baycol Bombs
2001–2004: Anti-Cholesterol Combo Pills
Appendix: Calories and Other Nutrients in Food
The Nutrition Chart
The USDA Nutrient Database
: Further Reading
What a difference a day makes. Or, to be more precise, 2,138 days. In the years since the first edition of Controlling Cholesterol For Dummies appeared, the medical and nutritional experts have (among other things):
Changed the numbers that say, “This is a healthy cholesterol level.”
Revised the definition of “bad cholesterol” (low-density lipoproteins, or LDLs) to reflect the discovery that some “bad” cholesterol may actually be just fine.
Introduced new combo drugs that zap both the cholesterol you get from food and the cholesterol your own body makes.
Re-evaluated the role of hormones in raising or lowering the risk of heart disease.
Clarified some of the differences between how male and female bodies handle cholesterol.
Changed the drill on which vitamins, minerals, and other nutrients may (or may not) reduce cholesterol levels.
Reaffirmed the virtues of the Mediterranean Diet and moderate drinking.
Added some new items to the list of foods that fight cholesterol.
Introduced new “functional” foods that fight cholesterol (including a chocolate laced with cholesterol-buster fatty acids).
Set up some new Web sites to provide cholesterol guidance on everything from defining cholesterol terms (what is a triglyceride, anyway?) to evaluating your own personal risk of a cholesterol-related heart attack.
In other words, the people who rule The World Of Cholesterol Medicine have been very busy little bees. Which is why you are holding this book in your hands. It contains tons of new info to help you control your cholesterol, keep your arteries as clear as a newborn babe’s, and thus keep your heart beating merrily along for years to come.
When it comes to solving life’s little problems — whether to eat that chocolate cake, whether to dye your hair orange, or whether to lower your cholesterol — I choose to follow the ancient Greek mantra, “Moderation in all things.”
In other words, I get to eat the cake about once a week; my hair is gray/
blonde, not orange; and this book is called Controlling Cholesterol For Dummies rather than, say, Knocking Cholesterol Down to Zero For Dummies.
The simple fact is that no one is perfect, but most people can be much, much better. The same principle holds true for your cholesterol levels. When cholesterol is the topic, lower is almost always better. (I talk about a few exceptions throughout this book.) But if you set a goal you can never reach — dropping 50 points off your cholesterol reading by two weeks from Tuesday — you’ll fall off the wagon long before your cholesterol level falls a milligram.
My point? This book is eminently reasonable and moderate; I designed it to help you (working with your doctor, of course) keep your cholesterol within safe boundaries.
Controlling Cholesterol For Dummies, 2nd Edition, doesn’t ask you to turn yourself into an anti-cholesterol fanatic — the kind of annoying person who sneers at other people’s dinner choices while acting superior about his own. (Actually, sneering and acting superior at the same time is a neat trick if you can do it. Just don’t try it on your friends at dinner.)
My goal with this book is to lay out the reasons why it makes sense to control your cholesterol and then present reasonable and moderate strategies to help you reach your goal.
Some of the information, like how to translate the cholesterol numbers you get on your annual physical, is simple. Other stuff, such as guidelines you can use to determine whether you’re a candidate for a heart attack — or for cholesterol-lowering medication — is more complex.
Throughout this book, the emphasis is on the idea that (here comes another catchy slogan) “Knowledge is power.” In this case, it’s the power to lower your cholesterol and reduce your risk of heart attack.
Don’t get me wrong. I write about nutrition, food, and health for a living, but I have to admit that some books and articles about these subjects can be pretty boring. (Unless the author is instructing you how to lose 30 pounds in 30 days or lower your cholesterol by 50 points in 50 minutes. But I deal with non-fiction subjects. Sorry.) I try to remedy this sleepy state of affairs with this book. So, if a few of my jokes don’t tickle your funny bone, forgive me. After all, how funny can high cholesterol and plaque-filled arteries be?
To make this book as easy to use as possible, the following conventions are followed throughout:
All Web addresses appear in monofont.
When this book was printed, some Web addresses may have needed to break across two lines of text. If that happened, rest assured that I haven’t put in any extra characters (such as hyphens) to indicate the break. So, when using one of these Web addresses, just type exactly what you see in this book, pretending the line break doesn’t exist.
New terms appear in italics and are closely followed by an easy-to- understand definition. I also use italics for emphasis once in a while.
Bold font highlights keywords in bulleted lists or identifies the action parts of numbered lists.
When you find information about the nutrient content of brand-name products in this book, you can assume that what you’re reading was right when I wrote it. But here’s the catch: Sometimes products change practically overnight. So use the numbers here as a guide, but be sure to check the product label when you shop. As poker players like to say, “Trust your friends — but cut the cards.”
Yes, you read that right. You don’t have to read everything contained within these snazzy black and yellow covers. Any text in a gray box is a sidebar. Sidebars contain “nice to know” (and may I add, pretty interesting) material, but skipping them won’t take away from your understanding of the subject at hand.
Additionally, anything marked with a Technical Stuff icon deals with nuts-and-bolts medical info that simply provides background information and in-depth scientific explanations about various subjects. You may skip these bits of text as well (although they provide some great info, if I do say so myself).
A writer has to make a few assumptions about her audience, and I’ve made a few assumptions about you. If you’ve picked up this book, I’m guessing that you fall into one or more of these categories:
You’ve been told by your doctor that your cholesterol levels aren’t up to par, and you have to do something about it.
You’ve heard all the talk about high cholesterol in recent years, and you want to find out what all the fuss is about.
You routinely buy every For Dummies book that hits the shelf, and this one is next on your list.
You’re a health-conscious individual.
You’re concerned about heart disease, and controlling the ol’ cholesterol levels has become very important to you.
I’ve also assumed that you don’t have a level of health-related knowledge to rival the U.S. Surgeon General’s. If this assumption is correct, you’ve come to the right place. Easy-to-follow explanations are a hallmark of this book.
But if you approach the subject of controlling cholesterol with some information already tucked away in that brain of yours, don’t worry — I’ve included plenty of info in this book for you as well.
This summary aims to whet your appetite for cholesterol control by giving you a glimpse of what’s ahead in the 14 regular chapters, four — count ’em, four — Part of Tens chapters, and one bang-up, nutrition-chart appendix. Use this section as a thumbnail guide to what you want to read first.
Chapter 1 is, well, the first chapter. It explains why you should read this book — to reduce your risk of heart attack. Chapter 2 explains the good side of cholesterol (yes, cholesterol has a good side), as well as the problems it can cause. Chapter 3 says, “Okay, now figure out your own personal risk of cholesterol-related heart disease.”
Don’t skip Chapter 3: The news may be better than you think. And hey, if it isn’t, the rest of the book tells you how to reverse the picture and improve your odds for a long, healthy life.
Yes, your diet pulls some weight when it comes to your cholesterol numbers. Actually, your diet matters big time. Chapter 4 lays out principles for a cholesterol-lowering diet proposed by all the usual suspects, oops, I mean experts. Chapter 5 tells you how to assemble a cholesterol-lowering diet. Chapter 6 tells how to apply the information in chapters 4 and 5 to real life.
Diet matters, but so does your lifestyle. Chapter 7 is a very important explanation of the relationship between your weight and your cholesterol levels. Chapter 8 describes how movin’ your bod can help push down your cholesterol.
Chapter 9 is not, repeat not, a both-sides-of-the-issue type of chapter. Smoking does many bad things, including lifting your cholesterol levels, so this chapter pulls no punches.
In Chapter 10, I head back into moderate territory — moderate drinking that is. In study after study, sober researchers have found that moderate drinking — one drink a day for a woman, two drinks a day for a man — appears to increase your “good” cholesterol and lower your risk of heart attack. Check it out.
Chapter 11 is all about nutritional supplements, including vitamins and how they affect your cholesterol, sometimes in surprising ways. Chapter 12 is a primer on cholesterol-lowering prescription drug products — the good, the bad, and (sorry about this) the truly ugly. Chapter 13 is a guide to medicines that may adversely affect your cholesterol (and your heart). Chapter 14 is filled with recipes for fun, heart-healthy party foods so that you can continue to control your cholesterol while celebrating special occasions.
I just love this part of the book because it lets me draw up lists of odd and unusual factoids that I may not otherwise be able to include.
Chapter 15 lists ten good Web sites for heart and cholesterol info. Chapter 16 has ten nifty nutrition Web sites. Chapter 17 is one of my favorites — ten cholesterol myths. Chapter 18 tickles my historical fancy with ten really important moments in cholesterol history.
This part also includes an appendix, which contains a chart of more than 500 foods and the cholesterol, fat, and fiber content for common servings. The material, from my old friend, the U.S. Department of Agriculture (USDA), is invaluable when you’re putting together heart-friendly meals. So use it.
For even more info on even more foods, check out the USDA Nutrient Database (which I discuss in Chapter 16) on the Web at www.nal.usda.gov/fnic/cgi-bin/nut_search.pl .
Throughout this book you find a collection of handy icons in the margins. These icons highlight particularly useful information and can help you get the most out of your copy of Controlling Cholesterol For Dummies, 2nd Edition.
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No, you don’t have to start at Chapter 1 and read straight through this book. As with all For Dummies books, this one is set up so you can read any chapter, in any order, and still come out ahead.
Sound good? Then keep on reading (starting wherever you want, of course).
In this part . . .
To do the best job of controlling your cholesterol, you need to have a handle on the basics — info such as what cholesterol is, where it comes from, what it does, and why some varieties are more threatening than others. And being a Serious Seeker of Knowledge, you probably want to be able to perform a realistic evaluation of your own risk of developing cholesterol-related problems. The info you need is right here in this part. Go for it.