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A long time ago, we simply told patients that your total cholesterol is too high. Then we would confuse you by telling you that your VLD-L is too high, or your HDL is too low, and finish the session by going into cholesterol ratios. It has now been simplified.
We know that all cholesterol particles are capable of producing atheromas or clogs, except for the HDL, which prevent clogs. We now simply subtract the HDL value from your total cholesterol, and you know how much good you have and how much bad.
Direct to consumer advertising has throngs of patients showing up at my office repeatedly asking for cholesterol testing in the hopes that the results may vindicate a poor lifestyle. Good values don't mean that you eat well. "Smart ads" on the tube suggest that taking a pill will make up for the poor lifestyle.
We are continually refining our knowledge of what causes heart attacks and how to prevent them. It seems that the heart attack rate rose quickly in the 1950's, plateaued, and now continues to increase despite millions of people taking cholesterol pills.
Equating overeating junk food and obesity with heart attacks is a tad too simple. Thinking that fat blocks arteries until they are choked off is also an oversimplification. I see lots of obese seniors who seem to have made it to a ripe old age. Science doesn't quite support the TV ads. For the majority of patients taking lipid lowering drugs without any other health problems, there seem to be no clear benefits. Of interest is that this is the largest consumer group. To a large degree the blame probably fall on us doctors. This is not to suggest that if you have had a heart attack, are diabetic or have heart disease that you should stop taking the prescribed drugs. The point is that lifestyle changes are probably the most important, but hardest to achieve factors.
Heart attacks are often caused by blood clots occurring in the arteries of the heart muscle. How these clots are formed used to be a bit of a mystery. Our main arteries are 3-ply structures. Excess cholesterol sub-particles such as VLD-L can lodge in the middle layer producing bulky structures called atheroma. Most of these atheroma don't really reduce blood flow significantly. What can happen is that the inner artery lining might sustain a micro tear. When that happens, inflammation cascades and various cell types arrive to attempt repair, and platelets form clots thinking that bleeding is occurring. These clots stop the flow of blood and can result in the damage that is seen with a heart attack. The clots can be dissolved with clot-busting drugs if given quick enough. The process produces elevations in certain particles such as C-Reactive Protien (CRP), troponin and histamine. Many of these particles have been investigated as possible predictors of impending heart disease, but little evidence exists to promote their usefulness in this regard.
The best solution is to take a good look at your lifestyle. Start walking to lose the first two pounds, and reduce smoking as the next step. Join me for the Heart and Stroke Ride. (See Sunday, June 1, 2014 The Becel Heart & Stroke Ride for Heart). Medication is not a quick answer to patch flaws in our lifestyles.
● Food Dyes: A Rainbow of Risks by Sarah Kobylewski, (Ph.D. Candidate, Molecular Toxicology Program, University of California, Los Angeles, and Michael F. Jacobson, Ph.D. (Executive Director, Center for Science in the Public Interest). June 2010. "Food dyes, synthesized originally from coal tar and now petroleum, have long been controversial. Many dyes have been banned because of their adverse effects on laboratory animals. This report finds that many of the nine currently approved dyes raise health concerns." Blue 1, Blue 2, Citrus Red 2, Green 3, Orange B, Red 3, Red 40, Yellow 5, Yellow 6. Authors' recommendations: "Because of those toxicological considerations, including carcinogenicity, hypersensitivity reactions, and behavioral effects, food dyes cannot be considered safe. The FDA should ban food dyes, which serve no purpose other than a cosmetic effect, though quirks in the law make it difficult to do so (the law should be amended to make it no more difficult to ban food colorings than other food additives). In the meantime, companies voluntarily should replace dyes with safer, natural colorings."
● Is Red 40 Food Coloring Dangerous to Your Health? By Amy Long Carrera, 21 Oct. 2013.
● Scientists Warn: Food Colors Damage Kids by Michelle Schoffro Cook, 31 Mar. 2011.
● Are You or Your Family Eating Toxic Food Dyes? By Joseph Mercola, 24 Feb. 2011.
● Living in Color: The Potential Dangers of Artificial Dyes by Rachel Hennessey, 27 Aug. 2012, Forbes. "Many popular candies, drinks, popsicles, puddings, yogurts, gums, boxed mac n' cheeses, baking mixes, pickles, meats, fruits, sauces and chips contain ingredients such as Yellow #5, Blue #1, and Red #40 - three of the most popular FDA-permitted ones. As if that's not enough, the dye in our day isn't limited to food. Chances are, if you take vitamins, use cough syrup, brush your teeth, wash your hands, shampoo your hair, launder your clothing and moisturize your lips on a daily basis - you come into contact with artificial dyes quite frequently."
● Food coloring from Wikipedia.
● Natural Food Colours from Food-Info, UK.
● Report on the Certification of Color Additives from U.S. Food and Drug Administration (FDA).
● Food Additives from Health Canada.
● Food Additives and Cancer from Canadian Cancer Society. "Food additives are chemicals that help preserve, colour and flavour our food. It is very unlikely that food additives cause cancer . . . Any food dyes or cosmetics that were once linked to cancer are no longer used in Canada."
● FDA Urged to Prohibit Carcinogenic "Caramel Coloring". Certified Specialist in Poison Information (CSPI) Says Artificial Caramel Coloring is Quite Different from Real Caramel. "February 16, 2011: WASHINGTON - The 'caramel coloring' used in Coca-Cola, Pepsi, and other foods is contaminated with two cancer-causing chemicals and should be banned, according to a regulatory petition filed today by the Center for Science in the Public Interest."
● Food Dyes Linked to Behavioral Problems from Inspiration Green.
● Artificial Food Coloring Truth from Macquirelatory.com. What Is Coal Tar? Blue No. 1, Blue No. 2, Green No. 3, Red No. 40, Red No. 3, Yellow No. 5, Yellow No. 6, What's Blue Lake 1?
● Food Coloring and Health. Food coloring may cause hyperacitivity. By Peggy Trowbridge Filippone, About.com Guide.
● DNA Damage Induced by Red Food Dyes Orally Administered to Pregnant and Male Mice by Shuji Tsuda, Makiko Murakami, Naonori Matsusaka, Kiyoshi Kano, Kazuyuki Taniguchi, and Yu F. Sasaki, Oxford Journals Toxicological Sciences. Laboratory of Veterinary Public Health, Department of Veterinary Medicine, Faculty of Agriculture, Iwate University, Japan. Toxicol Sci. May 2001.