Participants: Don Mackintosh, Kevin Bryant
Series Code: HFAL
Program Code: HFAL000039
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00:51 Hello and welcome to "Health for a Lifetime"
00:54 I'm Don Macintosh, your host, and today we're joined by 00:59 Dr. Kevin Bryant, from Wichita, Kansas 01:01 Thank you, Dr. Bryant, for being here! Good to be here. 01:04 One of the things you do as a family practice physician 01:08 is deal with lots of people when they receive lab tests. 01:12 And I understand you're involved in a program in the 01:14 community that looks at really heart disease. 01:19 Right, I have the pleasure of being involved in a community 01:23 outreach educational program 01:25 called: "Coronary Health Improvement Project" 01:28 dealing specifically with the risk factors that promote, 01:34 and cause heart disease. 01:35 How many people have you had 01:36 go through that program thus far? 01:38 We have approximately 600 in our community have gone through. 01:41 And do you have any followup for them once they... 01:43 How long is the program, and then do you have any followup? 01:46 The program lasts for 30 days. 01:48 It's a pretty intensive program. 01:50 And then on a monthly basis, we follow up continuing to 01:54 check their lipid levels, their blood cholesterol levels. 01:59 Cholesterol. 02:00 Do you see big changes? Are people happy with that? 02:04 Dramatic changes can take place in 30 days. 02:08 And, it's rewarding to me as a 02:10 physician to see people make those changes. 02:13 How many times do you do that a year? 02:14 We do it about twice a year now. 02:17 Well maybe some of the folks that are watching today 02:20 don't have the privilege of being in a program like that... 02:23 But let's say they've gone to the hospital, 02:27 or maybe seeing their physician, and they've heard a lot about 02:29 cholesterol. 02:30 Today, really, we're going to talk about how to tell 02:33 the difference between good and bad cholesterol, 02:35 and would it be fair to say that today it's going to be like 02:39 they've just gotten their lab tests back, 02:41 and this would be a good time for them to maybe get out 02:43 those numbers, so that they could learn about how to 02:46 look at those and find out what's happening. 02:48 Yeah, this program today is really designed to try and help 02:52 people understand what the numbers mean 02:54 when they get those reports back from their doctor. 02:57 Okay, so if you're watching today, and you had some 03:01 lab tests that you've had done, maybe cholesterol... 03:04 Run and get those tests, turn up the set, 03:09 and you can hear what's happening... 03:10 But go get those numbers because I think you'll 03:12 really find some things that can help you. 03:15 One thing that kind of intrigues me about the title of 03:18 today's show... You're saying that there is 03:20 GOOD cholesterol and that there is BAD cholesterol, 03:23 I don't know which you want to talk about first, 03:25 but what does that mean? 03:26 Well yeah, I think a lot of people, their impression 03:31 when they hear the word "cholesterol," that it's bad. 03:34 But there's actually good and bad cholesterol, 03:37 and we're going to try and explain that today. 03:40 And the first thing that I find most people 03:42 are confused about is... 03:44 They get a report back and it has cholesterol on it, 03:49 triglycerides, and many people are confused about even those 03:54 terms... thinking that their triglycerides and cholesterol 03:59 are the same thing, when in reality they are 04:01 2 different completely separate 04:04 chemical compounds in our body... 04:06 And so, we have to recognize there's 04:09 cholesterol and then triglycerides. 04:12 Cholesterol, if we had a lump of it here in your hand, 04:15 is kind of a waxy substance, 04:19 as where triglycerides is just a big name for OIL or FAT... 04:24 And so your vegetable oils, your margarine, your butter, 04:28 those are triglycerides. 04:31 And because both the triglycerides and cholesterol 04:35 are waxy or oily, they don't mix with water. 04:40 Oil and water doesn't mix. 04:42 Well that's true in our body. 04:43 Those substances, cholesterol and triglycerides, 04:47 in the bloodstream would not mix. 04:50 So they are 2 different things in other words. 04:53 Two different things, and because of the 04:56 chemical structure, they don't mix with water in the 05:00 serum in our blood. 05:01 So our body has a way to carry those 2 chemicals 05:06 around in the bloodstream produce protein molecules 05:11 that carry the cholesterol. 05:15 They're like little trucks in our bloodstream, 05:18 if you want to think of them that way... 05:19 that are carrying cholesterol and triglyceride around because 05:24 otherwise they would not mix in the bloodstream, 05:27 so they're carried by those. 05:29 And those protein molecules 05:32 are divided into different categories, 05:37 and, as you can see here, they are divided roughly into 3... 05:41 Actually there's, I think, 18 or 19 fractions or different 05:46 We're giving us the 3 main ones that you're going to see 05:49 on a lab result. 05:50 The first one is "LDL" and we're going to talk 05:53 in more detail about these, 05:55 but LDL has become known as BAD cholesterol. 06:00 "Lousy" density lipoprotein, 06:04 and lipoprotein is the name for the protein. 06:07 It just means "lipo" is fat, and then protein. 06:10 So it's the fat-protein combination. 06:14 So LDL is considered bad because it tends to carry cholesterol 06:20 to the wall of the artery. 06:22 It makes it fat; makes it clogged up. 06:25 That's the one that is kind of a culprit and we'll look at that 06:30 The good cholesterol is called "HDL" 06:34 So when you look at a lab result you want to look for 06:36 LDL - bad HDL is the good cholesterol. 06:41 "Happy" density lipo. Lousy and happy... all right 06:45 And it does kind of the opposite. 06:47 In a simplistic way, it's doing the opposite of the 06:51 bad cholesterol; it's trying to take cholesterol 06:54 out of the wall of the artery where these plaques are 06:57 in the artery, and take them back to the liver. 07:02 So the lousy dumps it off in the artery; 07:05 the happy says, "I'm not happy with that and takes it away. " 07:08 In a simplistic way that's the way to look at it. 07:11 And then, another one called VLDL is a protein that carries 07:16 a lot of the triglycerides or fat around in the bloodstream 07:19 Which are totally different than 07:21 cholesterol, what you've told us Exactly, completely different. 07:25 Now, if we look more specifically at the 07:31 low-density lipoprotein, the LDL what we called bad cholesterol, 07:37 we talk about it carrying cholesterol around. 07:42 Now, in essence, the cholesterol is the same cholesterol 07:46 whether it's in an LDL, or an HDL protein molecule. 07:52 But it's the protein molecule that makes the difference 07:56 where that cholesterol is going. 07:57 Is it going to the wall of the artery or out of the 08:00 wall of the artery back to the liver to be disposed of? 08:04 And that protein molecule is LDL?... is LDL or HDL 08:10 Now as time has gone on and research has been done 08:16 on this LDL molecule, we've discovered that 08:20 by itself, pure cholesterol does not damage 08:26 the wall of the artery or cause a problem. 08:29 It's only when that cholesterol and that protein becomes 08:35 oxidized, either exposed to air in the animal products 08:42 where the cholesterol may have 08:43 been if you're eating animal products... 08:47 or if sometimes in the body's metabolism 08:53 free radicals are produced that oxidize the cholesterol 08:58 and the LDL protein. 09:00 When that happens, the body then begins to recognize 09:04 this as actually as though it's a foreign body... 09:08 almost like a bacteria, an enemy. 09:09 And so part of the immune-fighting cells 09:15 particularly the ones called macrophages, actually begin 09:19 to engulf those particles... 09:22 ...the LDL particles in the wall of the artery in an attempt to 09:27 ...just like if it was an enemy. 09:30 Let me see if I have this straight... 09:32 So LDL, the lousy density lipoproteins, 09:39 are those that have been exposed to air either outside 09:41 the body, so food would be like any dairy products, 09:46 or anything that have been exposed to air, 09:49 or INSIDE the body that even 09:51 happens inside your body without your doing anything, 09:54 and so the point of this really is there are ways 10:01 trying to prevent that from taking place... 10:04 because that's the important point. 10:06 Just having the cholesterol, the LDL there, 10:09 is not going to damage the wall 10:13 of the artery until it becomes oxidized. 10:16 So if we can prevent that oxidation from taking place... 10:20 Either on the outside... either by not eating those 10:23 animal products because they have oxidized cholesterol 10:28 in them, which is going to be harmful to your vascular system, 10:34 or, and this is where our what we call antioxidants, 10:39 vitamins that are antioxidants are very important. 10:44 So ANTIOXIDATION... anti what the air is doing. 10:48 Right. They, in other words, prevent that process 10:52 from taking place. 10:53 So we know that even if we have 2 different groups of 10:59 people that have the same cholesterol levels; 11:03 one group is eating those things that are high in antioxidants 11:08 which are fruits and vegetables. 11:10 The other group was eating low; they don't have as many 11:14 antioxidants. 11:16 The group that is NOT eating the antioxidants in their food 11:21 are going to be at GREATER risk for heart disease, 11:24 even though their cholesterol levels are the same. 11:26 So they got their lab sheet out at home and they're 11:28 looking at it and it says my total cholesterol, 11:30 let's say it says it's 200, that's not enough to look at. 11:34 They've got to look at, what does it say concerning LDL; 11:37 what does it say concerning HDL? 11:39 We've TALKED about the LDL, what's a good number for LDL? 11:41 Okay right... well, LDL numbers, and this may be somewhat 11:46 different from if you have your lab value there 11:48 in front of you, the labs frequently put a reference 11:52 number, what's normal... and then they have a little 11:55 star that comes up if it's abnormal. Right 11:57 And, we're finding now that if that number is below 90, 12:04 that that's the ideal range. 12:08 There may be what's normal in America, 12:10 but we want to be ideal, and so 90 or below is really 12:14 the ideal range that we want to be in. 12:18 Now usually in those normal sheets, 12:20 what do they normally say in your lipid area? 12:25 What do they say is normal in your area? 12:28 Normally in America, below 130 is considered normal. 12:35 So that's quite a bit different than 90. 12:37 Right, we still find a lot of people with heart disease 12:40 with the LDL numbers between 100 and 130. 12:45 Should someone panic if their number says 120 or 30 today? 12:50 Not necessarily, I think that's a call to that person 12:53 to find out how do I lower that number... how do I get that down 12:59 And I think you've mentioned, sort of how to do that... 13:03 stay away from oxidized foods. 13:06 Well, right... because one of the main ways that LDL is 13:12 is raised in the bloodstream is by either eating cholesterol, 13:18 animal products that have cholesterol, 13:20 OR foods that are high in fat, particularly what are called 13:25 saturated fats. 13:27 Primarily those fats that are found in the animal products... 13:31 they are what cause the body to produce more of 13:35 this LDL protein to carry that cholesterol around. 13:40 We've been talking with Dr. Kevin Bryant. 13:43 He is a doctor in family practice. 13:48 He focuses on heart disease and helps people understand 13:51 their lab tests and their values. 13:53 We've talked about cholesterol, the bad type of cholesterol... 13:56 And when we come back, we're going to look further at a good 14:00 type of cholesterol... HDL 14:03 We hope that you join us. 14:17 Have you found yourself wishing that you could shed a few pounds 14:20 Have you been on a diet for most of your life, 14:22 but not found anything that will really keep the weight off? 14:25 If you've answered "yes" to any of these questions, 14:28 then we have a solution for you that works! 14:31 Dr. Hans Diehl and Dr. Aileen Ludington 14:34 have written a marvelous booklet called... 14:36 "Reversing Obesity Naturally" 14:38 and we'd like to send it to you FREE of charge. 14:41 Here's a medically sound approach successfully used 14:44 by thousands who are able to eat more and lose weight 14:47 permanently without feeling guilty or hungry 14:50 through lifestyle medicine. 14:52 Dr. Diehl and Dr. Ludington have been featured on 3ABN, 14:55 and in this booklet, they present a sensible approach 14:58 to eating, nutrition and lifestyle changes 15:01 that can help you prevent heart disease, diabetes, 15:03 and EVEN cancer. 15:05 Call or write today for your free copy of... 15:07 "Reversing Obesity Naturally" 15:08 and you could be on your way to a healthier, happier YOU! 15:12 It's ABSOLUTELY free of charge, so call or write today. 15:27 Welcome back, we've been talking with Dr. Kevin Bryant 15:32 from Wichita, Kansas, 15:33 He's a specialist in family practice... 15:36 And today, we're talking about heart disease. 15:38 And really, what we've been talking about is lab tests, 15:43 cholesterol... how can we tell whether or not we've had a good 15:46 result or not. 15:48 If you've just joined us, and you recently had a lab test, 15:51 and you know where it is, 15:53 why don't you run and go get that lab test and have it there 15:56 as you're listening to Dr. Bryant. 15:57 On the first part of the program we talked about 16:00 low-density lipoprotein, did I say that right? 16:03 You've got it down. 16:04 "Lousy" cholesterol because what it does is 16:07 it puts, you see if I'm right, 16:09 I'm seeing if you're a good teacher... 16:11 It puts the cholesterol right in the walls of our arteries 16:15 and thickens them up, and that can cause real problems. 16:18 So we don't want that to happen. 16:20 And so we explained that LDL, but now we want some good news. 16:25 We've had the bad news; do you have some 16:27 good news for us today, doctor? 16:29 Obviously, we've talked about the bad cholesterol, 16:33 now we want to look at the flip side, the good cholesterol, 16:36 and again, it's the same cholesterol, 16:38 it's just a different carrier truck that we've talked about; 16:43 the protein molecule is different. 16:45 So now, the good cholesterol is carried by an HDL protein, 16:51 so when you look at your lab result, 16:53 the HDL is good cholesterol. 16:57 Happy! "Happy" density lipoprotein is 17:01 one way of looking at it. 17:08 Now, the function that HDL has is opposite to the LDL. 17:12 It's reversing... it's taking cholesterol out of that wall 17:17 of the artery back to the heart. 17:19 It's almost like there's this tug-of-war between these 2 17:23 protein molecules. 17:25 Bad cholesterol protein LDL 17:28 putting it into the wall of the artery... 17:30 HDL trying to take it back out. 17:33 And so there's a balance here going on between the 2. 17:37 And that's why you want the bad cholesterol portion, the LDL 17:42 to be as low as possible. 17:44 You want the good cholesterol to be high. 17:49 So is there ever anyone that has a lab test 17:54 where there's no LDL? 17:57 Where there's no LDL? No 18:01 You would probably be "dead" if you had none. 18:06 Okay, so you'd have to have some. 18:08 Is there ANYTHING good about LDL that we have to have some? 18:12 Well actually, I mean, it is one of the carriers that carries 18:16 cholesterol; all of our cells NEED cholesterol. 18:19 So the arteries... they need cholesterol, the actual wall, 18:25 but the problem in America is they get too much. 18:27 They get too much... right, begins to clog the system up. 18:31 So, we can kind of tip the scale as who's going to win this 18:35 tug-of-war by what we eat or don't eat, 18:37 all those different kinds of things. Right 18:39 And now what we eat, affects 18:41 the LDL, the bad cholesterol. 18:44 What affects the HDL and raises that because we want more 18:49 of that... to take the cholesterol back out 18:51 of the wall of the artery; try and open the arteries up. 18:54 There are 3 main things that affect that. 18:57 Let us know those 3 things. 18:58 What are those 3 things, because we want to happy, happy, happy! 19:02 Well the first is our weight. 19:06 If we're overweight, obesity LOWERS the HDL, decreases it... 19:14 So as a person loses weight, over time, that will help 19:19 the HDL level rise. 19:22 And it doesn't happen overnight, 19:24 it happens usually in several months, sometimes up to a year. 19:30 As that weight is coming down, that the HDL number will go up. 19:34 We find, in this program that I'm involved with, 19:37 that in 30 days, the LDL, the bad cholesterol number 19:41 can come down dramatically, 19:43 but it may take months to a year for the HDL level to rise. 19:48 Oh, so in other words, if the LDL is going down, 19:50 you've started some good lifestyle things, 19:53 you need to wait a while for the HDL. 19:56 Yeah, don't expect that one to change overnight. 19:59 So weight is one issue. 20:01 Smoking is another issue. 20:03 Smoking also drives the HDL level down. How does that work? 20:08 Not exactly sure how that connection is there; 20:12 we've just seen that relationship that individuals 20:16 smoking have lower HDL levels and when they quit, 20:20 over time, that level rises again. 20:22 So losing weight, stopping smoking, 20:25 and then the 3rd, probably one of the most powerful ways 20:28 to raise the HDL level is exercise. 20:32 And it's really what we call dose-dependent relationship 20:37 ...The more you exercise, 20:39 the more effect it has on raising the HDL level. 20:43 Let me ask you a question about that... 20:45 Can you lose weight without exercising? 20:47 You can lose weight... 20:51 Just by caloric or by what you take in... 20:53 You could lose weight that way. 20:55 So exercise really should be looked at as something 20:58 different than losing weight. 21:00 I mean they may be related, but what you're saying 21:03 is that it's not enough to just lose weight by not 21:05 eating as much food; you need to be out there 21:08 if possible putting some pep in your step, 21:11 and spunk in your trunk just moving it. 21:14 Yeah, the exercise is what's going to help you 21:15 maintain that weight loss... 21:19 What if I can't walk? 21:21 What kind of exercise do I do then? 21:23 Maybe able to swim. Okay 21:26 Cycle. Water aquatics or something like that. Right 21:29 Anything to raise that HDL. 21:33 So lose weight, stop smoking, and exercise. Right 21:39 And the number that we're shooting for is above 40; 21:45 somewhere in the range of 40 or greater. 21:49 In fact, the higher you can get that number, the better. 21:53 So, let me just review a a little bit; 21:55 maybe someone just was joining us. 21:57 The LDL needs to be 90 or below. 22:02 The HDL, if possible, needs to be 40 or above. Right 22:09 Okay, now those are looking at the cholesterol issues. 22:15 Now, we're going to turn and focus on triglyceride. 22:19 What you've said is different, 22:20 completely different than cholesterol. 22:22 It's a different molecule. 22:23 It might be on the same sheet of paper, 22:25 you're looking at your lab tests, but it's different. 22:27 Right, and for a number of years, we weren't really sure 22:31 if triglycerides really affected your risk for heart disease... 22:36 We now know that it does. 22:39 Now triglycerides, again, are carried by what's called... 22:43 "VLDL" another protein molecule that's carrying 22:47 the triglycerides, so when you look at your lab tests 22:50 you'll look down sometimes and see "VLDL" 22:53 and that's mainly carrying triglycerides, 22:56 and also some of the cholesterol is carried in that, 22:59 and we'll talk about that. 23:01 But we know that if that value for triglyceride levels is 23:07 greater than 150, then the risk for heart disease 23:12 begins to go up... 23:13 And this is independent of what your cholesterol level is. 23:17 So, wait a minute, the triglyceride level, if it's 23:20 greater than 150... 23:22 Over 150, the risk for heart disease begins to go up 23:27 irregardless of what your cholesterol level might be. 23:31 So just standing alone looking at it... 23:33 You know, I've seen some tests, even my own lab tests 23:37 where the triglycerides one day seems to be real high, 23:40 the next day seems to be real LOW... 23:42 Is it, is it? Well, and this is how the blood 23:46 is drawn is very important. 23:48 To get an accurate measure of the triglyceride level, 23:51 you have to be fasting for at least 12 hours. 23:54 Oh, I see... So if someone is looking at a lab test today 23:58 and they just went in and got it drawn, 24:00 they went into the emergency room or something, 24:02 and they haven't been fasting, 24:03 then that's really not even something to look at. Right 24:06 Can't judge then. 24:07 Now there are a number of things that are involved in 24:11 raising and lowering those triglyceride levels, 24:15 and our illustration goes through a number of the 24:18 major determinates for triglyceride levels. 24:22 Excess weight, again, the weight RAISES 24:27 triglyceride levels. 24:29 Since triglycerides are fat molecules, 24:32 it only stands to reason that if you have a high fat intake, 24:36 you're going to have high fat levels in the bloodstream. 24:40 STRESS is an interesting one. 24:43 The higher the stress level, because of some of the 24:47 hormones that are produced from the stress reaction, 24:51 they stimulate the body to release fat and raises the 24:56 fat levels in the bloodstream. 24:58 I see, and then the other ones were the same... 25:00 lack of exercise, high fat intake and exercise. Right 25:03 And STRESS as well, so wow... 25:07 And sometimes diet areas... the high carbohydrate intake, 25:14 high sugar intake, alcohol intake can raise 25:18 the triglycerides. 25:20 Now, we've talked about the bad cholesterol, 25:27 good cholesterol, the triglyceride, VLDL. 25:33 If you add all those up, LDL, HDL, and the VLDL, 25:40 all those numbers, VLDL has to be divided by 5, 25:44 add those all up and that will give you your total cholesterol. 25:48 Okay so, say I have an LDL of 100, 25:51 I have an HDL of 50, and then I have an VLDL say of 200, 25:57 divided by 5 is 40. 25:59 That will give you your total cholesterol. 26:02 So your total cholesterol is carried in the blood by 26:05 these different protein molecules. 26:07 That's what that number means. Right. 26:08 LDL, HDL, VLDL divided by 5, all added together. Right 26:13 And that total cholesterol number really even though 26:19 some of the labs still report it as normal below 200, 26:24 and when we look around the world, 26:26 we find that populations that have total cholesterol levels 26:31 below 150 on the average, we don't find heart disease, 26:35 and so many of the researchers in this field are pushing 26:41 for a lower total cholesterol level. 26:43 Doctor, we have 30 seconds... 26:45 We've talked about... 26:46 I want to give you 30 seconds for this little answer. 26:49 We've talked about LDL.. "lousy" 26:52 We've talked about how to get that out of your system. 26:55 We've talked about HDL. 26:56 We've talked about how that's "happy"... 26:58 we want to elevate that. 27:00 And what are some... just summarizing some 27:03 things that people can do to have a good cholesterol? 27:07 Obviously, looking at diet. 27:11 Diet is going to be the foundation #1. 27:13 Okay, diet... what else? 27:15 #2 is going to be the exercise... Exercise 27:18 #3... is going to be looking at their weight... losing weight 27:22 And then you said.. #4... Smoking 27:25 Smoking and then maybe stress. 27:27 And stress. 27:28 Thank you so much for being with us, Dr. Bryant. 27:31 We've been talking with Dr. Kevin Bryant 27:33 from Wichita, Kansas. 27:35 We've learned that there's good cholesterol, 27:37 we've learned that there's bad cholesterol. 27:39 We've learned how to really 27:41 have a good cholesterol and what to do. 27:43 We hope that what you've learned today will be a help to you, 27:46 but not only you, maybe others that you know. 27:50 And as a result of today's program, that you will have 27:54 health that lasts for a lifetime! |
Revised 2014-12-17