Chewing the fat with Dr. Mary McGowan

Mary McGowan, M.D., is the worst thing that ever happened to cholesterol. As medical director of the Cholesterol Management Center at the New England Heart Institute at Catholic Medical Center, she works with the other professionals at the center to help people manage their cholesterol levels, and possibly prevent heart attacks.

McGowan, a board-certified internist and nationally recognized cholesterol expert, has written several books, including her newest, “50 Ways to Lower Your Cholesterol.” She also has some surprising information about today’s popular diets and the one thing we can change to live healthier lives.

Q: Explain what cholesterol is and what it does.

A: Cholesterol is a white, waxy substance that is insoluble in water. It is used to make bile, which aids in digestion. It’s needed for cell membranes and hormones. We make enough cholesterol in our livers. The average American, however, consumes an excessive amount of cholesterol and fat, and it can’t be removed from our blood stream.

Q: What’s the overall mission of the Cholesterol Management Center?

A: We are the only cholesterol center in the state. Many patients come to us following a cardiac event like a heart attack. We educate them on diet and exercise. For patients with cardiac disease, we may also use cholesterol-lowering medications, which can dramatically reduce cholesterol levels in some patients. We also try to stress to those on medication how crucial diet and exercise are which may make it possible to use less medication.

We also see a large group of people, including children, with genetic cholesterol abnormalities. Familial hypercholesterolemia is more common in those of French Canadian descent than in the general population. In New Hampshire, where many people are French Canadian, recognizing the cardiac risk associated with familial hypercholesterolemia is very important.

Our clinic has participated in a lot of cholesterol-lowering medication studies and many of our patients have participated in clinical trials. For instance, we worked with Lipitor for years before it came out. We are also looking at medications that increase HDL, or good cholesterol.

One that we’re working with now was recently described in the New England Journal of Medicine and we’re the only place in New Hampshire that is using the drug is our office. So we’re providing our patients cutting-edge research.

Q: Why made you decide to focus on blood lipid management as a career?

A: I was always interested in preventive cardiology. Cholesterol management provided an avenue for educating people on diet and exercise.

This is an exciting area of medicine. In the past 10 years, more has happened in cholesterol management than in any other field of cardiology.

Q: You’ve written several books on cardiac health and healthy lifestyles. What inspired you to become an author?

A: You can only see so many people in one day as a physician. In order to reach a larger audience, you need to lecture to the community, which I do, lecture to other physicians and, if you want to get your message across the country, you have to write books.

I was blessed with a group who helped make the books come alive. If it was just me, they might not be as well written. We have created books that are easy to read and provide people with information and inspiration. I’ve received letters from readers who have made changes in their lives. That makes the biggest difference to me as a writer and physician.

Q: Any new books coming out?

A: We’re thinking about addressing pediatric obesity and nutrition. If you look nationwide, so many kids are overweight or obese, we are poised for an epidemic of medical problems down the road. We’re seeing kids with problems related to cholesterol. One in five is developing diabetes type 2. We’ve seen some children in our clinic who weigh 300 or 400 pounds at 13 or 14 years old.

Q: Do you follow your own advice?

A: Yes, I really do. I exercise every day and eat right. Of course, I run into some of my patients at the grocery store and they do look in my basket, so that helps, too.

Q: What is your view of popular diets that are out right now like Atkins and South Beach?

A: Mary Card and Christie Lloyd, our nutritionists, reviewed all those diets and found that the South Beach is reasonable. The first two weeks are restrictive, but after then, you add back healthy carbohydrates. It is nutritionally sound and it works beautifully for patients with DM (diabetes type 2) and high triglycerides (a blood fat).

The bottom line is calorie restriction, and this is a major reason South Beach works well. You also need to exercise.

Q: Are the lifestyle guidelines in your heart-healthy books something that probably most of us should be following anyway, regardless of whether we have heart disease or not?

A: Absolutely! If you look at this country, 50 percent of deaths in this country are due to cardiac problems. These are things we recommend for everyone at risk of developing symptomatic cardiac disease. An ounce of prevention is worth a pound of cure.

Q: What is the one thing we as Americans should change about our lifestyle to become healthier?

Q: Not eating between meals.

Q: Not snacking?

A: Yes, and exercise every day. We’ve found in cultures that don’t snack, the people weighed less. Children have been taught now that everything needs food. Look at sporting events. They have become a snack fest. Everything is an excuse to eat.

Q: What about eggs — can we eat them or not?

A: There has been a lot of controversy with eggs. Our recommendation for people without heart disease is one to two yolks a week, for those with HD, one to two yolks a month. Egg whites are great, however.

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