Hiroaki Nakagawa writes:
Patient A's pain ("angina"chest
pain) may be due to narrowing of the arteries, because narrowing of arteries
especially coronary arteries causes a shortage of oxygen to the heart,
and this leads to "angina" chest pain. Of course, there is not
only a pain, but also a risk of a heart attack or a stroke. After considering
all of this, A's high LDL-levels must be lower.
A's favorite foods are basically bad for him. Patient A should avoid high cholesterol foods such as ice cream (ice cream is made from whole milk and whole milk contains 35mg cholesterol per one cup.), eggs (egg yolk has 213mg cholesterol) and fatty meats (animal fats include cholesterol and much saturated fatty acids and saturated fatty acids lead to high blood cholesterol).
If A wants to eat rich-tasting kinds of foods, he may choose healthier substitutes. For example, he could eat tofu ice cream (because tofu has no cholesterol and less saturated fatty acids than milk). He could try egg whites only or an egg substitute instead of a whole egg (since egg whites and egg substitutes have no cholesterol). And he should use protein and oil originated in vegetables as substitutes for fatty meats (vegetables have no cholesterol).
In addition, A had better begin exercising. To begin with, I think about 30 to 60 minutes of fast walking is better. Exercising burns body fats so cholesterol levels will lower.
At a glance patient B looks healthy but I think it is difficult to maintain her health in the not-too-distant future because of some dangerous factors which she has. First she is overweight. Her cholesterol level is normal now but being overweight may increase her blood cholesterol level and also may increase risk of heart diseases or other adult diseases.
Patient B has the habit of riding her bicycle on weekends. For the sake of losing her weight, she should continue this exercise and gradually increase her exercising time or the number of times she exercises.
Secondly, she smokes. Cigarette smoking is another important risk factor in the development of heart diseases. A person with two risk factors has four times the risk of someone without any risk factors.
Thirdly, her father died of diabetes. Some people, because of diet, metabolism or family history, absorb too much cholesterol into their blood and dispose of the "excess" too slowly. And given her family history, there is a danger that B might develop problems later on.
Her diet should be changed. Patient B had better eat whole-grain bread instead of white bread. Whole-grain bread contains many kinds of minerals and vitamins. Concerning cheese, she should avoid it, because it includes high cholesterol and much saturated fatty acids.
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