Not all cholesterol is bad

One of the indignities of aging is having to learn to crunch all of those new numbers. No, I am not talking about our golf handicaps or even fictional Social Security payouts.

I'm talking cholesterol. Those increasingly important and ominous scores we receive whenever we visit our doctors. Not unlike our waistline, these numbers tend to increase as we age. And, if you are anything like me, you dread the day when your doctor says: "Your cholesterol score is now borderline high. We need to watch this."

I guess it could be worse. I could have gone straight from normal to medication.

Still, it was a gulp! We all know by now that cholesterol is one of the leading risk factors for heart disease. And that heart disease is our No. 1 killer in the United States. We hate cholesterol, right? But not so fast: cholesterol is not all bad.

First off, cholesterol is very useful. Kind of like the spackle of the body, it is necessary to repair the cracks in our blood vessels. But to really understand the good and the bad of it, we have to know that there are two kinds of cholesterol that serve two different purposes.

One is called LDL -- low density lipoprotein. Imagine it as a dump truck. It transports cholesterol through the arteries. When there is too much of it, it dumps the cholesterol where it can build up on the artery walls. The resulting plaque damages the inner linings of arteries and can dislodge and cause arterial blocking.

The second kind is HDL -- high density lipoprotein. Now imagine a garbage truck. It collects that nasty plaque and carts it back to the liver where it is processed out.

Traditionally, physicians paid the most attention to our total cholesterol score, looking for it to be under 200. But lately, more attention is being paid to the HDL cholesterol score. They want to see it above 40. And there is evidence that you can't have too much of this "good" cholesterol.

In fact, for those 85 and older, a high HDL cholesterol score was a greater defense against fatal heart disease and stroke than having a low total cholesterol score.

Cholesterol is primarily genetically determined but there is still much we can do to increase our HDL score and therefore our bodies' natural ability to protect the heart. It's what they call in the med biz TLC -- or "therapeutic lifestyle change."

Here are three:

Diet. Soy protein is especially beneficial for upping those important HDL cholesterol scores. Foods with trans-fatty acids (fast foods, many commercially baked goods) are not. The latest report from the National Cholesterol Education Program recommends a diet consisting of saturated fats less than 7 percent of total calories plus adequate fiber and fish oils.

Moderate Alcohol Consumption. According to the experts at Johns Hopkins, half of alcohol's cardioprotective effects comes from its ability to raise HDL an average of 12 percent. And, by the way, contrary to popular myth, it doesn't have to be red wine; any alcohol will do.

Exercise. Can't get away from it: Exercise is essential for almost everything that ails us as we age. Like moderate alcohol imbibing, exercise has been shown to raise our HDL cholesterol scores 12 percent. Consistency rather than intensity is the key.

Dr. Michael O.L. Seabaugh is a Cape Girardeau native who is a licensed clinical psychologist with over 20 years experience helping individuals and couples with their emotional and relationship issues. He has a private practice in Santa Barbara and Santa Monica, Calif. Contact him at msea baugh@semissourian.com.