You may already know
that heart disease, or atherosclerosis, is the leading cause of death in the
United States of the age 65 or older population. But did you know it is also
now one of the leading causes of death after spinal cord injury (SCI)? This
makes sense when you realize survival after a SCI is now much better than in
the past because urinary tract and respiratory problems can be treated
successfully.
An important goal
toward reducing the risk of heart disease is to increase HDL, “good”
cholesterol, and lower intake of “normal” cholesterol. Spinal cord injured
individuals have a lower “good” cholesterol, HDL, than able-bodied individuals.
HDLs are considered good because they carry cholesterol away from the arteries
and back to the liver. Therefore just keeping track of body weight and total
cholesterol is not enough. If you have low “normal” total cholesterol ([less
than]200) but have a lower “good” cholesterol level ([less than]35), the risk
for heart disease still exists.
Atherosclerosis is a
condition that leads to hardening of the larger arteries which lead to the
heart or the brain. Blocking of these arteries leads to heart attack or stroke.
The hardening process develops gradually and is influenced by many different
factors including high blood pressure, obesity, inactivity, smoking, family
history of high cholesterol and diet. Family history can not be altered.
Inactivity and high blood pressure may or may not be controllable. The other
risk factors – smoking, weight and diet – can be reckoned with. Let’s focus on
weight and diet.
The American Heart
Association has developed dietary guidelines that are recommended to help lower
one’s risk for heart disease.
1. Total calories
should be sufficient to maintain ideal body weight. It is recommended that your
ideal body weight and recommended calorie intake be discussed with your doctor
or a registered dietician. Your ideal body weight may be 5 – 15% below that
recommended for the able-bodied population. Height, weight, age, sex, activity,
and medical conditions all need to be considered. Until you do that, you can
start reading labels and record your calorie intake for three days. This will
give you your current average. If your average intake is high (2100 – 2500 a
day or more), and you are overweight, cutting back to 1800 or 2000 will be a
good first step. Do not go below 1400 calories until you check with your
doctor!
2. Of your total
calories, only 30% of them should come from fat. Let’s say your calorie intake
should be approximately 1800 a day; your fat intake can be 30% of this or 600
calories. Divide 600 by 9 to get the number of fat grams this equals. In this
example, 66 grams of fat is the limit. This may sound like plenty, but one fast
food meal can easily use up your daily allowance. Fast food chains should have
nutrient content pamphlets available. Just ask!
3. Saturated fat
intake should only be 1/3 of your total fat intake. If your fat goal is 66
grams a day you are limited to 22 grams of saturated fat. Experts now say that
monitoring saturated fat intake is more important than watching total
cholesterol intake in fighting heart disease. Sources of saturated fat include
whole milk, cheese, butter, coconut oil and palm oil.
Long term compliance
is the goal and best accomplished with slower, gradual lifestyle changes. For
many it is easier to tackle the first two guidelines and then work toward
achieving the next two.
Besides watching your
diet, decreasing alcohol intake, quitting smoking, losing weight, and
exercising if possible, are ways to increase the HDL and lower your risk for
heart disease.
Remember, your
cholesterol level and/or weight did not rise overnight, so don’t expect
overnight results with this either. Progress can be slow. Record your weight
and lab values on a table to see results over time.
4. Cholesterol intake
should not exceed 300 mgs. per day. Cholesterol comes from animal products such
as egg yolks, meat (especially organ meat) milk, cheese, and butter. This
number is the same for everyone; it does not depend on caloric needs.
Keeping tabs on these
numbers is easy. The new food labels spell out the grams of fat, saturated fat,
and cholesterol for you. You just need to note the serving size and adjust if
you are eating more than this.
What
you can do about it -
* watch your diet,
* decrease alcohol
intake,
* quit smoking,
* lose weight
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