WEBVTT 1 00:00:00.160 --> 00:00:02.399 The topics and opinions expressed on the following show are 2 00:00:02.399 --> 00:00:04.320 solely those of the hosts and their guests, and not 3 00:00:04.360 --> 00:00:07.240 those of W four WN Radio It's employees or affiliates. 4 00:00:07.400 --> 00:00:10.960 We make no recommendations or endorsements for radio show programs, services, 5 00:00:11.039 --> 00:00:14.080 or products mentioned on air or on our web. No liability, 6 00:00:14.199 --> 00:00:17.039 explicit or implied shall be extended to W four WN 7 00:00:17.120 --> 00:00:20.199 Radio It's employees or affiliates. Any questions or common should 8 00:00:20.199 --> 00:00:21.519 be directed to those show hosts. 9 00:00:21.640 --> 00:00:38.520 Thank you for choosing W four WN Radio. 10 00:00:42.880 --> 00:00:46.479 Well, hello, and welcome to Fearless Fabulous You. I am 11 00:00:46.520 --> 00:00:49.640 your host, Melanie Young, and welcome to what's starting to 12 00:00:49.640 --> 00:00:53.439 be my tenth season. Ten years that I have been 13 00:00:53.479 --> 00:00:58.399 hosting this show. Wow, amazing, how far I've come. This 14 00:00:58.439 --> 00:01:01.880 shows started as a way to empower women to take 15 00:01:01.960 --> 00:01:04.599 charge of their health because I had recovered from breast 16 00:01:04.599 --> 00:01:08.519 cancer and was rethinking my health and how I took 17 00:01:08.519 --> 00:01:10.120 care of myself as well as what I wanted to 18 00:01:10.120 --> 00:01:13.200 do with my life. And from that I wrote a 19 00:01:13.200 --> 00:01:16.120 book called Fearless Fabulous You, Lessons on Living Life on 20 00:01:16.239 --> 00:01:18.280 your Terms and thought, how am I going to promote 21 00:01:18.280 --> 00:01:19.599 this book? And I said, oh, I'm going to show 22 00:01:19.599 --> 00:01:22.719 our show called Fearless, Fabulous You and find amazing women 23 00:01:23.079 --> 00:01:26.519 to interview about how we all can live life on 24 00:01:26.599 --> 00:01:30.680 our terms in good health. So if you do follow me, 25 00:01:30.719 --> 00:01:34.519 you know that heart health is a recurring theme. I 26 00:01:34.560 --> 00:01:36.959 always do at least two shows on heart health and 27 00:01:37.079 --> 00:01:42.680 other health topics at least in one season, and today 28 00:01:42.719 --> 00:01:45.400 we're going to address it again. I have hit the 29 00:01:45.480 --> 00:01:48.280 ripe old age of over sixty. I'm north of sixty, 30 00:01:48.840 --> 00:01:53.159 and I have learned, as many of my friends and 31 00:01:53.280 --> 00:01:57.680 funds and followers also north of sixty, that your metabulism 32 00:01:58.159 --> 00:02:02.120 just changes. It stactually starts chase in your fifties, but 33 00:02:02.239 --> 00:02:06.719 it keeps changing. And a recent visit to my primary 34 00:02:06.760 --> 00:02:09.599 care physician, because I am very good at going to 35 00:02:09.680 --> 00:02:13.479 all my scheduled Dutch's appointments, revealed that my cholesterol was 36 00:02:14.400 --> 00:02:19.000 a bit high and my weight was definitely too high 37 00:02:19.039 --> 00:02:22.800 for my small frame. And granted, I live a life 38 00:02:22.800 --> 00:02:25.599 of incredible travel and eating and drinking good food and 39 00:02:25.639 --> 00:02:28.960 writing about wine, reporting on all that on my other show, 40 00:02:29.000 --> 00:02:30.960 That Connected Table, but it was kind of a wake 41 00:02:31.039 --> 00:02:35.479 up call, particularly after knowing that I have heart disease 42 00:02:35.800 --> 00:02:39.479 in my family. My grandmother died of of cardiac arrest 43 00:02:39.919 --> 00:02:44.039 very suddenly, and my father had ongoing heart issues which 44 00:02:44.080 --> 00:02:48.080 resulted in a quintuple bypass surgery and a stent. It's 45 00:02:48.159 --> 00:02:51.639 not what ultimately did him in he died of metastasized 46 00:02:52.319 --> 00:02:57.439 prostate cancer. But knowing that I have a family history 47 00:02:57.479 --> 00:03:03.479 of heart condition, and knowing that my cholesterol was high, 48 00:03:03.479 --> 00:03:06.879 and knowing that my weight was even higher, I gave 49 00:03:06.919 --> 00:03:12.240 myself a six week turnaround plan. Obviously, nothing really can happen. 50 00:03:12.400 --> 00:03:14.520 Everything can't be achieved in six weeks, but you can 51 00:03:14.560 --> 00:03:18.319 make headway. And I'm a believer that you do this 52 00:03:18.479 --> 00:03:23.199 by diet and exercise. In Changing habits doesn't mean giving 53 00:03:23.280 --> 00:03:27.039 up everything you love, particularly if it's what pays your bills, 54 00:03:27.120 --> 00:03:31.240 like wine and wine writing. But it means moderation and 55 00:03:31.319 --> 00:03:34.879 making smarter decisions. So I am going to be addressing 56 00:03:34.919 --> 00:03:40.800 this today with an expert on my show. We're going 57 00:03:40.879 --> 00:03:44.840 to be speaking with doctor Elizabeth Klotus, who is a 58 00:03:45.039 --> 00:03:52.120 BORED certified practicing cardiologist, founder of the Preventative Cardiology Clinic 59 00:03:52.280 --> 00:03:57.199 near Minneapolis, Minnesota, and she trained at Mayo Clinic and 60 00:03:57.319 --> 00:04:01.680 John Hopkins. She's got a off of information She's also 61 00:04:02.120 --> 00:04:06.319 founder and chief medical officer of Step one Foods, which 62 00:04:06.800 --> 00:04:09.960 we will discuss at the end of the show is 63 00:04:11.919 --> 00:04:16.040 foods that are to help with managing lowering your cholesterol. 64 00:04:16.079 --> 00:04:17.959 Which we're going to talk about what you know you 65 00:04:17.959 --> 00:04:20.720 should be eating, and I always hate talking about what 66 00:04:20.720 --> 00:04:22.519 you should not be eating, but we're going to talk 67 00:04:22.560 --> 00:04:26.079 about adding in more because it's about crowding out bad 68 00:04:26.120 --> 00:04:29.399 stuff and adding in good stuff. Before we get into 69 00:04:29.399 --> 00:04:32.759 the conversation, I did, like I always do, I popped 70 00:04:32.759 --> 00:04:37.839 on over to the Center of Disease Control CDC website 71 00:04:37.839 --> 00:04:43.560 to get some facts to set this up. Cholesterol high. 72 00:04:43.600 --> 00:04:46.519 Total cholesterol in the United States is pretty big topic. 73 00:04:46.600 --> 00:04:52.959 Between twenty seventeen and twenty twenty recent stats, ten percent 74 00:04:52.959 --> 00:04:56.040 of adults age twenty year older had total cholesterol levels 75 00:04:56.079 --> 00:04:59.399 above two forty milligrams, and about seventeen percent had high 76 00:04:59.439 --> 00:05:04.079 debts to high density lipoprotein HDO or good cholesterol levels 77 00:05:04.120 --> 00:05:08.240 below forty milligrams. It's a a lot of technical talk 78 00:05:08.279 --> 00:05:10.959 for some of you, so I'll let the doctor weigh in. 79 00:05:11.439 --> 00:05:15.360 But here's the thing. In summary, high cholesterol has no symptoms, 80 00:05:15.399 --> 00:05:18.079 so many people don't even know that their cholesterol is 81 00:05:18.120 --> 00:05:20.399 too high. We're going to talk about how you can 82 00:05:20.480 --> 00:05:23.319 check it. We're also going to talk about why it 83 00:05:23.399 --> 00:05:27.079 matters because, according to the CDC, having high cholesterol raises 84 00:05:27.120 --> 00:05:30.639 the risk for heart disease, the leading cause of death 85 00:05:30.759 --> 00:05:34.560 and stroke the fifth leading cause of death stroke and 86 00:05:35.079 --> 00:05:38.959 for women, heart disease and cardiac arrests is like number 87 00:05:39.000 --> 00:05:45.279 one as from per the American Heart Association. So women 88 00:05:45.639 --> 00:05:50.120 have a high risk for heart disease and often, as 89 00:05:50.160 --> 00:05:54.240 I have explained on this show, symptoms are not like 90 00:05:54.800 --> 00:05:57.800 men and they're different. So we're going to dive into 91 00:05:57.839 --> 00:06:00.600 all this, and most importantly the takeaway is what can 92 00:06:00.680 --> 00:06:06.600 you do starting now to maintain a healthy cholesterol for 93 00:06:06.720 --> 00:06:11.959 you through lifestyle changes. So, doctor Elizabeth Klotis, Liz, as 94 00:06:12.000 --> 00:06:15.120 you said before we went on, welcome to Fearless, Fabulous. 95 00:06:14.600 --> 00:06:18.519 You, Oh Melanie, thank you so much for having me. 96 00:06:18.560 --> 00:06:21.920 I'm excited to be here with you. And honestly, as 97 00:06:21.959 --> 00:06:24.639 I was listening to the intro, we you know we 98 00:06:24.680 --> 00:06:26.600 could sit down and have coffee and talk about this 99 00:06:26.600 --> 00:06:31.279 for hours because our I think approach to heart disease 100 00:06:31.319 --> 00:06:35.120 prevention and interest in this area obviously is very much 101 00:06:35.199 --> 00:06:37.439 on the same page. So I really look forward to 102 00:06:37.480 --> 00:06:38.519 our conversation today. 103 00:06:39.160 --> 00:06:41.639 Absolutely. You know, I always like to start with a 104 00:06:41.639 --> 00:06:45.279 little backstory because I like to explain who my guests are, 105 00:06:45.360 --> 00:06:49.759 which I semi did. But I am curious why you 106 00:06:49.839 --> 00:06:53.759 decided to become a cardiologist. Was there something in your 107 00:06:53.800 --> 00:06:56.160 own life that said I want to You know, there's 108 00:06:56.160 --> 00:06:58.240 always a reason you become a doctor, and it is 109 00:06:58.279 --> 00:07:01.800 a long road, and becoming a specialist is that even 110 00:07:01.879 --> 00:07:04.199 longer road? So what inspired you? 111 00:07:05.720 --> 00:07:08.480 Well, yeah, the long road is for sure true. I 112 00:07:08.480 --> 00:07:12.480 mean from the time I graduated high school, they to 113 00:07:12.560 --> 00:07:15.600 the time I hung up my cardiology shingle was fourteen 114 00:07:15.720 --> 00:07:20.399 years of uninterrupted education. So it's a it's a very 115 00:07:20.439 --> 00:07:24.560 long road to get here. And actually it's interesting because 116 00:07:24.839 --> 00:07:27.639 I didn't get here kind of the way a lot 117 00:07:27.720 --> 00:07:30.120 you know, I didn't pick the specialty the way a 118 00:07:30.160 --> 00:07:33.639 lot of people pick their specialties. Right, they had you know, 119 00:07:33.680 --> 00:07:35.480 they broke their leg when they were young, so they 120 00:07:35.519 --> 00:07:38.399 became an orthopedic surgeon, or you know, their mom had 121 00:07:38.399 --> 00:07:42.759 cancer so they became an oncologist. Actually, my just like 122 00:07:43.439 --> 00:07:45.360 in your family have a history of cancer, you're a 123 00:07:45.360 --> 00:07:50.759 personal history of cancer. My my family is cancer everywhere 124 00:07:51.240 --> 00:07:55.079 and yet that's not that's not why it's and I 125 00:07:55.079 --> 00:08:01.199 didn't become an oncologist. I chose cardiology honestly because of 126 00:08:01.360 --> 00:08:07.199 a mentor that I had during medical training. It's you know, 127 00:08:07.319 --> 00:08:12.040 I did a rotation on cardiology when I entered internal medicine. 128 00:08:12.160 --> 00:08:15.600 Because it's a it's a layered uh, it's a layered 129 00:08:15.680 --> 00:08:19.199 education process. First, you you know, do your medical school, 130 00:08:19.240 --> 00:08:22.519 then you do an intro interro medicine residency, and then 131 00:08:22.639 --> 00:08:25.399 you specialize and go on to cardiology, which then you 132 00:08:25.439 --> 00:08:29.800 can further sub specialize into things like electrophysiology or congestive 133 00:08:29.839 --> 00:08:33.159 heart failure, you know, transplant management, things like that. Anyway, 134 00:08:34.039 --> 00:08:36.799 but it was literally on the first day of my 135 00:08:36.919 --> 00:08:43.559 cardiology rotation that uh, that my mentor inspired me. He 136 00:08:43.559 --> 00:08:48.879 he just his peers batter. He's he's retired, but this 137 00:08:49.000 --> 00:08:53.600 was a male clinic, and he just made every single 138 00:08:53.720 --> 00:08:59.080 patient and every single cardiology problem seemed fascinating and and 139 00:08:59.159 --> 00:09:02.159 it's an amazing thing, feeled. I mean, the heart is 140 00:09:02.200 --> 00:09:05.799 a miracle if you think about it. I mean, it beats, 141 00:09:05.840 --> 00:09:09.799 it pumps blood, you know, just all on its little like, 142 00:09:10.480 --> 00:09:13.759 all on its little alone, sixty times a minute. Sixty 143 00:09:13.879 --> 00:09:17.279 minutes an hour, twenty four hours a day, seven days 144 00:09:17.279 --> 00:09:19.639 a week, fifty two weeks a year, for you know, 145 00:09:19.799 --> 00:09:23.799 a hundred years. It just keeps going. It's amazing. There's 146 00:09:23.840 --> 00:09:26.240 there's no engine that does that. 147 00:09:27.840 --> 00:09:30.600 So right, quite an engine. And it is, you know, 148 00:09:30.679 --> 00:09:33.639 what keeps us living because technically, if your heart isn't beating, 149 00:09:33.679 --> 00:09:36.679 you're dead. You know, you could be brain dead, but 150 00:09:36.720 --> 00:09:38.960 your heart can keep beating, right. 151 00:09:39.559 --> 00:09:43.240 Yeah, it's a it's an obviously it's an incredibly important organ. 152 00:09:43.519 --> 00:09:45.799 And you know, and I think the other thing honestly 153 00:09:45.840 --> 00:09:48.399 that attracted me to cardiology is because you can do 154 00:09:48.480 --> 00:09:51.840 so much, you know there, you know you can, and 155 00:09:52.279 --> 00:09:56.200 it's and it's such a wide breadth of almost subspecialties 156 00:09:56.240 --> 00:09:58.759 within cardiology. You can almost be a you know, a 157 00:09:58.840 --> 00:10:02.960 radiologist in some sense and read heart ultrasounds and heart 158 00:10:03.000 --> 00:10:06.639 sets and heart MRIs. Or you can be almost a 159 00:10:06.679 --> 00:10:11.440 surgeon and an insert stance and you know, or you know, pacemakers. 160 00:10:11.639 --> 00:10:15.480 You can you know, be like what I what I do, 161 00:10:15.519 --> 00:10:18.639 which is be on the prevention end. And actually my 162 00:10:19.159 --> 00:10:21.519 hope is to put myself out of work is so 163 00:10:21.639 --> 00:10:23.600 people don't don't need us anymore. 164 00:10:24.320 --> 00:10:26.799 So I always said that when I wrote my book 165 00:10:26.879 --> 00:10:29.039 to help women diagnose with breast cancer, I hope no 166 00:10:29.039 --> 00:10:31.840 one ever has to buy my book. You know, you know, 167 00:10:31.879 --> 00:10:36.039 it's amazing, doctor clot Is, that we take our hearts 168 00:10:36.039 --> 00:10:39.240 for granted. You know, we talk about women talk about love. 169 00:10:39.320 --> 00:10:42.360 They're always looking for love, They're always looking for their soulmate. 170 00:10:42.440 --> 00:10:45.960 They're always you know, expressing themselves and you know, I 171 00:10:46.000 --> 00:10:50.240 love you and emoging their heart. But we mistreat it 172 00:10:50.320 --> 00:10:52.879 by not taking care of it. And it is really 173 00:10:53.559 --> 00:10:57.600 the beating heart is what defines you as living. And 174 00:10:57.679 --> 00:11:00.720 if you've ever held someone like I have, who watch 175 00:11:00.840 --> 00:11:03.799 their the heartbeat die, which I did with my mother, 176 00:11:03.879 --> 00:11:07.600 I watched her heartbeat die, it is a very powerful 177 00:11:07.679 --> 00:11:11.240 thing to watch someone who is dying and the last 178 00:11:11.240 --> 00:11:14.720 thing you see is a beating heart. It is the 179 00:11:14.799 --> 00:11:17.919 last thing to go. And we take it for granted, 180 00:11:19.240 --> 00:11:24.240 don't you agree? I, you know, very much so. 181 00:11:24.600 --> 00:11:27.240 And I think it's because it just kind of keeps 182 00:11:27.320 --> 00:11:31.759 doing its job right and and it can take an 183 00:11:31.799 --> 00:11:35.759 awful lot of abuse, which is you know, which is 184 00:11:35.840 --> 00:11:40.159 which is amazing. And again, our bodies are so incredibly resilient, 185 00:11:40.720 --> 00:11:45.639 but at some point we you know, we exceed the 186 00:11:45.639 --> 00:11:48.879 capacity of our bodies to make up for what we're doing. 187 00:11:49.519 --> 00:11:53.360 And that's why it's so important to start early in 188 00:11:53.440 --> 00:11:57.120 terms of your prevention efforts, because both the building of 189 00:11:57.200 --> 00:12:00.720 disease or the prevention of disease are cumulative of you know, 190 00:12:00.799 --> 00:12:05.600 those those efforts or those habits, you know, multiply over time. 191 00:12:06.159 --> 00:12:10.320 And you're right in terms of women, this is our disease. 192 00:12:10.519 --> 00:12:13.840 You know, we we think about and you've had breast cancer. 193 00:12:13.919 --> 00:12:16.159 So I don't in any way want to diminish breast 194 00:12:16.159 --> 00:12:19.159 cancer as a you know, as a as a health threat. 195 00:12:19.159 --> 00:12:21.840 It's a terrible disease. It takes, it takes a lot 196 00:12:21.840 --> 00:12:25.759 of women's lives. But you know, one out of thirty 197 00:12:25.840 --> 00:12:29.360 women will die from breast cancer, one out of three 198 00:12:29.600 --> 00:12:33.320 will die from heart disease. So so heart disease is 199 00:12:33.440 --> 00:12:38.600 our disease, and it is almost entirely preventable. Eighty percent 200 00:12:38.639 --> 00:12:42.279 of it need not exist. And you know, a family 201 00:12:42.399 --> 00:12:47.039 history is a risk factor for sure, but family history 202 00:12:47.080 --> 00:12:51.639 genetics are not destiny. Genetics are a you know, a 203 00:12:51.759 --> 00:12:55.120 risk factor. They add about twenty percent. They account for 204 00:12:55.120 --> 00:12:58.440 about twenty percent of your risk, which means eighty percent 205 00:12:58.799 --> 00:13:01.799 is something you have some control over if you have 206 00:13:01.919 --> 00:13:04.600 family history. Right, you're starting a little bit behind an 207 00:13:04.600 --> 00:13:07.519 eight ball, but it doesn't mean you're fated to this. 208 00:13:07.879 --> 00:13:10.200 And this is an avoidable. 209 00:13:09.639 --> 00:13:15.600 Disease, absolutely, and with all risk predenttion. I like to 210 00:13:15.639 --> 00:13:19.919 start with I have a little quadrant, but the two 211 00:13:19.960 --> 00:13:24.840 big ones nutrition and movement. I never say exercise, I 212 00:13:24.879 --> 00:13:28.720 say movement, but it's exercise, and those are the two 213 00:13:29.000 --> 00:13:36.039 that can help reverse a lot of damage. But you 214 00:13:36.120 --> 00:13:40.039 do have to start early. And what's interesting is so 215 00:13:40.200 --> 00:13:46.320 many parents should be aware that it starts with, you know, 216 00:13:46.360 --> 00:13:50.799 teaching good habits as children to their children, so that 217 00:13:51.039 --> 00:13:56.480 you know they're not sedentary, they're not eating the wrong foods, 218 00:13:56.519 --> 00:14:00.360 they're eating balanced diets, and they're leading an active life. 219 00:14:01.360 --> 00:14:04.120 I want to this show is about cholesterol because a 220 00:14:04.159 --> 00:14:06.960 lot of people don't even understand what cholesterol is. And 221 00:14:07.039 --> 00:14:10.120 it is a big term, and there's different terms. So 222 00:14:10.200 --> 00:14:13.559 I want you to define the different types of cholesterol 223 00:14:13.559 --> 00:14:17.320 because people here there's good cholesterol, people here there's bad cholesterol. 224 00:14:17.360 --> 00:14:19.519 They hear of diet here. There's a lot of terms. 225 00:14:20.200 --> 00:14:24.840 Yeah, so first of all, just in general, what is cholesterol, Well, 226 00:14:25.240 --> 00:14:31.600 cholesterol is a waxy fat like substance that can be 227 00:14:31.679 --> 00:14:34.720 found in all sorts of places inside our body. Every 228 00:14:34.799 --> 00:14:39.080 cell wall of every cell within our bodies has some cholesterol. 229 00:14:39.399 --> 00:14:44.120 We use cholesterol to make hormones, bile acids, vitamin D, 230 00:14:44.399 --> 00:14:47.480 and other substances, so cholesterol is actually important for our 231 00:14:47.519 --> 00:14:52.039 body structure and function. The problem is, if there's too 232 00:14:52.159 --> 00:14:55.840 much cholesterol circulating in the blood stream, some of the 233 00:14:55.960 --> 00:15:00.759 excess it can become trapped in artery walls, and this 234 00:15:00.840 --> 00:15:04.519 build up is called plaque. And if enough of it accumulates, 235 00:15:04.559 --> 00:15:08.679 that plaque can narrow blood vessels and make them less flexible, 236 00:15:09.399 --> 00:15:13.360 causing what's you know, typically referred to as hardening of 237 00:15:13.399 --> 00:15:17.279 the arteries. And it is this process, that accumulation of 238 00:15:17.320 --> 00:15:20.519 plaque in our arteries that leads to these potentially devastating 239 00:15:20.559 --> 00:15:23.879 health events like heart attacks and strokes or the need 240 00:15:23.919 --> 00:15:27.240 for procedures such as you know, bypass surgery and stents. 241 00:15:27.799 --> 00:15:30.720 So it's a you know, this is a progressive disease. 242 00:15:31.240 --> 00:15:36.039 And to your point, it starts early. You know, autopsy data, 243 00:15:36.120 --> 00:15:39.120 this this build up of gunk inside our arteries, it 244 00:15:39.240 --> 00:15:44.600 starts very early. You know, in autopsy studies performed on 245 00:15:45.200 --> 00:15:48.240 soldiers killed in the Korean and Vietnam War. So these 246 00:15:48.240 --> 00:15:51.080 are young men in their twenties and thirties. They were 247 00:15:51.120 --> 00:15:55.840 already seeing significant plaque build up when autopsies done are 248 00:15:55.960 --> 00:15:58.519 on children. What a tragic thing to do an autopsy 249 00:15:58.559 --> 00:16:01.279 on a child. But we're starting to find the earliest 250 00:16:01.320 --> 00:16:06.559 precursors of plaque in children as young as ten. So 251 00:16:07.120 --> 00:16:12.519 the earlier we start with preventive measures, the better. Okay, Now, cholesterol, 252 00:16:12.720 --> 00:16:15.519 so we talked about kind of what it is generally 253 00:16:16.279 --> 00:16:19.480 the way to You can't, for the most part, feel 254 00:16:19.639 --> 00:16:21.840 that you have high cholesterol. By the time you feel 255 00:16:21.879 --> 00:16:26.559 things like a heart attack stroke bypester, you've had cholesterol 256 00:16:26.559 --> 00:16:29.480 for an high cholesterol pH an offully long time. Really, 257 00:16:29.519 --> 00:16:31.840 the only way to know if you have an abnormal 258 00:16:31.919 --> 00:16:34.960 cholesterol profile is to get checked with a blood test, 259 00:16:35.799 --> 00:16:39.120 and when you do that, you will get four numbers. 260 00:16:39.639 --> 00:16:43.840 One is the total cholesterol, and then you'll get HDL cholesterol, 261 00:16:44.000 --> 00:16:48.600 LDL cholesterol, and triglyceterides. Okay, total cholesterol. The total cholesterol 262 00:16:48.720 --> 00:16:51.159 is the sum of all the cholesterol in your body, 263 00:16:51.240 --> 00:16:54.080 so it's kind of everything that's below the line. Those 264 00:16:54.120 --> 00:16:56.600 three other numbers. Those three other numbers make up the 265 00:16:56.639 --> 00:17:01.120 total cholesterol. The total cholesterol should typically be under two hundred. 266 00:17:02.279 --> 00:17:04.440 It's malograms per deest leader or the units, but we'll 267 00:17:04.480 --> 00:17:06.920 stop talking about the units because they're all the same anyway. 268 00:17:07.119 --> 00:17:10.200 It should be under two hundred. But the total cholesterol 269 00:17:10.400 --> 00:17:13.240 is actually less important than what it's made up out of, right, 270 00:17:13.279 --> 00:17:16.279 because I just said there's good cholesterol, bad cholesterol, trigolystrides, 271 00:17:16.480 --> 00:17:19.759 and you can have various combinations of those three things 272 00:17:19.799 --> 00:17:22.720 and end up with the same total but with very 273 00:17:22.759 --> 00:17:28.240 different health implications. Okay, let's start with good cholesterol HDL. 274 00:17:28.799 --> 00:17:31.799 HDL is the good cholesterol. It's the happy cholesterol. You 275 00:17:31.839 --> 00:17:33.799 want to keep it high if it helps you remember 276 00:17:33.839 --> 00:17:38.440 which is which. HDL is the cholesterol that is not 277 00:17:38.599 --> 00:17:41.319 depositing in our arteries. It's on its way out. So 278 00:17:41.319 --> 00:17:44.839 you actually want this number as high as possible. In women, 279 00:17:45.000 --> 00:17:47.319 we're happy to see it should be over fifty, so 280 00:17:47.720 --> 00:17:50.559 you know that's where you should be. If you have 281 00:17:50.599 --> 00:17:55.119 an HDL cholesterol under fifty, that's its own risk factor 282 00:17:55.400 --> 00:18:01.079 for earlier atherospherosis, so it should be over fifty. LDL 283 00:18:01.480 --> 00:18:04.640 is the bad stuff. This is the cholesterol that's potentially 284 00:18:04.640 --> 00:18:07.640 depositing in our arteries. It's the lousy cholesterol. You want 285 00:18:07.680 --> 00:18:11.119 to keep it low. This is the cholesterol that you know, 286 00:18:11.279 --> 00:18:17.160 all physicians obsess over because LDL cholesterol is most tightly 287 00:18:17.319 --> 00:18:21.599 linked to heart disease risk. It's almost you know, a 288 00:18:21.720 --> 00:18:26.599 linear line between LDL and heart disease risks. So the 289 00:18:26.720 --> 00:18:31.759 higher it is, the higher your risk. Most cardiologists, actually 290 00:18:31.759 --> 00:18:34.440 all cardiologists would say, you know, everyone should be under 291 00:18:34.480 --> 00:18:38.759 one thirty for LDL as you accumulate risk factors, and 292 00:18:38.799 --> 00:18:41.279 that could be a family history of heart disease, or 293 00:18:41.319 --> 00:18:43.960 you have high blood pressure, you're a smoker. At some point, 294 00:18:44.759 --> 00:18:49.279 under one hundred would be better. Once you have documented 295 00:18:49.359 --> 00:18:52.400 heart or vascular disease, so you've had a heart attack 296 00:18:52.519 --> 00:18:56.079 or stroke or bypasser to your stent, your LDL should 297 00:18:56.119 --> 00:18:58.759 fall under seventy. Now the vast majority of us will 298 00:18:58.799 --> 00:19:02.079 require medications to get there, and there's even data to 299 00:19:02.119 --> 00:19:05.400 show that under fifty is additionally protective. So the main 300 00:19:05.480 --> 00:19:10.599 message around LDL is the lower, the better. The last 301 00:19:10.680 --> 00:19:15.039 component of a cholesterol profile are the triglycerides. Triglycerides are 302 00:19:15.039 --> 00:19:18.000 not much of a cholesterol particle. They're actually mostly fat, 303 00:19:18.559 --> 00:19:20.640 So if you try to add up the three numbers, 304 00:19:20.680 --> 00:19:22.920 you won't get to the total. It doesn't add up right. 305 00:19:23.000 --> 00:19:27.519 So the formula is actually good cholesterol plus bad cholesterol 306 00:19:27.519 --> 00:19:30.480 plus one fifth of the triglycerides gets you to the total. 307 00:19:31.839 --> 00:19:39.039 Triglyceride levels should be under one fifty in everyone, But 308 00:19:39.160 --> 00:19:43.880 the range of triglycerides is very broad, so it's just 309 00:19:43.920 --> 00:19:46.519 a different animal. It lives on a different scale. The 310 00:19:46.559 --> 00:19:49.799 lowest triglycerides I've ever seen and someone on no medications 311 00:19:49.839 --> 00:19:52.640 is twenty seven. But the highest I've ever seen is 312 00:19:52.640 --> 00:19:56.759 in the thousands. So it's a ginormous range. But everyone 313 00:19:56.799 --> 00:20:01.160 should be under one fifty. Triglycerides on their own are 314 00:20:01.240 --> 00:20:04.119 not much of a risk factor for heart disease per se. 315 00:20:04.640 --> 00:20:08.200 They tend to be more of an indicator of metabolic health. 316 00:20:08.960 --> 00:20:12.079 You know, the higher your triglycerides are, the more likely 317 00:20:12.200 --> 00:20:15.559 things are out of whack. You know your weight's not right, 318 00:20:15.720 --> 00:20:20.160 you're eating poorly, you're not exercising, you're drinking too much. 319 00:20:20.279 --> 00:20:22.960 You know that triglycerides will give you up, like they'll 320 00:20:23.039 --> 00:20:26.279 be the first ones to rise and say like something's 321 00:20:26.359 --> 00:20:27.440 not quite right here. 322 00:20:29.359 --> 00:20:32.440 That makes a lot of sense, So just to recap LDL. 323 00:20:32.599 --> 00:20:36.480 You want your LDLs low, right, Yes, you want your 324 00:20:36.640 --> 00:20:43.400 HDLs high mm and you want your triglycerides low yep. Right, 325 00:20:44.880 --> 00:20:47.079 And you should go to the doctor like I do 326 00:20:47.240 --> 00:20:49.400 with a shopping list. I go with a checklist. Now't 327 00:20:49.400 --> 00:20:51.279 ever go to your doctor unless you have a checklist. 328 00:20:51.319 --> 00:20:53.200 And I have a checklist. If everything I want check 329 00:20:53.279 --> 00:20:55.079 because I swear if they if I don't have that, 330 00:20:55.240 --> 00:20:57.480 then won't do it. So you got to go in 331 00:20:57.519 --> 00:21:01.640 there and demand that you get all the necessary tests 332 00:21:01.920 --> 00:21:04.680 so that you can have them as a benchmark and 333 00:21:04.720 --> 00:21:06.799 read the results because you get them in your portal. 334 00:21:07.079 --> 00:21:10.519 It's it's your benchmark to see what you need to 335 00:21:10.559 --> 00:21:13.319 do if you need to do any adjusting. Now, the 336 00:21:13.400 --> 00:21:18.519 logical way that these get adjusted from a physician standpoint 337 00:21:18.680 --> 00:21:21.920 is to prescribe medication. 338 00:21:22.000 --> 00:21:26.519 Right yep, high cholesterol. Here's a pill. 339 00:21:25.559 --> 00:21:28.359 And that would normally be what. 340 00:21:29.720 --> 00:21:32.960 That would normally be a statin. So this these are 341 00:21:33.480 --> 00:21:36.480 you know, medications that most people are familiar with because 342 00:21:36.480 --> 00:21:39.599 they've heard them, because they're because they're so frequently prescribed. 343 00:21:40.400 --> 00:21:43.359 The original ones were you know, called lipatour and crust store. 344 00:21:44.319 --> 00:21:48.240 Now they're all basically all generic, so that for maybe 345 00:21:48.240 --> 00:21:51.759 a torvas dat YEP or suba STAT and SIMBA STAT 346 00:21:51.759 --> 00:21:54.920 and so that. So that's the category of girls. It's 347 00:21:54.960 --> 00:21:58.319 actually the most widely one of the most widely prescribed 348 00:21:58.720 --> 00:21:59.960 drug categories on the. 349 00:22:00.079 --> 00:22:05.319 Planet, exactly besides annadepressants and most of the relaxers. I 350 00:22:05.319 --> 00:22:07.160 could go on, because I do have and I do 351 00:22:07.279 --> 00:22:10.240 like my primary care physician, but he loves to prescribe things, 352 00:22:10.279 --> 00:22:13.720 and I hate taking pills. So my husband's taking satins. 353 00:22:13.880 --> 00:22:18.480 I'm not because I I don't. So there's a big 354 00:22:18.559 --> 00:22:24.480 reason I don't like taking drugs, prescription medication unless absolutely necessary. 355 00:22:24.559 --> 00:22:30.039 And the biggest reason is that I write about wine. 356 00:22:30.119 --> 00:22:34.359 It is a job, and I know that there are interactions, 357 00:22:34.400 --> 00:22:42.039 and I read interactions carefully. I also know that you 358 00:22:42.160 --> 00:22:44.759 can't operate a car, and there are certain things that 359 00:22:44.799 --> 00:22:47.720 affect your decision making. And I am one of those 360 00:22:47.759 --> 00:22:52.119 people who does not do well on prescription medication. I 361 00:22:52.160 --> 00:22:58.480 get foggy. I have had reactions from itching to brain 362 00:22:58.599 --> 00:23:01.319 fog to whatever. I also know that you have to 363 00:23:01.319 --> 00:23:03.720 be very careful if you drink wine, you've got to 364 00:23:03.839 --> 00:23:06.640 watch that, and if you're oper aning machinery. So for me, 365 00:23:07.359 --> 00:23:10.839 very few work and my mother was the same way. 366 00:23:12.519 --> 00:23:14.680 She would have reactions. You've got to be very careful. 367 00:23:14.799 --> 00:23:16.920 It's not that they're bad. You have to do what's 368 00:23:17.000 --> 00:23:20.359 right for you. My husband is taking a stat However, 369 00:23:20.480 --> 00:23:23.720 I'm a big believer that you you know, change a 370 00:23:23.839 --> 00:23:26.759 start with you and not what you pop. And it's 371 00:23:26.759 --> 00:23:28.880 not the pill you pop in your mouth, but the 372 00:23:28.920 --> 00:23:31.359 food you pop in your mouth. And if you want 373 00:23:31.359 --> 00:23:33.400 to get rid of the gunk, get rid of the junk. 374 00:23:35.240 --> 00:23:37.480 Could not have said it better myself. I'm going to 375 00:23:37.599 --> 00:23:39.680 use that line. Okay, pray. 376 00:23:40.160 --> 00:23:43.680 I do like to speak, but that is something I 377 00:23:43.880 --> 00:23:46.559 say quite a bit, and you know, I'm a big 378 00:23:46.599 --> 00:23:49.119 believer in it. It's hard, it's not easy to follow. 379 00:23:50.000 --> 00:23:52.240 But you go into the doctor and you find out 380 00:23:52.279 --> 00:23:54.799 you're twenty five pounds overweight in your cholesterol sigh, you go, 381 00:23:54.960 --> 00:23:56.799 I think I'm going to do something about it because 382 00:23:56.880 --> 00:24:02.240 I don't want to get sick. So again, this is 383 00:24:02.319 --> 00:24:05.680 a blood test. Anyone can have it. Is there a 384 00:24:05.720 --> 00:24:08.400 certain age that people should be starting to get their 385 00:24:08.480 --> 00:24:12.400 cholesterol check or should just be part of your Yeah. 386 00:24:12.359 --> 00:24:18.519 So actually, you know, it's it's recommended that the first 387 00:24:18.599 --> 00:24:23.319 cholesterol check happened in childhood and and you know a 388 00:24:23.319 --> 00:24:26.279 good rule of thumb. And this isn't exactly you know, 389 00:24:26.559 --> 00:24:30.640 like the you know, US Preventive Services Task Force would say, 390 00:24:30.680 --> 00:24:33.160 but it's close enough and it's really easy to remember 391 00:24:33.880 --> 00:24:39.200 once you know, before you turn ten, you know, twice 392 00:24:39.200 --> 00:24:42.119 in your or sorry, once in your teens, twice in 393 00:24:42.160 --> 00:24:45.839 your twenties, you know, three times in your thirties, four 394 00:24:45.880 --> 00:24:48.720 times in your forties, at least every other year in 395 00:24:48.759 --> 00:24:53.319 your fifties, and then yearly sixty onwards. So it's you know, 396 00:24:53.599 --> 00:24:56.680 it's it's something that should increase in prextent. It assumes 397 00:24:56.720 --> 00:24:59.519 your your your numbers are normal, right, you may need 398 00:24:59.559 --> 00:25:02.960 more free checks if they're abnormal or you're being started 399 00:25:03.000 --> 00:25:06.079 on a therapy or you're using diet to modify this, 400 00:25:06.279 --> 00:25:08.799 so then then you're going to need more frequent assessment. 401 00:25:08.880 --> 00:25:12.359