Avoiding Heart Problems

Whether your blood fats shoot up as a side effect of medications or because of how you eat, keeping the condition under control is wise. High amounts of fat in the blood is known as hyperlipidemia. How your body absorbs, clears, and otherwise metabolizes fats'as well as how you eat and the medications you take'all contribute to hyperlipidemia. Hyperlipidemia is a risk factor for heart and other vascular diseases and pancreatitis. In addition to hyperlipidemia, other risk factors for heart disease include family history of heart or vascular disease, age, sex, high blood pressure, diabetes and insulin resistance, cigarette smoking, and lack of exercise. It makes sense to start by controlling the factors you can. Quitting smoking and getting into some steady physical activity are key parts of lowering risks. In addition, adequate treatment for high blood pressure and any insulin resistance or diabetes play an important role. For hyperlipidemia, even if you are taking medications to regulate blood fat levels, diet is still the cornerstone of treatment. There are two main categories of blood lipids: triglycerides and cholesterol. Total cholesterol levels are made up primarily of low-density lipoproteins and high-density lipoproteins. LDL cholesterol can deposit cholesterol in blood vessels and should be kept low. HDL cholesterol is protective against heart disease because it carries blood cholesterol out of the body for disposal through the intestines and should be kept high. Recommended levels of blood lipids are shown in the table. You should keep track of your blood fats for the listed potential change in blood lipids if you are taking any of the medications listed below: ' Agenerase (amprenavir)*: increased cholesterol, triglycerides ' Crixivan (indinavir)*: increased cholesterol, triglycerides ' Fortovase (saquinavir): increased triglycerides ' Hivid (zalcitabine): increased triglycerides ' Kaletra (lopinavir): increased cholesterol, triglycerides ' Norvir (ritonavir): increased cholesterol, triglycerides ' Sustiva (efavirenz)*: increased cholesterol, triglycerides ' Videx EC (didanosine): increased triglycerides ' Ziagen (abacavir): increased triglycerides ' Zrivada (atazanavir): increased HDL cholesterol (* These can require avoidance of high-fat meals.) Recommendations to lower blood lipids include lowering the amount of fat and saturated fat in the diet. Dietary fat should represent between 25% and 35% of your total calorie intake. Most of this fat should be from monounsaturated fats. You can find these types of fats in nuts, nut oils, avocados, and olives. Moderate amounts of polyunsaturated fats should make up most of the balance of fat intake. An emphasis can be placed on a particular type of unsaturated fat called omega-3 fatty acids, which include fish fats, flaxseed, and canola oil. Saturated fats (which tend to be solid at room temperature) should be limited. These fats include animal sources of fat, margarine, coconut and palm oils, and shortening. Check the labels for the amount of fat and saturated fats. You should also check the labels and limit the amount you consume of trans-fatty acids found in hydrogenated fats, such as margarine. In addition to paying attention to the amount and types of fat you eat, cut back on alcohol and foods high in processed sugars that can push blood fats up. Including more fiber, especially soy-based fiber, can help to lower blood fats. Some soy foods to check out include soy milk, soy nut butter (looks like peanut butter), and tofu. Grains with soluble fiber like those found in oats, oatmeal, whole oat bread, and oat bran cereals are particularly good at helping to keep blood cholesterol in check. Other sources of fiber include grains, fruits, and vegetables. Whatever you decide to do, diet and exercise are important parts of your treatment plan. It seems that healthy eating is always in style. Fields-Gardner is the director of services for The Cutting Edge, an HIV nutrition company. She has written a book on HIV medications and a guide to nutritional management of HIV for clinicians.