ENJOYING A HEART-HEALTHY DIET: TESTING FOR CHOLESTEROL

It’s important to realise that your cholesterol level can vary considerably from day to day and month to month, even if you don’t change a thing in your diet. Unlike an absolute number such as your body temperature at exactly 98.6°F/36.7°C (unless you have a fever), cholesterol levels represent a range from the low end to the high end. Daily variability may range a full five per cent in either direction.
Thus if your cholesterol reading comes in at 5.2, it might mean that it could be 5.4 or 4.9 tomorrow. Or, of course, that number could represent the high or low end of your particular range.
Moreover, a number of things can influence your count. Stress plays an important role. Accountants demonstrate a higher cholesterol level prior to the tax deadline; it drops back down once the deadline passes. Medical students have shown a cholesterol increase just before major examinations. Even world-class athletes concerned about an upcoming event will experience a rise in cholesterol levels.
An illness can cause fluctuation, so it’s best not to have a test done when you’re suffering from the flu. Women will show a variation during their menstrual period. Your level will be higher in the winter than during summer months.
But don’t throw your hands up in despair. All this means that you shouldn’t trust a single number. That’s especially true for those who’ve just had a heart attack or bypass surgery, both of which can result in an abnormally low count. To have an accurate assessment of your cholesterol level, you should consider the average of at least three separate tests. If your cholesterol test comes in at well over 6.5 each of those times, it’s quite certain that you have a problem to contend with.
There’s been a bit of media publicity regarding testing accuracy. So how can you be sure of your own measurements? The most accurate cholesterol tests are performed in hospital laboratories, where the equipment is regularly serviced and calibrated for both accuracy and precision. Fingerprick tests such as you might see at a shopping mall or supermarket are fine as a way to monitor your levels, but you must realise that they will probably not be as accurate as those processed at a fully equipped laboratory. On the other hand, if the equipment is properly maintained and the personnel are well trained, one can expect a quite accurate measurement from a fingerprick test.
Regardless of the site or method of your test, you can take certain steps to ensure accuracy. If your doctor orders a laboratory test, he’ll probably want a full lipid profile; that is, a complete breakdown of total cholesterol, HDL and LDL cholesterol, and triglycerides. Fasting 12 to 14 hours prior to the test ensures an accurate measure of the triglycerides, and that number is used to calculate the level of LDL in your blood. Fasting is not required if only the total and/or HDL cholesterol will be measured.
Foods eaten the day before a cholesterol test will have little effect on the results, as long as the 12- to 14-hour fast is observed. The effect of a high-fat, high-cholesterol meal takes two to three days to show up in the cholesterol count.
If you have a fingerprick test, rest seated for about five minutes prior to blood drawing. Make sure your hands are warm so that the technician will not have to “milk” a drop of blood from your finger. Such milking results in inaccurately low tests. If cold hands are the result of inclement weather, keep your hands in your pockets during your five-minute rest. If they are cold as the result of stress, take those five minutes to do some deep breathing or biofeedback.
How do your cholesterol levels match up with others in the population? Compare yours with the tabulations in Tables 5A-5F (pages 316-18).
Women should note that their HDL levels typically are much higher than those for men. While a high total cholesterol count may be an initial cause for alarm, it may be balanced out by a very high HDL level. It is an unfortunate reality that many women today are being treated aggressively, perhaps even with drugs, for elevated cholesterol measurements when those elevations may be largely due to high levels of the protective HDLs.
Why might your cholesterol level be high? While we’ve heard so much about diet during the past few years, your eating habits may not be the only reason for cholesterol elevations.
Indeed, a significant part of the problem was inherited from your parents and grandparents. Some people are simply more genetically programmed to produce large amounts of cholesterol in their livers. Eating a high-fat, high-cholesterol diet just makes matters worse.
Other medical conditions also play significant roles. Hypothyroidism can result in cholesterol elevations. So can diabetes and menopause. Moreover, certain medications, such as antihypertensive drugs, can raise cholesterol levels. Your doctor will want to take all of these into consideration in diagnosing your own condition. But to effectively control your cholesterol, you have to play the principal role.
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Cardio & Blood/ Cholesterol
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