DEAR DR. DONOHUE: I keep reading about the different kinds of cholesterol, and you have commented on them from time to time. However, I am always left in the dark on just what is a good value and what is not. Will you please print all the cholesterol numbers?

Is it necessary to fast before cholesterol bloodwork? Does a weekend of bad eating result in a bad report if the blood is taken on a Monday? – I.E.

ANSWER: Your wishes are my command.

Total cholesterol ought to be less than 200 mg/dL (5.18 mmol/L).

HDL (high-density lipoprotein) cholesterol should not be less than 40 (1.03). Numbers higher than 60 (1.6) are wonderful. The higher the number, the better off you are. HDL cholesterol is the kind of cholesterol that prevents heart attacks and strokes.

LDL (low-density lipoprotein) cholesterol is bad cholesterol, the stuff that clings to artery walls and obstructs blood flow through them. It bears a major responsibility for heart attacks and strokes. If a person has no indication of heart disease, then a reading for LDL of 130 (3.4) is acceptable. Few people 50 and older have no indications of heart disease, so doctors would like to see it much lower. If a person has had a heart attack or has angina chest pain, the number should be 70 (1.8) or less. Many experts say you cannot have too low an LDL reading.

Dividing total cholesterol by HDL cholesterol gives a ratio that can compensate for both a high total and high HDL cholesterol. If most of the total is HDL cholesterol, then you don’t have to worry about the total number so much. For men, the ratio ought to be 4.5 or less; for women, 4.

A good triglyceride reading is less than 150 mg/dL (1.7 mmol/L). A borderline reading is 150 to 199 (1.7 to 2.2) and a high reading is 200 (2.3) and above.

It’s necessary to fast for an accurate triglyceride reading. You will save yourself a second trip if you fast for all cholesterol-related blood work. Two weekend days of dietary indiscretion won’t change your values that much.

The cholesterol booklet explains this confusing subject. Readers can obtain a copy by writing: Dr. Donohue – No. 201, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I just got out of the hospital for a duodenal ulcer. For more than a week, I had chest pain, and one morning I vomited. I turned myself in to the ER. A scope exam of my stomach and duodenum showed the ulcer. What does one do for an ulcer diet? I was told to avoid any food that upsets my stomach. Is it all a matter of trial and error? – J.C.

ANSWER: Previously, ulcer patients were told to eat a bland diet and to coat their stomachs with milk. It turns out milk doesn’t coat the stomach. In fact, the calcium in it actually increases acid production, something you don’t want with a healing ulcer.

With the advent of powerful medicines that all but suppress acid production, diet has taken a back seat in ulcer treatment. Many ulcer patients can’t tolerate caffeine or fatty, spicy or acidic foods, so they are best avoided during the healing stage.

The trial-and-error approach is an acceptable one.

DEAR DR. DONOHUE: I cannot bite apples, pears, nuts or anything hard – I don’t have my own teeth. If I combine these foods in my blender, am I getting the same nutrients as eating them whole? – T.A.

ANSWER: Sure, you are. The blender isn’t removing any nutrients.

In fact, if you will, pull out a chair at the breakfast table for me. The mixture sounds tasty. I’ll join you the next time I’m in town.

DEAR DR. DONOHUE: I take Fosamax for osteoporosis, plus calcium and magnesium. Magnesium is essential for calcium absorption. All doctors into nutrition recommend it. My own doctor and several nurses I know never mention the necessity of magnesium. I tell everyone about this. You can help by telling women. – J.C.

ANSWER: Magnesium doesn’t boost calcium’s absorption, but it works with calcium to prevent and correct osteoporosis. Many women don’t get the 320 mg a day they need (men need 420 mg). Foods with an abundance of magnesium include nuts, beans, whole grains, spinach, dark chocolate, baked potatoes with skin and leafy green vegetables.

I am happy to give some press coverage to magnesium. Thank you for bringing the subject up.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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