I agree that exercise is one key. The medical debate rages about not whether regular exercise is a good thing, but how much it matters to out-of-whack cholesterol per se. Whereas it would appear that exercise should reduce weight, and invigorate the system generally for proper functioning of the adrenals and the heart, -AND- being overweight raises the risk of disease of all kinds and puts an unecessary load on the heart, it still stands that a good many people who suffer from atherosclerosis are of proper weight and get lots of exercise! What do they do? They must diet, ingesting the proper foods at that, not just reducing calories. Whole grains and plentiful anti-oxidants are a must. Cutting transfat, too much saturated fats, and most polyunsaturates, over refined foods of high glycemic index and uncessary sugars must be done. Supplementation, once over 40 years of age would seem to be a very good idea.
I would say there is no "better than" to exercise. Diet is very, very important. I have heard it said that the problem of syndrome X is 75% diet and 25% exercise. I would put it at 60% diet and 40% exercise. I would say once you enter a problem area; being overweight, tired, out of breath, trouble sleeping or getting good rest, occasional nausea & weakness, angina, etc.. you HAVE to supplement. A condition requires therapy, and changing foodstuffs and walking 5 miles a day, no matter how admirable in other contexts, may not be enough.
As some articles point out, diabetes causes obesity, not the other way around. I am not sure to what extent I agree with that, but I would vote for it being a vicious cycle aspect for sure. One helps the other worsen.
Transient ischemia is very very serious. Overweight conditions must be dealt with. It requires a multi pronged approach, but the plating out of lipoprotein A and calcium on arterial walls may be a biochemical problem that is not directly related to the amount of activity of the organism directly. Marathon runners get cholesterol problems. We have to attack the beast in its lair, and that is in the blood chemistry of the individual.
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