High cholesterol is dangerous, prevent it!

During the last festive period, a woman in her middle age developed partial stroke and was admitted in the hospital. She recovered fully but the family felt that the problem might not be stroke since the woman’s blood pressure had never been high and her blood sugar level had always been within the normal range, meaning she was not hypertensive or diabetic.

Her blood sample, which was sent to the lab for investigations, showed elevated blood cholesterol, a condition called hypercholesterolemia. It was later found that high cholesterol was responsible for the first stroke she suffered.

Hypercholesterolemia, or high cholesterol, occurs when there is too much cholesterol in the body. Cholesterol is a soft, waxy, fat-like substance that is a natural component of all the cells in the body. The body makes all the cholesterol it needs. However, added cholesterol, which comes from the foods eaten, may cause harm. High cholesterol raises the risk for heart disease, heart attack, and stroke. When there is too much cholesterol circulating in the blood, it can create sticky deposits (called plaque) along the artery walls. Plaque can eventually narrow or block the flow of blood to the brain, heart, and other organs. Blood cells that get caught on the plaque form clots, which can break loose and completely block blood flow through an artery, causing heart attack or stroke. 

While heredity may be a factor for some people, the main culprits are lack of exercise and diets high in saturated fat. High cholesterol can be prevented, sometimes with lifestyle changes (diet and exercise) alone. If these do not work, your doctor may recommend medications to lower your cholesterol levels.

Signs and symptoms

In the early stages, there are usually no symptoms of high cholesterol. The only way to tell if the cholesterol is high is through a blood test.

Causes

In some cases, high cholesterol levels may be inherited; the liver may make too much cholesterol, or the body may not remove bad cholesterol from the blood efficiently. High cholesterol and elevated triglycerides can also be associated with other diseases, such as diabetes. But often, high cholesterol is caused by eating foods high in saturated fat and not getting enough exercise. High cholesterol is more common in people who are overweight or obese.

Risk factors: Being overweight or obese, eating a diet high in saturated fat and trans fatty acids (found in processed and fried foods); not getting enough exercise; family history of heart disease; high blood pressure; smoking; and diabetes.

Diagnosis: Most people do not have any symptoms of high cholesterol. A blood test is the only way to check levels of cholesterol in the blood. If the levels are above 200 mg/dL, the doctor will do a fasting lipid profile, a test performed after you abstain from food for nine to 12 hours.

Lipid profile

A lipid test generally determines four distinct numbers: total cholesterol, LDL, HDL and triglycerides. The LDL or low-density lipoprotein and the HDL or high-density lipoprotein are the two fundamental “cholesterol types”. The LDL is known to be negative (bad) when in excess. Therefore, minimising it will be much better. HDL, known to be the positive (good), is better when elevated. In addition, the lipid profile appraises the triglycerides (whole fat in a person’s body). They have an impact on the health in the same manner cholesterol does. At last, the total cholesterol (sum of HDL, LDL and 20 per cent of triglycerides) is integrated as well in the results.

It is important to say at this juncture that people with chronic conditions like hypertension, diabetes, obesity, among others, should have their lipids check periodically.

Have your blood checked today.

I will like to say that eating food containing fat or cholesterol does not lead to high cholesterol (hypercholesterolemia) since the body needs it for normal body metabolism. However, evidenced-based medicine shows that reducing the amount of food containing cholesterol is healthy and beneficial to all, especially those with hypercholesterolemia, hypertension and other heart-related disorders.

High blood cholesterol is treated with lifestyle changes and medicines. The main goal of treatment is to lower the low-density lipoprotein cholesterol level enough to reduce the risk for coronary heart disease, heart attack, and other related health problems. I once saw a patient with high cholesterol, after due explanation, I wrote in his case note TLC for three months. The patient asked the nurse about the cost of TLC. The nurse explained to him that TLC was an abbreviation for Therapeutic Lifestyle Changes and that it was a do-it-yourself treatment and with no fee charged for it.

Therapeutic Lifestyle Changes: TLC helps in lowering the LDL cholesterol. TLC is a three-part programme that includes a healthy diet, weight management, and physical activity. It is for anyone whose LDL cholesterol level is high.

Healthy diet: A dietician once said this “your diet is a bank account; good food choices are good investments.” With the TLC diet, less than seven per cent of the daily calories should come from saturated fat. This kind of fat is found in some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.

Not more than a quarter of our daily calories should come from all fats, including saturated, trans, mono-unsaturated, and poly-unsaturated fats. Mono-unsaturated and poly-unsaturated fats are healthier and cholesterol free examples include olive oil, groundnut oil and soybean oil. Foods high in soluble fibre also are part of the TLC diet.

These foods include whole-grain cereals such as oatmeal and oat bran. A diet rich in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. Such fruits are apples, bananas, oranges, pears.

Legumes include kidney beans, lentils, and cowpeas. A healthy diet also includes some types of fish, such as salmon, tuna (canned or fresh), and mackerel. These fish are a good source of omega-3 fatty acids.

These acids may help protect the heart from blood clots and inflammation and reduce the risk of heart attack. Red meat, (beef), goat meat, and porks, among others, have high cholesterol and may be avoided while Skinless poultry can be substituted for meats. Avoid fried meat. You can grill, roast or boil your meat. Frying with the oil increases the amount of cholesterol in the meat. You also should try to limit the amount of refined sugar or sodium (salt) that you eat. Try limiting alcohol intake.

Too much alcohol will raise the blood pressure, cause weight gain and raise triglyceride level. (Triglycerides are a type of fat found in the blood.)
Weight management: If you are overweight or obese, losing weight can help lower LDL cholesterol. Maintaining a healthy weight is especially important if you are at risk for heart disease and other health problems, such as diabetes and stroke. Obesity is associated with metabolic risk factors, which are a large waistline (abdominal obesity), a high triglyceride level, a low HDL cholesterol level, high blood pressure and high blood sugar.

Physical activity: Routine physical activity can lower LDL cholesterol and triglycerides and raise your HDL cholesterol level. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. It is advisable to do moderate exercise 30 minutes a day five days in a week or one can register in a gym. The more active you are, the more you will benefit.

Cholesterol-lowering medicines: In addition to lifestyle changes, medicines can help control high blood cholesterol, but they do not cure it. Thus, you must continue taking your medicine to keep your cholesterol level in the recommended range. Cholesterol-lowering medicines are statins. These medicines are safe for most people. They are strictly prescription drugs and cannot be got over the counter. In conclusion, while managing your cholesterol, take steps to manage other heart disease risk factors too. For example, if you have high blood pressure, work with your doctor to lower it.