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Right Diet Essential in Controlling Cholesterol, Reducing Coronaries

December 12, 1987|From Times Wire Services

Ron Goor, a biochemist with a graduate degree in nutrition, grew up no stranger to heart disease. His father had his first heart attack at 31 when Ron was only 3.

But it was not until Ron was the same age that he learned his own cholesterol level was high, giving him a substantial risk of early disability or death from an ailing heart and putting him in the company of 55% of adult Americans.

The discovery changed his life and his career. At 47, Goor has long since whittled his own cholesterol down to the 200 or below mark (200 milligrams per deciliter of blood) that years of research have shown to be desirable. He became the coordinator first of a landmark National Institutes of Health study that demonstrated the benefits of cholesterol control and of the NIH public education program that followed. Now, he and his wife, Nancy, have written "Eater's Choice: A Food Lover's Guide to Lower Cholesterol" (Houghton-Mifflin, $10.95).

The book is timely. A recent University of Southern California study demonstrates for the first time that unhealthy deposits of cholesterol, which clog the arteries supplying blood to the heart, not only can be prevented, but also made to shrink if they have already formed.

Even those well on their way to heart trouble have a chance to beat the odds. In fact, all participants in the USC study were enrolled because they had undergone a coronary artery bypass operation. There is a strong likelihood that grafts surgically implanted to serve as detours around obstructed sections of these arteries will themselves be narrowed--or shut--by fat deposits within three to five years, leaving their owners again at high risk of heart attack.

A 'Sat-Fat Budget'

The book explains how to eat healthy--as the American Heart Assn. recommends--and still eat well. The trick is to draw up what the Goors call a "sat-fat budget,' meaning that as long as you consume no more than 10% of your calories as saturated fat you will be doing well.

The system isn't magical, but the book's recipes, sample meal plans and especially tables listing the amount of saturated fat in grocery items and on fast-food restaurant menus make it both workable and flexible. By focusing on saturated fat, the most powerful dietary influence on blood cholesterol, you soon find out what combinations of your favorite or new foods are acceptable, Goor said. "That kind of self-discovery is the most powerful way to bring about permanent behavior change."

Suppose, for example, that you typically eat 1,800 calories a day and want to have ice cream occasionally. Because a serving of ice cream is 80 in sat-fat budget terms and must come out of a total sat-fat budget of 180, you are home free as long as you don't eat more than an additional 100 sat-fat calories.

Furthermore, you can borrow from yesterday or tomorrow if a special occasion--such as Thanksgiving Day--arises.

The system is simple, yet many Americans will opt for treating the problem with medications rather than going to the trouble of changing their diets.

Cholestyramine (brand name Questran) and colestipol (Colestid) prevent the body from absorbing cholesterol from the diet. In addition, niacin, one of the B vitamins, encourages the formation by the body of desirable high-density lipoproteins, which are regarded as protective of the heart, at the expense of the low-density lipoproteins, which are injurious.

Patients Developed Gout

But the drugs have side effects. This may mean that the patient must sometimes take still more drugs to get resulting side effects under control. Some USC study patients on colestipol and niacin developed gout, painful inflammation of the joints, particularly the big toe, because of a consequent rise in their uric acid levels. To treat it they took allopurinol, which can have its own side effect.

Besides being expensive, anti-cholesterol drugs should be taken only under a physician's supervision and only as a last resort. And they do not work well unless patients also limit their fat intake (as all the USC study patients did), stay away from cigarettes and exercise regularly.

"Diet is safer, cheaper and just as effective for most people as cholesterol-control drugs," said Basil Rifkind, of the NIH's National Heart, Lung and Blood Institute. "They may have to go to drugs eventually. But if they do, sticking to the diet will keep the drug doses lower than they would be otherwise and so lower both the costs of the medication and the probability of its having side effects."

The individual diet counseling that was given to the USC study patients will be available by mail sometime later this year. For details, write to Nutrition Scientific, Suite F, 1510 Oxford St., South Pasadena, CA 91030.

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