Ka Wai Ola - Office of Hawaiian Affairs, Volume 6, Number 2, 1 February 1989 — ʻAi Pono, E Ola [ARTICLE+ILLUSTRATION]

ʻAi Pono, E Ola

By Terry Shintani, M.D.

Cholesterol and the Healthy Heart

Do you know your eholesterol level? If you are 20 years old or over, you should, according to the National Heart Lung and Blood Institute (NHLBI). In recognition of the importance of these recommendations, Governor John Waihee and Mayor Frank Fasi have declared February to be "Hawai'i

Heart" Month. Why is this particularly important for the Hawaiian people? Let's start with the fact that heart disease iS/the leading killer of all Americans. Nearly 40 percent of all deaths in Amenea are due to heart attack. The actual numbers are well over 400,000 per year, the equivalent of more than four jumbo jets crashing every single day. As for pure Hawaiians, their rates of death from heart disease area a frightening 227 percent higher than an already unacceptably high rate of death for the general populahon when rates per 100,000 populahon are compared.

Cholesterol, as discussed by kauka Kekuni Blaisdell in previous articles, is a waxy substance that is deposited on artery walls and ean eventually shut off blood flow to parts of the heart, resulting in heart attack. There has been a direct relationship found between cholesterol level and heart attack. For every one percent you ean decrease your eholesterol level, you ean decrease your risk of heart attack by two percent. This is why it is so important to look at your cholesterol level.

NHLBI guidelines: 1. Everyone 20 years or older should be tested for cholesterol. 2. The cholesterol levels are categorized as follows: Low Risk Moderate Risk High Risk 200 200-239 240 or higher If your cholesterol level is 240 or higher, you are at high risk. You should see your physician for further testing to eheek the breakdown between HDL ("good cholesterol") and LDL ("bad cholesterol") and consultation on how to lower your eholesterol levels.

If your cholesterol level is from 200 to 240 you are at moderate risk. If you have two or more risk factors such as smoking, high blood pressure, or family history of heart disease or if you have a personal history of heart disease, you should also have the HDL and LDL tested.

If your cholesterol is over 200 with or without risk factors, dietary changes are recommended to reduce your cholesterol to below 200. If your cholesterol is below 200, you are in a low risk category. The NHLBI suggests that a repeat cholesterol test in five years is prudent. Some experts feel that a level closer to 150 is prudent. In previous articles, I have talked about how you ean lower your cholesterol in 30 days. Let me reiterate some of these suaqestions:

1. Decrease high cholesterol foods: This means decreasing all foods that eome from flesh including meats, poultry, dairy, ānd eggs. 2. Decrease saturated fat: Again, this means decreasing meats, $^ultry, and whole dairy foods. 3. Decrease total fat: Decreasing fried foods, oils, oily salad dressings, cream-based soups, margarine, and high-fat pastries. 4. Increase dietary fiber: Dietary fiber is found in abundance in grains, fruits and vegetables such as kalo(taro), 'ulu (breadfruit), 'uala (sweet potatoes), grains (oat bran is particularly good), and vegetables. 5. Increase starch: Decreasing calories from fat means that you need to increase them from some other source. Starch is the best alternative source.

6. Increase exercise: lt has been found that increasing exercise not only lowers cholesterol but also increases the HDL (good cholesterol) and decreases the LDL (bad cholesterol). One more point. The ancient Hawaiians' way of eating and living fulfilled all these criteria and they had very little heart disease. This may help guide and motivate you to make some positive changes onee you do know your cholesterol level. Dr. Shintani, physician and nutritionist, is the Director of Preventive Heakh Services at the Wai'anae Coast Comprehensive Health Center. A majori fy of their patients are Native Hawaiian.

The Oahu District Oouneil of the Association of Hawaiian Civic Clubs has announced its "Ali'i Sunday" Schedule for 1989. The ali'i (royalty) of Hawai'i are honored by civic club members in special services at Kawaiaha'o Church on the Sunday nearest their birthday.

Name of Ali'i Day of Birth Ali'i Sunday Celebration Date King William Charles Lunalilo January 31 January 29, 1989 Queen Elizabeth Ka'ahumanu March 17 March 12, 1989 Prince Jonah Kuhi'o March 26 March 19, 1989 Queen Lydia Liliu'okalani September 2 August 28, 1989 Princess Victoria Ka'iulani October 16 October 15, 1989 King David Kalakaua November 16 November 12, 1989 Princess Bernice Pauahi Bishop December 19 December 17, 1989 King Kamehameha V and December 17, 1989 Queen Kapiolani Kamehameha Ekahi June 11 June 11