KNOW THE SCORE
Kenneth H. Cooper, M.D., M.P.H.

There are many ways for a doctor to diagnose disease but probably the best place to start is with a simple blood test. Hopefully you are already getting an annual physical. If not, you should start. One of the staples of a routine physical exam is having your blood work done. Even though you might not have any symptoms of a problem that DOES NOT mean you are necessarily healthy. Take charge and make sure you know the important numbers of your blood work, which should always be done after a 12-hour fast.

WHAT SHOULD BE INCLUDED?
Since cholesterol is so closely tied to heart disease you definitely need to know what your TOTAL cholesterol is. It needs to be under 200, and preferable under 180. However, do not make the mistake of stopping there. The components, or sub-fractions, of cholesterol are critical to evaluating your health.

Make sure you know your HDL (the good cholesterol). It should be at least 45 for a man, and over 55 in a woman. Your LDL (the bad cholesterol) should be less than 100 or under 80 if you have heart disease.

The ratio or atherogenic index is also very important. That is your total cholesterol divided by your HDL. The lower the better. It should be less than 4.0 for men and less than 3.5 for women. Any ratio over 6 is a red flag.

Make sure your doctor is measuring your homocysteine (elevated levels are associated with heart disease, colon cancer, stroke, Alzheimers disease and, as we recently learned, congestive heart failure). It should be less than 10, and hopefully under 9. Elevated homocysteine is often controlled with an increased intake of vitamins B6, B12, and folic acid. Our recently completed clinical trial showed that Cooper Complete Multivitamins lowered homocysteine by an average of 17.2 percent.

I also encourage you to have your C-reactive protein (CRP) checked. This measure of inflammation is one of the hottest topics in medicine and is associated with both heart disease and diabetes. There are several different tests for CRP. At Cooper Clinic we use the hsCRP (hs stands for highly sensitive) and that should be below 0.3. Once again, vitamins can help lower elevated CRP (e.g. Cooper Complete has been shown to lower CRP by 32 percent).

Both CRP and homocysteine are not yet routine measurements by all doctors so you must ask if they are being taken. If not, request it. If the doctor or nurse says its not necessary then I would suggest finding a new doctor. The scientific literature supports the importance of these measures.

DONT FORGET THE TRIGLYCERIDES!
Most everyone has heard of triglycerides but they are often overshadowed by cholesterol. They shouldnt be. Your triglycerides should be less than 125 and less than 100 if you have heart disease.

High levels of triglycerides can trigger hearts attacks and strokes, even if your cholesterol is normal. Research shows that women might be in even greater danger than men when it comes to elevated triglyceride levels.

Being overweight and having elevated triglycerides often go hand in hand so maintaining a healthy weight is a great place to start. However, many people (approximately 25 percent of women of normal weight) are genetically predisposed to high triglycerides.

Also keep in mind that our triglycerides have a tendency to rise with age so just because they were normal when you were 30 does not necessarily mean they will be fine when you turn 50 or 60. Routine measurements, every one to two years, are a must.

NOT ALL CARBOHYDRATES ARE CREATED EQUAL
The main sources of triglycerides are fat and simple carbohydrates (refined sugar, white flour, pasta, processed foods). Monitoring your intake of saturated fat and reducing your consumption of simple carbohydrates will have an almost immediate impact on your triglyceride levels.

Complex carbohydrates found in fruits and vegetables do not increase triglycerides, in fact they have the opposite effect. A study at Stanford showed that a diet rich in whole grains, salads, vegetables, and beans lowered triglycerides by 25 percent. That is just one of the reasons we say five is fine, but nine is divine when it comes to the consumption of fruits and vegetables.

DONT BE SURPRISED!
You have probably heard me say that the two words I dislike the most are, if only. Doc, if only I had taken your advice then I wouldnt be in the condition I am today.

Our bodies are masterful at disguising disease until many times it is too late. We need to be proactive and take charge of our health. Dont find yourself uttering the words, if only.

If you haven't had your blood work checked recently then make an appointment today, and don't forget your homocysteine, C-reactive protein, and triglycerides.

Stay well and be active.

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