“Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy.

• Surgery: An operation in which doctors cut out the cancer.
• Chemotherapy: Use of special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
• Targeted therapy: Use of drugs to block the growth and spread of cancer cells. The drugs can be pills you take or medicines given in your veins. You will get tests to see if targeted therapy is right for your cancer type before this treatment is used.

Visit the National Cancer Institute for more information about ovarian cancer treatment.”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/ovarian-cancer/treatment/?cid=google:paid_search_co:ik_24:q1_24_rsa_refresh:ovarian&gad_source=1&gclid=EAIaIQobChMIj63WtM3HiAMVAU9HAR3BciZCEAAYASAAEgKu-_D_BwE)

1-Local Treatments/Therapies:

Some treatments are local, meaning they treat the tumor without affecting the rest of the body.

Types of local therapy used for ovarian cancer include that include:

A-Surgery

That is the main treatment most ovarian cancers. How much surgery you have depends on how far your cancer has spread and on your general health.  For women of childbearing age who have certain kinds of tumors and whose cancer is in the earliest stage, it may be possible to treat the disease without removing both ovaries and the uterus.

B-Radiation

Radiation is another form of therapy that might be used.  Radiation therapy uses high energy x-rays or particles to kill cancer cells. These x-rays may be given in a procedure that is much like having a regular x-ray. Aggressive chemotherapy is usually more effective, so radiation therapy is rarely used in this country as the main treatment for ovarian cancer. However, it can be useful in treating areas where the cancer has spread, either near the main tumor or in a distant organ, like the brain or spinal cord.  External beam radiation – This is the most common type of radiation therapy for women with ovarian cancer. External radiation therapy is much like getting an x-ray, but the radiation is stronger.

2-Systemic Treatment/Therapies:

This includes Chemo therapy, Hormone Therapy and Targeted Therapy.

A. Chemo Therapy:

Chemotherapy (chemo) is the use of drugs to treat cancer. Most often, chemo is a systemic treatment, meaning the drugs enter the bloodstream and reach almost all areas of the body. Chemo can be useful to kill very small amounts of cancer cells that may still be around after surgery, for cancers that have metastasized (spread), or to shrink very large tumors to make surgery easier. Most of the time, chemo uses drugs that are injected into a vein (IV) or given by mouth. In some cases, chemotherapy may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy.

Chemo for ovarian cancer usually involves getting two different types of drugs together. Getting a combination of drugs instead of just one drug alone seems to work better as a first treatment for ovarian cancer. Usually, the combination includes a type of chemo drug called a platinum compound (usually cisplatin or carboplatin), and another type of chemo drug called a taxane, such as paclitaxel (Taxol^®) or docetaxel (Taxotere^®). These drugs are usually given as an IV (put into a vein) every 3 to 4 weeks.

The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule is planned for your chemo.

Epithelial ovarian cancer often shrinks or even seems to go away with chemo, but the cancer cells may eventually begin to grow again. If the first chemo seemed to work well and the cancer stayed away for at least 6 to 12 months, it can be treated with the same chemotherapy used the first time. In some cases, different drugs may be used.

There are numerous other chemo drugs used that might be helpful in treating ovarian cancer.

B-Hormone Treatment/Therapies

It’s another treatment that may be used with the use of hormones or hormone-blocking drugs to fight cancer. This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors. 

Meds used in Hormone therapy is:

-Luteinizing Hormone Release Hormone Agonists

LHRH agonists (sometimes called GnRH agonists) can be used in systemic treatment also that will switch off estrogen production by the ovaries. These drugs are used to lower estrogen levels in women who are premenopausal. Examples of LHRH agonists include goserelin (Zoladex^®) and leuprolide (Lupron^®). These drugs are injected every 1 to 3 months. Side effects can include any of the symptoms of menopause, such as hot flashes and vaginal dryness. If they are taken for a long time (years), these drugs can weaken bones (sometimes leading to osteoporosis).

-Tamoxifen

Tamoxifen is a drug that is often used to treat breast cancer. It can also be used to treat ovarian stromal tumors and is rarely used to treat advanced epithelial ovarian cancer. Tamoxifen acts as an anti-estrogen in many tissues in the body, but as a weak estrogen in others. The goal of tamoxifen therapy is to keep any estrogens circulating in the woman’s body from stimulating cancer cell growth. The anti-estrogen activity of this drug can lead to side effects like hot flashes and vaginal dryness. Because tamoxifen acts like a weak estrogen in some areas of the body, it does not cause bone loss but can increase the risk of serious blood clots in the legs.

-Aromatase inhibitors

Aromatase inhibitors are drugs that block an enzyme (called aromatase) that turns other hormones into estrogen in post-menopausal women. They don’t stop the ovaries from making estrogen, so they are only helpful in lowering estrogen levels in women after menopause. These drugs are mainly used to treat breast cancer, but can also be used to treat some ovarian stromal tumors that have come back after treatment as well as low grade serous carcinomas. They include letrozole (Femara^®), anastrozole (Arimidex^®), and exemestane (Aromasin^®). These drugs are taken as pills once a day.

Common side effects of aromatase inhibitors include hot flashes, joint and muscle pain, and bone thinning. The bone thinning can lead to osteoporosis and bones that break easily.

C-Targeted Drug Therapy:

Typically, any treatment plans for a patient with ovarian cancer are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have some type of surgery to remove the tumor. Depending on the type of ovarian cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.

Those who to expect in treating ovarian cancer?

“Ovarian cancer is a type of cancer that begins in the female reproductive organs that produce and store eggs (ovaries). It occurs when abnormal ovarian cells divide and multiply uncontrollably. “Ovarian cancer” is a generic term for any primary malignant ovarian tumor. However, ovarian cancer is not one disease. There are many types of ovarian cancer, including some that are extremely rare and require specialized treatment. Therefore, establishing the correct diagnosis upfront is very important. The main types of ovarian cancer are named for the cells where the disease first forms. There is epithelial ovarian cancer, germ cell ovarian cancer, stromal ovarian cancer, and primary peritoneal ovarian. ”

MD Anderson Cancer Center

Most people are aware that October is Breast Cancer Awareness Month, but how many of you are also aware that September is Ovarian Cancer Awareness Month?

This cancer, Ovarian Cancer, is the more silent sister to breast cancer-which takes over the month of October with a worldwide pink party and numerous product promotions, some tasteful and some less so. Maybe people and product promoters are just drawn to pink versus the more reserved teal blue color for ovarian cancer. More likely it’s because breasts are visual and ovaries are invisible to the eye.

Remember ovarian cancer is very visible to those diagnosed with it and to their loved ones.  We need to make more noise about ovarian cancer awareness.  First you have to listen… to your body. Ovarian cancer can be sneaky.

Symptoms such as indigestion, bloating, painful intercourse, menstrual irregularities and back pain, can point to other less invasive conditions. While breast cancer has screening protocols like mammograms and breast self-examination, there is no reliable screening for ovarian cancer. Unfortunately for many women the disease is often detected at an advanced stage. Both breast and ovarian cancer are diagnosed in women of all ages and ethnic backgrounds.

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat, just like most other cancers in late stages as well, and is unfortunately frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.

Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions, such as constipation or irritable bowel.

Signs and symptoms of ovarian cancer may include and don’t ever ignore them:

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvis area
• Changes in bowel habits, such as constipation or diarrhea
• A frequent need to urinate (urgency including difficulty to void)
• Increased Abdominal Size
• Painful Sex
• Heavy menstrual bleedingWhen to see a doctorIf you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers. Only a small number of women are found to have genetic mutations that can lead to ovarian cancer.
• Certain factors may increase your risk of ovarian cancer:
• Make an appointment with your doctor if you have any signs or symptoms that worry you. 

Risk Factors:

• Age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
• Inherited gene mutation. A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer.
• The gene mutations that cause Lynch syndrome, which is associated with colon cancer, also increase a woman’s risk of ovarian cancer.
• Estrogen hormone replacement therapy, especially with long-term use and in large doses.
• Age when menstruation started and ended. If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
• Never being pregnant.
• Fertility treatment.
• Smoking.
• Use of an intrauterine device.
• Polycystic ovary syndrome.  In years past ovarian cancer used to be call  the silent killer but it’s really not completely silent, at least in some patients.  You shouldn’t ignore your symptoms!

“One in 5 children in the United States are obese. Childhood obesity puts kids at risk for health problems that were once seen only in adults, like type 2 diabetes, high blood pressure, and heart disease.  The good news? Childhood obesity can be prevented. Take action during National Childhood Obesity Awareness Month!  You can encourage communities, health professionals, and families to work together to raise awareness about the obesity epidemic and show people how to work towards a solution.  By raising awareness about childhood obesity, we can all work together to keep our kids healthy.”

U.S. Department of Health and Human Services – Health.org (https://health.gov/news/news-and-announcements/2018/09/toolkit-national-childhood-obesity-awareness-month)

It is shown that there are high rates of obesity worldwide which have been attributed to a combination of genetics and environment. Myriad environmental exposures may contribute to obesity, including calorie-rich diets, sedentary behavior, stress, and overuse of antibiotics. Just as important as the types of exposures is the timing. The period from conception to adolescence is known to be especially sensitive to obesity risks influenced by maternal fitness and childhood diet and physical activity. Parental experiences and fitness before conception, generational effects, and early-life events can also affect adult health.

The “CDC-Centers for disease control and prevention” have obesity facts they present as follows:

• “Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years.
• The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.
• The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012, now 18.4%.   Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period, now is 20.6%.
• In 2012, more than one third of children and adolescents were overweight or obese.
• Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors.
• Obesity is defined as having excess body fat.
• Overweight and obesity are the result of “caloric imbalance”—too few calories expended for the amount of calories consumed—and are affected by various genetic, behavioral, and environmental factors.”

WEB M.D. states “One third of children in the U. S. is overweight or obese, and this number is continuing to rise. Children have fewer weight-related health and medical problems than adults. However, overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem.

Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem. A physical exam and some blood tests can rule out the possibility of a medical condition as the cause for obesity.

Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits.

A child’s total diet and activity level play an important role in determining a child’s weight. Today, many children spend a lot time being inactive. For example, the average child spends approximately four hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may increase.”

The effects of childhood obesity impact a short time (if handled quick enough and obesity resolved) as opposed to a long lifetime of obesity. Childhood obesity has both immediate and long-term effects on a person’s health and well-being.

Presently by CDC, they state in this topic the following:

Childhood obesity is a serious problem in the United States putting children and adolescents at risk for poor health. Obesity prevalence among children and adolescents is still too high.

For children and adolescents aged 2-19 years¹:

• Hispanics (25.8%) and non-Hispanic blacks (22.0%) had higher obesity prevalence than non-Hispanic whites (14.1%).
• Non-Hispanic Asians (11.0%) had lower obesity prevalence than non-Hispanic blacks and Hispanics.

Here are childhood effects that can occur:

• Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease versus if one of your parents has cardiac disease one out of a 4 children family are at risk of getting it (25%) just based on the parents history.
• Obese adolescents are more likely to have pre-diabetes, a condition in which blood glucose levels indicate a high risk for development of diabetes.
• Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem.

Long-term health effects that can occur:

• Children and adolescents who are obese are likely to be obese as adults and are therefore more at risk for adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis.  One study showed that children who became obese as early as age 2 were more likely to be obese as adults. Overweight and obesity are associated with increased risk for many types of cancer, including cancer of the breast, colon, endometrium, esophagus, kidney, pancreas, gall bladder, thyroid, ovary, cervix, and prostate, as well as multiple myeloma and Hodgkin’s lymphoma.
• One of the best strategies to reduce childhood obesity is to improve the diet and exercise habits of your entire family. Treating and preventing childhood obesity helps protect the health of your child now and in the future.

The KEY to stopping childhood obesity into adulthood from is through Prevention (which starts in childhood):

• Healthy lifestyle habits, including healthy eating and physical activity, can lower the risk of becoming obese and developing related diseases.
• The dietary and physical activity behaviors of children and adolescents are influenced by many sectors of society, including families, communities, schools, child care settings, medical care providers, faith-based institutions, government agencies, the media, and the food and beverage industries and entertainment industries.
• Schools play a particularly critical role by establishing a safe and supportive environment with policies and practices that support healthy behaviors. Schools also provide opportunities for students to learn about and practice healthy eating and physical activity behaviors.

To prevent obesity and overweight in children we need our communities throughout the world to:

• Promote improvements to the nutritional value of the food children eat in schools, child care centers and after-school programs.
• Support increasing children’s physical activity through improved compliance with physical education mandates by New York City schools, as well as through making physical activities available in after-school programs and City parks and playgrounds.
• To increase education for children and parents about good nutrition, why healthy food choices are important, and how to combat obesity.
• To support efforts that help all in every state of America and in the world making healthy food choices, such as laws eliminating trans-fats, and policies to tax or limit the sizes of sugary beverages. Which has already started in many areas but we need to keep doing it and making it stronger for the children health now in their future.

“When we are born, our arteries are clear and healthy. They carry blood, oxygen, and nutrients from our hearts to every part of our bodies. They are the channels of life.

  VS

Modifiable Risk Factors putting you at risk for high cholesterol that can put you at risk for heart disease are:

High B/P, Diabetes, Low HDL=good cholesterol, High LDL=bad cholesterol, smoking, eating foods high in SATURATED FAT & CHOLESTEROL, harmful use of alcohol, and lack of any activity in your life (your regular routine doesn’t count like work unless your in a job severely active like construction building homes for example 5 days or week or a personal work out trainer 4 to 5 days week).

MAYO CLINIC states Factors Increasing your BAD Cholesterol:

• Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers and microwave popcorn, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your cholesterol.
• Obesity.
• Lack of exercise. Exercise helps boost your body’s HDL, or “good,” cholesterol while increasing the size of the particles that make up your LDL, or “bad,” cholesterol, which makes it less harmful.
• Smoking.
• Age. Because your body’s chemistry changes as you age, your risk of high cholesterol climbs. For instance, as you age, your liver becomes less able to remove LDL cholesterol.
• Diabetes. High blood sugar contributes to higher levels of a dangerous cholesterol called very-low-density lipoprotein (VLDL) and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.

Non-modifiable Risk Factors=4 types only which are factors we can’t control:

1-Heredity (The higher the risk is when the heredity is closer to you in your family tree=Nuclear family–mom, dad, and siblings).

2-Age (Men aged 45y/o or older & Women aged 55 y/o or older)

3-Gender (It may affect your risk, for years heart disease was considered a man’s disease but we now know that heart disease is the leading cause of death for women as well as men. Although men tend to develop coronary artery disease earlier in life, after age 65 the risk of heart disease for both genders is equal.)

4-Race (Heart disease is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans compared to Caucasians).

WHAT DOES ALL THIS MEAN?  To make this short & simple, from continuous high cholesterol over time, especially with history in your nuclear family puts you at risk for ATHERO-SCLEROSIS = Blockage In Arteries.  This puts at you at risk for a heart attack, stroke (Based on oxygen blocked by high cholesterol causing lack of oxygenated blood (nutrients) to the heart or brain due to high cholesterol build up in arteries supplying the heart and brain.  This is a high risk for MI & CVA).

Now it makes sense?  The answer to prevention or treatment of cardiac disease is changing or modifying your diet, if it’s unhealthy 100% or just partially. The answer includes exercise (from just walking or if you like working out, even better) and if needed medication but your doctor will decide. All these changes can modify your blood lipid profile=cholesterol control, which helps increasing your heart to a better tolerance with activity, stress and simply functioning. Recommended is going to a cardiologist for people diagnosed with heart conditions or your general practitioner with any illness/disease before making changes to help guide you towards the right choices. Your doctor can help you in determining which prevention or treatment plan is best for you.

Foods high in cholesterol=Fast foods, whole fat dairy products-milk/cheese/butter/mayonnaise/ bacon/processed deli meats/salad dressings and shortenings.

The key is to be living a healthy life. This consists of diet, exercise or activity and healthy habits learned and practiced routinely in your life that will help prevent or assist in treating cardiac disease. The better we treat ourselves regarding health the higher the odds we will live a longer   life. There is not just one food to eat or one type of exercise to do or one healthy habit to keep you healthy, there are choices. Wouldn’t you want less disease/illness for yourself and for others throughout the nation including the future generations?  It is all in change and that would be in your diet, activity getting increased and exercise balanced with rest.  Most importantly sticking to it regularly not doing these changes on occasion and that is all in how well you discipline yourself.

FOR MORE INFORMATION:

National Heart Lung and Blood Institute

P.O. Box 30105

Bethesda, MD 20824-0105

“Your cholesterol levels show how much cholesterol is circulating in your blood. Your HDL (“good” cholesterol) is the one number you want to be high (ideally above 60). Your LDL (“bad” cholesterol) should be below 100. Your total should be below 200. Talk with your provider about what your results mean for you and how to manage your cholesterol.

Your cholesterol levels are important because they help you know your risk for heart disease. Cholesterol is a type of lipid (fat) that helps your body perform many important functions. But too much cholesterol in your blood is harmful. It can enter your artery wall, damage its integrity and lead to atherosclerotic plaque (hardened deposits) forming.

Cholesterol travels through your blood silently. And it turns into plaque silently. Plaque buildup is like someone tiptoeing on a carpet. You might not see or notice its presence for a long time.”

Cleveland Clinic (https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean)

What is cholesterol?

Cholesterol forms in the liver but we also get cholesterol through foods we eat too. It is a waxy substance that has many important functions in the body. It is part of various hormones, the makeup of the walls of your body’s cells, a component of bile, and many other purposes. How the body processes it is very complex. It joins with a protein and forms a package called lipoprotein. These lipoproteins carry cholesterol through the blood.

What is the functions of cholesterol in the body?

How is cholesterol measured?

Cholesterol is measured in metric system units. The LDL’s (low density lipoproteins) have the bad cholesterol. LDL’s are the main source of blockage in the arteries. HDL’s (high density lipoproteins) have the good cholesterol. HDL’s help keep cholesterol from building up in the wall of the arteries.  Which most foods show on their labels how much LDL and HDL cholesterol is in a serving of the food your buying.  If it doesnt’t show the cholesterol levels on the label than don’t buy it unless its a treat once in awhile.

Through Cleveland Clinic they state the normal levels of cholesterol for total. HDL and LDL should be:

A HDL level for women 20 yrs old or higher should be 50mg/dl or greater.

A HDL level for men at 20 years old or older should be 40mg/dl or greater.

A LDL level for women or men at 20 years old or older should be less than 100mg/dl.

A total cholesterol level less than 200mg/dl is considered good. It represents the least risk of heart disease. Above that, your level is borderline high. If you are above 200 your level of cholesterol is high.

In our body we have cholesterol which is a type of fat. In certain foods is cholesterol depending on the food you buy. Your total cholesterol includes LDL (low-density lipoprotein) and HDL (high density lipoprotein) cholesterol. Let’s differentiate the two:

1.  LDL (low density lipoprotein) the bad cholesterol can build up in the arterial walls and form plaque in time.  What does this mean?

That build up in the arteries will reduce blood flow and increase your risk to heart disease, especially eating frequently the wrong foods with high and bad cholesterol over years (Example. coronary artery disease, high blood pressure, and eating like this for years can lead to a heart attack or from s/s arising scarring the person to go to the doctor and find out they have blockages & need surgery. The sign and symptoms arising scarring the person can range from chest pain, and can be radiating down the arms, sweating profusely, weakness/fatigue increases in your life, dizziness, you feel like you’re going to fall or actually due to the fatigue/weakness=low blood pressure due to the blockage or the heart just working too hard in doing its function since the cardiac output is decreased from the blockage) Take one of my dear friends who I have known almost 40 years who was a workaholic 10to14hr/7 days a week for at least 35 years and 2 years ago he had to undergo surgery for a coronary artery blockage bypass for 5 vessels blocked 80% to 100%. He should have been dead already due to a heart attach for such blockage but had a successful bypass done followed by long rehab and got better due to high cholesterol eating, smoking (that both play an impact in plaque & tar build up in the vessels) and he stopped but he also was obese by about 50lbs. and lost 30lbs due to better eating and less beer. This could have been prevented if he changed his diet, watched his weight, and quit smoking years ago but that takes discipline, making sacrifices is all within your hands to allow for healthy habits now (prevention) or later when problems occur (treatment), if caught in time. There is a way out of this happening to you.

2-HDL (high density lipoprotein) the good cholesterol it’s known as.  What does this mean?

Because it is thought to help remove bad cholesterol from the body; if you decide the right foods in the right portions that will have more HDL than LDL in them. Differentiating the 2, now another component to keep in mind is risk factors that can put you at risk for heart disease and your doctor will determine what additional risk factors you have putting you at risk for heart disease. These risk factors can be modifiable (controllable by individuals) or non-modifiable (non-controllable by individuals).  Stayed tune for Part II on cholesterol tomorrow covering all this!