My Flight Surgeon
Sr. Aviation Medical Examiner
Here is a PM question I received. I think the problem is common and the isuues are important to pilots and their careers. I am posting it (anonymously) with permission of the questioner.
DOC:
I went in last week for a regular physical and fasting bloods tests. The Doc's office said everything was fine and try to lose some weight before next year. Here are the results:
Cholesterol
My question to you is how good or bad are these numbers.
Well pardner, the lab numbers look good except the triglycerides. The 213 is too high. This may be an indication of metabolic syndrome, especially with a family history of diabetes. The goal for triglycerides is less than 150. To change this, you need to decrease your carbohydrates, eat whole wheat bread, and increase your exercise to at least 30 minutes of cardio a day. Don’t smoke!!
The total cholesterol is comprised of HDL, LDL and VLDL, that is why HDL + LDL do not equal the total.
Metabolic Syndrome
What is metabolic syndrome?
Metabolic syndrome (also called syndrome X) is a group of risk factors for heart disease. Many people who have type 2 diabetes also have metabolic syndrome.
You have metabolic syndrome if at least 3 of the following are true:
What causes metabolic syndrome?
Metabolic syndrome results from eating a diet that has too many calories and too much saturated fat, and not getting enough physical activity. You can lower your risk of heart disease and diabetes by improving your eating habits, getting more physical activity and losing weight. If you smoke, you should stop smoking.
Can physical activity help reduce my risk?
Yes. Not being active is one of the biggest risk factors for heart disease. "Exercise: A Healthy Habit to Start and Keep" provides useful tips on adding more physical activity to your life.
Can a healthy diet help reduce my risk?
Yes, what you eat can affect your health. "Nutrition: Tips for Improving Your Health" provides information about how to eat a more healthy diet. "Working With Your Doctor to Overcome Overweight and Obesity" offers tips on losing weight and living a healthier lifestyle.
The weight is TOO MUCH for your height. Your Body Mass Index is 41.5 (NORMAL IS <25 and >30 is classified as obese). Here I am, the pot calling the kettle black. I am 6’4” AND 270 # with a BMI of 28.5 – we all eat too much, not the right stuff and don’t exercise enough.
Your family history is not good. I know you can’t change who you chose for parents, but if you religiously change your lifestyle you will increase your longevity and quality of life. Metabolic syndrome frequently leads to diabetes (can be a deal breaker for a pilot if severe enough), heart disease and stroke. My opinion is that we need to have the best quality of life, god health, and be shot by a jealous husband at age 90.
Here is what I would want to see:
HDL of > 40 and preferably near 50
LDL of < 80 – there is not enough evidence for this yet but I push my LDL to the mid 70’s and the aggressive cardiologists are now pushing LDL to the 50’s in patients with diabetes and heart disease. It will be the standard of care in ayear or two.
Total cholesterol of < 160.
Triglycerides of < 150 and preferably < 130.
Exercise at least 30 minutes a day alternating cardio and strength training
Eat a balance diabetic diet at 2000-2200 calories a day, consider a consult with a registered dietician.
Repeat the labs after 6 months
Watch "Super-size Me", it will scare you!
Understand that the nurse is just telling you what the lab slip says about “normals” Normals are derived from plotting the median plus or minus 2 standard devialtions for a large number of people being tested. Since we are becoming a “broader” country, the “normals” will continue to rise over time. This does not necessarily mean that these values are optimal.
A long answer but it looks like you need to change your lifestyle.
DOC:
I went in last week for a regular physical and fasting bloods tests. The Doc's office said everything was fine and try to lose some weight before next year. Here are the results:
Cholesterol
- LDL 114
- HDL 40
- Total 197 Why doesn't HDL + LDL = total
- 84
- 213
- 332 lbs 6' 3" Large Frame (played college FB)
- Early 30's
My question to you is how good or bad are these numbers.
Well pardner, the lab numbers look good except the triglycerides. The 213 is too high. This may be an indication of metabolic syndrome, especially with a family history of diabetes. The goal for triglycerides is less than 150. To change this, you need to decrease your carbohydrates, eat whole wheat bread, and increase your exercise to at least 30 minutes of cardio a day. Don’t smoke!!
The total cholesterol is comprised of HDL, LDL and VLDL, that is why HDL + LDL do not equal the total.
Metabolic Syndrome
What is metabolic syndrome?
Metabolic syndrome (also called syndrome X) is a group of risk factors for heart disease. Many people who have type 2 diabetes also have metabolic syndrome.
You have metabolic syndrome if at least 3 of the following are true:
- You are overweight or obese and you carry the weight around your middle. For men, this means a waist that measures greater than 40 inches around. For women, it means a waist that measures greater than 35 inches around.
- You have high blood pressure (130/85 mm Hg or greater).
- You have a high amount of sugar in your blood (a fasting blood sugar of 110 mg/dL or greater).
- You have a high amount of fat in your blood (a triglyceride level of 150 mg/dL or greater).
- You have low HDL cholesterol (the "good" cholesterol). For men, this means an HDL level less than 40 mg/dL. For women, this means an HDL level less than 50 mg/dL.
What causes metabolic syndrome?
Metabolic syndrome results from eating a diet that has too many calories and too much saturated fat, and not getting enough physical activity. You can lower your risk of heart disease and diabetes by improving your eating habits, getting more physical activity and losing weight. If you smoke, you should stop smoking.
Can physical activity help reduce my risk?
Yes. Not being active is one of the biggest risk factors for heart disease. "Exercise: A Healthy Habit to Start and Keep" provides useful tips on adding more physical activity to your life.
Can a healthy diet help reduce my risk?
Yes, what you eat can affect your health. "Nutrition: Tips for Improving Your Health" provides information about how to eat a more healthy diet. "Working With Your Doctor to Overcome Overweight and Obesity" offers tips on losing weight and living a healthier lifestyle.
The weight is TOO MUCH for your height. Your Body Mass Index is 41.5 (NORMAL IS <25 and >30 is classified as obese). Here I am, the pot calling the kettle black. I am 6’4” AND 270 # with a BMI of 28.5 – we all eat too much, not the right stuff and don’t exercise enough.
Your family history is not good. I know you can’t change who you chose for parents, but if you religiously change your lifestyle you will increase your longevity and quality of life. Metabolic syndrome frequently leads to diabetes (can be a deal breaker for a pilot if severe enough), heart disease and stroke. My opinion is that we need to have the best quality of life, god health, and be shot by a jealous husband at age 90.
Here is what I would want to see:
HDL of > 40 and preferably near 50
LDL of < 80 – there is not enough evidence for this yet but I push my LDL to the mid 70’s and the aggressive cardiologists are now pushing LDL to the 50’s in patients with diabetes and heart disease. It will be the standard of care in ayear or two.
Total cholesterol of < 160.
Triglycerides of < 150 and preferably < 130.
Exercise at least 30 minutes a day alternating cardio and strength training
Eat a balance diabetic diet at 2000-2200 calories a day, consider a consult with a registered dietician.
Repeat the labs after 6 months
Watch "Super-size Me", it will scare you!
Understand that the nurse is just telling you what the lab slip says about “normals” Normals are derived from plotting the median plus or minus 2 standard devialtions for a large number of people being tested. Since we are becoming a “broader” country, the “normals” will continue to rise over time. This does not necessarily mean that these values are optimal.
A long answer but it looks like you need to change your lifestyle.