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Screening for high risk.

Kellogg's innovative contest pitted Jackson, Mississippi against Lansing, Michigan. Jackson took the lead, but everyone won.

A year ago in February, simultaneous mass-screening efforts were launched in Jackson, Mississippi, and Lansing, Michigan. Fourteen thousand Jacksonites and 7,000 Lansingers queued up to have their blood tested for cholesterol. The testing, part of a national competition to raise people's awareness of the "silent killer," was also a race between North and South to lower dietary cholesterol levels.

Initial screenings showed reason for concern. Jackson residents' cholesterol levels averaged 207 mg, and the cholesterol levels of Lansing residents averaged 212. (Michigan has one of the highest heart-attack rates in the country.) A cholesterol level of 200 or more is considered undesirable, although some physicians set the danger threshold lower.

Six months after the first screening, the results came in. The city of Jackson was declared the winner, but the sponsor of the contest, the Kellogg Company, feels that both sides won.

In Jackson, 69 percent of the participants are eating more fresh fruits and vegetables. In Lansing, 79 percent of the participants are eating less red meat. And-thanks to information programs during the screenings-more than 90 percent of the participants in both cities now understand the significance of their cholesterol levels.

* * *

Cholesterol, a natural fat, normally circulates in our blood. But an overabundance of cholesterol in our veins and arteries begins to congeal and to block the flow of blood.

When cholesterol blocks one of the arteries that serve the heart, part of the heart muscle dies from lack of oxygen-a heart attack. And that's a leading cause of death for Americans. We're being killed by our own diets.

Yet cholesterol is a natural, necessary substance. Infants, for example, need high levels of cholesterol for healthy growth, and mothers' milk is normally rich in cholesterol. As we grow older, however, our needs for cholesterol diminish, and too often in America, cholesterol becomes a deadly threat.

Some of the cholesterol that circulates within us is made by our own bodies. But for too many of us, cholesterol levels are raised dangerously high by the cholesterol in the meats, eggs, and dairy products we eat. Our circulatory systems are forced to carry not just our own cholesterol, but also the cholesterol produced by the cow that gave us last night's steak and the chicken that gave us this morning's eggs.

The good news for most of us is that we can substantially control our cholesterol levels by controlling our diets and working our bodies.

There is one more complicating factor to consider. Cholesterol-a waxy, fatty, protein-coated substance that travels through our circulatory systems-comes in good and bad varieties.

The bad one is LDL-that's medical terminology for low-density lipoprotein ("lipo" comes from the Latin word for fat). This is the stuff that blocks arteries, kills heart muscles, and creates heart attacks.

The good one is HDL-medical shorthand for high-density lipoprotein. HDL sweeps up LDL as it circulates in the blood and takes it back to our livers for reprocessing. HDL actually reduces the risks of suffering heart attacks.

So the idea is to raise the levels of HDL and lower the levels of LDL in order to set good cholesterol balances in our bodies, says Dr. Jack Hall, director of Cardiovascular Services at Methodist Hospital in Indianapolis, Indiana. Dr. Hall was one of the pioneers in calculating the medical risks that we raise or lower with our lifestyles. He has long urged his heart patients to lower their cholesterol with diet and exercise.

In screenings like the ones that Kellogg brought to Lansing and Jackson, the public is given the number of milligrams of cholesterol for each 100 milliliters of blood. The Saturday Evening Post's HEART MOBILE screens with similar equipment.

If your reading is less than 200, you probably shouldn't worry about the ratio of LDL and HDL. But if your reading is more than 200, you should see your doctor and take action.

Another test determines the relative levels of high-density and low-density cholesterols circulating in our blood. This test-based on a sample of blood taken after fasting-determines the levels of LDL and triglycerides by direct measurement and the level of HDL by inference, since HDL circulating levels are difficult to assay without more expensive testing.

The results of this test may be reported to the patient as a couple of ratios: the ratio of the desirable HDL to undesirable LDL, or the ratio of HDL to total cholesterol.

If enough HDL is circulating in the blood, it will keep the LDL plaques from growing on the walls of our arteries, and that's enough HDL to give us more complete protection from heart attacks.

Further tests are always recommended if a routine test or screening gives a high total cholesterol reading or if there is a family history of high cholesterol or heart attacks.

Most of us need to lower our cholesterol levels and improve our HDLLDL ratios. Here's how.

First, fix your diet! That means less fatty red meat; less of the fattiest dairy products-whole milk, hard cheeses, and butter; less sausage, bacon, and lunch meats; less of the foods prepared with hard shortenings, lard, palm oil, and coconut oil; fewer eggs and fewer dishes made with egg yolks. Those-alas-are mostly desserts.

A healthful diet also means ingesting more vegetables, fruits, and grains-particularly brans and other high-fiber grains; more vegetable oils and shortenings, such as those made from corn, olive, soybean, and safflower bases; and more white meat, such as fishand poultry.

This doesn't mean that Americans need to take up a monastic diet. If you yearn too much for butter to give it up, try one of the butter-margarine blends. If temptation proves too strong when you push your shopping cart down the cookie aisle, read the labels and reject anything made with palm or coconut oil.

Second, exercise your body! Exercise extends longevity in many good, healthful ways. One is to raise the ratio of HDL to LDL. Exercise, independent of diet, increases the production of HDL, gives us a better HDLLDL ratio, and lowers the level of LDL circulating in search of an artery to block.

Proper exercise, like a proper diet, does not mean a radical new lifestyle for most of us. The consensus is that something strenuous-even brisk walking (but make it brisk)-for 20 minutes a stretch, three times a week, is enough to give us most of the benefits of exercise.

Does it work?

Robert H. McKinney, a highly successful banker and community leader in Indianapolis, took up a regimen of regular, strenuous exercise and a strong, sensible diet-some fruit, lots of grains, and very little meat.

His cholesterol level was 255, and he had a dangerously low HDL level that placed him at the highest risk of suffering a heart attack. McKinney didn't want to accept a recommendation for bypass surgery. Instead, he went to the Pritikin Clinic in California, where he and his wife learned how to eat and exercise in order to reduce the total cholesterol level and increase his HDL level. In a surprisingly short time, his level of risk began dropping. In less than a year he had achieved a "very low risk for a heart attack." More than six years have passed, and he is still enjoying this low risk.

Another heart-attack-risk reducer, Jon DeHaan, was surprised when he was told at Dr. Ken Cooper's clinic in Dallas that his risk factor was in the top 5 percent of the population. He was walking right into a coronary and didn't know it. His total cholesterol was 285 and his HDL was almost nonexistent. Worse, his family had a history of early heart attacks. His father's first and fatal attack had come at age 40.

DeHaan went home to Indianapolis and had coronary-bypass surgery. Next, he went to the Pritikin Clinic. Now, he eats high-fiber foods and sticks to a vegetarian diet. "I get enough protein from skim milk, beans, and grains," he says. His total cholesterol is now 100.

DeHaan, who now sees Dr. Hall, says, "If I had known about Dr. Hall and his exercise and diet program in the early days, I'm sure I would never have needed to go for the bypass surgery-I could have controlled my risk with his care."

It works! And success like that is what is bringing such companies as Kellogg and The Saturday Evening Post Society to the cause.

Altering the all-American diet to reduce cholesterol is so important to our nation's health that the Society and the test kitchens at major cereal manufacturers have teamed up to publicize high-fiber, low-fat recipes. Kellogg provides the following tips to those participating in its free screening program.

* Use skim or 2 percent milk in place of whole milk. Substitute lowfat yogurt for sour cream. Neufchatel cheese can be substituted for cream cheese.

* In recipe preparation, a whole egg can be replaced with an egg substitute or two egg whites.

* Season and cook foods with herbs and spices rather than butter. Do not add extra butter or salt to cooking water.

* Steam fish instead of sauteeing or broiling them in butter. Skinless chick en can be poached in broth instead of sauteed. Be careful not to overcook.

* Prepare meat and main dishes with such dry-heat cooking methods as broiling, roasting, or baking.

* Grease pans with a vegetable spray. Nonstick pans reduce the need for added fat.

* Use vegetable oils or margarine in baked products rather than shortening , lard, or butter.

* Saute vegetables in low-fat broth rather than oil or butter.

* Follow serving-size suggestions in recipes to reduce extra fat, cholesterol, and calories.

Cereal: provide such a simple means of increasing the fiber content of many dishes that the cereal manufacturers' kitchens have provided us with these delightful fiber-enhancing recipes.

Fish Fillets Italiano

(Makes 6 servings)

2 tablespoons margarine

1-1/4 CUPS Quaker Oats (quick or old-fashioned, uncooked)

2 tablespoons grated Parmesan cheese

1 teaspoon Italian seasoning

1/8 teaspoon garlic powder 2 small zucchini, each cut into 1/4" wide strips

6 sole or flounder fillets (about 1-1/4 pounds)

2 tablespoons lemon juice

Saute oats, cheese, and seasonings in margarine, stirring frequently until golden brown; set aside.

Heat oven to 375'F. Sprinkle each fillet with 2 rounded tablespoons oat mixture. Divide zucchini evenly among fillets. Roll up, beginning at wide end; secure with toothpicks. Place s eam-side down in 8" or 9" glass baking dish; sprinkle with lemon juice. Cover with aluminum foil. Bake 20-25 minutes until fish fillets turn opaque; remove to serving plate. Top with remaining oat mixture. Serve with lemon wedges, if desired.

Microwave directions: Melt margarine in 8 "square microwave dish; add oats, cheese, and seasonings. Microwave at High (100%) 3-4 minutes or until golden; stir after 2 minutes. Remove from dish; set aside. Prepare fillets as recipe directs; place seamside down in same dish. Cover with wax paper. Microwave at High 6-7 minutes or until fillets turn opaque. Proceed as recipe directs.

Oat-Bran Muffins

(Makes 12 muffins)

1-1/4 CUPS all-purpose flour

1 tablespoon baking powder

2 cups Kellogg's Cracklin' Oat Bran cereal

1 cup skim milk

2 egg whites

3 tablespoons Puritan vegetable oil

Stir together flour and baking powder. Set aside, Measure Kellogg's Cracklin' Oat Bran cereal and milk into large mixing bowl. Stir to combine. Let stand 5 minutes or until cereal is softened. Add egg whites and oil. Beat well. Add flour mixture; stir only until combined. Portion batter evenly into 12 foil-lined 2 1/2 " muffinpan cups. Bake at 400'F. 20 minutes or until lightly browned.

Blueberry Bran Loaf

(Makes ]loaf)

1/2 cup A II-Bran cereal

1 cup all-purpose flour

3/4 cup whole-wheat flour

2 teaspoons baking powder

1/2 teaspoon baking soda

1-1/2 tablespoons firmly packed brown sugar

3/4 cup orange juice

2 egg whites

2 tablespoons vegetable oil

1 cup blueberries, fresh or frozen (not thawed)

Stir together first 6 ingredients; set aside. In large mixing bowl, beat orange juice, egg, and oil until wellcombined. Add flour mixture; stir only until combined. Gently stir in blueberries. Spread batter evenly in greased 81/2"x 4-1/2"x 2-1/2" loaf pan. Bake at 350'F. 50 minutes or until done. Let cool 10 minutes before removing from pan. Cool completely.
COPYRIGHT 1989 Saturday Evening Post Society
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1989 Gale, Cengage Learning. All rights reserved.

Article Details
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Title Annotation:blood cholesterol; includes recipes
Author:Ullmann, Harrison J.
Publication:Saturday Evening Post
Date:Jan 1, 1989
Previous Article:Impeccable Gregory Peck.
Next Article:Kauai: next link on the chain.

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