Heart Attacker #2: Cholesterol

Cholesterol wreaks havoc on your heart. Are you at risk?

Cholesterol: Why It's Bad

Cholesterol burst on the scene in the 1950s, grabbing headlines and giving America a grim new heart attack equation -- too much saturated fat in the diet equals too much cholesterol in the bloodstream equals clogged arteries and heart attacks. Despite the fact that heart disease has been the nation’s leading cause of death since 1921, nobody wanted to hear that the good things in life -- butter, cheese, ice cream, and fat-marbled steaks sizzling on grills on thousands of suburban patios -- just might spell doom.

The story centers on University of Minnesota researcher Ancel Keys, Ph.D. During World War II, Dr. Keys developed the infamous K rations that fueled the American military. In the early 1950s, he noticed that well-nourished American businessmen had soaring rates of heart disease, while rates among people living through food shortages in postwar Europe declined.

The connection was startling (and aspects of Dr. Keys’s research is often criticized today). After studying men in seven countries -- Finland, Greece, Yugoslavia, Italy, the Netherlands, Japan, and the United States -- and comparing their blood cholesterol levels, intake of saturated fats, and cardiovascular disease rates, Dr. Keys concluded that a “strong association” existed between saturated fats and heart health. One 1950s pop-culture Web site calls it “the day the pork rinds died.” Dr. Keys, who made the cover of Time magazine, recommended cutting saturated fat and eating more polyunsaturated fats (such as corn oil) to lower total cholesterol levels. Less total cholesterol, he reasoned, would lead to fewer heart attack deaths. It was the basis for America’s first heart-healthy “prudent diet,” recommended by the newly formed American Heart Association in 1957. But, as it turned out, the cholesterol story wasn’t that simple.

Fast-forward to the 21st century. Cholesterol isn’t necessarily a villain. Your liver (and your intestines and even your skin) manufactures this soft, waxy stuff every day to help your body build cell membranes and produce sex hormones, vitamin D, and fat-digesting bile acids. The raw material for your body’s cholesterol? The fat in your diet.

The real key to heart-healthy cholesterol levels, experts now say, isn’t simply getting a lower total cholesterol number on a blood test. It’s a smart balance between two basic types: “bad,” low-density, lipoproteins (LDLs) and “good,” high-density, lipoproteins (HDLs). The latest news: Heart experts are finding that the higher your HDLs and the lower your LDLs -- essentially, the closer you can come to the “natural” cholesterol balance discovered in hunter-gatherer societies -- the lower your risk for clogged coronary arteries and heart attack.

As you’ve learned, one type of cholesterol -- called LDL -- is bad for you, and so you want as low a reading as possible for that type, preferably under 100 milligrams per deciliter of blood. The other cholesterol -- HDL -- is good for you, and so you want a reading above 60 mg/dl. Together, you want them to add up to below 200.

LDL (mg/dl)	Risk	HDL (mg/dl)	Benefit
Under 100	Optimal	Under 40	Low
100–129	Near optimal	40-59	Average
130–159	Borderline high	60 and above	High
160–189	High
190 and above	Very high

• Healthy Heart
• Cholesterol
• • Heart Disease

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A co-worker had a unique scheme to meet women. He'd call numbers at random from the phone book. If a man picked up, he apologized for dialing the "wrong" number. But when a woman answered, he'd strike up a conversation. One day, the department manager overheard him bragging how he averaged two dates a week from this ploy. Was he fired? Did he receive a reprimand? No, he was named Director of Telemarketing.

-- Richard Reynolds