The Healing Power of Exercise

4
6–12
Leg extension
3
6–12
Leg curl
3
6–12
Because we did not emphasize the importance of not changing his diet to Dave, one of our study subjects, he proceeded to eat much more fat that he did prior to training. When we asked Dave why, he said, “Since exercise will lower my cholesterol, I should be able to eat more ice cream and other desserts, without having my cholesterol increase.” Although Dave’s cholesterol level did decrease, the benefits of exercise were not as dramatic as they could have been.
Do I Still Need to Exercise If I Change My Diet?
Don’t think that changing your diet is all you need. It is not. We base this on our own clinical experience plus volumes of research. In a 1998 study reported in the New England Journal of Medicine, researchers followed nearly 400 men and women who had levels of LDL cholesterol between 125 mg/dL and 210 mg/dL Exercise training was in the form of brisk walking or jogging 10 miles each week. Participants were divided into four groups:
Group 1. Diet without exercise
Group 2. No special diet, but regular exercise
Group 3. Diet plus regular exercise
Group 4. No special diet and no exercise
The diet was very low in cholesterol and saturated fat. Study subjects were observed for one year. What were the results?
All exercisers improved their fitness, whether they dieted or not.
Dieters who lowered fat intake from 30 percent to 22 percent of total calories lost about 7.5 pounds, whether they exercised or not.
Only dieters who exercised lowered their LDL cholesterol levels (by about 11 percent).
Adding exercise to a diet low in saturated fat doubles the diet’s cholesterol-lowering effect.
The authors of this study concluded that lowering fat intake from 30 percent to 22 percent of total calories lowers cholesterol only when you exercise.
However, it is important for us to remember that the typical American diet is so high in fat that when we eat 30 percent of our calories from fat, most of us will dramatically improve our cholesterol and triglyceride levels. Either a diet or exercise alone can improve your blood fat levels. But when exercise and diet are combined, they become a potent antidote for abnormal cholesterol levels.
How Much Exercise Do I Need?
Improving cholesterol and triglyceride levels usually requires a large dose of exercise. For instance, you can lower your blood pressure with 30 minutes of moderate walking, three times each week. However, more exercise is needed for cholesterol manipulation. If you are inactive and want to improve your cholesterol and triglyceride levels, you need to exercise the equivalent of 8 to 10 miles of jogging or brisk walking each week. The more miles you log, the higher your HDL cholesterol level can climb. Also, lowering the amount of fat in your diet will add to these cholesterol and triglyceride benefits. If you want to lower your LDL cholesterol by lifting weights, you need to work out for 45 to 60 minutes, three times each week. The successful programs are shown in Tables 6.5 and 6.6.
How Long Will It Take to See Reduced Cholesterol Levels?
Don’t despair if you fail to see improved cholesterol levels during the first few weeks of training. You will begin to feel better, and your endurance will improve even before you see enzyme and blood chemistry changes. After 12 weeks of aerobic exercise, about 50 percent of

cholesterol was lowered even more, and HDL cholesterol was raised. This was great news. Exercise changed all the major blood fat levels—and all in the right direction.
Cutting Cholesterol with Weight Lifting
By the early 1980s, it was becoming more clear that aerobic training improved cholesterol levels and burned up triglycerides, too. But what about pumping iron? Most scientists thought lifting weights was for those who wanted to look good, rather than be healthy, but they were wrong.
As we described earlier in this chapter, weight lifting, or any kind of resistance exercise using springs, bands, or air pressure, can change cholesterol levels. In several studies, including our own publication in the Journal of the American Medical Association, strength training lowered LDL cholesterol levels and improved the ratio of good (HDL) to total cholesterol levels. We found these benefits occured among both men and women after just 16 weeks of exercise. In our program, participants worked out three times each week, lifting weights for approximately 45 minutes to 1 hour. Our study participants used moderately heavy weights. If they could lift a weight 8 times (upper body) or 12 times (lower body), the amount of weight was increased by about 10 pounds (upper body) or 20 pounds (lower body). Altogether, our subjects used eight different exercises, with a minimum of three or four sets of three to eight repetitions per exercise (Table 6.5).
Why Diet If I Exercise?
Although this book is about exercise, we can’t emphasize enough the importance of your diet. We all splurge and eat foods that are loaded with fats, but this can’t be the rule. You can magnify the benefits of your workouts by making wise food choices. On the other hand, you can ruin all your hard work by poor food selections. For example, rewarding yourself for a workout by eating a typical cheeseburger will add more calories to your body than you would use on a five-mile run. In addition, you will be pummeling your body with high doses of saturated fat from the red meat and cheese.
TABLE 6.5 Weight-Lifting Exercises to Change Cholesterol

Sets
Reps
Upper Body Exercises

Bench press
4
3–8
Latissimus pull
3
3–8
Shoulder press
3
3–8
Arm curl
3
3–8
Rows
3
3–8
Lower Body Exercises

Leg press

If you are eating the typical American diet, which is not a healthy one, you can expect to reduce your cholesterol level by following any one of the diets found in Table 6.4, with the listing of each diet’s major nutrient amounts.
If your total cholesterol level is 240 mg/dL, you will lower it by about 11 mg/dL with the general recommended diet and 20 mg/dL with the higher-risk diet. If your LDL cholesterol is 160 mg/dL, the general recommended diet will drop your LDL level by about 7 mg/dL, while the high-risk diet will drop it by a little more than 12 mg/dL. If you lost weight, your cholesterol and LDL levels will drop even further. The Mediterranean diet is similar to the recommended diet in changing your LDL cholesterol level. However, it has an advantage of not reducing your HDL cholesterol, a problem that can occur when you reduce fat and increase carbohydrates. However, all diets work best when you are at your optimum weight (also see Chapter 7).
Fat is essential to our health. Fat contains vitamins A, D, E, and K. It is part of our cell membranes and is needed to form certain hormones.
Your Fat-Busting Enzymes
Certain types of enzymes control our body’s cholesterol and triglyceride levels. These enzymes can be changed by drugs, your body fat and muscle mass, and whether you exercise.
One enzyme, named lipoprotein lipase, also known as LPL, is located in the walls of our blood vessels and in our heart, fat stores, and muscles. This enzyme breaks down triglycerides. Low levels of LPL are associated with increased cardiovascular disease. So, higher LPL levels are good, and things that stimulate LPL action will help us avoid coronary heart disease.
Another enzyme, hepatic lipase (HL), breaks down HDL cholesterol, but in the process converts some of it to harmful LDL cholesterol. The higher our HL enzyme level, the lower our HDL cholesterol level, which increases the risk of developing heart disease.
A third important enzyme, with the very long name of lecithin cholesterol acyl transferase, is better known as LCAT. Although it sounds to us like a piece of heavy machinery that moves dirt (“Hey, get that LCAT over here to clear this section of land!”), it actually grabs onto cholesterol, cleaning it off of artery walls, in a way that is similar to the powerful sucking of a professional-quality vacuum cleaner.
Enzyme Changes and Exercise
Production of the enzymes that control our blood fat levels can be changed by exercise. LPL, the enzyme that breaks down triglycerides and increases HDL cholesterol levels, has been found in greater quantity among aerobic exercisers. Its effects are increased after just one exercise session. Also, losing body fat will increase the action of LPL.
Hepatic lipase (HL) is the enzyme that clears out our good HDL cholesterol and breaks it down. Endurance exercise tends to increase the amount of HDL cholesterol by reducing the activity of HL. One study found that HL action was lowered among middle-aged men after 15 weeks of exercise, although not all studies have found similar results. Likewise, the amount of LCAT, the enzyme that takes up cholesterol from the artery walls, can be increased by exercise. Not everyone will improve his or her enzyme function with exercise, likely due to individual differences. Similarly, not all drugs affect us in the same way, which is why we have so many different medications for the same medical problem. However, for many people, exercise can generate more enzyme activity and improve our blood fat levels.
Running Down Cholesterol and Triglycerides
In the mid 1970s, researchers at Stanford looked at the blood fat profiles of runners and of inactive men. They found that the amounts of protective HDL cholesterol were higher in the joggers, while triglyceride levels were significantly lower. Over the next few years, 66 studies concerned with the effect of exercise on cholesterol were published by researchers. When these programs were bundled together and analyzed, total cholesterol levels were lowered an average of 10 mg/dL, while triglycerides were reduced by an average of 16 mg/dL. When the researchers looked at the bad (LDL) and good (HDL) cholesterol, they found that LDL

cholesterol levels. Monosaturated fats and those fats that contain omega-3 fatty acids can be helpful, especially when they take the place of saturated fats in our diet.
The Heart-Healthy Diet
Although we need fat to survive, particularly the essential fatty acids mentioned earlier, it is important to limit our fat intake, no matter what kind of fat it is. For those without abnormal cholesterol levels, keep the total calories from fat below 30 percent and total daily cholesterol intake to less than 300 mg. That’s easy to remember: below 30 and 300. If you have problems with cholesterol, we recommend reducing total fat intake to about 20 percent of total calories and limiting the cholesterol in your diet to less than 200 mg each day. Table 6.4 lists some recommended diet therapies for high cholesterol levels.
By making simple food choices, you can lower your very bad cholesterol. Try doing the following:
TABLE 6.4 Cholesterol-Lowering Diets (amounts/day) Recommended
Nutrient
for Everyone
Higher Risk
Mediterranean
Total fat (percentage of total calories)
30%
20%
Less than 40%
Saturated fat(percentage of total calories)
About 10 %
About 5%
About 10%
Polyunsaturated fat (percentage of total calories)
About 10%
About 10%
About 10%
Monounsaturated fat(percentage of total calories)
About 10%
About 10%
About 20%
Cholesterol
300 mg or less
200 mg or less
300 mg or less
Carbohydrates (percentage of total calories)
About 55%
About 60%
About 45%
Protein (percentage of total calories)
About 15%
About 15%
About 15%
Select fish or skinned turkey and chicken, instead of red meat
Use skim milk instead of the types with 2 percent or greater fat content
Choose canola or olive oil for cooking
Limit egg yolks to four or fewer each week
Eat plenty of fresh vegetables and fruits
Avoid desserts with a high fat content
Reduce alcohol consumption to one or two drinks each day
Don’t eat unless you are hungry and stop eating when you are not hungry

The bottom line is that just because a margarine label says the product is low in cholesterol and saturated fat, that does not mean it is a healthy product. When fat is solid at room temperature, it is best to avoid it!
The Best Edible Fats
Not all fats are bad. But, animals (including us) do not make some of the healthier, less-saturated fats. Unlike their saturated cousins, monounsaturated and polyunsaturated fats are healthy. Also, there are certain fatty acids we need, but cannot make, and therefore we need to eat those fatty acids that are essential to our health.
Some fats contain omega-3 and omega-6 fatty acids, and these substances actually lower LDL cholesterol levels. Omega-3 fatty acids, found in fish, can reduce triglyceride levels (as long as the fish is not deep fried in animal fat or fat with high levels of trans fatty acids, such as hard margarine). Table 6.3 lists various types of fats, where they are found, and the effects of diets that are high in each fat.
Why Is My Cholesterol Different From Yours?
Our blood fat levels are controlled by many factors: what we eat, the levels of male and female hormones, genetic traits, smoking habits (lowers HDL cholesterol), our weight and percentage of body fat, the drugs we take, and the amount of exercise we get. The only factor we can’t change, no matter how hard we try, is our heredity. All the others can be altered by the choices we make.
Women have the benefit of estrogen, which increases HDL cholesterol levels and may be responsible for the fact that women live approximately seven years longer than men. Smoking cigarettes lowers HDL cholesterol levels, which is one reason it is one of the major risk factors for heart disease. Certain drugs can worsen our cholesterol and triglyceride levels, especially diuretics (water pills) and certain blood pressure and heart medications called beta blockers. Small amounts of alcohol (one to two drinks a day) may raise HDL cholesterol levels; however, higher amounts will increase triglyceride levels. In our society, alcohol abuse does much more harm to our health than can be offset by its ability to raise HDL cholesterol levels a few points.
Our Heredity and Our Blood Fats
We might not like it, but our heredity—the genes that make us unique beings—has a giant impact on our cholesterol and triglyceride levels. Some people have familial cholesterol and triglyceride abnormalities that, without treatment, can shorten lifespans and create rapidly progressive disease. It is important for anyone whose father, mother, or close relative had heart or blood vessel disease before age 50, to see his or her health care provider to measure cholesterol and triglyceride levels.
Breaking Down Cholesterol and Triglycerides
For greater health, we want our body to break down LDL cholesterol, chylomicrons, and VLDL (our main triglyceride particles) and create more HDL cholesterol “vacuum cleaners.” Although we often blame our shortcomings on heredity, we can take the bull by the horns (rather than eat the steer) and lower LDL cholesterol and triglyceride levels by making wise dietary choices (especially how much and what kind of fat we eat) and supercharging our fat-busting enzymes by losing excess body fat and getting regular exercise. The level of fat-metabolizing enzymes in your body depends, in part, on the amount and type of exercise you do.
What to Eat?
As far as our blood fat levels are concerned, highly saturated fats will increase LDL cholesterol levels by blocking our liver’s ability to break up the LDL molecules. By limiting saturated fat or the amount of cholesterol in our food, our liver becomes more effective at eliminating this harmful form of cholesterol. Eating foods high in polyunsaturated fats can help lower LDL

Estrogen and Cholesterol
Female hormones (estrogens) are one of the reasons that women are temporarily protected from heart disease and are typically about 10 years older than men when coronary disease strikes. After menopause, women can use estrogen or estrogen-like hormones to reduce LDL cholesterol and increase HDL cholesterol levels. These cholesterol levels usually change in the healthy direction by 15 percent each. Estrogen replacement therapy reduces the risk of heart disease by about 50 percent. A newer medication, raloxifene, has estrogen-like effects on bones and cholesterol levels. However, when tested in experimental animals, raloxifene was ineffective at reducing coronary artery obstruction when compared with estrogen.
Different Fats in Food
Although all fats contain the same amount of calories (9 calories for each gram), they are not all the same with regard to our health (Table 6.3). Most fats can be categorized as either saturated or unsaturated fats, based on their chemical structure. As a general rule, saturated fats are unhealthy and unsaturated fats are not unhealthy. In general, you can tell if a fat is saturated or unsaturated by how it appears at room temperature. Unsaturated fats are usually liquid, while saturated fats are solid at 70 degrees fahrenheit. Typically, the harder the fat, the more saturated it is. Butter, the animal product, is mainly saturated fat.
TABLE 6.3 The Lowdown on Fats
Type of Fat
Where Found
What It Does
Saturated
Worst is palmitic acid; most found in animal fat, also in coconut and palm oil
Raises total and LDL cholesterol; may cause certain cancers
Polyunsaturated
Vegetable oils, such as safflower sunflower, soybean, and corn
In small amounts it lowers LDL cholesterol; In high amounts that cause weight gain, it can decrease HDL and raise LDL cholesterol
Monounsaturated*
Oils such as olive, canola, peanut; also in peanuts, avocado, olives, pecans
Lowers LDL cholesterol
Omega-3 fatty acids
Fish oil and canola oil
Lowers triglycerides; also may reduce heart disease by lowering stickiness of platelets to reduce chance of blood clots
*When monounsaturated fats are hydrogenated (hardened) into more solid forms, such as margarine, they lose their cholesterol-lowering effect and are not much better than butter.
What is important to know is that meat from animals with four legs, many dairy products, and animal organs, even chicken liver, contain very high amounts of saturated fat. Eating these fats leads to high blood pressure, certain types of cancer, and heart and blood vessel diseases.
Vegetable Fats
Just because a fat is from vegetable sources does not mean it is healthy, especially when we start messing around with Mother Nature. By chemically changing a fat’s structure, we can create problems. For instance, hardening liquid vegetable oil to form stick margarine causes it to lose much of its unsaturated benefits. The reason stick margarine becomes more unhealthy is the process called hydrogenation. In this procedure, by-products called trans fatty acids are made. Trans fatty acids lower your good, HDL cholesterol level and raise your unhealthy, LDL cholesterol level, just like saturated fat. So, as liquid vegetable oil turns into a substance that looks like a stick of butter, it becomes almost as unhealthy as butter.
The amount of cholesterol you eat is less important than the amount of saturated fat in your diet. Most dietary cholesterol comes from egg yolks, dairy products, and red meat. We recommend eating less than 300 mg of cholesterol each day. If you have a high LDL cholesterol level, limit your intake to 200 mg per day.

0 mg
Greatly lowers LDL, raises HDL, and decreases triglycerides
$55.00
Cholestyramine
8 grams
Greatly lowers LDL
$35.00
(Questran, Preval ite)
(2 scoops)

Fenofibrate (TriCor)
67 mg
Greatly lowers triglycerides and LDL; raises HDL
$20.00
Fluvastatin (Lescol)
20 mg
Modestly lowers LDL and raises HDL
$37.00
Gemfibrozil (Lopid)
1,200 mg
Greatly lowers triglycerides and slightly raises HDL
$55.00
Lovastatin (Mevacor)
20 mg
Greatly lowers LDL, raises HDL, and slightly reduces triglycerides
$67.50
Pravastatin (Pravachol)
20 mg
Greatly lowers LDL, raises HDL, and slightly reduces triglycerides
$59.00
Simvastatin (Zocor)
10 mg
Greatly lowers LDL, raises HDL, and slightly reduces triglycerides
$61.00
Cerivastatin (Baycol)
0.3 mg
Greatly lowers LDL, raises HDL, and slightly lowers triglycerides
$45.00
Most lipoprotein-lowering drugs have few side effects. Medications that treat only very high triglyceride levels may cause gall bladder problems. However, muscle weakness and abnormal liver enzyme levels can result from many of these drugs. So, make sure your health care provider checks your liver enzymes if you are using these drugs. Also, these medications can interact with other drugs you may be taking. Since many of us have more than one health care provider but just one body, it is important to give each provider a list of your medications before taking a new drug.
Another group of cholesterol modifiers consists of substances made by plants, called phytosterols and stanols. Although the molecules resemble cholesterol, humans cannot absorb them very well. When added to our diet, phytosterols and stanols interfere with our ability to absorb cholesterol. In a Finnish study, adding these substances to margarine-like spreads lowered LDL cholesterol levels by 10 percent. Likewise, adding psyllium seed or bran to your diet can lower LDL cholesterol levels by about 10 percent.
Other ways to improve your cholesterol levels include eating large amounts of fruits, vegetables, and whole grain foods, lowering your total amount of body fat, and avoiding smoking and second-hand smoke.

blood vessels, reducing LDL cholesterol levels below 110 mg/dL will probably improve your ability to avoid heart disease. However, if you have coronary heart disease, it is recommended that your LDL-cholesterol be lower than 100 mg/dL. At this level, cholesterol plaques begin to dissolve, and arteries become unobstructed. You want your low-density lipoprotein cholesterol level to be low. The lower, the better.
Exercise and Cholesterol Levels
Despite medical breakthroughs, during the last 60 to 75 years Americans have exercised less, and this has reduced our ability to live longer, healthier lives. If lack of exercise can be likened to a major weapon directed at our health, then surely cholesterol is one of the most harmful bullets. The cholesterol circulating in your blood is a combination of LDL, VLDL, and HDL cholesterols. So you always have both good and bad cholesterol, and the main portion of the total cholesterol is LDL cholesterol. High total cholesterol levels are strongly associated with cardiovascular disease, and cardiovascular disease is the number-one killer in the United States, as well as in most other industrialized countries.
As you have learned, triglycerides are another risk factor for coronary heart disease because they assist in the build-up of harmful fatty plaques and reduce the sucking power of our body’s vacuum-cleaning (HDL) cholesterol. In addition, very high triglyceride levels (over 1,000 mg/dL) can damage your pancreas and cause your liver to swell.
Improving your blood cholesterol levels will reduce your risk of heart and blood vessel disease and will prolong your life. Predictions from long-term studies suggest that over 60 percent of coronary heart disease can be prevented by lowering the total cholesterol level just 20 percent, or LDL cholesterol by 30 percent. In addition as you become more fit, your physical stresses will be easier to manage, and you will be better able to reduce your emotional stress as well. So life just might seem a whole lot easier.
Reducing your total cholesterol level by just 3 percent will lower your chance of developing coronary heart disease by 15 percent.
What Kind of Treatment Improves Cholesterol Levels?
Drugs that lower cholesterol and triglyceride levels can be very effective therapy, but they are often quite expensive. For example, the most commonly used medicines, namely the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, also called statins, can cost about $420 to $2,640 per year, depending on the dose you need (Table 6.2), and you may not be lucky enough to have your insurance pay for your medication. So, while your neighbor takes his family to Disneyland, you stay at home to earn enough money to pay for your cholesterol-lowering drugs.
The medications listed in Table 6.2 are some of the major cholesterol- and triglyceride-reducing drug therapies. In addition, the vitamin niacin, in the form of nicotinic acid, can be used. Nicotinic acid, sold over-the-counter, lowers triglyceride and LDL cholesterol levels and raises HDL cholesterol levels. Although effective, you must take at least 400 mg each day to have a positive result. Typically, the dose is slowly increased to about 1.5 to 3 grams each day. At these dosages, nicotinic acid often causes uncomfortable flushing and gastrointestinal upset, and some people develop gout, a very painful form of arthritis. Also, because high doses of niacin can increase blood sugar levels, it should be used with caution if you have diabetes. Please note that nicotinamide, another form of the vitamin, does not lower cholesterol levels. A newer prescription formulation, Niaspan, is an extended-release niacin tablet. The dose of Niaspan is slowly increased over a three-month period. Although it produces fewer gastrointestinal and flushing symptoms, it is more expensive than over-the-counter nicotinic acid.
TABLE 6.2 Drugs That Improve Lipoprotein Levels
Generic Name (Trade Name)
Starting Daily Dose (Approximate)
What It Does
Cost for 30 Days (Approximate)
Atrovastatin (Lipitor)

What Are Lipoproteins?
Good question. No, make that a great question. When scientists discuss triglyceride and cholesterol levels, they often speak of them together as lipoproteins. In the same way oil and water do not mix, triglycerides and cholesterol cannot simply dissolve in our blood. Because of this, triglycerides and cholesterol require a special chemical transporter. The transporter is a combination of lipids (fats) and unique proteins called apoproteins. Thus the term lipoprotein is derived from the word lipid (or lipo) and the word protein.
The Good, the Bad, and the Ugly
Lipoproteins, or blood fats, take several forms. The main substances are (1) chylomicrons, (2) HDL (high-density lipoprotein) cholesterol, (3) VLDL (very low density lipoprotein), and (4) LDL (low-density lipoprotein) cholesterol.
When people mention their cholesterol level, they are usually speaking of total cholesterol. Your total cholesterol is a combination of all the different types of cholesterol, the good, the bad, and the . . . well you get the picture.
Chylomicrons
Chylomicrons (pronounced ky-low-my-krons) come from the fats we eat. Because fats are not well absorbed in their natural state, they need to be converted (or morphed) into a more absorbable substance. As fat passes from the stomach into our small intestines, the enzymatic action of our pancreatic juices and bile from our liver and gall bladder create chylomicrons by rearranging these fat molecules and improving digestion.
Chylomicrons contain mostly triglycerides. There are some people with abnormal chylomicron production, based on genetic problems. They are able to produce chylomicrons but are unable to also break them down. However, for most of us, the enzyme lipoprotein lipase breaks down chylomicrons. This enzyme slices off the fatty acids from the glycerol molecule; then we can use the fatty acids for energy or store them in our fat cells.
HDL Cholesterol
There are two major forms of HDL cholesterol, referred to as HDL2 and HDL3. Both forms protect us against cardiovascular disease. Most laboratories combine HDL2 and HDL3 counts and refer to the total as just HDL cholesterol.
HDL travels around in your bloodstream, sucking up cholesterol, much like a biological vacuum cleaner. HDL carries waxy cholesterol away from fatty deposits on your arteries, to be broken down in the liver. The higher your HDL cholesterol level, the better the cleaning job and the lower your risk of heart and blood vessel disease. To help you remember what is good for you, just remember that you want your high-density lipoprotein cholesterol to be high. The higher, the better.
Excess triglycerides in the blood stream are linked to coronary heart disease. High levels can be caused by genetic abnormalities, excessive fat intake, or uncontrolled metabolic problems such as diabetes.
VLDL Cholesterol
VLDL cholesterol contains mainly triglycerides, just like chylomicrons. VLDL can be formed by breaking up chylomicrons or can be manufactured by your liver. Then these triglyceride-loaded particles can be either transported to the rest of the body and used as energy, or stored in your thighs, waist, derriere, and other fat depots. Although high VLDL levels are related to coronary heart disease, they are not as damaging as LDL cholesterol. When VLDL (or chylomicron) levels increase, high triglyceride levels result and your HDL cholesterol level drops. This can compound the harm of a high VLDL cholesterol level.
LDL Cholesterol
LDL cholesterol is known as the “bad” cholesterol. Picture a molecule wearing a black cowboy hat, squeezing your arteries with black gloves, and depositing globs of yellow fat plaques. LDL cholesterol is a powerful risk factor for cardiovascular disease. For those without diseased

cholesterol already looked great! If her cholesterol was too good, it might not improve, no matter what she did.
We were beginning a study of exercise and cholesterol that, unlike many of the other exercise studies that used aerobic exercise, involved only weight lifting. In 1982, using strength training to improve your health was heresy to the exercise science world. Exercise was aerobics, and only aerobics (for example, jogging, cycling, and aerobic dance). Weight lifting was not considered to be a type of physical activity that made you healthier. Furthermore, this was a heavy, strength-building training program. If you could lift a weight eight times or more, we slapped on another 10 pounds.
Sandi brought other intangibles to the study besides her great lipid levels. She became the cheerleader in the group. She worked hard and encouraged others as she pumped iron, going from weight station to weight station, stopping occasionally to view a new muscular bulge in her arms and legs. If Sandi missed a workout, Dr. Goldberg became her personal trainer at the local Jewish Community Center on the weekend. She occasionally worked out extra times at the community center, sometimes with the Portland Trailblazer basketball team. She began to develop a reputation as “the superwoman.”
Although her blood fat levels were superb, Sandi’s cholesterol levels improved even further. Her HDL cholesterol level increased, and her triglyceride and LDL cholesterol levels dropped to record lows. Was our study published? It can be found in the Olympic edition of the Journal of the American Medical Association (1984). Although not everyone will find true love and happiness by entering into an exercise study, it worked for Sandi. First, she met a local television producer who was also in the study. He gave her a job at the station so she could move out of the guest bedroom at the Goldberg’s house. Then, while making up a missed training session, under the watchful eye of her brother-in-law, she met a very handsome (we had to say it) man who was impressed with the amount of weight she could lift. They spoke, dated, became engaged, and after a “heavy courtship,” married. Today they have two lovely children. Sandi continues to train every day and was even featured in the state’s major newspaper for her personal weight-lifting program. Dr. Goldberg still continues to take credit for her happiness.
What Is Fat?
In general, when people talk about fat, they are speaking of any substance that is made of small molecules called fatty acids. When three fatty acids are linked to a molecule called glycerol, a triglyceride (tri = three fatty acids, glycerol = glyceride) is formed. Triglycerides often are made from the fats we eat or can be manufactured in our bodies from other food sources, such as carbohydrates. Triglycerides are the main storage form of fat and energy in our body, and these stores can provide fuel for up to 100 hours of continuous exercise. Also, body fat is needed for production of certain hormones, and it cushions our organs and stores reserves of vitamins A, D, E, and K.
Fat is a very concentrated source of energy. It has over twice the number of calories (9 calories/gram) as carbohydrates or protein (each 4 calories/gram). So a pound of fat (3,500 calories) has more than twice the calories of 2 pounds of sugar or 2 pounds of protein.
What Is Cholesterol?
Although not strictly a fat, cholesterol is a waxy substance that travels in the company of triglycerides and other fats. But remember, don’t judge all cholesterol just by the company it keeps. Our bodies make and need some cholesterol, as do all other four-limbed animals. Cholesterol is an essential part of our cells’ membranes. Furthermore, cholesterol is the backbone for steroid hormones (such as estrogen and testosterone) and vitamin D and is an essential ingredient of our liver’s bile, which helps us digest the fat we eat. So, our body needs cholesterol. Otherwise we have no sex hormones and our cells fall apart. Unfortunately, too much cholesterol can have disastrous effects. Cholesterol is a major ingredient in the fatty deposits that form on the walls of our arteries, clogging blood flow to our heart, brain, muscles, and other tissues.