1. Most of your blood cholesterol is produced by: a. your kidneys b. your liver c. your pancreas d. food consumption (Your liver)

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1 I. TEST YOUR KNOWLEDGE OF CHOLESTEROL Choose the correct answer. 1. Most of your blood cholesterol is produced by: a. your kidneys b. your liver c. your pancreas d. food consumption (Your liver) 2. Only adults need to have their cholesterol checked. Children can't have high cholesterol. 3. All I really need to know is my total blood cholesterol number. 4. You know you have high cholesterol when: a. Your blood pressure is high. b. You have a lot of headaches. c. You start to gain weight. d. You have it checked by a doctor. (You have it checked by a doctor.) 5. If I have high cholesterol, the only thing I can do about it is take medication. 6. High cholesterol levels put me at risk for: a. atherosclerosis b. diabetes c. obesity d. high blood pressure (Atherosclerosis) 7. Which of the following is a major risk factor for heart disease and stroke? a. smoking b. family history of heart disease c. high blood pressure d. all of the above (All of the above) 8. Which of the following foods may hold a "hidden" source of cholesterol-raising fat? a. broiled salmon b. bran muffin c. T-bone steak d. eggs (Bran muffin)

2 9. Postmenopausal women should be on hormone therapy to lower their cholesterol and decrease risk for heart disease. 10. I know my HDL and LDL cholesterol numbers and my triglyceride level, and I know what I need to do to keep them in the low-risk range. (True, False) FEEDBACK: Feedback to question 1 Your liver produces about 1,000 mg of cholesterol a day all the cholesterol your body needs. Another 200 to 500 mg can come from the food you eat. Feedback to question 2 Compelling evidence shows that the atherosclerotic process (buildup of fatty plaque in arteries) starts in childhood and progresses slowly into adulthood. Children from high-risk families (parents with high cholesterol, or parents or grandparents with heart disease at 55 years or younger) should have their cholesterol levels tested. Feedback to question 3 Your blood cholesterol is primarily made up of two kinds of cholesterol. LDL (low-density lipoprotein) is the bad cholesterol because when too much of it circulates in the blood, it can slowly build up in the walls of the arteries that feed the heart and brain. HDL (high-density lipoprotein) is the good cholesterol because it helps remove bad cholesterol from arteries and prevent blockage. Triglyceride is a form of fat. It is made in your body and also comes from food. People with high triglycerides often have high total cholesterol, high LDL cholesterol and a low HDL cholesterol level. Feedback to question 4 High cholesterol has no symptoms, so the only way to know your cholesterol levels is by having them checked. Feedback to question 5 First and foremost you should check your lifestyle habits. Are you a smoker? Do you eat too much saturated fat, trans fat or cholesterol? Are you physically inactive? All of these modifiable factors can affect your cholesterol levels. Before starting you on medication, your physician will probably address your diet, exercise and smoking habits. Then, if heart-healthy eating, at least 30 minutes of physical activity on most, preferably all, days of the week and quitting smoking don t lower your cholesterol, your doctor may prescribe medication. Even if you re taking medication, it s important to maintain a heart-healthy lifestyle. Feedback to question 6 High cholesterol levels put you at risk for atherosclerosis (fatty buildups of plaque in artery walls). These deposits can contribute to blocking the blood flow to a part of the heart muscle and cause a heart attack. A high LDL level (more than 160 mg/dl or 130 mg/dl or above if you have

3 two or more risk factors for cardiovascular disease) indicates an increased risk of heart disease. Atherosclerosis in arteries in or leading to the brain can result in stroke. Feedback to question 7 You can also include diabetes and increasing age. Women tend to have lower total cholesterol levels than men before the age of menopause, but after menopause, women s LDL levels tend to rise. Risk factors for heart disease and stroke amplify one another rather than just adding up. The more risk factors you have, the higher your risk for heart disease and stroke. Feedback to question 8 Bran muffins and all baked goods may hold a hidden source of a cholesterol-raising fat. The nutrition label may list the cholesterol content as none or low, but look for hydrogenated fats and oils in the ingredients list. These are known as trans fats. They along with saturated fats are the main dietary causes of high blood cholesterol. The amount of trans fat is listed on the Nutrition Facts panel on the food. Learning to read and interpret food labels is important in limiting your intake of saturated fats. Feedback to question 9 Neither the American Heart Association nor the federal government s National Cholesterol Education Program recommends using postmenopausal hormone therapy (PHT, formerly called hormone replacement therapy or HRT) as an alternative to cholesterol-lowering drugs for women at risk for elevated cholesterol levels. PHT is not for every woman. To reduce the risk of a first heart attack or stroke, the American Heart Association recommends reducing risk factors such as high cholesterol and blood pressure with lifestyle changes and, if needed, taking medications. Feedback to question 10 If you answer True, you re probably already choosing a heart-healthy diet, getting at least 30 minutes of physical activity on most, and preferably all, days of the week and staying away from tobacco products. If you answer False, you need to have your cholesterol checked by your healthcare provider, learn all of your numbers and change your lifestyle if the numbers are borderline-high or high. If lifestyle changes alone don t lower your cholesterol level, talk to your healthcare provider about medication. And if you re on medication now, remember that you still need to live a heart-healthy lifestyle and take your medication exactly as your doctor has prescribed. II. VIDEO Watch the video on cholesterol. Choose the best answer. 1. How many per cent of Americans have high cholesterol? (18) 2. What is the name of the harmful cholesterol? (LDL) 3. It is best to limit the total fat intake to less than % of our daily calories. (30) 4. What type of food are saturated fats found in? (animal) 5. It is recommended to limit the intake of saturated fats to less than % of

4 our daily calories. (7) 6. Where are the unsaturated fats NOT found? (beef) 7. What is the process called during which margarine is made? (hydrogenation) 8. Which type of cholesterol does consumption of fiber help to lower? (LDL) 9. Which type of cholesterol does physical activity help to lower? (none) 10. Which type of cholesterol does smoking lower? (HDL) III. GAPFILL 1 Choose the correct words to complete the sentences. HEREDITY STROKE INVOLVED INTAKE RAISES DAIRY SAMPLE ABSORBED VARIETY SYNTHESISED BLOODSTREAM OVERWHELMING REASON Chemically, a lipid, cholesterol is an important constituent of body cells. It is also (involved) in the formation of hormones and bile salts and in the transport of fats in the (bloodstream) to tissues throughout the body. Most cholesterol in the blood is made in the body from a wide (variety) of foods, but especially from saturated fats. It is (synthesised) in the liver by combining fatty acids and alcohol. However, a small amount of cholesterol is (absorbed) directly from cholesterol-rich foods such as eggs, (dairy) products, and red meat. The level of cholesterol in the blood - which can be measured by analysis of a blood (sample) - is influenced by diet, (heredity) and metabolic diseases such as diabetes mellitus. There is (overwhelming) evidence that a high blood cholesterol level increases the risk of developing atherosclerosis and with it the risk of coronary artery disease or (stroke). Eating too much saturated fat also (raises) blood cholesterol levels in many people. For that (reason) it is recommended to limit saturated fat to less than 10 percent of calories, or about one third of total fat (intake). IV. GAP FILL 2 Complete the text. Use the following words:

5 INCREASES, STORED, REASON, LIMIT, EXCESSIVE, FUEL, CONSTITUENT, FOUND, OVERWHELMING, DAIRY, ENVIRONMENTAL There is (overwhelming) evidence that a high blood cholesterol level (increases) the risk of developing atherosclerosis. For that (reason) it is recommended to (limit) saturated fat to less than one third of total fat intake. Cholesterol is an important (constituent) of body cells. Animal fats, such as those (found) in meat and (dairy) products, are largely saturated. Persons with (excessive) adipose tissue can tolerate a colder (environmental) temperature. The (stored) fat is burned as (fuel) to produce energy.

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