CHOLESTEROL GUIDE: EVERYTHING YOU NEED TO KNOW

Cholesterol has always been regarded as something harmful to one's body. If you happen to be a fitness enthusiast then cholesterol is one thing that cannot be skipped. Cholesterol necessarily is not a bad thing. It is required as much as any other vitamin or mineral in the body. However, as the saying goes, anything in excess is harmful. This is undoubtedly true when it comes to cholesterol. Hypercholesterolemia i.e high cholesterol levels in the blood can increase the risk of developing heart disease, stroke, and pancreatitis.

What is cholesterol?

Cholesterol is a waxy fat-like substance that is normally present in the cells of our body. It is an important component of the cell membrane and also to helps in the formation of hormones and Vitamin D. Cholesterol is synthesized by our body and is also found in dietary sources. It is carried by our blood where it is required in the body. However, too much cholesterol in the blood can pose a threat to the normal functioning of the body. An increase in cholesterol levels leads to its deposition in the inner lining of the arteries eventually clogging them and not allowing blood to pass easily. An excess buildup of cholesterol in the lumen of the arteries causes discrepancies in blood flow leading to coronary heart diseases and myocardial infarction.

Cholesterol flows freely in the bloodstream by attaching itself to proteins, which are called lipoproteins. Three distinct types of lipoproteins carry cholesterol in the blood. they are:

• High-density lipoprotein (HDL) is also known as good cholesterol because it helps to carry cholesterol from the blood to the liver for metabolism.

• Low-density lipoprotein (LDL) is also known as bad cholesterol as it does not effectively metabolize and rather attaches as a build-up in and around the lumen of the arteries making them narrow and hard. High levels of LDL in the blood increase the risk of heart disease.

• Very low-density lipoprotein (VLDL): This is also referred to as bad cholesterol because it carries triglycerides and cholesterol that build up and lead to plaque formation in the arteries, also termed atherosclerosis.

What are the reasons for cholesterol?

Some people may tend to have increased levels of cholesterol inherently, but more often, high cholesterol levels are subject to bad food choices and a sedentary lifestyle. There can be more than one reason for cholesterol in your bloodstream. These are:

• Inactivity and obesity

• Unhealthy food choices

• Unmonitored alcohol consumption

• Smoking

• Age

• Genetic inheritance

• Medical conditions such as uncontrolled high blood pressure, diabetes, chronic kidney disease, hypothyroidism and Lupus.

What are the symptoms of cholesterol?

Unfortunately, there are no symptoms of cholesterol and one cannot identify if the blood has elevated levels of cholesterol. A routine blood examination with a complete lipid profile will be able to identify the exact amount of trigycerides, LDL cholesterol, and HDL cholesterol.

How is high cholesterol diagnosed?

High cholesterol is diagnosed with a lipid profile blood test, that measures the levels of

total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The normal range of these in the blood serum are as follows:

- Total cholesterol: 180mg/dL

- HDL cholesterol: >40 mg/dL

- LDL cholesterol: <100 mg/dL

- Triglycerides: <150 mg/dL

A total cholesterol level between 200 and 239 mg/dL is considered “borderline high” and any value above 240 mg/dL is considered "high".

HDL cholesterol level below 40 mg/dL is considered "poor".

LDL cholesterol level between 130 and 159 mg/dL is considered “borderline high” and any value above 160 mg/dL is considered “high”.

Diet for elevated cholesterol levels

High levels of cholesterol in the bloodstream can be controlled by adapting to healthy lifestyle changes. A major part of a healthy lifestyle depends on healthy eating habits.

Saturated fats raise the levels of low-density cholesterol in the bloodstream. Thus, a cholesterol-friendly diet should replace saturated and trans fats from your diet with healthy fats and have sufficient fibre content.

A low-cholesterol diet should also limit high-cholesterol-containing food items such as egg yolks, shrimp, milk, high-fat dairy products and so on. It should contain fruits, vegetables, and plenty of soluble fibre such as oats, legumes, lentils, and whole grains. Vegetables contain stanols, which can essentially reduce cholesterol in the blood.

Omega 3 fatty acids are another food constituent that not only lower LDL but also elevate the good cholesterol, HDL. Fish with abundant omega-3 fatty acids are salmon, tuna, and mackerel. Including omega-3 fatty acids, twice a week in the diet can significantly reduce cholesterol.

Treatment of high cholesterol

High cholesterol, although a cause of concern, can be managed effectively. Treatment of cholesterol and its management involves certain lifestyle modifications. Introducing an active lifestyle by following a moderate exercise regime, avoiding smoking and drinking, eating a low-cholesterol diet and living a stress-free life are some of the key factors in the treatment of cholesterol.

Avoiding saturated and trans-fat-containing foods is a must. In addition, total dietary fats should account for no more than 25 to 35% of your daily calories, with saturated fat accounting for no more than 7%. Processed meat and other packed foods with high salt, saturated fat, and trans fat content should best be avoided. Opt for lean proteins. Eat plenty of fresh fruits and vegetables high in fibre content.

If you have been diagnosed with hypercholesterolemia, depending upon the amount of LDL, HDL, and triglycerides in the blood, the doctor may prescribe appropriate medications, which mainly include statins. If you have already developed a heart condition due to elevated cholesterol levels you may be prescribed medications and a surgical treatment option such as a stent or a bypass, depending on your condition.

Management of hypercholesterolemia in individuals diagnosed with the condition involves taking medications as prescribed, following up with the doctor routinely, going for blood tests periodically as advised by the doctor to monitor the progress of the treatment, and following a healthy diet and lifestyle.

Conclusion

Cholesterol is an essential component of the cells in our body. However, too much cholesterol in the blood is linked to heart disease and stroke. The downside of hypercholesterolemia is that patients often do not have any symptoms. If you have a family history of hypercholesterolemia, or lead a sedentary lifestyle, or have a medical condition that predisposes you to the disease, or have been on a high saturated fat diet for a long time, then you must visit a doctor and go for a lipid profile test. Getting tested once yearly and detecting the condition early helps to get prompt treatment, manage the condition effectively, and prevent complications associated with the disease.