Dai Yoshizawa writes:
Similarities of Patient A and Patient
First, they do not have sufficient exercise, even though Patient B rides her bicycle on weekends. Secondly, their favorite foods are high in cholesterol.
Differences between Patient A and Patient B:
The level of patient A's LDL is 165. It is said that a high level like that is in the highest risk group ( Less than 130 is a good or desirable level, 130 to 159 is border line to high risk, 160 or above is high risk ). On the other hand, the cholesterol level of Patient B is 125. So she doesn't seem to have the risk of heart disease now. Second, Patient A has angina chest pains and narrowing of the arteries, and Patient B smokes a little. In addition, there is a history of diabetes in her family history (her father died of diabetes) and she also suffers from obesity. Patient In sum, A is now sick with angina pains, but patient B is not suffering from pain. However she has lots of risk factors.
What these patients should do and why ?
For Patient A , first, he should decrease the LDL level because high levels of LDLs are usually associated with an elevated blood cholesterol and an increase risk of heart disease due to cholesterol and fat being deposited in the arteries. Actually he has narrowing of the arteries, so he should be careful about his diet.
Dietary fiber helps lower cholesterol. So, to increase the fiber in his diet, he can eat apples, berries, prunes, carrots, lettuce. And he can replace white bread with whole-grain breads and cereals such as bran muffins, or eat brown rice instead of white rice. Let me think how he should do this. (1) He should eat dry bran cereal for breakfast, but be careful of the amount of dietary fiber in each brand of cereal because some brands may have less fiber than we think. (2) He can add one quarter cup of wheat bran for breakfast. (3) And he can eat cooked beans each week.
Patient A should start with one of these changes which means making a small change, and wait several days to a week before making another. If the change doesn't seem to make him feel better, he then can try other dietary changes. he needs to pay attention to drink more fluids when he increases the amount of fiber he eats. For example, if he doesn't now drink at least 6 glasses of liquid a day, he must drink at least two additional glasses of water a day to assist his new fiber intake.
Next he should avoid high cholesterol foods such as eggs, ice cream and fatty meats, or substitute foods with cottonseed oil, corn oil, soybean oil, safflower oil and so on, each of which has lots of monounsaturated fat. Some recent research studies say that a diet high in monounsaturated fatty acids is effective in reducing LDL ("bad" cholesterol) levels while keeping HDL ("good" cholesterol) levels the same.
Patient B does not appear to be in a serious stage but could be in the preliminary stage of heart disease. She has lots of risk factors such as smoking, being overweight, doing insufficient exercise, eating high cholesterol foods, and a family history of diabetes. First, she should resolve the dangers from diabetes, obesity, lack of exercise by stopping smoking. Increased exercise and losing excess body fat are also needed for her, because being overweight may also increase her blood cholesterol level in the future. Secondly, she should take care of her daily diet and keep in mind not to take fatty foods, and perhaps substitute some of these unhealthy foods with better choices, such as using skim milk. For her future, it's important to have more fiber foods.
Finally she should never forget that the more risk factors she has, the greater the odds of developing heart-related illness later in life. It is said if someone has two risk factors, these cause four times the risk of developing disease than for someone without any risk factors. Now it is not necessary for her to undergo urgent treatment like Patient A, but she should never forget the prevention value of reducing her current risk factors. In addition, and as a caution, after menopause, the cholesterol level of women usually increase to a level higher than that of men. So keep she should continue to check cholesterol levels more than a few times a year.
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