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One of the names of cholesterol—“the quiet killer”—is suitable rather for a detective story hero than for a medical reference book. However, as regards atherosclerosis—like in a good detective story—it is not that simple to trace the culprit. We will try to do it with the help of Ilmara Vina—Doctor of Biology, Chief Researcher at the Institute of Microbiology and Biotechnology of the University of Latvia and President of the Latvian Association for Medicinal Chemistry, affiliated with the Federation of the European Medicinal Societies. 

—Ilmara, many diseases nowadays are considered farfetched, meaning that their threat to health is exaggerated, by marketeers in the first place. For example, concerning cholesterol—is there any significant evidence that excess of cholesterol really threatens our health? 

stat lcbal vina—I would say that in this case not only health, but our lives are at stake. There are, of course, official statistics that prove this fact. For instance, according to the data of the World Health Organization (WHO), in 2005 alone, cardio-vascular diseases took the leading position with 374 cases out of 1000. That is why one of the top priorities set by the WHO is to search for an effective solution to this problem. In particular, one of the regions of Northern Europe has introduced a whole complex of preventive measures to reduce blood cholesterol level. The results were the following: the number of atherosclerosis cases has fallen down by 37%, death rate of cardio-vascular diseases—by 36%, number of strokes—by 62%, and the rate of unexpected deaths from strokes and heart attacks has fallen by 55%. 

—It is a well-known fact that part of the “bad” cholesterol is synthesized by the body itself—by the liver, to be precise. Can one influence this process in any way and what does it mainly depend on? 

—You’re quite right. Our body gets about 25% of cholesterol with food, but it’s a considerable amount. I would like to start with some details on this percentage. Unfortunately, nowadays a lot of fatty products with high cholesterol are widely advertized and are in high demand. 
These products are especially loved and preferred by kids, teenagers, young people and even some adults. Sometimes, with no possibility to have proper lunch or dinner, we content ourselves with fast food and other products of doubtful quality. Although such food is easily affordable due to low price and easy availability. The body of an adult provides for the daily synthesis of a certain amount of cholesterol, necessary for its vital functions—around 6-8 grams. But with fatty products the body gets more than 1 additional gram of cholesterol per day. 
Surprisingly, unhealthy diet is not the root of all evil. Some people thoroughly observe diets, observe their food regime and exclude all fatty and fried food and pastry. However, cholesterol remains at a high level. Why? Sometimes it’s conditioned by the genetic peculiarity of cholesterol metabolism: it is synthesized in the liver in excessive amounts. Thus its level increases in blood as well. So if your close relatives have had heart attacks or strokes, or suffer from hypertension or any other cardio-vascular disease—this is the first warning that your health deserves special care. Genetic predisposition combined with unbalanced diet, and consumption of food rich in fats and cholesterol—all of it can result in premature atherosclerotic changes in blood vessels and further—in unexpected progress of cardio-vascular complications, such as heart attacks or strokes. 

—In this case, which food should be avoided in the first place? How to distinguish which products in the supermarket are absolutely not welcome in one’s food basket? 

stat lcbal vina1—Everybody knows very well that fatty food is unhealthy. Smoked sausages and other smoked products, as well as pork and mutton are all rich in fats. There are, none the less, some “insidious” foodstuffs that are generally reputed as dietic, but in fact tend to provoke increase of the cholesterol level. For instance, one of our all time favorites and quite a healthy product—cheese. Some kinds of cheese have up to 45-50% of fat, which is a pretty big amount. Still, it’s necessary to eat cheese from time to time as it contains a lot of calcium, required by the body at any age. It’s enough just to choose low-fat cheese varieties for your diet—up to 14-17%. 
The same applies to other dairy products: being useful, some of them still contain a lot of fat. It is better to choose milk, buttermilk, yoghurt, curd and other dairy products with 1,5-2% of fat. Everything above that level—especially sour cream and cream—paves a straight way to atherosclerosis. Anyway, since the choice of dairy products is so wide nowadays, something tasty and healthy at the same time can be found effortlessly. 
Butter consumption should be reduced to 20 grams per day. It is preferable for the body to get fats from vegetable oils, like olive oil, sunflower or corn oil. 
A great deal of cholesterol is contained in all kinds of confectionary products, but not only in layer cakes or patisserie as many might have thought. Even seemingly innocent cookies can cause a lot of harm: sandy pastry often contains artificial butter which is extremely rich in cholesterol. And please, don’t get carried away by sweet buns, every once in a while is quite enough. 

—May be it is better to become a vegetarian and completely substitute animal fats with vegetable fats? All the more so, because many products nowadays are produced with vegetable fats… 

—Or with the so called fats of half-stiff consistency. As a result of chemical treatment, called hydro-refinement, vegetable fats change their spatial pattern and consistency—and solidify. 
Abundance and relatively low price of refined vegetable oils make them very convenient animal fat substitutes in the current era of “fattophobia”. Such refined vegetable fats are used in production of artificial butter, sour cream and curd substitutes, various dips, confectionary, etc. Manufacturers emphasize the low fat content of such products, however they often omit the fact that during the chemical treatment of vegetable fats their most useful property—unsaturation—is partly destroyed. These modified acids block receptors of the human body and prevent the linking of natural polyunsaturated fatty acids. Refinement process also inactivates vitamin A, beta-carotene and some other useful substances. 
Thus, for a proper diet choice: 1) carefully read the information on the packages of all products that you buy; 2) it is recommended to abstain from products with excessive content of hydro-refined vegetable oils, like palm and cocoa oil; 3) avoid regular consumption of such products. I don’t mean to say that these products are absolutely forbidden. However, their consumption should better be quite reserved. 

—We can control the food regime, but it is impossible to determine blood cholesterol without special tests. When and how often should it be done? 

—Preferably once a year. Though previously doctors recommended to undergo this kind of medical blood test to people over 40, today—taking into account the latest scientific and research medical data—it is better to start checking blood cholesterol already at the age of 20-25. Strokes and heart attacks have grown significantly “younger”, especially among men. Nowadays even 24-year-old people suffer from heart attacks due to excessive blood cholesterol, which is often genetically pre-determined. 
Remember: normal blood cholesterol level is 5.2 mmol/l. A higher index is fraught with cardio-vascular system dysfunctions. With cholesterol level of 7-8 mmol/l the risk of a stroke or heart attack is already extensive. Constant control of blood lipids—triglycerides, low-density lipid complexes (“bad” cholesterol) and high-density lipid complexes (“good” cholesterol)—allows doctors and patients to take proper measures for cholesterol reduction timely, if necessary. 

—Medicine is often blamed for curing the symptoms, but not the disease itself. Besides, patients don’t rush to visit a doctor, putting it off till the situation reaches a critical point. Atherosclerosis, however, is asymptomatic. Are there any preventive measures for this disease, or is it better to take action only when its first signs show up? 

—Let me answer this question by referring to interesting results of an international survey regarding the sale of pharmaceutical products. In the USA, for example, decholesterolization medicine is a best-seller in pharmacies. It would seem that as the “fast-food nation”, the Americans traditionally consume a great deal offatty, high-calorie products saturated with cholesterol. Paradoxic as it may seem, the total rate of cardio-vascular diseases and complications (strokes, heart attacks) in the USA has dropped drastically, compared to the 1960s. Why? Because today Americans have a habit of taking medicine for cholesterol level reduction. Healthcare has become a cult in America! They consider possible consequences of unhealthy diet way before cholesterol level exceeds dangerous limits. 
According to the same survey, pharmaceutical market leaders in Russia are: pain-killers, antibiotics and antidepressants. Whereas decholesterolization medicine is on the very last place! People in Russia are not used to taking care about health all the time and in particular, to check cholesterol level and reduce it, if necessary. “If I feel well, why do I need to check cholesterol level? When I start feeling bad, I will take blood tests and we’ll see”. It is time to change this fatal situation. The trouble is that sometimes understanding of the problem comes too late. Atherosclerosis plaques accumulate gradually: accrued in the heart area they provoke heart attacks, concentrated in the brain blood vessels they cause strokes. Cardio-vascular diseases are so treacherous because they emerge so unexpectedly, and, sadly, sometimes have an unfortunate outcome. Thus, a patient with high blood cholesterol, apart from the strict diet, is usually prescribed a hypolipidemic medicine. 

—Can conventional medicine serve as preventive measure against atherosclerosis to reduce blood cholesterol? Are there any negative consequences for the body? 

—If a patient is genetically predisposed to cholesteremia and strict diet doesn’t provide the expected results, or if the blood cholesterol exceeds 7-8 mmol/l, doctors as a rule prescribe an anti-cholesterol medicine. In this case it is a must. However, it is not that simple as one would wish. This type of medicine reduces blood cholesterol, but at the same time it has a negative side-effect on many vital functions of the body: on the digestive system, especially on the liver; on the hormonal regulation of metabolism; on the locomotor apparatus; on the reproductive system; on the peripheral and central nervous systems. 
Many years of practice have shown that medicines that reduce cholesterol level have to be taken in a protracted, sometimes even lifelong course. Serious side-effects of such therapy wear out the body and entail new pathologies. However, in terms of vital choice between stroke or heart attack and possible, but totally reversible, dysfunctions of liver and central nervous system, doctors often choose the least of two evils. This medicine saves lives. 

—As we know, LCBalance food supplement—a product of the Vision company—doesn’t offer its customers such poor choice. What is the reason? Is it less effective, since it doesn’t entail a dozen of side-effects? 

LCBalance food supplement is not just effective, but a truly high-performance product. It influences both ways of cholesterol formation in the body: its synthesis by the liver and supply with food. The main active ingredients of the LCBalance food supplement, which I would call “the salvation duo” for our cardio-vascular system, are phytosterols of the plant cells’ membranes and policosanol—a multicomponent extract of waxes of various nature. 
Formation of cholesterol happens after a complicated chain of biochemical transformations with about 20 ferments. The main ferment participating in the synthesis of cholesterol—HMG-CoA-reductase (reductase hyrdoxy-methyl-glutaril-coenzyme A)—differs from all other ferments in its action, which is irreversible, and also provides for cholesterol exit and speeds the process in general. 
Phytosterols prevent assimilation of cholesterol from animal fats by the intestines and promote its removal from the body. However, it is important that one of the food supplement ingredients—policosanol—inhibits the action of HMG-CoA-reductase by half: it is not recommended to decrease cholesterol level lower than the physiological standard, as it is also vital for normal functioning of the body. Lack of cholesterol can result in poorer brain performance, depression and apathy, increased risk of cancer and infectious diseases. With the introduction of LCBalance we have a perfect opportunity to reduce the synthesis of “bad” cholesterol in liver with the simultaneous enhancement of “good” cholesterol synthesis. It is wonderful news for those who take care of their health, especially for those 250 million people that are genetically predisposed to excessive synthesis of cholesterol. 
In order to enhance the LCBalance food supplement’s effect I would recommend to take this product together with such products as Beauty and Junior Be Big, that supplement policosanol with the active elements of bee wax and bamboo bark waxes, as well as with valuable polyunsaturated fatty acids and many other elements. I would also advise to follow the instructions on the LCBalance bottle that concern limiting the intake of vegetable bioflavonoids, as these substances affect enzymatic reactions in the liver. 
By the way, turning back to the world statistics, they show that 90% of the Americans, 70% of the Japanese, 50% of the population of Western and Central Europe take biologically active food supplements, compared to only 7% of the CIS population. So I would like to urge everyone to follow the example set by the countries where care for health has become a habit.