The waiter at the famous restaurant on Limone’s waterfront approaches the table of portatori, bearing armloads of plates like polenta with mushrooms, shrimp salads, and also pastas in various disguises. The bottles of white wine are pushed aside to make room for the red.
“I eat and drink so much now I am becoming as wide as a boat” says Lusi Gerald, who by her own admission likes to sleep until noon. “If I exercised and did not smoke or drink, I would be a super woman” then She lights her second cigarette of the meal. “I don’t want to be a super woman”.
Limone’s portatori credit their good health to more than just the protein, as they call their fortuitous mutation. “It is the olive oil” insists Peter Gerald, referring to Limone’s locally produced virgin olive oil. He is not so far off.
In 1988 experts with the United State National Cholesterol Education Program advised healthy adults over the age of 19 to get a cholesterol test every five years. But it has become clear that this basic test doesn’t do a good enough job of predicting who is going to get heart disease. So in 1993 the recommendation changed : Everyone should be tested for total cholesterol and for HDL (so called good cholesterol). Unfortunately HDL tests are not always accurate, in part because the techniques some laboratories use are unreliable. You can always ask your doctor whether you can trust HDL results from your laboratory.
Together, total cholesterol and HDL tests
give an idea of your levels of low-density lipoprotein, or LDL (so called bad cholesterol) that causes plaque to form in the arteries. LDL is not measured right off the bat, because the test is more difficult (it’s level is calculated using a formula that includes triglycerides, blood fats whose levels rise after meals). And getting your triglyceride levels requires a fast of at least nine hours to ensure they are at their baseline level. If your HDL or total cholesterol levels look bac, you will probably need this more complex LDL test.
Interpreting Your Results
High-density Lipoprotein (HDL)
Under 35 : This is not good. No matter what your total cholesterol score, you should have your blood analyzed for the level of LDL.
Over 35 : Anything between 35 and 60 is considered acceptable. And HDL level above 60 is thought to protect against heart disease, but you are not completely in the clear unless your total cholesterol score checks out as well.
Under 200: So far, so good. As long as your HDL level is at least 35, you can wait as long as 5 years before repeating the test.
200 to 239 : Borderline. Repeat the test within 2 years.
240 and over : High. You need to have your blood analyzed for LDL levels
Low-density Lipoprotein (LDL)
Under 130: Great. You do not need to be retested for total cholesterol and HDL for 5 years.
130 to 159 : Borderline high. What you should do depends on whether you have other risk factors. If you have no more than one other risk factor, you can wait a year and see what another test says. In the meantime, exercise and cut down on foods high in saturated fat and cholesterol. If you have two or more risk factors, follow the advice for those with high LDL.
160 or above : High. You need a doctor’s exam to determine of your LDL level is due to a treatable medical condition, such as liver or kidney problems. Your doctor will put you on a diet very low in saturated fat and cholesterol, designed to lower LDL. If your levels don’t respond after 6 months, you may be prescribed cholesterol lowering drugs.
AM I AT HIGH RISK ?
You are if you have two or more of the following risk factors. (Subtract a factor if your HDL level is at 60 or above).
- You have high blood pressure or diabetes
- You have a family history of premature heart disease (before age 55 in male relatives, age 65 in female relatives)
- You smoke
- You are a man over 44 or a woman over 54 (or if a younger woman, you are experiencing premature menopause without estrogen replacement therapy)
- Your HDL is below 35
Can cholesterol be too low ?
A few years ago many people were confused and worried by research suggesting that low blood cholesterol itself is risky. The studies indicated that when total cholesterol drops below 160, it increases the risk of dying of cerebral hemorrhage – a type of stroke and of certain types of cancer or by accident, murder or suicide. But closer inspection has revealed that low cholesterol is not to blame. Instead there are some medical conditions such as stomach or liver disorders, that lower cholesterol and increase the risk of death. There are some habits that do both as well, such as heavy drinking or smoking. These not only wreak havoc on organs but also increase the risk of accidents and other mis-adventures.
In short, people who have naturally low cholesterol levels should be thrilled, not worried. What’s more, heart patients who get their total cholesterol down to 160 milligrams have fewer heart attacks, require fewer treatments like bypass surgery, and live longer than do patients whose levels remain high.