Cholesterol: The Inside Story

When someone says cholesterol, it’s easy for someone to immediately think about heart attacks and regret devouring that greasy burger at lunch. Others may zone out when they start hearing scientific terms like HDL and triglycerides—comedian Steven Wright once made the tongue-in-cheek remark, “I drive way too fast to worry about cholesterol.”

With September being National Cholesterol Education Month, Learning the Healer’s Art sat down with BYU College of Nursing assistant professor Dr. Neil Peterson to learn the important facts about cholesterol and its impact on the body.

Learning the Healer’s Art: You’re one of our experts here in the College on physical fitness and related topics. This whole month is National Cholesterol Education Month and we’re trying to explain to students what cholesterol is and why it matters. What is cholesterol?

Dr. Neil Peterson: Cholesterol is an essential compound that stabilizes literally every cell in our body. It’s part of the cell wall. Some of the cholesterol you get from nutritional intake, but the rest of it is made by your body. Your body can usually make enough cholesterol for you to live on. Cholesterol is necessary for all of your cells and hormones and the bile that helps to break down fat that you eat. You do need cholesterol. It always has a bad connotation, of course, but it’s essential for living, kind of like fat. Everybody thinks fat is bad, but it’s essential as well.

LTHA: So cholesterol is something that your body needs.

Peterson: Yes. Not only does your body use it for all of your cell walls, but you need it for some hormones like testosterone and estrogen. It’s involved in the synthesis of Vitamin D, which is particularly important during winter time because people who have low levels of Vitamin D might be more depressed or have Seasonal Affective Disorder. It’s used in your bile which your body uses to break down fat that you eat, which is plentiful in the American diet.

LTHA: If we get most of our cholesterol naturally, when we eat a lot of unhealthy food, does that bring a lot of unnecessary cholesterol?

Peterson: Yes, that’s true. Now usually your body handles that just fine by processing it and just sending it right through your body. But still some of it does get absorbed, and the problem with that is excess cholesterol along with high amounts of fat can get deposited between cells and contribute to the hardening of your arteries. You’re more likely to have decreased blood flow and have strokes, heart attacks, and stuff like that.

LTHA: So if you get too much cholesterol, your body cannot handle all of it and it gets jammed in your veins?

Peterson: If your body cannot get rid of it, it just deposits it in places in your body. Generally we talk about two types of cholesterol: good cholesterol– High Density Lipoprotein (HDL)–and bad cholesterol, which is LDL or Low Density Lipoprotein. What happens is your body sends cholesterol out everywhere and transports it using LDL, but you don’t want it out there if it’s not being used. The way that your body brings it back to the liver is through HDL. Since we almost always have an excess of LDL, then you really want a high HDL (or good cholesterol) to bring it back to the liver to be processed and sent out of the body.

LTHA: What do you have to do to have high HDL?

Peterson: There’s a few things you can do. Exercise is one. Exercising increases HDL production. A lot of it has to do, we suspect, through this mechanism of increased blood through, especially at the skin level. When you exercise, especially vigorously, you can increase your HDL. Having a higher body weight or higher BMI can sometimes make it harder for your body to produce more HDL or you end up making more LDL cholesterol. Women tend to have really good HDL because of their hormones, but men’s HDL tends to not be as good.

LTHA: Does an unhealthy diet contribute?

Peterson: It mostly contributes to high fat content and also LDL, so bad cholesterol, but there’s a few things you can try to take to try and increase HDL naturally like Niacin*.

LTHA: When I go to the doctor and they test my cholesterol, what are they measuring?

Peterson: We have the ability to test lots of different types of cholesterol, but in general they’re looking at your triglycerides, which are a reflection of your diet. High sugar intake and high carbon intake will bump that up significantly. Then they look at LDL and HDL, and then they can look at other things like the ration of good to bad cholesterol, your total amount of cholesterol. One nice thing to look at is the ratio because if maybe your bad cholesterol is on the higher end, but if you’ve got really good HDL and as your body deposits the cholesterol you’re able to compensate for it by bringing it all back using your good cholesterol, then that’s not as bad. But you could have a normal LDL but if your HDL is so low that it can’t protect you from the LDL deposits peripherally, then you can still be in trouble.

LTHA: What are triglycerides?

Peterson: Triglycerides are a reflection of your diet. We do put that in with our cholesterol panel when we draw that on somebody.

LTHA: What are some health problems associated with having an HDL/LDL imbalance?

Peterson: When you have a hardening of the arteries, everybody usually thinks about having heart disease. What I think that some people don’t realize is that the hardening of the arteries is literally happening everywhere in your body. You have a higher chance of having heart disease, you have a higher chance of having a stroke of brain disease from those blood vessels being hardened, kidney problems, liver problems, everywhere. Blood vessels feed your entire body, and if those vessels are hardening everywhere, then you could be in trouble anywhere in your body from that. We just happen to see its affects more readily in places like the heart and brain.

LTHA: Is healthy living the main way to avoid these problems?

Peterson: Yes. To some degree you can’t stop it from happening because like I said your body naturally makes cholesterol and you need it for a lot of different things. Some is naturally going to get deposited in your blood vessels, but you can do some things to try to limit that, especially exercise. Good diet, as well. You can’t get cholesterol from plants; plants in general don’t contribute to your cholesterol at all. Eating lots of plant-based foods would prevent you from having too much dietary intake of cholesterol. We get it all from animal sources: beef, chicken, pork, stuff like that because again it’s animal-type cells that make cholesterol.

*Peterson notes that versions of Niacin that are promoted as “flush-free” deactivate the property of Niacin that addresses cholesterol problems and are significantly less useful.

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Happy Fall (Prevention Awareness Day)!

In 2007, a window washer astonished the world when miraculously he survived a 47-story fall. This past February, thousands of Youtubers viewed the footage of a Utah man surviving a 90-foot fall in the Grand Canyon.

While sensational falls like these attract a lot of media attention, they are just the tip of the iceberg.

In fact, the CDC estimates that every second of every day, an older American falls, making falls “the number one cause of injuries and deaths from injury among older Americans.”

That’s why today, the first day of fall, is Fall Prevention Awareness Day, sponsored by the American Council on Aging. The idea is to spread awareness of the dangers posed to seniors by falling and highlight preventative measures.

The CDC explains, “Each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.” The CDC also estimates that the problem will increase as more and more Americans turn 65.

“[Falls] are very common in the older population,” says assistant teaching professor Dr. Blaine Winters, an expert on head injuries and gerontology. He believes that most falls go unreported despite the massive dangers they pose. Part of this, he thinks, comes from a lack of understanding about the nature of fall injuries or the health risks that can lead to them.

“Many times we hear ‘Oh, she fell and broke her hip,’ but in reality her hip broke because of osteoporosis which made her fall,” he says. He also points out that many times the consequences of a fall worsen over time, meaning that many Americans do not initially seek treatment and thus increase the chance of more serious health problems like a stroke.

That is why, Winters says, anyone, particularly older adults, who has fallen should promptly visit the emergency room. However, even more important are the preventative measures that even college students can start in order to reduce their future risk of falling.

“Fall prevention begins before you’re at risk for falls,” he says. Health living, including exercise, is critical to maintaining strong and flexible muscles into old age. Having proper lighting and removing tripping hazards in homes are also important.

Exciting New NLC Tech Transforms Student Learning Experience

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Assistant Lab Supervisor Kristen Whipple watches as students learn how to operate the new Pyxis MedStation

One of BYU’s top learning facilities got some exciting new upgrades this summer. Among the more exciting improvements, the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC) now boasts eighteen new hospital beds, two new state-of-the-art classroom manikins, and two new Pyxis MedStation 4000 systems.

“In the NLC, our goal is to simulate real-life nursing scenarios for our students, so they are better prepared when they enter a hospital for first time,” said NLC supervisor Colleen Tingey. “The Pyxis MedStations are what students are most likely to see in Utah area hospitals.”

“Pyxis is actually a real, clinical machine that we use as a teaching tool,” Assistant Lab Supervisor Kristen Whipple added. “But the same Pyxis machine we use here could be used in any hospital.”

Acquired through a donation by the Fritz B. Burns Foundation, the Pyxis MedStation 4000 is a computerized medical dispenser that is quickly becoming a standard piece of equipment for nurses across the country. The Pyxis MedStation is programmed with a patient database to help nurses keep track of all of their patient’s specific medical needs.

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“The whole idea behind the machines is to improve patient safety,” Tingey explained. “Because the patient’s record is already programmed into the machine, it can then dispense the right medication for that patient and help the nurse avoid medical errors.”

Prior to this summer, the NLC had just one older version of Pyxis to use for all nursing simulations, which often ran simultaneously. Nervous nursing students would often waste valuable time waiting to get meds for their simulation because of backlog at the older machine.

“We’re really excited to have two Pyxis machines, instead of just one,” Whipple said. “Now it’s easier for students to access them during their simulations.”

Thanks to the Fritz B. Burns Foundation, NLC also welcomed two new additions to the College of Nursing manikin family. The new arrivals (one adult and one child) are auscultation manikins that help students learn to identify heart, lung, and bowel noises.

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Nursing student Aimee Schouten with the new pediatric auscultation manikin.

Students can use a stethoscope to listen to the manikin’s heart rate and breathing. Computer programs allow the professor to control what sounds the student hears, as well as the area on the manikin that the sound comes from. The professor can also program the manikin to emit different types of sounds or project the sound through a speaker, so the whole class can hear.

“When students practice on each other, they get to hear normal sounds,” Tingey explained. They get to hear what normal, healthy patients sound like. But they don’t get the opportunity to hear abnormal heart sounds. These manikins provide an opportunity for students to hear what an abnormal heart sounds like.”

Nursing faculty are especially excited about the new pediatric auscultation manikin. Whipple said that nursing faculty had specifically asked for this device to better teach pediatrics to nursing students. “Small children don’t just behave like small adults,” Whipple pointed out. “Their bodies are different than adult bodies; so we need to train in what’s specific to them. This pediatric simulator acts like a pediatric body would and helps us identify those sounds that are unique to children.”

The new adult auscultation manikin has several unique features that are useful to professors and nursing students. Professors can use the adult manikin’s computer program to display EKGs, phonograms, and ultra-sounds. This allows students to see the physiology behind any abnormal sounds they may hear.

“Basically, this manikin allows our students to not only identify abnormalities like heart tremors,” Tingey said. “But it also allows students to learn how the sound correlates to what’s happening in the heart.”

 

 

 

Four Steps to Food Safety

 

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Practicing Proper Food Safety Techniques Can Help Keep You Family Safe               (Image Courtesy of CDC)

An undercooked steak could be the difference between a good night’s sleep and a trip to the ER. Every year 48 million Americans suffer from one of the most preventable diseases on the planet—food poisoning. As part of National Food Safety Education Month, here are four easy tips from the Centers for Disease Control and Prevention (CDC) to prevent food poisoning.

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(Image Courtesy of CDC)

     1. CleanAccording to the National Health Service (NHS), a single flu virus can survive on your kitchen countertop for up to 24 hours. Use antibacterial soaps and cleaning supplies to rid your kitchen of any germs that may linger on your hands, utensils, or cutting boards. The CDC also recommends rinsing fresh fruits and vegetables under running water to clean off any dirt or pesticides before consumption.

(Check out this USDA Food Safety “Clean” Video for more details)

 

      2. Separate

Have you ever wondered why you need a separate bag for raw meats at the grocery store? This is to prevent cross-contamination—the spread of bacteria from one source to another, particularly from raw meat to other foods. Prevent cross-contamination by keeping raw meats, poultry, seafood, and eggs separate from produce and ready-to-eat foods. Also, be sure to sanitize any surfaces or utensils that touch raw meat or meat juices before using them elsewhere.

Make Sure You Separate Food to Prevent Cross-Contamination                  (Image Courtesy of CDC)

(Check out this USDA Food Safety “Separate” Video for more Details)

 

     3. Cook

How do you know if your steak is cooked well enough? Just because it looks done does not necessarily mean it’s bacteria-free. Checking your food’s internal temperature with a food thermometer is a key way to make sure it is fully cooked.

The CDC recommends the following internal temperatures for different dishes:

  • 145˚F: Internal Temperature for whole beef, lamb, fin fish, fresh pork and ham.
  • 160˚F: Internal Temperature for ground beef, pork, and lamb, and any egg dishes
  • 165˚F: Internal Temperature for all poultry (including ground chicken and turkey), stuffing, leftovers, and casseroles

(Check out this USDA Food Safety “Cook” Video for more Details)

 

       4. Chill

Did you know that germs can grow on some foods within two hours if they are not properly refrigerated? The CDC recommends keeping your refrigerator below 40˚F to slow bacterial growth. Check food labels and ensure that perishable food items are properly refrigerated. Also, be sure to thaw frozen meats properly using a microwave or cold water.

Grill Safety Chill Foods Sqaure image

(Check out this USDA Food Safety “Chill” Video for more Details)

 

 

For additional information, see the links below:

https://www.cdc.gov/features/befoodsafe/index.html

http://www.nhs.uk/chq/Pages/how-long-do-bacteria-and-viruses-live-outside-the-body.aspx

https://www.cdc.gov/foodsafety/education-month.html

 

 

Wait, Teachers Can Have Fun Too?

Think students are the only ones who enjoy summer? Here’s a look at what various BYU College of Nursing faculty and staff did over the break.

Scott Summers, Assistant Teaching Professor: An avid outdoorsman, Summers experimented with a new path to summit the Grand Teton Mountain in Wyoming. He also took his wife on her first climbing trip on the Birch Hollow route in Zion National Park. He also caught a foul ball at a MLB batting practice in Philadelphia.

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Summers climbing the Grand Teton Mountain.

Cara Wiley, Advisement Center Supervisor: Wiley journeyed widely this summer. First, she accompanied BYU nursing students on the Ecuador Public and Global Health clinical practicum, even celebrating her birthday in true South American fashion by having her face pushed into the cake. Second, she presented at an international conference for academic advising in Sheffield, England. She did not miss the chance to tour the countryside where one of the Jane Austen films was made.

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Wiley traveling in Ecuador with BYU students

Dr. Deborah Himes, Assistant Professor: Himes’ son returned from a mission in Argentina, following which the family visited the Grand Canyon. She also presented at the International Family Nursing Conference in Pamplona, Spain with two of her students.

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Himes’ family at the Grand Canyon. Her son Sam (far right) returned home this summer from a mission in Argentina.

Dr. Patricia Ravert, Dean: Ravert enjoys biking, but last year she ran afoul of a chicken in France and crashed. This year while biking with her brother between Pittsburg and Washington, DC, a squirrel hit both of their bikes, but luckily she avoided a repeat of last year’s accident. More dangerous were the snakes, including the copperhead that tried to bite one of their friends as he zoomed past.

Lacey Eden, Assistant Teaching Professor: Eden and her family toured the Kennedy Space Center in Florida, where they quickly became appreciative of the many technologies NASA has produced that now are commonplace household items. (see https://spinoff.nasa.gov/Spinoff2008/tech_benefits.html for more information).

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Eden’s family at the Kennedy Space Center.

Dr. Blaine Winters, Assistant Teaching Professor: Winters and his family went to Bend, Oregon and to Crater Lake National Park. There was a fire in the park and the billowing smoke hampered some of the sightseeing excursions they made. They also rented a beach house in Bandon, Oregon where they toured an old lighthouse and went crabbing on the dock.

Colleen Tingey, NLC Supervisor: Tingey spent time in Washington, DC to not only attend a national nursing simulation conference, but also to celebrate her 35th wedding anniversary with her husband, who is a BYU geology professor. They traveled to Hawaii and Alaska on geology trips and found time to visit their cabin in the Uinta Mountains.

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The cliffs in Hawaii where Tingey and her husband worked on a geography research project.

BYU Earns Bronze Level Campus Recognition from American College of Sports Medicine

Last October as the Pokémon Go craze swept the nation, dozens of BYU students were treated to an unusual sight—a Pikachu tromping around campus. In between taking selfies with students, the mascot vainly tried to use its stubby arms to stabilize a foam board sign hanging from its neck that advertised an upcoming Pokéthon 3K run/walk for the BYU community.

That weekend, 140 people attended the event, chasing Pokémon as they completed the course. Few knew that their participation was a fulfillment of the hopes of a small cadre of BYU professors trying to improve BYU fitness levels, and that it would contribute to BYU being recognized as a Bronze Level Campus by the American College of Sports Medicine (ACSM), a distinction awarded on June 1, 2017.

Nursing professors Dr. Neil Peterson and Craig Nuttall and exercise science professor Dr. James LeCheminant are working together to implement the college campus version of an ACSM program called Exercise is Medicine. The initiative focuses on improving the fitness levels of community members through holding events, education, and evaluating people’s fitness using a measure known as the Physical Activity Vital Sign, which measures how much people exercise per week.

“Exercise is something that frankly is probably one of the most important things in medicine right now, because it can treat most diseases that are out there,” Nuttall says. “You exercise, your diabetes risk goes down. You exercise, your hypertension risk goes down. You exercise, your cancer risk goes down.”

“The scientific evidence of the benefits of physical activity to support and improve health is overwhelming,” LeCheminant says. “Health initiatives in large venues, such as a university setting, have the potential to positively impact many people. Promoting ACSM’s theme of ‘Exercise is Medicine’ puts focus on health which can lead to a higher quality and more productive life.”

The Pokéthon was the pinnacle of the team’s efforts; it also helped qualify BYU to earn the Bronze Level Campus ranking. Other work has included teaching BYU nursing students about the Physical Activity Vital Sign and evaluating work that the university has already done to increase physical activity, such as closing down parts of Campus Drive and improving sidewalk availability.

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Peterson representing BYU at the Exercise is Medicine award ceremony

The organizers of Exercise is Medicine told Peterson, who is the project leader, that they were surprised to see the large role of the BYU College of Nursing in this endeavor, given that most universities were wholly reliant on their exercise science departments to implement the program.

“They were really happy that our leadership team is interdisciplinary,” Peterson says. “Another thing that was impressive that they mentioned to me was that at our Pokéthon fun walk two thirds of our participants were community members, so we weren’t just getting people on campus. It wasn’t just faculty, staff, and students; we had a very sizeable community involvement because we do want to make our campus healthier, but they see the campus as an epicenter for the community.”

The Bronze Level recognition will last two years, but the team plans to find ways to earn possibly a Silver Campus ranking in the next year.

“The university should be very proud of the efforts that they’ve done already to make the campus safer for pedestrians, making it a more walkable campus, and really using the built environment to promote physical activity,” Peterson says. “These different levels of the awards help to give us direction to make sure that we are meeting what some national recommendations are as far as improving physical activity and reducing sedentary behavior on campus and in the surrounding community.”

Incoming Nursing Students Embrace Potential at Orientation Dinner

At the fall new student orientation dinner on Wednesday, members of the incoming class joined their peers in celebrating their acceptance into the BYU College of Nursing.

“I love being able to provide relief to others,” said Elizabeth Pace, from Missouri. “I feel like my calling is to nurture and uplift other people.”

“We need to be the best we can be so we can elevate the profession of nursing,” added another student.

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Students listen to speakers at the dinner

The students—representing seventeen states and the country of Mexico—are among the highest-performing accepted students to the College of Nursing. The average GPA for the incoming class was a 3.9 and their average ACT score was 29.

“We really are so fortunate to have such great students in the program,” dean Dr. Patricia Ravert said in her address to the new students. Associate deans Dr. Jane Lassetter and Dr. Katreena Merrill also shared their gratitude and excitement with the new class.

For many of the students, the orientation provided a chance to reflect on the journey that has brought them to this point.

“Applying to the nursing program has really been an illuminating experience,” Rebecca Gabbitas from Arizona said. “I really developed a love of learning as I took the prerequisite courses for the major.”

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SNA officers speak to the new students

“It’s so gratifying to be admitted to the program,” Giovanna Worley from Utah added. “Not just because you get to study what you love, but because all the work and dedication that guides you to your life’s dream.”