Q. I have a strong family history of heart disease. My father died of a heart attack at age 64, and three brothers have had heart surgery. Two nephews have had heart attacks in their 40s; one of them died. And my sister had a stroke at age 53.
I myself have had atrial fibrillation and take Coumadin, sotalol, Lotensin, aspirin and Celebrex. I don't need cholesterol-lowering medicine, but I understand that heart problems can arise even for people with normal cholesterol levels.
I read that something called homocysteine can also contribute to heart attacks, and I wonder if this is the culprit in my family. Would I be a candidate for a homocysteine test? If it is elevated, can it be treated?
A. Although high cholesterol is a well-recognized risk factor for heart disease, normal cholesterol levels don't guarantee heart health. According to Dr. Michael Oliver of Britain's National Heart and Lung Institute, 30 percent to 40 percent of people who suffer heart attacks do not have abnormally high cholesterol.
Homocysteine is now getting more attention as a significant risk for heart disease. High levels of this amino acid, which result from digestion of meat, increase the likelihood of clogged arteries. Blood tests are available.
Vitamins such as folic acid, B-6 and B-12 might help lower homocysteine levels.
Q. My wife read that adding chocolate to milk cancels out the calcium. Is this statement true? I hate to give up my fat-free chocolate milk.
A. Although oxalate in the chocolate grabs some of the calcium and prevents its absorption, fat-free chocolate milk is still a fairly good source of calcium.
Q. I've been a travel agent off and on since 1954 and am a bit of a vagabond and an avid seeker of unusual customs. I happened to chat with a lady who, along with her family, suffered "turista" in what was then Ceylon. They told their taxi driver that they might have to stop in a hurry and why.
He replied, "I'll fix that." He drove to a coconut palm, whacked a coconut open with his machete and insisted they drink the coconut milk. This cured them within a relatively short time. It occurred to me that this might explain the power of coconut macaroon cookies to stop diarrhea.
A. Traveler's diarrhea (turista, Montezuma's revenge, King Tut gut) can ruin a vacation. We keep hearing that coconut has anti-diarrheal properties.
One woman told us that she was constipated during her stay in a Mexican village, while her husband frequently suffered diarrhea. The only difference in what they ate was the coconut milk she drank almost daily. He disliked coconut and wouldn't touch it.
Many people with chronic diarrhea associated with Crohn's disease have told us that coconut macaroon cookies are helpful. According to Mary Enig, an authority on the biochemistry of food and fat, coconut contains lauric acid. This fatty acid has antibacterial action, which might partially account for coconut's power against diarrhea.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of the People's Pharmacy, P.O. Box 52027, Durham, NC 27717, or e-mail them at their Web site (www.peoplespharmacy.com) on the HealthCentral.com network.