Cholesterol: the Good, the Bad, the Ugly

Q: I have heard about “good” and “bad” cholesterol. What’s the difference and how do I know which one I’m eating?

A: Way to be a buzz kill on Thanksgiving week!  Just kidding – great question.  Let’s begin with a little chemistry lesson.



Fat doesn’t dissolve in water and blood, so it has to get chauffeured around your body by cholesterol.  There are two main types of cholesterol: high density lipoprotein (HDL, “the good guy”) and low density lipoprotein (LDL, “the bad guy”).

HDL acts like a scavenger or vacuum cleaner, picking up cholesterol and transporting it back to the liver, where it is processed and put to many necessary uses like building cell walls and membranes, bile acids and hormones.

On the other hand, LDL picks cholesterol up from the liver and drops it off throughout the body. This is especially problematic in blood vessels where the excess cholesterol can form plaques. The blood vessels around your heart (“coronaries”) are the diameter of spaghetti; a little plaque in them can mean a lot of trouble, like a heart attack. Too much plaque in the vessels supplying your brain can mean a stroke.

How do you know when your LDL is too high? Unfortunately, high cholesterol has no specific symptoms so a blood test is the only way to find out.  While healthy eating and exercise can go a long way towards keeping your cholesterol in check, high cholesterol can have a genetic component so you should talk to your doctor about when you need to start screening.

Certain foods, like trans fats, can actually increase LDL and decrease HDL. On the other hand, fatty fish (like salmon), walnuts and oatmeal can actually decrease LDL.  If you’re a smoker, quitting can also improve the amount of HDL in your blood (among a host of other improvements to your health). To see more tips on cholesterol and what you can do to improve yours, check out the websites below:

American Heart Association

U.S. National Institutes of Health

The Mayo Clinic

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Victoria Rentel, MD
Student Health Services
The Ohio State University

How to Lower Your Blood Pressure

From time to time students will come to see me with mildly elevated blood pressure.  The goal is to have a blood pressure reading that is < 120/80.  I don’t typically start medications unless the blood pressure is > 140/90.

If you find your blood pressure slightly elevated, how do you go about lowering it without resorting to medications?

  • Control your weight, striving to keep your BMI < 25, through a good diet and regular exercise.
  • No smoking
  • Keep alcohol at a minimum, no more than 1 drink daily for women and 2 drinks daily for men.
  • Monitor your blood pressure, there are BP machines in the RPAC near the Sport Shop on the ground floor.

After making the above changes for 3 months, schedule an appointment with your health care provider for a re-evaluation.

Douglas Radman, M.D.

Should I have my cholesterol tested?

There are several risk factors for heart disease and stroke.  These include obesity, high blood pressure, diabetes, smoking history, high blood cholesterol levels, and family history of heart disease and stroke.  High cholesterol can build up in your blood vessels causing narrowing and reduced blood flow.  This can lead to heart disease and stroke.

The U.S. Preventive Task Force recommends that men get a blood cholesterol test at age 35 years and women at age 45 years.  This should be done every five years.  The cholesterol test may be performed at an earlier age or more frequently if you have any of the cardiovascular risk factors mentioned above.  The accuracy of cholesterol tests done at public screenings such as health fairs varies.  It is probably better to discuss this with your provider who can order more reliable testing.

Dr. Matthew Peters

Veggie Vitals: To Beet or Not To Beet

A couple of years ago I went to a healthy cooking demonstration here on campus.  The goal of the demo was to introduce different ways that veggies could be incorporated into a meal.  They started out with a beet smoothie.  Beets were not something that I had incorporated into my diet at that time, but I’m always game to try new things and I like smoothies, so I gave it a try.

Now, before allowing us to sample the smoothie they instructed us that we should carefully wash the beets and they recommended peeling it to remove the earthly taste.  They also suggested adding strawberries or some other fruit to add a bit of sweetness. They passed round the samples for us to try and well let’s just say I was not impressed.  To be honest I felt it tasted like dirt.  Blah!  Needless to say I was not enamored with the beet.

Fast forward a couple of years and I have joined an organic co-op, where they deliver a bag of fresh veggies to me every week.  And one week – yes, they include beets.  Not just the bottom portion which is what I would have considered to be the beet, but the whole plant, leafy greens included.  I must admit I was baffled.  Why not cut off the greens?  Were they just being lazy?  Or is this part of the organic thing – to give you the whole plant?

I did a bit of research and found that the whole plant is edible and that the greens offer benefits as well as the bulb or root.  Here are some of the health benefits of a beet as a whole:


  • Low in calories with zero cholesterol and a small amount of fat
  • Rich source of glycine betaine which can lower your risk for coronary heart disease, stroke, and peripheral vascular diseases.
  • Raw beets (ugh, think dirt) are an excellent source of folates which are necessary for DNA synthesis within cells. Cooking, however, significantly reduces the folate levels.
  • Rich source of B-complex vitamins.
  • Moderate levels of potassium which lowers heart rate and regulates metabolism
  • The greens are an excellent source of vitamin C which is a powerful antioxidant.
  • The greens are an excellent source of carotenoids, flavonoids antioxidants, and vitamin A which is required for maintaining healthy mucus membranes and skin and is essential for vision.

I have now embraced the beet, all of it, bulb/root and greens.  I, however, choose to roast the bulb with a bit of olive oil and garlic powder.  This removes the earthy taste and actually makes it kind of sweet.  The greens – those I put into a smoothie with a banana and berries.  Much, much better than the bulb!

I should caution you, however, that there is a very noticeable side effect from eating beets.  A day or so after consumption you will see a noticeable color change in your stool and potentially in your urine as well.

Tina Comston, M.Ed.

Five Numbers You Need to Know By Heart

According to the Centers for Disease Control, heart disease is the leading cause of death for both men and women in the United States, killing about 600,000 Americans each year.  There are five numbers, however, that each person should know to help keep their cardiovascular system healthy.

“These are the numbers doctors use to assess someone’s risk for getting heart disease, both short term and throughout their lifetime,” says Dr. Martha Gulati, director of preventive cardiology and women’s cardiovascular health at Ohio State’s Ross Heart Hospital. “When you monitor these numbers, you are empowered to work with your doctor to improve your heart health.” 

  • Blood pressure – This is the force of blood against the walls of the arteries. It’s measured as two numbers – the systolic pressure, as the heart beats, over the diastolic pressure, as the heart relaxes between beats. A normal blood pressure is under 120/80. Talk to your doctor if it is higher than that. Simple lifestyle changes can help you lower your blood pressure and potentially avoid medication.
  • BMI – Body Mass Index is the measurement of your weight for your body surface area and it’s considered a reliable indicator of body fatness for most people. A recent national survey commissioned by Ohio State’s Wexner Medical Center found nearly 2 out of 3 Americans don’t know what’s considered to be a healthy BMI. Use this BMI calculator to get your number. A BMI less than 18.5 is underweight. Below 25 is normal. A BMI of 25 through 29.9 is overweight, and 30 or higher is considered obese. “Knowing where you lie within that spectrum is really important because sometimes people will be very accepting of their weight thinking ‘Well, that number sounds reasonable.’ But is it reasonable for their height?” Gulati said.
  • Waist circumference – Fat that is carried around the abdomen increases the risk of heart disease and type 2 diabetes. Measure your waist at the belly button, not where your clothing waistband sits. Gulati says women should be at least less than 35 inches and men should be less than 40 inches at the waist.
  • Cholesterol – While the body makes all of the cholesterol it needs, it is also readily found in food. High cholesterol can lead to heart disease and atherosclerosis, or build-up of plaque in the arteries. Gulati says it’s important to know your total cholesterol number and your low-density lipoprotein, or LDL, number. That’s the bad cholesterol that can cause problems. A healthy cholesterol number is below 200. A healthy LDL number is below 100.
  • Blood sugar – This reading tells doctors how much glucose is in the blood. High levels of blood glucose cause diabetes, which increases the risk for cardiovascular disease. A healthy fasting blood sugar number is under 100 after not eating for eight hours.

Reposted by Tina Comston, M.Ed.

See original article at:…

Get a Jump on Exercise

Are you looking for a cheap, portable workout?  Try jumping rope.  A good jump rope typically sells for under $20, will fit in your backpack, and one size fits all.  Extra bonus, jumping rope is a great calorie-burner.  A 15-20 minute workout will burn off the calories from a candy bar.  To see how many calories you would burn, check out the calorie counter at WebMD.  Select sports for the activity and rope jumping for the exercise.

“It’s certainly good for the heart,” says Peter Schulman, MD, associate professor, Cardiology/Pulmonary Medicine, University of Connecticut Health Center in Farmington. “It strengthens the upper and lower body and burns a lot of calories in a short time.”

If you’re looking to get started, WebMD gives the following as the basic requirements:

For novices, a beaded rope is recommended because it holds its shape and is easier to control than a lightweight cloth or vinyl rope.

  • Adjust the rope by holding the handles and stepping on the rope.
  • Shorten the rope so the handles reach your armpits.
  • Wear properly fitted athletic shoes, preferably cross-training shoes.

You’ll need a four-by-six-foot area, and about 10 inches of space above your head. The exercise surface is very important. Do not attempt to jump on carpet, grass, concrete, or asphalt. While carpet reduces impact, the downside is it grabs your shoes and can twist your ankle or knee. Use a wood floor, piece of plywood, or an impact mat made for exercise.

Give it a try.  Who knows, perhaps you’ll find yourself following in the footsteps of Tori Boggs, a second-year industrial design student at Ohio State.


Read more at WebMD….

Submitted by Tina Comston, M.Ed.

The Great American Smokeout

Tobacco use remains the single largest preventable cause of disease and premature death in the US, yet about 43.8 million Americans still smoke cigarettes – Nearly 1 in every 5 adults. As of 2010, there were also 13.2 million cigar smokers in the US, and 2.2 million who smoke tobacco in pipes – other dangerous and addictive forms of tobacco.

The American Cancer Society marks the Great American Smokeout on the third Thursday of November each year by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting – even for one day – smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk.

The health benefits of quitting start immediately from the moment of smoking cessation. Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke.

Check out how your body recovers after quitting:

  • 20 minutes – your heart rate and blood pressure drop
  • 12 hours – the carbon monoxide level in your blood drops to normal
  • 2 weeks – 3 months – your circulation improves and your lung function increases
  • 1-9 months – coughing and shortness of breath decrease
  • 1 year – excess risk of coronary heart disease is half that of a continuing smokers
  • 2-5 years – stroke risk can fall to that of a non-smokers
  • 5 years – risk of cancer of mouth, throat, esophagus, and bladder are cut in half
  • 10 years – risk of dying from lung cancer is about half that of a continuing smokers
  • 15 years – risk of coronary heart disease is that of a non-smokers

Information taken from American Cancer Society (

Reviewed by Tina Comston, M.Ed.

An Apple a Day – Fact or Fiction

Last year I participated in a study here on campus regarding apples.  I had always wondered about the ‘Apple a day keeps the doctor away’ saying and I liked apples, so I thought, why not.  When I signed up for the study I was told that participants would be divided into four groups.  Group 1 would take a placebo each day; Group 2 would take a capsule each day containing polyphenols, a type of antioxidant found in apples; Group 3 would eat an apple each day; and Group 4 would not only eat an apple a day, but also apple sauce and drink a glass of apple juice.  Lucky me – I ended up in Group 4.  Let me just say, that was a lot of apple.

The study was held over a 4 week period.  Prior to starting the study a blood sample was taken and I was asked to spit in a cup.  After the 4 weeks another blood sample was taken and again I spit in a cup.  I wondered about the whole spitting in a cup thing, but having read the results of the study it now makes sense.

And the results, they were fairly significant.  Those individuals who consumed an apple a day for 4 weeks lowered by 40% the blood levels of oxidized LDL – “bad” cholesterol.  This is what contributes to the hardening of arteries.  As far as spitting in the cup, they also found that eating apples has some effect on the antioxidants in saliva which has implications for dental health.

It appears that ‘An Apple a Day’ could indeed keep the cardiologist away.  As for an apple, apple sauce, and apple juice – that was a bit much. 

To read more about this study:

Submitted by Tina Comston, M.Ed.

Do I need to have my cholesterol checked?

Do I need to have my cholesterol checked?

For most OSU students, the short answer is NO.  

The good news is that if you are younger than age 35 (for men) or younger than 45 (for women) you would only need to have your cholesterol checked if you have risk factors for heart disease.  If you don’t have risk factors, the likelihood that you have high cholesterol is VERY LOW.  The bad news is, because of that low risk, if you decide you just want to know what your cholesterol is, most insurances won’t cover the cost of the test (because they don’t see any reason you need to have it done).

So what are the risk factors that mean you should have your cholesterol checked, and make it likely that your insurance would pay for it?  These are based on research done by several groups, including the CDC (Centers for Disease Control and Prevention) and the USPSTF (United States Preventive Services Task Force).  The specific risk factors are:

  1. Obesity/ high BMI (body mass index)
  2. A family history of the following conditions (in your biological brother, sister, mother, or father):
  • Sudden Cardiac Death
  • Cardiovascular Disease (like a heart attack)
  • Hyperlipidemia (high cholesterol)

If you decide to have your cholesterol checked even though your insurance does not cover it, your least expensive option would be to have it checked at a Health Fair (sometimes done for free), or to come to the Student Health Center and go to the Registration Desk (first floor) and ask to have it done as an OIY (“Order It Yourself”) test.  You have to pay for it up front, but it only costs $20 and you get a printout from the lab within 15-30 minutes with the results and an explanation of the results.  If you have it done as part of an office visit with one of our providers, you’ll get billed for the lab test (usually at a higher rate) and the office visit, so it’ll be a lot more expensive.

If you have any questions about your risk factors for heart disease and whether or not you need to have your cholesterol checked, you can always make an appointment with us to discuss them – we’re here to help!

Mary Jane Elam, MD
Student Health Services
The Ohio State University

Benefits of Being Tobacco-Free

wikimedia commons

Now that Ohio State is considering a tobacco-free campus initative, perhaps we should learn if smoking bans lead to measurable positive health results.  A recent study looked at health benefits after a smoking ban was put in place in restaurants and workplaces in a community in Minnesota. 

They found:

  • A 33% decrease in heart attacks (myocardial infarctions)
  • A 17% decrease in sudden cardiac death

This study also measured other possible risk factors for heart problems, so that it avoided overestimating the benefit. 

The docs conducting the study concluded:

  • “Exposure to second-hand smoke should be considered a modifiable risk factor for MI”
  • “All people should avoid second-hand smoke exposure as much as possible, and those with coronary heart disease should have no exposure to second-hand smoke.”

If you are interested in advice about smoking and reducing your risk for heart disease, come visit a provider at Student Health Services.  We are happy for assist you.  Until then, squash that butt!

 Good Health!

 Roger Miller, MD (OSU Student Health Services)