Keep an eye on those cholesterol levels

"High cholesterol is a silent problem in most cases, and the symptoms manifest only in the late stages," says Dr. Gotabaya Ranasinghe, cardiologist at the Sri Jayewardenapura General Hospital, advising that before this happens, people need to be more aware of the fact that they need to live healthier lives, and be more proactive in preventing the onset of high cholesterol.
Cholesterol and resultant heart problems have become an increased threat to the health of Sri Lankans and Asians as a whole. People in the Indo-Asian group- India, Sri Lanka, Bangladesh and Pakistan have a 2-4 times higher prevalance of heart problems related to high cholesterol, than those in the west, says Dr. Ranasinghe.

What is even more alarming is that most of them, particularly in Sri Lanka, are ignorant of this fact."The reason for this is that people have grown used to giving too much importance to the international target levels of cholesterol and blood sugar," explained Dr. Ranasinghe, stressing that Sri Lankans can no longer do this because they are at greater risk of heart problems.

International guidelines are that a person should keep his or her LDL (Low-Density Lipoprotein, also referred to as bad cholesterol) level below 100. "When Sri Lankans get lipid profile tests done, and the LDL level adheres to what is known here as the approved level, they assume that they are healthy and not at risk of heart problems. Ideally, people in this group should maintain an LDL level of 60-70, and a HDL (High-density Lipoprotein, also referred to as good cholesterol) level of 50 or more for a woman, and 40 or more for a man. So ideally, for a normal person in this group, the total cholesterol should be below 130," Dr. Ranasinghe advises.

While Sri Lankans and others in the Indo-Asian group tend to eat more food with high LDL levels, and are unaware that they need to be even more careful and live healthier lives than Westerners, they are also unaware that they are at a fairly high risk of developing what is known as Metabolic Syndrome. In fact, they may already have it.

Metabolic Syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. It affects a large number of people, and prevalence increases with age. It is a condition which has been identified to a great extent in the Indo-Asia region. The effects of Metabolic Syndrome are an Impaired Glucose Tolerance (IGT) which causes an insulin resistance which leads to diabetes, cholesterol, and ultimately, the risk of a heart attack.

"This is, naturally, something more people need to know about, and remember when assessing their cholesterol and blood sugar levels," says Dr. Ranasinghe. Treatment of high cholesterol is also of great importance considering the impact it could have on a person's health. " Cholesterol levels can be regulated by a healthy lifestyle and diet, from a very early age," says Dr. Ranasinghe.

Food with less carbohydrates, less saturated fat, fruits, vegetables, nuts, grains and pulses have been proved to increase the amount of HDL in the system, whereas red meat, coconut oil (it is important to note that 80% of dietary fat is said to come from coconut), palm oil, butter, ghee and most dairy and bakery products should be eaten in moderation. A person's daily intake of cholesterol should be a little under 200 mg a day. While it is good to keep LDL levels at a minimum, every person needs a certain amount of cholesterol per day to boost the metabolism and for cell wall maintenance.

Exercise is essential, and the recommended amount is around 45-60 minutes a day."If a healthy diet and lifestyle are not maintained from an early stage, and cholesterol becomes a problem, a change in lifestyle will not be enough to bring down cholesterol to target levels. When it comes to this stage, medication is necessary," says Dr. Ranasinghe.

Statins are the most effective drug to combat high cholesterol. They reduce the risk of a heart attack by around 40-45% as well as the risk of strokes and cause the regression of cholesterol deposits in the arteries. As with most forms of medication, there are a few side effects, but these can be minimized by changes in dosage. In some cases, the side effects can disappear with time.

Some believe that this treatment could adversely affect the kidney, but this has not been proven. In extremely rare cases, the liver could suffer damage. Patients with liver complaints are advised to monitor the condition of the liver for around four weeks from the beginning of the treatment. If the liver does not show any signs of damage during this time, it is quite certain that there is no danger of liver damage as a result of the medication.