SEKAYA - 
BAHAN2:
Lapisan Atas:
5 biji telur
3 ketul gula melaka
2 SB gula
1 cawan air
1 SB minyak masak
Daun pandan
Lapisan Bawah:
1 1/2 cawan pulut
1 cawan santan pekat
sedikit garam
CARA2:
Lapisan Bawah:
1. Basuh dan toskan beras pulut.Rendam semalaman(Kalau nak lagi cepat, rendam dalam air mendidih selama 15 minit)
2.Toskan beras pulut dan letakkan di dalam loyang pengukus. Masukkan santan yang dikacau dengan sedikit garam.Pastikan pulut terendam sepenuhnya oleh santan.
3.Kukus sehingga masak.Setelah masak, tekan pulut hingga padat(Saya tak tekan padat sangat sebab bila lapisan atas diletak, ia akan menyerap ke dalam pulut, kuih jadi lebih sedap, terpulang kepada individu k)
Lapisan Bawah:
1. Cairkan gula melaka, air dan gula sehingga larut dan menggelegak.Letak bersama beberapa helai daun pandan.Setelah larut, tutup api dan tapis.biarkan sejuk
2. Pukul telur menggunakan hand whisk dan masukkan larutan gula melaka tadi.Pukul sebati dan masukan minyak masak. pukul lagi dan kacau sebati
3. Masukkan adunan ke atas pulut yang dikukus tadi dan kukus lagi lebih kurang setengah jam atau sehingga masak.Sedia dihidang
SEKAYA shared from shaed
Republish by The CC Resepi
BAHAN2:
Lapisan Atas:
5 biji telur
3 ketul gula melaka
2 SB gula
1 cawan air
1 SB minyak masak
Daun pandan
Lapisan Bawah:
1 1/2 cawan pulut
1 cawan santan pekat
sedikit garam
CARA2:
Lapisan Bawah:
1. Basuh dan toskan beras pulut.Rendam semalaman(Kalau nak lagi cepat, rendam dalam air mendidih selama 15 minit)
2.Toskan beras pulut dan letakkan di dalam loyang pengukus. Masukkan santan yang dikacau dengan sedikit garam.Pastikan pulut terendam sepenuhnya oleh santan.
3.Kukus sehingga masak.Setelah masak, tekan pulut hingga padat(Saya tak tekan padat sangat sebab bila lapisan atas diletak, ia akan menyerap ke dalam pulut, kuih jadi lebih sedap, terpulang kepada individu k)
Lapisan Bawah:
1. Cairkan gula melaka, air dan gula sehingga larut dan menggelegak.Letak bersama beberapa helai daun pandan.Setelah larut, tutup api dan tapis.biarkan sejuk
2. Pukul telur menggunakan hand whisk dan masukkan larutan gula melaka tadi.Pukul sebati dan masukan minyak masak. pukul lagi dan kacau sebati
3. Masukkan adunan ke atas pulut yang dikukus tadi dan kukus lagi lebih kurang setengah jam atau sehingga masak.Sedia dihidang
SEKAYA shared from shaed
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PAJERI NENAS -
BAHAN-BAHAN :
PAJERI NENAS shared from Nannie
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Alhamdulillah , secukup rasa kegemaran kami sekeluarga...
BAHAN-BAHAN :
1 biji nenas masak ranum -sederhana besar
5 cawan santan - boleh tambah
1 genggam udang kering
4 biji bawang merah
1 ulas bawang putih
2 cm halia
3 cm kayu manis
1 biji bunga lawang
3 biji bunga cengkih
1 peket serbuk kari daging
2-3 camca besar kerisik
gula dan garam secukup rasa
CARA MEMASAK :
Bersihkan nenas dan potong ikut saiz yang sesuai . Basuh udang kering.
Panaskan sedikit minyak dan tumiskan semua bawang + halia , kulit kayu manis , bunga lawang dan bunga cengkih . Kacau semua bahan dan masukkan udang kering . Kacau sampai bawang menjadi layu dan terus di masukkan rempah kari yg sudah di bancuh dengan sedikit air tadi dan kacau , biar sampai rempah masak dan terbit minyak.
Masukan semua santan dan kacau , biar kuah mendidih sekejap kemudian masukkan kerisik dan buah nenas . Masukkan garam dan gula secukup rasa dan terus kacau pajeri ini . Biarkan sampai nenas empuk , itu tanda pajeri sudah masak dan boleh la ditutup api . Dah pun masak....
Bila masak pajeri saya suka nenas yang masak ranum.
PAJERI NENAS shared from Nannie
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How to Burn Fat and Stay Healthy -
How to Burn Fat and Stay Healthy shared from shaed
Republish by The CC Resepi
- Avoid fad diets. There’s no magic bullet when it comes to weight gain. In particular, avoid diets that eliminate any one food group; you should be consuming carbohydrates, protein, and fat at every meal to stay balanced.[1]
- 2
Remember that fat is not as important as calories for controlling weight. To lose weight, you must burn more calories than you consume.[2] It’s as simple as that. The reason we’re taught to be wary of fatty foods is that they tend to have high calories; however, this often causes us to eliminate healthy fatty foods, like avocados, oils, and salmon,[3] from our diet unnecessarily. Just make sure you’re eating healthy monounsaturated and poly-unsaturated fats instead of saturated and trans fat.[2]- If you’re on a 2000-calorie-per-day diet, don’t eat more than 20 grams of saturated fat per day.[4]
- 3
Strength train . This means lifting weights at home or in the gym for at least 30 minutes at a time twice a week. Muscle helps speed your metabolism, as the bodies of muscular people burn more calories even while they’re at rest.[5] - 4
Cut down on processed foods. Stick with all-natural foods, which have little added preservatives and chemicals. If you can’t find it in nature, think twice before you eat it. - 5
Do cardio exercise. For example, interval training, which means alternating between low- and high-intensity activity, is a quick and extremely effective way to improve heart health and endurance. Note that anyone over the age of 60 or who has heart disease, high blood pressure, or arthritis should consult a doctor before attempting interval training.[6] - 6
Carefully consider eating more frequently. Instead of having 3 square meals a day, many go for 6 micro meals to sustain their energy and steady their blood-sugar levels[7] while on a low-calorie diet. There is, however, a tendency for people to justify turning “micro meals” into junk food sessions; research has indicated that people often consume not just more calories, but emptier ones when taking the snacking approach.[8] Know yourself well enough to make this choice. - 7
Aim for least 3 to 4 exercise sessions per week in the beginning. Once you get into the habit of exercising, work up to 4 to 5 sessions per week (or more). - 8
Control your portions by eating low energy-density foods. For example, vegetables and fruits are packed with not only healthful vitamins and minerals, but also a lot of water, giving them a low energy density (i.e. more substance, fewer calories). They also tend to have a high fiber content, which is not only good for you, but also take longer to digest and make you feel full for longer.[9] - 9
Drink more water. Water is a major player in weight control. Besides being a major part of your body, water helps flush metabolic wastes keeping your metabolism charged.[10] It can also help you feel fuller, so don't wait until you feel thirsty. Start by drinking at least a half-gallon (2 liters) of water every day. People who are active, live in hot climates, experience fluid loss through fever or diarrhea, etc. should increase their intake. - 10
Eat more fiber. A high-fiber diet can improve bowel health, lower blood cholesterol, control your blood-sugar level, and make you less likely to overeat. The recommended fiber intake is 30 grams a day for men and 21 for women; after the age of 50, this jumps up to 38 for men and 25 for women. Some good sources of fiber include fruits and vegetables (with the skin), whole grains, and legumes.[11] One way to start is instead of drinking orange juice for breakfast, eat an orange; it will make you feel fuller. - 11
Get a full night’s sleep. Adults should sleep 7 to 9 hours every night; school-aged children should sleep 10 to 11.[12] One study conducted by The American Journal of Clinical Nutrition demonstrated that men who had 4 hours of sleep consumed 500 more calories than they did after having 8 hours of sleep.[13] Be careful not to oversleep, however, as this has also been associated with weight gain.[14] - 12
Make lifestyle changes. In addition to making large gestures, change your approach to the everyday stuff to make your new habits stick. Park farther away from the store, take the stairs instead of the elevator, or garden more frequently to sneak a little extra movement into your day.[5] Instead of eating distractedly in front of the computer or TV, which promotes mindless overeating,[15] set time aside to slowly enjoy each meal.
How to Burn Fat and Stay Healthy shared from shaed
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Understanding Cholesterol: The Good, the Bad, and the Necessary -
Excerpted from The Harvard Medical School Guide to Lowering Your Cholesterol
By Mason W. Freeman, M.D. with Christine Junge
Reprinted by permission of the McGraw-Hill Companies; © Copyright 2005 by President and Fellows of Harvard College. All Rights Reserved.
For more information or to purchase this book, follow this link:
http://www.health.harvard.edu/books/Lowering_Your_Cholesterol.htm
High cholesterol is a serious health problem that affects about fifty million Americans. It's a major risk factor for cardiovascular disease (CVD), which half of all men and a third of all women will get at some time in their lives. I'll spend the majority of this book on the two things my patients ask about most: how cholesterol and heart disease are connected and what they can do to optimize their cholesterol levels. But I want to take a few pages early on to clarify that cholesterol in and of itself isn't bad. While too much cholesterol can be harmful, just the right amount of it does a lot of important work in the body. But like carbohydrates in recent years, cholesterol has gotten such a bad rap that most people don't know the good it does.
Cholesterol performs three main functions:
Without cholesterol, none of these functions would take place, and without these functions, human beings wouldn't exist.
Cholesterol is a fat, or lipid. It is also a sterol, from which steroid hormones are made. If you held cholesterol in your hand, you would see a waxy substance that resembles the very fine scrapings of a whitish-yellow candle. Cholesterol flows through your body via your bloodstream, but this is not a simple process. Because lipids are oil-based and blood is water-based, they don't mix. If cholesterol were simply dumped into your bloodstream, it would congeal into unusable globs. To get around this problem, the body packages cholesterol and other fats into minuscule protein-covered particles called lipoproteins (lipid + protein) that do mix easily with blood. The proteins used are known as apolipoproteins.
The fat in these particles is made up of cholesterol and triglycerides and a third material I won't discuss much, phospholipid, which helps make the whole particle stick together. Triglycerides are a particular type of fat that have three fatty acids attached to an alcohol called glycerol—hence the name. They compose about 90 percent of the fat in the food you eat. The body needs triglycerides for energy, but as with cholesterol, too much is bad for the arteries and the heart.
The two main types of lipoproteins important in a discussion on heart disease are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Though the names sound the same, these two particles are as different as night and day. The differences stem from their densities, which are a reflection of the ratio of protein to lipid; particles with more fat and less protein have a lower density than their high-protein, low-fat counterparts. There are countless other lipoproteins, some of which I'll discuss in later chapters, but in order to get a basic understanding of how cholesterol affects your body and how the food you eat affects your cholesterol levels, LDL and HDL are the ones to start with.
In most people, 60 to 70 percent of cholesterol is carried in LDL particles. LDL particles act as ferries, taking cholesterol to the parts of the body that need it at any given time. Unfortunately, if you have too much LDL in the bloodstream, it deposits the cholesterol into the arteries, which can cause blockages and lead to heart attacks. That's why people refer to LDL as the "bad" cholesterol. The good news is that the amount of LDL in your blood-stream is related to the amount of saturated fat and cholesterol you eat. So, most people can decrease their LDL if they follow a reduced-fat diet. When you get a fasting cholesterol test, your doctor should test for the level of LDL cholesterol.
HDL is basically the opposite of LDL. Instead of having a lot of fat, HDL has a lot of protein. Instead of ferrying cholesterol around the body, HDL acts as a vacuum cleaner sucking up as much excess cholesterol as it can (see Figure 1.1). It picks up extra cholesterol from the cells and tissues and takes it back to the liver, which takes the cholesterol out of the particle and either uses it to make bile or recycles it. This action is thought to explain why high levels of HDL are associated with low risk for heart disease. HDL also contains antioxidant molecules that may prevent LDL from being changed into a lipoprotein that is even more likely to cause heart disease. Lifestyle changes affect HDL levels—exercise can increase them, while obesity and smoking lower them. As for diet, in general, the high-fat diets that raise LDL also raise HDL, while low-fat diets lower both. However, by carefully choosing the right foods, you can eat a diet that lowers LDL without lowering HDL, as I'll discuss in Chapter 6.
Cholesterol is so important to the body that it makes it itself—Mother Nature doesn't leave it up to humans to get whatever they need from diet alone. So even if you ate a completely cholesterol-free diet, your body would make the approximately 1,000 mg it needs to function properly. Your body has the ability to regulate the amount of cholesterol in the blood, producing more when your diet doesn't provide adequate amounts. The regulation of cholesterol synthesis is an elegant process that is tightly controlled.
The system works much as your thermostat and furnace work to regulate the temperature in your home. The thermostat in this case is a protein that can sense the cholesterol content of a cell. When it senses a low level of cellular cholesterol, the protein signals the genes of the cell (the furnace in this analogy) to produce the proteins that make cholesterol. The cell makes more cholesterol, and it also makes more proteins on the cell surface that can capture the circulating LDL particles, thereby retrieving cholesterol by bringing it in from the blood. It is this regulation that permits the commonly used cholesterol-lowering drugs to work so effectively, which I will describe in more detail in Chapter 8.
Almost all of the cells of the body can make the cholesterol they need. The liver, however, is an especially efficient cholesterol factory, efficient enough that it can afford to export much of what it makes. The liver packages much of its cholesterol into lipoproteins that can be delivered to cells throughout the body, providing a supplement to what each cell can make on its own. This supplement is especially important to the areas of the body that utilize a lot of cholesterol—like the testes in men and the ovaries in women, where the sex hormones are created.
In an attempt to make the public health message about keeping your cholesterol at a healthy level easy to understand, educators often don't emphasize the point that all humans make substantial quantities of cholesterol. But it's important that you understand this because it clears up confusion a lot of my patients voice. When I tell a patient that she has high cholesterol, she may say, "How could that be? I hardly eat any foods with cholesterol. My body must somehow make cholesterol—that's what's wrong!" So I have to explain that making cholesterol isn't something that she uniquely and unluckily does—all humans do it, and we wouldn't survive otherwise.
Your blood cholesterol level is determined by the sum of how much cholesterol your body makes and how much you take in from food, minus how much your body uses up or excretes. High cholesterol can result from a problem in any of the variables in that equation—your body may produce more cholesterol than it needs due to a genetic predisposition, you may be getting too much from your diet, or you may not excrete cholesterol in your bile efficiently. The fact that Americans have higher blood cholesterol levels than citizens of the Far East or Africa could be due to differences in genetic factors, but most evidence suggests that our higher cholesterol levels are largely a product of our high-fat, high-cholesterol diet.
Your body does need food to fuel the cholesterol production process, but it can be virtually any kind of food, even the cholesterol-free kind. As long as the food contains carbon—which carbohydrates, fats, and proteins all do—it provides the body with the building blocks to make its own cholesterol. Cholesterol is made out of the carbon that is recycled from the food you eat. Saturated fats, however, raise blood cholesterol levels more than other types of food, which is why people watching their cholesterol are told to avoid them. This is true even if saturated fat (which doesn't have any cholesterol in itself but is often found in foods with high cholesterol) is eaten in a cholesterol-free food. Why saturated fat does this is still something of a biological mystery.
There are a variety of genetic disorders that affect how the body makes lipids. In terms of heart disease risk, the most detrimental lipid disorders increase LDL levels and decrease HDL levels. The majority of these disorders are caused by a few problematic genes combined with environmental factors such as obesity or a diet high in saturated fat. As far as treatment goes, it doesn't matter if your high cholesterol is caused by problematic genes or not. Medication and lifestyle changes are still prescribed based on your HDL and LDL levels. However, the discovery of these genetic problems has greatly increased researchers' understanding of lipoproteins and cholesterol.
A family history of heart troubles can increase anyone's risk for heart disease, but for people with a gene mutation that causes extremely high cholesterol levels—and at an early age—it nearly guarantees it.
Nearly.
Kelly's father died of a heart attack at twenty-eight, before she was born. A police officer, he collapsed while trying to break up a fight. An autopsy showed that three of his coronary arteries were nearly 80 percent blocked—an unusual circumstance in such a young man. Kelly's mom is a nurse, and despite the reluctance of her doctors, she had Kelly's cholesterol tested when Kelly was one year old. The sobering result: Kelly's cholesterol was 350.
The pediatricians hadn't dealt with such a high cholesterol level in a child so young, and so they referred Kelly to a specialist. Early treatment consisted of a low-fat, low-cholesterol diet. "It wasn't nearly as bad as people might think," says Kelly. "My mom modified recipes, even for baking, and I would eat 'treats' occasionally, like pizza or cake at a birthday party. I was also very active, playing soccer, softball, taking dance classes, and swimming a lot in the summer. My mom really encouraged this, too."
While Kelly's mother had special motivation to be so vigilant, it's a good lesson for all parents. "In some ways, it was good to have to adopt a healthy lifestyle so early," she says. "It would be very hard to suddenly have to start eating a certain diet and develop the exercise habit."
In elementary school, Kelly started taking the cholesterol-lowering medication Questran, which had to be mixed into a beverage. Kelly recalls, "It tasted horrible and I usually took it during school, so it made me feel 'different' from other kids." Her mom decided against trying niacin, which is used to lower cholesterol, because of the side effects, but as a teenager Kelly did take the herbal supplement Cholestin, which helped somewhat. I first saw Kelly when she was eighteen years old, and our initial step was to try one of the statins. This step produced a dramatic improvement in her cholesterol—better results than we achieved with other drugs. I recently switched Kelly to the statin Lipitor, starting at a lower dose and working up to 80 mg/day. She took time off from her medications when pregnant and breastfeeding, but overall she has had no side effects and is looking forward to continued good results.
Kelly has familial hypercholesterolemia, specifically Frederickson type IIa. This condition is usually due to a mutation in the LDL receptor, although there are at least two other genetic mutations that could cause the same picture. Kelly's LDL is quite high, but her HDL is in a very healthy range, and she's never had a problem with high triglycerides. Her daughter, who is seven, shows no signs of cholesterol problems, but her two-year-old son's cholesterol is about 260, with a relatively low HDL level.
Kelly, like her mom, is a nurse and knows what she needs to do to protect her health and that of her children. But she is quick to point out that she leads a healthy lifestyle not only to keep her cholesterol in check. She also wants to stay healthy and live a long life for her kids and husband. And she wants to set a good example along the way. "It can be difficult sometimes. Things get hectic with a job and raising a family. Occasionally when things get crazy, I think how easy it would be to pick up dinner at a fast-food joint. And once in a while, I do, but fast food isn't part of our lifestyle."
Although she doesn't "worry" about it, Kelly knows that heart disease is still the leading cause of death for women. That knowledge almost seems inescapable based on news reports and even the ads for cholesterol-lowering drugs. Still, she says that she feels good about taking all the necessary steps to protect her heart health. "I tell my daughter that there's nothing wrong with my heart but that I have to see a specialist regularly to check up on it to keep it healthy." Her mom—and stepdad—continue to play an active role in looking after Kelly's heart health and that of her children.
The loss of Kelly's dad is tragic. Fortunately, her mom put two and two together and helped set Kelly on a healthy path that is likely to steer her away from heart problems and makes it less likely that one terrible family "tradition" will be carried forward.
For most people—especially those with high cholesterol—the liver and other cells aren't the body's only sources of cholesterol. Our society's typical high-fat diet also packs a powerful cholesterol punch. How can cholesterol from a hamburger and French fries eventually make its way to your heart's arteries? As you eat food with cholesterol, your intestines go through a complex process of breaking down fat molecules and building them into new molecules that the body can use (see Figure 1.2).
Intestinal enzymes rapidly dismantle the long, complex fat molecules into their component fatty acids, reassemble them into new triglyceride molecules, and package these new triglycerides—along with a small amount of cholesterol—into chylomicrons, a lipoprotein that has a very, very low density. The amount of triglyceride-rich particles in the blood increases for several hours after a meal as the intestines release a barrage of chylomicrons filled with triglycerides.
At the same time, dietary carbohydrates and proteins that are absorbed from the intestines pass to the liver, which converts them to triglyceride molecules, packages them with apolipoproteins and cholesterol, and releases the resulting very low-density lipoproteins (VLDL) into the bloodstream. As chylomicrons and VLDL course around the body, they temporarily stick to the walls of blood vessels in muscles that need energy or in fatty tissue that stores energy. Enzymes come along and remove most of their load of triglyceride molecules, which are then transported inside the muscle or fat cells. As triglyceride is drained from the chylomicron or VLDL particles, their protective protein coats are rearranged and reconfigured, essentially giving them a new address label that can be read by the liver or other tissues that take up lipoproteins.
Both chylomicrons and VLDL become more and more dense as they give up their low-density fatty cargo. Eventually, all that remains is the packaging material—the protein and cholesterol—and a fraction of the original triglyceride. Chylomicron remnants don't linger in the circulation—the liver filters them from the system and recycles their components.
Many of the triglyceride-depleted VLDL remnants, though, keep circulating and undergo further modification of their lipid and protein content. Eventually these particles are converted to LDL. Virtually all cells in the body can take up and use LDL for their individual needs. But because there are usually more LDL particles in circulation at any one time than your body can use, it's your liver's job to clear the excess from the blood and use it to make more bile acids or new lipoproteins. If the liver can't keep up with the supply of LDL, these particles can come to rest in the wrong places, typically in the lining of blood vessels. In extreme cases, they may settle in the skin and tendons, where they form yellow deposits.
HDL is made by the liver and intestines and has two main jobs. HDL particles give chylomicrons and VLDL the proteins that signal the liver to trap them and extract their fat. They also sponge up excess cholesterol from the linings of blood vessels and else-where and carry it off to the liver for disposal.
People who can't package lipoproteins effectively in the liver because of a genetic mutation still carry out the majority of the body's functions quite well, although they do tend to have problems absorbing vitamins A, D, E, and K and often have blood cell and neurological problems as a result. Those vitamins are fat-soluble, meaning they are carried in the fat particles that make up lipoproteins, so if the body can't package these molecules, it can't absorb the vitamins.
When patients come to me because they have high cholesterol, I'm always amazed at how interested they are not only in the "how-they-can-get-better" part but also in why they have a problem. I think the knowledge of the two goes hand in hand. Knowing how cholesterol is made in the body and how cholesterol is absorbed from food is the foundation for understanding how the right eating plan and, when necessary, cholesterol-lowering drugs, are effective.
Understanding Cholesterol: The Good, the Bad, and the Necessary shared from shaed
Republish by The CC Resepi
By Mason W. Freeman, M.D. with Christine Junge
Reprinted by permission of the McGraw-Hill Companies; © Copyright 2005 by President and Fellows of Harvard College. All Rights Reserved.
For more information or to purchase this book, follow this link:
http://www.health.harvard.edu/books/Lowering_Your_Cholesterol.htm
High cholesterol is a serious health problem that affects about fifty million Americans. It's a major risk factor for cardiovascular disease (CVD), which half of all men and a third of all women will get at some time in their lives. I'll spend the majority of this book on the two things my patients ask about most: how cholesterol and heart disease are connected and what they can do to optimize their cholesterol levels. But I want to take a few pages early on to clarify that cholesterol in and of itself isn't bad. While too much cholesterol can be harmful, just the right amount of it does a lot of important work in the body. But like carbohydrates in recent years, cholesterol has gotten such a bad rap that most people don't know the good it does.
Cholesterol performs three main functions:
- It helps make the outer coating of cells.
- It makes up the bile acids that work to digest food in the intestine.
- It allows the body to make Vitamin D and hormones, like estrogen in women and testosterone in men.
Without cholesterol, none of these functions would take place, and without these functions, human beings wouldn't exist.
What Is Cholesterol?
Cholesterol is a fat, or lipid. It is also a sterol, from which steroid hormones are made. If you held cholesterol in your hand, you would see a waxy substance that resembles the very fine scrapings of a whitish-yellow candle. Cholesterol flows through your body via your bloodstream, but this is not a simple process. Because lipids are oil-based and blood is water-based, they don't mix. If cholesterol were simply dumped into your bloodstream, it would congeal into unusable globs. To get around this problem, the body packages cholesterol and other fats into minuscule protein-covered particles called lipoproteins (lipid + protein) that do mix easily with blood. The proteins used are known as apolipoproteins.
The fat in these particles is made up of cholesterol and triglycerides and a third material I won't discuss much, phospholipid, which helps make the whole particle stick together. Triglycerides are a particular type of fat that have three fatty acids attached to an alcohol called glycerol—hence the name. They compose about 90 percent of the fat in the food you eat. The body needs triglycerides for energy, but as with cholesterol, too much is bad for the arteries and the heart.
A Lipoprotein by Any Other Name
The two main types of lipoproteins important in a discussion on heart disease are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Though the names sound the same, these two particles are as different as night and day. The differences stem from their densities, which are a reflection of the ratio of protein to lipid; particles with more fat and less protein have a lower density than their high-protein, low-fat counterparts. There are countless other lipoproteins, some of which I'll discuss in later chapters, but in order to get a basic understanding of how cholesterol affects your body and how the food you eat affects your cholesterol levels, LDL and HDL are the ones to start with.
What Are the Different Types of Fats?Most people are vaguely familiar with the terms saturated and unsaturated fat. But what do they really mean? All fats have a similar chemical structure: a chain of carbon atoms bonded to hydrogen atoms. What differs is the length and shape of their carbon atoms and the number of hydrogen atoms. These slight structural differences create crucial differences in how the body reacts to them. I'll go into more detail about diet and cholesterol in Chapter 6, but for now, here's a primer:
|
Low-Density Lipoproteins (LDL)
In most people, 60 to 70 percent of cholesterol is carried in LDL particles. LDL particles act as ferries, taking cholesterol to the parts of the body that need it at any given time. Unfortunately, if you have too much LDL in the bloodstream, it deposits the cholesterol into the arteries, which can cause blockages and lead to heart attacks. That's why people refer to LDL as the "bad" cholesterol. The good news is that the amount of LDL in your blood-stream is related to the amount of saturated fat and cholesterol you eat. So, most people can decrease their LDL if they follow a reduced-fat diet. When you get a fasting cholesterol test, your doctor should test for the level of LDL cholesterol.
High-Density Lipoproteins (HDL)
HDL is basically the opposite of LDL. Instead of having a lot of fat, HDL has a lot of protein. Instead of ferrying cholesterol around the body, HDL acts as a vacuum cleaner sucking up as much excess cholesterol as it can (see Figure 1.1). It picks up extra cholesterol from the cells and tissues and takes it back to the liver, which takes the cholesterol out of the particle and either uses it to make bile or recycles it. This action is thought to explain why high levels of HDL are associated with low risk for heart disease. HDL also contains antioxidant molecules that may prevent LDL from being changed into a lipoprotein that is even more likely to cause heart disease. Lifestyle changes affect HDL levels—exercise can increase them, while obesity and smoking lower them. As for diet, in general, the high-fat diets that raise LDL also raise HDL, while low-fat diets lower both. However, by carefully choosing the right foods, you can eat a diet that lowers LDL without lowering HDL, as I'll discuss in Chapter 6.
You Mean My Body Makes Cholesterol?
Cholesterol is so important to the body that it makes it itself—Mother Nature doesn't leave it up to humans to get whatever they need from diet alone. So even if you ate a completely cholesterol-free diet, your body would make the approximately 1,000 mg it needs to function properly. Your body has the ability to regulate the amount of cholesterol in the blood, producing more when your diet doesn't provide adequate amounts. The regulation of cholesterol synthesis is an elegant process that is tightly controlled.
| FIGURE 1.1 HDL to the Rescue High cholesterol levels result in atherosclerosis, a narrowing or hardening of the arteries that can cause heart disease, stroke, and other major health problems. Fortunately, the body uses its own "good" cholesterol to clear out the "bad" cholesterol before it becomes harmful. |
The system works much as your thermostat and furnace work to regulate the temperature in your home. The thermostat in this case is a protein that can sense the cholesterol content of a cell. When it senses a low level of cellular cholesterol, the protein signals the genes of the cell (the furnace in this analogy) to produce the proteins that make cholesterol. The cell makes more cholesterol, and it also makes more proteins on the cell surface that can capture the circulating LDL particles, thereby retrieving cholesterol by bringing it in from the blood. It is this regulation that permits the commonly used cholesterol-lowering drugs to work so effectively, which I will describe in more detail in Chapter 8.
Almost all of the cells of the body can make the cholesterol they need. The liver, however, is an especially efficient cholesterol factory, efficient enough that it can afford to export much of what it makes. The liver packages much of its cholesterol into lipoproteins that can be delivered to cells throughout the body, providing a supplement to what each cell can make on its own. This supplement is especially important to the areas of the body that utilize a lot of cholesterol—like the testes in men and the ovaries in women, where the sex hormones are created.
In an attempt to make the public health message about keeping your cholesterol at a healthy level easy to understand, educators often don't emphasize the point that all humans make substantial quantities of cholesterol. But it's important that you understand this because it clears up confusion a lot of my patients voice. When I tell a patient that she has high cholesterol, she may say, "How could that be? I hardly eat any foods with cholesterol. My body must somehow make cholesterol—that's what's wrong!" So I have to explain that making cholesterol isn't something that she uniquely and unluckily does—all humans do it, and we wouldn't survive otherwise.
Your blood cholesterol level is determined by the sum of how much cholesterol your body makes and how much you take in from food, minus how much your body uses up or excretes. High cholesterol can result from a problem in any of the variables in that equation—your body may produce more cholesterol than it needs due to a genetic predisposition, you may be getting too much from your diet, or you may not excrete cholesterol in your bile efficiently. The fact that Americans have higher blood cholesterol levels than citizens of the Far East or Africa could be due to differences in genetic factors, but most evidence suggests that our higher cholesterol levels are largely a product of our high-fat, high-cholesterol diet.
Your body does need food to fuel the cholesterol production process, but it can be virtually any kind of food, even the cholesterol-free kind. As long as the food contains carbon—which carbohydrates, fats, and proteins all do—it provides the body with the building blocks to make its own cholesterol. Cholesterol is made out of the carbon that is recycled from the food you eat. Saturated fats, however, raise blood cholesterol levels more than other types of food, which is why people watching their cholesterol are told to avoid them. This is true even if saturated fat (which doesn't have any cholesterol in itself but is often found in foods with high cholesterol) is eaten in a cholesterol-free food. Why saturated fat does this is still something of a biological mystery.
Family History Lessons: Familial Hypercholesterolemia
There are a variety of genetic disorders that affect how the body makes lipids. In terms of heart disease risk, the most detrimental lipid disorders increase LDL levels and decrease HDL levels. The majority of these disorders are caused by a few problematic genes combined with environmental factors such as obesity or a diet high in saturated fat. As far as treatment goes, it doesn't matter if your high cholesterol is caused by problematic genes or not. Medication and lifestyle changes are still prescribed based on your HDL and LDL levels. However, the discovery of these genetic problems has greatly increased researchers' understanding of lipoproteins and cholesterol.
A family history of heart troubles can increase anyone's risk for heart disease, but for people with a gene mutation that causes extremely high cholesterol levels—and at an early age—it nearly guarantees it.
Nearly.
Kelly's father died of a heart attack at twenty-eight, before she was born. A police officer, he collapsed while trying to break up a fight. An autopsy showed that three of his coronary arteries were nearly 80 percent blocked—an unusual circumstance in such a young man. Kelly's mom is a nurse, and despite the reluctance of her doctors, she had Kelly's cholesterol tested when Kelly was one year old. The sobering result: Kelly's cholesterol was 350.
The pediatricians hadn't dealt with such a high cholesterol level in a child so young, and so they referred Kelly to a specialist. Early treatment consisted of a low-fat, low-cholesterol diet. "It wasn't nearly as bad as people might think," says Kelly. "My mom modified recipes, even for baking, and I would eat 'treats' occasionally, like pizza or cake at a birthday party. I was also very active, playing soccer, softball, taking dance classes, and swimming a lot in the summer. My mom really encouraged this, too."
While Kelly's mother had special motivation to be so vigilant, it's a good lesson for all parents. "In some ways, it was good to have to adopt a healthy lifestyle so early," she says. "It would be very hard to suddenly have to start eating a certain diet and develop the exercise habit."
In elementary school, Kelly started taking the cholesterol-lowering medication Questran, which had to be mixed into a beverage. Kelly recalls, "It tasted horrible and I usually took it during school, so it made me feel 'different' from other kids." Her mom decided against trying niacin, which is used to lower cholesterol, because of the side effects, but as a teenager Kelly did take the herbal supplement Cholestin, which helped somewhat. I first saw Kelly when she was eighteen years old, and our initial step was to try one of the statins. This step produced a dramatic improvement in her cholesterol—better results than we achieved with other drugs. I recently switched Kelly to the statin Lipitor, starting at a lower dose and working up to 80 mg/day. She took time off from her medications when pregnant and breastfeeding, but overall she has had no side effects and is looking forward to continued good results.
Kelly has familial hypercholesterolemia, specifically Frederickson type IIa. This condition is usually due to a mutation in the LDL receptor, although there are at least two other genetic mutations that could cause the same picture. Kelly's LDL is quite high, but her HDL is in a very healthy range, and she's never had a problem with high triglycerides. Her daughter, who is seven, shows no signs of cholesterol problems, but her two-year-old son's cholesterol is about 260, with a relatively low HDL level.
Kelly, like her mom, is a nurse and knows what she needs to do to protect her health and that of her children. But she is quick to point out that she leads a healthy lifestyle not only to keep her cholesterol in check. She also wants to stay healthy and live a long life for her kids and husband. And she wants to set a good example along the way. "It can be difficult sometimes. Things get hectic with a job and raising a family. Occasionally when things get crazy, I think how easy it would be to pick up dinner at a fast-food joint. And once in a while, I do, but fast food isn't part of our lifestyle."
Although she doesn't "worry" about it, Kelly knows that heart disease is still the leading cause of death for women. That knowledge almost seems inescapable based on news reports and even the ads for cholesterol-lowering drugs. Still, she says that she feels good about taking all the necessary steps to protect her heart health. "I tell my daughter that there's nothing wrong with my heart but that I have to see a specialist regularly to check up on it to keep it healthy." Her mom—and stepdad—continue to play an active role in looking after Kelly's heart health and that of her children.
The loss of Kelly's dad is tragic. Fortunately, her mom put two and two together and helped set Kelly on a healthy path that is likely to steer her away from heart problems and makes it less likely that one terrible family "tradition" will be carried forward.
The Other Source: Diet
For most people—especially those with high cholesterol—the liver and other cells aren't the body's only sources of cholesterol. Our society's typical high-fat diet also packs a powerful cholesterol punch. How can cholesterol from a hamburger and French fries eventually make its way to your heart's arteries? As you eat food with cholesterol, your intestines go through a complex process of breaking down fat molecules and building them into new molecules that the body can use (see Figure 1.2).
Intestinal enzymes rapidly dismantle the long, complex fat molecules into their component fatty acids, reassemble them into new triglyceride molecules, and package these new triglycerides—along with a small amount of cholesterol—into chylomicrons, a lipoprotein that has a very, very low density. The amount of triglyceride-rich particles in the blood increases for several hours after a meal as the intestines release a barrage of chylomicrons filled with triglycerides.
FIGURE 1.2 How Food Becomes Cholesterol |
At the same time, dietary carbohydrates and proteins that are absorbed from the intestines pass to the liver, which converts them to triglyceride molecules, packages them with apolipoproteins and cholesterol, and releases the resulting very low-density lipoproteins (VLDL) into the bloodstream. As chylomicrons and VLDL course around the body, they temporarily stick to the walls of blood vessels in muscles that need energy or in fatty tissue that stores energy. Enzymes come along and remove most of their load of triglyceride molecules, which are then transported inside the muscle or fat cells. As triglyceride is drained from the chylomicron or VLDL particles, their protective protein coats are rearranged and reconfigured, essentially giving them a new address label that can be read by the liver or other tissues that take up lipoproteins.
Both chylomicrons and VLDL become more and more dense as they give up their low-density fatty cargo. Eventually, all that remains is the packaging material—the protein and cholesterol—and a fraction of the original triglyceride. Chylomicron remnants don't linger in the circulation—the liver filters them from the system and recycles their components.
Many of the triglyceride-depleted VLDL remnants, though, keep circulating and undergo further modification of their lipid and protein content. Eventually these particles are converted to LDL. Virtually all cells in the body can take up and use LDL for their individual needs. But because there are usually more LDL particles in circulation at any one time than your body can use, it's your liver's job to clear the excess from the blood and use it to make more bile acids or new lipoproteins. If the liver can't keep up with the supply of LDL, these particles can come to rest in the wrong places, typically in the lining of blood vessels. In extreme cases, they may settle in the skin and tendons, where they form yellow deposits.
HDL is made by the liver and intestines and has two main jobs. HDL particles give chylomicrons and VLDL the proteins that signal the liver to trap them and extract their fat. They also sponge up excess cholesterol from the linings of blood vessels and else-where and carry it off to the liver for disposal.
People who can't package lipoproteins effectively in the liver because of a genetic mutation still carry out the majority of the body's functions quite well, although they do tend to have problems absorbing vitamins A, D, E, and K and often have blood cell and neurological problems as a result. Those vitamins are fat-soluble, meaning they are carried in the fat particles that make up lipoproteins, so if the body can't package these molecules, it can't absorb the vitamins.
Why You Need to Know
When patients come to me because they have high cholesterol, I'm always amazed at how interested they are not only in the "how-they-can-get-better" part but also in why they have a problem. I think the knowledge of the two goes hand in hand. Knowing how cholesterol is made in the body and how cholesterol is absorbed from food is the foundation for understanding how the right eating plan and, when necessary, cholesterol-lowering drugs, are effective.
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What Is Cholesterol? -
To understand high blood cholesterol (ko-LES-ter-ol), it helps to learn about cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body.Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat.
Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside.
Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important.
LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)
HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.
High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.
People who have high blood cholesterol have a greater chance of getting coronary heart disease, also called coronary artery disease. (In this article, the term “heart disease” refers to coronary heart disease.)
The higher the level of LDL cholesterol in your blood, the GREATER your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the LOWER your chance is of getting heart disease.
Coronary heart disease is a condition in which plaque (plak) builds up inside the coronary (heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis).
Atherosclerosis
Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart.
Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina (an-JI-nuh or AN-juh-nuh) or a heart attack may occur.
Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems or death.
Plaque also can build up in other arteries in your body, such as the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease (P.A.D.).
Lowering your cholesterol may slow, reduce, or even stop the buildup of plaque in your arteries. It also may reduce the risk of plaque rupturing and causing dangerous blood clots.
What Is Cholesterol? shared from shaed
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To understand high blood cholesterol (ko-LES-ter-ol), it helps to learn about cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body.Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat.
Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside.
Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important.
LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)
HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.
What Is High Blood Cholesterol?
High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.
People who have high blood cholesterol have a greater chance of getting coronary heart disease, also called coronary artery disease. (In this article, the term “heart disease” refers to coronary heart disease.)
The higher the level of LDL cholesterol in your blood, the GREATER your chance is of getting heart disease. The higher the level of HDL cholesterol in your blood, the LOWER your chance is of getting heart disease.
Coronary heart disease is a condition in which plaque (plak) builds up inside the coronary (heart) arteries. Plaque is made up of cholesterol, fat, calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis).
Atherosclerosis
Figure A shows the location of the heart in the body. Figure B shows a normal coronary artery with normal blood flow. The inset image shows a cross-section of a normal coronary artery. Figure C shows a coronary artery narrowed by plaque. The buildup of plaque limits the flow of oxygen-rich blood through the artery. The inset image shows a cross-section of the plaque-narrowed artery.
Over time, plaque hardens and narrows your coronary arteries. This limits the flow of oxygen-rich blood to the heart.
Eventually, an area of plaque can rupture (break open). This causes a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina (an-JI-nuh or AN-juh-nuh) or a heart attack may occur.
Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.
A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems or death.
Plaque also can build up in other arteries in your body, such as the arteries that bring oxygen-rich blood to your brain and limbs. This can lead to problems such as carotid artery disease, stroke, and peripheral arterial disease (P.A.D.).
Outlook
Lowering your cholesterol may slow, reduce, or even stop the buildup of plaque in your arteries. It also may reduce the risk of plaque rupturing and causing dangerous blood clots.
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The Truth about High Cholesterol -
The Truth about High Cholesterol shared from shaed
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By Dr. Mercola
Cholesterol could easily be described as the smoking gun of the last two decades. It's been responsible for demonizing entire categories of foods (like eggs and saturated fats) and blamed for just about every case of heart disease in the last 20 years.
Yet when I first opened my medical practice in the mid-80s, cholesterol, and the fear that yours was too high was rarely talked about. Somewhere along the way however, cholesterol became a household word -- something that you must keep as low as possible, or suffer the consequences.
You are probably aware that there are many myths that portray fat and cholesterol as one of the worst foods you can consume. Please understand that these myths are actually harming your health.
Not only is cholesterol most likely not going to destroy your health (as you have been led to believe), but it is also not the cause of heart disease.
And for those of you taking cholesterol-lowering drugs, the information that follows could not have been given to you fast enough. But before I delve into this life-changing information, let's get some basics down first.
What Is Cholesterol, and Why Do You Need It?
That's right, you do need cholesterol.
This soft, waxy substance is found not only in your bloodstream, but also in every cell in your body, where it helps to produce cell membranes, hormones, vitamin D and bile acids that help you to digest fat. Cholesterol also helps in the formation of your memories and is vital for neurological function.
Your liver makes about 75 percent of your body's cholesterol,1 and according to conventional medicine, there are two types:
- High-density lipoprotein or HDL: This is the "good" cholesterol that helps keep cholesterol away from your arteries and remove any excess from arterial plaque, which may help to prevent heart disease.
- Low-density lipoprotein or LDL: This "bad" cholesterol circulates in your blood and, according to conventional thinking, may build up in your arteries, forming plaque that makes your arteries narrow and less flexible (a condition called atherosclerosis). If a clot forms in one of these narrowed arteries leading to your heart or brain, a heart attack or stroke may result.
Also making up your total cholesterol count are:
- Triglycerides: Elevated levels of this dangerous fat have been linked to heart disease and diabetes. Triglyceride levels are known to rise from eating too many grains and sugars, being physically inactive, smoking cigarettes, drinking alcohol excessively and being overweight or obese.
- Lipoprotein (a), or Lp(a): Lp(a) is a substance that is made up of an LDL "bad cholesterol" part plus a protein (apoprotein a). Elevated Lp(a) levels are a very strong risk factor for heart disease. This has been well established, yet very few physicians check for it in their patients.
Understand this:
Your Total Cholesterol Level Is NOT a Great Indicator of Your Heart Disease Risk
Health officials in the United States urge everyone over the age of 20 to have their cholesterol tested once every five years. Part of this test is your total cholesterol, or the sum of your blood's cholesterol content, including HDL, LDLs, and VLDLs.
The American Heart Association recommends that your total cholesterol should be less than 200 mg/dL, but what they do not tell you is that total cholesterol level is just about worthless in determining your risk for heart disease, unless it is above 300.
In addition, the AHA updated their guidelines in 2004, lowering the recommended level of LDL cholesterol from 130 to LDL to less than 100, or even less than 70 for patients at very high risk.
In order to achieve these outrageous and dangerously low targets, you typically need to take multiple cholesterol-lowering drugs. So the guidelines instantly increased the market for these dangerous drugs. Now, with testing children's cholesterol levels, they're increasing their market even more.
I have seen a number of people with total cholesterol levels over 250 who actually were at low heart disease risk due to their HDL levels. Conversely, I have seen even more who had cholesterol levels under 200 that were at a very high risk of heart disease based on the following additional tests:
- HDL/Cholesterol ratio
- Triglyceride/HDL ratio
HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your cholesterol. That ratio should ideally be above 24 percent.
You can also do the same thing with your triglycerides and HDL ratio. That ratio should be below 2.
Keep in mind, however, that these are still simply guidelines, and there’s a lot more that goes into your risk of heart disease than any one of these numbers. In fact, it was only after word got out that total cholesterol is a poor predictor of heart disease that HDL and LDL cholesterol were brought into the picture. They give you a closer idea of what’s going on, but they still do not show you everything.
Cholesterol Is Neither 'Good' Nor 'Bad'
Now that we’ve defined good and bad cholesterol, it has to be said that there is actually only one type of cholesterol. Ron Rosedale, MD, who is widely considered to be the leading anti-aging doctor in the United States, does an excellent job of explaining this concept:2"Notice please that LDL and HDL are lipoproteins -- fats combined with proteins. There is only one cholesterol. There is no such thing as 'good' or 'bad' cholesterol.
Cholesterol is just cholesterol.
It combines with other fats and proteins to be carried through the bloodstream, since fat and our watery blood do not mix very well.
Fatty substances therefore must be shuttled to and from our tissues and cells using proteins. LDL and HDL are forms of proteins and are far from being just cholesterol.
In fact we now know there are many types of these fat and protein particles. LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation.
Thus, you might say that there is 'good LDL' and 'bad LDL.'
Also, some HDL particles are better than others. Knowing just your total cholesterol tells you very little. Even knowing your LDL and HDL levels will not tell you very much."
Cholesterol Is Your Friend, Not Your Enemy
Before we continue, I really would like you to get your mind around this concept.
In the United States, the idea that cholesterol is evil is very much engrained in most people's minds. But this is a very harmful myth that needs to be put to rest right now."First and foremost," Dr. Rosedale points out, "cholesterol is a vital component of every cell membrane on Earth. In other words, there is no life on Earth that can live without cholesterol.
That will automatically tell you that, in and of itself, it cannot be evil. In fact, it is one of our best friends.
We would not be here without it. No wonder lowering cholesterol too much increases one's risk of dying. Cholesterol is also a precursor to all of the steroid hormones. You cannot make estrogen, testosterone, cortisone, and a host of other vital hormones without cholesterol."
Vitamin D and Your Cholesterol
You probably are aware of the incredible influence of vitamin D on your health. If you aren't, or need a refresher, you can visit my vitamin D page.
What most people do not realize is that the best way to obtain your vitamin D is from safe exposure to sun on your skin. The UVB rays in sunlight interact with the cholesterol on your skin and convert it to vitamin D.
Bottom line?
If your cholesterol level is too low you will not be able to use the sun to generate sufficient levels of vitamin D.
Additionally, it provides some intuitive feedback that if cholesterol were so dangerous, why would your body use it as precursor for vitamin D and virtually all of the steroid hormones in your body?
Other "evidence" that cholesterol is good for you?
Consider the role of "good" HDL cholesterol. Essentially, HDL takes cholesterol from your body's tissues and arteries, and brings it back to your liver, where most of your cholesterol is produced. If the purpose of this was to eliminate cholesterol from your body, it would make sense that the cholesterol would be shuttled back to your kidneys or intestines so your body could remove it.
Instead, it goes back to your liver. Why?
Because your liver is going to reuse it."It is taking it back to your liver so that your liver can recycle it; put it back into other particles to be taken to tissues and cells that need it," Dr. Rosedale explains. "Your body is trying to make and conserve the cholesterol for the precise reason that it is so important, indeed vital, for health."
Cholesterol and Inflammation - What's the Connection?
Inflammation has become a bit of a buzzword in the medical field because it has been linked to so many different diseases. And one of those diseases is heart disease... the same heart disease that cholesterol is often blamed for.
What am I getting at?
Well, first consider the role of inflammation in your body. In many respects, it's a good thing as it's your body's natural response to invaders it perceives as threats. If you get a cut for instance, the process of inflammation is what allows you to heal.
Specifically during inflammation:
- Your blood vessels constrict to keep you from bleeding to death
- Your blood becomes thicker so it can clot
- Your immune system sends cells and chemicals to fight viruses, bacteria and other "bad guys" that could infect the area
- Cells multiply to repair the damage
Ultimately, the cut is healed and a protective scar may form over the area.
If your arteries are damaged, a very similar process occurs inside of your body, except that a "scar" in your artery is known as plaque.
This plaque, along with the thickening of your blood and constricting of your blood vessels that normally occur during the inflammatory process, can indeed increase your risk of high blood pressure and heart attacks.
Notice that cholesterol has yet to even enter the picture.
Cholesterol comes in because, in order to replace your damaged cells, it is necessary.
Remember that no cell can form without it.
So if you have a bunch of damaged cells that need to be replaced, your liver will be notified to make more cholesterol and release it into your bloodstream.
This is a deliberate process that takes place in order for your body to produce new, healthy cells.
It's also possible, and quite common, for damage to occur in your body on a regular basis. In this case, you will be in a dangerous state of chronic inflammation.
The test usually used to determine if you have chronic inflammation is a C-reactive protein (CRP) blood test. CRP level is used as a marker of inflammation in your arteries. Generally speaking:
- A CRP level under 1 milligrams per liter of blood means you have a low risk for cardiovascular disease
- 1 to 3 milligrams means your risk is intermediate
- More than 3 milligrams is high risk
Even conventional medicine is warming up to the idea that chronic inflammation can trigger heart attacks. But they stop short of seeing the big picture.
In the eyes of conventional medicine, when they see increased cholesterol circulating in your bloodstream, they conclude that it -- not the underlying damage to your arteries -- is the cause of heart attacks.
Which brings me to my next point.
The Insanity of Lowering Cholesterol
Sally Fallon, the president of the Weston A. Price Foundation, and Mary Enig, Ph.D, an expert in lipid biochemistry, have gone so far as to call high cholesterol "an invented disease, a 'problem' that emerged when health professionals learned how to measure cholesterol levels in the blood."3
And this explanation is spot on.
If you have increased levels of cholesterol, it is at least in part because of increased inflammation in your body. The cholesterol is there to do a job: help your body to heal and repair.
Conventional medicine misses the boat entirely when they dangerously recommend that lowering cholesterol with drugs is the way to reduce your risk of heart attacks, because what is actually needed is to address whatever is causing your body damage -- and leading to increased inflammation and then increased cholesterol.
As Dr. Rosedale so rightly points out:"If excessive damage is occurring such that it is necessary to distribute extra cholesterol through the bloodstream, it would not seem very wise to merely lower the cholesterol and forget about why it is there in the first place.
It would seem much smarter to reduce the extra need for the cholesterol -- the excessive damage that is occurring, the reason for the chronic inflammation."
I'll discuss how to do this later in the report, but first let's take a look at the dangers of low cholesterol -- and how it came to be that cholesterol levels needed to be so low in the first place.
If Your Cholesterol Is Too Low...
All kinds of nasty things can happen to your body. Remember, every single one of your cells needs cholesterol to thrive -- including those in your brain. Perhaps this is why low cholesterol wreaks havoc on your psyche.
One large study conducted by Dutch researchers found that men with chronically low cholesterol levels showed a consistently higher risk of having depressive symptoms.4
This may be because cholesterol affects the metabolism of serotonin, a substance involved in the regulation of your mood.
On a similar note, Canadian researchers found that those in the lowest quarter of total cholesterol concentration had more than six times the risk of committing suicide as did those in the highest quarter.5
Dozens of studies also support a connection between low or lowered cholesterol levels and violent behavior, through this same pathway: lowered cholesterol levels may lead to lowered brain serotonin activity, which may, in turn, lead to increased violence and aggression.6
And one meta-analysis of over 41,000 patient records found that people who take statin drugs to lower their cholesterol as much as possible may have a higher risk of cancer,7 while other studies have linked low cholesterol to Parkinson's disease.
What cholesterol level is too low? Brace yourself.
Probably any level much under 150 -- an optimum would be more like 200.
Now I know what you are thinking: "But my doctor tells me my cholesterol needs to be under 200 to be healthy." Well let me enlighten you about how these cholesterol recommendations came to be. And I warn you, it is not a pretty story.
This is a significant issue. I have seen large numbers of people who have their cholesterol lowered below 150, and there is little question in my mind that it is causing far more harm than any benefit they are receiving by lowering their cholesterol this low.
Who Decided What Cholesterol Levels Are Healthy or Harmful?
In 2004, the U.S. government's National Cholesterol Education Program panel advised those at risk for heart disease to attempt to reduce their LDL cholesterol to specific, very low, levels.
Before 2004, a 130-milligram LDL cholesterol level was considered healthy. The updated guidelines, however, recommended levels of less than 100, or even less than 70 for patients at very high risk.
Keep in mind that these extremely low targets often require multiple cholesterol-lowering drugs to achieve.
Fortunately, in 2006, a review in the Annals of Internal Medicine8 found that there is insufficient evidence to support the target numbers outlined by the panel. The authors of the review were unable to find research providing evidence that achieving a specific LDL target level was important in and of itself, and found that the studies attempting to do so suffered from major flaws.
Several of the scientists who helped develop the guidelines even admitted that the scientific evidence supporting the less-than-70 recommendation was not very strong.
So how did these excessively low cholesterol guidelines come about?
Eight of the nine doctors on the panel that developed the new cholesterol guidelines had been making money from the drug companies that manufacture statin cholesterol-lowering drugs.9
The same drugs that the new guidelines suddenly created a huge new market for in the United States.
Coincidence? I think not.
Now, despite the finding that there is absolutely NO evidence to show that lowering your LDL cholesterol to 100 or below is good for you, what do you think the American Heart Association STILL recommends?
Lowering your LDL cholesterol levels to less than 100.10
And to make matters worse, the standard recommendation to get to that level almost always includes one or more cholesterol-lowering drugs.
The Dangers of Cholesterol-Lowering Medications
If you are concerned about your cholesterol levels, taking a drug should be your absolute last resort. And when I say last resort, I'm saying the odds are very high, greater than 100 to 1, that you don't need drugs to lower your cholesterol.
To put it another way, among the more than 20,000 patients who have come to my clinic, only four or five of them truly needed these drugs, as they had genetic challenges of familial hypercholesterolemia that required it.
Contrast this to what is going on in the general population. According to data from Medco Health Solutions Inc., more than half of insured Americans are taking drugs for chronic health conditions. And cholesterol-lowering medications are the second most common variety among this group, with nearly 15 percent of chronic medication users taking them (high blood pressure medications -- another vastly over-prescribed category -- were first).11
Disturbingly, as written in BusinessWeek early in 2008, "Some researchers have even suggested -- half-jokingly -- that the medications should be put in the water supply."12
Count yourself lucky that you probably do NOT need to take cholesterol-lowering medications, because these are some nasty little pills.
Statin drugs work by inhibiting an enzyme in your liver that's needed to manufacture cholesterol. What is so concerning about this is that when you go tinkering around with the delicate workings of the human body, you risk throwing everything off kilter.
Case in point, "statin drugs inhibit not just the production of cholesterol, but a whole family of intermediary substances, many if not all of which have important biochemical functions in their own right," say Enig and Fallon.
For starters, statin drugs deplete your body of Coenzyme Q10 (CoQ10), which is beneficial to heart health and muscle function. Because doctors rarely inform people of this risk and advise them to take a CoQ10 supplement, this depletion leads to fatigue, muscle weakness, soreness, and eventually heart failure.
Muscle pain and weakness, a condition called rhabdomyolysis, is actually the most common side effect of statin drugs, which is thought to occur because statins activate the atrogin-1 gene, which plays a key role in muscle atrophy.13
By the way, muscle pain and weakness may be an indication that your body tissues are actually breaking down -- a condition that can cause kidney damage.
Statin drugs have also been linked to:
- An increased risk of polyneuropathy (nerve damage that causes pain in the hands and feet and trouble walking)
- Dizziness
- Cognitive impairment, including memory loss14
- A potential increased risk of cancer15
- Decreased function of the immune system16
- Depression
- Liver problems, including a potential increase in liver enzymes (so people taking statins must be regularly monitored for normal liver function)
And recently a possible association was found between statins and an increased risk of Lou Gehrig's disease.17
Other cholesterol-lowering drugs besides statins also have side effects, most notably muscle pain and weakness.
Are Cholesterol Drugs Even Effective?
With all of these risks, the drugs had better be effective, right? Well, even this is questionable. At least, it depends on how you look at it.
Most cholesterol-lowering drugs can effectively lower your cholesterol numbers, but are they actually making you any healthier, and do they help prevent heart disease?
Have you ever heard of the statistic known as NNT, or number needed to treat?
I didn't think so. In fact, most doctors haven't either. And herein lies the problem.
NNT answers the question: How many people have to take a particular drug to avoid one incidence of a medical issue (such as a heart attack)?
For example, if a drug had an NNT of 50 for heart attacks, then 50 people have to take the drug in order to prevent one heart attack.
Easy enough, right?
Well, drug companies would rather that you not focus on NNT, because when you do, you get an entirely different picture of their "miracle" drugs. Take, for instance, Pfizer's Lipitor, which is the most prescribed cholesterol medication in the world and has been prescribed to more than 26 million Americans.18
According to Lipitor's own Web site, Lipitor is clinically proven to lower bad cholesterol 39-60 percent, depending on the dose. Sounds fairly effective, right?
Well, BusinessWeek actually did an excellent story on this very topic earlier this year,19 and they found the REAL numbers right on Pfizer's own newspaper ad for Lipitor.
Upon first glance, the ad boasts that Lipitor reduces heart attacks by 36 percent. But there is an asterisk. And when you follow the asterisk, you find the following in much smaller type:"That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."
What this means is that for every 100 people who took the drug over 3.3 years, three people on placebos, and two people on Lipitor, had heart attacks. That means that taking Lipitor resulted in just one fewer heart attack per 100 people.
The NNT, in this case, is 100. One hundred people have to take Lipitor for more than three years to prevent one heart attack. And the other 99 people, well, they've just dished out hundreds of dollars and increased their risk of a multitude of side effects for nothing.
So you can see how the true effectiveness of cholesterol drugs like Lipitor is hidden behind a smokescreen.
Or in some cases, not hidden at all.
Zetia and Vytorin: No Medical Benefits
Early in 2008, it came out that Zetia, which works by inhibiting absorption of cholesterol from your intestines, and Vytorin, which is a combination of Zetia and Zocor (a statin drug), do not work.
This was discovered AFTER the drugs acquired close to 20 percent of the U.S. market for cholesterol-lowering drugs. And also after close to 1 million prescriptions for the drugs were being written each week in the United States, bringing in close to $4 billion in 2007.20
It was only after the results of a trial by the drugs' makers, Merck and Schering-Plough, were released that this was found out. Never mind that the trial was completed in April 2006, and results were not released until January 2008.
And it's no wonder the drug companies wanted to hide these results.
While Zetia does lower cholesterol by 15 percent to 20 percent, trials did not show that it reduces heart attacks or strokes, or that it reduces plaques in arteries that can lead to heart problems.
The trial by the drugs' makers, which studied whether Zetia could reduce the growth of plaques, found that plaques grew nearly twice as fast in patients taking Zetia along with Zocor (Vytorin) than in those taking Zocor alone.21
Of course, the answer is not to turn back to typical statin drugs to lower your cholesterol, as many of the so-called experts would have you believe.
You see, statins are thought to have a beneficial effect on inflammation in your body, thereby lowering your risk of heart attack and stroke.
But you can lower inflammation in your body naturally, without risking any of the numerous side effects of statin drugs. This should also explain why my guidelines for lowering cholesterol are identical to those to lower inflammation.
How to Lower Inflammation, and Thereby Your Risk of Heart Disease, Naturally
There is a major misconception that you must avoid foods like eggs and saturated fat to protect your heart. While it's true that fats from animal sources contain cholesterol, I've explained earlier in this article why this should not scare you -- but I'll explain even further here.
This misguided principle is based on the "lipid hypothesis" -- developed in the 1950s by nutrition pioneer Ancel Keys -- that linked dietary fat to coronary heart disease.
The nutrition community of that time completely accepted the hypothesis, and encouraged the public to cut out butter, red meat, animal fats, eggs, dairy and other "artery-clogging" fats from their diets -- a radical change at that time.
What you may not know is that when Keys published his analysis that claimed to prove the link between dietary fats and coronary heart disease, he selectively analyzed information from only six countries to prove his correlation, rather than comparing all the data available at the time -- from 22 countries.
As a result of this "cherry-picked" data, government health organizations began bombarding the public with advice that has contributed to the diabetes and obesity epidemics going on today: eat a low-fat diet.
Not surprisingly, numerous studies have actually shown that Keys' theory was wrong and saturated fats are healthy, including these studies from Fallon and Enig's classic article The Skinny on Fats:22
- A survey of South Carolina adults found no correlation of blood cholesterol levels with "bad" dietary habits, such as use of red meat, animal fats, fried foods, butter, eggs, whole milk, bacon, sausage and cheese.23
- A Medical Research Council survey showed that men eating butter ran half the risk of developing heart disease as those using margarine.24
Of course, as Americans cut out nutritious animal fats from their diets, they were left hungry. So they began eating more processed grains, more vegetable oils, and more high-fructose corn syrup, all of which are nutritional disasters.
It is this latter type of diet that will eventually lead to increased inflammation, and therefore cholesterol, in your body. So don't let anyone scare you away from saturated fat anymore.
Chronic inflammation is actually caused by a laundry list of items such as:
- Oxidized cholesterol (cholesterol that has gone rancid, such as that from overcooked, scrambled eggs)
- Eating lots of sugar and grains
- Eating foods cooked at high temperatures
- Eating trans fats
- A sedentary lifestyle
- Smoking
- Emotional stress
So to sum it all up, in order to lower your inflammation and cholesterol levels naturally, you must address the items on this list.
How to Lower Your Cholesterol Naturally...
- Make sure you're getting plenty of high-quality, animal-based omega3-fats. I prefer those from krill oil. New research suggests that as little as 500 mg may lower your total cholesterol and triglycerides and will likely increase your HDL cholesterol.
- Reduce, with the plan of eliminating, grains and sugars in your daily diet. It is especially important to eliminate dangerous sugars such as fructose. If your HDL/Cholesterol ratio is abnormal and needs to be improved it would also serve you well to virtually eliminate fruits from your diet, as that it also a source of fructose. Once your cholesterol improves you can gradually reintroduce it to levels that don't raise your cholesterol.
- Eat the right foods for your nutritional type. You can learn your nutritional type by taking our FREE test.
- Eat a good portion of your food raw.
- Eat healthy, preferably raw, fats that correspond to your nutritional type. This includes:
- Olive and olive oil
- Coconut and coconut oil
- Organic raw dairy products (including butter, cream, sour cream, cheese, etc.)
- Avocados
- Raw nuts
- Seeds
- Eggs (lightly cooked with yolks intact or raw)
- Organic, grass-fed meats
- Get the right amount of exercise, especially Peak Fitness type of exercise. When you exercise you increase your circulation and the blood flow throughout your body. The components of your immune system are also better circulated, which means your immune system has a better chance of fighting an illness before it has the opportunity to spread.
- Avoid smoking and drinking excessive amounts of alcohol.
- Address your emotional challenges. I particularly love the Emotional Freedom Technique (EFT) for stress management.
So there you have it; the reasons why high cholesterol is a worry that many of you simply do not need to have, along with a simple plan to optimize yours.
If someone you love is currently taking cholesterol-lowering drugs, I urge you to share this information with them as well, and take advantage of the thousands of free pages of information on www.Mercola.com.
For the majority of you reading this right now, there's no reason to risk your health with cholesterol-lowering drugs. With the plan I've just outlined, you'll achieve the cholesterol levels you were meant to have, along with the very welcome "side effects" of increased energy, mood and mental clarity.
Too good to be true?
Hardly.
For the vast majority of people, making a few lifestyle changes causes healthy cholesterol levels to naturally occur.
As always, your health really is in your hands. Now it's up to you to take control -- and shape it into something great.
The Truth about High Cholesterol shared from shaed
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How`s your cholestrol -
How’s your cholesterol? Time to get it checked!
Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke. Cholesterol can be tricky to understand, though, because not all is bad for you. Some is actually good for you. The most important thing you can do as a first step is to know your cholesterol numbers by getting your cholesterol tested. Here are some easy ways for you to understand what the testing involves, how it can help you and ways to improve your health by improving your cholesterol.
The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol : All adults age 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides — once every five years.
This test is done after a nine- to 12-hour fast without food, liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. View an animation of cholesterol score.
Your test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). To determine how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors such as age, family history, smoking and high blood pressure.
A complete fasting lipoprotein profile will show the following four results.
*Your total cholesterol score is calculated by the following: HDL + LDL + 20% of your triglyceride level.
How`s your cholestrol shared from shaed
Republish by The CC Resepi
Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke. Cholesterol can be tricky to understand, though, because not all is bad for you. Some is actually good for you. The most important thing you can do as a first step is to know your cholesterol numbers by getting your cholesterol tested. Here are some easy ways for you to understand what the testing involves, how it can help you and ways to improve your health by improving your cholesterol.
The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol : All adults age 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides — once every five years.This test is done after a nine- to 12-hour fast without food, liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. View an animation of cholesterol score.
Your test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). To determine how your cholesterol levels affect your risk of heart disease, your doctor will also take into account other risk factors such as age, family history, smoking and high blood pressure.
A complete fasting lipoprotein profile will show the following four results.
Your Total Blood (or Serum) Cholesterol Level
| Total Cholesterol Level | Category |
| Less than 200 mg/dL | Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk. |
| 200 to 239 mg/dL | Borderline high |
| 240 mg/dL and above | High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL. |
*Your total cholesterol score is calculated by the following: HDL + LDL + 20% of your triglyceride level.
How`s your cholestrol shared from shaed
Republish by The CC Resepi
'Wanita Pertama' milikku... -
'Wanita Pertama' milikku... shared from Nannie
Republish by The CC Resepi
Dalam hati ada taman , berbunga-bunga saja hati ni bila melihat deretan pokok ros yang saya bela/jaga hidup sihat , syukur alhamdulillah . Mata dan hati ni tenang saja bila terpandang 'wajah-wajah' ayu manis ni yang sentiasa tersenyum . Saya tak pernah jemu menjaga/bela pokok ros walaupun macam-macam juga dugaan yang saya dah lalui sepanjang jaga pokok ros ni sebab pokok ros ni agak 'manja' tetapi jika kita jaga dengan elok akhirnya diri sendiri yang happy sebab pokok ros yang 'manja' ni akan hidup subur dan berbunga cantik menawan .
Kali ni saya nak share gamabr bunga ros yang baru sebulan saya bela ni nama pokok ros ni 'First Lady' a.k.a 'Wanita Pertama' . Bunga ros FL ni memang terlalu cantik dengan baunya lembut sedap dibau . Pokok ros FL ni pun senang nak hidup dan rajin berbunga serta bunganya tahan lama juga dalam 3-4 hari . Anggun cantik dan menawan ros 'Wanita Pertama'......penyeri laman ros Nannie ^_^
Kali ni saya nak share gamabr bunga ros yang baru sebulan saya bela ni nama pokok ros ni 'First Lady' a.k.a 'Wanita Pertama' . Bunga ros FL ni memang terlalu cantik dengan baunya lembut sedap dibau . Pokok ros FL ni pun senang nak hidup dan rajin berbunga serta bunganya tahan lama juga dalam 3-4 hari . Anggun cantik dan menawan ros 'Wanita Pertama'......penyeri laman ros Nannie ^_^
Ciptaan Ilahi yang sangat cantik..
So beautiful..
Menawan..
Rupa ros FL bila dah full bloom..
Sekali kembang berkuntum-kuntum ^_^
'Wanita Pertama' milikku... shared from Nannie
Republish by The CC Resepi
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