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Folks watching cholesterol levels should keep up the good work


Are you confused about lowering your cholesterol too much?

You probably shouldn't be.

Despite last week's front page story about the perils of cholesterol levels below 160, most people still need to be more concerned about getting cholesterol levels down.

Very few people get lab results below 160, which seems to be the danger point.

The New York Times wire service article noted that the study reported in the Archives of Internal Medicine consisted of 350,000 men. Of those, only 6 percent had very low cholesterol levels.

The folks doing the research are focused on the which-comes-first-phenomenon of "does very low cholesterol cause illness, or does illness cause very low cholesterol?"

They never mention diet.

In fact, I have never known a patient with a cholesterol level above 200 who was able to reduce that to below 160 by making dietary changes.

My experience with diet and cholesterol levels is that people fall in three main categories. Some have very high cholesterol levels, even when they carefully watch their diets. Others have cholesterol levels below 200, no matter how much fat, saturated fat and cholesterol they eat. The third group is diet responsive -- when they improve their diet, their cholesterol level comes down.

I'm wondering if those folks with very low cholesterol levels are diet responsive.

The medical community is concerned that folks with high cholesterol levels might abandon their cholesterol-lowering diets out of fear of going too low.

That would be foolish, indeed.

And highly unlikely, since most people smart enough to stay on that diet are also smart enough to count down to 160, then stop.

The biggest fear is that this curious information will undermine our national health care initiatives which have been so successful in reducing deaths from heart disease.

That, too, would be foolish.

As individuals, we can't wait for research results before we eat our next meal. So what reasonable thing can we do in the !B meantime?

If your cholesterol is above 200, get help from your doctor or dietitian in making dietary changes, or perhaps beginning medication to get you into more ideal territory.

If your cholesterol is between 160 and 200, keep doing what you're doing. Get re-checked every few years.

If it's below 160, keep in touch with your doctor, and be sure he stays tuned to the evolving research.

And ask if he wants you to eat some of those formerly forbidden

goodies to find out if you're diet responsive!

Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center in Baltimore.

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