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For reasons that are still under study, cholesterol levels are influenced by a number of life-style factors. For instance, regular exercise can significantly raise the level of protective HDL. Alas, a couple of push-ups a day will not do the trick, says Dr. Josef Patsch of Houston's Baylor College of Medicine: "You need sustained aerobic exercise for 20 minutes at least four times a week to really benefit." A less strenuous way to raise HDL levels may be to have a daily shot or two of alcohol. "The evidence is indirect," reports Epidemiologist Stephen Hulley of the University of California at San Francisco, "but social drinkers have HDL levels as much as 33% higher than those found in teetotalers." On a more sober note, U.C.S.F.'s Dr. Richard Havel warns: "Anyone who recommends raising HDL by drinking is playing with fire." Stress too has a detrimental effect. Studies have shown that the cholesterol levels of medical students peak at exam time, while accountants hit their high point around April 15.
By applying these lessons, says Shra-gai, "my life was totally changed." Today the man who used to love steak says, "I won't touch it." At a restaurant, "if I choose fish, I ask the chef to skip the butter or please to sauté it in wine." Every morning, regardless of weather, the man who once spurned exercise goes for an eightmile, two-hour hike through the wooded mountain trails near his home. He no longer smokes. His workdays average between eight and ten hours, but he insists, "I can absolutely stay away from the tension now. If I feel the pressure, I take off. Business associates get used to it; I set my own pace." Shragai no longer lives in fear of a sudden heart attack: his blood pressure and pulse rate are down, and most remarkable, his cholesterol level has dropped to an exemplary 195.
More and more Americans are deciding to take such precautions before, not after, disaster strikes. Three years ago, officials at the San Diego County school system became alarmed by the growing number of workmen's-compensation and health-insurance claims being filed by employees. "Most of the claims stemmed from poor health maintenance," recalls Risk Management Analyst Florine Belanger. To counter the problem, Belanger organized a program that offered employees a complete physical examination, followed by counseling on diet, exercise and stress management. "We thought we'd try to get the employees of our schools interested in changing their life-style," explains Belanger.
Janet Crowell, 42, a teacher's aide for the handicapped, is one of 1,500 teachers and staff members in seven of the county's 46 districts who have enrolled. After only four months, Crowell is jogging twelve miles a week, has lost 20 Ibs. and has reformed her diet. Says she: "I used to eat too many cheese and milk products and pasta with meat sauces." Now she favors raw vegetables, yogurt and a lot of pasta but with less sauce. In the Escondido district, where one-third of the employees are in the program, workmen's-compensation claims have dropped 34%, and health-insurance claims are down about 20%. Says Belanger: "We've caught the problems before they happen."