Cholesterol is a natural substance found in animal products. It is also made in our body, in the liver. It is important for many functions of our body. It is a soft, fat-like, waxy substance found in the bloodstream and in all the cells in our body.
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| Dr. Indu Waidyatilake |
Though it is a substance that our body needs to function efficiently, too much cholesterol in the blood is a major risk factor for heart attacks and strokes.
What makes your cholesterol level high or low?
In some families, due to genetic factors, an abnormally high cholesterol level is seen. Hence you should be careful if you have a family history of cholesterol or lipid disorders. Your diet plays a major role in determining your cholesterol level. Lack of exercise and too much alcohol also raise your chance of getting a bad cholesterol report.
There are two main types of blood cholesterol: LDL (the "bad" cholesterol) and HDL (the "good" cholesterol).
LDL (bad) cholesterol
When high levels of LDL cholesterol circulate in the blood, they can slowly build up on the inner walls of the arteries that supply blood to the heart and brain. Together with other substances, it can form plaques (thick hard deposits). More and more plaques will narrow the arteries and may eventually block the blood flow. This, in turn, may lead to a heart attack or a stroke.
HDL (good) cholesterol
High levels of HDL cholesterol protect against heart attacks while low levels of HDL increase the risk of heart disease. HDL cholesterol takes excess cholesterol away and carries it back to the liver to be excreted. It can also remove some of the cholesterol already attached to the walls of arteries.
Lipid profile
To know your cholesterol level you must have a cholesterol test (lipid profile). It is recommended that every one aged 20 and older should have a fasting lipid profile at least once in five years. But if you are at risk of heart disease or have a family history of lipid disorders, your doctor may want you to have this test more often. Children from families with a high risk of heart disease should also be screened.
Preparation for the test
This must be done after 9 to 12 hours of fasting. One should be seated at least for five minutes, prior to giving blood for the test.
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| A cross section of an artery –-Images courtesy Getty |
The person who is getting the test done should not have any acute illness or infection at the time of the test (in which case he/she should postpone it by at least two weeks). After a heart attack, if this test is not done with- in 24 hours, it should be done only after three months to get an accurate report.
If your test results show that the bad cholesterol is too high, your doctor will advise you as to what you should do.
He may screen you for the risk factors for heart disease.
If your cholesterol levels are very high or if you have a tendency to get a heart attack in the future, he may prescribe drugs, to lower your cholesterol level. But the most important part of the management is lifestyle modification.
Your diet, weight, physical activity and exposure to tobacco smoke are important factors that affect your cholesterol level. These factors can be controlled by
- eating a heart-healthy diet
- engaging in regular physical activity and
- avoiding tobacco smoke.
Some healthy eating
suggestions
Replacing foods that contain saturated fats with foods that contain poly-unsaturated and mono-unsaturated fats will help lower blood cholesterol levels. Foods high in poly-unsaturated fats include margarine spreads and oils (such as sunflower, soybean), fish, some nuts and seeds. Foods high in mono-unsaturated fats include margarine spreads and oils (such as olive, canola and peanut), avocados and some nuts.
Foods rich in dietary fibre can reduce the level of LDL cholesterol in the blood. Foods containing soluble fibre include fruits, legumes and cereals. Eat plenty of green leaves, kohila, wetakolu etc and also small fish at least thrice a week. Select lean meat (meat trimmed of fat and chicken without skin).
Suggestions for physical
activities
Being physically active can improve your cholesterol status tremendously. Exercise increases your HDL cholesterol and decreases the LDL cholesterol level. It also promotes weight control.
For most people, it is best to aim for a total of 30 minutes of exercise a day, at least five days a week. However, one can divide one's activity for the day into two sessions of 15 minutes each.
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| Nuts: Healthy food |
An often-heard excuse is that the patient does not have the time to engage in exercise.
This is not an acceptable excuse. The lack of time can be addressed in some simple, practical ways:
- Get off the bus two or three stops before the regular one and walk that distance.
- If you have to do your marketing on foot, take a circuitous route to get the required exercise without a time constraint.
- Think of the required exercise as a benefit rather than a burden.
(The writer is a Lecturer at the Faculty of Medicine, University of Colombo) |
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