Share this article

print logo

GOING INSIDE THE NUMBERS TO GAUGE HEALTH

Since research shows that medical reasons are one of the greatest motivators for getting into shape, I thought that seeing the dangers behind your blood test numbers might help you make some healthy changes.

< Cholesterol count<< Cholesterol, a thick, fatlike substance, is part of the cell membrane and one of the building blocks of a variety of hormones -- including estrogen and testosterone -- and bile, which digests fat. High cholesterol levels, along with high blood pressure, family history, smoking, age and gender, are among the risk factors for cardiovascular disease. Your body makes the majority of the cholesterol you need. The problem begins when we take in too much dietary cholesterol and saturated fat, both of which come mainly from red meats and dairy products, such as butter and cheese.

Cholesterol circulates in the bloodstream by attaching to proteins called lipoproteins, which vary in density. Low-density lipoprotein, or LDL ("bad cholesterol"), accumulates along the walls of arteries, forming plaques that clog up blood vessels. This puts tremendous stress on the heart, ultimately causing cardiovascular disease (CVD). High-density lipoprotein, or HDL ("good cholesterol"), acts like "a mini-dump truck or scavenger collecting the oxidative LDL and removing it from artery walls and your body, which reduces your risk for heart attack or stroke," says Steven E. Nissen, medical director at the Cleveland Clinic Cardiovascular Coordinating Center.

The first number in your "lipid profile" -- your total cholesterol -- can be misleading, according to Nissen. You must look at the breakdown of HDL and LDL. While there is no "normal" cholesterol level, there are desirable goals. Keeping your cholesterol under these limits lowers your cardiovascular risk.

"Unfortunately, it is very difficult to actually move up your HDL by making lifestyle changes; that is, it's hard to get rid of plaque once it's there. Niacin in high-prescription doses raises HDL, but it also has side effects, including itching, headache and flushing," says Nissen.

Triglycerides are the chemical form in which most fat exists in food and the body. Excess triglycerides in the blood have been linked to coronary artery disease. However, Nissen suggests that triglycerides are not as powerful a risk factor as LDL and HDL levels.

Another test that is not standard, but that Nissen strongly recommends, is for C-reactive protein (CRP) levels. Elevated CRP is a marker of inflammation and has also been shown to be an independent risk factor for heart disease and stroke.

Find out your chances of having a heart attack in the next 10 years: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=pub

< Watching blood sugar<< According to the American Diabetes Association, 18.2 million people in the United States -- 6.3 percent of the population -- have diabetes. Unfortunately, 5.2 million people don't know it. Those with diabetes are at high risk for heart disease and stroke, as well as high blood pressure, blindness, kidney disease, amputations and more. And once you have diabetes, you have it for life.

"If you work hard, you can control diabetes with diet and exercise, but it never goes away," says Christopher D. Saudek, professor of endocrinology and metabolism at Johns Hopkins University School of Medicine in Baltimore.

In type 2 diabetes, insulin, which is necessary for the body to process sugar (glucose), is too weak, or there's not enough to do the job. When glucose builds up in your blood instead of going into your cells, your cells become starved for energy and your body is stressed. That may affect your eyes, kidneys, nerves and/or heart. What's the single biggest risk factor for getting type 2 diabetes? Being overweight or obese, says Saudek.

The most reliable test to determine diabetes is a fasting plasma glucose (FPG) test, which measures your blood sugar after an overnight fast.

Another common test, once an individual is diagnosed with diabetes, is hemoglobin A1c, which measures the average blood sugar level over three months. According to Saudek, an HbA1c over 7 percent would indicate poor blood sugar control. Although not all doctors agree, some advocate the use of HbA1c as a diagnostic tool. A level of 6 to 7 percent would be an indicator for diabetes.

< Charles Stuart Platkin is a syndicated health, fitness and nutrition columnist. Write to info@thedietdetective.com.