THE NUMBERS GAME\Attempting to stay healthy and reduce the risk of stroke or heart\attack, Americans watch their cholesterol counts.
Robin Schyman once thought her petite figure gave her the green light to eat whatever she wanted, including chocolate - daily.
"I would eat it in any form," she said. "As a topping for ice cream or frozen yogurt, and during my day I would eat chocolate candy."
But Schyman, 37, of Westlake Village, couldn't understand why her cholesterol count was a whopping 397 when she weighed in at only 100 pounds.
That was 10 years ago, and her first reaction was to ignore it - until she discovered how dangerous her high-calorie, sedentary lifestyle had become.
"It did make me nervous for the future. I was afraid of dying and that it would affect my longevity," Schyman said. "It was almost like I made the decision unconsciously. Once I decided I was going to do it, I was completely committed."
So what do you do when you find out your cholesterol has reached a potentially dangerous level of 240 or more?
Don't panic. You can make a change for the better.
"Data shows that if a large amount of people lower their cholesterol significantly, they can reverse heart disease. It is never too late," said Daniel Eisenberg, a cardiologist and president of the American Heart Association in Los Angeles.
A combination of diet and exercise - and in some cases, medication - can produce benefits in four to six weeks, said Michael Levey, director of cardiac rehabilitation at West Hills Regional Medical Center.
It may help to know you're not alone. Though awareness has caused the nation's cholesterol levels to decline from 240 to 220 over the last 20 years, Americans are still finding it difficult to change their high-fat ways, Eisenberg said.
"America is specifically oriented to foods that are high in fat. We have a taste for fat," Eisenberg said. "Fat is still found in everything we eat. People are confused about the truth. They don't know who to believe."
The American Heart Association is trying to help people make sense of it all. Anyone with a family history of diabetes or heart disease, who smokes, has high blood pressure or is overweight is susceptible to higher levels of cholesterol, the buildup of white, waxy fat that is manufactured by the liver.
But - and here is where some of the confusion creeps in - not all cholesterol is bad. High-density lipoproteins (HDLs) are beneficial because they search the blood stream for fatty substances and take them back to the liver. It's the low-density lipoproteins (LDLs) that are unwelcome: They stick to the walls of arteries, eventually slowing blood flow, referred to as atherosclerosis.
If left untreated, large buildups of this fatty plaque eventually can stop the blood flow in the cerebral or coronary arteries, causing a stroke or heart attack.
Finger-prick tests that measure cholesterol can be found at health fairs and blood drives, but the most accurate reading is through a laboratory test, which reveals the ratio of HDLs and LDLs. Doctors recommend you fast for at least eight hours before taking the test.
Beginning at age 21, a cholesterol test should be performed at least once, and then every five years if it's below 200, Eisenberg said. Tests should increase for borderline levels between 200 and 239, while anything above 240 is considered high and should be checked every six months until it has improved.
Robert Goka wasn't surprised to learn his cholesterol level was an unhealthy 252. The Northridge man has a family background of high blood pressure and strokes. Plus, he had smoked for about 15 years before he quit a decade ago.
"Psychologically," said Goka, 59, "(high cholesterol) didn't do anything for me. I got other things to worry about more than that."
That is, until his doctor reminded him that his family's history should serve as a warning. He now eats a low-fat diet and takes a cholesterol-reducing drug, which has brought his level to 193.
"I could die if didn't do anything," he said.
Rina Sherman of West Hills, on the other hand, never figured she would have a problem with cholesterol: She was a slender woman and had no family history of heart disease or strokes. Yet 10 years ago, her cholesterol came in at 265. Sherman is now taking a cholesterol-reducing drug and is on a low-fat diet.
"I wanted to find a way to get it down," said Sherman, who is in her 50s. "It is no good to get clogged arteries."
The first step for people whose cholesterol is found to be 240 or higher is to take the test again to make sure it wasn't a lab error, Eisenberg said. There may be other causes as well, like a thyroid or blood-sugar problem.
If it is determined to be caused by your diet, consider some changes in your eating before asking for expensive drugs that help lower cholesterol, Eisenberg said.
Ellen Bauersfeld, a registered dietitian and consulting nutritionist in Tarzana, suggests using meat as a condiment, not a main entree. Shy away from saturated fats like butter, mayonnaise and blue cheese dressing and opt, instead, for foods that are high in soluble fiber, like oat bran, barley, beans and broccoli.
"On a 2,000-calorie diet, the total grams of fat should be less than 65 grams, and the total saturated fats should be less than 20 grams," Bauersfeld said.
At first, that wasn't so easy for Schyman. Used to eating anything she wanted, Schyman was resentful that she had to "read the labels on everything I bought.
"The first time (at the grocery store) made me depressed, and I also felt angry because I did not have a choice in it," Schyman said. "I looked at the people in the market buying chips and cookies, and they were doing something I couldn't do. I felt lonely, and this hurt."
Now she's a changed woman, having adapted to living on a restricted diet.
"I will be really hungry, but I can't stop and get fast food," Shuyman said. "I haeve to go to a decent restaurant and get something cooked to order. I can't be on the road and just go and get a candy bar. It takes a lot of planning just to eat out and to go traveling. I now carry fruit or nonfat snacks, rice cakes and crackers."
Exercise also is key to lowering bad cholesterol and bolstering your good cholesterol.
"As long as you are healthy and your doctor approves, go for a minimum of aerobic activity three times a week, such as walking briskly for 20 minutes to a half an hour, or some low-impact aerobics," Eisenberg said. "Try for a minimum of 20 minutes to half-hour every other day."
Finally, doctors will suggest medication - primarily in cases in which a person is genetically predisposed to high cholesterol. More than 26 million prescriptions were written for cholesterol-lowering drugs in 1992, the latest year for which statistics are available.
While a variety of medications are prescribed by cardiologists and family physicians, Questran is most recommended to fight high cholesterol. Schyman, for instance, has lowered her cholesterol to 203 with the drug, which she will take for life.
"This sandy powder is the only cholesterol medication that does not affect the liver and acts as a sponge to block the absorption of cholesterol," said Steven Landis, a pharmacist at Kaiser Permanente Medical Center in Woodland Hills. "The only real side effect, though, is that it also blocks the absorption of other medications."
Statins also are effective in reducing the liver's production of cholesterol and increasing the breakdown of the fatty substances already in the system.
Doctors say a cholesterol-lowering plan should include more than taking drugs. People should exercise more and reduce fat in their diets.
"You can't just say, 'OK, I am going to take a drug and then have a couple of Big Macs,' " said Levey of West Hills Regional Medical Center. "It takes a strong willingness to work at it."
Photo (1) When her cholesterol level hit e397, Robin Schyman said she became "nervous for the future" and changed her habits. One such alteration adding regular exercise in her Westlake Village neighborhood. Evan Yee/Daily News (2) Concerned about a cholesterol count that reached 265, Rina Sherman of West Hills prepares a healthy meal of veal marsala, a green salad, fruit salad and bread. Terri Thuente/Daily News (3) In stubbord or extreme cases, medicines are prescribed to reduce cholesterol. Myung J. Chun/Daily News