Teach meaning behind cholesterol numbers
Change numbers to prevent heart disease
Cholesterol is a common word. Most people easily connect it with heart disease. Yet in spite of this familiarity, many Americans have cholesterol in the high-risk range.
People need to know and understand their numbers, says Lisa Randall, RD, CDE, health education coordinator at Inland Northwest Health Services Community Health Education and Resources in Spokane, WA.
Measuring cholesterol can predict the risk of heart disease, which is caused by the narrowing of coronary arteries from cholesterol and fat deposits, a process called atherosclerosis.
According to the National Heart Lung Blood Institute based in Bethesda, MD, when not enough oxygen-carrying blood reaches the heart, a person may experience chest pain called angina. When a coronary artery becomes completely blocked, it usually results in a heart attack.
"Heart disease does not start when people have angina or a heart attack. It has been going on for many years. One out of every two men and one out of every three women will develop heart disease at some time in their life. It often starts when people are young. At 20 years of age people are starting to show the buildup of plaque in their arteries," says Randall.
To help prevent heart disease, people need to know their total cholesterol number, which is the sum of all the cholesterol in the blood. According to the NHLBI, a total number less than 200mg/dL is desirable. A number in the range of 200-239mg/dL is borderline high, and anything over 240mg/dL is high. A person with high cholesterol is twice as likely to have heart disease as someone in the desirable range.
In addition, people need to understand the difference between HDL and LDL, says Randall.
"They need to know what their total cholesterol is and what percentage of that are the HDL and the LDL," she explains.
According to the NHLBI, high-density lipoproteins (HDL) help prevent cholesterol from building up in the artery walls by carrying it in the blood from other parts of the body back to the liver, which expels it. To help people remember that a high HDL number is desired, Randall connects the "H" to happy.
On the other hand the low-density lipoprotein (LDL) is the main source of cholesterol buildup and blockage in the arteries. Because a high LDL is not desired, Randall connects the "L" to lousy.
"If a person has a really high HDL and not so great LDL that isn't as bad as having a really low HDL and high LDL," says Randall.
She recommends the use of the "10 Year Heart Attack Risk Calculator" as a teaching tool. It is located on the NHLBI Web site. [http://www.nhlbi.nih.gov]
Impacting the numbers
Once people understand the direct relationship between high cholesterol levels and heart disease they need to know what impacts these numbers. Randall says that by working with patients at risk for heart disease for many years, she has noted that weight loss reduces cholesterol levels. While heredity, age, smoking and alcohol consumption all factor into the cause of heart disease, it would not be such a big health problem in the United States if obesity were not so common, says Randall.
Obesity is a result of eating too many calories and exercising too little, she adds. Yet lifestyle change is difficult. Often, physicians will prescribe a drug called a statin to lower LDL cholesterol levels while people work to make the necessary lifestyle changes, says Randall.
Education about cholesterol works well in a classroom setting with the use of a variety of teaching methods, says Randall. In a group, those with family members that have heart disease are usually more motivated to make lifestyle changes, and they share what they have done.
Witnessing how a certain lifestyle resulted in heart disease can motivate change. Randall says instant gratification is a high priority in American society, and people don't look at the consequences behavior might have in the future.
To help people visualize what is happening within their bodies when cholesterol is high, Randall draws pictures on a white board to show the progression of plaque buildup. Models are also good so people can touch the inside of an artery and see what it looks like when it is clogged.
Yet information is not enough. Barriers to lifestyle change also must be addressed. People raising a family are often under a lot of stress and pressure and do not schedule time for exercise and meal preparation. "People eat out a lot, and the amount of fat in these foods whether fast food or fine dining is contributing to obesity. Also the fact they are not expending any calories in making the meal," says Randall.
It's good to have a multitude of tools and resources to help people learn as well. Randall says a list of community resources, such as senior exercise programs or low-cost exercise options like local walking paths, are important. In addition handouts with information, such as the types of activities that burn the most calories, are helpful.
People must learn that a lifestyle change is the goal not losing weight. Numbers can quickly change if bad habits are reintroduced after weight loss, such as eating out more in fast food restaurants.
Cholesterol levels change over time depending on a person's pattern of eating, says Randall.
[Editor's Note: The National Heart Lung Blood Institute has named September "National Cholesterol Education Month." For more information visit the institute's Web site: http://hp2010.nhlbihin.net/cholmonth/.]
Source
For more information about cholesterol education, contact:
- Lisa Randall, RD, CDE, Health Education Coordinator, Inland Northwest Health Services Community Health Education and Resources, 601 W. 1st Street, Spokane, WA 99201. Telephone: (509) 232-8135. E-mail: [email protected].
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